IVMS Pharmacology Flash Facts

Pharmacology Flash Facts
Q0001:Bioavailability
- Measure of absorption;- F = AUC oral/AUC injected x 100;AUC = Area Under the Curve of;[Plasma] vs. Time
Q0002:Volume of Distribution
- Vd = D/C (mL);D = amount of drug in body;C = [plasma];Low Vd -> drug in plasma;- Med Vd -> in p & interstitium;High Vd -> in p; i; & tissues/cells
Q0003:Drug Metabolism: Phase I v II
Phase I;-Converts lipophilic into slightly polar; water-soluble metabolites;- Cytochrome P-450;Phase II;-Yields very polar; inactive metabolites that the kidneys can excrete;- Conjugation reactions
Q0004:Clearance (CL)
CL = rate of drug elimination/[plasma];= rate at which a volume of fluid is cleared of drug;= blood flow x extraction rate;= Vd x Ke (L/hr)
Q0005:Elimination constant (Ke)
Ke gives information about the amount of time to reach a steady state or wash-out;Ke = CL/Vd (1/hr);*independent of drug dose.
10
Q0006:Half-life (t1/2)
11
Time required to change amount of drug in body by 1/2;t1/2 = ln(0.5)/-Ke = 0.693Vd/CL;Infusion: 94%Css - 4 t1/2;87.5% 3;75% - 2;50% - 1
12
Q0007:Stead State Plasma Concentration (Css)
13
elimination = rate of administration;Css = R/(Vd x Ke) = R/CL;R = infusion rate (amount/time)
14
Q0008:Loading & Maintenances doses
15
Loading dose = Vd x Cp/F;Maintenance = Cp x CL/F;Cp = target plasma Css
16
Q0009:Pharmacodynamics: Efficacy v. Potency
17
Efficacy = maximal response produced by a drug (~ Vmax);Potency = amount required to elicit a response; expressed as ED50=EC50= dose causing 50% max effect
18
Q0010:Pharmacodynamics: antagonists and partial agonists
19
Competitive ant: decreases potency;Noncompetitive ant: decreases efficacy;Partical ag: lower max. efficacy than full; (potency is independent of efficacy)
20
Q0011:Urine pH - fx on drug elimination
21
Weak acids: pH = pKa + log(A-/HA);-Digested in acidic environments (<pKa);-Trapped in basic environment (A-);Treat overdose with bicarbonate;Weak bases: pH = pKa + log (B/BH+);-Digested in basic environments (>pKa);-Trapped in acidic environment (BH+);-Treat overdose with ammonium Cl
22
Q0012:Therapeutic index
23
TD50/ED50 = median toxic dose/median effective dose;Measure of drug safety (higher # is more safe)
24
Q0013:Maximum dosing interval (tau-max)
25
Concentration constrained dosing;tau-max = ln(Cmax/Cmin)/k
26
Q0014:(amount of drug)/(fluid compartment concentration)
27
Vd
28
Q0015:protein bound drugs;liver and kidney disease;pharmacodynamic variable altered?
29
Vd
30
Q0016:Vd eq
31
Vd = drug amount/drug concentration
32
Q0017:Cl eq
33
Cl = elimination rate/[drug]
34
Q0018:t1/2 eq
35
t1/2 = .7*Vd/Cl
36
Q0019:10% remaining concentration;# half lives?
37
3.3
38
Q0020:12.5% remaining concentration;# half lives?
39
40
Q0021:25% remaining concentration;# half lives?
41
42
Q0022:Loading dose eq
43
Loading dose = Cp*Vd/F
44
Q0023:Maintenance dose eq
45
Maintanence Dose = Cp*CL/F;Cp= target [drug];F = bioavailability
46
Q0024:change in loading dose with renal/hepatic disease
47
Unchanged
48
Q0025:change in maintanence dose with renal/hepatic disease
49
lower
50
Q0026:zero order elimination;constant __ of drug eliminated per time
51
amount
52
Q0027:first order elimination;constant __ of drug eliminated per time
53
fraction
54
Q0028:zero order elimitation;Cp decreases linearly/exponentially?
55
linearly
56
Q0029:first order elimination;Cp decreases linearly/exponentially?
57
exponentially
58
Q0030:Phase I metabolism;resulting metabolite characteritics
59
slightly polar;water soluble;often still active
60
Q0031:Phase I metabolism reactions
61
oxidation;reduction;hydrolysis
62
Q0032:oxidation;reduction;hydrolysis;Phase?
63
Phase I
64
Q0033:cytochrome P-450;phase?
65
Phase I
66
Q0034:Phase II metabolism;resulting metabolite characteristics
67
very polar;inactive;*renally excreted
68
Q0035:Phase II metabolism reactions
69
acetylation;glucuronidation;sulfanation
70
Q0036:acetylation;glucuronidation;sulfanation;Phase?
71
Phase II
72
Q0037:conjugation;Phase?
73
Phase II
74
Q0038:Phase metabolism lost in geriatrics
75
Phase I
76
Q0039:competitive antagonist effect on agonist dose curve
77
shift to right;**decreased potency
78
Q0040:noncompetitive antagonist effect on agonist dose curve
79
shifts downward;**decreased efficacy
80
Q0041:EC50 vs Kd in system w/ spare receptors
81
EC50 < Kd
82
Q0042:partial agonist vs full agonist
83
less efficacy
84
Q0043:phase 1 clinical trial questions
85
is it safe?;pharmacokinetics?
86
Q0044:Phase 2 clinical trial questions?
87
does it work in patients?
88
89
Does it work double blind?
90
91
Postmarketing is it safe?
92
Q0047:amount of drug in body/_______ = Vd
93
plasma drug concentration ;;(Vd is Volume of Distribution)
94
Q0048:rate of elimination of drug/[plasma drug] = ?
95
CL (Clearance)
96
Q0049:(.7)(Vd)/CL = ?
97
T 1/2
98
Q0050:A drug infused at a constant rate reaches about 94% of steady state after _______ t 1/2s.
99
100
Q0051:A loading dose is calculated using this formula.
101
Loading Dose = (Cp)(Vd)/F ;(Cp = target plasma conc; F = bioavailability)
102
Q0052:A maintenance dose is calculated using this formula.
103
(Cp)(CL)/F;(CL = Clearance)
104
Q0053:Rate of elimination is proportional to _______ ______ in 1st order elimination.
105
drug concentration
106
Q0054:In the case of EtOH; which is elimated by _____ order elimination; a constant amount of drug is eliminated per unit time.
107
zero
108
Q0055:Phase ____ (I or II) reactions yield slightly polar metabolites that are often _____ (active or inactive)
109
I; active
110
Q0056:Phase ____ (I or II) reactions yield very polar metabolites that are often _____ (active or inactive) and are excreted by the _______.
111
II; inactive; kidney
112
Q0057:Phase II reactions are often of this type.
113
conjugation
114
Q0058:Cytochrome P-450 is involved in _____ phase (I or II) reactions.
115
116
Q0059:A drug patent lasts for _____ years after filing for application.
117
20
118
Q0060:How many phases are there in drug development?
119
120
Q0061:Drugs are first tested in patients in phase _____ of clinical testing; pharmacokinetic safety is determined in phase ______ of clinical testing; double blind tests are done in phase ____ and post-market surveillance is done in phase _____.
121
2;1;3;4
122
Q0062:In a dose response curve; a competitive antagonist shifts the curve _____;a non-competitive antagonist shifts the curve ______.
123
right;down
124
Q0063:What pharmacologic relationship would determine the existence of spare receptors?
125
EC50 is lower then Kd (EC50 is more to the left)
126
Q0064:What does it mean if EC50 and Kd are equal?
127
The system does not have spare receptors
128
Q0065:A partial agonist acts on the same receptor system as a full agonist? T/F
129
TRUE
130
Q0066:What's the main difference between a partial agonist and a full agonist?
131
A partial agonist has a lower maximal efficacy.
132
Q0067:Is a partial agonist less potent than a full agonist?
133
Not necessarily. It can be less; more or equally potent as a full agonist.
134
Q0068:Equation for Half Life
135
T 1/2 = (0.7 x Vd)/CL
136
Q0069:Percent of concentration in the following number of half lives;1;2;3;3.3
137
1 = 50%;2 = 75%;3 = 87.5%;3.3 = 90%
138
Q0070:How do the Loading and Maintenance doses change in a patient w/ Renal or Hepatic dysfunction?
139
Loading - unchanged;;Maintenance - Decreased
140
Q0071:Equation for Theraputic Index
141
TI = Toxic dose/Effective dose
142
Q0072:Phase in clinical drug testing;safety; pharmacokinetics
143
144
Q0073:Phase in clinical drug testing;Protocol; dose level; work on patients
145
146
Q0074:Phase in clinical drug testing;double blind study; efficacy; adverse effects
147
148
Q0075:(3) drugs that use Zero-order elimination
149
Alcohol;;Aspirin;;Phenytoin
150
Q0076:What phase of a reaction uses cytP-450?;What is the purpose of this phase?
151
Phase I;converts lipophilic to polar
152
Q0077:What is the main focus of Phase II reactions?
153
Conjugation
154
Q0078:When pH < pKa; what is more common?;(2);which can pass through the membrane?
155
HA and BH+;;HA passes thru the membrane (uncharged)
156
Q0079:Definition;Amount of the drug required for a given response
157
Potency
158
Q0080:what is the first NT to everything?;the first receptor?
159
NT: ACh;Receptor: Nicotinic
160
Q0081:what system does not have a synapse from the spinal cord to the tissue?
161
Somatic NS;(skeletal muscle);ACh to Nicotinic receptor
162
Q0082:what is the only sympathetic ACh?;what is the receptor?
163
Sweat gland;;receptor: Muscarinic
164
Q0083:what is the receptor for the Parasympathetic system at the tissue?
165
Muscarinic
166
Q0084:what are the Adverse Effects of Acetylcholine?;which is the only Nicotinic receptor response?
167
DUMBBELSS;Diarrhea; Urination;Miosis;Bradycardia; Bronchoconstriction;Excite skeletal muscle (N);Lacrimation;Sweat; Salivation
168
Q0085:what receptors use Gq as their second messenger?;(5)
169
HAVe 1 M&M;H1;Alpha1;V1;M1;M3
170
Q0086:what G-protein uses Phospholipase C?
171
Gq
172
Q0087:what receptors use Gi as their second messenger?;action?
173
MAD 2s;M2;Alpha2;D2;inhibits Adenylyl Cyclase
174
Q0088:what receptor increases gastric acid secretion?
175
H2
176
Q0089:Inhibits choline re-entering the presynaptic terminal
177
Hemicholinium
178
Q0090:Inhibits ACh into vesicles
179
Vesamicol
180
Q0091:Inhibits NE into vesicles
181
Reserpine
182
Q0092:Inhibits release of ACh into synaptic membrane
183
Botulinum
184
Q0093:Inhibits release of NE into synaptic membrane
185
Guanethidine
186
Q0094:Promotes release of NE into synaptic membrane
187
Amphetamines
188
Q0095:Inhibits reuptake of NE into presynaptic nerve;(2)
189
Cocaine;TCA
190
Q0096:what receptor does NE act on in the presynaptic neuron as neg feedback to inhibit its release?
191
alpha-2
192
Q0097:(3) Cholinomimetrics and use of each
193
Bethanechol - post-OP activates GI/GU;Carbachol Glaucoma;Pilocarpine - Glaucoma
194
Q0098:Anticholinesterase used for post-OP activation of GI/GU; myasthinia gravis;what is it an antidote for?
195
Neostigmine;;antidote: Curarae (NMJ block)
196
Q0099:Anticholinesterase used for glaucoma and crosses BBB;what is it an Antidote for?
197
Physostigmine;;antidote: Atropine overdose
198
Q0100:(3) ACh receptor blockers
199
Atropine;;Scopalamine;;Ipratropium
200
Q0101:ACh receptor blocker used for Motion Sickness
201
Scopolamine;(DOC)
202
Q0102:ACh receptor blocker used for Asthma/COPD
203
Ipratropium
204
Q0103:what drug slows the HR at 0.5mg and increases it at >1.0mg?
205
Atropine;(muscarinic antagonist)
206
Q0104:what are the AE of Atropine?
207
Opposite of DUMBBELSS;Hot as hare;Dry as bone;Red as beet;Blind as Bat;Mad as hatter
208
Q0105:Insecticide antidote
209
Atropine
210
Q0106:Nicotinic ACh receptor antagonist;use?
211
Hexamethonium;use;prevents reflex bradycardia caused by NE
212
Q0107:drug used for intubation for its rapid onset and quick duration in causing flaccid paralysis
213
Succinylcholide
214
Q0108:which NMJ (nicotinic) blocker also releases histamine?
215
Tubocurarine
216
Q0109:Epinepherine effects on;1. BP;2. HR;3. TPR
217
Epinepherine;BP: Inc Systolic; Dec Diastolic;HR: Inc (tachycardia);TPR: Dec
218
Q0110:NE effects on;1. BP;2. HR;3. TPR
219
NE;BP: BIG INC in systolic and diastolic;HR: DECREASES;TPR: BIG INCREASE
220
Q0111:Isoproterenol effects on;1. BP;2. HR;3. TPR
221
Isproterenol;BP: Decrease in systolic and diastolic;HR: BIG INCREASE;TPR: BIG DECREASE
222
Q0112:DOC for Shock to increase renal perfusion and for CHF to increase CO
223
Dopamine
224
Q0113:DOC for CHF to increase CO w/o increasing oxygen demand
225
Dobutamine
226
Q0114:Alpha agonist that is used for HTN w/ renal Dz
227
Clonidine
228
Q0115:what occurs if atropine is given before NE?
229
Heart rate increases instead of decreases
230
Q0116:a1-blocker for urinary retention in BPH and HTN
231
Prazosin
232
Q0117:a2-blocker for depression
233
Mirtazapine
234
Q0118:what occurs w/ BP if a-blocker is given before Isoproterenol?
235
No change!
236
Q0119:what occurs w/ BP if a-blocker is given before Epinepherine?
237
Reverses the vasoconstriction effect of Epi and Decreases BP
238
Q0120:which beta-blockers are beta1 selective?
239
if they start w/ A-M in alphabet;(except Labetalol - partial agonist)
240
Q0121:what glaucoma drug should not be used in closed-angle glaucoma?
241
Epinepherine
242
Q0122:Antidote/Tx for;Salicylates
243
Alkalinize urine
244
Q0123:Antidote/Tx for;Anticholinesterases;Organophosphates;(2)
245
Atropine;;Pralidoxime
246
Q0124:Antidote/Tx for;Antimuscarinic;Anticholinergic agents
247
Physostigmine
248
Q0125:Antidote/Tx for;beta-blockers
249
Glucagon
250
Q0126:Antidote/Tx for;Digitalis;(4)
251
Stop Dig;;normalize K;;Lidocaine;;Magnesium
252
Q0127:Antidote/Tx for;Iron
253
Deferoxamine
254
Q0128:Antidote/Tx for;Lead;(3)
255
CaEDTA;;Dimercaprol;;Succimer (kids)
256
Q0129:Antidote/Tx for;Arsenic; gold; mercury;(2)
257
Dimercaprol;;Succimer (kids)
258
Q0130:Antidote/Tx for;Copper
259
Penicillamine
260
Q0131:Antidote/Tx for;Cyanide;(3)
261
Nitrite;;Hydrocobalamin;;Thiosulfate
262
Q0132:Antidote/Tx for;Methemoglobin
263
Methylene Blue
264
Q0133:Antidote/Tx for;Carbon Monoxide
265
100% O2;(or hyperbaric O2)
266
Q0134:Antidote/Tx for;Methanol;Ethylene glycol (antifreeze);(2)
267
Ethanol;;Fomepizole
268
Q0135:Antidote/Tx for;Opioids;(2)
269
Naloxone;;Naltrexone
270
Q0136:Antidote/Tx for;Benzodiazepines
271
Flumazenil
272
Q0137:Antidote/Tx for;TCAs
273
NaHCO3
274
Q0138:Antidote/Tx for;Heparin
275
Protamine
276
Q0139:Antidote/Tx for;Warfarin;(2)
277
Vitamin K;;FFP
278
Q0140:Antidote/Tx for;tPA; Streptokinase
279
Aminocaproic acid
280
Q0141:Urine pH and drug elimination for;Weak acids
281
alkalinize urine w/ Bicarb
282
Q0142:Urine pH and drug elimination for;Weak bases
283
Acidify urine w/ NH4Cl
284
Q0143:What is the reversible cholinesterase inhibitor indicated for the Tx of Alzheimer's Dz?
285
Tacrine
286
Q0144:what is the skeletal muscle relaxant that acts directly on the contractile mechanism of the muscle fiber?
287
Dantrolene
288
Q0145:which Glaucoma agent acts by decreaseing production of aqueous humor?
289
Timolol
290
Q0146:why is Epi mixed w/ anesthetics?
291
to retard the systemic absorption
292
Q0147:which muscles are most affected by tubocurarine?
293
fine movement muscles (head; neck; face)
294
Q0148:what is the alpha receptor-assoc eye muscle?
295
Radial muscle
296
Q0149:what agent for bronchial asthma causes tremor?
297
Salmeterol;(b-agonist)
298
Q0150:what ANS drug class masks hypoglycemia in treated diabetics?;how?
299
b-blockers;;blocks catecholamines; which stimulate Glyconeogenesis
300
Q0151:(2) MAO inhibitors that are used for depression
301
Tranylclpromine;;Phenelzine sulfate
302
Q0152:DOC for thyroid storm
303
Propranolol
304
Q0153:Definition;two drugs act on the same tissue via independent receptors resulting in effects in the opposite direction
305
Physiologic antagonist
306
Q0154:Definition;when two drugs combine and the activity of one or both drugs is blocked
307
Chemical antagonist
308
Q0155:equation for the Elimination constant;(2)
309
Ke = 0.7/half-life = CL/Vd
310
Q0156:when calculating an IV dosage; what needs to be remembered?
311
multiply drug (mg/kg) by weight (kg)
312
Q0157:(2) equations for Extraction ratio
313
ER = (Ci-Co)/Ci = CL/Q
314
Q0158:Which is not absorbed well in the stomach;Aspirin (pKa = 3) or Propranolol (pka = 9.4)?
315
Propranolol
316
Q0159:the AE of convulsions are MC w/ what drug?
317
Strychnine
318
Q0160:what drug can cause Hypocalemic Tetany?
319
Edetate Disodium (Na-EDTA)
320
Q0161:what mineral toxicity can decrease Amylase secretion?
321
Zinc
322
Q0162:AE of drug is Congenital goiter; Hypothyroidism
323
Methimazole
324
Q0163:AE of drug is Agenesis of fetal kidneys
325
Chlorambucil
326
Q0164:Km: Definition
327
Km = Substrate at 0.5*Vmax;Km reflects the affinity of the enzyme for its substrate
328
Q0165:Vmax indicates what?
329
Vmax is directly proportional to the enzyme concentration.
330
Q0166:Relationship between Km and affinity
331
-The lower the Km; the higher the affinity;-Smaller Km means enzyme is saturated earlier; which means that small amounts of substrate are picked up by the enzyme.
332
Q0167:Reading an inverse curve: Y-intercept equals ?
333
1/Vmax;The higher the Y-intercept the lower the Vmax
334
Q0168:Reading an inverse curve: X-intercept equals ?
335
(1/-Km);The further to the right the x-intercept; the greater the Km
336
Q0169:Reading an inverse curve: Slope equals ?
337
Km/Vmax
338
Q0170:Reading an inverse curve: Effect of a competitive inhibitor
339
X-intercept farther to the right; meaning Km is greater; because you need more substrate to get the same effect as the competitive inhibitor is hogging the enzyme;The y-intercept is the same; meaning Vmax hasn't changed; because there isn't any more enzyme;;The slope is greater; because Km has increased while Vmax has stayed the same.
340
Q0171:Reading an inverse curve: Effect of a noncompetitive inhibitor
341
The x-intercept is the same; meaning Km is the same; because the affinity for the enzyme hasn't changed; there's just less of it;;The y intercept has increased; meaning Vmax has decreased; because enzyme has been inactivated by the noncompetitive inhibitor;The slope is greater; because Vmax has decreased while Km has stayed the same.
342
Q0172:Competitive inhibitor: Resemble substrate
343
Yes
344
Q0173:Competitive inhibitor: Overcome by increased substrate?
345
Yes
346
Q0174:Competitive inhibitor: Binds active site?
347
Yes
348
Q0175:Competitive inhibitor: Effect on Vmax
349
Unchanged. The amount of enzyme has not changed.
350
Q0176:Competitive inhibitor: Effect on Km
351
Increased. A lot more substrate needs to be available to seize the active sites.
352
Q0177:Noncompetitive inhibitor: Resemble substrate?
353
No
354
Q0178:Noncompetitive inhibitor: Overcome by increased substrate?
355
No
356
Q0179:Noncompetitive inhibitor: Binds active site?
357
No
358
Q0180:Noncompetitive inhibitor: Effect on Vmax
359
Decreased. Takes the enzyme out.
360
Q0181:Noncompetitive inhibitor: Effect on Km
361
Unchanged. Does not change the affinity for the enzyme.
362
Q0182:Volume of distribution: Abbreviation
363
Vd
364
Q0183:Vd: Stands for what?
365
Volume of distribution
366
Q0184:Volume of distribution: definition
367
Vd = (amount of drug in the body)/(plasma drug concentration)
368
Q0185:Volume of distribution: What alters it?
369
Liver and kidney disease
370
Q0186:Where are drugs with a low Vd distributed?
371
plasma
372
Q0187:Where are drugs with a medium Vd distributed?
373
extracellular space
374
Q0188:Where are drugs with a high Vd distributed?
375
tissues
376
Q0189:Clearance: definition
377
=(rate of elimination of drug)/(plasma drug concentration);=Vd x Ke where Ke=elimination constant
378
Q0190:Half life: definition
379
The time required to change the amount of drug in the body by 1/2 during elimination (or during a constant infusion).
380
Q0191:What percentage of steady state is a drug at after: 1 half life
381
50%
382
Q0192:What percentage of steady state is a drug at after: 2 half lives
383
75%
384
385
87.50%
386
Q0194:What percentage of steady state is a drug at after: 3.3 half lives
387
90%
388
389
94%
390
Q0196:How many half lives does it take for a drug to reach the following percentage of steady state: 50%
391
1 half life
392
393
2 half lives
394
Q0198:How many half lives does it take for a drug to reach the following percentage of steady state: 87.5%
395
3 half lives
396
397
3.3 half lives
398
399
4 half lives
400
Q0201:Cp stands for what?
401
target plasma concentration
402
Q0202:What is the abbreviation for target plasma concentration?
403
Cp
404
Q0203:In pharmacology; what is F an abbreviation for?
405
Bioavailability
406
Q0204:What is the abbreviation in pharmacology for bioavailability?
407
408
Q0205:Loading dose: Definition
409
Loading dose = (Cp * Vd)/F (where Cp equals the target plasma concentration; Vd equals volume of distribution; and F equals bioavailability)
410
Q0206:Maintenance dose: Definition
411
Maintenance dose = (Cp * CL)/F (where Cp is the target plasma concentration and CL is clearance and F is bioavailability)
412
Q0207:Zero-order elimination: definition
413
Constant elimination over time regardless of drug.
414
Q0208:How does Cp vary with time during zero-order elimination?
415
Cp decreases linearly with time.
416
Q0209:Zero-order elimination: Drug examples
417
-Ethanol;-Phenytoin;-Aspirin (at high concentrations)
418
Q0210:First-order elimination: definition
419
Rate of elimination is proportional to drug concentration
420
Q0211:Zero-order elimination vs First-order elimination: Comparison
421
Zero-order: Constant amount of drug eliminated per unit time;1st-order: Constant fraction of drug eliminated per unit time
422
Q0212:How does Cp vary with time during first-order elimination?
423
Cp decreases exponentially with time.
424
Q0213:Urine: Which species get trapped in urine?
425
Ionized species
426
Q0214:In what kind of environment is the following trapped?: Weak acids
427
Basic environments
428
Q0215:In what kind of environment is the following trapped?: Weak bases
429
Acidic environments
430
Q0216:In what kind of environment is the following digested?: Weak acids
431
Acidic environments (below pKa)
432
Q0217:In what kind of environment is the following digested?: Weak bases
433
Basic environments (above pKa)
434
Q0218:How do you treat an overdose of the following?: Weak acids
435
Bicarbonate
436
Q0219:How do you treat an overdose of the following?: Weak bases
437
Ammonium chloride
438
Q0220:Phase I metabolism: Processes
439
Cytochrome P450;-reduction;-oxidation;-hydrolysis
440
Q0221:Phase II metabolism: Processes
441
Conjugation;-acetylation;-glucuronidation;-sulfation
442
Q0222:Phase I metabolism: Metabolites
443
-slightly polar;-water-soluble;-often still active
444
Q0223:Phase II metabolism: Metabolites
445
-very polar;-renally excreted;-inactive
446
Q0224:What phase of metabolism do geriatric patients lose first?
447
Phase I
448
Q0225:Effect on dose/effect curve of: competitive antagonist
449
Shifts curve to the right; decreasing potency and increasing EC50.
450
Q0226:Effect on dose/effect curve of: noncompetitive antagonist
451
Shifts curve downward; decreasing efficacy
452
Q0227:What is EC50?
453
Dose causing 50% of maximal effect
454
Q0228:What is Kd?
455
Concentration of drug required to bind 50% of receptor sites
456
457
5 half lives
458
459
97%
460
Q0231:Effect on dose/effect curve: Spare receptors
461
The drug binding and drug effect are independent of each other with effect to the left of binding;This means that EC50 is lower than Kd; so very little drug needs to bind to get 50% of the effect.
462
Q0232:Effect on dose/effect curve: Partial agonist
463
-Lower maximal efficacy;-Potency independent (amount of dose to get to maximum effect)
464
Q0233:Therapeutic Index: Definition
465
=(TD50)/(ED50);where TD50 equals median toxic dose; and ED50 equals median effective dose.
466
Q0234:blocks cell wall synthesis by inhibition of peptidoglycan cross-linking
467
penicillin;ampicillin;tiracillin;piperacillin;imipenem;aztrenam;c ephalosporins
468
Q0235:block peptidoglycan synthesis
469
bacitracin; vancomycin; cycloserine
470
Q0236:disrupt bacterial/fungal cell membranes
471
polymyxins
472
Q0237:block nucleotide synthesis
473
sulfonamides; trimethoprim
474
Q0238:block fungal cell memebranes
475
amphotericin B;nystatin;fluconazole/azoles
476
Q0239:block nuecliotide synthesis
477
sulfonamides; trimethoprim
478
Q0240:block DNA topoisomerases
479
quinolones
480
Q0241:red orange body fluids
481
Rifampin
482
Q0242:Block Protein synthesis at 50S ribosomal subunit
483
chlorophenicol; erythromycin/macrolides; lincomycin; clindamycin; streptogramins (quinupristin; dalfopristin); linezolid
484
Q0243:block protein synthesis at 30S ribosomal subunit
485
Aminoglycosides ; tetracylins
486
Q0244:bactericidal antibiotics
487
penicillin; cephalosporins; vancomycin; aminoglycosides; floroquines; metronidazole
488
Q0245:penicillin G
489
IV form of penicillin
490
Q0246:penicillin V
491
oral form of penicillin
492
Q0247:MOA of penicillin
493
1. bind penicillin binding protein (aka tranpepsidase);2. block transpepsidase cross-lining of cell wall;3. activate autolytic enzymes;(works on dividing bacteria)
494
Q0248:clinical use of penicillin?
495
bactericidal ;for gram-positive cocci/rods;gram-negative cocci;spirochetes
496
Q0249:is penicillin penicillinase resistant?
497
no
498
Q0250:toxisity of penicillin
499
hypersensitivity reactions; drug-induced coombs positivehemolytic anemia
500
Q0251:how do gram negative bacteria protect themselves from penicillin?
501
1.prvent peniciiln from penetrating cell layers by altering porins;2. beta-lactase enzyme;3.alter molecular structure of transpepsidase so beta-lactam antibiotic (penicillin) no bind to it
502
Q0252:example of a bacteria that uses: altered molecular structure of transpepsidase so beta-lactam antibiotic (penicillin) no bind to it
503
MRSA
504
Q0253:how do gram positive bacteria protect themselves from penicillin?
505
1. secrete beta-lactamase = penicillinase(S aureus) and try to intercept antibiotic outside the cell wall
506
Q0254:name the penicillinase resistant penicillin?
507
methicillin; nafcillin;dicloxacillin
508
Q0255:clinical use of penicillinase resistant penicillin?why such narrow spectrum?
509
s. Aureus - but not MRSA;B/C HAVE BULKIER r GROUP
510
Q0256:TOXICITY of penicillinase resistant penicillin
511
HYPERSENSITIVITY reactions
512
Q0257:which penicillinase resistant penicillin causes intersitial nephritis?
513
methicillin
514
Q0258:aminopenicillins - names?
515
ampicillin; amoxicillin
516
Q0259:MOA of aminopenicillins diff than penicillins?
517
wider specturm b/c better penitration through gram negative outer membrane and better binding to transpepsidase
518
Q0260:are aminopenicillins penicillinase sensitive?
519
yes
520
Q0261:clinical use of aminopenicillins?
521
extended-spectrum penicillin;gram-poitive and gram neg rods(H.influenza;E coli;listeria monocytes; proteus mirabilis; salmoella; enterococci;note: they are one of few drugs against gram-positive enterococcus
522
Q0262:toxicity of aminopenicillins?
523
hypersensitivity reactions ;ampicillin rash ;psuedomembranous colitis
524
Q0263:anti-pseudomonals?
525
ticarcillin; carbeicillin; pipercillin
526
Q0264:diff in MOA of anti-pseudomonals and penicillin?
527
nothing but extensed spectrum
528
Q0265:clinical use of anti-pseudomonals?
529
psudomonas spp. and gram negative rods ;anerobes (bacteroides fragalis)
530
Q0266:are anti-pseudomonals susceptible to penillinase? what can use to help with?
531
yes;give wiht clavulanic acid - which is a beta-lactamase inhibitor
532
Q0267:toxicity of anti-pseudomonals?
533
hypersensitivity reactions
534
Q0268:B lactamdrugs that inhibit cel wall synthesis but are less susceptible to penicilinase. and a bactericidal
535
cephalosprins
536
Q0269:what are the first generation cephalosporins?
537
cefazolin; cephalexin;cef with lin xin
538
Q0270:clinical use of 1st generation cephalosporins?
539
gram positive cocci; proteus mirabilis; ecoil; klebsiella pneumoniae;pek
540
Q0271:what are the 2nd generation cephalosporins?
541
cefoxitin; cefaclor;cefuroxime;furry fox is fat
542
Q0272:clinical use of 2nd generation cephalosporins?
543
gram positive cocci;h. influenza; enterobacter aerogenes; neiseseria spp;proteus mirabilis; ecoil; klebsiella pneumoniae;hen peks
544
Q0273:what are the 3rd generation cephalosporins?
545
cetriaxone; cefotaxime; ceftazidime
546
Q0274:clinical use of 3rd generation cephalosporins?
547
serious gram negative infections resistant to oteher B lactams;meningitis (most penetrate BBB)
548
Q0275:ceftazidime used for what?
549
pseudomonas
550
Q0276:ceftriaxone used for what?
551
gonorrhea
552
Q0277:what are 4th generation cephs?
553
cefepime and cefpiramide;pime mide
554
Q0278:clinical use of 4th generation cephalosporins?
555
increased activity against pseudomonas and gram positive organisms
556
Q0279:toxicities of all cephs?
557
hypersensitivity reactions;cross hypersensitivity wiht penicillins;increased nephro tox of aminoglycosides;disuliram like reaciton w/ ethanol
558
Q0280:what is aztreonam?
559
a monobactam resistan to Beta lactamase
560
Q0281:what is the mOA of aztreonam?
561
inhibits cell wall synthesis ( binds to PBP3) synergistic with aminoglycosides ;no cross-allergy with penicillin
562
Q0282:what is the clinical use of aztreonam?
563
gram negative rods;klebiella spp;pseudomonas spp; serratia spp;NO activity against gram positive gram positives or anerobes
564
Q0283:toxicity of aztreonam?
565
usually nontoxic; occasional GI upset
566
Q0284:what drugs avoid during preg?
567
SAFE Moms Take Really Good Care;Sulfonamides;Aminoglycosides ;Fluoroquinolone;Erythromycin;Metronidazole;Tetracyclins; Ribavirin;Griseoulvin;Chloamphenicol
568
Q0285:what birth defect sulfonamides cause?
569
kernicterus
570
Q0286:what birth defect aminoglycosides cause?
571
ototoxicity
572
Q0287:what birth defect Fluoroquinolones cause?
573
Cartilage damage
574
Q0288:what birth defect erthyromycin cause?
575
acute cholestatic hepatitis in mom
576
Q0289:what birth defect clarithromycin cause?
577
embryotoxic
578
Q0290:what birth defect metronidazole cause?
579
mutagenesis
580
Q0291:what birth defect tetracylines cause?
581
discolored teeth; inhibition of bone growth
582
Q0292:what birth defect ribavirin cause?
583
teratogenic
584
Q0293:what birth defect griseofulvin cause?
585
teratogenic
586
Q0294:what birth defect choloramphenicol cause?
587
gray baby
588
Q0295:treat onchoceriasis
589
Ivermectin (rIVER blindness treated wiht IVERmectin)
590
Q0296:treat nemaode/ roundworm (pinworm;whipform infections
591
mebendazole/thiabendazole
592
Q0297:used to treat;giant worm - ascaris;Hookwormnectar/ancylostoma;pinworm-enterobius
593
pyrantel pamoate
594
Q0298:used to treat ;trematode/flukeschistosomes;paragonimus;clonochis;and ;cyticercosis
595
praziquantel
596
Q0299:treat cestode/tapeworm-diphyllobothrium latum;taenia;x-cept cysticercosis
597
Niclosamine
598
Q0300:RX leishmaniasis
599
pentavalent antimony
600
Q0301:Rx Malaria
601
Chloroquine;quinine;meloquine;atovaquone;proguanil
602
Q0302:Rx Latent hypnozoite(liver) forms of malaria(P.vivax; P.Ovale)
603
primaquine
604
Q0303:RX giardiasis ;amebic dysentry(e. histolytica); bacterial vaginitis (gardnerella vavginalis; Trichomonas
605
Metronidazole
606
Q0304:RX pneumocystis carnii pneumonia prophylaxis
607
TMP-SMX; pentamindine
608
Q0305:RX chagas disease; american typanosomiasis (T. cruzi)
609
Nifurtimox
610
Q0306:RX African trypanocomiasis (sleeping sickness)
611
Suramin
612
Q0307:what is imipenem/cilastratin. meropenem?
613
broad spectrum ; B lactamase resistant carbenem-always administered with cilastatin
614
Q0308:what is cilastatin and why is it administered with imipenem?
615
it is a renal dihydropeptidase inhibitor to decease the inactivation of renal tubules
616
Q0309:clinical use of imipenem/cilastatin; meropenem
617
gram poitive cocci; gram negative rods; and anerobes ;enterobactor- drug of choice
618
Q0310:drug of choice for enteobacter ?
619
imipenem/cilastatin; meropenem
620
Q0311:what is tox of imipenem/cilastatin; meropenem?
621
GI distress ; skin rash; CNS tox(seizures)@ high plasma levels
622
Q0312:what drung inhibits cell wall mucopeptide formation by binding D-ala D ala of cell wall precursors.
623
vancomycin
624
Q0313:how does vancomycin resistance occur?
625
D-ALA D-ALA TO D-ALA D-LAC
626
Q0314:is vacomycin bactericidal or static?
627
bactericidal
628
Q0315:what is the clinical use of vancomycin?
629
gram positive multidrug resistant organisms includ S. aureus and C. difficile
630
Q0316:what causes nephrotox; ototox; thrombophlebitis and diffuse flusing
631
vancomycin
632
Q0317:what causes red man syndrome
633
vancomycin
634
Q0318:how prevent red man syndrom
635
pretraeat with antihistamines and slow inusion rate
636
Q0319:30 s inhibitors
637
AT 30 ;Aminoglycosides - bacteriocidal;Tetracyclines bacteristatic
638
Q0320:50 s inhibitors
639
cell at 50;Chloamphenicol;erythromycin;lincomycin;cLindamycin;all bacterio static
640
Q0321:examples of aminoglycosides
641
streptomycin; gentamycin;tobramycin; amikacin
642
Q0322:they are bactericidal ;inhibit ormaltion of initiation complex and cause misrading of mrna ;require o2 for uptake ;therfore ineffective angainst anaerobes
643
aminoglycosides
644
Q0323:severe gram negative infections ;synergistic with B lactam antibiotics
645
aminoglycosides
646
Q0324:used for bowel surgery
647
neomycin
648
Q0325:cause neph tox-es used wiht cephalosporins;ototox espec with loop diuretics;teratogen
649
aminoglycosides
650
Q0326:B lactamase clevage of B lactam ring ;resistance against what?
651
penicillins/cepalosporins
652
Q0327:Modification via acetylation; adenylation; or phosporylation;resistance against what
653
aminoglycosides
654
Q0328:terminal D alla of cell wall component with D LAC decreased affinity of drug;resistance against what
655
vancomcin
656
Q0329:mod via acetylaion;resistance against what
657
choloramphenicol;aminoglycosides
658
Q0330:methylation of rRNA near erythromycin's ribosomebinding site;resistance against what
659
macrolides
660
Q0331:increased transport out of cell;resistance against what
661
tetracyclin
662
Q0332:altered enzyme (bacterial dihydropteroate synthetase) or resistance against what
663
sulfonamides
664
Q0333:increased paba synthesis
665
sulfonamides
666
Q0334:decreased uptake
667
tetracyclin and sulfonamides
668
Q0335:antimirobial prophylaxis;meningococcal
669
riampin(drug o choice);minocyclin
670
Q0336:antimirobial prophylaxis;gonorrhea
671
ceftriaxone
672
Q0337:antimirobial prophylaxis;syphillis
673
Benzathine penicillin G
674
Q0338:antimirobial prophylaxis;history recurrent UTI's
675
TMP-SMX
676
Q0339:antimirobial prophylaxis;pneumocytis carinii pneumonia
677
TMP-SMX (drug of choice);aerosolized pentamidine
678
Q0340:antimirobial prophylaxis;endocarditis with surgical or dental procedures
679
penicillins
680
Q0341:inhibits cell wall synthesis ;used for fungus
681
caspofungin
682
Q0342:clinical use invasive aspergillos
683
caspofugin
684
Q0343:GI upset and flushing
685
caspofugin
686
Q0344:inhibits fungal enzyme squalene epoxidase
687
terbinafine
688
Q0345:used to treat dermatophytoses;escecially onychomycosis
689
terbinafine
690
Q0346:inhibits DNA synthesis by conversion to luorouracil; which completes wiht uracil
691
flucytosine
692
Q0347:used in systemic fungal infections (candida; cryptococcus)
693
flucytosine
694
Q0348:causes nausea; vomiting; diarrhea; bone marrow suppression
695
flucytosine
696
Q0349:interferes wiht micotubule funtion; disrupts mitosis
697
griseofulvin
698
Q0350:deposits in keratin-containing tissues (nails)
699
griseofulvin
700
Q0351:used for oral treatmetn of superficial infections
701
griseofulvin
702
Q0352:inhibits growth of dermatophytes (tinea and ringworm)
703
griseofulvin
704
Q0353:is a teratogenic; carcinogenic; causes confusion; headaches; increased p-450 and warfarin metabolism
705
griseofulvin
706
Q0354:binds to ergosterol ;disrupting ungal membranes ;too toxic for systemic use
707
nystatin
708
Q0355:forms membrane pores that allow leakage of electrolyrtes and distrupts homeostatis;bind ergosterol
709
amphotericin B
710
Q0356:causes fever/chills (shake and bake) ; hypotention; neph tox; arrythmias; anemia; IV phlebiis (amphoterrible) ;hydration reduces nephrotox
711
amphotericin B
712
Q0357:used for wide specturm of systemic mycosis ;cryptococcus; blastomyces; coccidiodies; aspergillus; histoplasma; candida; mucor(systemic mycoses);intathecally for fungal memingitis; no cross BBB
713
amphotericin B
714
Q0358:swish and swallow or oral candidiasis(thrush);topical or diaper rash or vaginal candidiasis
715
nystatin
716
Q0359:inhibit fungal steroid ergosterol synthesis
717
fluconazol; kepconazole; clotrimazole; itaconazole; voricconazole
718
Q0360:systemic mycosis
719
720
Q0361:used ofr cytptococcial meningitis in AIDS patinets and candidal infections of all types -yeast infections
721
fluconazol
722
Q0362:blastomyces; coccidiodies; histoplasma; candida albicans ;
723
ketoconazole;
724
Q0363:hormone inhibition (gynecomastia); liver disfunciton (inhibit cytochrome p-450) fever and chills
725
726
Q0364:inhibits bacterial dihydrofolate reductase ;bacteriostatic
727
trimethoprim
728
Q0365:causes megaloblastic anemia; leukopenia; granulocytopenia ;(may alleviate wiht supplimental folinic acid)
729
trimethoprim
730
Q0366:used in combination wiht sulfonamides (TMP-SMX) causeing sequential block o folate sntheiss ;-combo used in for what organisms?
731
trimethoprim;used or UTI'S shegella; salmoella; pneumocystis carinii pneumonia
732
Q0367:What are the Macrolides:
733
Erythromycin; azithromycin; clarithromycin
734
Q0368:Inhibit protein synthesis by blocking translocation; bind to the 23S rRNA of the 50S ribosomal subunit; bacteriostatic
735
Macrolides
736
Q0369:Clinical use of macrolides
737
URIs; pneumonias; STDs-- gram positive cocci (streptococcal infections in patients allegic to penicillin); Mycoplasma; Legionella; Chlamydia; Neisseria
738
Q0370:GI discomfort (most common cause of noncompliance); acute cholestatic hepatitis; eosinophilia; skin rashes.
739
Macrolides toxicity
740
Q0371:Increases serum concentration of theophyllines; oral anticoagulants
741
Macrolides toxicity
742
Q0372:Chloamphenicol mechanism
743
Inhibits 50S peptidyltransferase; bacteriostatic
744
Q0373:Meningitis (Haemophilus influenzae;Neisseria meningitidis; Streptococcus pneumoniae
745
clinical use of chlorophenicol
746
Q0374:tox chloroamphenicol
747
anemia(doe dependent); aplastic anemia(does independnet); gray abby syndrome (in premature infants b/c they lack liver udp-glycuronyl transferase
748
Q0375:clocks peptide bond formation at 50s ribosomal subunit . bacteriostatic
749
clindamycin
750
Q0376:treats anaerobes above the diaphram
751
clindamycin
752
Q0377:treat anaerobic infections (Bacteroides fragalis; clostridium perfringens)
753
clindamycin
754
Q0378:pseudomembranous colitis (C. difficile overgrowth. fever ; diarrhea
755
clindamycin
756
Q0379:types of sulfonamides
757
sulfamethoxazole (SMX) sulfisoxazole; triple sulfas; sulfadiazine
758
Q0380:PABA antimetabolites inhibit dihydropteroate synthase. bacteriostatic
759
sulfonamides MOA
760
Q0381:clinical use of sulfonamides
761
gram-positive; gram-negative; Nocaria; Chlamydia. Triple sulfas or SMX for simple UTI
762
Q0382:Hypersensitivity reactions; hemolysis if G6PD deficient; nephrotoxicity (tubulointerstitial nephritis)
763
Sulfonamides
764
Q0383:kernicterus in infacnts
765
Sulfonamides
766
Q0384:displace other drugs from albumin (e.g. warfarin)
767
Sulfonamides
768
Q0385:What are the fluoroquinolones
769
ciprofloxacin; norfloxacin; ofloxacin; sparfloxacin; moxifloxacin; gatifloxacin; enoxacin; nalidixic acid (a quinolone)
770
Q0386:inhibit DNA gyrase (topoisomerase II); bacericidal
771
fluoroquinolones' mechanism
772
Q0387:clinical use of fluoroquinolones
773
gram-negative rods or urinary and GI tracts (including Pesudonomas); Neisseria; some gram-positive organisms
774
Q0388:GI upset; superinfections; skin rashes; headache; dizziness.
775
fluoroquinolones tox
776
Q0389:Contradicted in pregnant women and children because animal studies show damage to cartilage.
777
778
Q0390:Tendonitis and tendon rupture in adults; leg cramps and myalgias in kids.
779
780
Q0391:Metronidazole mechanism
781
forms metabolites in the bacterial cell; bactericidal
782
Q0392:Antiprotozoal
783
Metronidazole clinical use
784
Q0393:Giardia; Entamoeba; Trichomonas; Gardnerella vaginalis; anaerobes (bacteriodes; clostridium)
785
786
Q0394:used with bismuth and amoxicillim (or tetracycline) for "triple therapy" against H. pylori
787
788
Q0395:polymixin B and polymixin E are examples of what?
789
polymixins!duh
790
Q0396:bind to cell membranes of bacteria and distrupt their osmotic properties ;care cationic;basic ;act like detergents
791
polymixins;-myxins mix up membranes
792
Q0397:resistant to grm negative infections
793
polymixins
794
Q0398:neurotox; acute renal tubular necrosis
795
polymixins
796
Q0399:streptomycin ;pyrazinamide;isoniazid(INH);rifampin;ethambutol;cycloserin e (2nd line therapy)
797
ANTI-TB DRUGS
798
Q0400:tb prophylazxis?
799
INH isoniazid
800
Q0401:deacerased synthesis of mycolic acid
801
isoniazid
802
Q0402:hemolysis if G6PD deficincy ; enurotox; hepatotox; SLE ;
803
INH
804
Q0403:what can prevent neurotox in INH
805
pyridoxine vit b6
806
Q0404:common tox to all anti-tb drugs
807
all hepatotoxic
808
Q0405:inhibits DNA- dependent RNA polymerase
809
Rifampin
810
Q0406:used against TB delays reasistance to dapsone when used for leprosy ;used for meningococcal prophylaxis in contacts of childeren with H. influenza type B
811
Rifampin
812
Q0407:causes minor heptotox and drug interaction (increased P 450)
813
Rifampin
814
Q0408:inhibits influenza neuroaminidase. so release of progeny virus is decreased
815
Zanamivir; oseltamivir
816
Q0409:influeza A and B
817
Zanamivir; oseltamivir
818
Q0410:inhibits synthesos o guanine nucleotides by competivitly inhibiting IMP dehydrogenase
819
Ribavirin MOA
820
Q0411:RSV; chronic hepatitis C
821
Clinical use of ribavirin
822
Q0412:hemolytic anemia; sever teratogen
823
ribavirin
824
Q0413:preferentially inhibits viral DNA polymerase when phosphorylates by viral thymidine kinase
825
acyclovir
826
Q0414:HSV;VZV;EBV;mucocutaneous and genital herpes lesions. prophylaxis in immunocompromised patients
827
acyclovir
828
Q0415:delirium; tremor; nephrotox
829
acyclovir
830
Q0416:lack of thymidine kinase
831
acyclovir
832
Q0417:phosphorylation by viral kinas preferentially inhibits CMV DNA polymerase
833
Ganciclovir
834
Q0418:CMV ; esecially in immunocompromised patients
835
Ganciclovir
836
Q0419:leukopenia; neutropenia; thrombocytopenia; renal tox. MOre tox to host enzymes than acyclovir
837
Ganciclovir
838
Q0420:Mutated CMV DNA polymerase or lack of thymidine kinase
839
Ganciclovir
840
Q0421:blocks viral penetration/uncoating(M2 protein) may buffer pH o endosome. also caus the release of dopamine rom intact nerve terminals
841
Amantadine
842
Q0422:prophylaxis and treatmetn for influenza A; parkinson's disease
843
Clinical use of amantadine
844
Q0423:ataxia; dizziness; slurred speech
845
tox of amantadine
846
Q0424:Mutated M2 protein. In 2006 ; 90% of influenza A were resistant to amantadine
847
amantadine
848
Q0425:is a derivative with fewer Cns side effects . does not cross the BBB
849
rimantidine
850
Q0426:Viral DNA polymerase inhibitor that binds to the pyroposphate binding site o the enzyme . does not require activatiation by viral kinase
851
foscarnet
852
Q0427:nephrotox
853
foscarnet tox
854
Q0428:mutated DNA Polymerase
855
mechanism of resistance of foscarnet
856
Q0429:glycoproteins from human leukocytes that block various various stages of RNA and DNA syntheiss. Induce ribonuclease that degrades viral mRNA
857
Intererons
858
Q0430:pyrofosphate analog
859
foscarnet
860
Q0431:IFN alpha used for what
861
chronic hep B and C;KAPOSi's sarcoma
862
Q0432:IFN b
863
MS
864
Q0433:IFN gamma
865
NADPH; OXIDASE DEFICIENCY
866
Q0434:NEUTROPENIA
867
tox or interferone
868
Q0435:plioconanl
869
for poliovirus inhibits penetration of picornavirus into cell
870
Q0436:saquinavir ; ritonavir ; indinavir nelfinacir amprenavir used for what?are what>
871
HIV THERAPY ;are protease inhibitors;NAVIR tease a protease inhibitor
872
Q0437:what inhibits assembly of new virus by blocking protease in progency virons
873
protease inhibitors for HIV therapy;saquinavir ; ritonavir ; indinavir nelfinacir amprenavir
874
Q0438:cause GI intolerance (N; dia); hyperglycemia; lipodystrophy; thrombocytopenia(indinavir)
875
HIV therapy
876
Q0439:ZIDOVUDINE(AZT); didanosine (ddI); zalcitabine(ddC); stavudine(d4T); lamivudine(3TC);abacavir
877
nucleosides - reverse transcriptase inhibitores for HIV
878
Q0440:nin nucleoside reverse transcriptase inhibitors for HIV
879
Nevirapine; efavirenz;delavirdine
880
Q0441:prefeentially inhibit reverse transcriptase of HIV; incorporation of viral genome into ost DNA
881
reverse transcriptase inhibitors both types
882
Q0442:cause bone marrow suppression (neutropenia and anemia); peripheral neuropathy; lactic ascisoiss(neucleosides) rash (non-nucleaosides); megaloblastic anemia(AZT)
883
TOX of reverse transcriptase inhibitors both types
884
Q0443:highly active antiretroviral therapy
885
HAART
886
Q0444:what is HAART
887
combo therapy o protease inhibitos reverse transcriptase inhibitors
888
Q0445:at what cell count is HAART INDICATED
889
<500cells/mm3 of CD4; or high viral load
890
Q0446:is AZT USED during preg why?
891
yes - to reduce risk o etal transmission
892
Q0447:Clinical use of tetracyclines:
893
Vibrio cholerae; Acne; Chlamydia; Ureaplasma; Urealyticum; Mycoplasma pneumoniae; Tularemia; H. pylori; Borrelia burgdorferi (Lyme Disease); Rickettsia;Vaccum the Bedroom
894
Q0448:GI distress; discoloration of teeth and inhibition of bone growth in children; photosensitivity; contradiction in pregnancy
895
Tetracycline toxicity
896
Q0449:Tetracyclines
897
Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA; limited to CNS penetration
898
Q0450:This is fecally eliminated and can be used in patients with renal failure
899
Doxycycline ;(must not take with milk; antacids; or ironcontaintaing preparations because divalent cations inhibit its absorbtion in the gut)
900
Q0451:What are the tetracyclines?
901
Tetracyclines; doxycycline; demeclocycline; minocycline
902
Q0452:block mRNA synthesis
903
rifampin
904
Q0453:penicillin;blocks ___ (1.) cross-linking of cell wall by binding PBP's;activates ___ (2.) enzymes;and is bacteriCIDAL for ___(3; 4; 5; 6.)
905
1. transpeptidase;2. autolytic;3. gram pos cocci;4. gram pos rods;5. gram neg cocci;6. spirochetes
906
Q0454:methicillin; nafcillin; dicoxacillin;are penicillinase __ (1);have ___ (2) spectrum due to ___ (3);tx: (4)
907
1. resistant;2. narrow;3. bulkier R group;4. staph a
908
Q0455:ampicillin and amoxacillin;penicillinase __ (1);which has greater oral bioavailabiliity? (2);tx: (3-8)
909
1. sensitive;2. amOxacillin;3. Haemophilus;4. E. coli;5. listeria;6. proteus;7. salmonella;8. enterococci;(HELPS kill Enterococci)
910
Q0456:carbenicillin; piperacillin; ticarcilin;penicillinase __ (1);tx: (2; 3)
911
1. sensitive;2. pseudomonas;3. gram neg rods
912
Q0457:cephalosporins inhibit __ (1);1st gen tx (2-4);2nd gen tx (5-10);3rd gen tx (11-12);(13) for pseduomonas;(14) for gonorrhea;4th gen tx (15-16)
913
1. Proteus 2. E coli 3. Klebsiella (PEcK);4. Haemophilus 5. Enterobacter aerogenes 6. Neisseria 7. Proteus 8. E coli 9. Klebsiella 10. Serratia (HEN PEcKS);11. serious gram neg and 12. meningitis;13. ceftazidime;14. ceftriaxone;15. pseudomonas and gram pos
914
Q0458:aztreonam;beta lactamase __(1);inhibits cell wall synthesis by binding __(2);synergistic w/ __ (3);tx: (4-6);used for patients;(7)
915
1. resistant;2. PBP3;3. aminoglycosides;4. Klebsiella;5. pseudomonas;6. serratia;7. with penicillin allergy and those with renal insufficiency who can't tolerate aminoglycosides
916
Q0459:impipenem;the kill is lastin w/ ; (1.)because (1) inhibits (2)to dec inactivation in renal tubules;beta lactamase (3);tx (4-6);drug of choice for (7)
917
1. cilastatin;2. renal dihydropeptidase I;3. resistant;4. gram pos cocci;5. gram neg rods;6. anaerobes;7. enterobacter
918
Q0460:vancomycin;inhibits cell wall mucopeptide formation by binding (1);tx: serious gram pos MDR organisms including; (2-3);it is generally well tolerated but side effects include (4-7)
919
1. D-ala-D-ala;2. staph a;3. C. difficille;4. Nephrotoxicity;5. Ototoxicity;6. Thrombophlebitis;7. red man syndrome (minimized w/ HA)
920
Q0461:mnemonic for protein synthesis inhibitors;
921
buy AT 30; CELL at 50;Aminoglycosides bacteriCIDAL;Tetracyclines;Chloramphenicol;Erythromycin; Lincomycin;cLindamycin
922
Q0462:aminoglycosides;require _(1) for uptake;tx (2);synergistic w/ (3);use (4) for bowel surgery;toxicity (5; 6)
923
1. O2 (-> innefective against anaerobes);2. severe gram neg rod inf;3. beta lactams;4. neomycin;5. nephrotoxicity;6. otoxicity;(amiNOglycosides)
924
Q0463:testracyclines;(1) is fecally eliminated -> can be used w/ renal failure;must not take w/ (2) because divalent cations inhibit absorption;tx (3-10)
925
1. doxycyclin;2. milk; anatids; Fe;3. vibrio 4. acne 5. chlamydia 6. ureaplasma urealyticum 7. mycoplasma pneumonia 8. borellia 9. rickettsia 10. tularemia;(VACUUM your Bed Room Tetracyclines)
926
Q0464:macrolides;tx generally (1-3);specifically- (4-8)
927
1. URI;2. pneumonia;3. STDs;4. gram pos cocci;5. mycoplasma;6. legionella;7. chlamydia;8. neisseria
928
Q0465:chloramphenicol;tx (1);limit use because of (2);causes Gray baby syndrome because they lack (3)
929
1. meningitis;2. toxicities- dose dependent anemia; dose independent aplastic anemia;3. UDP-glucuronyl transferase
930
Q0466:clindamycin;tx (1)
931
anaerobes above the diaphragm
932
Q0467:sulfonamides;inhibit (1);tx (2-5);toxicity (6-9)
933
dihydropteroate synthase;2. gram pos;3. gram neg;4. nocardia;5. chlamydia;6. hemolysis of G6pD;7. nephrotoxicity;8. kernicterus in infants;9. displace drugs from albumin
934
Q0468:simple UTIs;recurrent UTIs
935
triple sulfas or SMX;TMP-SMX
936
Q0469:trimethoprim inhibits (1);toxicity (2);may alleviate w/ supplemental (3)
937
1. DHF reductase;2. TMP- treats marrow badly (megaloblastic anemia; leukopenia; granulocytopenia);3. folinic acid
938
Q0470:TMP/SMX combo used for;(1-4)
939
recurrent UTIs;salmonella;PCP;shigella;(USPS)
940
Q0471:fluoroquinolones;inhibit (1);tx: (2);toxicity (3)
941
1. DNA topoisomerase I (gyrase);2. gram neg rods of UT tract and GI tract;3. damage to cartilage; tendonitis; tendon rupture;(Fluoroquinolones hurt attachments to your bones)
942
Q0472:metronidazole tx (1-3);toxicity: (4)
943
1. giardia;2. entamoeba;3. trichomonas;(GET on the metro);4. disulfiram like effect w/ alcohol
944
Q0473:polymyxins are cationic basic proteins that act like (1);tx (2);toxicity (3-4)
945
1. detergents;2. res gram neg inf;3. neurotoxicity;4. acute renal tubular necrosis
946
Q0474:isoniazid;dec synthesis of;(1);only agent used as solo prophylaxis for (2);toxicity (3-6);different half-lives in (7)
947
1. mycolic acids;2. mycobacterium TB;3. hemolysis if G6PD def;4. SLE-like syndrome;5. neurotoxicity (can prevent with B6);6. hepatotoxicity;(INH Injures Neurons and Hepatocytes);7. slow vs fast acetylators
948
Q0475:rifampin;inhibits (1);tx (2-5);6. Four R's of rifampin;
949
1. DNA dep RNA pol;2. TB;3. delays resistance to dapsone for leprosy;4. meningococcal prophylaxis;5. H. influenze B prphylaxis;6. RNA pol inhibitor;Revs up P450;Red/orange body fluids;Rapid resistance if used alone
950
Q0476:1. name the five anti-TB drugs;2. which is used alone for prophylaxis;3. all are ;
951
1. Rifampin; Ethambutol; Streptomycin; Pyrazinamide; INH (RESPIre);2. INH;3. hepatotoxic
952
Q0477:aminoglycoside resistance
953
modification via;acetylation;adenylation;phosphorylation
954
Q0478:vancomycin resistance
955
replace terminal D-Ala w/ D-lac to dec affinity
956
Q0479:macrolide resistance
957
methylation of rRNA near erythromycin's ribosome binding site
958
Q0480:tetracycline resistance
959
dec uptake or inc transport out of cell
960
Q0481:sulfonamide resistance
961
altered enzyme;dec uptake;inc PABA
962
Q0482:prophylaxis for;1. meningococcus;2. gonorrhea;3. syphilis;4. recurrent UTI;5. PCP
963
1. rifampin;2. ceftriaxone;3. benzathine penicillin G;4. TMPSMX;5. TMP-SMX
964
Q0483:amphotericin;binds (1);tx (2);cross the bbb? (3);toxicity (4)
965
1. ergosterol - tears holes in wall;2. systemic mycoses;3. doesn't cross BBB- use intrathecaly for fungal meningitis;4. "shake and bake" fevers and chills; arrhythmias (amphoterrible)
966
Q0484:nystatin;binds (1);tx (2)
967
1. ergosterol;2. swish and swallow for thrush
968
Q0485:azoles;inhibit (1);tx (2);(3) for cryptococcal meningitis and candida;(4) for blasto; coccidioides; histo; candida;also used to tx (5);toxicity (6-7)
969
1. ergosterol synthesis;2. systemic mycoses;3. fluconazole;4. ketoconazole;5. hypercortisolism;6. gynecomastia;7. inh P450
970
Q0486:flucytosine;inhibits (1);tx (2)
971
1. DNA synthesis by conversion to FU which competes w/ uracil;2. systemic fungal infections
972
Q0487:caspofungin ;inhibits (1);tx (2)
973
1. cell wall synthesis;2. invasive aspergillosis
974
Q0488:terbinafine;inhibits (1);tx (2)
975
1. squalene epoxidase which converts squalene to lanosterol;2. dermatoophytoses
976
Q0489:griseofulvin;inhibits (1);tx (2);toxicity (3)
977
1. microtubules fx;2. oral tx of superficial infections;3. inc warfarin metabolism
978
Q0490:amantadine;blocks (1);causes release of (2);tx (35);amantadine mnemonic (6)
979
1. uncoating;2. DA;3. influenza A;4. rubellA;5. Parkinson's;6. Amantadine blocks influenza A and rubellA and causes problems with the cerebellA
980
Q0491:rimantadine has (1) CNS side effects than amantadine
981
fewer
982
Q0492:zanamivir inhibits (1);tx (2-3)
983
1. neuramidase;2. influenza A;3. influenza B
984
Q0493:ribavirin inhibits (1);tx (2);toxicities (3-4)
985
1. IMP dehydrogenase -> no guanine;2. CMV;3. hemolytic anemia;4. teratogenic!
986
Q0494:acyclovir;MOA (1)
987
inhibits DNA pol when phosphorylated by viral thymidine kinase
988
Q0495:DHPG (dihydroxy-2-propoxymethyl guanine);= (1);MOA (2);tx (3);toxicities (4-7)
989
1. ganciclovir;2. phosphorylation by viral kinase -> preferential inhibition of CMV DNA pol;3. CMV;4. thrombocytopenia;5. leukopenia;6. neutropenia;7. renal toxicity
990
Q0496:foscarnet;MOA (1);tx (2);toxicity (3)
991
1. binds to pyrophosphate binding site of DNA pol -> inhibition;(FOScarnet - pyroFOSphate analog);2. CMV retinitis if ganciclovir fails;3. renal toxicity
992
Q0497:"-navir" drug;MOA
993
protease inhibitor
994
Q0498:Rerverse transcriptase inhibitors;(6)
995
abacavir;lamivudine;didanosine;stavudine;zidovudine (AZT);zalcitabine;(AL DiSsed ZZ and NED);nevirapine;efavirenz;delavirdine;(NED is a nonnucleoside)
996
Q0499:interferons;tx (3);toxicity (4)
997
chronic HBV;HCV;kaposi sarcoma;neutropenia
998
Q0500:tx for onchocerciasis
999
ivermectin;(tx rIVER blindness with IVERmectin)
1000
Q0501:taenia solium;transmission;tx
1001
undercooked pork tapewom;praziquantel;albendazole for cysticercosis
1002
Q0502:echinococcus granulosus;transmission;tx
1003
dog feces -> cysts in liver;albendazole
1004
Q0503:trematodes;tx
1005
praziquantel
1006
Q0504:schistosoma;transmission;tx
1007
from snails -> granulomas and fibrosis of spleen and liver;praziquantel
1008
Q0505:clonorchis sinensis;transmission;tx
1009
undercooked fish -> biliary tract inflammation;praziquantel
1010
Q0506:paragonimus westernami;transmission;tx
1011
undercooked crab meat -> inflammation of lung;praziquantel
1012
Q0507:ancylcostomal duodenale
1013
hookworm;mebendazole
1014
Q0508:ascaris lumbricoides
1015
mebendazole
1016
Q0509:enterobius vermicularis
1017
pinworm;mebendazole
1018
Q0510:strongyloids stercoralis
1019
invermectin
1020
Q0511:trichinella spiralis
1021
thiabendazole
1022
Q0512:dracuncullus medinensis
1023
nitridazole;(Dracula comes out at Night)
1024
Q0513:loa loa
1025
transmitted by deer fly;can see worm crawling in conjunctiva;tx diethylcarbamazine
1026
Q0514:toxocara canis
1027
diethylcabamazine
1028
Q0515:wucheria bancrofit
1029
diethycarbamazine;(can cause elephantiasis)
1030
Q0516:Imipenem/cilastatin What is imipenem?
1031
broad spectrum beta-lactamase-resistant carbapenem
1032
Q0517:Imipenem What do you always administer it with and why?
1033
cilastatin -- it decreases inactivation of imipenem in renal tubules
1034
Q0518:Imipenem/cilastatin What do you use it for?
1035
Gram pos cocci; gram neg rods and anaerobes (broad spectrum); drug o' choice for Enterobacter;the girl from Ipanema was a Broad; y era Enterita
1036
Q0519:Imipenem/cilastatin What bug is it the drug of choice for?
1037
Enterobacter
1038
Q0520:Imipenem/cilastatin What are its side-effects
1039
GI distress; skin rash; seizures at high conc;kid with skin problems getting nervous (upset stomach; shaking) when talking to girl from Ipanema
1040
Q0521:Vancomycin Is it bactericidal or bacteriastatic and why?
1041
Bactericidal because it blocks cross linkage and elongation of peptidoglycan by binding D-ala D-ala protion of cell wall.
1042
Q0522:Vancomycin How does resistance to Vanco occur?
1043
D-ala D-ala is replaced with D-ala D-lactate which vanco does not block
1044
Q0523:Vancomycin What is it used for?
1045
Used for serious infection that is resistant to other drugs (e.g. gram pos multi-drug resistant organisms like S. aureus and C. difficile; methicillin resistant staph (MRSA))
1046
Q0524:Vancomycin What are the important toxicities of vanco?
1047
generally NOT many problems except; Nephrotoxicity; Ototoxicity and Thrombophlebitis;*also red man syndrome; give with histamine to prevent
1048
Q0525:Vancomycin What can happen with rapid infusion of vanco?
1049
Red man's syndrome. Diffuse flushing which can be controlled by pretreatment with anti-histamines and with slow infusion rate
1050
Q0526:Protein Synthesis Inhibitors Which drugs target bacterial protein synthesis by blocking the 30S unit vs 50S unit?
1051
Buy AT 30; CELL at 50
1052
Q0527:Protein Synthesis Inhibitors What does AT stand for?
1053
A = Aminoglycosides (streptomycin; gentamicin; tobramycin an damikacin. And T = Tetracyclines
1054
Q0528:Protein Synthesis Inhibitors What does CELL stand for?
1055
C = Chloramphenicol; E= Erythromycin; L= Lincomycin and L= cLindamycin
1056
Q0529:Which of the Protein Synthesis Inhibitors are bactericidal?
1057
Only the aminoglycosides are; the rest are bacteriostatic
1058
Q0530:Aminoglycosides Name some aminoglycosides?
1059
Gentamicin; neomycin; amikacin; tobramycin and streptomycin;mean GNATS
1060
Q0531:Aminoglycosides How do these drugs work?
1061
They inhibit formation of the initiation complex in mRNA translation
1062
Q0532:Aminoglycosides Why are they ineffective against anaerobes?
1063
They require oxygen for uptake into bacteria
1064
Q0533:Aminoglycosides When would you use aminoglycosides?
1065
against severe gram-negative rod infections
1066
Q0534:Aminoglycosides What drugs can you use aminoglycosides with for synergy?
1067
the drugs that inhibit cell wall synthesis (e.g. penicillin and cephalosporins -- the beta-lactam antibiotics). Presumably this allows the drug to get in with out reliance on oxygen transport
1068
Q0535:Aminoglycosides What drug in this class is commonly used for bowel surgery?
1069
Neomycin
1070
Q0536:Aminoglycosides What are the major toxicities?
1071
Nephrotoxicity (esp w/ cephalosporins); Ototoxicity (esp w/ loop diuretics); Teratogen;mean GNATS canNOT kill anaerobes
1072
Q0537:Tetracyclines Name some tetracylcines
1073
Tetracycline; doxycycline; demeclocycline; minocycline
1074
Q0538:Tetracyclines How does it work?
1075
Blocks t-RNA attachment to 30S subunit
1076
Q0539:Tetracyclines Which tetracycline can you use in patients with renal failure and why?
1077
Can use doxycycline because its elimination is fecal
1078
Q0540:Tetracyclines Should you take these drugs with a glass of milk?
1079
NO; because it intereferes with absorption in the gut as does antacids and iron-containing preparations; or any divalent cations
1080
Q0541:Tetracyclines What are tetracyclines used for?
1081
Toby; VACUUM THe Bed Room-- Vibrio cholerae; Acne; Chlamydia; Ureaplasma; Urealyticum; Mycoplasma pneumoniae; Tularemia; H pylori; Borrelia burgdorferi; Rickettsia
1082
Q0542:Tetracyclines What are the common toxicities
1083
GI distress; teeth discoloration; inhibition of bone growth in children; Fanconi's syndrome and photosensitivity. Contraindicated in pregnancy
1084
Q0543:Macrolides Name some macrolides?
1085
Erythromycin; azithromycin; Clarithromycin;EaZy was a Crip Mac
1086
Q0544:Macrolides How do these drugs work?
1087
bind to 23S rRNA of 50S and inhibit translocation; bacteriostatic
1088
Q0545:Macrolides What are they used for?
1089
URIs; pneumonias; STDs -- streptococcal in patients that are allergic to PNC --- Mycoplasm; Legionella; Chlamydia; Neisseria;Eryc's Nipple's at the Mid Clavicular Line
1090
Q0546:Macrolides Pneumonic for macrolide use?
1091
Eryc's Nipple is at his Mid Clavicular Line (Eryc is brand name for erythromycin; and eazy e's real name). Neisseria; Mycoplasm; Chlamydia; Legionella.
1092
Q0547:Macrolides What are the major toxicities?
1093
GI discomfort; acute Cholestatic hepatitis; Eosinophilia; skin rashes;increases serum theophylines and oral anticoagulants;the Mac eazy E was a Gangsta Crip with bad Skin
1094
Q0548:Macrolides What is the most common cause for noncompliance to macrolides?
1095
GI discomfort
1096
Q0549:Chloramphenicol How does this drug work?
1097
inhibits 50S peptidyltransferase
1098
Q0550:Chloramphenicol Main use?
1099
Meningitis (H. influenzae; N. meningitides; S. pneumo). Used conservatively b/c of toxicity
1100
Q0551:Chloramphenicol What are the main toxicities?
1101
Anemia and aplastic anemia (both dose dependent); gray baby syndrome (in premes b/c they lack UDP-glucoronyl transferase)
1102
Q0552:Clindamycin How does it work?
1103
blocks peptide bond formation at 50S;with CLINdamycin; the amino acids don't CLINk together
1104
Q0553:Clindamycin When do you use it?
1105
Anaerobic infections (e.g. Bacteroides fragilis and C.perfringens)
1106
Q0554:Clindamycin Toxicities?
1107
Pseudomembranous colitis; fever; diarrhea
1108
Q0555:Sulfonamides Name some sulfonamides
1109
Sulfamethoxazole (SMX); sulfisoxazole; triple sulfa and sulfadiazine
1110
Q0556:Sulfonamides How does it work?
1111
Inhibits bacterial folic acid synthesis from PABA by blocking dihydropteroate synthase.
1112
Q0557:Sulfonamides What are its uses?
1113
Gram-positive; gram-negative; Nocardia; Chlamydia. Triple sulfas and SMX for simple UTIs
1114
Q0558:Sulfonamides Toxicities?
1115
hypersensitivity rxn; hemolysis if G6PD deficient; nephorotoxicity (tubulointerstitial nephritis); kernicterus in infants; displace other drugs from albumin (e.g. warfarin)
1116
Q0559:Trimethoprim How does it work?
1117
inhibits folic acid pathway by blocking dihydrofolate reductase which humans have as well
1118
Q0560:Trimethoprim What are its uses?
1119
used in combo with Sulfamethoxazole (TMP-SMX) causing a sequential block of folate synthesis. Used for recurrent UTIs; Shigella; Salmonella; and prophylaxis for PCP in AIDS patients
1120
Q0561:Trimethoprim Toxicities?
1121
Megaloblastic anemia; pancytopenia (may be alleviated with supplemental folinic acid)
1122
Q0562:Fluoroquinolones What the most famous floroquinolone?
1123
Ciprofloxacin (treatment for Anthrax)
1124
Q0563:Fluoroquinolones How does it work?
1125
inhibits DNA gyrase (topoisomerase II)
1126
Q0564:Fluoroquinolones What are its uses?
1127
Gram neg rods or urinary and GI tract (incl. pseudomonas); Neisseria; some gram pos spp
1128
Q0565:Fluoroquinolones What population is contraindicated for use?
1129
pregnancy and children
1130
Q0566:Fluoroquinolones What are its toxicities?
1131
GI upset; superinfection; skin rashes; headache; dizziness and tendonitis and tendon rupture in adults. FluoroquinoLONES hurt attachment to BONES.
1132
Q0567:Metronidazole How does it work?
1133
forms toxic metabolites in the bacteria. Bactericidal.
1134
Q0568:Metronidazole What are its uses?
1135
antiprotazoal;Giardia; Entamoeba; Trichomonas;GET on the Metro;anaerobes;gardnerella vaginalis; Bacteroides; clostridium;Used with bismuth and amoxicillin (or tetracycline) for triple therapy against H pylori;BAM!
1136
Q0569:What is the role of Metronidazole in H. pylori infection?
1137
Used as part of triple therapy: bismuth; amoxicillin and metronidazole;BAM!
1138
Q0570:Metronidazole Main toxicity?
1139
disulfiram-like (antabuse) reaction to alcohol and headache
1140
Q0571:Which drug do you use to treat anaerobic infections above the diaphram and which for below the diaphram
1141
anaerobes above diaphram: Clindamycin; and anaerobes below diaphram: metronidazole
1142
Q0572:Polymyxins How does it work?
1143
disrupts osmotic properties of bacteria; acts like a detergent
1144
Q0573:Polymyxins What is it used for?
1145
resistant gram negative infections
1146
Q0574:Polymyxins Toxicities?
1147
neurotoxicity; acute renal tubular necrosis
1148
Q0575:Isoniazid How does it work?
1149
decreases synthesis of mycolic acid
1150
Q0576:Isoniazid What is it used for?
1151
MTB (mycobacterium tuberculosis). The only agent used as solo prophylaxis against TB
1152
Q0577:Isoniazid Toxicities?
1153
Hemolysis if G6PD deficient; neurotoxicity; hepatotoxicitiy; drug induced SLE. INH; Injures Neurons and Hepatocytes
1154
Q0578:Isoniazid What vitamin prevents neurotoxicity
1155
Vitamin B6 (pyridoxine)
1156
Q0579:Isoniazid Why are toxicities particularly important to monitor in patients taking INH?
1157
INH half-lives are different in fast versus slow acetylators!
1158
Q0580:Rifampin How does it work?
1159
inhibits DNA-dependent RNA polymerase
1160
Q0581:Rifampin What is it used for?
1161
Mycobacterium tuberculosis; delays resistance to dapsone when used for leprosy; meningococcal prophylaxis
1162
Q0582:Rifampin Toxicities?
1163
Minor hepatotoxicity and increases P-450
1164
Q0583:Rifampin How can it be used for leprosy?
1165
rifampin delays resistance to dapsone when used for leprosy
1166
Q0584:Rifampin What would happen if you used rifampin alone?
1167
get rapid resistance
1168
Q0585:Rifampin What does it do to bodily fluids?
1169
makes them red/orange in color
1170
Q0586:Rifampin What are the 4 R's of Rifampin
1171
RNA polymerase inhibitor; Revs up microsomal p-450; Red/Orange body fluids; Resistance is rapid if used alone
1172
Q0587:Anti-TB Drugs What are the anti-TB drugs?
1173
Rifampin; Ethambutol; Streptomycin; Pyrazinamide; Isoniazid (INH) -- RESPIre
1174
Q0588:Anti-TB Drugs What do you use for TB prophylaxis?
1175
INH
1176
Q0589:Anti-TB Drugs What toxicity is common to all?
1177
hepatotoxicity
1178
Q0590:Most common resistance mechanism for penicillins / cephalosporins.
1179
Beta-lactamase cleavage of beta-lactam ring.
1180
Q0591:Most common resistance mechanism for aminoglycosides.
1181
Modification via acetylation; adenylation; or phosphorylation.
1182
Q0592:Most common resistance mechanism for vancomycin.
1183
Terminal D-ala of cell wall component replaced with D-lac; decrease affinity.
1184
Q0593:Most common resistance mechanism for Chlorampenicol.
1185
Modification via acetylation.
1186
Q0594:Most common resistance mechanism for macrolides.
1187
Methylation of rRNA near erythromycin's ribosome-binding site.
1188
Q0595:Most common resistance mechanism for tetracycline.
1189
Decrease uptake or increase transport out of cell.
1190
Q0596:Most common resistance mechanism for sulfonamides.
1191
Altered enzyme (bacterial dihydropteroate synthetase); decrease uptake; or increase PABA synthesis.
1192
Q0597:drug of choice for prophylaxis of meningococcal infection.
1193
Rifampin (drug of choice)
1194
Q0598:Drug of choice for gonorrhea.
1195
Ceftriaxone. 3rd generation cephalosporin.
1196
Q0599:Drug of choice for syphilis.
1197
Benzathine penicillin G.
1198
Q0600:Drug of choice for meningococcal infection. Drug of choice for history of recurrent UTIs.
1199
TMP-SMX.
1200
Q0601:Drug of choice for Pneumocystis carinii pneumonia.
1201
TMP-SMX (drug of choice); aerosolized pentamindine
1202
Q0602:Viral adsorption and penetration into the cell is blocked by ---------.
1203
Gama-globulins (non-specific).
1204
Q0603:Uncoating of the virus after its penetration into the cell is blocked by --------.
1205
Amantadine (influenza A).
1206
Q0604:Antiviral chemotherapy: Early viral protein synthesis is blocked by --------.
1207
Fomivirsen (CMV).
1208
Q0605:Antiviral chemotherapy: Viral nuclei acid synthesis is blocked by --------.
1209
Purine; pyrimidine analogs; reverse transcriptase inhibitors.
1210
Q0606:Late viral protein synthesis and processing is blocked by --------.
1211
Methimazole (variola); protease inhibitors.
1212
Q0607:Antiviral chemotherapy: Packaging and assembly of new viron is blocked by --------.
1213
Rifampin (vaccinia).
1214
Q0608:Mechanism of action of Amantadine.
1215
Blocks viral penetration/uncoating; may buffer pH of endosome. Also causes the release of dopamine from intact nerve terminals. "Amantadine blocks influenza A and rubellA and causes problems with the cerebellA."
1216
Q0609:Clinical uses of Amantadine.
1217
Prophylaxis for influenza A; Parkinson's disease.
1218
Q0610:Symptoms of Amantadine toxicity.
1219
Ataxia; dizziness; slurred speech. (Rimantidine is a derivative with fewer CNS side effects.) "Amantadine blocks influenza A and rubellA and causes problems with the cerebellA."
1220
Q0611:Mechanism of action of Zanamivir.
1221
Inhibits influenza neuraminidase.
1222
Q0612:Clinical use of Zanamivir.
1223
Both influenza A and B.
1224
Q0613:Mechanism of action of Ribavirin.
1225
Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase.
1226
Q0614:Clinical use of Ribavirin.
1227
RSV (respiratory syncytial virus).
1228
Q0615:Symptoms of Ribavirin toxicity.
1229
Hemolytic anemia. Severe teratogen.
1230
Q0616:Mechanism of aciton of Acyclovir.
1231
Perferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase.
1232
Q0617:Clinical use of Acyclovir.
1233
HSV; VZV; EBV. Mucocutaneous and genital herpes lesions. Prophylaxis in immunocompromised patients.
1234
Q0618:Symptoms of Acyclovir toxicity.
1235
Delirium; tremor; nephrotoxicity.
1236
Q0619:Mechanism of action of Ganciclovir.
1237
Phosphorlation by viral kinase; perferentially inhibits CMV DNA polymerase.
1238
Q0620:Clinical use of Ganciclovir.
1239
CMV; especially in immunocompromised patients.
1240
Q0621:Symptoms of Ganciclovir toxicity.
1241
Leukopenia; neutropenia; thrombocytopenia; renal toxicity. More toxic to host enzymes than acyclovir.
1242
Q0622:Mechanism of action of Foscarnet.
1243
Viral DNA polymerase inhibitor that binds to the pyrophophate binding site of the enzyme. Does not require activation by viral kinase. "FOScarnet = pyroFOSphate analog."
1244
Q0623:Clinical use of Foscarnet.
1245
CMV retinitis in immunocompromised patients when ganciclovir fails.
1246
Q0624:Foscarnet toxicity.
1247
Nephrotoxicity.
1248
Q0625:Saquinavir; ritonavir; indinavir; nelfinavir; amprenavir are example of this type of anti-HIV drug.
1249
Protease inhibitor.
1250
Q0626:Mechanism of action of protease inhibitors.
1251
Inhibit assembly of new virus by blocking protease enzyme.
1252
Q0627:Symptoms of protease inhibitor toxicity.
1253
GI intolerance (nausea; diarrhea); hyperglycemia; lipid abnormalities; thrombocytopenia (indinavir).
1254
Q0628:Zidovudine (AZT); didanosine (ddI); zalcitabine (ddC); stavudine (d4T); lamivudine (3TC); and abacavir are examples of --------- reverse transcriptase inhibitors.
1255
Nucleoside.
1256
Q0629:Nevirapine; delavirdine; and efavirenz are examples of --------- reverse transcriptase inhibitors.
1257
Non-nucleoside.
1258
Q0630:Mechanism of action of reverse transcriptase inhibitors.
1259
Preferentially inhibit reverse transcriptase of HIV; prevent incorporation of viral genome into host DNA.
1260
Q0631:Symptoms of reverse transcriptase inhibitor toxicity.
1261
Bone marrow supression (neutropenia; anemia); periphral neuropathy; lactic acidosis (nucleosides); rash (nonnucleosides); megaloblastic anemia (AZT).
1262
Q0632:Highly active antiretroviral therapy (HAART) generally entails combination therapy with ---------- and ----------.
1263
Protease inhibitors; reverse transcriptase inhibitors.
1264
Q0633:When should HIV therapy be initiated?
1265
When patients have low CD4 counts (<500 cells/mm3) or high viral load.
1266
Q0634:Mechanism of action of Interferons.
1267
Glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis.
1268
Q0635:Clinical use of Interferons.
1269
Chronic hepatitis B and C; Kaposi's sarcoma.
1270
Q0636:Symptoms of Interferon toxicity.
1271
Neutropenia.
1272
Q0637:protease inhibitors name them
1273
never (NAVIR) tease a pro-tease inhibitor. All end in "navir"
1274
Q0638:protease inhibitor MOA
1275
inhibits assembly of new virus by inhibiting protease in progeny virus
1276
Q0639:protease inhibitor toxicity
1277
GI intolerance (nausea; diarhea); hyperglycemia; lipodystrophy; thrombocytopenia (indinavir) metabolic syndrome
1278
Q0640:reverse transcriptase inhibitors
1279
nucleoside: zidoVUDINE (AZT); staVUDINE (d4T); lamiVUDINE; abacavir; zalcitabine (ddC); didanosine (3TC). Non-nucleosides: Never deliver nucleosides. Nevirapine; efavirenz; delavirdine
1280
Q0641:reverse transcriptase inhibitors MOA
1281
preferentially inhibits HIV reverse transcriptase. Prevents incorporation of viral genome into host DNA
1282
Q0642:reverse transcriptase toxicity
1283
BM supression (neutropenia; anemia); peripheral neuropathy; LACTIC ACIDOSIS (nucleosides); rash (non nucleosides); megaloblastic anemia (didovudine
1284
Q0643:reverse transcriptase inhib clinical use
1285
HAART. Combination tx w/ protease inhibitors and reverse transcriptase inhibitors. Started when pts have CD4<500 or high viral load. AZT used in preg to reduce transmission risk
1286
Q0644:interferons mechanism
1287
block various stages of viral RNA and DNA syn. Induces ribonuclease that degrades viral mRNA.
1288
Q0645:interferon clinical use
1289
IFN alpha. Chronic hepatitis B and C; Kaposi sarcoma. IFN beta - MS. IFN gamma - NADPH oxiodase deficiency
1290
Q0646:interferon toxicity
1291
neutropenia; depression
1292
Q0647:pleconaril MOA
1293
prevents attachment of poliovirus to cell
1294
Q0648:Sulfamethoxazole (SMX);sulfisoxizole;triple sulfas;sulfadiazine
1295
MECH: bacteriostatic; inhibits dihydropterate synthase which bac need to make folate;USE: Gm+; Gm-; Nocardia; Chlamydia; PCP; UTIs;TOX;Cystalluria (tubulo-interstitial nephritis);hypersensitivity;hemolytic anemia (G6PD deficiency);Kernicterus;drug potentiation (warfarin; displaces other drugs from albumin)
1296
Q0649:Trimethoprim (TMP)
1297
MECH: bacteriostatic; inhibits bac dihydrofolate reductase interfering with folate production. Folate is needed for nucleic acids; cell growth;USE: With sulfas; Gm-s are resistant;TOX: folate deficiency megaloblastic anemia; leukopenia; granulocytopenia (reversed with folinic acid - bac can't use)
1298
Q0650:Co-Trimoxazole;Bactrim
1299
MECH: inhibits two sequential steps of folate production in bac;USE: UTI (recurrent/chronic); PCP; Shigella; Salmonella; gonococcal urethritis; oropharyngeal gonorrhea;TOX: derm; GI; heme (megaloblastic anemia; leukopenia; thrombocytopenia - reversed by folinic acid); HIV druginduced fever; drug interactions (warfarin)
1300
Q0651:Penicillin G
1301
IV form;MECH;1. Bind penicillin-binding proteins;2. Block transpeptidase cross-linking of cell wall;3. Activate autolytic enzymes;USE: bateriocidal for gm+ cocci (esp. pneumococcus); gm+ rods (listeria); gm- cocci (gonococcus); spirochetes (syphillis);TOX: Hypersensitivity rxn (sometimes causing hemolytic anemia via haptens associated with RBC); diarrhea (imbalance of gut flora)
1302
Q0652:Penicillin V
1303
Oral form;MECH;1. Bind penicillin-binding proteins;2. Block transpeptidase cross-linking of cell wall;3. Activate autolytic enzymes;USE: bateriocidal for gm+ cocci (esp. pneumococcus); gm+ rods (listeria); gm- cocci (gonococcus); spirochetes (syphillis);TOX: Hypersensitivity rxn (sometimes causing hemolytic anemia via haptens associated with RBC); diarrhea (imbalance of gut flora)
1304
Q0653:Methicillin
1305
Penicillinase-resistant penicillin;MECH;1. Bind penicillinbinding proteins;2. Block transpeptidase cross-linking of cell wall;3. Activate autolytic enzymes;USE: S. aureus (except MRSA);TOX: Hypersensitivity rxn; *interstitial nephritis*
1306
Q0654:Nafcillin
1307
Penicillinase-resistant penicillin;MECH;1. Bind penicillinbinding proteins;2. Block transpeptidase cross-linking of cell wall;3. Activate autolytic enzymes;USE: S. aureus (except MRSA);TOX: Hypersensitivity rxn
1308
Q0655:Oxacillin
1309
1310
Q0656:Cloxacillin; dicloxacillin
1311
1312
Q0657:Ampicillin
1313
Aminopenicillin;MECH;1. Bind penicillin-binding proteins;2. Block transpeptidase cross-linking of cell wall;3. Activate autolytic enzymes;USE: penicillin + more gm- enterobac;H. flu;E. coli;Listeria;Proteus;Salmonella;*combine with beta lactamase inhibitors (clavulanic acid) to extend;TOX: Hypersensitivity rxn; rash; pseudomembranous colitis
1314
Q0658:Amoxicillin
1315
Aminopenicillin (more orally bioavailable than Amp);MECH;1. Bind penicillin-binding proteins;2. Block transpeptidase cross-linking of cell wall;3. Activate autolytic enzymes;USE: penicillin + more gm- enterobac;H. flu;E. coli;Listeria;Proteus;Salmonella;*combine with beta lactamase inhibitors (clavulanic acid) to extend;TOX: Hypersensitivity rxn; rash; pseudomembranous colitis
1316
Q0659:Clavulanic acid;Sulbactam;Tazobactam
1317
beta -lactamase inhibitors;-Competitive inhibitor;-Combine with penicillinase-sensitive penicillins
1318
Q0660:Ticarcillin
1319
Anti-pseudomonal;MECH;1. Bind penicillin-binding proteins;2. Block transpeptidase cross-linking of cell wall;3. Activate autolytic enzymes;USE: Pseudomonas aeruginosa & gm- rods (H. flu; enterobactor; E. coli; Proteus);*combine with beta -lactamase inhibitors (clavulanic acid) to extend to Klebsiella;TOX: Hypersensitivity rxn
1320
Q0661:Carbenicillin
1321
1322
Q0662:Piperacillin
1323
1324
Q0663:Cefazolin
1325
1st Gen Cephalosporin w/ bone penetration;MECH: beta lactam; inhibits cell wall synthesis (like penicillins);USE: gm+ cocci &;Proteus;E. coli;Klebsiella;TOX: Hypersensitivity reactions; disulfiram-like rxn
1326
Q0664:Cephalexin
1327
1st Gen Cephalosporin w/oral admin;MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm+ cocci &;Proteus;E. coli;Klebsiella;TOX: Hypersensitivity reactions; disulfiram-like rxn
1328
Q0665:Cefotoxitin
1329
2nd Gen Cephalosporin ;MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm+ cocci & Bacteroides fragilis;H. flu;Enterobactor;Neisseria;Proteus;E. coli;Klebsiella;Serratia;TOX: Hypersensitivity reactions; disulfiram-like rxn
1330
Q0666:Cefaclor
1331
2nd Gen Cephalosporin (oral);MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm+ cocci &;H. flu;Enterobactor;Neisseria;Proteus;E. coli;Klebsiella;Serratia;TOX: Hypersensitivity reactions; disulfiram-like rxn; *serum sickness*
1332
Q0667:Cefuroxime
1333
2nd Gen Cephalosporin (oral);MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm+ cocci &;H. flu;Enterobactor;Neisseria;Proteus;E. coli;Klebsiella;Serratia;TOX: Hypersensitivity reactions; disulfiram-like rxn
1334
Q0668:Ceftriaxone
1335
3rd Gen Cephalosporin w/ long t1/2 and good CSF penetration;MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm- HEN PEcKS +; esp. Neisseria gonorrhea;TOX: Hypersensitivity reactions; disulfiram-like rxn
1336
Q0669:Cefotaxime
1337
3rd Gen Cephalosporin w/ good CSF penetration;MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm- HEN PEcKS +;TOX: Hypersensitivity reactions; disulfiram-like rxn
1338
Q0670:Ceftazidime
1339
3rd Gen Cephalosporin ;MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm- HEN PEcKS +; esp. P. aeruginosa;TOX: Hypersensitivity reactions; disulfiramlike rxn
1340
Q0671:Cefepime
1341
4th Gen Cephalosporin w/ good CSF penetration;MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm+ & P. aeruginosa; E. coli; Klebsiella; Proteus;TOX: Hypersensitivity reactions; disulfiram-like rxn
1342
Q0672:Aztreonam
1343
Monobactam;MECH: Inhibits cell wall synthesis; resistant to beta -lactamase;USE: Gm- rods: Klebsiella; Pseudomonas; Serratia;*No activity against gm+ or anaerobes;TOX: usually none
1344
Q0673:Imipenam/cilastatin
1345
Carbapenam;MECH: Inhibits cell wall synthesis; resistant to beta -lactamase;*cilastatin protects imapenam from cleavage which creates a nephrotoxic metabolite;USE: very broad spectrum: gm+ cocci; gm- rods; anaerobes; esp. Enterobacter;TOX: GI; rash; seizures (at high plasma levels)
1346
Q0674:Vancomycin
1347
MECH: bactericidal; inhibits cell wall formation by bindin Dala D-ala portion of cell wall precursors;USE: gm+ MDR organisms - S. aureus; C. diff;TOX: Fever; chills; phlebitis; red man syndrome (fast infusion); nephrotox; ototox
1348
Q0675:Tetracycline
1349
MECH: Bacteriostatic; binds 30S and prevents aminoacyltRNA attachment to inhibit protein synthesis;USE: V. cholera; Acne; Chlamydia; Ureaplasma; Mycoplasma pneumo; Tularemia; H. pylori; Borrelia burdorferi; Rickettsia;TOX: GI distress; binds calcifying tissue teeth discoloration & disrupted growth; photosensitivity;Contraindicated in preg and renal failure; don't take with milk
1350
Q0676:Doxycycline
1351
MECH: Bacteriostatic; binds 30S and prevents aminoacyltRNA attachment to inhibit protein synthesis;USE: V. cholera; Acne; Chlamydia; Ureaplasma; Mycoplasma pneumo; Tularemia; H. pylori; Borrelia burdorferi; Rickettsia;TOX: GI distress; binds calcifying tissue teeth discoloration & disrupted growth; photosensitivity;*Can be used in pts with renal failure
1352
Q0677:Demeclocycline
1353
MECH: Bacteriostatic; binds 30S and prevents aminoacyltRNA attachment to inhibit protein synthesis; *antagonized ADH;USE: SIADH; V. cholera; Acne; Chlamydia; Ureaplasma; Mycoplasma pneumo; Tularemia; H. pylori; Borrelia burdorferi; Rickettsia;TOX: GI distress; binds calcifying tissue teeth discoloration & disrupted growth; photosensitivity;Contraindicated in preg and renal failure; don't take with milk
1354
Q0678:Minocycline
1355
MECH: Bacteriostatic; binds 30S and prevents aminoacyltRNA attachment to inhibit protein synthesis;USE: V. cholera; Acne; Chlamydia; Ureaplasma; Mycoplasma pneumo; Tularemia; H. pylori; Borrelia burdorferi; Rickettsia; *can cross BBB to eradicate carrier state;TOX: GI distress; binds calcifying tissue teeth discoloration & disrupted growth; photosensitivity; *vestibular problems;Contraindicated in preg and renal failure; don't take with milk
1356
Q0679:Gentamicin
1357
MECH: bactericidal; binds 30S inhibiting formation of initiation complex and causing mRNA misreading. Requires O2 for uptake;USE: only aerobic; gm- rods;TOX: Nephrotox (dose-related); Ototox; teratogen
1358
Q0680:Neomycin
1359
Topical;MECH: bactericidal; binds 30S inhibiting formation of initiation complex and causing mRNA misreading. Requires O2 for uptake;USE: only aerobic; gm- rods;TOX: Nephrotox (dose-related); Ototox; teratogen
1360
Q0681:Amikacin
1361
1362
Q0682:Tobramycin
1363
1364
Q0683:Streptomycin
1365
1366
Q0684:Erythromycin
1367
MECH: binds 50S inhibiting translocation step;USE: same as PenG (good for pts with PEN allergies); URIs; pneumonias; STDs; Mycoplasma; Legionella; Chlamydia; Neisseria;TOX: GI; acute cholestatic hepatitis; eosinophila; skin rash; metabolized in liver and interferes with warfarin; theophyline leading to accumulation
1368
Q0685:Clarithromycin
1369
MECH: binds 50S inhibiting translocation step;USE: same as PenG (good for pts with PEN allergies); URIs; pneumonias; STDs; Mycoplasma; Legionella; Chlamydia; Neisseria;TOX: GI; acute cholestatic hepatitis; eosinophila; skin rash; metabolized in liver and interferes with warfarin; theophyline leading to accumulation
1370
Q0686:Azithromycin
1371
MECH: binds 50S inhibiting translocation step;USE: same as PenG (good for pts with PEN allergies); URIs; pneumonias; STDs; Mycoplasma; Legionella; Chlamydia; Neisseria; H. flu; Moraxella; MAI;TOX: GI; acute cholestatic hepatitis; eosinophila; skin rash; metabolized in liver and interferes with warfarin; theophyline leading to accumulation
1372
Q0687:Chloramphenicol
1373
MECH: bacteriostatic; inhibits 50S peptidyltransferase;USE: Broad spectrum; but nasty toxicities limit use. Enters CNS readily: H. flu; N. meningitidis; S. pneumo;TOX: hemolytic anemis (G6PD deficiency); aplastic anemia; gray baby syndrome (UDP-glucuronyl transferase deficiency in newborn)
1374
Q0688:Clindamycin
1375
MECH: blocks peptide bond formation at 50S;USE: Anaerobes above the diaphragm: B. frag; C. perf;TOX: pseudomembranous colitis; diarrhea; fever
1376
Q0689:-floxacin;Cipro-; moxi-; gati-; nor-; o-; spar-;
1377
MECH: bactericidal; inhibit DNA gyrase DNA cleavage;USE;- gm- rods of GI;Klebsiella;Enterobacter;E. coli;Proteus;Serratia;Shigella;- gm- rods of urinary tract;KEEPSS + P. aeruginosa;- Resistant respiratory infections: pneumococcus;- Neisseria;TOX: GI; CNS (HA; N/V; dizziness); skin rash/photosensitivity;*Tendonitis/rupture in adults; cramps and myalgias in kids
1378
Q0690:Isoniazid
1379
MECH: inhibits synthesis of mycolic acids;USE: Mycobacterium Tuberculosis;TOX: Neurotox (peripheral neuritis; B6/pyridoxine can prevent); hepatotox; hemolysis (G6PD deficient); SLE-like syndrome
1380
Q0691:Rifampin
1381
MECH: inhibits DNA dependent RNA polyerase;USE: Mycobacterium Tuberculosis; M. leprae; prophylaxis of meningococcus and H. flu contacts;TOX: minor; drug interactions (increased P450); rapid resistance if used alone
1382
Q0692:Pyrazinamide
1383
USE: Mycobacterium Tuberculosis
1384
Q0693:Ethambutol
1385
USE: Mycobacterium Tuberculosis
1386
Q0694:Dapsone
1387
USE: M. leprae
1388
Q0695:Amphotericin B
1389
Polyene antifungal;MECH: binds ergosterol which disrupts fungal membrane leakage;USE: wide spectrum for systemic infections - Blasto; Histo; Cocci; Crypto; Aspergillus; Mucor; Candida;*intrathecally for meningitis (doesn't cross BBB);TOX: highly toxic - fever/chills; hypotension; nephrotox (hydration reduces); arrhythmias; anemia; phlebitis
1390
Q0696:Nystatin
1391
Polyene antifungal;MECH: binds ergosterol which disrupts fungal membrane leakage;USE: Too toxic for systemic use oral thrush; diaper rash; vaginal candidiasis;TOX: same as amphotericin
1392
Q0697:Azoles;Floconazole; ketoconazole; itraconazle; voriconazole
1393
MECH: Inhibits ergosterol synthesis disrupting membrane (don't use with ampho);USE: Systemic mycoses - ;Flucon for crypto;Keto for blasto; cocci; histo; candida;TOX: Hormone synthesis inhibition endocrine abnormalities; liver dysfxn (inhibits cytP-450); fever; chills
1394
Q0698:Flucytosine
1395
MECH: inhibits DNA synthesis;USE: systemic candida; crypto;*resistance develops - use with ampho;TOX: N/V; dairrhea; bone marrow suppression; hepatotox
1396
Q0699:Caspofungin
1397
MECH: inhibits cell wall synthesis;USE: invasive aspergilloss;TOX: GI; flushing
1398
Q0700:Terbinafine
1399
MECH: inhibits fungal enzyme squalene epoxidase;USE: dermatophytoses
1400
Q0701:Griseofulvin
1401
MECH: interferes with microtubules disrupts mitosis;USE: dermatophytosis - oral treatment of superficial infxns;TOX: teratogenic; carcinogenic; HA; increased P-450 and warfarin metabolism
1402
Q0702:Metronidazole
1403
MECH: nitro group serves as an electron-acceptor; forming reduced cytotoxic compounds that bind proteins and DNA cell death;USE;anaerobic protazoa: E. histolytica; Giardia; Trichomonas;anaerobic bac: Bacteroides; C. difficile; Gardnerella;TOX: GI; metallic taste; oral yeast infection; disulfiram-like effect; neurotox (rarely)
1404
Q0703:Primaquine
1405
MECH: not understood - oxidants kill schizonts;USE: P. vivax and P. ovale (liver stage);TOX: Hemolytic anemia (G6PD deficient)
1406
Q0704:Chloraquine
1407
MECH: inhibits schizont's ability to break down heme build up; also kills RBC; alkalinization of food vacuole; decreased DNA synthesis;USE: Plasmodium sporozites in the blood;TOX: GI; pruritis; HA
1408
Q0705:Quinine
1409
MECH: effects DNA synthesis;USE: chloraquine-resistant Plasmodium;TOX: cinchonism - N/V; tinnitus; vertigo; hemolytic anemia
1410
Q0706:Mefloquine
1411
MECH: effects DNA synthesis;USE: choraquine-resistant Plasmodium;TOX: cinchonism - N/V; tinnitus; vertigo; disorientaiton
1412
Q0707:Pyrimethamine
1413
MECH: inhibits plasmodial dihydrofolate reductase block of DNA synthesis;USE: sporonticide; P. falciparum; with sulfonamide treats P. malariae and Toxoplasma gondii
1414
Q0708:Melarsoprol
1415
MECH: reacts with enzymes;USE: african sleeping sickness trypanosoma brucei;TOX: CNS; hypersensitivity; GI
1416
Q0709:Nifurtimox
1417
MECH: oxygen radicals;USE: Trypanosoma cruzi (American);TOX: hypersensitivity; GI
1418
Q0710:Stibugluconate
1419
USE: Leishmania
1420
Q0711:Albendazole; Mebendazole; Thiabendazole
1421
MECH: inhibits microtubules paralysis passing of worms in stool;USE: intestinal nematodes;Ancyclostoma (hookworm);Ascaris (roundworm);Enterobius;Strongyloides;Trichinella;TOX: GI; teratogenic
1422
Q0712:Pyrantel pomoate
1423
MECH: depolarizing neuromuscular blocking agent;USE;Ancyclostoma (hookworm);Ascaris (roundworm);Enterobius;TOX: N/V; HA; rash
1424
Q0713:Diethylcarbamazine
1425
MECH: increased phagocytosis of fillaria;USE;Wuchereria bancrofti (elephantitis);Loa loa (skin swelling);Onchocerca volvulus (river blindness);TOX: reaction caused by death of parasites
1426
Q0714:Ivermectin
1427
MECH: targets GABA paralysis;USE: Onchocerca volvulus (river blindness);TOX: contraindicated with other GABA agonists
1428
Q0715:Praziquantel
1429
MECH: increased calcium permeability paralysis;USE;Trematodes - Schistosoma; Clonorchis; Paragonimus westermani;Cestodes - Taenia; Echinococcus
1430
Q0716:Niclosamide
1431
MECH: inhibits ADP phosporylation death of scolex (head);USE: Cestodes - Taenia; Echinococcus
1432
Q0717:Amantadine
1433
MECH: Blocks viral penetration/uncoating (M2); causes release of DA;USE: influenza A prophylaxis and treatment; Parkinson's dz;TOX: cerebellar (ataxia; dizziness; slurred speech)
1434
Q0718:Rimantidine
1435
MECH: Blocks viral penetration/uncoating (M2);USE: influenza A prophylaxis and treatment;TOX: doesn't cross BBB (fewer side fx than amantadine)
1436
Q0719:Ribavarin
1437
MECH: inhibits viral mRNA synthesis ;USE: RSV; HepC; Influenza A & B;TOX: hemolytic anemia; teratogen
1438
Q0720:Acyclovir
1439
MECH: preferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase;USE: HSV (mucocutaneous and genital lesions); VZV; EBV; prophylaxis in immunocompromised;TOX: delirium; tremor; nephrotox (in dehydrated);RESISTANCE: lack of thymidine kinase
1440
Q0721:Gancyclovir
1441
MECH: preferentially inhibits CMV DNA polymerase when phosphorylated by viral thymidine kinase;USE: CMV; esp. in immunocompromised;TOX: leukopenia; neutropenia; thrombocytopenia; delirium; tremor; nephrotox ;RESISTANCE: lack of thymidine kinase or mutated DNA pol
1442
Q0722:Foscarnet
1443
MECH: Binds pyrophosphate site of viral DNA polymerase causing inhibition;USE: CMV retinitis in immunocompromised after gancyclovir failure (IV only);TOX: nephrotox;RESISTANCE: mutated DNA pol (does not require kinase activation)
1444
Q0723:Zidovudine (AZT);didanosine (ddI);zalcitabine (ddC);stavudne(d4T);lamivudine (3TC);abacavir
1445
Reverse transcriptase inhibitors - nucleosides;MECH: inhibit RT; prevent viral incorporation;USE: HIV with HAART; reduce maternal-to-infant transmission;TOX: bone marrow suppression; peripheral neuropathy; lactic acidosis; megaloblastic anemia(AZT)
1446
Q0724:Nevirapine;efavirenz;delavirdine
1447
Reverse transcriptase inhibitors - non-nucleosides;MECH: inhibit RT; prevent viral incorporation;USE: HIV with HAART; reduce maternal-to-infant transmission;TOX: bone marrow suppression; rash; elev liver enzymes
1448
Q0725:Saquinavir;ritonavir;indinavir;nelfinavir
1449
Protease inhibitors;MECH: block protease to inhibit assembly of new virions;USE: HIV with HAART;TOX: dyslipidemia; insulin resistance/hyperglycemia; lipodystrophy
1450
Q0726:Enfuviritide
1451
MECH: binds gp41 preventing HIV fusion with target cell;USE: salvage regimen
1452
Q0727:Interferons (alpha; beta; gamma)
1453
MECH: glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis; induce ribunuclease to degrade viral mRNA;USE;IFNalpha - chronic hepB and hepC; karposi's saroma;IFNbeta - MS;IFN NADPH oxidase deficiency;TOX: Neutropenia
1454
Q0728:Mechanism of action of the anti-fungal therapy polyenes.
1455
Form artificial pores in the cytoplasmic membrane.
1456
Q0729:Mechanism of action of the anti-fungal therapies terbinafine and azoles.
1457
Terbinafine blocks the conversion of squalene to lanosterol. Azoles block the conversion of lanosterol to ergosterol.
1458
Q0730:Mechanism of action of the anti-fungal therapy flucytosine.
1459
Inhibits DNA synthesis by conversion to fluorouracil; which competes with uracil.
1460
Q0731:Mechanism of action of the anti-fungal therapy griseofulvin.
1461
Disrupts microtubles. Deposits in keratin-containing tissues.
1462
Q0732:Mechanism of action of Amphotericin B.
1463
Binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes and disrupt homeostasis. "Amphotericin 'tears' holes in the fungal membrane by forming pores."
1464
Q0733:Clinical uses of Amphotericin B.
1465
Used for a wide spectrum of sytemic mycoses. Cryptococcus; Blastomyces; Coccidioides; Aspergillus; Histoplasma; Candida; Mucor (systemic mycoses). Intrathecally for fungal meningitis; does not cross blood-brain barrier.
1466
Q0734:Symptoms of Amphotericin B toxicity.
1467
Fever/chills ("shake and bake"); hypotension; nephrotoxicity; arrhythmias ("amphoterrible").
1468
Q0735:Mechanism of action of Nystatin.
1469
Binds to ergosterol; disrupting fungal membranes.
1470
Q0736:Clinical use of Nystatin.
1471
Swish and swallow for oral candidiasis (thrush). Topical for diaper rash or vaginal candidiasis.
1472
Q0737:Mechanism of action for fluconazole; ketoconazole; clotrimazole; miconazole; itraconazole; voriconazole.
1473
Inhibits fungal steroid (ergosterol) synthesis. Blocks: lanosterol -> ergosterol
1474
Q0738:Clinical uses of fluconazole; ketoconazole; clotrimazole; miconazole; itraconazole; voriconazole.
1475
Systemic mycoses. Fluconazole for cryptococcal meningitis in AIDS patients and candidal infections of all types (i.e; yeast infections). Ketoconazole for Blastomyces; coccidioides; Histoplasma; Candida albicans; hypercortisolism.
1476
Q0739:Symptoms of fluconazole; ketoconazole; clotrimazole; miconazole; itraconazole; voriconazole toxicity.
1477
Hormone synthesis inhibition (gynecomastia); liver dysfunction (inhibits cytochrome P-450); fever; chills.
1478
Q0740:Mechanism of action of Flucytosine.
1479
Inhibits DNA synthesis byconversion to fluorouracil; which competes with uracil.
1480
Q0741:Clinical uses of Flucytosine.
1481
Used in sytemic fungal infections (e.g. Candida; Cryptococcus).
1482
Q0742:Flucytosine toxicity.
1483
Nausea; vomitting; diarrhea; bone marrow suppression.
1484
Q0743:Mechanism of action for Caspofungin.
1485
Inhibits cell wall synthesis.
1486
Q0744:Clinical use of Caspofungin.
1487
Invasive aepergillosis.
1488
Q0745:Symptoms of Caspofungin toxicity.
1489
GI upset; flushing.
1490
Q0746:Mechanism of action of Terbinafine.
1491
Inhibits the fungal enzyme squalene epoxidase. Inhibits squalene -> lanosterol
1492
Q0747:Clinical use of Terbinafine.
1493
Used to treat dermatophytoses (especially onychomycosis).
1494
Q0748:Mechanism of action of Griseofulvin.
1495
Interfers with microtubule function; disrupts mitosis. Deposits in keratin-contianing tissues (e.g. nails).
1496
Q0749:Clinical use of Griseofulvin.
1497
Oral treatment of superficial infections; inhibits growth of dermatophytes (tinea; ringworm).
1498
Q0750:Symptoms of Griseofulvin toxicity.
1499
Teratogenic; carcinogenic; confusion; headaches; increase warfarin metabolism.
1500
Q0751:opioid receptors that may be involved in altering reactivity to pain are located in these regions of the brain?
1501
basal ganglia; hypothalamus; limbic structures; and cerebral cortex
1502
Q0752:what are the types of opioid receptors?
1503
mu; delta; and kappa
1504
Q0753:this opioid receptor plays a major role in the respiratory depressant actions of opioids?
1505
Mu receptor
1506
Q0754:activation of this receptor is involved in the sedative actions of opioids?
1507
Kappa receptor
1508
Q0755:all 3 major opioid receptors are coupled to their effector by these things?
1509
G proteins and activate phospholipase C or inhibit adenylyl cyclase
1510
Q0756:at the postsynaptic level activation of the opioid receptors causes this to occur?
1511
opening of K+ channels to cause hyperpolarization (IPSP)
1512
Q0757:at the presynaptic evel opioid receptor activation can close these ion channels?
1513
voltage gated Ca2+ channels to inhibit neurotransmitter release
1514
Q0758:examples of strong opioids?
1515
morphine; methadone; meperidine; fentanyl; levorphanol; and heroin
1516
Q0759:these opioid are partial agonists and have mild to moderate analgesic efficacy?
1517
Codeine; hydrocodone and oxycodone
1518
Q0760:this agent is a very weak opioid agonist?
1519
Propoxyphene
1520
Q0761:pupillary constriction is characteristic effect of all opioids except this one; which has a muscarinic blocking action?
1521
Meperidine
1522
Q0762:this condition includes rhinorrhea; lacrimation chills; gooseflesh; muscle aches; diarrhea; yawning; anxiety and hostility?
1523
abstinenece syndrome
1524
Q0763:which opioids are useful cough suppressants?
1525
Codeine and detromethorphan
1526
Q0764:opioids used to treat diarrhea?
1527
loperamide and diphenoxylate
1528
Q0765:this opioid may be useful in acute pulmonary edema because of its hemodynamic actions?
1529
Morphine
1530
Q0766:what is the triad of opioid overdose signs?
1531
pupillary constriction; comatose state; and respiratory depression
1532
Q0767:diagnosis of opioid overdose is confirmed by this action?
1533
IV injection of Naloxone (opioid antagonist)--->prompt signs of recovery
1534
Q0768:concomitant use of certain opioid like meperidine with MAOIs can result in this condition?
1535
hyperpyrexic coma
1536
Q0769:meperidine has also been implicated in serotonin syndrome when used with this antidepressant class?
1537
SSRIs
1538
Q0770:the prolonged activity of Buprenorphine is clinically useful to suppress withdrawal signs in dependency states;how does this property affect Naloxone reversal efforts?
1539
Buprenorphine is resistant to naloxone reversal due to its prolonged activity
1540
Q0771:this drug decreases the craving for Alcohol and is approved for adjunctive use in alcohol dependency programs?
1541
Naltrexone
1542
Q0772:Effects of H1 receptor activation
1543
Increased capillary dilation and permeability (hypotension; edema); bronchoconstriction; activation of nociceptive receptors (pain; pruritus)
1544
Q0773:Effects of H2 receptor activation
1545
Increased gastric acid secretion (ulcers); positive inotropism
1546
Q0774:H1 antagonist drugs
1547
Diphenhydramine; promethazine; chlorpheniramine; meclizine; hydroxyzine; loratadine; fexofenadine
1548
Q0775:Uses of H1 antagonists
1549
Hay fever; rhinitis; urticaria; motion sickness and vertigo (meclizine); nausea in pregnancy
1550
Q0776:Adverse effects of H1 antagonists
1551
M block and sedation; GI distress; allergic reactions.
1552
Q0777:Substances that increase proton pump activity
1553
ACh; gastrin; histamine (H2 receptors)
1554
Q0778:H2 antagonist drugs
1555
Cimetidine; ranitidine
1556
Q0779:MOA of H2 antagonists
1557
Indirectly decrease proton pump activity (histamine increases proton pump activity)
1558
Q0780:Uses of H2 antagonists
1559
Peptic ulcer disease; GERD; Zollinger-Ellison
1560
Q0781:Side effects of H2 antagonists
1561
GI distress; dizziness; sommnolence; Cimetidine: inhibits P450 --> increases effects of quinidine; phenytoin; TCAs; warfarin; also decreases androgens --> gynecomastia
1562
Q0782:Omeprazole
1563
Direct; irreversible proton pump inhibitor. Uses: PUD; GERD; Zollinger-Ellison; H. pylori. Side effects: decreases bioavailability of weak acids (fluoroquinolones; ketoconazole); inhibits P450
1564
Q0783:Misoprostol
1565
PGE1 analog; increases mucus and bicarbinote; decreases HCL secretion. Use: NSAID-induced ulcers.
1566
Q0784:Sulcralfate
1567
Polymerizes in stomach to coat ulcers. Increases healing and decreases ulcer recurrence.
1568
Q0785:Drugs that require acid stomach pH to be absorbed
1569
Azoles; fluoroquinolones; warfarin
1570
Q0786:Drugs used as antiemetics
1571
5HT3 antagonists (ondansetron); DA antagonists (metoclopramide); H1 blockers (diphenhydramine; meclizine); muscarinic blockers (scopolamine)
1572
Q0787:Metabolism of serotonin
1573
5HT is metabolized by MAOa to 5-hydroxyinolacetic acid (marker for carcinoid)
1574
Q0788:Buspirone
1575
Partial 5HT1a agonist used for generalized anxiety disorder
1576
Q0789:Sumatriptan
1577
5HT1d agonist in cerebral vessels; used for migraine
1578
Q0790:Olanzapine
1579
Atypical antipsychotic; 5HT2a receptor antagonist; decreases psychosis
1580
Q0791:Cyproheptadine
1581
5HT2 antagonist used in carcinoid
1582
Q0792:Ondansetron
1583
5HT3 antagonist; used as antiemetic in chemotherapy; radiation and post-op. 5HT3 receptors are found in area postrema
1584
Q0793:Ergonovine
1585
Uterine muscle contraction after placental delivery
1586
Q0794:Ergotamine
1587
Partial 5HT2 and alpha agonist causes vasoconstriction to decrease pulsation in migraine acute attack. Side effect is vasoconstriction (prinzmetal)
1588
Q0795:Prophylaxis of migraine headaches
1589
Propranolol; verapamil; amitriptyline; valproic acid
1590
Q0796:PGE2
1591
Vasodilation in kidneys; increases renal blood flow; increases gastric mucosal blood flow (mucoprotection); activates osteoclasts; fever; pain; maintains ductus arteriosus
1592
Q0797:Prostacyclin (PGI2)
1593
Vasodilation and inhibits platelet aggregation
1594
Q0798:COX1
1595
Constitutive enzyme synthesizes GI PGs and TxA2
1596
Q0799:COX2
1597
Inducible enzyme synthesizes PGs involved in inflammation; fever and pain.
1598
Q0800:Zileuton
1599
Lipoxygenase inhibtor used in asthma
1600
Q0801:Zafirlukast and -lukasts
1601
Leukotriene receptor antagonist used in asthma
1602
Q0802:MOA of aspirin
1603
Nonselective; irreversible COX inhibitor via acetylation of serine near active site
1604
Q0803:Actions of aspirin
1605
Low dose: antiplatelet aggregation (post-MI); moderate dose: analgesia; antipyeresis; hyperuricemia; High dose: antiinflammatory; uricosuria
1606
Q0804:Effects of aspirin on acid-base and electrolytes
1607
Antiinflammatory doses: uncoupling of ETC --> increases respiration --> decreased pCO2 --> resp. alkalosis --> renal compensation via HCO3 excretion --> compensated respiratory alkalosis. Toxic doses: inhibits respiratory center -> decreases respiration --> resp. acidosis plus ETC uncoupling --> metabolic acidosis; decreases ATP; hyperthermia; hypokalemia
1608
Q0805:Side effects of aspirin
1609
Gastritis; ulcers; bleeding; tinnitus; vertigo; decreased hearing; bronchoconstriction; hypersensitivity (asthma; nasal polyps; rhinitis); Reye syndrome; increased bleeding time; renal dysfunction at high doses
1610
Q0806:Aspirin overdose management
1611
Gastric lavage; alkalinization of urine (zero-order kinetics at toxic doses)
1612
Q0807:Celecoxib
1613
Selective COX-2 inhibitor. Antiinflammatory. Increases PT when used with warfarin; prothrombotic. Cross hypersensitivity with sulfonamides. Potential cardiotoxicity resulted in withdrawal of rofecoxib.
1614
Q0808:Acetaminophen
1615
Inhibits COX in CNS only. No antiplatelet activity; not implicated in Reye syndrome; no effects on uric acid; no bonchoconstriction. Metabolized via P450. Hepatotoxic due to reactive metabolite N-acetylbenzoquinonemine; which is inactivated by GSH. Upon GSH depletion; metabolite damages hepatocytes; nausea; vomiting; abdominal pain; centrilobular necrosis. Inducers of P450 enhance toxicity. Management of hepatotoxicity: N-acetylcysteine.
1616
Q0809:Hydroxychloroquine
1617
Used for rheumatoid arthritis. Stabilizes lysosomes and decreases chemotaxis. Side effects: GI distress; visual dysfunction; hemolysis in G6PDH deficiency
1618
Q0810:Methotrexate
1619
Used for rheumatoid arthritis. Cytotoxic to lymphocytes. Side effects: hematotoxicity; mucositis; crystalluria
1620
Q0811:Sulfasalazine
1621
Used for rheumatoid arthritis. Decreases B cell function; possibly inhibits COX. Side effects: GI distress; rash; hemolysis in G6PDH deficiency; drug-induced lupus
1622
Q0812:Glucocorticoids
1623
Used in rheumatoid arthritis. Decrease LTs and platelet activating factor (PAF). Side effects: ACTH suppression; Cushingoid state; osteoporosis; GI distress; glaucoma
1624
Q0813:Gold salts
1625
Used in rheumatoid arthritis. Decreases lysosomal and macrophage functions. Side effects: dermatitis; hematotoxicity; nephrotoxicity
1626
Q0814:Penicillamine
1627
Used in rheumatoid arthritis. Suppresses T cells and circulating rheumatoid factor. Side effects: proteinuria; hematotoxicity; autoimmune disease.
1628
Q0815:Etanercept
1629
Used in rheumatoid arthritis. Binds TNF. Side effects: hypersensitivity; injection site reactions; infections
1630
Q0816:Infliximab
1631
Used in rheumatoid arthritis. Monoclonal antibody to TNF. Side effects: infusion reactions; infections
1632
Q0817:Anakinra
1633
Used in rheumatoid arthritis. IL-1 receptor antagonist. Side effects: infections; injection site reactions
1634
Q0818:Colchicine
1635
Used in acute gout. Binds tubulin --> decreases microtubular polymerization ; decreases LTB4 and leukocyte/granulocyte migration. Side effects: diarrhea; GI pain; hematuria; myelosuppression; neuropathy
1636
Q0819:Allopurinol
1637
Prodrug converted by xanthine osidase into alloxanthine which inhibits the enzyme --> decreases purine metabolism --> decreases uric acid. Side effects: GI distress; neuropathy; rash; vasculitis; stones.
1638
Q0820:Probenecid
1639
Inhibits tubular reabsorption of urate. Interactions: inhibits secretion of acidic drugs (cephalosporins; fluoroquinolones). Side effects: GI distress; rash; nephrotic syndrome; crystallization
1640
Q0821:Glucocorticoid drugs
1641
Cortisol; prednisone; triamcinolone; betamethasone; dexamethasone
1642
Q0822:MOA of glucocorticoids
1643
Inhibits leukocyte migration; phagocytosis and capillary permeability; decreases PGs; LTs; expression of COX2; PAF and interleukins
1644
Q0823:Uses of glucocorticoids
1645
Antiinflammatory and immunosuppressive
1646
Q0824:Side effects of glucocorticoids
1647
Suppression of ACTH --> cortical atrophy; shock if abruptly withdrawn; cushingoid syndrome; hyperglycemia (increased gluconeogenesis); osteoporosis with vertebral fractures; gastric acid secretion (ulcers); Na+ and H2O retention with edema and hypertension; hypokalemic alkalosis; hypocalcemia; inhibits bone growth in children; decreases wound healing (infections); increased sorbitol (glaucoma; cataracts); mental dysfunction.
1648
Q0825:Role of beta agonists in asthma
1649
Selective beta 2 agonists: Relief of acute bronchoconstriction (albuterol; metaproterenol; terbutaline) and prophylaxis of nightime attacks (salmeterol). Side effects include anxiety; tremors and CV toxicity
1650
Q0826:Ipratropium
1651
Muscarinic blocker causes bronchodilation in acute asthma. Safer than beta 2 agonists in patients with cardiovascular disease. DOC in bronchospasm induced by beta -blockers.
1652
Q0827:Theophylline
1653
Inhibits phosphodiesterase --> increases cAMP --> bronchodilation. Also antagonizes adenosine (broncoconstrictor). Narrow therapeutic index. Side effects: nausea; diarrhea; increases HR; arrhythmias. Increased toxicity with erythromycin; cimetidine and fluoroquinolones.
1654
Q0828:Role of glucocorticoids in asthma
1655
Decreases reactivity by decreasing PGs; LTs and Ils; May cause oropharyngeal candidiasis and retarded bon growth with chronic use; low doses prevent desensitization of beta receptors.
1656
Q0829:Zafirlukast; mentelukast
1657
LTD4 antagonists with slow onset. Used prophylactically for antigen; exercise or drug-induced asthma.
1658
Q0830:Zileuton
1659
Selective inhibitor of lypoxygenases --> decreased Ils. Rapid onset; adjunct to steroids.
1660
Q0831:MOA of NSAIDS
1661
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
1662
Q0832:Difference between aspirin and other NSAIDS
1663
Aspirin irreversibly inhibits cyclooxygenase
1664
Q0833:Four main actions of NSAIDS
1665
Anti-inflammatory; analgesia; antipyretic and antiplatelet activity
1666
Q0834:Agent used for closure of patent ductus arteriosus
1667
Indomethacin
1668
Q0835:Aspirin is contraindicated in children with viral infection
1669
Potential for development of Reye's syndrome
1670
Q0836:SE of salicylates
1671
Tinnitus; GI bleeding
1672
Q0837:NSAID also available as an ophthalmic preparation
1673
Diclofenac
1674
Q0838:NSAID available orally; IM and ophthalmically
1675
Ketoralac
1676
Q0839:NSAID that is used for acute condition; such as preop anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
1677
Ketoralac
1678
Q0840:Newer NSAIDs that selectively inhibit COX-2
1679
Celecoxib and rofecoxib
1680
Q0841:COX 2 inhibitors may have reduced risk of
1681
Gastric ulcers and GI Bleeding
1682
Q0842:COX 2 inhibitors should be used cautiously in pts with
1683
Pre-existing cardiac or renal disease
1684
Q0843:Acetaminophen only has
1685
Antipyretic and analgesic activity
1686
Q0844:SE of acetaminophen
1687
Hepatotoxicity
1688
Q0845:Antidote for acetaminophen toxicity
1689
N-acetylcysteine
1690
Q0846:DMARDs are slow acting drugs for
1691
Rheumatic disease
1692
Q0847:MOA of gold salts
1693
Alter activity of macrophages and suppress phagocytic activity of PMNs
1694
Q0848:SE of gold salts
1695
Dermatitis of the mouth aplastic anemia and agranulocytosis
1696
Q0849:Causes bone marrow suppression
1697
Methotrexate
1698
Q0850:SE of penicillamine
1699
Aplastic anemia and renal
1700
Q0851:Interferes with activity of T-lymphocytes
1701
Hydroxychloroquine
1702
Q0852:Anti-malarial drug used in rheumatoid arthritis (RA)
1703
Hydroxychloroquine
1704
Q0853:SE of hydroxychloroquine
1705
Retinal destruction and dermatitis
1706
Q0854:MOA of Leflunomide (newer agent)
1707
Inhibiting Dihydroorotate Dehydrogenase which leads to decreased pyrimidine synthesis
1708
Q0855:Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)
1709
Infliximab and etanercept
1710
Q0856:Anti-rheumatic agent also used for ulcerative colitis
1711
Sulfasalazine
1712
Q0857:NSAIDS used in gout
1713
Indomethacin and phenylbutazone
1714
Q0858:NSAID contraindicated in gout
1715
Aspirin
1716
Q0859:SE of phenylbutazone
1717
Aplastic anemia and agranulocytosis
1718
Q0860:MOA of Colchicine (used in acute gout)
1719
Selective inhibitor of microtubule assembly
1720
Q0861:SE of colchicine
1721
Kidney and liver toxicity
1722
Q0862:Agent used to treat chronic gout by increasing uric acid secretion
1723
Probenecid and sulfinpyrazone
1724
Q0863:Allopurinol treats chronic gout by inhibiting
1725
Xanthine oxidase
1726
Q0864:Disease caused by excess ergot alkaloids
1727
St. Anthony's Fire
1728
Q0865:Endogenous substances commonly interpreted as histamine; serotonin; prostaglandins; and vasoactive peptides
1729
Autocoids
1730
Q0866:Syndrome of hypersecretion of gastric acid and pepsin usually caused by gastrinoma; it is associated with severe peptic ulceration and diarrhea
1731
Zollinger-Ellison Syndrome
1732
Q0867:Drug that causes contraction of the uterus
1733
Oxytocin
1734
Q0868:Distribution of histamine receptors H1; H2; and H3
1735
Smooth muscle; stomach; heart; and mast cells; nerve endings; CNS respectively
1736
Q0869:Prototype antagonist of H1 and H2 receptors
1737
Diphenhydramine and impromidine respectively
1738
Q0870:1st generation antihistamine that is highly sedating
1739
Diphendydramine
1740
Q0871:1st generation antihistamine that is least sedating
1741
Chlorpheniramine or cyclizine
1742
Q0872:2nd generation antihistamines
1743
Fexofenadine; loratadine; and cetirizine
1744
Q0873:Generation of antihistamine that has the most CNS effects
1745
First generation due to being more lipid-soluble
1746
Q0874:Major indication for H1 receptor antagonist
1747
Use in IgE mediated allergic reaction
1748
Q0875:Antihistamine that can be used for anxiety and insomnia and is not addictive
1749
hydroxyzine (Atarax)
1750
Q0876:H1 antagonist used in motion sickness
1751
Dimenhydrinate; meclizine; and other 1st generation
1752
Q0877:Most common side effect of 1st generation antihistamines
1753
Sedation
1754
Q0878:Lethal arrhythmias resulting from concurrent therapy with azole fungals (metabolized by CYP 3A4) and these antihistamines which inhibit the 3A4 iso-enzyme.
1755
Terfenadine and astemizole (have been removed from the market)
1756
Q0879:H2 blocker that causes the most interactions with other drugs
1757
Cimetidine
1758
Q0880:Clinical use for H2 blockers
1759
Acid reflux disease; duodenal ulcer and peptic ulcer disease
1760
Q0881:Receptors for serotonin (5HT-1) are located
1761
Mostly in the brain; and they mediate synaptic inhibition via increased K+ conductance
1762
Q0882:5HT-1d agonist used for migraine headaches
1763
Sumatriptan; naratriptan; and rizatriptan
1764
Q0883:Triptan available in parenteral and nasal formulation
1765
Sumatriptan
1766
Q0884:H1 blocker that is also a serotonin antagonist
1767
Cyproheptadine
1768
Q0885:5HT2 antagonist mediate synaptic excitation in the CNS and smooth muscle contraction
1769
Ketanserin; cyproheptadine; and ergot alkaloids (partial agonist of alpha and serotonin receptors)
1770
Q0886:Agents for reduction of postpartum bleeding
1771
Ergonovine and ergotamine
1772
Q0887:Agents used in treatment of carcinoid tumor
1773
Ketanserin cyproheptadine; and phenoxybenzamine
1774
Q0888:5HT-3 antagonist used in chemotherapeutic induced emesis
1775
Ondansetron; granisetron; dolasetron and alosetron
1776
Q0889:5ht-3 antagonist that has been associated with QRS and QTc prolongation and should not be used in patients with heart disease
1777
Dolasetron
1778
Q0890:DOC of chemo induced nausea and vomiting
1779
Odansetron
1780
Q0891:Drug used in ergot alkaloids overdose; ischemia and gangrene
1781
Nitroprusside
1782
Q0892:Reason ergot alkaloids are contraindicated in pregnancy
1783
Uterine contractions
1784
Q0893:SE of ergot alkaloids
1785
Hallucinations resembling psychosis
1786
Q0894:Ergot alkaloid used as an illicit drug
1787
LSD
1788
Q0895:Dopamine agonist used in hyperprolactinemia
1789
Bromocriptine
1790
Q0896:Peptide causing increased capillary permeability and edema
1791
Bradykinin and histamine
1792
Q0897:Mediator of tissue pain; edema; inactivated by ACE; and may be a contributing factor to the development of angioedema
1793
Bradykinin
1794
Q0898:Drug causing depletion of substance P (vasodilator)
1795
Capsaicin
1796
Q0899:Prostaglandins that cause abortions
1797
Prostaglandin E1 (misoprostol) PGE2; and PGF2alpha
1798
Q0900:Difference between COX 1 and COX 2
1799
COX 1 is found throughout the body and COX 2 is only in inflammatory tissue
1800
Q0901:Drug that selectively inhibits COX 2
1801
Celecoxib; valdecoxib; and rofecoxib
1802
Q0902:Inhibitor of lipoxygenase
1803
Zileuton
1804
Q0903:Major SE of zileuton
1805
Liver toxicity
1806
Q0904:Inhibitor of leukotrienes (LTD4) receptors and used in asthma
1807
Zafirlukast and montelukast
1808
Q0905:Used in pediatrics to maintain patency of ductus arteriosis
1809
PGE1
1810
Q0906:Approved for use in severe pulmonary HTN
1811
PGI2 (epoprostenol)
1812
Q0907:Prostaglandin used in the treatment impotence
1813
Alprostadil
1814
Q0908:Irreversible; nonselective COX inhibitor
1815
Aspirin
1816
Q0909:Class of drugs that reversibly inhibit COX
1817
NSAIDS
1818
Q0910:Primary endogenous substrate for Nitric Oxidase Synthase
1819
Arginine
1820
Q0911:MOA and effect of nitric oxide
1821
Stimulates cGMP which leads to vascular smooth muscle relaxation
1822
Q0912:Long acting beta 2 agonist used in asthma
1823
Salmeterol
1824
Q0913:Muscarinic antagonist used in asthma
1825
Ipratropium
1826
Q0914:MOA action of cromolyn
1827
Mast cell stabilizer
1828
Q0915:Enzyme which theophylline inhibits
1829
Phosphodiesterase
1830
Q0916:Methylxanthine derivative used as a remedy for intermittent claudication
1831
Pentoxifylline
1832
Q0917:Antidote for severe CV toxicity of theophylline
1833
Beta blockers
1834
Q0918:MOA of corticosteroids
1835
inhibit phospholipase A2
1836
Q0919:SE of long term (>5 days) corticosteroid therapy and remedy
1837
Adrenal suppression and weaning slowly; respectively
1838
Q0920:Parathyroid hormone (PTH) acts on these receptors to inc. cAMP in bone and renal tubular cells?
1839
G-protein couples receptors
1840
Q0921:Vit D is a derivative of this compound?
1841
7-dehydrocholesterol
1842
Q0922:the actions of Vit D are mediated through receptors in this location?
1843
nuclear receptors (which regulate gene expression)
1844
Q0923:Bone formation may be increased by the administration of this form of Vit D?
1845
24;25-dihydroxyvitamin D (secalcifediol)
1846
Q0924:Vit D supplements and synthetic derivatives are used in these conditions?
1847
deficiency states such as: chronic renal failure; intestinal osteodystrophy; & nutritional rickets
1848
Q0925:this hormone has been used in conditions in which an acute reduction of serum calcium is needed (eg Paget's disease and hypercalcemia)?
1849
Cacitonin
1850
Q0926:what is the benefit of using salmon calcitonin over human calcitonin?
1851
Salmon Calcitonin has a longer half life and greater potency
1852
Q0927:these drugs can prevent or delay bone loss in postmenopausal women through inhibition of PTHstimulated bone resorption?
1853
Estrogens and SERMS (tamoxifen and Raloxifen)
1854
Q0928:chronic systemic use of these drugs is a common cause of osteoporosis in adults?
1855
Glucocorticoids
1856
Q0929:these hormone are useful in the intermediate term treatment of Hypercalcemia?
1857
Glucocorticoids
1858
Q0930:examples of bisphosphonates?
1859
alendronate; etidronate; pamidronate; and risedronate (ALL END IN -DRONATE)
1860
Q0931:actions of bisphosphonates?
1861
reduce both resorption and formation of bone; affect Vit D produciton; calcium absorption from GI tract; and direct effects of OsteoClasts
1862
Q0932:chronic therapy with this class of drugs can slow the progress of postemenopausal osteoporosis and REDUCES FRACTURES?
1863
Bisphosphonates
1864
Q0933:what is the oral bioavailability of bisphosphonates?
1865
LOW <10% (and food impairs absorption)
1866
Q0934:side effect of bisphosphonates?
1867
Esophageal ulceration (so pts shoudl take with lots of H2O)
1868
Q0935:acute toxicity of this compound (as would occur w/ ingestion of Rat poison) results in GI and Neurologic symptoms?
1869
Fluoride
1870
Q0936:what is seen with CHRONIC Fluoride toxicity (fluorosis)?
1871
Ectopic bone formation and Bony Bumps on Bones (exostoses)
1872
Q0937:antibiotic used to reduce serum calcium and bone resorption in Paget's disease and hypercalcemia?
1873
Plicamycin (mithramycin)
1874
Q0938:what are the serious toxicities of Plicamycin?
1875
thrombocytopenia; hemorrhage; hepatic and renal damage (so not used commonly; mainly restricted to short term treatment of serious hypercalcemia)
1876
Q0939:diuretics that can affect serum calcium levels?
1877
Thiazides and Furosemide (Loop)
1878
Q0940:(5) Parkinsons drugs
1879
BALSA;Bromocriptine;Amantadine;Levodopa;Selegiline;Anti muscarinics
1880
Q0941:Parkinson drug;agonized dopamine receptors
1881
Bromocriptine
1882
Q0942:Parkinson drug;Increases Dopamine;(2)
1883
Amantidine;;L-Dopa
1884
Q0943:Parkinson drug;selectively inhibits MAO-B; thereby increasing availability of DA
1885
Selegiline
1886
Q0944:Parkinson drug;improves cholinergic activity (tremor and rigidity)
1887
Benztropine;(anti-muscarinic)
1888
Q0945:what coverts L-dopa to dopamine in the brain?;AE to periphreal L-dopa/carbidpoa
1889
Carboxylase;;AE;Arrthymias
1890
Q0946:serotonin agonist causing vasoconstriction for Tx of migraine or cluster HA;what specific receptor?;AE
1891
Sumatriptan;receptor: 5HT-1D;AE: Coronary vasospasm
1892
Q0947:AE of Benzodiazepines
1893
Sedation
1894
Q0948:(3) drugs that are first-line for Tonic-Clonic seizures
1895
PVC;Phenytoin;;Valproic Acid;;Carbamazepine
1896
Q0949:(2) drugs that are first-line for Absent seizures
1897
Ethosuximide;;Valproic Acid
1898
Q0950:MOA of Valproic Acid;(3) AE;Aside from Bipolar d/o; what other psych Dx can it be used for?
1899
MOA;Na-channel (and Ca-channel) blocker;AE;Hepatotoxicity;Neural tube defects in fetus;Tremor;(also can be used for Schizophrenia)
1900
Q0951:What are the (4) Tx for Status Epilepticus
1901
Diazepam;;Lorazepam;;Phenytoin;;Phenobarbital
1902
Q0952:DOC for seizures in pregnant women and children
1903
Phenobarbital
1904
Q0953:DOC for Trigeminal neuralgia; Tonic-Clonic seizures; schizophrenia and bipolar disorder;(2) AE;what monthly test should be done to patient?
1905
Carbamazepine;AE;Hepatotoxicity;Aplastic Anemia;monthly test: LFTs
1906
Q0954:(2) epilepsy drugs that can cause Stevens-Johnson syndrome
1907
Ethosuximide;Lamotrigine
1908
Q0955:MOA of Ethosuximide
1909
Blocks T-type Ca-channels
1910
Q0956:epileptic drug that blocks Na channels and inhibits glutamate release from presynaptic neurons;AE (4)
1911
Phenytoin;AE;Gingival hyperplasia;Hirsutism;SLE-like syndrome;Nystagmus and ataxia
1912
Q0957:drug class that facilitates GABA action by increasing the duration of Cl- channel opening;contraindication?
1913
Barbiturates;[barbiDURATes inc DURATion];CI: Porphyria
1914
Q0958:Barbiturate that is used in ansthesia induction
1915
Thiopental
1916
Q0959:drug class that facilitates GABA action by increasing the frequency of Cl- channel opening;use (4)*
1917
Benzodiazepines;use (Dumb ASS);Detoxification;Anxiety;Status epilepticus;Sleep issues (walking; terrors)
1918
Q0960:(3) short-acting Benzos
1919
short TOM thumb;Triazolam;Oxazepam;Midazolam
1920
Q0961:DOC for Huntington's DZ;(3)*
1921
Practice Hunting Trees;Phenothiazines;Haloperidol;Tetrabenazine
1922
Q0962:DOC for Tourette's
1923
Haloperidol
1924
Q0963:beta-blocker used to Tx tremor
1925
Propranolol
1926
Q0964:DOC in Wilson's Dz
1927
Penicillamine
1928
Q0965:(3)* Neuroleptic Antipsychotics that block the D2 receptors;main use?
1929
THC;Thioridazine;;Haloperidol;;Chlorpromazine;use: Schizophrenia
1930
Q0966:AE of Neuroleptics (antipsychotics);for each receptor blocked;1. DA;2. Muscarinic;3. Alpha;4. Histamine
1931
DA: Hyperprolactinemia; gynecomastia;Muscarinic: dry mouth; constipation;Alpha: Hypotension;;Histamine: Sedation
1932
Q0967:Dx;rigidity; myoglobinuria; autonomic instability; hyperpyrexia; recent Tx for schizophrenia;Tx?;(3 possible)
1933
Neuroleptic Malignant syndrome;Tx;1. Bromocriptine;2. Amantidine;3. Dantrolene
1934
Q0968:Dx;strange oral-facial movements; chorea; recent neuroleptic ingestion
1935
Tardive Dyskinesia
1936
Q0969:(3) Atypical Antipsychotics
1937
OLanzapine; CLOZapine; RISPERidone;[its not ATYPICAL for OLd CLOZets to RISPER]
1938
Q0970:MOA of Atypical antipsychotics;which is used to Tx OCD?;which causes Agranulocytosis as an AE?
1939
block Serotonin and Dopamine receptors;OLanzapine OCD;CLOZapine - Agranulocytosis
1940
Q0971:(4)* AE of Lithium;Use?
1941
Lithium;LMNOP;Lithium AE =;Movement (tremor);Nephrogenic DI;hypOthyroidism;Pregnancy problems;Use: Mood stabilizer for Bipolar disorder to block manic events
1942
Q0972:(4)* SSRIs;;AE? (2)
1943
"the CITy PAROt FLU down SERTRAIL";CITalopram;;PAROxetine;;FLUoxetine;;SERTR ALine;AE: Sexual dysfunction and N/V
1944
Q0973:(3) TCAs;MOA;Basic (not toxic) AE (2)
1945
CIA;Clomipramine;Imipramine;Amitriptyline;MOA: block reuptake of NE and Serotonin;AE;Sedation;anticholinergic side effects
1946
Q0974:TCA used for bedwetting
1947
Imipramine
1948
Q0975:TCA used for OCD
1949
Clomipramine
1950
Q0976:Toxicity of TCA;(3)
1951
("Tri-C");Convulsions;;Coma;;Cardiotoxicity
1952
Q0977:(5)* Heterocyclic Antidepressants
1953
"you need BUtane in your VEINs to MURder for a MAP of alcaTRAZ";BUproprion;VENlafaxine;MIRtazapine;MAProti line;TRAZodone
1954
Q0978:heterocyclic that also Tx smoking
1955
Bupropion
1956
Q0979:heterocyclic that inhibits Serotonin; NE and DA reuptake
1957
Venlafaxine
1958
Q0980:heterocyclic that is an alpha2-blocker
1959
Mirtazapine
1960
Q0981:what (3) drugs can MAO-inhibitors not combine with?;why?
1961
Tyramine - HTN crisis;SSRI - Serotonin syndrome;B-agonist - Serotonin syndrome
1962
Q0982:what does it mean if an anesthetic has a high solubility in blood?;(2)
1963
slower induction and slower recovery time;(Low blood solubility = rapid induction and recovery time)
1964
Q0983:what does it mean if an anesthetic has a high solubility in lipids?
1965
Increased Potency;High lipid solubility = 1/MAC
1966
Q0984:AE of Halothane
1967
Hepatotoxicity
1968
Q0985:(5)* types of IV anesthetics
1969
B.B.King on OPIATES PROPOses FOOLishly;Barbs;Benzos;Ketamine;Opiates;Propofol
1970
Q0986:common Benzo used for endoscopy
1971
Midazolam
1972
Q0987:how can you tell Amide local anesthetics versus esters?;MOA of locals
1973
AmIdes have 2 "I's" in the name;ex: LIdocaIne;MOA: Nachannel blockers
1974
Q0988:which local anesthetic has cardiovascular toxicity?
1975
Bupivacaine
1976
Q0989:used to Tx hyperthermia caused by inhalation anesthetics and neuroleptic malignant syndrome;MOA
1977
Dantrolene;;MOA;prevents release of Ca from SR of skeletal muscles
1978
Q0990:what mixed agonist/antagonist of opioid receptors can place a person on Methadone back into withdrawal?
1979
Pentazocine
1980
Q0991:what is the only opioid delivered parenterally?
1981
Fentanyl
1982
Q0992:what is the only local anesthetic used topically?
1983
Benzocaine
1984
Q0993:(2) MAO inhibitors
1985
Phenelzine;;Tranylcypromine
1986
Q0994:what NT does it block;Neuroleptics
1987
Dompamine (D2)
1988
Q0995:what NT does it block;Atypical antipsychotics
1989
Serotonin;Dopamine
1990
Q0996:what (2) NT does it block;TCAs
1991
Serotonin;NE
1992
Q0997:what NT does it block;Heterocyclics
1993
Vary;
1994
Q0998:which SSRI also inhibits NE?
1995
Fluoxetine
1996
Q0999:which opiate receptor has the majority of the AE and Euphoria?;which has Dysphoria?
1997
U - Euphoria (and AE);;K - Dysphoria
1998
Q1000:in addition to Tx schizo; what abdominal Sx does Chlorpromazine Tx?
1999
Nausea and Vomiting
2000
Q1001:what class of Antipsychotics have AE associated w/ blocking Dopamine; Muscarinic; alpha and Histamine receptors?
2001
Neuroleptics;Chlorpromazine ("-AZINES") and Haloperidol
2002
Q1002:Which Schizophrenic drug is also effective in minimizing the emotional bluntness and social withdrawal Sx?
2003
Olanzapine
2004
Q1003:what "NSAID" does not inhibit prostaglandin synthesis?
2005
Acetaminophen
2006
Q1004:general anesthetic that causes AE of Hyperthermia; HTN; HyperK; tachycardia; muscle rigidity and Metabolic Acidosis?
2007
Halothane
2008
Q1005:which Benzo is good for alcohol withdrawal?
2009
Diazepam
2010
Q1006:which anti-alcohol med causes nausea and vomiting w/ alcohol consumption?
2011
Disulfiram
2012
Q1007:what Benzo is good versus Agoraphobia and Panic disorders?
2013
Alprazolam
2014
Q1008:what anti-epileptic / anti-psychotic can induce seizures?
2015
Clozapine
2016
Q1009:AE of Propofol
2017
Metabolic Acidosis
2018
Q1010:list the progressive depression of the CNS;(5)
2019
Sedation -> Hypnosis -> Anesthesia ->;Coma -> death
2020
Q1011:what is the effect a local anesthetic has on nerve fibers?
2021
Pain -> Sensory -> Motor
2022
Q1012:What is the underlying cause of Parkinson's?
2023
loss of dopaminergic neurons and excess cholinergic activity
2024
Q1013:Mneumonic for Parkinson's Disease drugs?
2025
BALSA: Bromocriptine; Amantiadine; Levodopa (+carbidopa); Selegiline (+COMT inhibitors); Antimuscarinics
2026
Q1014:MOA of Bromocriptine?
2027
agonize dopamine receptors (ergot alkaloid and partial dopamine agonist)
2028
Q1015:Agents that increase dopamine?
2029
Amantadine (increase dopamine release); Ldopa/carbidopa(converted to dopamine in CNS)
2030
Q1016:MOA of Selegiline and entacapone/tolcapone?
2031
Prevent dopamine breakdown (Selegiline=selective MAO type B inhibitor)and (entacapone/tolcapone=COMT inhibitors)
2032
Q1017:MOA of Benztropine?
2033
Curbs excess cholinergic activity (antimuscarinic)
2034
Q1018:Antimuscarinic that improves tremor and rigidity but has little effect on bradykinesia?
2035
Benztropine
2036
Q1019:Clinical use of L-dopa/carbidopa?
2037
Parkinsonism
2038
Q1020:MOA of L-dopa/carbidopa?
2039
Increase dopamine levels in brain. Cross BBB and converted by dopa decarboxylase in CNS to dopamine.
2040
Q1021:Toxicity of L-dopa?
2041
Arrhythmias from peripheral conversion to dopamine; dyskinesia after doses and akinesia between doses.
2042
Q1022:How can you avoid L-dopa induced arrhythmias?
2043
Give with carbidopa = a peripheral decarboxylase inhibitor
2044
Q1023:Selegiline MOA?
2045
Inhibits MAO-B; increase dopamine availability
2046
Q1024:Selegiline toxicity?
2047
enhance adverse effects of L-dopa
2048
Q1025:Sumatriptin MOA?
2049
5-HT1D agonist. Causes vasoconstriction.
2050
Q1026:Clinical use of Sumatriptin?
2051
acute migraine; cluster headaches
2052
Q1027:Sumatriptin toxicity and contraindications?
2053
coronary vasospasm; contraindicated in pts with CAD or angina
2054
Q1028:Clinical use of phenytoin?
2055
1st line for generalized tonic-clonic seizures and status epilepticus prophylaxis. Also a class IB antiarrhythmic.
2056
Q1029:MOA of phenytoin?
2057
increase Na+ channel inactivation. Inhibits glutamate (excitatory) release.
2058
Q1030:Clinical use of Carbamazepine?
2059
1st line for generalized tonic-clonic seizures and trigeminal neuralgia. Also for simple and complex partial seizures.
2060
Q1031:MOA of Carbamazepine?
2061
increase Na+ channel inactivation
2062
Q1032:Toxicity of Carbamazepine?
2063
diplopia; atazia; agranulocytosis; aplastic anemia; liver toxicity; teratogenesis; induces cyto P-450
2064
Q1033:Toxicity of phenytoin?
2065
nystagmus; diplopia; ataxia; sedation; gingival hyperplasia; hirsutism; megaloblastic anemia; teratogenesis; malignant hyperthermia; SLE-like syndrome; induces cyto P-450
2066
Q1034:Lamotrigine MOA?
2067
blocks voltage-gaated Na+ channels
2068
Q1035:Clinical use Gabapentin?
2069
simple and complex partial seizures; generalized tonic-clonic. Also peripheral neuropathy.
2070
Q1036:MOA of Gabapentin?
2071
increase GABA release
2072
Q1037:Topiramate MOA?
2073
blocks Na+ channels; increase GABA action
2074
Q1038:Gabapentin toxicity?
2075
sedation; ataxia
2076
Q1039:Lamotrigine toxicity?
2077
Stevens-Johnson syndrome.
2078
Q1040:Topiramete toxicity?
2079
sedation; mental dulling; kidney stones; weight loss
2080
Q1041:Phenobarbital clinical use?
2081
1st line in preggers and kids. Generalized tonic-clonic and simple and complex partial seizures.
2082
Q1042:Barbituate toxicity?
2083
sedation; tolerance; dependence; cyto P-450 induction; resp/CV depression; additive with alcohol
2084
Q1043:Barbituate MOA?
2085
increases GABA-A action by increase DURATION of Clchannel opening; which decreases neuron firing. [barbiDURATe=increased DURATion]
2086
Q1044:Valproic acid clinical use?
2087
1st line for generalized tonic-clonic seizures. Also for myoclonic and absence seizures.
2088
Q1045:Valproic acid MOA?
2089
increase Na+ channel inactivation. Increase GABA concentration.
2090
Q1046:Valproic acid toxicity?
2091
GI distress; fatal hepatotoxicity; neural tube defects; tremor; weight gain
2092
Q1047:Ethosuximide clinical use?
2093
1st line for absence seizures.
2094
Q1048:MOA ethosuximide?
2095
blocks thalamice T-type Calcium channels
2096
Q1049:Ethosuximide toxicity?
2097
GI distress; lethargy; headache; urticaria; Stevens-Johnson syndrome
2098
Q1050:Benzodiazepine clinical uses?
2099
1st line for acute status epilepticus; also for seizures of eclampsia
2100
Q1051:Name 4 barbituates.
2101
Phenobarbital; pentobarbital; thiopental; secobarbital
2102
Q1052:Barbituate contraindication?
2103
porphyria
2104
Q1053:Name some Benzodiazepines. (8)
2105
diazepam; lorazepam; triaxolam; temazepam; oxazepam; midazolam; chlordiazepoxide; alpraxolam
2106
Q1054:MOA of Benzos?
2107
Facilitate GABA-A action by increse FREQUENCY of Clchannel opening
2108
Q1055:What drug class do you use for alcohol withdrawalDTs?
2109
Benzos
2110
Q1056:What are the 3 short-acting Benzos?
2111
TOM thumb= Triazolam; Oxazepam; Midazolam
2112
Q1057:Do benzos or barbituates have a higher risk of resp depression and coma?
2113
Barbituates
2114
Q1058:How do you treat a Benxo overdose?
2115
Flumazenil (competitive antagonist at GABA receptor)
2116
Q1059:Name 6 inhaled anesthetics
2117
halothane; enflurane; isoflurane; sevoflurane; methoxyflurane; nitrous oxide
2118
Q1060:Effects of inhaled anesthetics?
2119
myocardial and resp depression; nausea/emesis; increase cerebral blood flow
2120
Q1061:Toxicity of halothane; methoxyflurane; and enflurane?
2121
hepatotoxicity (halothane); nephrotoxicity (methoxyflurane); proconvulsant (enflurane)
2122
Q1062:Drug classes used as IV anesthetics? (5)
2123
Barbiturates; Benzos; Ketamine; Opiates; Propofol
2124
Q1063:Name the local anesthetics that are esters
2125
procaine; cocaine; tetracaine; amides
2126
Q1064:Name the local anesthetics that are amides
2127
lidocaine; mepivacaine; bupivacaine
2128
Q1065:barbiturate used as IV anesthetic?
2129
thiopental - used for short surgical procedures and induction of anesthesia
2130
Q1066:drug used for endoscopy?
2131
midazolam
2132
Q1067:Arrylcyclohexamine (ketamine) effects?
2133
CV stimulant; disorientation; hallucination; bad dreams; increase cerebral blood flow
2134
Q1068:Opeates used during general anesthesia?
2135
morphine; fentanyl
2136
Q1069:MOA of local anesthetics?
2137
block Na+ channels. Tertiary amines penetrate membrane in uncharged form; then bind to ion channels as charged form.
2138
Q1070:Order of nerve block?
2139
small diameter>large diameter. Myelinated>unmyelinated. Size predominates over myelination.
2140
Q1071:order of loss during nerve block?
2141
pain(1st)>temp>touch>pressure
2142
Q1072:how do you enhance local action?
2143
give with vasoconstrictors (EPI)
2144
Q1073:What happens to local anesthetics in infected tissues?
2145
tissue is acidic; anesthetics are charged and can't penetrate membrane. More anesthetic is needed.
2146
Q1074:What receptor do neuromuscular blocking drugs target and what are they used for clinically?
2147
motor (vs. autonomic) nicotinic receptor. Used for muscle paralysis in surgery or mechanical ventilation.
2148
Q1075:Depolarizing neuromuscular blocking drug?
2149
succinylcholine
2150
Q1076:nondepolarizing neuromuscular blocking drugs?
2151
tubocurarine; atracurium; mivacurium; pancuronium; vecuronium; rapacuronium
2152
Q1077:What is dantrolene used for?
2153
treatment of malignant hyperthermia and neuroleptic malignant syndrome
2154
Q1078:MOA of dantrolene?
2155
prevents release of calcium from the SR of skeletal muscle
2156
Q1079:How do you reverse blockade of nondepolarizing neuromuscular blocking drugs?
2157
neostigmine; edrophonium; and other cholinesterase inhibitors
2158
Q1080:Name 4 antipsychotics (neuroleptics).
2159
thioridazine; haloperidol; fluphenazine; chlorpromazine
2160
Q1081:What is the MOS of antipsychotics?
2161
block dopamine D2 receptors
2162
Q1082:Drug class used to treat excess dopamine connected with schizophrenia?
2163
antipsychotics
2164
Q1083:Adverse effects of antipsychotics?
2165
extrapyramidal symptoms; gynacomastia; dry mouth; constipation; hypotension; sedation. Important: neuroleptic malignant syndrome and tardive dyskinesia!
2166
Q1084:Symptoms of neuroleptic malignant syndrome?
2167
rigidity; myoglobinuria; autonomic instability; hyperpyrexia
2168
Q1085:How do you treat neuroleptic malignant syndrom?
2169
dantrolene and dopamine agonists
2170
Q1086:What are EPS side effects?
2171
acute dystonia; akinesia; akathisia; tardive dyskinesia (often irreversible)
2172
Q1087:Name 3 atypical antipsychotics.
2173
clozapine; olanzapine; riserperidone
2174
Q1088:MOA of clozapine?
2175
blocks 5-HT2 and dopamine receptors
2176
Q1089:Clinical use of olanzapine?
2177
schizo positive and neg. symptoms; OCD; anxiety disorder; depression; mania; tourettes
2178
Q1090:Side effects of atypical antipsychotics?
2179
fewer EPS and fewer anticholinergic side effects than typical antipsychotics. Clozapine may cause agranulocytosis.
2180
Q1091:Clinical use of lithium?
2181
mood stabilizer for bipolar affective disorder; blocks relapse and acute mania events
2182
Q1092:Side effects of lithium?
2183
tremor; hypothyroidism; nephrogenic diabetes insipidus; teratogenesis. Narrow therapeautic window!!
2184
Q1093:Buspirone MOA?
2185
stimulates 5-HT1a receptors
2186
Q1094:Buspirone clinical use?
2187
generalized anxiety disorder
2188
Q1095:Name the 4 main classes of antidepressants.
2189
SSRIs; TCAs; Heterocyclic antidepressants; MAOIs
2190
Q1096:Name 4 SSRIs.
2191
fluoxetine; sertraline; paroxetine; citalopram
2192
Q1097:Toxicity of SSRIs?
2193
fewer side effects than TCAs. GI distress; sexual dysfunction; "serotonin syndrome" if used with MAOIs (= hyperthermia; muscle rigidity; CV collapse)
2194
Q1098:Do antidepressants work immediately?
2195
No; usually takes 2-3 weeks
2196
Q1099:What drug class do the following belong to: imipramine; amitriptyline; desipramine; nortriptyline; clomipramine; doxepin?
2197
TCAs
2198
Q1100:How do TCAs work?
2199
block reuptake of NE and serotonin
2200
Q1101:Which TCAs have more anticholinergic side effects?
2201
tertiary TCAs (amitriptyline) have more than secondary TCAs (nortriptyline)
2202
Q1102:What are the major toxixities associated with TCAs?
2203
"Tri-C's" = Convulsions; Coma; Cardiotoxicity (arrhythmias). Also resp. depression and hyperpyrexia (extremely high fever)
2204
Q1103:Name the 5 heterocyclic antidepressants.
2205
Bupropion; Venlafaxine; Mirtazapine; Maprotiline; Trazodone
2206
Q1104:Which antidepressant is also used for smoking cessation?
2207
Bupropion
2208
Q1105:MOA of Venlafaxine?
2209
inhibits serotonin; NE; and dopamine reuptake
2210
Q1106:MOA of Mirtazapine?
2211
alpha-2 antagonist (increases release of NE and serotonin); 5HTs and 5-HT3 receptor antagonist
2212
Q1107:MOA of Maprotiline?
2213
blocks NE reuptake
2214
Q1108:MOA of trazodone?
2215
inhibits serotonin reuptake
2216
Q1109:Name 2 MAOIs
2217
phenelzine; tranylcypromine
2218
Q1110:Clinical use of MAOIs?
2219
atypical depression with psychotic or phobic features; anxiety; hypochondriasis
2220
Q1111:Important toxicity of MAOIs?
2221
Hypertensive crisis with tyramine ingestion (red wine; cheese; fava beans) and meperidine.
2222
Q1112:define dopamine hypothesis (& the disorder it references)?
2223
hypothesis of schizophrenia proposes that disorder is caused by relative excess of function activity of the neurotransmitter dopamine in specific neuronal tracts in the brain
2224
Q1113:what type of dopamine receptor is found on the caudate putamen; nucleus accumbens; cerebral cortex; and hypothalamus that is negatively coupled to adenylyl cyclase?
2225
D2
2226
Q1114:blockade of D2 receptors has this adverse effect?
2227
extramyramidal dysfunction
2228
Q1115:most of the newer atypical drugs (olanzapine; quetiapine; risperidone) have high affinity for this receptor?
2229
5-HT 2A (although they may also interact with D2 and other receptors)
2230
Q1116:with the exception of this drug all antipsychotic drugs block H1 receptors to some degree?
2231
Haloperidol
2232
Q1117:what is the function of the dopaminergic mesocorticalmesolimbic pathways?
2233
regulates mentation and mood
2234
Q1118:what is the function of the dopaminergic nigrostriatal tract?
2235
extrapyramidal function
2236
Q1119:what is teh function of the dopaminergic tuberoinfundibular pathway?
2237
control of prolactin release
2238
Q1120:what are the positive symptoms of psychophrenia?
2239
hyperactivity; bizarre ideation; hallucinations; and delusions
2240
Q1121:newer atypical durgs are reported to improve some of the negative symptoms of schizophrenia including?
2241
emotional blunting and social withdrawl
2242
Q1122:this drug has been sued as the sole agent in the manic phase and acts as mood stabilizer in bipolar disorder?
2243
Olanzapine
2244
Q1123:this antipsychotic durg is used mainly in Tourette's syndrome?
2245
Molindone
2246
Q1124:with the exception of this drug most phenothiazine have antiemetic actions?
2247
thioridazine
2248
Q1125:this phenothiazine is used soley for its antiemetic properties?
2249
Prochlorperazine
2250
Q1126:extrapyramidal toxicity occurs most frequently with this drug?
2251
Haloperidol (and the more potent piperazine side chain phenothiazines (eg fluphenazine; trifluoperazine)
2252
Q1127:this toxicity includes choreoathetoid movements of the muscles of the lips and buccal cavity and may be irreversible?
2253
Tardive dyskinesias
2254
Q1128:which drug has the strongest autonomic effects?
2255
Thioridazine
2256
Q1129:which drug has the weakest autonomic effects?
2257
Haloperidol
2258
Q1130:all of the atypicals can cause this side effect?
2259
orthostatic hypotension
2260
Q1131:failure ot ejaculate is common in men treated with these drugs?
2261
Phenothiazines
2262
Q1132:endocrine and metabolic side effects of antipyschotics?
2263
hyperprolactinemia; gynecomastia; and amenorrheagalactorrhea syndrome and infertility; significant also {weight gain and hyperglycemia (diabetogenic action) w/ olanzapine and clozapine}
2264
Q1133:pts particularly sensitive to the extrapyramidal effects of antipsychotics may develop this syndrome?
2265
malignant hyperthermic syndrome
2266
Q1134:what is the treatment for malignant hyperthermia?
2267
Dantrolene (and perhaps dopamine agonists)
2268
Q1135:sedation is a marked side effect with phenothiazines especially this one?
2269
Chlorpromazine
2270
Q1136:what is the least sedating of the newer agents?
2271
Aripiprazole
2272
Q1137:visual impairment due to retinal deposits has occurred with this drug
2273
thioridazine
2274
Q1138:at high doses this drug can cause severe conduction defects in the heart resulting in fatal ventricular arrhythmias?
2275
Thioridazine
2276
Q1139:this drug prolongs the QT interval of the ECG?
2277
Ziprasidone
2278
Q1140:this drug causes a small but important (1-2%) incidence of agranulocytosis and at high doses has caused seizures?
2279
Clozapine
2280
Q1141:plasma levels of this drug may be altered by changes in body water?
2281
Lithium
2282
Q1142:dehydration of treatment with thiazide diuretics may result in an increase in levels of this drug that may reach toxic levels?
2283
Lithium
2284
Q1143:this drug increases the renal clearance of Lithium?
2285
Tehophylline
2286
Q1144:MOA of lithium?
2287
inhibits recycling of neuronal membrane phosphoinositides involved in teh generation fo inositol triphosphate (IP3) and DAG. these 2nd messengers are imp in amine neurotransmission
2288
Q1145:what are the adverse neurologic symptoms of Lithium?
2289
tremor; sedation; ataxia; & aphasia
2290
Q1146:this renal condition occurs commonly at therapeutic dug levels of lithium?
2291
Diabetes insipidus
2292
Q1147:Edema is a frequent adverse effect of this drug?
2293
Lithium
2294
Q1148:acneiform skin eruptions occur and leukocytosis is always present when on this drug?
2295
Lithium
2296
Q1149:the use of Lithium in prenancy may increase incidence of this congenital defect?
2297
Congentical Cardiac Anomalies (Ebstein's anomaly)
2298
Q1150:Lithium is contraindicated in this group of people?
2299
nursing mothers
2300
Q1151:what is the amine hypothesis of mood?
2301
postulates that brain amines; particularly NE and serotonin (5-HT) are neurotransmitters in pathways that function in the expression of mood- a funcitonal decrease in the activity of such amines -->depression and an increase --->mood elevation
2302
Q1152:what is the acute effect of tricyclic drugs?
2303
to inhibit the reuptake mechanisms (transporters) responsible for the termination of synaptic actions of both NE and serotonin in the brain
2304
Q1153:this drug has the unique action to increase amine release from nerve endings by antagonism of presynaptic alpha2 adrenoceptors?
2305
Mirtazapine (alpha2 receptors are involved in feedback inhibition)
2306
Q1154:this is a common CNS side effect of tricyclic drugs and some heterocyclic agents?
2307
Sedation
2308
Q1155:MAOIs; SSRIs; and bupropion are more likely to cause this CNS effect?
2309
CNS stimulation
2310
Q1156:antagonism of these receptors occurs with all tricylcics?
2311
antagonism of muscarinic receptors (marked with amitriptyline and doxepin)
2312
Q1157:what are the cardiovascular effects that occur most commonly with tricyclics?
2313
hypotension from alpha blockade and depression of cardiac conduction (may lead to arrhytmias)
2314
Q1158:what happens to the convulsive threshold when on TCAs and MAOIs?
2315
lowers seizure threshold so seizures may occur (esp with overdoses)
2316
Q1159:MAOIs are most useful in patients with these additional symptoms to depression?
2317
anxiety; phobic features; and hypochondriasis
2318
Q1160:this class of drugs can also be used in the treatment of bipolar disorder; acute panic attacks; phobic disorders; enuresis; ADHD and chronic pain states
2319
TCAs
2320
Q1161:high doses of this drug show efficacy in neuropathic pain?
2321
Venlafaxine
2322
Q1162:these drugs are effective in Obsessive compulsive disorder?
2323
Clomipramine and SSRIs
2324
Q1163:this class of drugs is also approved for use in pts with generalized anxiety disorders; panic attacks; social phobias; Bulemia; an dprementral dysphoric disorder and may be useful in alcohol dependence treatment?
2325
SSRIs
2326
Q1164:this drug is used int eh management of patients attemptins to withdraw from nicotine dependence?
2327
Bupropion
2328
Q1165:what are the 3 C's associated with TCA overdose?
2329
coma; convulsions; and cardiotoxicity
2330
Q1166:a withdrawal syndrome has been described for this class fo drugs that includes nausea; dizziness; anxiety; tremor and palpitations?
2331
SSRIs
2332
Q1167:this class of drugs are inhibitors of P450 which leads to increased activity of other drugs including TCAs and Warfarin?
2333
SSRIs
2334
Q1168:this syndrome occurs with combo of fluoxetine and MAOI?
2335
serotonin syndrome
2336
Q1169:define serotonin syndrome?
2337
life threatening syndrome includes severe muscle rigidity; myoclonus; hyperthermia; cardiovascualr instability; and marked CNS stimulatory effects including seizures
2338
Q1170:MAOIs administered with this class of drugs can result in Serotonin syndrome?
2339
SSRIs
2340
Q1171:what are the low potency antipsychotics
2341
chlorpromazine;thioridazine
2342
Q1172:what are the side effects of thioridazine
2343
most cardiotoxic in OD ;irreversible retinal pigmentation
2344
Q1173:what are the side effects of chlorpromazine
2345
hepatic toxicity ;derm problems (skin eruptions; discoloration);deposits in lens and cornea ;most sedating
2346
Q1174:are low or high potency antipsychotics more associated with neurologic side effects?;non-neurologic?
2347
high potency ;low potency
2348
Q1175:examples of high potency antipsychotics
2349
haloperidol;perphenazine ;fluphenazine
2350
Q1176:what are EPS
2351
pseudoparkinsonism ;akathisia ;acute dystonia
2352
Q1177:aside from EPS what are other neurologic side effects
2353
TD ;NMS ;decreased seizure threshold
2354
Q1178:how to treat acute dystonia
2355
anticholinergic ;antihistamine
2356
Q1179:how to treat NMS
2357
stop the offending drug immediately;give skeletal muscle relaxant;provide medical support;switch to low potency med
2358
Q1180:how to treat TD
2359
substitute low potency or atypical antipsychotic
2360
Q1181:how to treat pseudoparkinsonism
2361
anticholinergic (genztropine; ex) ;b/c DA normally suppresses ACh activity; if you give anticholinergic it will cause increased release of DA and relieve sx ;can also tx with antihistamine
2362
Q1182:which neuro side effect takes >6mo to develop?
2363
TD
2364
Q1183:Side effects of amitryptiline
2365
sedation ;anticholinergic
2366
Q1184:which HCA is most serotonin specific
2367
clomipramine
2368
Q1185:which HCA is least sedating
2369
desipramine
2370
Q1186:which HCA has the least anticholinergic effects
2371
desipramine
2372
Q1187:which HCA stimulates appetite
2373
desipramine
2374
Q1188:what are the effects of desipramine
2375
least sedating;stim appetite;least anticholinergic
2376
Q1189:effets of doxepin
2377
sedation ;antihistaminergic ;anticholinergic
2378
Q1190:which HCA is likely to cause orthostatic hypotension
2379
imipramine
2380
Q1191:which HCA may cause seizures
2381
maprotiline
2382
Q1192:which HCA has low cardiotoxicity
2383
maprotiline
2384
Q1193:which HCA is LEAST likely to cause orthostatic hypotension
2385
nortriptyline
2386
Q1194:other than depression; uses for amitryptiline
2387
depresssion with insomnia ;chronic pain
2388
Q1195:other than depression; uses for clomipramine
2389
OCD
2390
Q1196:other than depression; uses for desipramine
2391
panic do ;depression in elderly ;eating DO ;(think of side effects)
2392
Q1197:other than depression; uses for doxepine
2393
GAD ;PUD
2394
Q1198:other than depression; uses for maprtoiltine
2395
anxiety with depressive features
2396
Q1199:other than depression; uses for nortriptyline
2397
depression in elderly ;pruritus ;pts with cardiac dz
2398
Q1200:which HCAs are good for treating depression in elderly?
2399
nortriptyline ;desipramine
2400
Q1201:General side effects from SSRIs?
2401
SIG HAS ;Sexual side effects;Insomnia;GI probs;HA;Anorexia;Serotonin syndrome (if given w MAOIs)
2402
Q1202:What are SSRIs used to treat?
2403
OCD (fluvoxamine);Premature ejac ;Panic d/o;PMDD (fluoxetine) ;Social phobia (paroxetine) ;Hypochondriasis;Chronic pain ;PTSD;paraphilias
2404
Q1203:which SSRI --> weight loss
2405
fluoxetine
2406
Q1204:which SSRI --> agitation and insomnia
2407
fluoxetine;"one FLU over the cuckoo's nest"
2408
Q1205:which SSRI is most sedating
2409
paroxitine
2410
Q1206:which SSRI is most anti-cholinergic
2411
paroxitine
2412
Q1207:which of sSRIs is most likely --> GI probs
2413
sertraline
2414
Q1208:which SSRI is most cardiotoxic
2415
citalopram
2416
Q1209:SNRI
2417
Venlafaxine;duloxetine ;5HT and NorE reuptake inhib
2418
Q1210:NDRI
2419
buproprion ;norE/DA reuptake inhib
2420
Q1211:SARI
2421
Nefazodone ;Trazodone ;5HT antagonist and reuptake inhib
2422
Q1212:NASA
2423
Mirtazapine ;norE and 5HT antag
2424
Q1213:advantage to SNRIs
2425
rapid sx relief;few sexual side effects
2426
Q1214:other than depression; uses of duloxetine
2427
refractory depression ;urine stress incontinence
2428
Q1215:other than depression; uses of venlafaxine
2429
refractory depression ;GAD ;social phobia
2430
Q1216:contradindications for buproprion
2431
seizures ;eating d/o ;psychosis (at higher doses; high DA effects) ;mania
2432
Q1217:other than depression; uses of MAOIs
2433
atypical depression;pain d/o ;eating d/o ;panic d/o ;social phobia
2434
Q1218:Pharmacological treatment for: Alcohol withdrawal
2435
Benzodiazepines
2436
Q1219:Pharmacological treatment for: Anorexia/bulimia
2437
SSRIs
2438
Q1220:Pharmacological treatment for: Anxiety
2439
1. Barbiturates;2. Benzodiazepines;3. Buspirone (for GAD; does not cause sedation or addiction; and does not interact with EtOH);4. MAO inhibitors;5. Venlafaxine (SNRI; for GAD);6. Olanzapine (an atypical antipsychotic)
2440
Q1221:Pharmacological treatment for: Atypical depression
2441
MAO inhibitors
2442
Q1222:Pharmacological treatment for: Bipolar disorder
2443
Mood stabilizers (Lithium; Valproic acid; Carbamazepines)
2444
Q1223:Pharmacological treatment for: Depression
2445
1. SSRIs (endogenous depression);2. SNRIs (when SSRIs are ineffective or neuropathic pain);3. TCAs/Maprotiline (severe major depression);4. MAO inhibitors (atypical depression or inability to use TCAs);5. Bupropion;6. Mirtazapine;7. Trazodone/Nefazodone;8. Olanzapine (an atypical antipsychotic)
2446
Q1224:Pharmacological treatment for: Depression with insomnia
2447
Trazodone and Mirtazapine
2448
Q1225:Pharmacological treatment for: OCD
2449
1. Fluvoxamine (an SSRI);2. Olanzapine (an atypical antipsychotic);3. Clomipramine (a TCA)
2450
Q1226:Pharmacological treatment for: Panic disorder
2451
TCAs and Buspirone
2452
Q1227:Pharmacological treatment for: Schizophrenia
2453
1. Typical Neuroleptics;2. Atypical neuroleptics (for positive and negative symptoms)
2454
Q1228:Mechanism of neuroleptics
2455
Most block dopamine D2 receptors (as excess dopamine effects are connected with schizophrenia)
2456
Q1229:Mechanism of Venlafaxine
2457
Inhibits reuptake of serotonin (at all doses); norepinephrine(at high doses); and dopamine (mild)
2458
Q1230:Mechanism of lithium
2459
Not established; possibly related to inhibition of PIP resynthesis leading to its relative depletion in neurons
2460
Q1231:Mechanism of buspirone
2461
Stimulates 5-HT1A receptors
2462
Q1232:Mechanism of SSRIs
2463
Selective serotonin reuptake inhibition; leading to down regulation of presynaptic inhibitory receptors; leading to increased release of neurotransmitter; leading to therapeutic response.
2464
Q1233:Mechanism of tricyclic antidepressants
2465
1. Nonselectively inhibit reuptake of norepinephrine and serotonin (beneficial);2. Block serotonergic; alpha-adrenergic; histaminic; and muscarinic receptors (not beneficial)
2466
Q1234:Mechanism of clozapine
2467
Blocks D2 like normal neuroleptic; but also blocks 5HT2 as well as D1; D4; muscarinic; and alpha-adrenergic receptors.
2468
Q1235:Mechanism of risperidone
2469
Blocks 5HT2 receptors more than D2 receptors
2470
Q1236:Mechanism of aripiprazole
2471
Partial agonist of D2 and 5HT1A receptors; and blocks 5HT2A receptors.
2472
Q1237:Mechanism of bupropion
2473
Unknown
2474
Q1238:Mechanism of mirtazapine
2475
Alpha2 antagonist (increasing release of NE and serotonin) and potent 5-HT2 and 5-HT3 receptor antagonist
2476
Q1239:Mechanism of duloxetine
2477
SNRI. Inhibits reuptake of serotonin and norepinephrine at all dose.
2478
Q1240:Mechanism of nefazodone and trazodone
2479
Block 5-HT1 presynaptic autoreceptors; thereby increasing serotonin release. Weak inhibitors of serotonin re-uptake.
2480
Q1241:Mechanism of MAO inhibitors
2481
Irreversibly inhibits monoamine oxidase which normally inactivates monoamines such as NE; 5-HT; and DA that leak out of presynaptic vesicles. MAO inhibitors allow these leaky molecules to accumulate and activate post synaptic response.
2482
Q1242:Pharmacological treatment for: Psychosis
2483
1. Typical neuroleptics
2484
Q1243:Pharmacological treatment for: Acute mania
2485
1. Typical neuroleptics;2. Olanzapine;3. Lithium (relapse and treatment)
2486
Q1244:Pharmacological treatment for: Tourette syndrome
2487
1. Typical neuroleptics;2. Olanzapine
2488
Q1245:Pharmacological treatment for: Bedwetting
2489
1. Imipramine (a tricyclic antidepressant)
2490
Q1246:Pharmacological treatment for: Hypochondriasis
2491
1. MAO inhibitors
2492
Q1247:Antidepressants which have adverse effect of GI distress
2493
SSRIs: all;SNRIs: all;Atypical: Nefazodone;Tricyclic: Clomipramine;MAO inhibitors: none
2494
Q1248:Antidepressants which have adverse effect of sedation
2495
Note: useful effect if agitated;SSRIs;1. Fluvoxamine;2. Paroxetine;SNRIs: none;Atypical: All except bupropion;Tricyclic: All except desipramine and protryptiline;MAO inhibitors: none
2496
Q1249:Antidepressants which have high potential for orthostatic hypertension
2497
SSRIs: none;SNRIs: none;Atypical: none;Tricyclic;1. Amitriptyline;2. doxepin;MAO inhibitors: All
2498
Q1250:Antidepressants which have adverse effect of weight gain
2499
SSRIs: none;SNRIs: none;Atypical: Mirtazapine;Tricyclic: (so big you need a DICTAphone to type);1. Doxepin;2. Imipramine;3. Clomipramine;4. Trimipramine;5. Amitriptyline;MAO inhibitors: none
2500
Q1251:Toxicities of typical neuroleptics
2501
1. Extrapyramidal dopamine side effects;2. Endocrine dopamnine side effects (dopamine receptor antagonism leading to hyperprolactinemia leading to gynecomastia);3. Blocking muscarinic receptors (dry mouth; constipation);4. Blocking alpha-adrenergic receptors (hypotension);5. Blocking histamine receptors (sedation);6. Neuroleptic malignant syndrome;7. Tardive dyskinesia
2502
Q1252:Describe neuroleptic malignant syndrome.
2503
Neuroleptic malignant syndrome can cause you HARM;1. Hyperpyrexia;2. Autonomic instability;3. Rigidity;4. Myoglobinuria
2504
Q1253:How is neuroleptic malignant syndrome treated?
2505
Dantrolene or dopamine agonists (bromocriptine)
2506
Q1254:Describe tardive dyskinesia and what causes it?
2507
Long-term antipsychotic use leads to dopamine receptor sensitization which causes stereotypic oral-facial movements
2508
Q1255:Mechanism and treatment for extrapyramidal side effects
2509
Blocking of dopamine's inhibitory effects causes excess stimulation by acetylcholine. Treat wth anticholinergic drugs like thioridazine.
2510
Q1256:Toxicities of atypical neuroleptics
2511
Weight gain. Clozapine may cause agranulocytosis. (Requires weekly WBC monitoring.) Fewer extrapyramidal and anticholinergic side effects than typical neuroleptics.
2512
Q1257:Which atypical neuroleptic can cause agranulocytosis?
2513
Clozapine (requires weekly WBC monitoring)
2514
Q1258:Toxicities of lithium
2515
Mnemonic: LMNOPP (prounounced "pee-pee");Lithium side effects;1. Movement (Tremor);2. Narrow therapeutic window;3. hypOthyroidism;4. Pregnancy problems (Teratogenesis);5. Polyuria as lithium is ADH antagonist; leading to nephrogenic diabetes insipidus
2516
Q1259:Toxicities of SSRIs
2517
1. GI distress;2. Sexual dysfunction (anorgasmia);3. Serotonin syndrome (with MAO inhibitors)
2518
Q1260:What is serotonin syndrome?
2519
Excess serotonergic activity caused by use of both SSRIs and MAO inhibtiors;1. Hyperthermia;2. Muscle rigidity;3. Cardiovascular collapse
2520
Q1261:Side effects and toxicities of tricyclic antidepressants
2521
TCAs mess you up. Make you a stuttering SHAARCCC;1. Sedation;2. Hyperpyrexia;3. alpha-blocking effects;4. atropine-like (anticholinergic) effects (tachycardial; urinary retention; confusion and hallucinations in elderly);5. Respiratory depression;and the Tri-C's;6. Convulsions;7. Coma;8. Cardiotoxicity (arrhythmias)
2522
Q1262:Treatment for confusion and hallucinations in elderly on tricyclic antidepressants
2523
Due to anticholinergic activity. Use nortriptyline instead.
2524
Q1263:Toxicities of bupropion
2525
1. Stimulant effects (tachycardia; insomnia);2. Headache;3. Seizure in bulimic patients
2526
Q1264:Toxicities of venlafaxine
2527
Things have trouble going down your SINCS (GI distress);1. Stimulant effects;2. Increased blood pressure;3. Nausea;4. Constipation;5. Sedation
2528
Q1265:Toxicities of mirtazapine
2529
1. Sedation;2. Increased appetite;3. Weight gain;4. Dry mouth
2530
Q1266:Toxicities of Maprotiline
2531
1. Sedation;2. Orthostatic hypotension
2532
Q1267:Toxicities of Trazodone
2533
1. Sedation;2. Nausea;3. Priapism;4. Postural hypotension
2534
Q1268:Toxicities of MAO inhibitors
2535
1. Hypertensive crisis with tyramine ingestion and meperidine;2. CNS stimulation;3. Serotonin syndrome (when coadministered with SSRIs or beta-agonists);4. Increased risk of orthostatic hypotension
2536
Q1269:which lipid-lowering agent has best effect on HDL?
2537
niacin (side effects: flushing which is dec'd by aspirin or longterm use)
2538
Q1270:which statin is NOT metabolized by P450 system?
2539
pravastatin
2540
Q1271:which lipid lowering agent causes a slight increase in TG?
2541
bile acid resins (cholestyramine; colestipol)
2542
Q1272:which lipid loweirng agents have biggest lowering effect on TGs?
2543
"fibrates"--gemfibrozil; clofibrate; bezafibrate; fenofibrate
2544
Q1273:which lipid lowering agents work by decreasing production of VLDL?
2545
niacin
2546
Q1274:which lipid lowering agents work by stimulating LPL/enhancing rate of catabolism of VLDL?
2547
fibrates (gemfribrozil; clofibrate; bezafibrate; fenofibrate)
2548
Q1275:which class of lipid lowering agents is safest and what is the effect?
2549
cholesterol absorption blockers (ezetimibe). only decreases LDL. no effect on HDL or TGs
2550
Q1276:which antihypertensive can cause a positive Coombs test?
2551
methyldopa (cental acting alpha agonist; safe for preggers)
2552
Q1277:which antiHTNives have sexual side effects?
2553
hexamthonium (ganglionic blocker--sexual dysfxn); guanethidine (inhibits Mg-ATPase--sexual dysfxn); beta blockers (impotence)
2554
Q1278:which antiHTNive can cause hypertrichosis?
2555
minodixil (a vasodilator; use with beta blocker to prevent relfex tachycardia and w/diuretic to block salt retention)
2556
Q1279:which CCB should NOT be used for arrhythmias?
2557
nifedipine
2558
Q1280:MOA of nitroglycerin
2559
vasodilate by releasing NO in smooth muscle--> increase in cGMP and smooth muscle relaxation; dilates veins>> arteries
2560
Q1281:which heart drug has "Monday dz" as a toxicity
2561
(tolerance during the work week and loss of tolerance over weekend-> tachycardia; dizzinesss; headache); nitroglycerin
2562
Q1282:half life of digoxin?
2563
40hrs
2564
Q1283:MOA of cardiac glycosides
2565
directly inhibit Na/K ATPase--> indirect inhibition of Na/Ca exchanger leads to increased intracellular calcium
2566
Q1284:clinical use of cardiac glycosides
2567
CHF (to increase contractility); afib (decreases conduxn at AV node; depresses SA node)
2568
Q1285:what diuretics should go with digoxin?
2569
spironolactone/K+ sparers b/c hypokalemia potentiates dig toxicity
2570
Q1286:what increases toxicities of digoxin
2571
renal failure; hypokalemia; quinidine (dec'd clearance; displaces dig from tissue binding sites)
2572
Q1287:antidote to digoxin toxicity
2573
slowly normalize K+; lidocaine; cardiac pacer; anti-dig Fab fragments
2574
Q1288:name 4 Class IA antiarr
2575
quinidine; amiodarone; procainamide; disopyramide (queen amy proclaims diso's pyramid)
2576
Q1289:name 3 Class IB antiarr
2577
lidocaine; mexiletine; tocainide
2578
Q1290:name 3 Class IC antiarr
2579
flecainide; encainide; propafenone
2580
Q1291:very short acting class II antiarr?
2581
esmolol (beta blocker(
2582
Q1292:name 4 class III antiarr
2583
sotalol; ibutilide; bretylium; amiodarone
2584
Q1293:name 2 class IV antiarr
2585
verapamil; diltiazem
2586
Q1294:compare the class I antiarr in terms of effect on AP duration
2587
IA (Na; intermediate acting)--increase duration; IB (Na; fast acting)--decrease duration; IC (Na; slow acting)--no change in AP
2588
Q1295:usefulness of IA antiarr?
2589
(quinidine; amiodarone; procainamide; disopyramide) affect both ATRIAL and VENTRICULAR s; esp reenrant and ectopic tachycardias
2590
Q1296:which antiarrhythmics useful in acute ventricular arrhytmias; esp post MI?
2591
IB (lidocaine; mexiletine; tocainide)
2592
Q1297:drug of choice in diagnosing/abolishing AV nodal arrhythmias
2593
adenosine (maybe cause flushing)
2594
Q1298:which antiarr contraindicated post-MI?
2595
class IC (flecainide; encainide; propafenone)
2596
Q1299:when use class IC antiarr?
2597
usually only as last resort in refractory tachyarrhythmias
2598
Q1300:which antiarr only work on AV and SA nodes?
2599
class II (beta blockers)
2600
Q1301:which antiarr can cause dyslipidemia?
2601
metoprolol (class II)
2602
Q1302:amiodarone toxicities
2603
pulmonary fibrosis; hepatotoxicity; thyroidisms; corneal deposits; photodermatitis; neurologic effects; constipation; check PFTs; LFTs; TFTs!!!
2604
Q1303:use of class IV antiarr?
2605
(nondihydropyridine CCBs; verpamil; diltiazem); primarily affect AV nodal cells--> good for prevention of nodal arrhythmias
2606
Q1304:antiarrhythmic effect of K+?
2607
depresses ectopic pacemakers; esp in digoxin toxicity
2608
Q1305:botulinum toxin mechanism
2609
blocks ACh release
2610
Q1306:choline acetyltransferase action
2611
synthesizes ACh
2612
Q1307:acetylcholinesterase
2613
breaksdown ACh
2614
Q1308:rate-limiting step in NE synthesis
2615
Tyrosine hydroxylase (tyrosine to dopa)
2616
Q1309:metyrosine action
2617
inhibits tyrosine hydroxylase
2618
Q1310:uptake I
2619
norepinephrine transporter into neuron
2620
Q1311:uptake II
2621
uptake by extraneuronal tissue
2622
Q1312:Monoamine oxidase action
2623
makes catecholamine aldehydes
2624
Q1313:Catechol-o-methyltransferase (COMT) action
2625
makes (nor)metanephrine
2626
Q1314:physostigmine action
2627
inhibits cholinesterase
2628
Q1315:carbidopa action
2629
dopa decarboxylase inhibition
2630
Q1316:receptor type which stimulates adenylyl cyclase
2631
Beta 1;2
2632
Q1317:Gi receptor types
2633
a2; M2
2634
Q1318:receptor types stimulating PKC
2635
a1
2636
Q1319:phenylephrine mechanism
2637
a1 agonist
2638
Q1320:methoxamine mechanism
2639
a1 agonist
2640
Q1321:mydriasis
2641
dilated pupil
2642
Q1322:Phentolamine mechanism
2643
competitive a1 antagonist;**short half life
2644
Q1323:phentolamine uses
2645
dx pheochromocytoma
2646
Q1324:pphenoxybenzamine mechanism
2647
noncompetitive a1 antagonist;*long acting
2648
Q1325:phenoxybenzamine use
2649
treat pheochromocytoma
2650
Q1326:prazosin mechanism
2651
alpha1 antagonist
2652
Q1327:prazosin use
2653
tx of hypertension and CHF
2654
Q1328:prazosin risks
2655
syncope after first oral dose;reduced efficacy with chronic use
2656
Q1329:clonidine mechanism
2657
a2 agonist--> reduced symp outflow
2658
Q1330:clonidine use
2659
tx of hypertension
2660
Q1331:methyldopa mechanism
2661
metabolite a-methyl*norepinephrine* is a2 agonist
2662
Q1332:methyldopa use
2663
tx of hypertension
2664
Q1333:yohimbe mechanism
2665
alpha 2 antagonist
2666
Q1334:Isoproterenol mechanism
2667
stimulates b1 and b2
2668
Q1335:dobutamine mechanism
2669
b1 agonist
2670
Q1336:uses of dobutamine
2671
tx of pulmonary edema; coronary bypass post op
2672
Q1337:Propranolol mechanism
2673
competitive inhibitor of b1 and b2
2674
Q1338:uses of propranolol
2675
tx of angina;ventricular arrhythmia;htn *dec renin*;post myocardial infarction
2676
Q1339:propranolol side efx
2677
worse heart failure;reduced AV conduction;nightmares;fatigue;cold extremities
2678
Q1340:Metoprolol mechanism
2679
b1 blocker
2680
Q1341:atenolol mechanism
2681
b1 blocker; does not cross blood brain barrier.slow
2682
Q1342:atenolol uses
2683
htn (one a day);glaucoma
2684
Q1343:bromocriptine mechanism
2685
dopanergic agonist
2686
Q1344:tyramine mechanism
2687
displaces NE into synaptic cleft
2688
Q1345:population vulnerable to tyramine related hypertension
2689
pts on monoamine oxidase inhibitors
2690
Q1346:Phenylpropanolamine mechanism
2691
indirect sympathetic stim
2692
Q1347:methacholine mechanism
2693
cholinergic
2694
Q1348:bethanachol mechanism
2695
muscarinic agonist
2696
Q1349:pilocarpine mechanism
2697
muscarinic agonist
2698
Q1350:bethanachol uses
2699
improved gastric emptying;tx of urinary retension (if no physical obstruction)
2700
Q1351:pilocarpine uses
2701
induce salivation;open angle glaucoma--constricts iris sphincter (miosis)
2702
Q1352:methacholine use
2703
provoke bronchoconstriction for dx testing;(methacholine challenge)
2704
Q1353:atropine mechanism
2705
muscarinic antagonist
2706
Q1354:atropine use
2707
raising heart rate when vagal activity is pronounced **vasovagal syncope;decreased respiratory secretions for intubation
2708
Q1355:Bezold-Jarisch reflex
2709
bradyardia; hypotension; nausea from high nicotine dose
2710
Q1356:ganglionic blocking agents mechanism
2711
block Nn receptors
2712
Q1357:insectiside mechanism
2713
anticholinesterase
2714
Q1358:physostigmine mechansim
2715
"reversible" short acting cholinesterase inhibitor;enters CNS
2716
Q1359:neostigmine mechanism
2717
"reversible" short acting cholinesterase inhibitor;does not enter CNS
2718
Q1360:physostigmine side effects
2719
enters cns; restlessness; apprehension; hypertension;typical muscarinic/nicotinic efx
2720
Q1361:why neostigmine no enter cns?
2721
quaternary amine (charged)
2722
Q1362:uses of neostigmine
2723
myasthenia gravis;glaucoma
2724
Q1363:propranolol "traditional" frequency of dosing
2725
4 times a day
2726
Q1364:atenolol mechanism
2727
b1 selective blocker
2728
Q1365:metroprolol mechanism
2729
b1 blocker
2730
Q1366:metabolism of propranolol
2731
heavily liver metabolized;protein bound;interindividual variability
2732
Q1367:atenolol metabilism
2733
reduced hepatic metabolization (vis a vis propranolol)
2734
Q1368:metroprolol metabolism
2735
less hepaticlly metabolized (vis a vis propranolol)
2736
Q1369:esmolol clinical use
2737
b blocker for critical care
2738
Q1370:esmolol metabolism
2739
short half life; IV use only
2740
Q1371:labetolol mechanism
2741
b blocker with a1 effect
2742
Q1372:carvedilol clinical use
2743
CHF
2744
Q1373:carvedilol mechanism
2745
beta blocker with a1 blocking
2746
Q1374:type of b blocker for treatment of portal hypertensive bleeding
2747
non selective (propranolol in US)
2748
Q1375:betablocker type for essential tremor
2749
non selective
2750
Q1376:vascular headache prophylaxis betablocker type
2751
propranolol (non selective and more lipophilic)
2752
Q1377:methyldopa side effects
2753
sedation; depression; dry mouth
2754
Q1378:special situations in which methyldopa is particularly safe
2755
for htn in pts with ischemic heart disease (no efx on CO);does not block baroreceper rflx;--safe for anti-htn in elective surgery
2756
Q1379:dosing of methyldopa
2757
delayed onset of effect (needs to be metabolized to methyelNE);twice a day for maintanence
2758
Q1380:drug of choice for hypertensive pregnant pts
2759
methyldopa
2760
Q1381:why clonidine is poor choice in pts with *severe* HTN?
2761
clonidine rebound. withdrawal syndrome w/ massive symp discharge
2762
Q1382:pharmacokinetics of prazosin
2763
hepatic metabolism
2764
Q1383:pharmacokinetics of terazosin and doxazosin
2765
longer lasting than prazosin
2766
Q1384:labetolol R R stereoisomer mechanism
2767
b1 antagonist and partial b2 agonist
2768
Q1385:labetalol SR stereoisomer mechanism
2769
a1 antagonist
2770
Q1386:S isomer of Carvedilol
2771
b blocker (both isomers a1 blockers)
2772
Q1387:The critical factor affecting the therapeutic utility of nitrates
2773
tolerance
2774
Q1388:what is given along with nitroprusside?
2775
Na2S2O3 (Na thiosulfate);the antidote to CN
2776
Q1389:pharmacokinetics of nitroprusside
2777
infusion only--dissolved immediately prior to use in glucose/water;rapid/potent/fast half life
2778
Q1390:nitroprusside clinical use
2779
acute hypertensive crisis
2780
Q1391:mechanism of hydralazine
2781
who the fuck knows
2782
Q1392:clinical utility of hydralazine
2783
hypertension--use with beta blocker and diuretic;heart failure
2784
Q1393:metabolism of hydralazine
2785
acetylated (pt variability)
2786
Q1394:hydralazine side effects
2787
Na retention; coronary steal
2788
Q1395:minoxidil mechanism
2789
sulfate metabolite opens atp sensitive k channel;-hyperpolarizes cell;--arterial vasodilation
2790
Q1396:chemical class: nifedipine
2791
1;4 dihydropyridines
2792
Q1397:chemical class: verapamil
2793
phenylalkamines
2794
Q1398:chemical class: diltiazem
2795
benzothiazepines
2796
Q1399:verapamil mechanism
2797
L type calcium channel blocker;cardiac selective
2798
Q1400:diltiazem mechanism
2799
L type calcium channel blocker;intermediate cardiac/vascular selective
2800
Q1401:nifedipine mechanism
2801
L type calcium channel blocker;vascular selective
2802
Q1402:diltiazem and verapamil tx for what arrythmia
2803
supraventricular tachycardia
2804
Q1403:CCB metabolism
2805
protein bound and big first pass effect;low bioavailability
2806
Q1404:CCBs inhibit what entity important for drug interactinos
2807
CYP 3A4
2808
Q1405:interaction of CCBs and beta blockers
2809
profound conduction and contractile depression;decreased liver flow (betas) less clearance of CCBs
2810
Q1406:chemistry of captopril
2811
contains a sulfhydryl group at zinc ligand site;--other ACE inhibs do not
2812
Q1407:hyperkalemia in ace inhibitors???
2813
decrease in aldosterone;**beware in pts with bad kidneys
2814
Q1408:he "diluting segment" of the nephron.
2815
thick ascending limb
2816
Q1409:mannitol site of action
2817
proximal tubule
2818
Q1410:mannitol characteristics of diuresis
2819
loss of H2O in excess of Na and Cl
2820
Q1411:Acetazolamide site of action
2821
proximal tubule; inhibits carbonic anhydrase
2822
Q1412:acetazolamide characteristics of diuresis
2823
loss of Na; HCO3; Cl; and K
2824
Q1413:Furosemide site of action
2825
thck ascending loop of henle
2826
Q1414:furosemide characteristics of diuresis
2827
loss of Na; Cl; K;Lose Mg and Ca;potentially loss of 50% filtered Na
2828
Q1415:Thiazide like diuretics site of action
2829
distal tubule +/- proximal tubule inner medullary collecting tubule
2830
Q1416:thiazide like diuretics characteristics of diuresis
2831
loss of Na; Cl and K;increase blood Ca and uric acid;**prevent kidney stones;**inhibit osteoporosis
2832
Q1417:chemistry of carbonic anhydrase inhibitors
2833
contain sulfamyl moiety;i.e. are sulfonamides
2834
Q1418:acetazolamide mechanism
2835
noncompetitive carbonic anhydrase inhibitor
2836
Q1419:pharmacokinetics of acetazolamide
2837
absorbed from GI;eliminated by kidney;actively secreted by organic acid transport system
2838
Q1420:clinical uses of carbonic anhydrase inhibitors
2839
glaucoma
2840
Q1421:toxicity of carbonic anhydrase inhibitors
2841
metabolic acidosis;renal stone formation (renal stones from alkaline pH);K+ wasting;decreased NH3 secretion
2842
Q1422:furosemide mechanism
2843
Na-K-Cl2 symport inhibitor
2844
Q1423:ethacrynic acid mechanism
2845
Na-K-Cl2 symport inhibitor
2846
Q1424:ethacrynic acid chemistry
2847
not a sulfonamide
2848
Q1425:furosamide chemistry
2849
contains sulfamyl moiety
2850
Q1426:loop diuretics and mg++; ca++
2851
substantial urinary loss of these divalent cations;**abolishes lumen positive potential
2852
Q1427:pharmacokinetics of loop diuretics
2853
absorved in GI;secretion via organic acid secretion;threshold effect--once at effective dosage; more wont help;**can increase frequency for more urination
2854
Q1428:toxicity of furosemide
2855
K+ loss;ototoxicity;H loss with metabolic alkalosis
2856
Q1429:hydrochlorothiazide chemistry
2857
sulonamide (sulfamyl moiety)
2858
Q1430:hydrochlorothiazide mechanism
2859
inhibit Na trnasport in distal convoluted tubule
2860
Q1431:pharmacokinetics of hydrochlorothiazide
2861
rapidly absorbed from GI;filterd and secreted in proximal tubule;binds to plasma proteins
2862
Q1432:thiazide diuretics and calcium
2863
increase Ca++ reabsorption
2864
Q1433:triamterene chemistry
2865
organic base; not sulfonamide
2866
Q1434:amiloride chemistry
2867
organic base; not sulfonamide
2868
Q1435:triamterene mechanism
2869
inhibition of Na+ channel in collecting tubule;k sparing
2870
Q1436:amiloride mechanism
2871
inhibition of Na+ channel in collecting tubule;k sparing
2872
Q1437:amiloride pharmacokinetics
2873
partially absorbed from GI;completely eliminated in kidney
2874
Q1438:triamterene pharmacokinetics
2875
well absorbed from GI;elimenated by renal excretiona and metabolism
2876
Q1439:toxicity of amiloride and triamterene
2877
do not combine with spironolactone;caution with ace inhibitors;do not combine with K+ supplements
2878
Q1440:spironolactone mechanism
2879
competitive aldosterone inhibitor
2880
Q1441:Na+ channel blocking drugs terminate and prevent arrhythmias by
2881
slowing conduction to interrupt a reentrant circuit; increasing refractoriness to terminate functional reentry and so that there is "less room" for premature beats (which cause slowed conduction ? reentry to occur)
2882
Q1442:Tx of atrial flutter/fibrillation to slow ventricular response
2883
AV nodal blockers;verapamil/diltiazem;beta blockers;digitalis
2884
Q1443:tx of atrial flutter/fibrillation to maintain normal rythm
2885
(increase refractoriness in fast respone tissue);class Ia;Class Ic;Class III
2886
Q1444:tx of supraventricular reentrant tachycardias: Acute (IV);;***(Almost always; the reentrant loop involves the AV node)
2887
adenosine (drug of choice);verapamil or beta blocker;digitalis;maneuvers to increase vagal tone: vasalva; carotid massage
2888
Q1445:txt of svt reentrant (assuming AV node) tachycardia: oral (chronic)
2889
verapamil or diltiazem;beta blocker;digitalis;class Ic
2890
Q1446:tx of svt using a bypass tract;(fast response tissue)
2891
Class Ia;Class Ic;Class III;**avoid empiric tx with AV node blockers
2892
Q1447:tx of ventricular arrhythmias: acute (IV);**(slow condux; increase refractoriness in fast response tissue>ventricles)
2893
lidocaine--Ib;procainamide--Ia;amiodarone--III
2894
Q1448:tx of ventricular arrhythmia: chronic
2895
class Ia;Class Ib;Class Ic;class III
2896
Q1449:tx of undiagnosed wide complex tachycardia
2897
could be PSVT or VT. "all bets are off";**avoid verapamil
2898
Q1450:tx for narrow complex tachycardia
2899
usually slow response=av node;adenosine;verapamil;esmolol
2900
Q1451:tx of unstable rhythm causing hemodynamic compromise
2901
shock the muthafucka
2902
Q1452:QUINIDINE class and mechanism
2903
Ia;blocks Na+ and multiple K+ currents;a-receptor block and vagal inhibition
2904
Q1453:Quinidine antiarrhythmic use
2905
chronic therapy of atrial fib/flutter (and VT)
2906
Q1454:Quinidine problems
2907
diarrhea;more death in pts with a-fib?;torsade de pointes 25%
2908
Q1455:procainamide class and mechanism
2909
Ia;blocks Na and K+;metabolite N-acetylprocainamide blocks K+ channels
2910
Q1456:procainamide use
2911
IV for SVT adn ventricular arrhythmia
2912
Q1457:procainamide things to look out for
2913
dose adjustment in renal disease;lupus syndrome w/ chronic therapy
2914
Q1458:LIDOCAINE class and use
2915
Ib;decrease incidence of V fib;**mortality increase
2916
Q1459:lidocaine dosage issues
2917
rapid distribution half life;slow elimination half life;clearance reduced in CHF and liver disease
2918
Q1460:Flecainide Class Ic use
2919
effective at surpressing isolated PVC and reentrant SVT;*BUT INCREASED mortality in patients following myocaridal infarction. wtf
2920
Q1461:esmolol class and usage
2921
Class II; beta blocker;short half life=9 min;useful for reckless beta blockade
2922
Q1462:why does bretylium (class III) suck?
2923
due to hypotensive effect; bretylium can cause hemodynamic collapse during previously well-tolerated VT (therefore use lidocaine; procainamide first)
2924
Q1463:amiodarone useage; but sucks b/c?;class?
2925
Class I + II + III + IV action; very effective for most arrhythmias; but NOT first-line oral therapy because ;; multiple toxicities: eye; *lungs*; liver; skin; thyroid during chronic treatment
2926
Q1464:verapamil: NEVER USE WHEN
2927
undiagnosed; wide complex tachycardia (? hemodynamic collapse); "preexcited" atrial fibrillation over an accessory pathway in the Wolff-Parkinson-White syndrome (may cause ? heart rate; VF); heart failure; sinus node dysfunction; AV block (*caution: Class I + IV*)
2928
Q1465:DILTIAZEM usefulness
2929
intravenous form: useful AV nodal blocker usually without hypotension (especially for rate control of atrial fibrillation)
2930
Q1466:ADENOSINE good for?
2931
Acute therapy of choice for: supraventricular tachycardias; undiagnosed wide-complex tachycardia;**short acting-seconds
2932
Q1467:Quinidine; Verapamil; Amiodarone; (? Flecainide);interactinos with ;Digitalis
2933
inc digitalis concentration and toxicity
2934
Q1468:amiodarone interactions with ;warfarin; digoxin; procainamide; quinidine
2935
decreased drug metabolism and excretion;increased drug effects
2936
Q1469:renal disease interaction wtih ;procainamide (Ia) and dofetilide (III)
2937
decreased clearance
2938
Q1470:liver disease interaction with lidocaine
2939
decreased clearance
2940
Q1471:heart failure interaction with lidocaine
2941
decreased clearance;decreased central volume (lidocaine) whatever the fuck that means
2942
Q1472:disopyramide; flecainide; beta blockers; verapamil interaction with;heart failure
2943
worsen heart failure
2944
Q1473:dofetilide interaction with cimetidine and ketoconazole
2945
increased dofetilide concentrations
2946
Q1474:plasmin; enzyme type
2947
serum protease
2948
Q1475:enzyme that dissolves clots
2949
plasmin
2950
Q1476:what do kringle domains on plasminogen activators bind
2951
fibrin
2952
Q1477:Streptokinase mechanism
2953
indirect activator of plasminogen;helps one plasminogen activate another
2954
Q1478:streptokinase problems
2955
allergic rx's ;bleeding; hypotension
2956
Q1479:urokinase mechanism
2957
direct activator of plasminogen
2958
Q1480:urokinase metabolism
2959
liver; short half life 15 min
2960
Q1481:urokinase inactivation
2961
inactivated by PAI-1
2962
Q1482:second generation thrombolytic with long half life
2963
APSAC;60 mins. given by bolus
2964
Q1483:APSAC; what is it?
2965
complex of streptokinase and plasminogen
2966
Q1484:t-PA mechanism
2967
binds to fibrin and activates plasmin **clot specific**
2968
Q1485:pharmacokinetics of t-PA
2969
PAI-1 irreversibly inhibits;cleared in liver;short half life; 6 mins
2970
Q1486:Reteplase; what is it?
2971
genetically engineered derivative of t-PA;just the kringle and protease; not glycosylated
2972
Q1487:TNK-t-PA (tenecteplase); wtf is it?
2973
t-PA with no glycosylation site
2974
Q1488:the two antifibrinolytics?
2975
Amicar (e-aminocaproic acid) or tranexamic acid
2976
Q1489:digoxin effects at AV node
2977
increased ERP; and decreased conduction;slower ventricular rate during atrial flutter/fib
2978
Q1490:Digoxin effects at His-Purkinje fibers
2979
increased automaticity;premature ectopic beats
2980
Q1491:digitalis effect on PR interval
2981
increased
2982
Q1492:digitalis effect on ST segment
2983
depressed
2984
Q1493:digitalis effect on amplituted of T waves
2985
decreased;may invert
2986
Q1494:digitalis effect on QT interval
2987
decreased
2988
Q1495:aspirin mechanism
2989
blocks cyclooxegenase--> no thromboxane A2
2990
Q1496:Dipyridamole action
2991
Inhibits cyclic nucleotide phosphodiesterase to increase intraplatelet accumulation of cAMP; Blocks the uptake of adenosine
2992
Q1497:Ticlopidine and Clopidogrel mechanism
2993
Metabolites Inhibit platelet activity via effects on; Inhibition of ADP induced platelet activation (primary); Glycoprotein IIb/IIIa receptor; von Willebrand factor
2994
Q1498:pharmacokinetics of ticlodipine and Clopidogrel
2995
delay in onset;effects persist several days
2996
Q1499:ticlodipine and Clopidogrel interactions
2997
activated by CYP3A4;inhibitors of CYP3A4 may reduce activation
2998
Q1500:Adverse effects of Ticlodipine and Clopidogrel
2999
neutropenia in 3% of pts. ticlodipine problem
3000
Q1501:(Abciximab mechanism
3001
antibody to the IIb/IIIa receptor;
3002
Q1502:factors inactivated by heparin
3003
thrombin (II);activated IX; X; XI; and XII;**inactivates free thrombin; thus best for preventing clots
3004
Q1503:administration of heparin
3005
IV; not absorbed thru GI
3006
Q1504:never ever administer heparin this way
3007
intra muscular
3008
Q1505:Two forms of heparin-induced thrombocytopenia (HIT)
3009
1 heparin induced platelet aggregation leading to decreased platelets;2 Rarer. b/t 7 and 11 days. immune response with thrombotic complications
3010
Q1506:what to do if in case of severe bleeding from heparin overdose
3011
discontinue infusion;protamine administration
3012
Q1507:protamine mechanism
3013
binds to and inactivates heparin;**possible allergic toxicity
3014
Q1508:mechanism of low molecular weight heparin
3015
bind antithrombin/factor Xa
3016
Q1509:LMWH and PTT
3017
b/c very little binds to AT-III/thrombin; little effect on PTT;NOT USED FOR MONITORING
3018
Q1510:advantages of LMWH over regular heparin
3019
less frequent administration;sub-q administration;more predictable response to dose
3020
Q1511:Direct Thrombin Inhibitors?
3021
lepirudin; agatroban
3022
Q1512:lepirudin; agatroban mechanism
3023
directly inhibit binding of thrombin to fibrinogen
3024
Q1513:warfarin action;which factors affected?
3025
antagonist of vitamin K;affects synthesis of II; VII; IX; X; protein C; and protein S
3026
Q1514:adverse effects of warfarin
3027
bleeding; yo;paradoxical thrombis;--pretein C and S fucked up first
3028
Q1515:beta blockers and hepatic metabolism
3029
atenolol only beta blocker not metabolized in liver
3030
Q1516:Bethanecol (class and application)
3031
direct cholinomimetic; postop and neurogenic ileus and urinary retention;
3032
Q1517:Bethanecol (class and action)
3033
direct cholinomimetic; Activates Bowel and Bladder smooth muscle; resistant to AChE
3034
Q1518:Carbachol (class and application)
3035
direct cholinomimetic; glaucoma;
3036
Q1519:Carbachol (class and action)
3037
direct cholinomimetic; activates ciliary muscle of the eye (open angle glaucoma); pupillary sphincter (narrow angle); resistant to ACHE
3038
Q1520:pilocarpine (class; application)
3039
direct cholinomimetic; glaucoma;
3040
Q1521:pilocarpine (class; action)
3041
direct cholinomimetic; activates ciliary muscle of the eye (open angle glaucoma); pupillary sphincter (narrow angle); resistant to ACHE
3042
Q1522:Neostigmine (class; application)
3043
indirect cholinomimetic (anticholinesterase); postop and nuerogenic ileus and urinary retention; myesthenia gravis; reversal of neuromuscular junction blockade (postop)
3044
Q1523:Neostigmine (class; action)
3045
indirect cholinomimetic (anticholinesterase); increased endogenous Ach
3046
Q1524:Pyridostigmine (class; application)
3047
indirect cholinomimetic (anticholinesterase); myesthenia gravis
3048
Q1525:Pyridostigmine (class; action)
3049
indirect chlinomimetic (anticholinesterase); increased endogenous Ach; increased strength
3050
Q1526:Edrophonium (class; application)
3051
indirect cholinomimetic (anticholinesterase); dx of myesthenia gravis (very short acting)
3052
Q1527:Edrophonium (class; action)
3053
3054
Q1528:Physostigmine (class; application)
3055
indirect cholinomimetic (anticholinesterase); glaucoma (crosses BBB) and atropine overdose
3056
Q1529:Physostigmine (class; action)
3057
indirect cholinomimetic (anitcholinesterase); increased endogenous Ach
3058
Q1530:Echothiophate (class; application)
3059
indirect cholinomimetic (anticholinesterase); glaucoma
3060
Q1531:Echothiophate (class; action)
3061
3062
Q1532:Symptoms of Cholinesterase inhibitor poisoning
3063
DUMB BELSS - Diarrhea; Urination; Miosis; Bronchospasm; Bradycardia; Excitation of skeletal muscle and CNS; Lacrimation; Sweating and Salivation (also abdominal cramping)
3064
Q1533:What are parathion and organophosphates?
3065
cholinesterase inhibitors that are likely to poison you
3066
Q1534:What is the antidote to cholinesterase inhibitor poisoning?
3067
atropine (muscarinic antag) plus pralidoxime (chem antagonist used to regenerate active cholinesterase)
3068
Q1535:Atropine (class; site of action; application)
3069
Cholinoreceptor blocker (muscarinic antag); Eye; produce mydriasis and cycloplegia
3070
Q1536:tropicamide (class; site of action; application)
3071
Cholinoreceptor blocker; Eye; produce mydriasis and cycloplegia
3072
Q1537:Benztropine (class; site of action; application)
3073
cholinoreceptor blocker; CNS; Parkinson's
3074
Q1538:Scopolamine (class; site of action; application)
3075
Cholinoreceptor blocker; CNS; Motion Sickness
3076
Q1539:Ipratropium (class; site of action; application)
3077
Cholinoreceptor blocker; Respiratory; Asthma; COPD
3078
Q1540:Methscopolamine (class; site of action; application)
3079
Cholinoreceptor blocker; Genitourinary; Reduce urgency in mild cystitis and reduce bladder spasms
3080
Q1541:oxbutin (class; site of action; application)
3081
3082
Q1542:Glycopyrrolate (class; site of action; application)
3083
3084
Q1543:Actions of Atropine
3085
Blocks SLUD (Salivation; Lacrimation; Urination; Defecation) also pupil dilation and cycloplegia
3086
Q1544:ADR of Atropine
3087
hot as a hare; dry as a bone; red as a beet; blind as a bat; mad as a hatter. Also rapid pulse; constipation. Can cause glaucoma in elderly; urinary retention in BPH pts; and hyperthermia in infants
3088
Q1545:Hexamethonium (MOA and application)
3089
Nicotinic Ach receptor antagonist; ganglionic blocker; prevents vagal reflex responses to changes in BP (for experimental models)
3090
Q1546:Epinephrine (class; selectivity; applications)
3091
catecholamine; direct general agonist (a1; a2; b1; b2); anaphylaxis; glaucoma (open angle); asthma; hypotension
3092
Q1547:NE (class; selectivity; applications)
3093
catecholamine; a1; a2; b1; hypotension (but decreased renal perfusion)
3094
Q1548:Isoproterenol (class; selectivity; applications)
3095
catecholamine; b1 = b2; AV block (rare)
3096
Q1549:Dopamine (class; selectivity; applications)
3097
catecholamine; D1 = D2 > b > a; shock (increased renal perfusion); heart failure
3098
Q1550:Dobutamine (class; selectivity; applications)
3099
catecholamine; b1 > b2; shock; heart failure
3100
Q1551:Amphetamine (class; selectivity; applications)
3101
sympathomimetic; indirect general agonist (releases stored catecholamines); narcolepsy; obesity; ADD
3102
Q1552:Ephedrine (class; selectivity; applications)
3103
sympathomimetic; indirect general agonist (releases stored catecholamines); nasal decongestion; urinary incontinence; hypotension
3104
Q1553:Phenylephrine (class; selectivity; applications)
3105
sympathomimetic; a1 > a2; pupil dilator; vasoconstriction; nasal decongestion
3106
Q1554:Albuterol (class; selectivity; applications)
3107
sympathomimetic; b2 > b1; asthma
3108
Q1555:Terbutaline (class; selectivity; applications)
3109
sympathomimetic; b2 > b1; asthma
3110
Q1556:Cocaine (class; selectivity; applications)
3111
sympathomimetic; indirect general agonist (uptake inhibitor); causes vasoconstriction and local anesthesia
3112
Q1557:Clonidine (class; selectivity; applications)
3113
sympathomimetic; centrally acting a-agonist; decreased central adrenergic outflow; hypertension; especially with renal dz (no decreas in renal perfusion)
3114
Q1558:a-methyldopa (class; selectivity; applications)
3115
sympathomimetic; centrally acting a-agonist; decreased central adrenergic outflow; hypertension; especially with renal dz (no decreas in renal perfusion)
3116
Q1559:Phenoxybenzamine (class; application; toxicity)
3117
nonselective; irreversible a-blocker; pheochromocytoma; tox: orthostatic hypotension; reflex tachycardia
3118
Q1560:Phentolamine (class; application; toxicity)
3119
nonselective; reversible a-blocker; pheochromocytoma; tox: orthostatic hypotension; reflex tachycardia
3120
Q1561:Prazosin (class; application; toxicity)
3121
a1 blocker; HTN; urinary retention in BPH; tox: 1st dose orthostatic hypotension; dizziness; HA
3122
Q1562:Terazosin (class; application; toxicity)
3123
3124
Q1563:Doxazosin (class; application; toxicity)
3125
3126
Q1564:Mirtazapine (class; application; toxicity)
3127
a2 blocker; Depression; tox: sedation; increased serum cholesterol; increased appetite
3128
Q1565:How do beta blockers work to treat HTN?
3129
decreased cardiac output; decreased renin secretion
3130
Q1566:5 major side effects for hydrochlorothiazide
3131
hypokaleia; slight hyperlipidemia; hyperuricemia; hypercalcemia; hyperglycemia
3132
Q1567:4 major side effects for loop diruetics
3133
potassium wasting; metabolic alkalosis; ototoxicity; hypotension
3134
Q1568:clonidine side effects (2)
3135
dry mouth; severe rebound hypertension
3136
Q1569:methyldopa side effects (2)
3137
sedation; positive Coombs test
3138
Q1570:hexamethonium side effects (4)
3139
severe orthostatic hypotension; blurred vision; constipation; sexual dysfunction
3140
Q1571:reserpine side effects (4)
3141
sedation; depression; nasal stuffiness; diarrhea
3142
Q1572:guanethidine side effects (4)
3143
orstastic/exericse hypotension; sexual dysfunction; diarrhea
3144
Q1573:prazosin side effects (3)
3145
1st-dose orthostatic hypotensoin; dizziness; headache
3146
Q1574:beta-blocker major side effects (6)
3147
asthma; impotence; sleep problems; bradycardia; chf; av block
3148
Q1575:hydralazine side effects (4)
3149
lupus like snydrome; reflex tachycardia; angina; salt retention
3150
Q1576:minoxidil side effets (5)
3151
hair; pericardial effusion; reflex tachycardia; angina; salt retention
3152
Q1577:vasodilator: calcium blocker side effects (3)
3153
flushing; constipatipn; nausea
3154
Q1578:nitroprusside major side efect
3155
cyanodie toxicity
3156
Q1579:captopril side effects (8)
3157
hyperkalemia; cough; angioedema; proteinuria; taste changes; hypotension; pregnancy (fetal renal damage); rash
3158
Q1580:ARB side effect (losartan)
3159
fetal renal toxicity; hyperkalemia
3160
Q1581:two drugs that cause hyperkalemia
3161
losartan and captopril
3162
Q1582:what do you have to do wit hhydralazine and minoxidil?
3163
use beta blockers to treat reflex tachy; diuretic to block salt retention
3164
Q1583:mechanism of hydralazine
3165
increase cGMP; smooth muscle relaxation; vasodilatoin; afterload reduction
3166
Q1584:what is dilation is hydralazine selective for
3167
arerioles
3168
Q1585:clinical use for hydralazine (2)
3169
severe hypertension; CHF
3170
Q1586:mechanism for clonidine
3171
alpha2 agonist
3172
Q1587:mechanism for methyldopa
3173
alpha2 agonist
3174
Q1588:mechanism for prazosin
3175
alpha1 blocker
3176
Q1589:mechanism for reserpine
3177
decrease norepi
3178
Q1590:mechanism for guanethidine
3179
decrease norepi
3180
Q1591:block ach receptor
3181
hexamethonium
3182
Q1592:name 3 calcium channel blockers
3183
nifedipine; verapamil; diltiazem
3184
Q1593:mechanism of calcium blockers
3185
block voltage-dependent calcium channels on cardiac/smooth muscle and reducing muscle contractility
3186
Q1594:rank vascular smooth muscle block by calcium blocker
3187
nifedipine>diltiazem>verapamil
3188
Q1595:rank heart smooth muscle block by calcium blocker
3189
verapamil>diltiazem>nifedipine
3190
Q1596:use for calcium blockers
3191
hypertension; angina; arryhtmia (not nifedipine)
3192
Q1597:calcium blocker toxicity (3)
3193
cardiac depression; peripheral edema; flushing;
3194
Q1598:mechanism for nitro drugs
3195
vasodilate by releasing nitric oxide; increase cGMP; smooth muscle relaxation; decrease preload
3196
Q1599:rank the preference for dilation in nitro drugs
3197
veins > arterioles
3198
Q1600:clinical use for nitro drugs (4)
3199
angina; pulmonary edema; aphrodisiac; erection enhancer
3200
Q1601:name side effects for nitro (4)
3201
tachycardia; hypotension; headache; monday disease
3202
Q1602:define monday disease
3203
build tolerance to nitro during work; resensitize on weekend and get tachy and dizziness
3204
Q1603:goal of antianginal therapy
3205
reduce myocardial oxygen consumption
3206
Q1604:name 5 determinants of antianginal therapy
3207
end diastolic volume; blood presure; heart rate; contractility; and ejection time
3208
Q1605:how does nitro effect end diastolic volume; blood pressure; contractility; heart rate; and ejection time
3209
decrease; decrease; increase (reflex); increase (reflex); decrease
3210
Q1606:how does beta-blocker affect diastolic volume; blood pressure; contractility; heart rate; ejection time
3211
increase; decrease; decrease; decrease; increase
3212
Q1607:name 3 factors that combo beta-blockers + nitrates will decrease
3213
blood pressure; heart rate; and overall myocardial oxygen consumption
3214
Q1608:for calcium channel blockers; what drug is similar to nitro
3215
nifedipine
3216
Q1609:for calcium channel blockers; what durg is similar to beta-blockers
3217
verapamil
3218
Q1610:define bioavailability; protein bound percentage; where ecreted; and 1/2 life for digoxin
3219
75%; 20-40%; kidney; 40 hours
3220
Q1611:mechanism for digoxin
3221
block na/k atpase; increase na; slow na/ca antiport; increaes ca; positive inotrope
3222
Q1612:how does digoxin affect arryhtmia
3223
vagal effects increase PR; decrease QT; T wave inversion on ECG
3224
Q1613:name 2 uses for digoxin
3225
CHF (increase contractility) and a fib (decrease conduction at AV node)
3226
Q1614:5 major general digoxin side efects
3227
nausea; vomiting; diarrhea; blurry yellow vision; arryhtmia
3228
Q1615:name 3 contraindications with digoxin
3229
renal failure; quinidine (will displace dig on protein; potentiate effect); hypokalemia (potentiate effect)
3230
Q1616:what is the antidote for digoxin
3231
slowly normalize K; lidocaine; cardiac pacer; anti-dig FAB fragments
3232
Q1617:describe function that all class I antiarryhtmics have
3233
decrease slope of phase 4 depolarization
3234
Q1618:define state dependency and state what drugs are state dependent
3235
class I antiarryhtmics. selectively depress tissue what is depolarized
3236
Q1619:name 4 class Ia drugs
3237
quinidine; amiodarone; procainamide; disopyramide
3238
Q1620:name 3 mechanisms of class Ia
3239
increase AP duratoin; increase ERP; increase QT interval
3240
Q1621:what do you use class Ia for?
3241
atrial and ventricular arryhtmias
3242
Q1622:quinidine toxicities
3243
cinchonism: headache; tinnitisum; thrombocytopenia plus torsades
3244
Q1623:procainamide toxicity
3245
reversible lupus like side effect
3246
Q1624:name 3 class IB drugs
3247
lidocaine; mexiletine; tocainide
3248
Q1625:mechanism for class IB
3249
decrease AP duration.
3250
Q1626:where does class IB affect?
3251
affect ischemic or depolarized purkinje ventricular tissue.
3252
Q1627:what is class IB useful for?
3253
acute ventricular arryhtmias (post-MI) and digitalis induced arryhtmia
3254
Q1628:name 4 side effects of class IB
3255
local anesthetic; cns stimulation; cns depression; cardiovascular depression
3256
Q1629:name 3 class IC drugs
3257
flecainide; encainide; propafenone
3258
Q1630:name mechanism of class IC
3259
no effect on AP
3260
Q1631:what is class IC sueful for?
3261
v-tach that progress to V fib and also for SVT. usuaully only good for refractory tachyarryhtmias
3262
Q1632:class IC toxicities
3263
proarryhtmitic; especially post-mI (contraindiciated)
3264
Q1633:name 5 class II antiarrythmiycs
3265
propanolol; esmolol; metoprolol; atenolol; timolol
3266
Q1634:mechanism of class II drugs
3267
decrease camp; decrease CA; decrease slope phase 4; increase PR interval at AV node
3268
Q1635:what is a short acting class II
3269
esmolol
3270
Q1636:name 5 side effects of class II drugs
3271
mask hypoglycema; impotence; asthma; CV effects (bradycardia; av block; chf). sleep
3272
Q1637:name 4 class III drugs
3273
sotalol; ibutilide; bretylium; amiodarone
3274
Q1638:mehcanism of class III
3275
increase AP duration; incrase ERP; increase QT; used when others fail
3276
Q1639:sotalol toxicity
3277
torsades; excessive beta-block
3278
Q1640:ibutilide toxicity
3279
torsades
3280
Q1641:bretylium toxicity
3281
new arrhythmias; hypotension
3282
Q1642:amiodorone toxicity
3283
hypothyrodism/hyperthyrodism; pulmonary fibrosis; hepatic toxicity; corneal deposits; skin deposits (photodermatitis); neurologic defects; constipation; bradycardia; heart block; chf
3284
Q1643:what 3 tests to do before using amiodarone?
3285
PFT; LFT; TFT
3286
Q1644:name 2 class IV antiarrhytmics
3287
verapamil; diltiazem
3288
Q1645:mechanism for class IV
3289
affect AV nodal cells; decrease conduction velocity; incrase ERP; increase PR.
3290
Q1646:what is class IV used for
3291
prevent nodal arryhtmias (SVT)
3292
Q1647:what are 4 general side effects for class IV
3293
constipation; flushing; edema; cv (chf; av block; sinus node depression)
3294
Q1648:bepridil toxicity
3295
torsades
3296
Q1649:adenosine function
3297
drug of choice in diagnosisng/abolishing AV nodal arryhtmias
3298
Q1650:potassium function
3299
depress ectopic pacemaker; esp in dig toxicity
3300
Q1651:magnesium function
3301
torsades and dig toxicity use
3302
Q1652:Parasympathetic preganglionic neurons release the neurotransmitter -------- which act on -------- receptors.
3303
Ach; nicotinic.
3304
Q1653:Parasympathetic postganglionic neurons release the neurotransmitter -------- which act on ------- receptors.
3305
Ach; muscarinic.
3306
Q1654:Sympathetic preganglionic neurons to sweat glands release the neurotransmitter ------- which act on ------receptors.
3307
Ach; muscarinic.
3308
Q1655:Sympathetic postganglionic neurons to sweat glands release the neurotransmitter ------- which act on ------receptors.
3309
Ach; muscarinic.
3310
Q1656:Sympathetic preganglionic neurons to glands; cardiac and smooth muscles release the neurotransmitter ------- which act on ------- receptors.
3311
Ach; nicotinic.
3312
Q1657:Sympathetic postganglionic neurons to glands; cardiac and smooth muscles release the neurotransmitter ------- which act on ------- receptors.
3313
NE; alpha and beta
3314
Q1658:Sympathetic preganglionic neurons to renal vascular smooth muscle release the neurotransmitter ------- which act on ------- receptors.
3315
dopamine; D1
3316
Q1659:Sympathetic postganglionic neurons to renal vascular smooth muscle release the neurotransmitter ------- which act on ------- receptors.
3317
Dopamine; D1
3318
Q1660:Sympathetic preganglionic neurons to the adrenal medulla release the neurotransmitter ------- which act on ------receptors.
3319
Ach; nicotinic.
3320
Q1661:Sympathetic preganglionic neurons to the adrenal medulla synapse directly on ------- cells of the adrenal medulla.
3321
Chromaffin.
3322
Q1662:Somatic neurons synapse directly on -------- muscle and release the neurotransmitter ------- which act on ------receptors.
3323
skeletal muscle; Ach; nicotinic.
3324
Q1663:Ach is synthesized from acetyl-CoA and choline by the enzyme ---------.
3325
Choline acetyltransferase.
3326
Q1664:The transport of choline into the nerve terminal can be inhibited by --------.
3327
Hemicholinium.
3328
Q1665:The release of transmitter from vesicles in the nerve ending require the entry of ------ into the neuron.
3329
Calcium.
3330
Q1666:The action of Ach in the synapse is terminated by its metabolism to acetate and choline by the enzyme ---------.
3331
Acetylcholinesterase.
3332
Q1667:In the noradrenergic nerve terminal; tyrosine is hydroxylated to -------; which is decarboxylated to --------; which is finally hydroxylated to NE.
3333
DOPA; dopamine.
3334
Q1668:Dopamine is transported into vesicles for hydroxylation to NE. This transport can be blocked by the drug --------.
3335
Reserpine.
3336
Q1669:The action of NE and DA is terminated by --------and ----------.
3337
Reuptake; diffusion (different than for Ach).
3338
Q1670:The --------- drugs promote catecholamine release.
3339
Amphetamine.
3340
Q1671:The drugs --------- and ---------- inhibit the reuptake of NE.
3341
Cocaine; TCA.
3342
Q1672:The release of NE from a sympathetic nerve ending is modulated by ---------; --------- and ---------.
3343
NE; Ach; angiotensin II.
3344
Q1673:NE inhibits its own release at the noradrenergic nerve terminal through --------- receptors.
3345
Alpha 2.
3346
Q1674:Angiotensin II --------- (inhibits / stimulates) the release of NE from the noradrenergic nerve terminal.
3347
Stimulates.
3348
Q1675:Ach inhibits the release of NE from the noradrenergic nerve terminal by binding to --------- receptors.
3349
M1.
3350
Q1676:Clinical application and action of Bethanechol.
3351
Postoperative and neurogenic ileus and urinary retention. / Activates bowel and bladder smooth muscle.
3352
Q1677:Clinical application and action of Carbachol and Pilocarpine.
3353
Glaucoma. / Activates ciliary muscle of eye (open angle); pupillary sphincter (narrow angle).
3354
Q1678:Clinical application / action of Neostigmine.
3355
Postoperative and neurogenic ileus and urinary retention; myasthenia gravis; reversal of neuromuscular junction blockade (postoperative). / Increase endogenous Ach.
3356
Q1679:Clinical application / action of Pyridostigmine.
3357
Myasthenia gravis. / Increase Ach; increase strength.
3358
Q1680:Clinical application / action of Edrophonium.
3359
Diagnosis of myasthenia gravis (extremely short acting). / Increase endogenous Ach.
3360
Q1681:Clinical application / action of Physostigmine.
3361
Glaucoma (crosses blood-brain barrier) and atropine overdose. / Increase endogenous Ach.
3362
Q1682:Clinical application / action of Echothiophate.
3363
Glaucoma. / Increase endogenous Ach.
3364
Q1683:Symptoms of cholinesterase inhibitor poisoning.
3365
Diarrhea; Urination; Miosis; Bronchospasm; Bradycardia; Excitation of skeletal muscle and CNS; Lacrimation; Sweating; Salivation (also abdominal cramping). "DUMBBELSS".
3366
Q1684:Cholinesterase inhibitor poisoning may be caused by --------.
3367
Parathion and other organophosphates.
3368
Q1685:The cholinesterase regenerator ------- can be used as an antidote for cholinesterase inhibitor poisoning.
3369
Pralidoxime.
3370
Q1686:Mechanism of action of Pralidoxime.
3371
Regenerates active cholinesterase; chemical antagonist; used to treat organophosphate exposure.
3372
Q1687:Clinical uses of the muscarinic antagonist Atropine.
3373
Dilate pupils; decrease acid secretion in peptic ulcer disease; decrease urgency in mild cystitis; decrease GI motility; reduce airway secretions; and treat organophosphate poisoning. "Blocks SLUD: Salivation; Lacrimation; Urination; Defecation."
3374
Q1688:Side effects of Atropine.
3375
Increase body temp; rapid pulse; dry mouth; dry/flushed skin; disorientation; mydriasis with cycloplegia; and constipation. "Atropine parasympathetic block side effects: Blind as bat; Red as a beet; Mad as a hatter; Hot as a hare; Dry as a bone."
3376
Q1689:Hexamethonium (ganglionic blocker) blocks -------receptors.
3377
Nicotinic.
3378
Q1690:tropi are anti-muscarinic; mneumonic?
3379
while vacationing in the tropics you lie on a beach and your muscles waste away!
3380
Q1691:benztropine is used to treat
3381
Parkinson's disease
3382
Q1692:scopolamine is used to treat
3383
motion sickness
3384
Q1693:name 2 antimuscarinic drugs that act on the CNS
3385
benztropine; scopolamine
3386
Q1694:name a muscarinic used to treat motion sickness
3387
scopolamine
3388
Q1695:name a muscarinic used to treat Parkinson's disease
3389
benztropine
3390
Q1696:mechanism of action of benztropine
3391
antimuscarinic
3392
Q1697:mechanism of action of scopolamine
3393
antimuscarinic
3394
Q1698:name three antimuscarinics that act on eye
3395
atropine; homatropine; tropicamide
3396
Q1699:the action of atropine is ______
3397
produce mydriasis; cycloplegia
3398
Q1700:mechanism of atropine is
3399
antimuscarinic
3400
Q1701:the action of homatropine is ______
3401
3402
Q1702:mechanism of homatropine is
3403
antimuscarinic
3404
Q1703:the action of tropicamide is
3405
3406
Q1704:mechanism of tropicamide is
3407
antimuscarinic
3408
Q1705:ipatropium is used to treat
3409
asthma; COPD
3410
Q1706:mechanism of ipatropium is
3411
antimuscarinic
3412
Q1707:name an antimuscarinic used to treat asthma and COPD
3413
ipatropium
3414
Q1708:(2) diuretics used for HTN;;what do both lower as an AE?
3415
Thiazides;Loops;;both lower K+
3416
Q1709:Vasodilator used for severe HTN and CHF;AE?
3417
Hydralazine;;AE: SLE-like effects
3418
Q1710:Vasodilator used for emergency HTN situations;AE?
3419
Nitroprusside;;AE: converts to cyanide
3420
Q1711:Anti-HTN; anti-anginal and anti-arrhythmic class that works by reducing heart contractility;(2) AE
3421
Calcium channel blockers;;AE: Cardiac depression; Edema
3422
Q1712:which of the calcium channel blockers most specific for;Vascular Smooth Muscle
3423
Nifedipine
3424
Q1713:which of the calcium channel blockers most specific for;Heart muscle
3425
Verapamil
3426
Q1714:Drug for angina that also is effective against pulmonary edema
3427
Nitroglycerine
3428
Q1715:what are the (5)* determinants of myocardial oxygen consumption?
3429
BEECH;BP;Ejection time;EDV;Contractility;HR
3430
Q1716:Drug used for CHF and A-fib can cause arrthymias;what are the ECG changes?;(3)
3431
Digoxin;ECG;Inc PR;Dec QT;T-wave inversion
3432
Q1717:MOA of digoxin;(2) AE?
3433
Inhibit Na/K pump to indirectly inhibit Na/Ca antiport; causing Ca increase inside cell;AE;Yellow vision; Arrhythmias
3434
Q1718:(4)* class IA antiarrhythmics
3435
Queen Amy Proclaims Diso's PYRAMID;Quinidine;Amiodarone;Procainamide;Disopyrami de
3436
Q1719:MOA of class IA Na-channel blockers;what type of arrhythmias is it good for?
3437
Inc action potential duration by Inc QRS (QT interval);Use: Ventricular Arrhythmia
3438
Q1720:how do the Na-channel blockers affect HR; CO; BP and SV?
3439
Dec HR -> Dec CO -> Dec BP -> Inc SV;(more time to fill)
3440
Q1721:AE for Quinidine
3441
Cinchonism;HA; Tinnitus; thrombocytopenia; Torsades de Pointes
3442
Q1722:why are Procainamide and Disopyamide successful at slowing the QT interval?
3443
both are Amides; which are metabolized in the liver giving NH4 that can be converted to GLU -> GABA
3444
Q1723:AE for Procainamide
3445
SLE-like effects
3446
Q1724:DOC for V-Tach
3447
Lidocaine;(b/c it affects ischemic tissues and works quickly; IV only)
3448
Q1725:what is the class and drug that is the last resort (V-fib) as a ;Na-channel blocker?;when is it contra-indicated?
3449
Class IC: Flecainide;;CI;post-MI (leads to heart stopping)
3450
Q1726:Na-channel blocker class/drug that decreases Action Potential time
3451
Class IB: Lidocaine
3452
Q1727:(3) drugs that can block both Na and Ca channels;what Dx are they good for?
3453
Procainamide;;Phenytoin;;Quinidine;use: Wolf Parkinson White
3454
Q1728:Class II antiarrhythmics class and MOA
3455
Beta-blockers;MOA;Dec cAMP and Ca currents ->;Dec slope of phase 4 and Inc PR interval
3456
Q1729:(3) AE of Beta-blockers
3457
blocking betas make me SICk;Sedation;;Impotence;;CV effects (bradycardia; CHF)
3458
Q1730:B-blocker;Longest acting
3459
Propranolol
3460
Q1731:B-blocker;Shortest acting
3461
Esmolol
3462
Q1732:B-blocker;also blocks Alpha-receptors;(for Pheos and HTN crisis);(2)
3463
Labetalol;;Carvedilol
3464
Q1733:B-blocker;for Miosis
3465
Timolol
3466
Q1734:B-blocker;also blocks K+ channels
3467
Sotalol
3468
Q1735:B-blocker;good for patient w/ DM; asthmatics; MI and elderly
3469
Atenolol
3470
Q1736:(3)* drugs in Class III anti-arrhythmics
3471
BiAS to K-channel blockers;Bretylium;;Amiodarone;;Sotalol
3472
Q1737:MOA of K-channel blockers
3473
Inc AP by Inc QT interval
3474
Q1738:AE of Amiodarone;(4)
3475
Amy aught to run PFTs; LFTs and TFTs or you'll be BLUE;Pulmonary fibrosis;Hepatotoxicity;Hyper/Hypothyroidism (contains iodine);turns skin Blue
3476
Q1739:Class of choice for Atrial arrhythmias;MOA
3477
Ca-Channel blockers;;For AV nodal cells; Inc ST segment and Inc PR interval
3478
Q1740:DOC for Digitalis-induced arrthymias
3479
Phenytoin
3480
Q1741:drug that inhibits VLDL production; Dec TG and Dec HDL breakdown;AE?
3481
Niacin;;AE: Flushing
3482
Q1742:class that increases the production of lipoprotein lipase to ;Inc breakdown of TG;(2) AE?
3483
Fibrates;"-FIBR-" (Gemfibrozil; Fenofibrate);AE: GI upset; gall stones
3484
Q1743:contraindication of Bile Acid Sequestrants?
3485
High TG levels;BAS Increases TG
3486
Q1744:DOC in AV nodal arrhythmias
3487
Adenosine
3488
Q1745:Antiarrhythmic that depresses ectopic pacemakers ;(esp digoxin toxicity)
3489
Potassium
3490
Q1746:(3) First generation H1 blockers
3491
Diphenhydramine (Benadryl);;Chlorpheniramine (Chlortrimeton);;Promethazine (Phenergan)
3492
Q1747:Clinical uses (3) and AE (3) of First generation H1 blockers
3493
Uses;Motion sickness;Allergy (hives; itching; nasal);Sleep aid;AE;Sedation;Antimuscarinic;Anti-alpha-adrenergic
3494
Q1748:(3) Second generation H1 blockers;Use?
3495
Loratadine (Claritin);;Fexofenadine (Allegra);;Centirazine (Zyrtec);Use: Non-drowsy Allergic rhinitis; Hay fever
3496
Q1749:Name and MOA of a Nasal Decongestant
3497
Pseudoepherine (Sudafed);Alpha-agonist leading to vasoconstriction
3498
Q1750:(2) Cough suppressants
3499
Codeine;;Dextromethophan (DM)
3500
Q1751:Name and MOA of expectorant
3501
Guaifenesin;(Robitussin);;Inc. respiratory secretions and viscosity
3502
Q1752:Long acting B2-agonist for Asthma Prophylaxis
3503
Salmeterol
3504
Q1753:Methylxanthine used for Severe asthma;MOA?;(2) AE?
3505
Theophylline;Bronchodilator by Inh Phosphodiesterase and Dec cAMP hydrolysis;AE;Cardiotoxicity;Neurotoxicity
3506
Q1754:Drug and MOA of Mast Cell Stabilizers;Use?
3507
Cromolyn;causes Mast cells not to release histamine;use: Only for Prophylaxis
3508
Q1755:what is the most potent anti-inflammatory agent that is effective for mild; moderate and severe asthma ;(first line for chronic asthma)?;MOA?
3509
Glucocorticosteroids;;Inh NF-kB transcription factor that induces TNF-alpha; inhibiting formation of PGE and LTE
3510
Q1756:(2) Adverse effects of Glucocorticoids?
3511
Oral candidiasis;;bone demineralization
3512
Q1757:Leukotriene effect modulator that inhibits lipoxygenase and leukotriene formation;AE?
3513
Zileuton;;AE: Hepatotoxicity
3514
Q1758:(2) Leukotriene effect Modulator that binds the leukotriene receptors;Use?
3515
Zafirlukast;;Montelukast;;Use: Prophylaxis; mild/moderate asthma
3516
Q1759:Muscarinic antagonist that prevents bronchoconstriction
3517
Ipratropium
3518
Q1760:non-specific Beta-agonist that relaxes bronchial smooth muscle;AE?
3519
Isoproterenol;;AE: tachycardia
3520
Q1761:What asthma agents deal with an early response (bronchoconstriction)?;(4)
3521
My BLT;Muscarinic antagonist;;Beta-agonist;;Leukotriene antagonist;;Theophylline
3522
Q1762:what asthma agents deal w/ mast cells releasing mediators?;(2)
3523
Cromolyn;;Steroids
3524
Q1763:Ganglionic blocker (rarely used) for the rapid reduction of HTN
3525
Trimethaphan
3526
Q1764:only drug that reduces morbidity and mortality in heart failure
3527
Spironoloactone
3528
Q1765:drug given IV for severe acute heart failure
3529
Dobutamine
3530
Q1766:what anti-HTN drug may ilicit a positive Coombs test and hemolytic anemia?
3531
Methyldopa
3532
Q1767:DOC for variant angina
3533
Nifedipine
3534
Q1768:what drug interaction w/ Digoxin increases its toxicity?
3535
Thiazides;(Dec K+ -> Inc Dig toxicity)
3536
Q1769:Anti-anginal Tx that has AE of severe constipation
3537
Verapamil
3538
Q1770:(2) AE of Adenosine
3539
Burning sensation in chest;;SOB
3540
Q1771:(2) AE of Dobutamine
3541
Inc HR and BP
3542
Q1772:HTN medication that has AE of "Loss of taste"
3543
ACEi
3544
Q1773:patient treated w/ anti-arrhythmic that causes recurrent attacks of feeling faint and experiencing episodes of loss of consciousness. what drug?
3545
Quinidine
3546
Q1774:Cardiac AP drug;affects Phase 4;(3)
3547
Digoxin;;Verapamil ;(Ca-channel blockers);;Lidocaine
3548
Q1775:Cardiac AP drug;affects Phase 0 to slow conduction and prolong repolarization
3549
IA drugs;(All class I slow conduction; but only IA prolongs repolarization)
3550
Q1776:Cardiac AP drug;affects Phase 0 but causes no change in repolarization
3551
Class IC - Flecainide
3552
Q1777:Cardiac AP drug;blocks Na; Ca and K channels
3553
Amiodarone
3554
Q1778:Drug that lowers HTN by inhibiting Peptidyl Dipeptidase
3555
ACEi;(at biochemical level)
3556
Q1779:drug class for CHF that decreases Preload and BV
3557
ACEi
3558
Q1780:only Drug class that increases the survival rate in CHF
3559
ACEi
3560
Q1781:Diuretics
3561
Bumetanide (Bumex);furosemide (Lasix);HCTZhydrochlorothiazide (Microzide; Esidrix);spironolactone (Aldactone);triamterene (Dyrenium/ Maxide w/ HCTZ)
3562
Q1782:Beta-Blockers
3563
Atenolol (Tenormin);Labetolol (Normodyne; Trandate);metoprolol (Lopressor);nadolol (Corgard);propranolol (Inderal);timolol (Timoptic)
3564
Q1783:ACE Inhibitors
3565
Benazepril (Lotensin);captopril (Capoten);enalapril (Vasotec);fosinopril (Monopril);lisinopril (Zestril);moexipril (Univasc/ Uniretic w/HCTZ);quinapril (Accupril);ramipril (Altace)
3566
Q1784:Angiotensin II Antagonist
3567
Losartan (Cozaar; Hyzaar w/ HCTZ);valsartan (Diovan)
3568
Q1785:Calcium channel blockers
3569
Amlodipine (Norvasc; Lotrel w/ Benazepril);Diltiazem (Cardizem; Tiazac);felodipine (Plendil);isradipine (Dynacirc);nicardipine (Cardene);nifedipine (Procardia; Adalat);nisoldipine (Sular; Nisocor);verapamil (Calan; Covera; Isoptin)
3570
Q1786:Alpha Blockers
3571
Doxazosin (Cardura);Prazosin (Minipress);Terazosin (Hytrin)
3572
Q1787:Others
3573
Clonidine (Catapres);diazoxide (Hyperstat IV);hydralazine;alpha-methyldopa (Aldomet?);minoxidil (Loniten);sodium nitroprusside (Nipride)
3574
Q1788:Class I Na+ Channel Blockers?;(1A)
3575
Disopyramide (Norpace);Procainamide (Procan);Quinidine (Quinidex)
3576
Q1789:Class I Na+ Channel Blockers (1b)?
3577
Lidocaine (Elamax/Lidoderm);Mexiletine (Mexitil);Tocainide (Tonocard)
3578
Q1790:Class I Na+ Channel Blockers (1c)?
3579
Flecainide (Tambocor);Propafenone (Rhythmol);Others;Adenosine;Digoxin
3580
Q1791:Class II B-Blockers
3581
Esmolol (Brevibloc);Metoprolol (Lopressor;Toprol);Pindolol (Visken);Propranolol (Inderal)
3582
Q1792:Class III K+ Channel Blockers
3583
Amiodarone (Cordarone);Bretylium (Bretylol);Sotalol (Betapace)
3584
Q1793:Class IV Ca++ Channel Blockers
3585
Diltiazem (Cardizem; Tiazac);Verapamil (Calan; Covera; Isoptin)
3586
Q1794:Mechanism of action of Class IA antiarrhytmics?
3587
Na+ Channel Blockers;class 1A slows phase 0 depolarization
3588
Q1795:Mechanism of action of Class IB antiarrhytmics?
3589
Na+ Channel Blockers;Class 1B shortens phase 3 repolarization
3590
Q1796:Mechanism of action of Class IC antiarrhytmics?
3591
Na+ Channel Blockers;Class 1C markedly slows phase 0 depolarization
3592
Q1797:Mechanism of action of Class 2 antiarrhytmics?
3593
Class II B-Blockers (supresses phase 4 depolarization)
3594
Q1798:Mechanism of action of Class 3 antiarrhytmics?
3595
Class III K+ Channel Blockers (prolongs phase 3 repolarizaion)
3596
Q1799:Mechanism of action of Class 4 antiarrhythmics?
3597
Class IV Ca++ Channel Blockers (shortens action potential)
3598
Q1800:What are the clinical uses of the H1 blockers?
3599
allergy; motion sickness; sleep aid
3600
Q1801:Name the H1 blockers. (3 1st generation and 3 2nd generation).
3601
1st = diphenhydramine; dimenhydrinate; chlorpheniramine. 2nd = loratadine; fexofenadine; desloratadine
3602
Q1802:The side effects of H1 blockers?
3603
sedation; animuscarinic; anti-alpha-adrenergic. 2nd gen far less sedating.
3604
Q1803:What classes of drugs are used to treat asthma?
3605
B-agonists; B2-agonists; methylxanthines; muscarinic antagonists; cromolyn; corticosteroids; antileukotrienes
3606
Q1804:Name the nonspecific B-agonist that causes bronchial smooth muscle relaxation and tachycardia.
3607
Isoproterenol
3608
Q1805:Name the B2 agonist used during acute asthma exacerbations.
3609
Albuterol
3610
Q1806:What is Salmeterol used for?
3611
long-acting B2-agonist used for prophylaxis
3612
Q1807:What is the MOA of Theophylline (a methylxanthine)?
3613
causes bronchodilation by inhibiting phosphodiesterase and decreasing cAMP hydrolysis.
3614
Q1808:Adverse effects of Theophylline?
3615
Narrow therapeautic index! Limited use! Cardiotoxicity and neurotoxicity
3616
Q1809:Which class of drugs does Ipratropium belong to?
3617
Muscarinic antagonists
3618
Q1810:What is the MOA of Cromolyn and what is its clinical use?
3619
prevents degranulation of mast cells; therefore only effective for prophylaxis and not during and asthma attack.
3620
Q1811:What is 1st line therapy for chronic asthma?
3621
corticosteroids (beclomethasone and prednisone)
3622
Q1812:What is the MOA of beclomethasone?
3623
inhibit cytokine synthesis. Inactivate NF-kappaB; the tf that induces TNF-alpha
3624
Q1813:What is the MOA of Zileuton?
3625
5-lipoxygenase pathway inhibitor that blocks conversion of arachidonic acid to leukotrienes
3626
Q1814:What are Zafirlukast and montelukast especially good at treating? (MOA?)
3627
aspirin-induced asthma; b/c they block leukotriene receptors
3628
Q1815:Do expectorants (Guaifenesin) suppress the cough reflex?
3629
No; they only remove excess sputum
3630
Q1816:What is N-acetylcystine?
3631
a mucolytic that can loosen mucus plugs in CF patients
3632
Q1817:Epinephrine
3633
Properties - stimulates both (vasoconstriction - esp skin; Pharmacology Flash Facts mucosa and kidneys) and (bronchodilatation) receptors. 2 stimulation may also decrease mast cell secretions. vital capacity increases due to relief of bronchial mucosal congestion. not effective orally; rapidly absorded IM or SQ;Indications - acute asthmatic attacks; hypersensitivity reactions; prolongation of infiltration anesthetic action; topical hemostatic effect;SE; Tox - anxiety; termor; palpitations; tachycardia; headache; diaphoresis; pallor;CI - HTN; hyperthroid; ischemic heart disease; cerebrovascular insufficiency. don't use if 3634 than 60 unless asthma is older intractable.
Q1818:Ephedrine
3635
Properties - stimulates both and receptors and increases the release of NE. vasoconstriction/cardiac stimulation --> increase pulse pressure. CNS stimulant. Rapidly absorbed PO. Compared to epi - longer duration of action; more central effects; lower potency;Indications - chronic asthma (rarely used now); mydratic (aqueously);SE; Tox - CNS stimulation; increased PVR.
3636
Q1819:Isoproterenol
3637
Properties - stimulates receptors. all smooth muscle is relaxed and PVR is lowered in skeltal; renal; and mesenteric vascular beds. rapidly absorded after inhalation;Indications relieves respiratory distress in severe asthmatic attacks but rarely used now that there's more selective agents;SE; Tox acute toxicity less than with epi. tachycardia; headache; flushing; nausea; dizziness; diaphoresis. anginal pain/cardiac arrhythmias. tolerance can occur.
3638
Q1820:Metaproterenol
3639
Properites - 2 selective. relaxes smooth muscle of bronchi; uterus; skeletal muscle vasculature; decreases airway resistance. resistant to COMT methylation. PO or inhaled; duration up to 4 hours;Indications - bronchodilator in treatment of asthma; reversible bronchospasm;SE; Tox tachycardia; hypertension; nervousness; termor; palpitations; n/v. caution in pts with severe HTN; coronary artery disease; CHF; hyperthroid. tolerance less like compared to inhaled isoproterenol.
3640
Q1821:Terbutaline
3641
Properties - 2 selective when given orally but causes cardio effects similar to isoproterenol when given SQ. resistant to COMT methylation;Indications - only 2 agonist used parenterally for tx of status asthmaticus;SE; Tox - oral causes tremor. dizziness; nervousness; fatigue; tinnitus; palpitations rare. SQ causes same effects as epi.
3642
Q1822:Salmeterol
3643
Properties - 2 selective. longer actinging;Indications - asthma prophylaxis.
3644
Q1823:Albuterol
3645
Properties - similar to terbutaline. 2 selective. aviable as oral and aersol preparation. peak effect 30-40 min with 3-4 hour duration;Indications - reversible obsructive airway disease;SE; Tox - nervousness; termor; headache; insomnia; weakness; dizziness; tachycardia; palpitations. use in caution in pts wtih coronary artery insufficiency; HTN; hyperthroid; DM and pts recieving MAO-I or TCAs.
3646
Q1824:Theophylline
3647
Properties - inhibits phosphodiesterase --> increased cAMP. relaxes bronchial smooth muscles --> increased VC; potent Pharmacology Flash Facts CNS stimulant; imporves diaphragmatic contractility. positive inotropic action. increases water and electrolyte excretion. oral; rectal; or parental. distributed into all compartments; 60% pro bound;Met/Excr- liver met; t1/2 = 8 hrs;Indications bronchodilator in asthma and COPD; improve diaphragmatic function in COPD; reduceds prolonged apnea in preterm infants;SE; Tox - oral causes headache; nervousness; dizziness; n/v; epigastric pain. iv causes cardiac arrhythmias (blocks adenosine receptors which then increases AV nodal conduction); hypotension;3648 cardiac arrest and seizures;in children; CNS stimulation; diuresis; fevers;monitor serumm levels (tox at >20 mg/L; benefit at 7 10)
Q1825:Cromolyn Sodium/Nedocromil
3649
Pharmacology Flash Facts Properties - inhibits the degranulation of mast cells preventing the realse of histamine and other autacoids after immunologic and nonimmunologic stimulation. inhaled because of low oral absorption;Met/Excr - excreted unchanged within a few days. maximal levels reached within minutes with t1/2 = 1 hr. response observed within weeks;Indications - prevent asthma attacks esp. in cold and exercise induced asthma. most protective n kids with chronic unstable asthma. can also be used as a nasal spray for allergic rhinitis;SE; Tox - seen in less than 5% of pts. sore thraot; cough; dry mouth most common. 3650 urticaria; maculopapular dermatitis; gastroenteritis.
Q1826:Prednisone/Prednisolone
3651
Class - corticosteroids. reduce inflammation and edema and potentiate the bronchodilating effects of adrenergic agonists. inactivate NF-kB the transcription factor that induces the production of TNF-;Indications - severe chronic and acute bronchospasm;SE; Tox - suppression of growth; osteoporosis; aggravation of diabetes; aseptic bone necrosis; adrenocortical suppresions.
3652
Q1827:Beclomethasone dipropionate
3653
Class - corticosteroids. reduces inflammation and edema na dpotentiates the bronchodilating effects of adrenergic agonists;Properties - inhaled in metered doses. highly potent. only minor systemic absorption and rapid metabolism so it has no effect on the HPA axis;Indications - substiute for oral preparations in selected individuals with severe steroiddependent asthma;SE; Tox - oropharyngeal and laryngeal candidal infection. hoarseness; sore throat; dry mouth.
3654
Q1828:Atropine/Ipratropium Bromide
3655
Properties - block muscarinic receptors thereby inhibiting aceycholine-induced bronchoconstriction;Indications - in asthma pts unresponsive to adrenergic agents and methylxantihines. bromidey is often used in COPD because it also reduced secretions;SE; Tox - drowsiness; sedation; dry mouth; blurred vision; urinary retenion; constipation. not as pronounced with ipratropium because it does not cross the BBB.
3656
Q1829:Zileuton
3657
Class - anitleukotriene;Properties - inhibits 5-lipoxygenase therefore blocks synthesis of leukotrienes. use with corticosteroids;Indications - prophylaxis of asthma;SE; Tox diarrhea; headache; increased risk of infections.
3658
Q1830:Zafirlukast
3659
Blocks LTD4 leukotriene receptors. LTD4 is a receptors function in bronchoconstriction; vasoconstriction; contraction of smooth muscle and increased vascular permeability.
3660
Q1831:First Generation H1 Blockers
3661
Examples - Diphenhydramine; dimenhydrinate; chlorpheniramine;Indications - Allergy; motion sickness; sleep aid;Toxicity - Sedation; antimuscarinic; anti--adrenergic.
3662
Q1832:Second Generation Histamine Blockers
3663
Examples - Loaratidine; fexofenadine; desloratadine;Indications - Allergy;Toxicity - far less sedating than first generation.
3664
Q1833:What are the short acting beta-2-adrenoreceptor agonists? What are they used to treat?
3665
Albuterol; levalbuterol; metaproterenol; pirbuteol;These drugs are used for the treatment of the acute bronchoconstriction of asthma by relaxing bronchial smooth muscle.
3666
Q1834:What are the long acting beta-2-adrenoreceptor agonists? How are they chemically different than short acting beta-2 adrenoreceptor agonists?
3667
Salmeterol; formoterol;These drugs have lipophilic side chains that slow diffusion out of the airway.
3668
Q1835:What is isoproterenol?
3669
Nonselective beta-receptor agonists and a potent bronchodilator.
3670
Q1836:What is the most common adverse effect of beta-2 adrenoreceptor agonists?
3671
Skeletal muscle tremor. Other: tachycardia; arrhythmias; exacerbation of angina.
3672
Q1837:Theophylline; theobromine; and caffeine are part of what drug family that is used to treat asthma? What are the pharmacologic effects of theophylline?
3673
Methylxanthines;Pharmacologic effects: relax bronchial smooth muscle; decrease histamine release; stimulate ciliary transport of mucus; stimulate medullary respiratory center.
3674
Q1838:Name two anticholinergic drugs used to treat asthma.
3675
Ipratropium bromide and atropine. They inhibit AChmediated constriction of bronchial airways and also decrease vagal stimulated mucus secretion.
3676
Q1839:How does cromolyn sodium treat asthma?
3677
Cromolyn sodium inhibit the release of mediators from mast cells; suppress the activation of neutrophils; eosinophiles; and monocytes and inhibit the cough reflex.
3678
Q1840:How should cromolyn sodium be used in order to effectively combat asthma?
3679
Cromolyn sodium is used prophylactically. It does not reverse an established bronchospasm. It is also the only antiasthmatic that inhibits both early and late phase responses.
3680
Q1841:When is nedocromil sodium used in place of cromolyn sodium?
3681
Nedocromil is more effective in blocking bronchospasm induced by exercise or cold air.
3682
Q1842:How does beclomethasone treat asthma?
3683
It is a glucocorticoid that increases airway diameter by attenuating prostaglandin and leukotriene synthesis via inhibition of phopholipase A2.
3684
Q1843:What are the side effects of oral administration of budesoide and flunisolide?
3685
These are glucocorticoids. Side effects include hoarseness and oral candidiasis. More serious adverse effects are adrenal suppression and osteoporosis.
3686
Q1844:The -lukast drugs are antagonists of the _______.
3687
Montelukast and zafirlukast are antagonists of the leukotriene receptor LT1. This blocks LTC; D; E4.
3688
Q1845:Name the asthmatic drug that inhibits 5-lipoxygenase; the rate-limiting enzyme in leukotriene biosynthesis.
3689
Zileuton.
3690
Q1846:What is omalizumab?
3691
Omalizumab is an anit-IgE antibody that binds to IgE's Fc receptors; blocking the binding of IgE to mast cells and basophils.
3692
Q1847:Allergic rhinitis; but not rhinitis associated with colds; can be effectively treated with antihistamines (H1-receptor antagonists). Name a few.
3693
Diphenhydramine; brompheniramine; chlorpheniramine; and loratadine.
3694
Q1848:What is clemastine used to treat?
3695
Rhinorrhea. It is a second generation H1-receptor antagonist.
3696
Q1849:What is an antitussive?
3697
Medicine used to inhibit or suppress coughing.
3698
Q1850:Name the mucolytic drug used to reduce the viscosity of mucus and treat COPD exacerbations.
3699
Acetylcysteine: cleaves disulfide bonds.
3700
Q1851:An asthmatic female who is recovering from an MI is on several medications. She complains about bruising easily. Blood panel reveals elevated ALT. What antiasthmatic is she on?
3701
Zilueton - inhibits metabolism of warfarin and increases liver enzymes.
3702
Q1852:Why are opiods effective in the suppression of coughing?
3703
They act centrally to decrease sensitivity of the cough center to peripheral stimuli.
3704
Q1853:What initiates coughing?
3705
Cough receptors; specialized stretch receptors in the trachea and bronchial tree; send vagal afferents to the cough center.
3706
Q1854:Theophylline has several mechanims; many which are unknown. What are two known moa's of this drug?
3707
Adenosine-receptor antagonist activity and the inhibition of phosphodiesterase.
3708
Q1855:What drug is used to counter opioid overdose?
3709
Naltrexone.
3710
Q1856:Which drug is most contraindicated in patients with COPD: acebutolol; nadolol; atenolol; esmolol; metoprolol?
3711
Nadolol because it is a non-selective beta antagonist.
3712
Q1857:What asthma drug can cause U-waves on ECG? How?
3713
Albuterol may cause potassium to shift into cells; resulting in hypokalemia.
3714
Q1858:What drug can be used to stop the bronchoconstriction resulting from an asthmatic allergic reaction?
3715
Zileuton. Asprin diverts the arachidonic acid pathway to the leukotrienes. Zileuton blocks 5-lipoxygenase which is the enzyme that forms the LTs.
3716
Q1859:4 H2 blockers
3717
cimetidine; ranitidine; famotidine; nizatidine
3718
Q1860:MOA of H2 blockers
3719
reversibly block H2 receptors which causes decreased H+ secretion by gastric parietal cells
3720
Q1861:cimetidine toxicities
3721
P450 inhibitor; antiandrogenic; crosses BBB (confusion; HAs; dizziness) and placenta
3722
Q1862:2 proton pump inhibitors
3723
omeprazole; lansoprazole
3724
Q1863:MOA of PPIs
3725
irreversibly bind H+/K+ ATPase in gastric parietal cells
3726
Q1864:MOA of bismuth; sucralfate
3727
bind to ulcer base and provide physical protection; allow bicarb secretion to reestablish pH gradient in mucous layer
3728
Q1865:triple tx of H. pylori?
3729
metronidazole + bismuth + amoxicilin/tetracycline
3730
Q1866:MOA of misoprostol
3731
PGE1 analog; that increases production and secretion of gastric mucous barrier and decreases acid production
3732
Q1867:toxicity/contraindications for misoprostol
3733
(PGE1 analog) diarrhea; not for women of childbearing potential
3734
Q1868:which 2 muscarinic antagonists used for treatment of peptic ulcer?
3735
pirenzepine; propantheline
3736
Q1869:toxicities of pirenzepine and propantheline?
3737
tachycardia; dry mouth; difficulty focusing eyes
3738
Q1870:overuse of aluminum hydroxide can cause what problems?
3739
(antacid) constipation; hypophosphatemia; proximal mm weakness; osteodystrophy; seizures
3740
Q1871:overuse of magnesium hydroxide can cause what problems?
3741
(antacid) diarrhea; hyporeflexia; hypotension; cardiac arrest
3742
Q1872:overuse of calcium carbonate can cause what problems?
3743
(antacid)hypercalcemia; rebound acid increase
3744
Q1873:MOA of infliximab
3745
monoclonal TNF-alpha ab
3746
Q1874:clinical use of infliximab
3747
Crohn's dz; rheumatoid arthritis
3748
Q1875:infliximab toxicity
3749
respiratory infection; fever; hypotension
3750
Q1876:MOA sulfasalazine
3751
combo antibacterial (sulfapyridine) and anti-inflammatory (mesalamine); activated by colonic bacteria
3752
Q1877:clinical use of sulfasalazine
3753
UC; Crohn's disease
3754
Q1878:toxicity of sulfasalazine (5)
3755
malaise; nausea; sulfonamide toxicity; reversible oligospermia
3756
Q1879:MOA of ondansetron
3757
5-HT3 antagonist (powerful central acting anti emetic)
3758
Q1880:clinical use of ondansetron
3759
antiemetic; to control vomiting post-op and in pts undergoing chemotherapy
3760
Q1881:toxicity of ondansetron
3761
headache; constipation
3762
Q1882:MOA of cisapride
3763
acts thru serotoni R to increase Ach release at myenteric plexus; increases esophageal tone; increases gastric and duodenal contracitlity and improves transit time (prokinetic)
3764
Q1883:Clinical use of cisapride
3765
prokinetic (on GIT) but no longer used because of serious interactions with erythromycin; ketoconazole; nefazodone; fluconazole (-->torsades de pointes!)
3766
Q1884:MOA of metoclopramide
3767
D2 R antagonist; increases resting tone; contractility; LES tone; motility but does not increase transit time thru colon. (pro-kinetic)
3768
Q1885:clinical use of metoclopramide
3769
diabetic and post-surgery gastroparesis
3770
Q1886:toxicity of metoclopramide
3771
(D2 R antag). Increased Parkinsonian effects; restlessness; drowsiness; fatigue; depression; nausea; constipation.
3772
Q1887:drug interactions of metoclopramide
3773
digoxin and diabetic agents
3774
Q1888:contraindications for metoclopramide?
3775
(D2 R antag) pts with small bowel obstruction
3776
Q1889:Calcium carbonate
3777
Class - nonsystemic Antacid;Indication - PUD; reflux esophagitis;SE; Tox - hypercalcemia (esp. with dairy products); renal stones; Ca stimulates secretion of gastrin and HCl --> acid rebound
3778
Q1890:Aluminum hydroxide
3779
Class - nonsystemic Antacid;Indications - PUD;SE; Tox *constipation*; hypophosphatemia; proximal myopathy; encephalopathy in pts on dialysis
3780
Q1891:Magnesium salts
3781
Class - nonsystemic Antacid;Indication - PUD;SE; Tox *diarrhea*; milk-alkali syndrome with dairy products; metabolic *alkalosis* esp. in renal insufficiency. exacerbation of CHF; edema because of sodium intake;CI - HTN
3782
Q1892:Antacids
3783
All can cause hypokalemia.
3784
Q1893:Cimetidine
3785
Class - H2 blockers (block parietal cell histamine receptors);Indications - Tx/prevent PUD; ZE; gastritis; mild GERD;Properties - acid secretion inhibited for 4 hours;SE; Tox - only H2 blocker to inhibit P450 system --> increase serum levels of EtOH; warfarin; digitoxin; TCA; phenytoin; carbamazepine; beta -blockers; benzos. antiadrogenic; decreased renal excretion of creatinine.
3786
Q1894:Ranitidine
3787
Class - H2 blockers (block parietal cell histamine receptors);Indications - Tx/prevent PUD; ZE; gastritis; mild GERD;Properties - more potent than cimetidine. 1-2x daily;SE; Tox - less than cimetidine; doesn't penetrate CNS as much; no P450 effect.
3788
Q1895:H2 Blockers
3789
cimetidine; ranitidine; famotidine; nizatidine
3790
Q1896:Omeprazole; Lansoprazole
3791
Class - PPI;Indications - GERD; PUD; ZE; gastritis. esp. when refractory to H2 blockers;Properties - irreversible inhibition; prodrug that diffuses into acid space of secretory canaliculus where it is protonated to active form;SE; Tox overgrowth of bacteria
3792
Q1897:Sucralfate
3793
Indications - PUD;Properties - activated in acid environment. negative charges bind to positively-charged proteins in ulcerated tissue. Provides physical protection;SE; Tox minor. mostly constipation. decrased absoprtion of ciproflaxin; norflaxin. because it needs acid to be activated; do not give with antacids; H2 blockers; PPIs.
3794
Q1898:Bismuth
3795
Indications - PUD;Properties - binds to ulcerr providing physical protection. possible antimicrobial activity against H. pylori.
3796
Q1899:Misoprostol
3797
Class - PGE? analog;Indications - prevent gastric ulcers caused by NSAIDS;SE; Tox - Diarrhea;CI - potentially childbearing women (induces labor).
3798
Q1900:Antibiotics for PUD
3799
Tetracycline; Metronidazole; Clarithromycin; plus H2 blocker drastically reduces recurrence compared to H2 blocker alone.
3800
Q1901:Ipecac
3801
Class - Emetic;Properties - irritates GI tract; stimulates chemoreceptor zone. Onset = 15-30 min.
3802
Q1902:Prochlorperazine; chlorpromazine; metoclopramide
3803
Class - Dopamine receptor antagonists;Properties - Act at D2 receptors at chemoreceptor trigger zone --> antiemesis.
3804
Q1903:Ondansetron
3805
Class - Antiemetic;Properties - 5-HT3 antagonist;Indications - control vomiting postop and during chemotherapy;SE; Tox headache; constipation.
3806
Q1904:Bulk-forming Laxatives
3807
Examples - dietary fiber; semisynthetic polysaccharides/cellulose (methylcellulose);Properties osmotic effect --> fluid/electrolyte renetion in intestinal lumen. increased fecal mass/softness --> accelerated transit. Works within 1-3 days after PO administration;Indications diverticular disease; IBS;SE; Tox - flatulance; electrolyte imbalances; esophogeal/intestinal obstruction therefore take with fluids
3808
Q1905:Castor Oil
3809
Class - Stimulant laxative;Properties - hydrolyzed in small intestine to active ingredient --> decreased reabsorption of electrolytes/fluids and stimulates peristalsis. works within 1-3 hours after PO administration;SE; Tox - chronic use impairs absorption of essential nutrients; excacerbates dehydration and electrolyte disturbances.
3810
Q1906:Bisacodyl
3811
Class - Stimulant laxative;Properties - onset of action (oral) = 6-12h; (rectal) = 1h;SE; Tox - fluid/electrolyte deficiencies; rash; rectal burning
3812
Q1907:Anthroquinones
3813
Class - Stimulant Laxative. (cascara and senna; eg);Properties effect at large intestine. Increase peristalsis.
3814
Q1908:Docusates
3815
Class - Stimulant Laxative;Properties - anionic surfactant. Softens stool by emulsifying water; fat; and feces. Onset of action = 1-3d;Indications - used after abdominal surgery and postMI;SE; Tox - nausea; cramping. Don't use with mineral oil.
3816
Q1909:Salt-containing Osmotic Laxatives
3817
Properties - contain Mg; phosphate; sulfate salts. fluid retention --> increased motility. Onset of action = 2h; semifluid stools;Indications - bowel evacuation prior to surgery/imaging;SE; Tox - Mg salts --> hypermagnesemia in pts with renal insufficiency. Na salts exacerbate CHF; cause dehydration.
3818
Q1910:Lactulose
3819
Class - nonsalt Osmotic Laxative;Properties - semisynthetic disaccharide. Traps ammonia as NH4+; enhances excretion of nitrogenous wastes in hepatic insuffiency. Onset of action = 1-3d;Indications - laxative and in hepatic encephalopathy;SE; Tox - N/V; flatulence; diarrhea; dehydration; hypokalemia.
3820
Q1911:Mineral Oil
3821
Class - Surfactant Laxative;Properties - softens stool;SE; Tox - limiting. pneumonitis after aspiration; imparied absorption of fat-soluble nutrients; pruritus ani (ew.)
3822
Q1912:Loperamide
3823
Class - Opiate;Indications - Diarrhea;Properties - since it poorly crosses BBB; it has few side effects and low potential for abuse. decreases GI motility.
3824
Q1913:Infliximab
3825
Class - monoclonal Ab to TNF-alpha (a proinflammatory cytokine);Indications - Crohn's Disease; rheumatoid arthritis;SE; Tox - respiratory infection; fever; hypotension
3826
Q1914:Sulfasalazine
3827
Class - combo of sulfapyridine (antibacterial) and mesalamine (anti-inflmmatory);Indications - Ulcerative colitis; Crohn's disease;SE; Tox - Malaise; nausea; sulfonamide toxicity (hypersensitivity rxn; hemolysis in G6PD deficient pts; nephrotoxicity; kernicterus; displacing drugs (warfarin) from albumin)
3828
Q1915:examples of H2 blockers
3829
cimitidine ;ranitidine;famotidine;nizatidine;(-tidine)
3830
Q1916:mechanism of H2 blockers
3831
reversibly bind to H2 recetors; blocking H2 activation and decreased H+ release by parietal cells
3832
Q1917:toxicity of H2 blockers
3833
cimitidine has the most: anti-androgenic effects; p450 interactions; crosses BBB (--> dizziness; confusion; HA); can cross placenta;rantidine and cimetidine decrease renal excretion of creatinine
3834
Q1918:examples of PPI
3835
omeprazole ;lansoprazole ;(-prazole)
3836
Q1919:MOA of PPI
3837
irreversibly binds to H-K-ATPase pump in parietal cells
3838
Q1920:clinical use for H2 inhibitor
3839
peptic ulcers;gastritis ;mild GERD
3840
Q1921:clinical uses for PPI
3841
peptic ulcers; gastritis; GERD; Zollinger-Ellison syndrome
3842
Q1922:MOA of bismuth
3843
binds at the base of the ucler; giving physical protection ;allows HCO3- secretion to re-establish pH gradient in mucus layer
3844
Q1923:clinical use of bismuth
3845
ucler healing;traveller's diarrhea
3846
Q1924:MOA sucralfate
3847
binds at base of ulcer; giving physical protection ;allows HCO3- secretion to re-establish pH gradient in mucus layer
3848
Q1925:clinical use of sucralfate
3849
increase ulcer healing ;traveller's diarrhea
3850
Q1926:MOA of misoprostol
3851
agonizes PGE1; increases production of mucous barrier ;decreases acid production
3852
Q1927:what is the triple therapy against HP?
3853
metronidazole ;bismuth;amoxy (or tetracycline)
3854
Q1928:clinical uses for misoprostol
3855
prevention of NSAID induced ulcers ;maintain patent PDA ;induce labor
3856
Q1929:toxicity of misoprostol
3857
abortofacient
3858
Q1930:examples of muscarinic antagonists
3859
pirenzepine ;propantheline
3860
Q1931:MOA of muscarinic antagonists
3861
blocks M1 receptors on ECL cells and M3 receptors on parietal cells (vagal stimulation goes ot M3) ;blocking M1 receptor decreases H2 secretion and blocking M3 decreases H+ secretion
3862
Q1932:clinical uses for muscarinic antagonists
3863
peptic ulcer
3864
Q1933:toxicity of muscarinic antagonist
3865
tachycardia;dry mouth;difficulty focusing eyes
3866
Q1934:toxicity associated with Al(OH)3
3867
constipation (minimum amt of feces);muscle weakness;osteodystrophy ;seizures;hypokalemia
3868
Q1935:toxicity associated with Mg(OH)2
3869
diarrhea ;hyporeflexia;hypotension;cardiac arrest ;hypokalemia
3870
Q1936:toxicity associated with calcium carbonate
3871
hypercalcemia;rebound acid increase;hypokalemia
3872
Q1937:MOA of infliximab
3873
mAB against TNF-alpha
3874
Q1938:clinical uses of infliximab
3875
Crohn's disease;RA
3876
Q1939:toxicity assicated with infliximab
3877
respiratory infx;hypotension ;fever
3878
Q1940:MOA sulfasalazine
3879
combo of sulfapyridine and mesalamine (antibacterial and anti-inflammatory) ;activated by colonic bacteria
3880
Q1941:clinical use of sulfasalazine
3881
UC ;CD
3882
Q1942:toxicity of sulfasalazine
3883
malaise;nausea;sulfonamide toxicity ;reversible oligospermia
3884
Q1943:MAO ondansetron
3885
seratonin antagonist ;antiemetic
3886
Q1944:clinical use for ondansetron
3887
control vomiting post-op and in pts taking chemo
3888
Q1945:toxicity associated with ondansetron
3889
HA;constipation
3890
Q1946:examples of pro-kinetic agents
3891
cisapride ;metoclopramide
3892
Q1947:MOA cisapride
3893
increases ACh release at myenteric plexus ;increases esophageal ton e;increases gastric and duo contractility ;improves transit time
3894
Q1948:cisapride toxicity
3895
NO LONGER USED b/c of interactions with erythromycin; ketoconazole; nefazodone; fluconazole
3896
Q1949:MOA metoclopramide
3897
D2 recepotr antagonist;increses resting tone; contractility; LES tone; motolity ;does not increase transit time through colon
3898
Q1950:which motility agent increases transit time through colon?
3899
cisapride
3900
Q1951:clinical use of metoclopramide
3901
diabetic and post-surggery gastroparesis
3902
Q1952:toxicity of metoclopramide
3903
increased parkinsonian effects;restlessness ;drowsiness;fatigue;depression;nausea;constipation
3904
Q1953:drug interactions with metoclopramide
3905
digoxin ;DM meds
3906
Q1954:when is metoclopramide contraindicated
3907
pts with small bowel obstruction
3908
Q1955:Cimetidine
3909
Reversible H2 Blocker;AE: P450 Inhibitor;Antiandrogenic;Cross BBB (confusion; etc);Decrease Creatinine excretion.
3910
Q1956:Omeprazole
3911
Irreversibly inhibts ACTIVE pumps;P450 clearance and INHIBITION;Prodrugs must be pronated in cells.
3912
Q1957:Bismuth. Sucralafate.
3913
Bind to ucler base; providing physical protrection. Allow HCO3 secretion to reestablish pH gradient in mucous;Also anti-Diarrhea;Part of H. pylori triple therapy.
3914
Q1958:Misoprostol
3915
Prostaglandin analog;SE: Diarrhea;Contraindicated in childbearing women.
3916
Q1959:Pirenzepine; Propantheline.
3917
Muscarinic antagonists (M1 on ECL cells and M3 on parietal cells);SE: Tachycardia; dry mouth; cycloplegia.
3918
Q1960:Loperimide
3919
Opioid anti-diarrheal;Excluded from CNS by mdr transporter;SE: cIx in children.
3920
Q1961:Sulfasalazine
3921
Sulfapyridine (antibacterial) + Mesalanine (antiinflammatory). Activated by colonic bacteria;SE: Malaise; nausea; sulfonamide toxicity; oligospermia (reversible).
3922
Q1962:Ondansetron
3923
Antiemeic. 5HT3 antagonist;SE: Headache; Constiplation.
3924
Q1963:Antacids in general
3925
Can effect absorption; bioavailablity; urinary excretion of other drugs by changing gastric pH or delaying gastric emptying;Cause systemic alkalosis; hypokalemia.
3926
Q1964:Aluminum Hydroxide
3927
Antacid;SE: Constipation; hypophospahtemia; proximal muscle weakness; osteodystrophy; seizures
3928
Q1965:Magnesium Hydroxide
3929
Antacid;SE: Diarrhea (osmotic); hyporeflexia; hypotension; cardiac arrest.
3930
Q1966:Calcium Carbonate
3931
Antacid;SE: Hypercalcemia; REBOUND ACID INCREASE;Also; can chelate and decrease effectiveness of other drugs (Tetracyclines).
3932
Q1967:Cisapride
3933
Prokinetic Agent;5HT receptors to increase ACh release at the myenteric plexus. Increase esophageal tone; increase gastric/duodenal contractitlity;SE: NO LONGER USED. TORSADES DES POINTES when given with erythromycin; ketoconazole; flucanazole; nefazodone.
3934
Q1968:Metoclopramide
3935
D2 receptor antagonist. Increases resting tone; contractility; LES tones; motility. DOES NOT influence colon transport time;Used for gastroparesis (DM and post surgery);SE: Increases Parkinsonian effects. Interacts with digoxin and DM agents. cIx if small bowel obstructed.
3936
Q1969:Aspirin
3937
Properties - inhibits COX therefore preventing TXA2 synthesis (irreversible inhibition at platelets - life long = 7-10 days) but endo can continue to produce anticoagulant PGI2. Can prolong bleeding time after one dose;Indications - prevent reinfarct; prevent MI; prevent occlusion in coronary artery bypass grafts. pts with TIAs to prevent stroke.
3938
Q1970:Why is there a yellow jacket in here?
3939
Cuz mom left the door open for no reason. If I get stung while studying; I'm just not taking the boards.
3940
Q1971:Clopidogrel
3941
Properties - inhibits plately aggrecation by irreversibly modifying the platelt ADP receptor;Indications - reduction of atherosclorotic events in pts with known atherosclorosis.
3942
Q1972:Ticlopidine
3943
Properties - inhibits expression of glycoprotein IIb/IIIA receptors on platelets. GPIIb/IIIA has fibrinogen binding sites;Indications - pts with stroke precursors who can't tolerate aspirin;SE; Tox - life-threatening blood dyscrasia.
3944
Q1973:Heparin
3945
Properties - accelarates antithrombin III (heparin cofactor) Pharmacology binding to thrombin which then Flash Facts thrombin; Xa; XIa; inactivates XIIa; and kallikrein. Given IV/SQ. Prolongs PTT; thrombin time; whole blood clotting time. only anticoagulate that works within minutes;Met/Excr - liver met by heparinase;Indications - sq in low doses to prevent clot for pts at high risk; used to stop ongoing thrombosis; in the acute phase of MI; safe in pregnant women because doesn't cross the placenta;SE; Tox bleeding - monitor PTT! protamine sulfate reverses the anticoag effect of heparin but too much causes its own anticoagulant effect. so that's helpful. transient and mild 3946 thrombocytopenia. hypersensitivity. chonically; osteoporosis. elevation of LFTs.
Q1974:Low Molecular Weight Heparins
3947
Properties - have more antifactor Xa activity; less inactivation of thrombin; less inhibition of platelets. longer half life than heparin. don't need to be monitored but are not easily reversible;Indications - hip replacements.
3948
Q1975:Hirudin
3949
Properties - a thrombin inhibitor - binds to the active site and fibrinogen recognition site of thrombing. little bleeding at therapeutic doses. given IV or SQ.
3950
Q1976:Streptokinase
3951
Properties - produced by beta -hemolytic strep. forms complexes with plasminogen which can then cleave free plasminogen into plasmin. longest half life of the thrombolytic agents;Indications - AMI;SE; Tox - bleeding; hypersensitivity-Ag reactions. rare anaphylaxis.
3952
Q1977:Alteplase (tPA)
3953
Properties - an endogenously produce serine protease. "fibrin selective" - activates only plasminogen bound to fibrin; so V; VIII remain active. Half life of only 5 minutes;SE; Tox Hemorrhage with no less incidence than streptokinase.
3954
Q1978:E Aminocaproic Acid (anistreplase)
3955
Properties - a lysine analog that binds to lysine-binding sites on plasminogen and plasmin to block plasmin's binding to fibrin; inhibiting fibrinolysis;Indications - Tx of systemic hyperfibrinolysis with surgical commplications following heart surgery and portocaval shunt. or cancer and blah. can reverse the action of thrombolytic agents.
3956
Q1979:Epoetin alpha
3957
Properties - growth factor produced by the kidney that stimulates RBC production. Given parenterally;Indications anemia secondary to renal failure and chemotherapy; secondary to AZT in AIDS pts. used prior to surgery to alleviate potential surgical blood loss and to facilitate autologous blood donation.
3958
Q1980:Sargramostim
3959
Properties - recombinant granulocyte granulocyte-macrophage colony-stimulating factor. Produced by T lymphocytes leads to proliferation of granulocytes; monocytes; macrophages; megakaryocytes;Indications - neutropenia;SE; Tox induration; thrombophlebitis at site; bone pain; fever; rashes; myalgias. limit-dose if pleuritis; pleural effusions; pericarditis.
3960
Q1981:Filgrastim
3961
Properties - recombinant granulocyte colony-stimulating factor. produced by monocytes; fibroblasts; endothelial cells and stimulates the production of neutrophils;Indications chemotherapy-induced neutropenia and others;SE; Tox - less severe than with GM-CSF. bone pain and vascultitis.
3962
Q1982:Abciximab
3963
Properties - binds to glycoprotein receptor IIb/IIIa on activated platelets;Indications - acute coronary snydromes; PTCA;SE; Tox - bleeding; thrombocytopenia.
3964
Q1983:Name 4 antiplatelet drugs and their MOA
3965
aspirin: inhibits CO dec. TXA2;clopidogrel: modifies ADP receptor;Ticlopidine: inhibits GPIIb/IIIa expression;Abciximab: binds GPIIb/IIIa
3966
Q1984:Heparin MOA;lab?
3967
activates antithrobin III;(thus decreases thrombin and inactivates IXa-XIIa);increase PTT
3968
Q1985:Heparin use
3969
immediate anticoag;(pulmonary embolism; stroke; angina; MI; DVT)
3970
Q1986:What can you administer to reverse the heparin effects?
3971
protamine sulfate;(binds neg. charged heparin)
3972
Q1987:Low MX heparins;(enoxaprin);(used in hip replacements);MOA;advantages
3973
act more at Xa;;longer half-life;subQ administration;do not have to monitor PTT
3974
Q1988:Warfarin MOA (an oral agent);lab?
3975
interferes w/ Vit K dep modification II; VII; IX; X; Protein C and S;follow PT
3976
Q1989:Warfarin use
3977
chronic anticoag
3978
Q1990:How do you treat warfarin overdose
3979
IV of Vit K and fresh frozen plasma
3980
Q1991:What drugs can increase the hepatic metab. of warfarin (3)
3981
barbituates;glutethimide;rifampin
3982
Q1992:what drugs can decrease the metabolism of warfarin (6);IMPORTANT
3983
metronidazole;trimethoprim;disulfiram;cimetidine;phenylbuta zone;sulfonamides;(influenza vaccine and acute alcohol intox)
3984
Q1993:Heparin or warfarin; which crosses the placenta?
3985
warfarin;(it is teratogenic)
3986
Q1994:Name 4 thrombolytic agents and their use
3987
streptokinase;anistrepelase (ASPAC);atelplase (tPA);urokinase;early MI
3988
Q1995:Aminocaproic acid class;MOA
3989
fibrinolytic inhibitor;blocks plasmin biding to fibrinogen and fibrin
3990
Q1996:Name the follwing hematopoeitic growth factors;RBC;GM-CSF;C-CSF;macrophage (2)
3991
erythropoietin;Sargamostin (recombinant);Filgrastim (recombinant);Il-3 and M-CSF
3992
Q1997:Heparin
3993
Activates antithrombin III; decreases thrombin & factor Xa;Intrinsic pathway inhibitor; increases PTT more than PT;Short half-life. Does not cross placenta;Antidote = protamine sulfate
3994
Q1998:Warfarin
3995
Inhibits synthesis & gamma-carboxylation of vit K dependent factors (II; VII; IX; X; prot C; prot S);Crosses placenta (teratogen);Inhibits extrinsic pathway; increases PT;Antidote = vitamin K; fresh frozen plasma
3996
Q1999:Aspirin
3997
Irreversibly inhibits COX-1 and COX-2;Increased bleeding time. No change to PT; PTT;SE: ulcers; bleeding; hyperventilation; Reye's syndrome; tinnitus (CN8)
3998
Q2000:Clopidogrel; Ticlopidine
3999
Inhibits platelet aggregation. Irreversibly blocks ADP receptors; blocks GP IIb/IIIa expression;SE: ticlopidine = neutropenia
4000
Q2001:Abciximab
4001
Inhibits platelet aggregation; antibody to GP IIb/IIIa receptors;SE: thrombocytopenia
4002
Q2002:tPA; urokinase; streptokinase; anistreplase
4003
Thrombolytics; aid conversion of plasminogen to plasmin and cleaves thrombin/fibrin clots;Antidote = aminocaproic acid (fibrinolysis inhibitor)
4004
Q2003:Heparin
4005
Anticoagulant;MECH: increased activity of antithrombin (III) which inhibits thrombin (IIa); Xa; and IXa (given parenterally; short t1/2; monitor PTT);USE: PE; MI; angina; stroke; DVT; can be used during preg (doesn't cross placental);TOX: bleeding; thrombocytopenia; drug-drug interactions (very negative molecule); hypersensitivity; antiplatelet antibodies
4006
Q2004:Enoxaparin
4007
LoAnticoagulant;MECH: increased activity of antithrombin (III) to inhibit Xa (can be given subcu; longer t1/2);USE: PE; MI; angina; stroke; DVT; can be used during preg (doesn't cross placental);TOX: bleeding; thrombocytopenia; drug-drug interactions (very negative molecule); hypersensitivity; antiplatelet antibodies
4008
Q2005:Protamine sulfate
4009
MECH: very positively charged molecule binds heparin which is negatively charged;USE: reversal of heparinization
4010
Q2006:Warfarin/coumadin
4011
Anticoagulant;MECH: interferes with normal synthesis and carboxylation of vitamin-K dependent clotting factors - II; VII; IX; X; C; S (oral; long t1/2; several days to take effect; monitor PT);USE: long term anticoagulation - DVT; PE prophylaxis;TOX: bleeding teratogenic; drug-drug interactions (
4012
Q2007:Alteplase / tPA (tissue plasminogen activator)
4013
Thrombolytic;MECH: activates plasminogen bound to fibrin to plasmin which dissolves fibrin clots; recombinant human protein;USE: Acute MI and ischemic stroke (within 3-6 ours of the event); PE; DVT;TOX: bleeding (internal and external)
4014
Q2008:Streptokinase
4015
Thrombolytic;MECH: activates plasminogen (free and bound) to plasmin which dissolves fibrin clots; isolated from streptococci;USE: Acute MI and ischemic stroke (within 3-6 ours of the event); PE; DVT;TOX: bleeding (internal and external); hypersensitivity rxn
4016
Q2009:Urokinase
4017
Thrombolytic;MECH: activates plasminogen (free and bound) to plasmin which dissolves fibrin clots; isolated from streptococci;USE: PE;TOX: bleeding (internal and external); less antigenic than streptokinase
4018
Q2010:APSAC (anistreplase)
4019
Thrombolytic;MECH: lys-plasminogen/streptokinase complex which binds fibrin and becomes slowing activated;TOX: non-selective; long lasting hypocoagulable state
4020
Q2011:Aminocaproic acid
4021
Anti-thrombolytic;MECH: inhibits fibrinolysis;USE: thrombolytic toxicity
4022
Q2012:Aspirin (ASA)
4023
Antithrombotic;MECH: Acetylates and irreversibly inhibits cyclooxygenase (COX-1 and -2) to prevent conversion of arachidonic acid to prostaglandins: (1) inhibition of thromboxane (TxA2) decreased activity and aggregation of platelets; (2) at high doses; it decreased synthesis of PGI2 by endothelial cells which reduces the antithrombotic action;USE: antipyretic; analgesic; anti-inflammatory; anti-platelet;TOX: gastric ulceration; bleeding; hyperventilation; Reye's syndrome; tinnitus
4024
Q2013:Dipyridamole
4025
Antithrombotic;MECH: inhibits platelet uptake of adenosine which had vasodilatory and antiaggregating activity;USE: prophylaxis in pts with prosthetic heart valves
4026
Q2014:Clopidigrel (Plavix) & Ticlopidine
4027
Antithrombotic;MECH: (1) irreversibly block ADP receptors decreased platelet aggregation; (2) prevent glycoprotein IIb/IIIa expresion decreased fibrinogen binding;USE: acute coronary syndromes; percutaneous; transluminal coronary angiography;TOX: bleeding; thrombocytopenia
4028
Q2015:Abciximab; Eptifibatide & Tirofiban
4029
Antithrombotic;MECH: chimeric monoclonal antibody; synthetic peptide; & peptide mimetic that bind IIb/IIIa decreased fibrinogen binding decreased platelet aggregation;USE: MI; angina; percutaneous coronary intervention;TOX: bleeding
4030
Q2016:Mechlorethamine
4031
Alkylating Agent;MECH: binds Ns and Os of purines and pyrimidines in DNA abnl base pairing; depurination; ring cleavage and DNA strand crosslinks; acts in late G1 and S phase;USE: IV route; MOPP regime for Hodgkins dz;TOX: leukopenia and thromboctyopenia
4032
Q2017:Cyclophosphamide
4033
Alkylating Agent;MECH: binds Ns and Os of purines and pyrimidines in DNA abnl base pairing; depurination; ring cleavage and DNA strand crosslinks; acts in late G1 and S phase; requires bioactivation by liver which also creates a toxic metabolite (acrolein);USE: oral; IV; or IM; nonHodgkin's lymphoma; breast & ovarian CA; immunosuppressant;TOX: myelosuppression; hemorrhagic cystitis (Acrolein) can be prevented with MESNA
4034
Q2018:Ifosfamide
4035
Alkylating Agent;MECH: binds Ns and Os of purines and pyrimidines in DNA abnl base pairing; depurination; ring cleavage and DNA strand crosslinks; acts in late G1 and S phase; requires bioactivation by liver which also creates a toxic metabolite (acrolein);USE: oral; IV; or IM; nonHodgkin's lymphoma; breast & ovarian CA; immunosuppressant;TOX: myelosuppression; hemorrhagic cystitis (less tox than cyclophosphamide)
4036
Q2019:Chlorambucil
4037
Alkylating Agent;MECH: binds Ns and Os of purines and pyrimidines in DNA abnl base pairing; depurination; ring cleavage and DNA strand crosslinks; acts in late G1 and S phase;USE: orally for CLL; some lymphomas; and Hodgkins;TOX: less severe marrow suppression than other nitrogen mustards
4038
Q2020:Busulfan
4039
Alkylating Agent;MECH: binds Ns and Os of purines and pyrimidines in DNA abnl base pairing; depurination; ring cleavage and DNA strand crosslinks; acts in late G1 and S phase;USE: orally for CML;TOX: pulmonary fibrosis; hyperpigmentation
4040
Q2021:Carmustine; lomustine; semustine
4041
Alkylating Agent;MECH: binds Ns and Os of purines and pyrimidines in DNA abnl base pairing; depurination; ring cleavage and DNA strand crosslinks; acts in late G1 and S phase;USE: highly lipophillic cross BBB treat brain tumors (including GBM); Hodgkin's dz;TOX: myelosuppression; renal failure; CNS tox (dizziness; ataxia)
4042
Q2022:Streptozocin
4043
Alkylating Agent;MECH: binds Ns and Os of purines and pyrimidines in DNA abnl base pairing; depurination; ring cleavage and DNA strand crosslinks; acts in late G1 and S phase;USE: pancreatic islet cell CA and carcinoid;TOX: NOT myelosuppressive; renal tox is dose-limiting
4044
Q2023:Cisplatin
4045
Platinum compound;MECH: complexes with DNA to form cross-links (like alkylating agents);USE: testicular; ovarian; and bladder CAs;TOX: nephrotox; ototox; peripheral neuropathy
4046
Q2024:Carboplatin
4047
Platinum compound;MECH: complexes with DNA to form cross-links (like alkylating agents);USE: testicular; ovarian; bladder; transitional; NSC lung CA;TOX: myelosuppression; nephrotox; ototox; peripheral neuropathy
4048
Q2025:Methotrexate
4049
Antimetabolite;MECH: S-phase specific folic acid analogue that inhibits dihydrofolate reductase decreased DNA and protein synthesis;USE: ALL; choriocarcinoma; trophoblastic tumors; Burkitt and other non-Hodgkin's lymphoma; osteogenic sarcoma; abortion; ectopic pregnancy; RA; psoriasis;TOX: myelosuppressive (treat with leucovorin/folinic acid); Gi; nephrotox
4050
Q2026:Cytarabine
4051
Antimetabolite;MECH: S-phase specific pyrimidine antagonist - metabolites inhibit DNA polyermase;USE: Acute leukemias (esp. AML) and non-Hodgkin's lymphoma;TOX: leukopenia; thrombocytopenia; megaloblastic anemia
4052
Q2027:Flourouracil (5-FU)
4053
Antimetabolite;MECH: S-phase specific pyrimidine antagonist; activated form complexes folic acid that inhibits thymidilate synthase decreased DNA and protein synthesis;USE: parenterally colon CA and other solid cancers; topically basal cell CA;TOX: myelosuppression (rescue with thymidine); photosensitivity
4054
Q2028:Mercaptopurine & Thioguanine
4055
Antimetabolite;MECH: analogues of purines; activated by HGPRTase; block de novo purine synthesis;USE: leukemias; lymphomas (not CLL or Hodgkins);TOX: bone marrow suppression
4056
Q2029:Fludararbine
4057
Antimetabolite;MECH: analogues of purines; interferes with DNA synthesis;USE: CLL;TOX: bone marrow suppression
4058
Q2030:Vincristine
4059
Vinca alkaloid;MECH: M-phase specific; binds tubulin to prevent microtubule polymerization mitotic spindle can't form;USE: lymphoma (MOPP); Wilm's tumor; choriocarcinoma;TOX: neurotox (areflexia; peripheral neuritis); paralytic ileus
4060
Q2031:Vinblastine
4061
Vinca alkaloid;MECH: M-phase specific; binds tubulin to prevent microtubule polymerization mitotic spindle can't form;USE: lymphoma (MOPP); Wilm's tumor; choriocarcinoma;TOX: bone marrow suppression
4062
Q2032:Paclitaxel
4063
MECH: M-phase specific; stabilizes microtubles so that the mitotic spindle cannot break down in anaphase;USE: ovarian & breast CA;TOX: myelosuppression; hypersensitivity
4064
Q2033:Etoposide
4065
MECH: G2-phase specific; inhibits topoisomerase II ds DNA breaks;USE: SCLC; prostate and testicular CA;TOX: leukopenia
4066
Q2034:Dactinomycin (actinomycin D)
4067
Antibiotic;MECH: intercalates into DNA; phase nonspecific;USE: Wilm's tumor; Ewing's sarcoma; rhabdomyosarcoma;TOX: myelosuppression
4068
Q2035:Doxorubicin (adriamycin); daunorubicin
4069
Antibiotic;MECH: intercalate into DNA; generate free radicals DNA strand breaks;USE: part of many regimens (ABVD); Hodgkin's; myelomas; sarcomas; solid tumors;TOX: cardiotoxicity; alopecia
4070
Q2036:Bleomycin
4071
MECH: induces formation of free radicals DNA strand breaks (G2 phase specific);USE: testicular CA; lymphomas (ABVD);TOX: pulmonary fibrosis; skin changes
4072
Q2037:Imatinib (Gleevec)
4073
MECH: bcr-abl tyrosine kinase inhibitor ;USE: CML (Philadelphia chrom); GI stromal tumors;TOX: fluid retention
4074
Q2038:Trastumab (Herceptin)
4075
MECH: IgG against HER2 protein (erb-B2); cell death by antibody dependent cytotoxicity;USE: Metastatic breast cancer;TOX: cardiotoxicity
4076
Q2039:Tamoxifen; raloxifene
4077
MECH: competitive antagonist of estrogen receptor block estrogen-dependent growth;USE: breast cancer; osteoporosis;TOX: hot flashes; increased risk of endometrial cancer (not raloxifene)
4078
Q2040:Prednisone
4079
MECH: may trigger apoptosis (glucocorticoid);USE: CLL; Hodgkin's; autoimmune dzs;TOX: Cushing-like symptoms
4080
Q2041:Rituximab
4081
MECH: binds CD20 antigen on B-cells cell lysis;USE: non-hodgkin's lymphoma; thrombocytopenic purpura;TOX: derm and GI
4082
Q2042:which cancer drugs are cell cycle specific (5)
4083
antimetabolites (MTX; 5-FU; 6-MP); etoposide; bleomycin; vinca alkaloids; paclitaxel
4084
Q2043:which cancer drugs are cell cycle nonspeficic (2)
4085
alkylating agents; antibiotics
4086
Q2044:MOA of MTX
4087
S-phase specific antimetabolite. Inhibits duhydrofolate reductase (b/c is folate acid analog)
4088
Q2045:Clinical uses of MTX
4089
leukemias; lymphomas; choriocarcinomas; sarcomas; abortion; ectopic preggers; RA; psoriasis
4090
Q2046:toxicities of MTX
4091
myelosuppression (use leucovorin for "rescue"); macrovesicular fatty change in liver
4092
Q2047:MOA 5-FU
4093
S-phase specific antimetabolite. Bioactivated form (5F-dUMP complexes with folic acid and inhits thymidylate synthase
4094
Q2048:Clinical use of 5-FU
4095
colon cancer and other solid tumors; basal cell carcinoma (topical). Synergy with MTX
4096
Q2049:toxicity of 5-FU
4097
myelosuppression which is NOT reversible with leucovorin (vs MTX); photosensitivity
4098
Q2050:MOA 6-MP
4099
blocks de novo purine synthesis
4100
Q2051:what activates 6-MP?
4101
HGPRTase
4102
Q2052:Toxicities of 6-MP
4103
done marrow; GI; liver; metabolized by xanthine oxidase so increased toxicity with allopurinol
4104
Q2053:MOA cytarabine (ara-C)
4105
inhibits DNA polymerase
4106
Q2054:Clinical use of ara-C?
4107
AML
4108
Q2055:toxicities of ara-C
4109
leukopenia; thrombocytopenia; megaloblastic anemia
4110
Q2056:MOA of cyclophosphamide/ifosfamide
4111
(alkylaying agts) covalently x-link DNA at guanine N-7; require bioactivation by liver
4112
Q2057:Clinical use of cyclophosphamide/ifosfamide
4113
non-Hodgkin's lymphoma; breast and ovarian carcinomas
4114
Q2058:toxicities of cyclophosphamide
4115
myelosuppressin; hemorrhagic cystitis (use mesna!!)
4116
Q2059:4 nitrosoureas
4117
carmustine; lomustine; semustine; streptozocin
4118
Q2060:MOA of nitrosoureas
4119
(e.g. carmustine; steptozocin). Alkylate DNA; require bioactivation; CROSS BBB!!
4120
Q2061:toxicities of nitrosoureas
4121
CNS (dizziness; ataxia)
4122
Q2062:MOA of cisplatin; carboplatin
4123
act like alkylating agents
4124
Q2063:clinical uses of cisplatin?
4125
testicular; bladder; ovary; and lung carcinomas
4126
Q2064:toxicity of cisplatin?
4127
nephrotoxicity and acoustic nerve damage
4128
Q2065:MOA of busulfan
4129
alkylates DNA
4130
Q2066:clinical use of busulfan
4131
CML
4132
Q2067:toxicities of busulfan
4133
pulmonary fibrosis; hyperpigmentation
4134
Q2068:MOA of doxorubucin; daunurubicin
4135
generate free radicals and noncovalently intercalate into DNA
4136
Q2069:Clinical uses of doxorubucin; daunorubicin
4137
part of ABVD treatment for Hodgkin's; also for myelomas; sarcomas; solid tumors
4138
Q2070:toxicities of doxorubicin; daunorubicin
4139
cardiotoxic; myelosuppression; marked alopecia; toxic extravasation
4140
Q2071:MOA dactinomycin
4141
DNA intercalater
4142
Q2072:clinical uses of dactinomycin
4143
Wilm's tumor; Ewing's sarcoma; rhabdomyosarcoma (for childhood tumors!)
4144
Q2073:toxicity of dactinomycin
4145
myelosuppression
4146
Q2074:MOA of bleomycin
4147
induces formation of free radicals-->DNA strand breaks
4148
Q2075:Clinical uses of bleomycin
4149
testicular cancer; part of ABVD for Hodgkin's (along with doxorubicin/daunorubicin)
4150
Q2076:toxicities of bleomycin
4151
PULMONARY FIBROSIS; skin changes; MINIMAL myelosuppression
4152
Q2077:MOA of etoposide
4153
G2 phase specific agt; inhibits topoisomerase II
4154
Q2078:Clinical uses of etoposide
4155
small cell carcinoma of lung and prostate; testicular carcinoma
4156
Q2079:Toxicities of etoposide
4157
myelosuppression; GI irritation; alopecia
4158
Q2080:MOA of prednisone
4159
steroid; may trigger apoptosis?
4160
Q2081:Clinical uses of prednisone
4161
lots but spefically part of MOPP regimen for Hodgkin's ; CLL
4162
Q2082:Toxicities of prednisone
4163
Cushing-like sxs; immunosuppression; CATARACTS; acne; OSTEOPOROSIS; HTN; peptic ulcers; hyperglycemia; psychosis
4164
Q2083:MOA of tamoxifen; raloxifene
4165
estrogen R antagonits in breasts; agonists in bone
4166
Q2084:tamoxifen vs raloxifene
4167
tamoxifen may increase risk of endometrial cancer but raloxifene is an endometrial ANTAGonist
4168
Q2085:MOA of trastuzumab (herceptin)
4169
monoclonal Ab against HER-2; helps kill breast cancer cells that overexpress HER-2
4170
Q2086:Clinical use of trastuzumab
4171
(herceptin) metastatic breast cancer
4172
Q2087:toxicity of trastuzumab
4173
cardiotoxicity
4174
Q2088:MOA of imatinib?
4175
(Gleevec) Phl chromosome bcr-abl tyrosine kinase inhibitor
4176
Q2089:Clinical uses of imatinib
4177
(gleevec) CML; GI stromal tumors
4178
Q2090:toxicity of imatinib
4179
(gleevec) fluid retention
4180
Q2091:MOA of vincristine; vinblastine
4181
(vinca alkaloids) M phase specifics; bind tubulin and block polymerization of microtubules
4182
Q2092:Clinical uses of vincristine; vinblastine
4183
part of MOPP regimen (as is prednisone) for lymphoma; Wilms' tumor; choriocarcinoma
4184
Q2093:toxicity of vincristine
4185
neurotoxicity; paralytic ileus
4186
Q2094:toxicity of vinblastine
4187
myelosuppression (vinBLASTine BLASTS bone marrow)
4188
Q2095:MOA of taxols
4189
(e.g. paclitaxel) M phase specific agents to bind tubulin and disallow microtubule breakdown
4190
Q2096:clinical uses of taxols
4191
ovarian and breast carcinomas
4192
Q2097:toxicities of taxols
4193
myelosuppression and hypersensitivity
4194
Q2098:Which cancer drugs are M-phase specific?
4195
taxols and vinca alkaloids
4196
Q2099:protects against rejection from organ transplants. does not induce bone marrow depression.
4197
Cyclosporine
4198
Q2100:alkylating agent of both purine and pyrimidine bases of DNA. treatment for CLL.
4199
Cyclophosphamide
4200
Q2101:causes nepho and ototoxicity
4201
Cisplatin
4202
Q2102:anti-metabolite of folic acid: inhibits dihydrofolate reductase
4203
Methotrexate
4204
Q2103:this drug can block or reduce the host toxicity of Methotrexate by providing a reduced folate to increase folic acid
4205
Leucovorin Rescue
4206
Q2104:toxicity profile includes pneumonitis and pulmonary fibrosis
4207
Bleomycin
4208
Q2105:drug used in organ transplantation = kidney allografts. Allopurinol can inc. the activity by inhibiting its biotransformation by xanthine oxidase
4209
Azathiorine
4210
Q2106:chemotherapy regimen used in hodgkin's disease
4211
MOPP = Mechlorethamine (nitrogen mustard); Oncovorin (aka Vincristine blocks microtubule assembly); Procarbazine; Prednisone (glucocorticoid that induces apoptosis)
4212
Q2107:estrogen receptor blocker used to treat breat tumors; can potentially result in endometrial cancer.
4213
Tamoxifen
4214
Q2108:antiandrogenic. used w/ Leuprolide (LHRH analog) to treat prostate cancer
4215
Flutamide
4216
Q2109:progesterone receptor inhibitor used to treat Endometrial cancer
4217
Megestrol
4218
Q2110:androgenic steroid used to treat mammary cancer in postmenopausal women
4219
Fluoxymesterone
4220
Q2111:folic acid analog that inhibits tetrahydrofolate synthesis by inhibiting dihydrofolate reductase. used to treat ALL and Psoriasis
4221
Methotrexate
4222
Q2112:treatment for Brain tumor
4223
Lomustine and Carmustine
4224
Q2113:side effect of carmustine
4225
pulmonary fibrosis
4226
Q2114:drug that attaches to beta cells and is used to treat pancreatic insulinomas
4227
Streptozocin
4228
Q2115:pyrimidine analog that is DOC for AML
4229
Cytarabine (AraC)
4230
Q2116:used for Wilms tumor and rhabdomyosarcoma
4231
Dactinomycin
4232
Q2117:used for oat cell carcinoma
4233
Etoposide
4234
Q2118:used for Ovarian Cancer
4235
Paclitaxel
4236
Q2119:can decrease nephrotoxicity caused by chronic use of Cisplatin
4237
Amifostine
4238
Q2120:Catalyzes the activation of antithrombin III to decrease thrombin and Xa;Uses (2);site of action?
4239
Heparin;;Uses;Immediate anticoagulation;(PE; MI; stroke; DVT);Used during pregnancy (does not cross);site: Blood
4240
Q2121:Interferes w/ factors II; VII; IX and X and protein C and S;Use;site of action?
4241
Warfarin;use;Chronic coagulation;[the EX-PaTriot went to WAR];EXtrinsic-PT pathway;site: Liver
4242
Q2122:drug class that aids in conversion of plasminogen to plasmin (which cleaves thrombin and fibrin clots);name (4)
4243
Thrombolytics;Streptokinase;Urokinase;tPA (alteplase);Antistreplase
4244
Q2123:what inhibits plasminogen to plasmin?
4245
Aminocaproic acid
4246
Q2124:what glycoprotein in platelet binds to exposed collagen?;which bind together to aggregate?
4247
to collagen: GP-1a;;together: GP-IIb/IIIa
4248
Q2125:The only irreversible binder in the group to inhibit COX-1 and COX-2
4249
Aspirin
4250
Q2126:drug inhibits platelet binding by irreversibly blocking ADP receptors; thereby inhibiting fibrinogen binding by preventing GP-IIb/IIIa expression;(2) uses;AE?
4251
Clopidogrel;use;Acute Coronary syndrome;Coronary stenting;AE;Neutropenia;(tiCLOPidine)
4252
Q2127:drug that binds directly to GP-IIb/IIIa on activated platelets; preventing aggregation;use?
4253
Abciximab;;use;Angioplasty
4254
Q2128:S-phase specific anti-cancer drugs;(5)
4255
Methotrexate;5-FU;Cytarabine;6-MP;Hydroxyurea
4256
Q2129:S-phase antimetabolite that inhibits DHF reductase resulting in low dTMP;(2) AE?
4257
Methotrexate;;AE;Myelosuppression;Macrovesicular fatty liver
4258
Q2130:what reduces the myelosuppression toxicity in Methotrexate?
4259
Leucovorin
4260
Q2131:S-phase pyrimidine analog that inhibits thymidylate synthase; resulting in low dTMP;(3) uses;(2) AE
4261
5-Fluorouricil (5-FU);uses;Colon CA;solid tumors;Basal cell CA;AE;Myelosuppression;photosensitivity
4262
Q2132:S-phase that blocks Purine synthesis and is activated by HGPRTase;(2) uses?;what can increase toxicity?
4263
6-Mercaptopurine (6-MP);use;Leukemias (not CLL);Lymphomas (not Hodgkin);inc Toxicity: Allopurinol;(metabolized by Xanthine Oxidase)
4264
Q2133:S-phase tha inhibits DNA polymerase to compete w/ dCTP;use?;(3) AE
4265
Cytarabine (ARA-C);use: AML;AE;Leukopenia;Thrombocytopenia;Megaloblastic anemia
4266
Q2134:Alkylating agent covalently x-link DNA at guanine N7;use (3);AE
4267
Cyclophosphamide;use;Non-Hodgkins lymphomas;Breast CA;Ovarian CA;AE;hemorrhagic CYSTITIS
4268
Q2135:Alkylating agent class that crosses BBB;name drugs (2);AE
4269
Nitrosoureas;drugs;"-MUSTINE";Streptozocin;AE;CNS toxicity (dizzy; ataxia)
4270
Q2136:(2) anti-cancer drugs that act like Alkylating agents and form free radicals; they cause AE of Ototoxicity and Nephrotoxicity;use (4)
4271
Cisplatin; Carboplatin;use (BOLT);Bladder CA;Ovarian CA;Lung CA;Testicular CA;;[BOLT ON the PLAnTation]
4272
Q2137:Alkalaying agent of DNA used as DOC for CML;(2) AE
4273
Busulfan;AE;Pulmonary fibrosis;hyperpigmentation
4274
Q2138:(2) anti-cancers that generates free radicals and noncovalently intercalate in DNA (breaking strands); AE include cardiotoxicity;(2) uses;another AE
4275
Doxorubicin (Adriamycin);Danorubicin;use;Hodgkins (A in ABVD combo);solid tumors;AE;Alopecia
4276
Q2139:another name for;Doxorubicin
4277
Adriamycin
4278
Q2140:what anti-cancer drug that intercalates in DNA; is used for childhood tumors?
4279
ACTinomycin-D;[children ACT out]
4280
Q2141:drug that induces formation of free radicals to cause breaks in DNA; AE is pulmonary fibrosis;(2) uses
4281
Bleomycin;use;Testicular CA;Hodgkins (B in ABVD combo)
4282
Q2142:G2-specific agent that inhibits Topoisomerase-II;(3) uses
4283
EToPoSide (VP-16);uses;T: Testicular CA;P: Prostate CA;S: Small cell CA of lung
4284
Q2143:MC glucocorticoid in cancer therapy;(2) uses;aside from usual corticoid AE (cushings; osteoporosis) what other AE?
4285
Prednisone;use;Hodgkins (P in MOPP combo);CLL;AE;cataracts
4286
Q2144:monoclonal Ab against HER-2 (erb-B2)--Breast CA;AE
4287
Trastuzumab (HERceptin);AE;Cardiotoxicity
4288
Q2145:monoclonal Ab against the Philadelphia chromosome brc-abl tyrosine kinase
4289
Gleecec (Imatinib)
4290
Q2146:M-phase specific alkaloids that bind to tubulin and block polymerization of microtubules so that spindle fibers cannot form;use (3);AE (2)
4291
Vincristine ("Oncovin"); Vinblastine;use;Hodgkins (O in MOPP combo);Wilm's Tumor;Choriocarcinoma;AE;Vincristine Neurotoxicity;Vinblastine - BLASTs bone marrow
4292
Q2147:M-phase specific that bind to tubulin and hyperstabilize polymerized microtubules so that spindle fibers cannot breakdown (anaphase cant occur);use (2);AE (2)
4293
Taxols (Paclitaxel);use;Ovarian CA;Breast CA;AE;myelosuppression;Hypersensitivity
4294
Q2148:what are the drugs in the ABVD Hodgkins combo?
4295
Adriamycin (doxorubicin);Bleomycin;Vinblastine;Dacarabazine
4296
Q2149:what are the drugs in the MOPP Hodgkins combo?
4297
Mechlorethamine;Oncovoin (Vincristine);Prednisone;Procarbazine
4298
Q2150:DOC for CLL
4299
Prednisone
4300
Q2151:DOC in CML;(2)
4301
Gleevac;;Busulfan
4302
Q2152:DOC in AML
4303
Cytarabine
4304
Q2153:anti-cancer drug that causes Pancreatitis
4305
Asparaginase
4306
Q2154:anti-cancer drug that causes oral and GI ulcers
4307
5-FU
4308
Q2155:which ant-cancer drugs are clasified as Alkylating agents?;(4)*
4309
"at NITe the CYCLOne picked-up the BUS and CAR";NITrosureas;CYCLOphosphamide;BUSulfan;CARbop latin; cisplatin
4310
Q2156:what anti-cancer drug works in the G-0 phase?
4311
Busulfan
4312
Q2157:which anti-cancer drugs generate free radicals?;(3)*
4313
BAD radicals;Bleomycin;Actinomycin-D;Doxorubicin; Daunorubicin
4314
Q2158:(2) drugs that work in the G-2 phase
4315
Bleomycin;;Etoposide (VP-16)
4316
Q2159:Inhibit IL-2 production/secretion
4317
Cyclosporine (calceneurin); Tacrolimus (FK506)
4318
Q2160:IL-2 Inhibitors (downstream)
4319
Sirolimus (mTOR inhibitor); Daclizumab (mAb against IL-2 receptor)
4320
Q2161:Antimetabolites
4321
Azathioprine (6MP precursor; lymphtoxic); Mycophenolate mofetil (Inhibits de novo Guanine synethesis)
4322
Q2162:Other Action
4323
Muronomab-CD3 (OKT3)--mAb binds to CD-3 on T-cells
4324
Q2163:activated T helper cells secrete this cytokine which causes proliferation and activation of two subsets of T helper cells; TH1 & TH2
4325
IL-2
4326
Q2164:function of TH1 cells?
4327
cell mediated immunity and delayed hypersensitivity reactions
4328
Q2165:what do TH1 cells produce?
4329
IFN-gamma; IL-2 and TNF-B (which activate macrophages; CTLs; & NK cells.
4330
Q2166:what do TH2 secrete when activated?
4331
IL-4; IL-5; IL-6 (which promote B cell proliferation and differentiation)
4332
Q2167:what is the action of IL-10?
4333
down regulate the action of TH1 cells
4334
Q2168:what is action of IFN-gamma on helper T cells?
4335
down regulates TH2 response
4336
Q2169:name an agent that acts at the step of antigen recognition in the immune response?
4337
antibodies including Rho(D) immune globulin; antilymphocyte globulin; and muromonab CD3.
4338
Q2170:name an agent that acts at the step of differentiation and synthesis in the immune response?
4339
cyclosporine; tacrolimus; dactinomycin; and antilymphocytic globulin and monoclonal anti-T cell antibodies
4340
Q2171:MOA of glucocorticoids?
4341
decrease the synthesis of Prostaglandins; leukotrienes; cytokines; and other signaling molecules that participate in immune responses (eg Platelet activating factor). They also inhibit proliferation of T cells and to a lesser degree dampen humoral immunity. continuous therapy lowers IgG levels through inc. catabolism
4342
Q2172:what is the toxicity of corticosteroids?
4343
adrenal suppression; growth inhibition; muscle wasting; osteoporosis; salt retention; diabetogenesis and possible psychosis
4344
Q2173:MOA of cyclosporine?
4345
binds to cyclophilin to inhibit Calcineurin; a cytoplasmic phosphatase. which prevents T cell production of cytokines that would be produced w/ TCR activation
4346
Q2174:MOA of tacrolimus?
4347
binds to FK-binding protein and inhibits calcineurin; a phosphatase that regulates the ability of activated T cells to produce cytokines; thus inhibiting this cytokine production (same action as cyclosporine but diff binding site)
4348
Q2175:MOA of Sirolimus?
4349
ALSO binds to FKBP however it inhibits T cell RESPONSE to Cytokines w/o affecting cytokine production (and potent inhibitor of B cell prolif. antibody product. and mononuclear cell responses to colony stimulating factors as well)
4350
Q2176:most frequent toxicities of Cyclosporine and Tacrolimus?
4351
renal dysfunction; hypertension and neurotoxicity
4352
Q2177:sirolimus is more likely than cyclospoine or tacrolimus to induce this side effect?
4353
HyperTriglyceridemia; hepatotoxicity; diarrhea and myelosuppression
4354
Q2178:MOA of Mycophenolate Mofetil?
4355
rapidly converted to mycophenolic acid; which inhibits inosine monophosphate dehydrogenase; an enzyme in the de novo pathway of purine synthesis. SO this suppresses BOTH B & T cell ACTIVATION
4356
Q2179:toxicity of Mycophenolate mofetil?
4357
neutropenia
4358
Q2180:MOA of Azathioprine?
4359
prodrug transformed to antimetabolie mercaptopurine; which inhibits enzymes in purine metabolism. It is cytotoxic to early phase of lymphoid cell proliferation w/ greater effect on Tcells than B cells
4360
Q2181:toxicity of azathioprine?
4361
associated with inc incidence of cancer. toxic effects inc by concomitant use of allopurinol b/c azathio is metabolized by xanthine oxidase
4362
Q2182:MOA of cyclophosphamide?
4363
transformed by liver enzymes to an alkylating agent that is cytotoxic to proliferating lymphoid cells. greater effect on B CELLS than T cells and will inhibit an estrablished immune response
4364
Q2183:MOA of etanercept?
4365
recombinant form of TNF receptor that binds TNF-a; a proinflamm cytokine; thereby decreasing formation of IL and adhesion molecules (used in RA)
4366
Q2184:name two monoclonal antibodies that block the actions of TNF-alpha?
4367
Infliximab and adalimumab
4368
Q2185:MOA of the RA drug Leflunomide?
4369
arrests lymphocytes in the G1 phase of cell cycle
4370
Q2186:what is thalidomide used for?
4371
Leprosy; SLE; and as an anti-Cancer drug also aphthous ulcers and the wasting syndrome in AIDS is treated with the Rx
4372
Q2187:MOA of thalidomide?
4373
sedative drug notorious for teratogenic effects; ALSO suppresses TNF production
4374
Q2188:MOA Antilymphocyte globulin and Antithymocyte Globulin?
4375
selectively block cellular immunity rather than Antibody formation; which account for their ability to suppress organ graft rejection; a cell mediated process
4376
Q2189:MOA of RhoD immune globulin?
4377
feedback immunosuppression
4378
Q2190:MOA Muromonab-CD3?
4379
MAb binds to the CD3 antigen on surface of thymocytes and mature T cells and blocks the killing action of CTLs and other T cell functions
4380
Q2191:MOA of daclizumab?
4381
highly specific MAb that binds to the alpha subunit of the IL2 receptor expressed on T cells and prevents activation by IL2
4382
Q2192:what is the drug that induces remission in treatmentresistant Crohn's disease?
4383
Infliximab (targeted against TNF-alpha)
4384
Q2193:MOA of Aldeslekin?
4385
recombinant IL-2; that promotes production of cytoxic T cells and activates NK cells - indicated for adjunctive trx of renal cell carcinoma and malignant melanoma
4386
Q2194:IFN-beta-1b has some beneficial effects in this relapsing disorder?
4387
MS
4388
Q2195:what disease is IFN-alpha-2a used for?
4389
hairy cell leukemia; chronic myelogenous leukemia; malignant mealnoma; Kaposi's sarcoma and hep B and C
4390
Q2196:this drug is used for immunization against TB?
4391
BCG (Bacille Calmette-Guerin) (it activates macrophages and results in enhancement of immune responses)
4392
Q2197:MOA thymosin?
4393
stimulates maturation of pre-T cells in thymusand promotes formation of T cells from lymphoid stem cells (Used in DiGeorge's syndrome; thymic aplasia)
4394
Q2198:define mechanism of Type 2 hypersensitivity drug allergy?
4395
involves IgG or IgM antibodies that are bound to circulating blood cells.
4396
Q2199:give examples of type 3 hypersensitivity reactions?
4397
Drug induced serum sickness and vasculitis; stevens johnson from sulfonamide therapy is another
4398
Q2200:examples of type 4 hypersensitivity?
4399
contact dermatitis (cell mediated injury)
4400
Q2201:examples of drugs that commonly cause a type 1 hypersens. rxn?
4401
penicillins and sulfonamides
4402
Q2202:DOC for long-term obesity management;MOA;(2) AE
4403
Orlistat;(Inhibits pancreatic lipases);AE;Steatorrhea;GI pain
4404
Q2203:Drug that acts as a short and long-term obesity management;MOA;(2) AE
4405
Sibutramine;(Serotonin and NE reuptake inhibitor);AE;Tachycardia;HTN
4406
Q2204:Inhibits thyroid hormone synthesis and decreases peripheral conversion of T4 -> T3;(3) AE
4407
Propylthiouracil (PTU);AE;Aplastic anemia;skin rash;Agranulocytosis (rare)
4408
Q2205:DOC for Turner's syndrome
4409
Somatostatin;(also GH deficiency)
4410
Q2206:What (4) disorders does Octreotide (somatostatin analog) treat?
4411
"C 8 (Oct) GAG";Carcinoid;;Gastrinoma;;Acromegaly;;Glucagonoma
4412
Q2207:Tx for Central DI
4413
Desmopressin
4414
Q2208:Tx for Hypothyroidism;(3) AE
4415
Levothyroxine; Triiodothyronine;AE;Tachycardia;Heat intolerance;Tremors
4416
Q2209:(4) Dx that use Glucocorticoids as Tx;AE?
4417
Addisons Dz;;Inflammation;;Immune supression;;Asthma;AE: Iatrogenic Cushing's syndrome
4418
Q2210:A 5-alpha-reductase inhibitor used to Tx BPH and promote hair growth*
4419
Finasteride
4420
Q2211:a Non-steroidal competitive inhibitor of androgens at the testosterone receptor to Tx prostate CA
4421
Flutamide
4422
Q2212:Tx PCOS
4423
Oral birth control
4424
Q2213:(2) drugs that inhibit steroids and are used in PCOS to treat hirsutism
4425
Ketoconazole;;Spironolactone
4426
Q2214:Inhibits cGMP phosphodiesterase causing Inc cGMP and smooth muscle relaxation in corpus cavernosum;(2) AE?
4427
Sildenafil (or Vardenafil);AE;headache;blue-green vision;(head throbs w/ blue balls)
4428
Q2215:what drug is both an agonist and antagonist to GnRH?;(explain);Use for each?
4429
Leuprolide;Pulsitile fashion: Agonist;(Infertility);Continuous: Antagonist;(prostate cancer)
4430
Q2216:Partial agonist at estrogen receptors in pituitary gland;Use?;AE?
4431
Clomiphene;(prevents Neg feedback to increase LH and FSH);Use;Stimulate Ovulation (infertility Tx);AE;Ovarian enlargement; multiple preg
4432
Q2217:Competitive inhibitor of Progestins at progesterone receptor;Use?;(2) AE?
4433
Mifepristone (RU-486);Abortifacient (prevents implantation);AE;Heavy bleeding;GI upset
4434
Q2218:greatest AE of oral contraception
4435
Hypercoagulable state
4436
Q2219:Tx for hormone replacement therapy and Osteoporosis;(2)
4437
Raloxifene;(SERM);;Estrogen/Progesterone therapy
4438
Q2220:for contraception; what is in Oral; Depo and an implant?
4439
Oral: E2/P4 combo;Depo: Medroxyprogesterone;Implant: Norgestrel
4440
Q2221:DOC for Breast CA w/ estrogen receptors;AE?
4441
Tamoxifen;(SERM);AE: Endometrial hyperplasia
4442
Q2222:what drug class has AE of Acne; decreased HDL; depression; hirsutism; weight gain
4443
Progestins
4444
Q2223:Drug that activates E2 receptors in Endometrium and blocks them in Breast
4445
Tamoxifen
4446
Q2224:Drug that activates E2 receptors in bone and blocks them in Breast and Endometirum
4447
Raloxifene
4448
Q2225:DOC for reduction of bone resorption and increasing new bone formation
4449
Alendronate;(bisphosphonate)
4450
Q2226:MOA of Etidronate
4451
Inhibition of the formation of Hydroxyapatite crystals
4452
Q2227:DOC for Padget's Dz
4453
Calcitonin
4454
Q2228:what is the treatment for Tetany following a thyroidectomy?
4455
Calcium gluconate
4456
Q2229:What drug is useful in testing endocrine function?;How?;MOA
4457
Metyrapone;Tests Pituitary-adrenal axis;Inhibits 11b-OH
4458
Q2230:how do glucocorticoids work as anti-inflammatory and immunosupressive drugs?
4459
Reduce capillary permeability and edema at the inflam site and prevent PMNs from entering interstitial space
4460
Q2231:DOC to inhibit Prolactin release
4461
Bromocriptine
4462
Q2232:Rapid onset insulin form
4463
Lispro
4464
Q2233:(2) Maintenance forms of insulin (peak 4 - 12 hrs)
4465
NPH;;Lente
4466
Q2234:Longest acting insulin
4467
Glargine
4468
Q2235:MOA of Sulfonylureas
4469
blocks K+ channels in Beta cell causing opening of Ca channels; releasing insulin from storage vesicles
4470
Q2236:DOC for Rickets or any Vit-D deficiency;MOA
4471
Calcitrol;(enhances intestinal absorption of calcium)
4472
Q2237:DOC androgen derivative for Endometriosis
4473
Danazol;(monitor LFTs)
4474
Q2238:Dx;postmenopausal female develops weakness; polyuria and polydipsia; also mild acidosis and nephrocalcinosis
4475
Hypervitaminosis D;(too much Vit-D)
4476
Q2239:MOA of PTU
4477
Inhibition of Thyroidal Peroxidase
4478
Q2240:what drug inhibits; by acting as a competitor; the accumulation of Iodide in thyroid follicular cells?
4479
Potassium Perchlorate
4480
Q2241:what is the Tx for Graves Dz in pregnent woman?
4481
PTU
4482
Q2242:Steroid derivative that promotes the synthesis of factors II; VII; IX and X and may interfere w/ effects of Warfarin or result in thromboemboli?
4483
Ethinyl Estradiol
4484
Q2243:steroid to help promote lung maturity
4485
Betamethasone
4486
Q2244:Drug that lowers serum calcium from cancers
4487
Plicamycin
4488
Q2245:Octreotide
4489
Properties - Synthetic somatostatin analog given SQ;Indications - acromegaly; glucagonoma; insulinoma; GI bleeding; intractable diarrhea
4490
Q2246:Leuprolide
4491
Properties - GnRH analog that inhibits gonadotropin release when given in continuous doses. Given SQ or IM;Indications - Prostate cancer; PCOS; uterine fibroids; endometriosis.
4492
Q2247:Bromocriptine
4493
Properties - Dopamine receptor agonist. Given orally;Indications - hyperprolactinemia and associated infertility and breast ingorgement; inhibit lacation postpartum. Can also be used with octreotide in acromegaly;SE; Tox - N/V; arrhythmias; hypotension; paranoia/psychosis.
4494
Q2248:Oxytocin
4495
Properties - posterior pituitary hormone. Given IV to induce/maintain labor; IM to control postpartum bleeding; as a nasal spray to cause milk secretion.
4496
Q2249:DDAVP (desmopressin)
4497
Properties - analog of ADH with no V1 effects (so no smooth muscle contraction --> HTN);Indications - central diabetes insipidus
4498
Q2250:Menotropins
4499
Properties - partially degraded FSH and LH;Indications induces ovulation in infertile women when followed by HCG. induces spermatogenesis in infertile men when following HCG;SE; Tox - overstimulation of ovaries --> multiple pregnancies; ovarian cysts.
4500
Q2251:Cosyntropin
4501
Properties - a sythetic ACTH analog which is less antigenic;Indications - Used in the diagnosis of adrenal function (failure to respond indicates primary adrenal disorder).
4502
Q2252:Levothroxine sodium
4503
Properties - levo isomer of T4 given orally or IV. T4 has halflife of 6-7 days;Indications - hypothyroidism. preferred drug because cheaper; easier to monitor; and has longer half life than synthetic T3 drug.
4504
Q2253:Iodine
4505
Properties - 50+mg/d will lead to autoinhibition of thyroid hormone production. Blocks uptake of iodide by the gland and diminishes vascularity. Given as Lugol solution (iodine and potassium iodide). Works within 24 hours;Indications given preop to shrink the gland before surgical removal; as tx for thyroid storm. NOT long term;SE; Tox - dose-related. hypersensitivity; head cold symptoms; gastric irritation; parotitis. long-term use --> sudden disinhibition --> acute hyperparathyroidism.
4506
Q2254:Propylthiouricil (PTU) and methimazole
4507
Pharmacology Flash Facts Class - Thioamides;Properties - inhibit the peroxidase enyzmes (oxidation of iodide and coupling of iodinated tyrosyl groups) --> decreased hormone synthesis. Also inhibits peripheral T4 --> T3. Onset of action after performed hormones have been metabolized;Indications - control of hyperthyroidism until surgery; until the effect of radioactive iodide begins; and long-term therapy for mild-moderate cases. PO;SE; Tox - maculopapular rash; joint pain; headache; nausea; hair loss. Rare; serious agranulocytosis. Can cross placenta and enter breast milk; PTU is more protein-bound 4508 therefore less likely to do so.
Q2255:Radioactive Iodine
4509
Properties - Either PO or IV; it is taken up rapidly by the thyroid --> thyroglobulin. Causes destruciton of the gland by emission of beta particles with minimal damage to surrounding tissue;Indications - hyperthyroidism;SE; Tox - overdosage --> delayed hypothyroidism;CI - pregnancy.
4510
Q2256:Calcitonin
4511
Properties - lowers serum calcium; inhibits bone resorption; blocks Ca; phosphate release from bone;Indications hypercalcemia; hyperPTH; vitamin D toxicity; Paget disease; bone tumors; osteoporosis;SE; Tox - hypersensitivity rxns; hypocalcemia
4512
Q2257:Vitamin D
4513
Indications - hypocalcemia due to rickets; hypoPTH; osteomalacia;SE; Tox - hypercalcemia
4514
Q2258:Diphosphonates
4515
Properties - analogs of pyrophosphate bind to hydroxyapatite crystals and reduce their formation; growth; and dissolution --> less bone turnover;Indications hypercalcemia of malignancy; Page disease; osteoporosis; hyperPTH
4516
Q2259:Sulfonylureas
4517
Examples - Tolbutamide; chlorpropamide; glyburide; glipizide;Properties - stimulates insulin release by closing K channels in beta cell membrane --> depol --> Ca influx and insulin release;Indications - NIDDM;SE; Tox - hypoglycemia esp. with long-acting chlorpropamide and high-potency glyburide and glipizide; skin rashes; GI upset; hypothyroidism; disulfiram-like reaction; esp with chlorpropamide
4518
Q2260:Metformin
4519
Properties - mechanism unknown; possibly inhibits gluconeoneogenesis; increases glycolysis --> decreased serum glucose levels;Indications - NIDDM; don't need islet function;SE; Tox - NO hypoglycemia; can result in lactic acidosis
4520
Q2261:Glitazones or Thiazolidinediones (the longest name EVER)
4521
Examples - Pioglitazone; risiglitazone;Properties - increase target cell response to insulin. can be used alone or with other agents;SE; Tox - weight gain; troglitazone is hepatotoxic
4522
Q2262:Repaglinide
4523
Properties - sulfonylurea-like; stimulates insulin release
4524
Q2263:Acorbose
4525
Properties - inhibits alpha -glucosidase of brush border and prevents asorption of glucose;SE; Tox - GI discomfort
4526
Q2264:Short acting insulins?
4527
insulin; lispro
4528
Q2265:intermediate insulins?
4529
NPH
4530
Q2266:long acting insulins?
4531
lente; ultralente
4532
Q2267:MOA of insulin?
4533
liver (increased glucose stored as glycogen) Muscle (increased glycogen and protein synth; K uptake) Fat (aids TG storage)
4534
Q2268:Uses of insulin other than DM1?
4535
life threatening hyperkalemia and stress induced hyperglycemia
4536
Q2269:Insulin toxicity?
4537
hypoglycemi; hypersensitivity rxn (very rare)
4538
Q2270:Name the first generation sulfonylureas.
4539
tolbutamide; chlorpropamide
4540
Q2271:name the second generation sulfonylureas.
4541
glyburide; glimeperide; glipizide
4542
Q2272:MOA of sulfonylureas.
4543
close K channel in beta cell membrane so cell depolarizes triggers insulin release via increased Ca influx
4544
Q2273:Are sulfonylureas good for DM1; DM2 or both?
4545
DM2. (useless in DM1 b/c needs some islet fxn)
4546
Q2274:First generation sulfonylureas toxicities?
4547
disulfiram-like effects
4548
Q2275:Second generation sulfonylurea toxicity?
4549
hypoglycemia
4550
Q2276:What class of drugs is metformin?
4551
biguanide
4552
Q2277:Probable MOA of metformin?
4553
decreased GNG; increased glycolysis; decreased serum glucose
4554
Q2278:Metformin for DM1; DM2 or both?
4555
both
4556
Q2279:Metformin toxicity?
4557
lactic acidosis (contraindicated in renal insufficiency; CHF; elderly)
4558
Q2280:MOA of glitazones?
4559
increased target cell response to insulin
4560
Q2281:Glitazones; DM1; DM2 or both?
4561
DM2
4562
Q2282:Glitazone toxicities/
4563
weight gain; CHF (fluid retention); (troglitazone is hepatotoxic)
4564
Q2283:name two alpha glucosidase inhibitors.
4565
acarbose; miglitol
4566
Q2284:alpha glucosidase inhibitor MOA?
4567
inhibit intestinal brush border alpha glucosidases (delayed sugar hydrolysis and glucose absorption lead to decreased postpradial hyperglycemia)
4568
Q2285:alpha glucosidase inhibitor toxicity?
4569
flatulence
4570
Q2286:Orlistat MOA?
4571
alters fat metabolism by inhibiting pancreatic lipases
4572
Q2287:Indications for orlistat?
4573
long term obesity management
4574
Q2288:Orlistat toxicities?
4575
steatorrhea; GI discomfort; reduced absorption of fat soluble vitamins; HA
4576
Q2289:Sibutramine MOA?
4577
sympathomimetic SNRI
4578
Q2290:Indication for sibutramine?
4579
short-term and long term obesity management
4580
Q2291:Sibutramine toxicity?
4581
HTN; tachycardia
4582
Q2292:Propylthiouracil; methimazole MOA?
4583
inhibit organification and coupling of thyroid hormone synthesis. Propylthiouracil also decreases peripheral conversion of T4 to T3
4584
Q2293:Indications for propylthiouracil or methimazole?
4585
hyperthyroidism
4586
Q2294:Toxicities of propylthiouracil and methimazole?
4587
skin rash; agranulocytosis (rare); aplastic anemia
4588
Q2295:Indication for somatostatin?
4589
GH deficiency; turner's syndrome
4590
Q2296:Indication for octreotide?
4591
acromegaly; carcinoid; gastrinoma; glucagonoma
4592
Q2297:Indication for oxytocin?
4593
stimulates labor; uterine contractions; milk let-down; controls uterine hemorrhage
4594
Q2298:Indication for desmopressin?
4595
Central (not nephrogenic) DI
4596
Q2299:Uses of levothyroxine; triiodothyroxine?
4597
hypothyroidism; myxedema
4598
Q2300:Levothyroxine; triiodothyroxine toxicity?
4599
tachycardia; heat intolerance; tremors
4600
Q2301:What kind of drug is triamcinolone?
4601
glucocorticoid
4602
Q2302:MOA of glucocorticoids?
4603
decreased production of leukotrienes/prostaglandins by inhibiting PLA2 and COX-2 expression
4604
Q2303:Uses of glucocorticoids?
4605
addison's; inflammation; immune suppression; asthma
4606
Q2304:Glucocorticoid toxicity?
4607
iatrogenic cushings (buff hump; moon facies; truncal obesity; muscle wasting; thin skin; easy bruisability; osteoporosis; adrenocortical atrophy; peptic ulcers)
4608
Q2305:Action and use of Finasteride?
4609
5alpha-reductase inhibitor (decreased conversion of testosterone to dihydrotestosterone). Used for BPH and baldness
4610
Q2306:Action and use of Flutamide?
4611
nonsteroidal competitive inhibitor of androgens at the testosterone receptor. Used in prostate ca
4612
Q2307:Action and use of ketoconazole?
4613
inhibit steroid synth; used in polycystic ovarian syndrome to prevent hirsutism
4614
Q2308:Action and use of spironolactone?
4615
inhibit steroid synth; used in polycystic ovarian syndrome to prevent hirsutism
4616
Q2309:MOA of sildenafil/vardenafil?
4617
inhibit cGMP phosphodiesterase causing increased cGMP; smooth musc relax in corpus cavernosum; increased blood flow and erection
4618
Q2310:Use of sildenafil/vardenafil?
4619
treatment of erectile dysfxn
4620
Q2311:Toxicity of sildenafil/vardenafil?
4621
HA; flushing; dyspepsia; blue-green color vision. Risk of lifethreatening hypotension in pts taking nitrates
4622
Q2312:MOA of leuprolide?
4623
GnRH analog w/agonist properties when used in pulsatile fashion; antagonist properties when used in continuous fashion (continous causes transient initial burst of LH and FSH)
4624
Q2313:Use of leuprolide?
4625
infertility (pulsatile); prostate ca (continuous w/flutamide); unterine fibroids
4626
Q2314:Toxicity of leuprolide?
4627
antiandrogen; N/V
4628
Q2315:MOA of clomiphene?
4629
partial agonist at estrogen receptors in pituitary gland. Prevents nrm feedback inhibition and increases release of LH and FSH from pituitarystimulates ovulation
4630
Q2316:Use of clomiphene?
4631
tx of infertility
4632
Q2317:Toxicity of clomiphene?
4633
hot flashes; ovarian enlargement; multiple simultaneous pregnancies; visual disturbances
4634
Q2318:MOA of mifepristone (ru-486)?
4635
competitive inhibitor of progestins at progesterone receptors
4636
Q2319:Use of mifepristone?
4637
abortifactant (prevents implantation)
4638
Q2320:Toxicity of mifepristone (ru-486)?
4639
heavy bleeding; GI effects (N/V; anorexia); ab pain
4640
Q2321:Advantages of oral contraceptives (5)?
4641
reliable; decreased risk of endometrial/ovarian ca; decreased risk ectopic preg; decreased pelvic infxn; regulation of menses
4642
Q2322:Disadvantages of oral contraception (5)?
4643
taken daily; no STD protection; increased triglycerides; depression/wt gain/nausea/HTN; hypercoaguable state
4644
Q2323:Which drugs cause gynecomastia as a side effect?
4645
Some Drugs Create Awesome Knockers! - Spironolactone; Digitalis; Cimetidine; Alcohol; Ketoconazole
4646
Q2324:Finasteride use and mechanism
4647
used for BPH and male-pattern baldness; blocks 5-alphareductase to prevent conversion of T to DHT
4648
Q2325:Flutamide use and mechanism
4649
nonsteroidal competitive inhibitor of androgens. blocks T receptor. Used in prostate carcinoma
4650
Q2326:Kotoconazole use and mechanism
4651
inhibits steroid synthesis; used in treatment of polycystic ovarian syndrome to prevent hirsutism
4652
Q2327:Spironolactone use and mechanism
4653
inhibits steroid binding; used in Polycystic ovarian syndrome to prevent hirsutism
4654
Q2328:Mechanism of Leuprolide?
4655
GnRH analog with agonist properties when used in pulsatile fashion. Antagonist when used continuously.
4656
Q2329:Uses of Leuprolide?
4657
Infertility (pulsatile); prostate cancer (continuous use with flutamide); uterine fibroids
4658
Q2330:Toxicity of Leuprolide?
4659
antiandrogen; nausea; vomiting
4660
Q2331:Sildenafil; Vardenafil mechanism
4661
Inhibits cGMP phosphodiesterase --> increased cGMP --> smooth muscle relaxation in corpus cavernosum --> increased blood flow --> PENILE ERECTION!
4662
Q2332:Toxicity of Sildenafil and Vardenafil?
4663
HA; flushing; dyspepsia; impaired blue-green color vision. DO NOT USE WITH NITRATES!!! causes hypotension
4664
Q2333:mechanism of Mifepristone (RU-486)?
4665
competitive inhibitor of progestins at progesterone receptors
4666
Q2334:clinical use of mifepristone
4667
termination of pregnancy. used with misoprostol (PGE1)
4668
Q2335:toxicity of mifepristone
4669
heavy bleeding; GI effects (nausea; vomiting; anorerxia); abdominal pain
4670
Q2336:advantages of OCPs?
4671
decreased risk of endometrial and ovarian cancer; decreased incidence of ectopic pregnancy; decreased pelvic infections; regulation of menses
4672
Q2337:disadvantages of OCPs?
4673
no protection against STDs; increased triglycerides; depression; weight gain; nausea; hypertension; hypercoagulable state
4674
Q2338:What is Dinoprostone?
4675
PGE2 analog causing cervical dilation and uterine contraction; inducing labor
4676
Q2339:Ritodrine/Terbutaline are what?
4677
B2 agonists that relax the uterus
4678
Q2340:What is anastrozole?
4679
aromatase inhibitor used in postmenopausal women with breast cancer.
4680
Q2341:What are the toxicities of estrogens (ethinyl estradiol; DES; mestranol)
4681
increased risk of endometrial cancer; bleeding in postmenopausal women; clear cell adenocarcinoma of vagina in females exposed to DES in utero; increased risk of thrombi
4682
Q2342:What is the toxicity of testosterone?
4683
masculinization in females; reduces intratesticular testosterone in males by inhibiting Leydig cells; leads to gonadal atrophy. premature closure of epiphyseal plates. increased LDL; decreased HDL
4684
Q2343:Mechanism of Clomiphene?
4685
partial agonist at estrogen receptors in pituitary gland. prevents normal feedback inhibition and increased release of LH and FSH from pituitary; which stimulates ovulation
4686
Q2344:Uses of Clomiphene?
4687
treat infertility and PCOS.
4688
Q2345:toxicity of clomiphene?
4689
hot flashes; ovarian enlargement; multiple pregnancies; visual disturbances
4690
Q2346:mechanism of Tamoxifen?
4691
estrogen antagonist on breast tissue. used to prevent recurrence of ER-positive breast cancer
4692
Q2347:mechanism and use of Raloxifene?
4693
estrogen agonist on bone; reduces reabsorption of bone; used to treat osteoporosis
4694
Q2348:MOA of mannitol
4695
(osmotic diuretic); increases tubular fluid osmolarity; thereby increasing urine flow
4696
Q2349:Clinical uses of mannitol
4697
shock; drug OD; to decrease intracranial/intraocular P
4698
Q2350:MOA acetazolamide
4699
carbonic anhydrase inhibitor; causes self-limited NaHCO3 diuresis and reduction in total-body bicarb stores
4700
Q2351:Clinical uses of acetazolamide
4701
glaucoma; urinary alkalinization; metabolis alkalosis; altitute sickness
4702
Q2352:toxicities of acetazolamide
4703
hyperchloremic metabolic acidosis; neuropathy; NH3 toxicity; sulfa allergy
4704
Q2353:MOA of ethacrynic acid
4705
(diuretic); phenoxyacetic acid derivative--NOT sulfonamide-that works like furosemide (loop diuretic)
4706
Q2354:Clinical use of ethacrynic acid
4707
diuresis in pts with sulfa allergy (b/c NOT a sulfonamide)
4708
Q2355:toxicity of ethacrynic acid
4709
similar to furosemide (OH DANG) but can be used in hyperuricemia and no sulfa allergy
4710
Q2356:MOA of furosemide
4711
sulfonamide loop diuretic; inhibits Na-K-2Cl contransporter of thick ascending limb; abolishes hypertonicity of medulla which prevents concentration of urine; increases Ca excretion
4712
Q2357:toxicity of furosemide
4713
OH DANG! Ototoxicty; Hypokalemia; Dehydration; Allergy; Nephritis (interstitial); Gout
4714
Q2358:MOA hydrochlorothiazide
4715
thiazide loop diuretic. Inhibits NaCl reabsorption in early distal tubule which reduces diluting capacity of nephron.
4716
Q2359:thiazide diuretics vs. loop diuretics with respect to calcium?
4717
loop diuretics (furosemide; ethacrynic acid)--increase Ca excretion; thiazides DECREASE Ca excretion.
4718
Q2360:4 K+ sparing diuretics
4719
spironolactone; triamterene; amiloride; eplereone
4720
Q2361:MOA of spironolactone
4721
competitive aldosterone R antagonist in cortical collecting tubule
4722
Q2362:MOA of triamterene
4723
(K+sparer) block Na channels in CCT (same as amiloride)
4724
Q2363:MOA of amiloride
4725
(K+sparer) blocks Na channels in CCT (same as triameterene)
4726
Q2364:Clinical use of K+ sparing diuretics
4727
hyperaldosteronism; K+ depletion; CHF
4728
Q2365:toxicity of K+ sparing diuretics
4729
hyperkalemia; endocrine effects (eg. Spironolactone-gynecomastia; antiandrogenics)
4730
Q2366:which diuretics decrease the blood pH (more acidic)
4731
carbonic anhydrase inhibitors (acetazolamide); K+ sparers (spironolactone; triamterene; amiloride; eplererone)
4732
Q2367:which diuretics increase blood pH (make more basic)
4733
loop diuretics (furosemide; ethacrynic acid); thiazides
4734
Q2368:3 AcE inhibitors
4735
captopril; enalapril; lisinopril
4736
Q2369:MOA of ACE inhibitors
4737
inhibit angiotensin converting enzyme which reduces levels of angiotensin II and prevents inacitvation of bradykinin (potent vasodilator); renin release increased b/c of lack of feedback inhibition
4738
Q2370:effect of ACE inhibitors on renin release?
4739
renin release increased due to loss of feedback inhibition
4740
Q2371:Clinical uses of ACE inhibitors
4741
HTN; CHF; diabetic renal disease
4742
Q2372:toxicities of ACE inhibitors
4743
CAPTOPRIL: cough; angioedema; proteinuria; taste changes; hypOtension; preggers problems; rash; increased renin; lower angiotension II. Also hyperkalemia.
4744
Q2373:can ACE inhibitors be used in bilateral renal artery stenosis?
4745
no
4746
Q2374:Why am I so frightened right now?
4747
Cuz the man who lives in our fridge is making really angry noises and there's a moth that keeps flying into my head.
4748
Q2375:Democlocycline
4749
Properties - antagonizes ADH ;Indications - SIADH.
4750
Q2376:Drugs that cause SIADH
4751
carbamazepine (seizures; manic) TCAs; thiazides; phenothiazines (neuroleptics?); chlorpropamide (sulfonylura for DM); cisplatin (anti-neoplastic)
4752
Q2377:Pulmonary infiltrations inducing drugs
4753
"Go BAN Me!";Gold;Bleomycin/ Busulphan/ BCNU;Amiodarone/ Acyclovir/ Azathioprine;Nitrofurantoin;Melphalan/ Methotrexate/ Methysergide
4754
Q2378:Respiratory depression inducing drugs
4755
"STOP breathing";Sedatives and hypnotics;Trimethoprim;Opiates;Polymyxins
4756
Q2379:Monoamine oxidase inhibitors: members
4757
"PIT of despair";Phenelzine;Isocarboxazid;Tranylcypromine; A pit of despair; since MAOs treat depression.
4758
Q2380:Gynaecomastia-causing drugs
4759
DISCOS;Digoxin;Isoniazid;Spironolactone;Cimetidine;Oestro gens;Stilboestrol
4760
Q2381:Sulfonamides: common characteristics
4761
SULFA;Steven-Johnson syndrome/ Skin rash / Solubility low;Urine precipitation/ Useful for UTI;Large spectrum (gram positives and negatives);Folic acids synthesis blocker (as well as synthesis of nucleic acids);Analog of PABA
4762
Q2382:Muscarinic effects
4763
SLUG BAM;Salivation/ Secretions/ Sweating;Lacrimation;Urination;Gastrointestinal upset;Bradycardia/ Bronchoconstriction/ Bowel movement;Abdominal cramps/ Anorexia;Miosis
4764
Q2383:Clopidogrel: use
4765
CLOPIdogrel is a drug that prevents ;CLots; an Oral Platelet Inhibitor (OPI).
4766
Q2384:Morphine: side-effects
4767
MORPHINE;Myosis;Out of it (sedation);Respiratory depression;Pneumonia (aspiration);Hypotension;Infrequency (constipation; urinary retention);Nausea;Emesis
4768
Q2385:Methyldopa: side effects
4769
METHYLDOPA;Mental retardation;Electrolyte imbalance;Tolerance;Headache/ Hepatotoxicity;psYcological upset;Lactation in female;Dry mouth;Oedema;Parkinsonism;Anaemia (haemolytic)
4770
Q2386:4-Aminopyradine (4-AP) use
4771
4-AP is For AP";For AP (action potential) propagation in Multiple Sclerosis
4772
Q2387:LITHIUM
4773
L- lithium intox;M-metallic taste; movement disorders;Nnephrogenic diabetes insipidus;O - hypothyroidism;P - contra in pregnancy
4774
Q2388:Calcium chelator
4775
Tetracycline
4776
Q2389:Brown teeth
4777
Tetracycline
4778
Q2390:Gray-baby syndrome
4779
Chloramphenicol
4780
Q2391:Oto- and nephrotoxicity
4781
Vancomycin; aminoglycosides
4782
Q2392:Optic neuritis
4783
Ethambutol
4784
Q2393:Polyarthralgia
4785
Pyrazinamide
4786
Q2394:Induces cytochrome P450
4787
Rifampin
4788
Q2395:Red-man syndrome
4789
Vancomycin
4790
Q2396:Pseudomembranous colitis
4791
Clindamycin
4792
Q2397:Kernicterus
4793
Sulfonamides
4794
Q2398:Megaloblastic anemia (supplement with vitamin B6)
4795
Trimethoprim-sulfamethoxazole
4796
Q2399:Cartilage damage; tendonitis
4797
Fluoroquinolones
4798
Q2400:Orange bodily fluids
4799
Rifampin
4800
Q2401:Fast vs. slow acetylators
4801
Isoniazid
4802
Q2402:Infusion-related toxicity
4803
Amphotericin B
4804
Q2403:D-Ala-D-Ala
4805
Vancomycin
4806
Q2404:PBP3
4807
Aztreonam
4808
Q2405:Blocks peptidyltransferase
4809
Chloramphenicol
4810
Q2406:Blocks peptide bond formation
4811
Clindamycin
4812
Q2407:Blocks ribosomal translocation by preventing exit of tRNA
4813
Macrolides
4814
Q2408:Inhibits initiation complex; causes mRNA misreading; blocks translocation
4815
Aminoglycosides
4816
Q2409:Blocks tRNA binding to ribosome
4817
Tetracycline
4818
Q2410:Bactericidal for H. flu; S. pneumo; N. meningitidis
4819
Chloramphenicol
4820
Q2411:Blocks initiation step of protein synthesis
4821
Linezolid
4822
Q2412:PABA analogue
4823
Sulfonamides
4824
Q2413:Prevents synthesis of dihydrofolic acid
4825
Sulfonamides
4826
Q2414:Inhibits dihydropteroate synthetase
4827
Sulfonamides
4828
Q2415:Prevents synthesis of tetrahydrofolic acid
4829
Trimethoprim
4830
Q2416:Inhibits dihydrofolate reductase
4831
Trimethoprim
4832
Q2417:Resistance is due to rRNA methylation
4833
Clindamycin; macrolides
4834
Q2418:DNA gyrase; topoisomerase IV
4835
Fluoroquinolones
4836
Q2419:RNA polymerase
4837
Rifampin
4838
Q2420:Inhibits mycolic acid synthesis
4839
Isoniazid
4840
Q2421:Inhibits arabinogalactan synthesis
4841
Ethambutol
4842
Q2422:Inhibits microtubule function
4843
Griseofulvin
4844
Q2423:Inhibits beta(1;3)D-glucan synthetase
4845
Caspofungin
4846
Q2424:Binds ergosterol
4847
Amphotericin B; nystatin
4848
Q2425:Inhibits lanosterol demethylation by cytochrome P450
4849
Azoles
4850
Q2426:Inhibits thymidylate synthase
4851
Flucytosine
4852
Q2427:Used to treat cryptococcal meningitis
4853
Flucytosine
4854
Q2428:Used for meningococcal prophylaxis
4855
Rifampin
4856
Q2429:Used to treat Pseudomonas infection in CF patients
4857
Fluoroquinolones
4858
Q2430:Used to treat nocardiosis
4859
Sulfonamides
4860
Q2431:Used to treat VRE; MRSA; PRSP
4861
Linezolid
4862
Q2432:Used to treat C. perfringens and B. fragilis
4863
Clindamycin
4864
Q2433:Used to treat Mycoplasma pneumoniae
4865
Tetracycline
4866
Q2434:Used to treat chlamydia
4867
Tetracycline
4868
Q2435:Used to treat Legionella
4869
Macrolides
4870
Q2436:Used to treat gonorrhea
4871
Ceftriaxone
4872
Q2437:Used to treat H. flu meningitis
4873
Chloramphenicol
4874
Q2438:Agranulocytosis;(2)*
4875
Clozapine;Carbamazepine;[AGRANny parked her CARBAM in the CLOZet]
4876
Q2439:Aplastic Anemia;(3)
4877
Chloramphenicol;NSAIDs;Benzene
4878
Q2440:Atropine-like Side Effects;(sedation; seizures; coma; anticholinergic effects; arrhythmias)
4879
TCAs
4880
Q2441:Cardiotoxicity;(2)
4881
Doxorubicin;Daunorubicin;[double D "Rubis" are a "sin" for the chest]
4882
Q2442:Cartilage Damage in children
4883
Fluoroquinolones (Ciprofloxacin)
4884
Q2443:Cinchonism (HA; tinnitus);and;Torsades de pointes
4885
Quinidine
4886
Q2444:Cough
4887
ACE Inhibitors
4888
Q2445:Diabetes Insipidus
4889
Lithium
4890
Q2446:Disulfiram-like effect;and;Metallic taste
4891
Metronidazole
4892
Q2447:Extrapyramidal Side Effects
4893
Antipsychotics;Typical > Atypical;(Thioridazine; Haloperidol; Chlorpromazine)
4894
Q2448:Fanconis Syndrome;(growth failure; rickets; dehydration)
4895
Tetracycline
4896
Q2449:Gingival Hyperplasia
4897
Phenytoin;;[PHEN he's TOYIN' w/ GINGer]
4898
Q2450:Gray Baby Syndrome
4899
Chloramphenicol
4900
Q2451:Gynecomastia;(6)*
4901
Some Excellent Drugs Create Awesome Knockers;Spirolactone;Estrogens;Digitalis;Cimetidine;Alcohol (chronic);Ketoconazole
4902
Q2452:Hemolytic Anemia in G6PD-deficiency;(5)*
4903
C'PISA;Chloramphenicol;Primaquine;Isoniazid;Sulfonamides; Aspirin;[AN ENEMIA (enemy) and 6 PDs knocked down C'PISA]
4904
Q2453:Hepatitis
4905
Isoniazid
4906
Q2454:Hot Flashes; Flushing;(3)*
4907
No Cold Temp;Niacin;Calcium Channel Blockers;Tamoxifen
4908
Q2455:Induce CP450;(6)*
4909
Queen Barb takes Phen-phen & Refuses Greasy Carbs;Quinidine;- Barbiturates;- Phenytoin;- Rifampin;Griseofulvin;- Carbamazepine
4910
Q2456:Inhibit CP450;(8)*
4911
Inhibitors Stop Cyber Kids From Eating Grapefruit Salad;Isoniazid;- Sulfonimides;- Cimetidine;- Ketoconazole;- FQ (Ciprofloxacin);- Erythromycin;- Grapefruits/St. Johns Wort
4912
Q2457:Interstitial Nephritis
4913
Methicillin
4914
Q2458:What is Monday Disease?;Cause?
4915
- Nitroglycerin Industrial exposure -> tolerance during week > loss of tolerance during weekend -> headache; tach; dizziness upon re-exposure
4916
Q2459:Orange Body Fluids
4917
Rifampin
4918
Q2460:Osteoporosis;(2)
4919
Heparin;Corticosteroids
4920
Q2461:Positive Coombs Test
4921
Methyldopa
4922
Q2462:Pulmonary Fibrosis;(2)*
4923
Amiodarone;Bleomycin;[AMY cant BLEOw anymore]
4924
Q2463:Red Man Syndrome;(histamine release)*
4925
Vancomycin;[red mAN vAN]
4926
Q2464:Severe HTN with Tyramine;and;Serotonin syndrome (w/ meperidine)
4927
MAOIs
4928
Q2465:SLE-like Syndrome / Drug-induced Lupus;(7)*
4929
Lupus Quickly Moaned In Pain - His Penis Cracked;Quinidine;- Methyldopa;- INH;- Procainamide;Hydralazine;- Penicillamine;- Chlorpromazine
4930
Q2466:Tardive Dyskinesia
4931
- Antipsychotics ;(Thioridazine; Haloperidol; Chlorpromazine)
4932
Q2467:Tinnitus;(2)*
4933
Aspirin;Quinidine;[ApirIN for QuIN-tIN Tinnitus]
4934
Q2468:Torsades de pointes;(2 classes)
4935
Class III;Class IA antiarrhythmics
4936
Q2469:fetal Spina Bifida
4937
Valproic Acid;[no folIC ACID or valproIC ACID]
4938
Q2470:fetal Renal Dysgenesis -> death;(2)
4939
ACE inhibitors;ARB
4940
Q2471:Arrhythmias and Yellow visual changes
4941
Digoxin
4942
Q2472:Acute cholestatic Hepatitis
4943
Macrolides
4944
Q2473:Massive Hepatic Necrosis;(4)*
4945
A Hepatic Ending Varies;- Acetaminophen;- Halothane;Ethanol;- Valproic acid
4946
Q2474:Livedo Reticularis;(patchy swollen blood vessels on legs with cold)
4947
Amantidine
4948
Q2475:Thyroid toxicity;(2)
4949
Lithium;Amiodarone
4950
Q2476:Severe rebound HA and HTN;dry mouth
4951
Clonidine
4952
Q2477:Hemorrhagic Cystitis;Myelosuppression
4953
Cyclophosphamide
4954
Q2478:Photosensitivity;(3)*
4955
SAT for a photo;- Sulfonamides;- Amiodarone;- Tetracycline
4956
Q2479:Stevens-Johnson syndrome;(2)
4957
Sulfonamides;Ethosuximide
4958
Q2480:Seziures;(3)*
4959
Impending Big Chills;- Imipenem;- Bupropion;- Cilastatin
4960
Q2481:Retinal Toxicity
4961
- Chloroquine;[CHLORine in pools hurts eyes]
4962
Q2482:both Nephrotoxicity & Ototoxicity;(3)
4963
Aminoglycosides;Loop diuretics;Cisplatin;[an ALCoholic cant hear well and urinates a lot]
4964
Q2483:Priapism ;(prolonged erection w/o sexual stimulation)
4965
Trazodone;(anti-depressant)
4966
Q2484:Erectile dysfunction;(3 classes)*
4967
No Tone Bone;- Neuroleptics;- TCAs;- Beta-blockers
4968
Q2485:Malignant Hyperthermia
4969
Succinylcholide
4970
Q2486:Enhances erections
4971
- Dopamine agonist;[it's DOPE AGain to get a big erection]
4972
Q2487:atropine-like side effects
4973
tricyclics
4974
Q2488:cardiac toxicity
4975
doxorubicin; daunorubicin
4976
Q2489:coronary vasospasm
4977
cocaine
4978
Q2490:cutaneous flushing
4979
niacin (lipid lowerer; increases HDL); CCB; adenosine; vancomycin (red man syndrome!)
4980
Q2491:torsades de pointes
4981
class III antiarrythm (sotalol); class IA antiarrhythm. (quinidine); cisapride
4982
Q2492:agranulocytosis (3)
4983
clozapine (atypical antipsych; least EPS); carbamazepine (AED; mood stabilizer; P450 inducer); colchicine
4984
Q2493:aplastic anemia
4985
chloramphenicol; benzene; NSAIDs; also: propylthioracil; methimazole (inhibit organificatin and coupling of thyroid hormone synth)
4986
Q2494:gray baby syndrome
4987
(ab distention; progressive pallid cyanosis; vasomotor collapse) chloramphenicol (binds 50s; inhibits peptidlytransferase)
4988
Q2495:hemolysis in G6PD deficient pts
4989
sulfonamides; INH; aspirin; ibuprofen; primaquine; nitrofurantoin (abx)
4990
Q2496:thrombotic complications
4991
OCPs
4992
Q2497:cough
4993
ace inhibitors (bradykinin!)
4994
Q2498:pulmonary fibrosis
4995
bleomycin (induces free radical formation; for testicular cacner; lymphomas--ABVD regimen); amiodarone (class IA antiarrhthm); busulfan (alkylates DNA; CML; also causes hyperpigmentation)
4996
Q2499:acute cholestatic hepatitis
4997
macrolides (dont give to preggers!)
4998
Q2500:focal to massive hepatic necrosis
4999
halothane (inhaled anesthetic); valproic acid; acetaminophen; Amanita phalloides (mushroom poison alpha amanitin->inhibits euk RNA pol)
5000
Q2501:gynecomastia
5001
Some Drugs Create AwesomE Knockers--Spironolactone; Digitalis; Cimetidine; Alcohol chronique; Estrogens; Ketoconazole
5002
Q2502:gingival hyperplasia
5003
phenytoin
5004
Q2503:osteoporosis
5005
corticosteroids; heparin
5006
Q2504:photosensitivity
5007
sulfonamides; amiodarone; tetracycline; also 5-FU
5008
Q2505:SLE-like syndrome
5009
hydralazine (antiHTN for preggers; stim cGMP); INH; procainamide (Class IA antiarrh.); phenytoin
5010
Q2506:Fanconi's syndrome
5011
expired tetracycline
5012
Q2507:interstitial nephritis
5013
methicillin; also acute interstitial nephritis: NSAIDs; beta lactams; sulfa diuretics; phenytoin; cimetidine; methyldopa
5014
Q2508:hemorrhagic cystitis
5015
cyclophosphamide; ifosfamide
5016
Q2509:diabetes insipidus
5017
lithium; demeclocycline
5018
Q2510:seizures
5019
bupropion (heterocyclic antidepressant; no sexual side effects); imipenem/cilastin
5020
Q2511:disulfiram-like reaction
5021
metronidazole; some cephalosporins; procarbazine (antineoplastic alkylator); sulfonylureas
5022
Q2512:nephrotoxicity/neurotoxicity
5023
polymyxins
5024
Q2513:nephrotoxicity/ototoxicty
5025
aminoglycosides; loop diuretics; cisplatin
5026
Q2514:Acetaminophen: Antidote
5027
N-acetylcysteine
5028
Q2515:Salicylates: Antidote
5029
Alkalnize urine; dialysis
5030
Q2516:Anticholinesterases; organophosphates: Antidote
5031
Atropine; Pralidoxime
5032
Q2517:Antimuscarinic (Atropine); anticholinergics: Antidote
5033
Physostigmine (AChE inhibitors)
5034
Q2518:B-blockers: Antidote
5035
Glucagon
5036
Q2519:Digitalis: Antidote
5037
1. Stop digitalis;2. Normalize K+;3. Lidocaine;4. Mg2+;5. anti-dig Fab fragments
5038
Q2520:Iron: Antidote
5039
Deferoxamine
5040
Q2521:Lead: Antidote
5041
- CaEDTA; Dimercaprol (1st line for adults);- Succimer (kids - "sucks" to be a kid with lead poisoning);- Penicillamine
5042
Q2522:Arsenic: Antidote
5043
Dimercaprol; Succimer;Penicillamine
5044
Q2523:Mercury: Antidote
5045
Dimercaprol; Succimer
5046
Q2524:Gold: Antidote
5047
Dimercaprol; Succimer;Penicillamine
5048
Q2525:Copper: Antidote
5049
Penicillamine
5050
Q2526:Cyanide: Antidote
5051
1. Nitrite - (oxidizes Hemoglobin to methemoglobin [Fe3+]; which has high afinity for CN- but low affinity for O2);2. Hydroxocobalamin;3. Thiosulfate
5052
Q2527:Methanol; Ethylene glycol: Antidote
5053
Ethanol; dialysis;- Fomepizole
5054
Q2528:Methemoglobin: Antidote
5055
Methylene blue
5056
Q2529:Carbon monoxide: Antidote
5057
100% 02; hyperbaric O2
5058
Q2530:Opioids: Antidote
5059
Naloxone/Naltrexone
5060
Q2531:Benzodiazepines: Antidote
5061
Flumazenil
5062
Q2532:TCA's: Antidote
5063
NaHCO3 (nonspecific) ??
5064
Q2533:Heparin: Antidote
5065
Protamine
5066
Q2534:Warfarin: Antidote
5067
Vit K (hours); Fresh Frozen Plasma (instant)
5068
Q2535:tPA; streptokinase: Antidote
5069
Aminocaproic acid
5070
Q2536:Lead poisoning: LLEEAADD
5071
- Lead Lines on gingivae and long bone epiphyses (on xray);Encephalopathy; Erythrocyte basophilic stippling;Abdominal colic; Anemia (sideroblastic);- Drops-wrist and foot drop; Dimercaprol as antidote (Succimer for kids)
5072
Q2537:Inducers of CYP450
5073
Quinidine;Barbiturates (phenobarbitol);Phenytoin;Rifampin;Griseofulvin;Carbemaze pine;St. Johns Wort
5074
Q2538:Inhibitors of CYP450
5075
Isoniazid (INH);Sulfonylureas;Cimetidine;Ketoconazole;Erythromycin; Grapefruit Juice
5076
Q2539:tx benzodiazepam overdose
5077
flumazenil
5078
Q2540:go from phospholipids in the cell membrane to lukotrienes and other products of arachidonic acid metabolism
5079
1. phospholipid in cell membrane -> phospholipase A2 (+ by bradykinin and angiotensin; - by corticosteroids);2. phospholipase A2 -> arachidonic acid;3a. arachidonic acid becomes PGG2 via cyclooxygenase (- by NSAIDS) -> PGG2 broken down by hydroperoxidase to PGH2 -> PGH2 becomes thromboxane A2 (inhibited by dipyridamole); PGE2; PGF2; and PGI2 (aka prostacyclin);3b. arachidonic acid becomes 5-HPETE via 5-lipoxygenase -> 5-HPETE becomes leukotrienes
5080
Q2541:what causes the cough and angioedema in patient on an ACEI
5081
bradykinin
5082
Q2542:how much epinephrine do you use in shock
5083
1:1000 dilution subcutaneously
5084
Q2543:what is dantrolene used for
5085
treatment of malignant hyperthermia after halothane
5086
Q2544:treat acetaminophen overdose
5087
acetylcysteine to replace used of GSH (neutralizes acetaminophen free readicals formed in the liver cytochrome system)
5088
Q2545:mechanism of a loop diuretic
5089
blocks Na-K-2Cl cotransport in the thick ascending limb in the renal medulla; also blocks Ca reabsorption
5090
Q2546:treat cyanide poisoning (useful to know that taking nitropusside orally instead of IV gives cyanide poisoning)
5091
infusion of sodium thiosulfate -> produce thiocyanate;also use amyl nitrite
5092
Q2547:complication of corticosteroid inhaler
5093
thrush
5094
Q2548:isotretinoin given to a young woman requires;
5095
pregnancy test; then put them on OCs
5096
Q2549:mechanism of propylthiouracil
5097
blocks iodinqation of the tyrosine residues of thyroglobulin; also blocks coupling of DIT an MIT; only drug that can be used in pregnancy but may produce goiter in the newborn and nail defects
5098
Q2550:what does the P450 in the liver do
5099
makes drugs water soluble
5100
Q2551:what do angioedema and renal failure have to do with one another
5101
ACEI
5102
Q2552:MOA of retinoic acid
5103
behaves like a steroid in that it binds to receptors in the nucleus w/ subsequent transcription of genes; proteins produced by the action ar eimportant in growth; differentiation; reproduction; and embryonic development; also used in treatment of acute progranuloctyic leukemia
5104
Q2553:allopurinol MOA in purine synthesis
5105
blocks xanthine oxidase (takes hypoxanthine to xanthine and xanthine to uric acid); mercaptopurine degradation is inhibited also
5106
Q2554:most common antibiotic used to prevent endocarditis in patients w/ valvular disease
5107
amoxicillin (all vavlular diseases except asymptomatic MVP and all congential heart disease except asymptomatic ASD)
5108
Q2555:drug that may cause yellow coloration of skin that can be mistaken for jaundice
5109
quinacrine;(chlorpromazine and arsenic produce blue-grey color to the skin)
5110
Q2556:diffuse erythema followed by separation of the skin (scalded skin syndrome or toxic epidermal necrolysis)- drug?
5111
barbituates; sulfonamides; phenytoin; NSAIDS
5112
Q2557:hair loss in a woman- drug?
5113
oral contraceptives (predictable side effect- estrogen causes hair to be at same stage of development; may also occur after delivery)
5114
Q2558:erythematous; hyperpigmented plaque-like lesion that recurs at the same site every time?
5115
fixed drug eruption (phenolphthalein; NSAIDS; tetracycline; Bactrim; and barbituates are the most common)
5116
Q2559:group of drugs that has the highest association w. urticarial and maculopapular lesions
5117
amoxicillin; TMP/SMX; ampicillin/penicllin (rashes are the MOST COMMON adverse reaction to drugs; with maculopapular rashes leading the list; most drug reactions involving the skin are NOT type I hypersensitivity related)
5118
Q2560:elderly woman on thiazides is most at risk for developing;
5119
gout
5120
Q2561:tardive dyskinesia; malignant syndrome (sweating; hyperpyrexia; autonomic instability)
5121
neuroleptics
5122
Q2562:antipsychotic drug requiring visual exam
5123
thioridazine (also produces heart conduction defects)
5124
Q2563:nephrogenic diabetes insipidus- drug?
5125
lithium for bipolar disturbances
5126
Q2564:drug contraindicated w/ MAOI
5127
epinephrine
5128
Q2565:use of phentolamine
5129
non-selective alpha blocker that lowers blood pressure during surgery for a pheochromocytoma
5130
Q2566:mechanism of AZT
5131
inhibits reverse transcriptase; produces a macrocytic anemia unrelated to folate/B12
5132
Q2567:treatment of Pb poisoning
5133
BAL and EDTA
5134
Q2568:drugs involved in folate metabolism
5135
phenytoin blocks intestinal conjugase (polyglutamate to monoglutamate); BCP blocks uptake of monoglutamate; methotrexate/TMP-SMX block dihydrofloate reductase
5136
Q2569:MOA of cromolyn sodium
5137
stabilizes mast cell membrane preventing release of preformed mediators and release of prostaglandins/leukotrienes after the release reaction
5138
Q2570:methotrexate MOA
5139
blocks dihydrofolate reductase and the conversion of dihydrofolate to tetrahydrofolate
5140
Q2571:glucoronyl transferase in liver renders compounds;
5141
water soluble
5142
Q2572:COX inhibitors
5143
aspirin inhibits irreversible;NSAIDS reversible
5144
Q2573:thromboxane A2
5145
synthesized in platelet; vasoconstrictor and increases platelet aggregation; also a bronchoconstrictor
5146
Q2574:effect of proton blockers
5147
blocks H-K-ATPase proton pump in parietal cell; not a receptor mediated event
5148
Q2575:H2 blockers
5149
blocks H2 receptor; which normally activates adenylate cyclase producing cAMP which stimulates protein kinase
5150
Q2576:misoprostol
5151
blocks the prostaglandin receptor; which normally inhibits adenylate cyclase and cAMP production
5152
Q2577:treatment of schistosomiasis and clonorchiasis
5153
praziquantel
5154
Q2578:7-fold membrane spanning protein- drug?
5155
propranolol
5156
Q2579:phase 3 clinical trials
5157
double blind
5158
Q2580:ticlopidine
5159
substitute for aspirin in preventing strokes; CAD if the patient is allergic to aspirin; causes neutropenia
5160
Q2581:drug induced SLE
5161
hydralazine;INh;procainamide;phenytoin
5162
Q2582:overdose of succinylcholine
5163
acetylcholine blocker
5164
Q2583:finasteride
5165
blocks 5-a-reductase which converts testosterone ino dihydrotestosterone; hence testosterone would increase proximal to the block and dihydrotestosterone would decrase -> increases hair growth
5166
Q2584:flutamide; cyproterone and spironolactone
5167
block androgen receptors; hence testosterone/dihydrotestosterone increase byt have no physiologic effect
5168
Q2585:ketoconazole
5169
inhibits testosterone synthesis (suppresses adrenal steroid synthesis)
5170
Q2586:leuprolide
5171
GnRH analogue; which when given in sustained fashion inhibits FSH and LH; hence lowering testosterone and estrogen levels
5172
Q2587:ACEI
5173
increase in renin and ATI; but a decrease in ATII and aldosterone; aldosterone eventually increases; hence the addition of spironoladctone to keep aldosterone suppressed; increases longevity in CHF
5174
Q2588:arsenic poisoning
5175
dimercaprol
5176
Q2589:chloroquine in treatmento f malaria- malaria recurred; why?
5177
exoerythrocytic/hepatic stage (P. vivax and P. ovale); drug kills active disease but does not eradicate hepatic stage
5178
Q2590:primaquine in treatment of malaria
5179
not good in active stage byt does kill the hepatic stage of p. vivax and p. ovale
5180
Q2591:dantrolene MOA
5181
reduces the release of Ca from the sarcoplasmic reticulum of skeletal muscle; antispasmodic drug also used in treating malignant hyperthermia
5182
Q2592:methanol
5183
increased anion gap metabolic acidosis due to conversion of methanol into formic acid; optic nerve degeneration and blindness; treat w/ alcohol infusion to block metabolism of methanol by alcohol dehydrogenase
5184
Q2593:botulsim toxin
5185
blocks the release of acetylcholine; used to treat LES spasm in achalasia
5186
Q2594:ribavirin
5187
used in severe RSV infection in kids
5188
Q2595:asthma
5189
albuterol (b2 selective agonist); may cause hypokalemiadrives K into cells
5190
Q2596:acetylcholine breakdown
5191
occurs in the synapse into choline and acetate by acetylcholinesterase in the cleft; products are recycled and not excreted
5192
Q2597:know the graph of norepi/epi and isoproterenol and their effects on blood pressure and heart rate
5193
plus the effect of alpha -1 blockers
5194
Q2598:amphotericin
5195
disrupts cell membrane permeability; binds to ergosterol in the membrane
5196
Q2599:ketoconazole
5197
inhibits the metabolism of nosedating antihistamines like Seldane leading to cardiac arrhytmias
5198
Q2600:be very familiar w/ secondary messengers
5199
IP3 DAG and on and on
5200
Q2601:opiod toxicity tx
5201
naloxone (opiod receptor antagonist)
5202
Q2602:codeine
5203
metabolized into morphine in amall amounts owing to significant first pass metabolism of morphine in liver
5204
Q2603:delirium trements tx
5205
benzodiazepines
5206
Q2604:lovastatine
5207
HMG CoA reductase inhibitors
5208
Q2605:patent ductus arteriosus- keep open w/ ?
5209
PGE
5210
Q2606:penicillin
5211
beta lactam antibiotic that inhibits cell wall synthesis; binds to specific receptors in cytoplasmic membrane; inhibits transpeptidase enzymes that cross-link linear peptidoglycoan chains that form part of the cell wall; activate autolytic enzymes in the cell wall
5212
Q2607:cephalosporins + aminoglycosides
5213
synergistic effect of enhancing nephrotoxicity
5214
Q2608:erythromycin
5215
interacts w/ 50S subunit of bacterial ribosomes leading to inhibition of protein synthesis;inhibits the formation of the initiation complex and interferes w/ translocation reactions;resistance develops secondary to plasmid mediated formation of enzymes that methylate reactions;resistance develops secondary to plasmid mediated formation of enzymes that methylate the receptor that erythromycin binds with;coliforms produce an transmissible plasmid that produces an esterase that hydrolyzes the lactone ring of erythromycin 5216
Q2609:chloramphenicol
5217
gray baby syndrome (dose related aplastic anemia)
5218
Q2610:sulfonamides; dapsone
5219
may precipiate hemolysis in G6P deficiency
5220
Q2611:TMP
5221
inhibits dihydrofolate reductase; plasmid mediated resistance; TMP + SMX has a synergistic effect from the sequential blockade of folate synthesis; since SMX blocks dihydropterate synthase; which is an enzyme that converts PABA into DHF
5222
Q2612:metronidzole
5223
produces a disulfiram like reaction
5224
Q2613:fluconazole
5225
tx of esophageal candidiasis
5226
Q2614:ganciclovir
5227
first drug used in treating CMV retinitis; the most common cause of blindness in AIDS; foscarbet is used if ganciclovir doesn't work
5228
Q2615:clolinomimetic used in treating open angle glaucoma
5229
pilocarpine;physostigmine
5230
Q2616:dobutamine
5231
inotropic (increase contractility) vasodilator (decreases afterload) that activates alpha 1 and beta 1 > beta 2 activity without much chronotropic effect; used in the treatment of shock (cardiogenic) associated w/ hypotension; hyptension associated w/ renal failure of CHF
5232
Q2617:dopamine
5233
stimulates cardiac beta 1 receptors; peripheral alpha receptors; and dopaminergic receptors in vessels in the renal and splanchnic bed; at low doses it is primarily a vasodilator that increases renal and splanchnic blood flow; at high doses it increases cardiac contractility and cardiac output via its activation of cardiac beta 1 receptors
5234
Q2618:benzodiazepine MOA
5235
via its own receptors in the thalamus; limbic structures; and cerebral cortex which are part of the GABA freceptgorchloride ion channel macromolecular complex; benzo'd facilitate the inhibitor action of GABA via increased conductgance in the chloride ion channels (flumazenil blocks this effect by blocking the receptor for benzos and is the treatment of choice for benzo overdose)
5236
Q2619:a child who ingests 30 adult aspirin is most likely to develop;
5237
increased anion gap metabolic acidosis ;(adults get mixed metabolic acidosis and respiratory alkalosis);tx is to perform gastric lavage and add activated charcoal and to produce an alkalone urine for increased excretion
5238
Q2620:open angle gaucoma is best treated w/
5239
a beta blocker (timolol is good; pilocarpine may als be used; most common type of glaucoma; produces gradual loss of peripheral vission (tunnel vision) and optic atrophy)
5240
Q2621:trazodone
5241
second degneration anti-depressant; inhibition of serotonin reuptake; sedation; may cause priapism
5242
Q2622:thioridazine complication
5243
retinitis pigmentosum
5244
Q2623:tamoxifen
5245
anti-estrogen; estrogen receptor partial agonist that blocks the binding of estrogen to their redceptors in ERA-[os breast cancer cells; also protects against osteoporosis and CAD; risk factor for endometrial cancer; can be used in treating progestin resistant endometrial cancer
5246
Q2624:acetaminophen
5247
analgesic and antipyrietic but not an anti-inflammatory agent; inhibiots prostaglandin synthesis in the CNS; very weak COX inhibitor; most common drug causing acute fulminant hepatitis; converted into free readicals in the liver; glutathione inactivates the FRs
5248
Q2625:digitalis toxicity
5249
tx w/ digoxin FAB antibodies
5250
Q2626:cephalosporins
5251
first generation: drug of choice for surgical prophylaxis in many cases;second: sinusitis (cefuroxime); mixed anaerobic infection;third: minigitis; GC (ceftriaxone)
5252
Q2627:cromolyn sodium in asthma
5253
only for prophylaxis; blocks early and late asthmatic responses to allergens
5254
Q2628:omeprazole
5255
inhibits the proton pump located on the luminal membrane of the parietal cell; useful in the treatment of ZE syndrome; GERD; and h. pylori infection
5256
Q2629:clozapine
5257
blocks D4 and 5-HT receptors more so than D2 receptors
5258
Q2630:fever in a patient on a loop diuretic
5259
do not use any type of NSAID (including aspirin) since it blocks renal synthesis of prostaglandin; which it does not interfere with prostaglandin synthesis. Loop diuretics lead to volume depletion; hence angiotensin II will be elevated (vasoconstricts efferent arteriole);loss of prostaglandin effect predisposes the patent to renal failure
5260
Q2631:pathogenesis of cough and angioedema in ACEI
5261
increase in bradykinin
5262
Q2632:red man syndrome
5263
iv vancomycin
5264
Q2633:drug for bacterial carrier states (s. aureus; N. meningitidis; h. influenza)
5265
rifampin
5266
Q2634:single dose drug for GC and chlamydia
5267
azithromycin
5268
Q2635:Rx of malignant hypertension
5269
nitroprusside
5270
Q2636:patient on Lasix who develops fever and needs antipyrietic
5271
use acetaminophen; do not use NSAIDs since they block prostaglandin production in the kidneys
5272
Q2637:antihypertensive and antiarrhtymic drug that lowers blood pressure and increases heart rate
5273
Ca channel blocker (nifedipine)
5274
Q2638:What drugs are Ototoxic; Auditory?
5275
Loops (Ethacrynic Acid > Furosemide);VANCOMYCIN;Macrolides;Cisplatin
5276
Q2639:What drugs are Ototoxic; Vestibular?
5277
Minocycline
5278
Q2640:What drugs are Ototoxic Auditory and Vestibular?
5279
Aminoglycosides
5280
Q2641:What drugs are Ototoxic causing Tinnitus?
5281
Quinidine/Quinine (cinchonism);ASA (salicylism)
5282
Q2642:What drugs are nephrotoxic?
5283
Vancomycin;Aminoglycosides;Amphothericin B;Foscarnet (hypercalcemia);Cisplatin (minimized w/ Amifestine);Cyclosporine
5284
Q2643:What drug causes causes SIADH?
5285
Carbamazepine;Chlorpropamide
5286
Q2644:What drug causes Nephrogenic DI?
5287
Lithium;Demeclocycline
5288
Q2645:What drug causes hemorrhagic cystitis?
5289
Cylcophosphamide
5290
Q2646:How do you prevent hemorrhagic cystitis w/ cyclophosphamide?
5291
MESNA
5292
Q2647:How do you minimize nephrotoxicity from Cisplatin?
5293
Amifostine
5294
Q2648:What are the hepatotoxic drugs?
5295
AMIODARONE;STATINS;VALPROIC ACID (hepatitis);Felbamate;Tolcapone;TETRACYCLINE (in pregnancy);RIPE TB therapy (Rifampin; Isoniazid; Pyrazinamide);ACETAMINOPHEN
5296
Q2649:What do you give to OD w/ ACETAMINOPHEN?
5297
Acetylcysteine
5298
Q2650:What drugs cause Blood dyscrasias?
5299
Carbamazepine
5300
Q2651:What drug causes Aplastic Anemia?
5301
Felbamate
5302
Q2652:What drug causes agranulocytosis?
5303
Clozapine
5304
Q2653:What drug causes aplastic anemia and is dose dependent and dose independent?
5305
Chloramphenicol
5306
Q2654:What HIV medication causes Blood dyscrasias (anemia/bone marrow suppresion)?
5307
Zidovudine
5308
Q2655:What anticoagulant produces thrombocytopenia?
5309
Heparin
5310
Q2656:What drug causes thrombotic thromocytopenia; purpura or TPP?
5311
Ticlopidine
5312
Q2657:Most Cancer chemotherapeutic drugs cause?
5313
Blood Dyscrasias
5314
Q2658:What drugs cause pancreatitis?
5315
Valproic Acid;Didanosine/Zalcitabine;Sulindac;Asparaginase
5316
Q2659:What drug used for seizures causes pancreatitis?
5317
Valproic Acid
5318
Q2660:What drug used for HIV cause pancreatitis?
5319
Didanosine;Zalcitabine
5320
Q2661:What NSAID causes pancreatitis?
5321
Sulindac
5322
Q2662:What drug used for ALL causes pancreatitis?
5323
Asparaginase
5324
Q2663:What drugs produce gingival hyperplasia?
5325
Phenytoin;Nifedipine;Cyclosporine
5326
Q2664:What drugs cause SLE in SLOW acetylators?
5327
Hydralazine;Isoniazid;Procainamide
5328
Q2665:Drugs w/ problems with Atypical Pseudocholinesterase?
5329
Succinylcholine (prolongs the activity)
5330
Q2666:What drug causes malignant hyperthermia?
5331
Halothane/SUX
5332
Q2667:What drug causes Hemolytic Anemia in G6PD deficiency?
5333
Sulfonamide;Primaquine;Quinidine
5334
Q2668:What drugs cause disulfiram like reaction?
5335
Metronidazole;Chlorpropamide;Griseofulvin;Cefamandole;Ce fotetan;Cefoperazone
5336
Q2669:What drug (combination) causes Serotonin Sx?
5337
MAOIs; TCAs; SSRIs; Meperidine
5338
Q2670:What drug causes acute hypertensive crisis?
5339
Non-Selective MAOIs + Tyramine
5340
Q2671:What are the non-selective MAOIs?
5341
Phenelzine;Trancylpromine
5342
Q2672:What contains Tyramine?
5343
Aged Cheese;Red Wine
5344
Q2673:What DDI (drug-drug interaction) causes decrease in B.P. and possible death?
5345
Sildenafil + Nitroglycerin
5346
Q2674:What two drugs in anti-cancer therapy you should never mix?
5347
6-MP (Azathioprine) + Allopurinol;precipitate gout
5348
Q2675:DOC for Borrelia?
5349
Doxycicline
5350
Q2676:DOC for Ricketssia?
5351
Doxycycline
5352
Q2677:DOC for T. pallidum?
5353
Penicillin G
5354
Q2678:DOC for gonorrhea?
5355
Ceftriaxone;"Floxacins"
5356
Q2679:DOC for Atypicals (Chlamydia; Mycoplasma)?
5357
Doxycicline or ;Macrolide
5358
Q2680:DOC listeria?
5359
Ampicillin
5360
Q2681:DOC Legionella?
5361
Macrolide
5362
Q2682:DOC Step (Group A)?
5363
Pen G [V]
5364
Q2683:DOC C. difficile?
5365
Metronidazole;or Vancomycin
5366
Q2684:DOC enterococcus?
5367
Penicillin + AG (Aminoglucoside)
5368
Q2685:DOC P. areuginosa?
5369
Ticarcillin + AG
5370
Q2686:DOC for T. pallidum but penicillin allergy?
5371
Doxycicline
5372
Q2687:DOC N. gonorreah but Penicillin Allergy?
5373
Floxacin
5374
Q2688:DOC for Listeria but penicillin allergy?
5375
TMP-SMX
5376
Q2689:DOC Strep (Group A) but penicillin allergy?
5377
Macrolide
5378
Q2690:DOC enterococcus but penicillin allergy?
5379
Vacomycin + AG
5380
Q2691:DOC P. areuginosa but penicillin allergy?
5381
Aztreonam
5382
Q2692:DOC Borrelia in Pregnancy or Child?
5383
Amoxicillin
5384
Q2693:DOC Ricketssia in Pregnancy or Child?
5385
Chloramphenicol
5386
Q2694:DOC N. gonorrhea in Pregnancy or Child?
5387
Ceftriaxone
5388
Q2695:DOC atypicals [chlamydia; Mycoplasma] in Pregnancy or Child?
5389
Macrolide
5390
Q2696:DOC P. areuginosa w penicillin allergy?
5391
Aztreonam; AG; Floxacin
5392
Q2697:DOC for Borelia for a prenant woman?
5393
Amoxicillin
5394
Q2698:DOC N. gonorrhea for a prenant woman?
5395
Ceftriaxone
5396
Q2699:DOC Atypicals [Chlamydia; Mycoplasma] for a prenant woman?
5397
Macrolide
5398
Q2700:DOC for Borrelia in Children?
5399
Amoxicillin
5400
Q2701:DOC N. gonorrhea in Children?
5401
Ceftriaxone
5402
Q2702:DOC Atypicals in Children?
5403
Macrolides
5404
Q2703:What is the Serotonin Sx?
5405
Hyperthermia;Rigidity;Autonomic Instability;Myoclonus;Kind of like when having sex!!!
5406
Q2704:What causes Serotonin Sx in w/ Meperidine?
5407
Combination w/ MAOIs; TCAs;but it is a metabolite called normeperidine that acts like SSRI
5408
Q2705:How do protease inhibitors work?
5409
Inhibit Aspartate Protease
5410
Q2706:Name two protein inhibitors?
5411
Indinavir;RitonAVIR;gp120;gp41
5412
Q2707:What happens to Uric Acid at high does Aspirin?
5413
UA stays in the lumen and is peed out = uricosuric
5414
Q2708:What happens to Uric acid w/ low dose Aspirin?
5415
Transport of UA (Uric Acid) is blocked from the blood to the lumen so it causes hyperuricemia;Aspirin (low dose) blocks secretion of Uric Acid
5416
Q2709:What drug protects patient from nephrotoxicity taking cisplatin?
5417
Amifostine
5418
Q2710:What drug prevents cardiotoxicity w/ Doxorubicin?
5419
Dexrazoxane
5420
Q2711:What drug prevents toxicity to epithelial; GI and bone marrow in Methotrexate high dose anti-cancer tx?
5421
Leucovorin;restores purines
5422
Q2712:Where does Aspirin work?
5423
COX-1;Cycloxygenase 1
5424
Q2713:Where does abcximab work?
5425
GP IIB/IIIA receptor on platelets. Can't join together
5426
Q2714:Where does ticlopidine work? (Clopidrogel)
5427
Blocks ADP release
5428
Q2715:Where does propilthioracil and Methimazole work?
5429
Peroxidase in thyroid synthessis
5430
Q2716:Where does Iodide (high dose) work?
5431
blocks release of proteolytic T3 ---> T4
5432
Q2717:Where does Propilthioracil and Propanolol work?
5433
inhibit deiodinase (liver) conversion of T4 to T3
5434
Q2718:28 year old chemist presents with MPTP exposure;What NT is depleted?
5435
Dopamine
5436
Q2719:Woman taking tetracycline exhibits photosensitivity;What are the clinical manifestations?
5437
Rash on sun-exposed regions of body
5438
Q2720:Nondiabetic patient presents with hypoglycemia but low levels of C peptide;What is the diagnosis
5439
Surreptitious insulin injection
5440
Q2721:African American male who goes to Africa develops hemolytic anemia after taking malaria prophylaxis;What is the enzyme defficiency
5441
Glucose 6 phosphate dehydrogenase
5442
Q2722:27 year old female with history of psychiatric illness now has urinary retention due to neuroleptic;What do you treat it with?
5443
Bethanechol
5444
Q2723:Farmer presents with dyspnea; salivation; miosis; diarrhea; cramping and blurry vision;What caused this and what is the mechanism
5445
Insecticide poisoning; inhibition of acetylcholinesterase
5446
Q2724:Patient with recent kidney transplant is on cyclosporine for immunosuppresion; he requires antifungal agent for candidiasis;What antifungal drug would result in cyclosporine toxicity?
5447
Ketoconazole
5448
Q2725:Man on several medications including antidepressants and antihypertensives; has mydriasis and becomes constipated;What is the cause of symptoms?
5449
TCA
5450
Q2726:55 year old postmenopausal woman on tamoxifen therapy;What is she at increased risk of acquiring?
5451
Endometrial carcinoma
5452
Q2727:Woman on MAO inhibitor has hypertensive crisis after meal;What did she ingest?
5453
Tyramine (wine or cheese)
5454
Q2728:After taking clindamycin; patient develops toxic megacolon and diarrhea;What is the mechanism of diarrhea?
5455
Clostridium difficile overgrowth
5456
Q2729:Man starts a medication for hyperlipidemia. He then develops rash; pruritus and GI upset;What drug was it?
5457
Niacin
5458
Q2730:Patient is on carbamazepine;What routine workup should be done?
5459
LFT's
5460
Q2731:23 year old female who is on rifampin for TB prophylaxis and on birth control (estrogen) gets pregnant;Why?
5461
Rifampin augments estrogen metabolism in liver rendering it less effective
5462
Q2732:Patient develops cough and must discontinue captopril;WHat is a good replacement drug and why doesnt it have the same side effects?
5463
Losartan - an angiotensin II receptor antagonist; does not increase bradykinin as captopril does
5464
Q2733:Relates the amount of drug in the body to plasma concentration
5465
Vd - volume of distribution
5466
Q2734:Formule for volume of distribution
5467
Vd = amount of drug in the body/plasma drug concentration
5468
Q2735:Vd of plasma protein-bound drugs can be altered by what disease?
5469
Liver and kidney
5470
Q2736:Relates the rate of elimination to plasma concentration
5471
CLEARANCE
5472
Q2737:Formula for clearance
5473
Cl = rate of elimination of drug/plasma drug concentration
5474
Q2738:The time required to change the amount of drug in the body by 1/2 during elimination (or during constant infusion) is called _
5475
Half life T1/2
5476
Q2739:After 1 half life concentration of drug equals _ %
5477
50%
5478
Q2740:After 2 half lifes concentration of drug equals_
5479
75%
5480
Q2741:A drug infused at constant rate reaches about _ % of steady state after 4 T1/2
5481
94
5482
Q2742:Formula for T1/2
5483
T1/2 = 0.7 * Vd/CL
5484
Q2743:Loading dose formula
5485
Loading dose = Cp * Vd/F;Cp= target plasma concentration;F = bioavailibility
5486
Q2744:Formula for maintenance dose
5487
Cp * CL / F;Cp = target plasma concentration;F = bioavailibility
5488
Q2745:In patients with impaired renal or hepatic function; the loading dose decreases; increases or remains unchanged? ;Maintenance dose?
5489
Loading dose remains unchanged;Maintenance dose decreases
5490
Q2746:Rate of elimination is constant (constant amount of drug is eliminated per unit time) - what order elimination?;What happens to target plasma concentration?
5491
Zero order elimination;Target plasma concentration decreases linearly with time
5492
Q2747:Rate of elimination is proportional to drug concentration (constant fraction of drug eliminated per unit time) - what order elimination? ;What happens to target plasma concentration?
5493
First order elimination;Cp decreases exponentially with time
5494
Q2748:Give examples of drugs with zero order elimination
5495
Ethanol;Phenytoin;Aspirin (at high or toxic concentration)
5496
Q2749:Phase I metabolism (reduction; oxidation; hydrolysis) yields _ metabolites (often still active)
5497
Slightly polar; water soluble
5498
Q2750:What phase of metabolism associated with cytochrome P450
5499
Phase I
5500
Q2751:What phase of metabolism associated with conjugation
5501
Phase iI
5502
Q2752:Phase II metabolism (acetylation; glucoronidation; sulfation) yields _ metanolites (renally excreted)
5503
Very polar; inactive
5504
Q2753:Geriatric patients lose which phase of metabolism first?
5505
Phase I
5506
Q2754:Is it safe? Pharmacokinetics? - which phase of clinical testing of the drug
5507
Phase I
5508
Q2755:Does it work in patients?- which phase of clinical testing of the drug
5509
Phase II
5510
Q2756:Does it work? Double blind - which phase of clinical testing of the drug
5511
Phase III
5512
Q2757:What happens in phase IV of clinical testing of the drug
5513
Postmarketing surveillance
5514
Q2758:A competitive antagonist shifts agonist curve where?
5515
To the right
5516
Q2759:A noncompetitive antagonist (irreversible) shifts agonist curve where?
5517
Downward
5518
Q2760:Name antibiotics that block cell wall synthesis by inhibition of peptidoglycan cross linking
5519
Penicillin;Ampicillin;Ticarcillin;Pipercarcillin;Imipenem;Aztre onam;Cephalosporins
5520
Q2761:Name antibiotics that block peptidoglycan synthesis
5521
Bacitracin;Vancomycin;Cycloserine
5522
Q2762:Name antibiotics that block protein synthesis at 50S ribosomal unit
5523
Chloramphenicol;Erythromycin/macrolides;Lincomycin;Clind amycin;Streptogramins (quinupristin; dalfopristin);Linezolid
5524
Q2763:Name antibiotics that block protein synthesis at 30S ribosomal unit
5525
Aminoglycosides;Tetracyclines
5526
Q2764:Name antibiotics that block nucleotide synthesis
5527
Sulfonamides;Trimethoprim
5528
Q2765:Name antibiotics that block DNA topoisomerase
5529
Quinolones
5530
Q2766:Name antibiotic that blocks mRNA synthesis
5531
Rifampin
5532
Q2767:Name bactericidal antibiotics
5533
Penicillin;Cephalosporins;Vancomycin;Aminoglycosides;Fluo roquinolones;Metronidazole
5534
Q2768:Name drugs that disrupt bacterial/fungal cell membrane
5535
Polymyxins
5536
Q2769:Name drugs that disrupt fungal cell membranes
5537
Amphotericin B;Nystatin;Flucoconazole/azoles
5538
Q2770:Oral form of penicillin is called _ ;IV form?
5539
Penicillin V;Penicillin G
5540
Q2771:Mechanism of penicillin
5541
- Binds penicillin binding proteins;- Blocks transpeptidase cross linking of cell walls;- Activates autolytic enzymes
5542
Q2772:This antibiotic is bactericidal for gram positive cocci; gram positive rods; gram negative cocci and spirochetes. Not penicillinase resistant
5543
PENICILLIN
5544
Q2773:Toxicity of penicillin
5545
Hypersensitivity reactions;Hemolytic anemia
5546
Q2774:Methicillin; nafcillin; dicloxacillin - mechanism of action? ;Narrow or broad action? ;Penicillinase resistant or not?
5547
Same as penicillin;Narrow action;Penicillinase resistant because of bulkier R groups
5548
Q2775:Methcillin; nafcillin and dicloxacillin are clinically used for treatment of what bug?
5549
S. aureus
5550
Q2776:Methicillin toxicity
5551
Interstitial nephritis
5552
Q2777:Methcillin; nafcillin; dicloxacillin toxicity
5553
Hypersensitivity reactions
5554
Q2778:Ampicillin; Amoxicillin- mechanism of action;Penicillinase sensitive or resistant? ;Spectrum narrow or wide?
5555
SAME AS PENICILLIN;Wide spectrum;Penicillinase sensitive
5556
Q2779:Ampicillin; amoxicillin can be combined with _ to enhance spectrum
5557
Clavulinic acid
5558
Q2780:Which has greater oral bioavailibility - amoxicillin or ampicillin
5559
AmOxicillin has greater Oral bioavailibility
5560
Q2781:Name antibiotics that are extended-spectrum penicillins - against certain gram positive and gram negative rods ;Name rods
5561
HELPS kill enterococci - H influenzae; E.coli; Listeria monocytogenes; Proteus mirabilis; Salmonella; enterococci;Ampicillin; amoxicillin
5562
Q2782:Toxicity for ampicillin and amoxicillin
5563
Hypersensitivity reactions; ampicillin rash; pseudomembranous colitis
5564
Q2783:Mechanism for carbenicillin; pipercillin; ticarcillin;Spectrum?
5565
Same as penicillin; extended spectrum
5566
Q2784:Name penicillins used for treatment of Pseudomonas; and gram negative rods;Is it penicillinase resistant or sensitive;Can it be used with clavulinic acid
5567
Carbencillin; Piperacillin; Ticarcillin;Penicillinase sensitive;Use with clavulinic acid
5568
Q2785:Toxicity for carbencillin; piperacillin; ticarcillin
5569
Hypersensitivity reactions
5570
Q2786:Beta lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases; bactericidal
5571
CEPHALOSPORINS
5572
Q2787:Which cephalosporins target gram positive cocci + Proteus ; E. coli;Klebsiella
5573
1st generation
5574
Q2788:Which cephalosporins target gram positive cocci + H. flu; Enterobacter; Neisseria; Proteus; E coli Klebsiella; Serratia
5575
2nd generation
5576
Q2789:Which cephalosporins target serious gram negative infections resitant to other beta lactams; meningitis (most penetrate BBB) - give examples
5577
3d generation - ceftazidime; ceftriaxone
5578
Q2790:3d generation cephalosporin used for treatment of Pseudomonas
5579
Ceftazidime
5580
Q2791:3d generation cephalosporin used for treatment of gonorrhea
5581
Ceftriaxone
5582
Q2792:Which cephalosporins have increased activity agains Psedudomonas and gram positive organisms
5583
4th generation
5584
Q2793:Is there cross hypersensitivity between cephalosporins and penicillin
5585
Yes; 5-10%
5586
Q2794:Toxicity for cephalosporins
5587
Hypersensitivity reactions;Increase nephrotoxicity of aminoglycosides;Disulfiram like reaction with ethanol (in cephalosporins with methylthiotetrazole group) cefamandole
5588
Q2795:A monobactam resistant to beta lactamases. Inhibits cell wall synthesis (binds to PBP3); synergistic with aminoglycosides; no cross allerginicity with penicillins
5589
AZTREONAM
5590
Q2796:This antibiotic is used for Gram negative rods (Klebsiella; Pseudomonas; Serratia); no activity agains gram positives or anaerobes; for penicillin allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides
5591
AZTREONAM
5592
Q2797:Is there any toxicity associated with AZTREONAM
5593
Usually nontoxic; occasional GI upset
5594
Q2798:Broad spectrum beta lactamase resistant carbapenem
5595
Imipenem
5596
Q2799:Imipenem is ALWAYS administered with _ ;WHY?
5597
CILASTATIN;Inhibitor of renal dihydropeptidase I - to decrease inactivation of the drug in renal tubules
5598
Q2800:Drug of choice for Enterobacter; also active against gram positive cocci; gram negative rods and anaerobes
5599
Imipenem + cilastatin
5600
Q2801:Toxicity associated with Imipenem/cilastatin
5601
GI distress; skin rash; CNS toxicity (seizures) at high plasma levels
5602
Q2802:Inhibits cell wall mucopeptide formation by binding D ala D ala portion of cell wall precursors. Resistance occurs with amino acid change of D ala D ala to D ala D lac
5603
VANCOMYCIN
5604
Q2803:This antibiotic is used for serious gram positive multi drug resistant organisms; including S aureus; and Clostridium difficile (pseudomembranous colitis)
5605
VANCOMYCIN
5606
Q2804:Diffuse flushing ("red man syndrome") associated with vancomycin can be largely prevented by?
5607
Pretreatment with antihistamines and slow infusion rate
5608
Q2805:Toxicity for Vancomycin
5609
Nephrotoxicity;Ototoxicity;Thrombophlebitis;Well tolerated in general - does NOT have many problems
5610
Q2806:Gentamicin; neomycin; amikacin; tobramycin; streptomycin - what class of antibiotics?
5611
Aminoglycosides
5612
Q2807:Bactericidal; inhibit formation of initiation complex and cause misreading of mRNA. Require O2 for uptake; therefore ineffective against anaerobes
5613
AMINOGLYCOSIDES
5614
Q2808:Which aminoglycoside is used for bowel surgery
5615
Neomycin
5616
Q2809:Aminoglycosides are _ with beta lactams
5617
Synergistic
5618
Q2810:Aminoglycosides are clinically used for treatment of _
5619
Severe gram negative rod infections
5620
Q2811:Toxicity of aminoglycosides
5621
Nephrotoxicity (especially with cephalosporins);Ototoxicity (especially with loop diuretics)
5622
Q2812:Doxycycline; demeclocycline; minocycline - name class of antibiotics
5623
Tetracyclines
5624
Q2813:Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA; limited CNS penetration
5625
Tetracyclines
5626
Q2814:Which tetracycline is fecally eliminated and can be used in patients with renal failure
5627
Doxycycline
5628
Q2815:Must NOT take tetracyclines with _ ;Why?
5629
Milk;Antacids;Iron containing preparations;Divalent cations inhibit its absorption in gut
5630
Q2816:Clinical use of tetracyclines
5631
Vibrio cholerae;Acne;Chlamydia;Ureaplasma;Urealyticum;Mycoplas ma pneumonia;Borelia burgdorferi;Riccketsia;Tularemia;VACUUM your BedRoom Tonight
5632
Q2817:Toxicity of tetracyclines
5633
GI distress; discoloration of teeth and inhibition of bone growh in children; photosensitivity
5634
Q2818:Erythromycin; azithromycin; clarithromycin- name class of antibiotics
5635
Macrolides
5636
Q2819:Inhibit protein synthesis by blocking translocation bind to 23S rRNA of 50S ribosomall subunit; bacteriostatic
5637
Macrolides
5638
Q2820:Clinical use macrolides
5639
URI;Pneumonia;STD;gram positive cocci (streptococcal infections in patients allergic to penicillin); Mycoplasma; Legionella; Chlamydia; Neisseria
5640
Q2821:Toxicity macrolids
5641
GI discomfort; acute cholestatic hepatitis; eosinophilia; skin rashes
5642
Q2822:Patient on antibiotic therapy develops acute cholestatic hepatitis - which clas of drug?
5643
Macrolides
5644
Q2823:Most common cause of non compliance with macrolides
5645
GI discomfort
5646
Q2824:Inhibits 50S peptidyltransferase; bacteriostatic
5647
Chloramphenicol
5648
Q2825:This drug is used for treatment of meningitis (H flu; N meningitidis; Strep pneumoniae) but conservatively used due to toxicities
5649
Chloramphenicol
5650
Q2826:Toxicities with chloramphenicol
5651
Anemia (dose dependent);Aplastic anemia (dose independent);Gray baby syndrome
5652
Q2827:Which drug causes gray baby syndrome and why
5653
Chloramphenicol - premature infants because they lack liver UDP-glucuronyl transferase)
5654
Q2828:Blocks peptide bond formation at 50S ribosomal subunit; bacteriostatic
5655
Clindamycin
5656
Q2829:Which antibiotic is used to treat anaerobic infections (Bacteroides fragilis; Clostridium perfringens)
5657
CLindamycin
5658
Q2830:Toxicity associated with clindamycin
5659
Pseudomembranous colitis (C. difficile overgrowth); fever; diarrhea
5660
Q2831:PABA antimetabolites inhibit dehydropteorate synthase; bacteriostatic
5661
Sulfonamides
5662
Q2832:Which sulfonamides are used for treatment of simple UTI
5663
Triple sulfas or SMX
5664
Q2833:Clinical use of sulfonamides
5665
Gram positive;Gram negative;Nocardia;Chlamydia
5666
Q2834:Toxicity with sulfonamides
5667
Hypersensitivity reactions;Hemolysis if G6PD deficient;Nephrotoxicity (tubulointerstitial nephritis);Kernicterus in infants;Displace other drugs from albumin (warfarin)
5668
Q2835:Antibiotic inhibits dihydropteorate synthase
5669
Sulfonamides
5670
Q2836:Antibiotic inhibits dihydrofolate reductase
5671
Trimethoprim; pyrimethamine
5672
Q2837:Inhibits bacterial dihydrofolate reductse; bacteriostatic
5673
Trimethoprim
5674
Q2838:This drug is used in combination with sulfonamides causing sequential block of folate synthesis
5675
Trimethoprim
5676
Q2839:This drug is used for recurrent UTI's; Shigella; Salmonella; Pneumocystis carinii pneumonia
5677
TMP-SMX
5678
Q2840:Toxicity of trimethoprim
5679
Megaloblastic anemia;Leukopenia;Granulocytopenia;TMP Treats Marrow Poorly
5680
Q2841:Toxicity connected with trimethoprim can be alleviated by _
5681
Supplemental folinic acid
5682
Q2842:Ciprofloxacin; norfloxacin; ofloxacin; sparfloxacin; moxifloxacin; gatifloxacin; enoxacin - name class
5683
Fluoroquinolones
5684
Q2843:Antibiotics inhibit DNA gyrase (topoisomerase II); bactericidal
5685
Fluoroquinolones
5686
Q2844:Used clinically for treatment of gram negative rods of urinary and GI tracts (including Pseudomonas); Neisseria; some gram positive organisms
5687
Fluoroquinolones
5688
Q2845:Are fluoroquinolones safe in pregnant women
5689
Contraindicated in pregnant women and in children because animal studies show damage to cartilage.
5690
Q2846:Fluoroquinolones toxicity
5691
Tendonitis and tendon rupture in adults;GI upset;Superinfections;Skin rashes;Headache;Dizziness;FluoroquinoLONES hurt attachments to your BONES
5692
Q2847:Forms toxic metabolites in bacterial cells; bactericidal
5693
Metronidazole
5694
Q2848:Antiprotozoal; Giardia; Entamoeba; Trichomonas; Gardenrella vaginalis; anearobes (bacteroides; clostridium) name drug
5695
Metronidazole
5696
Q2849:This drug is used with bismuth and amoxicillin (or tetracycline) for "triple therapy" against H pylori
5697
Metronidazole
5698
Q2850:Anaerobic infections above diaphragm - ?;Anaerobic infections below diaphragm?
5699
Above - clindamycin;Below - metronidazole
5700
Q2851:Toxicity of metronidazole
5701
Disulfiram like reaction with alcohol; headache
5702
Q2852:Bind to cell membranes of bacteria and disrupt their osmotic properties; cationic; basic proteins that act like detergents - treat resistant gram negativ infections
5703
Polymyxins
5704
Q2853:Toxicity for polymyxins
5705
Neurotoxicity;Acute renal tubular necrosis
5706
Q2854:Name anti TB drugs
5707
RESPIre;Rifampin;Ethambutol;Streptomycin;Pyrazinamide;Is oniazid
5708
Q2855:2nd line therapy for TB
5709
Cycloserine
5710
Q2856:All anti TB drugs have same toxicity - name it
5711
liver toxicity
5712
Q2857:Anti TB drug - decreases synthesis of mycolic acids
5713
Isoniazid
5714
Q2858:The only agent used as solo prophylaxis against TB
5715
Isoniazid
5716
Q2859:Toxicity for INH (Isoniazid)
5717
Hemolysis if G6PD defficient;Neurotoxicity;Hepatoxocitiy;SLE like syndrome;INH - Injures Neurons and Hepatocytes
5718
Q2860:_ can prevent neurotoxicity caused by isoniazid
5719
Pyridoxine (B6)
5720
Q2861:Which anti TB drug has different half lifes in fast vs slow acetylators
5721
Isoniazid
5722
Q2862:Anti TB drug - inhibits DNA dependent RNA polymerase
5723
Rifampin
5724
Q2863:Delays resistance to dapsone when used for leprosy
5725
Rifampin
5726
Q2864:Used for meningococcal prophylaxis and chemoprophylaxis in contacts of children with H influenzae type B
5727
Rifampin
5728
Q2865:Rifampin toxicity
5729
Minor hepatoxicity and drug interactions (increases P450)
5730
Q2866:Rifampin 4 R's
5731
RNA polymerase inhibitos;Revs up P450;Red/orange body fluids;Rapid resistance if used alone
5732
Q2867:Beta lactamase cleavage of beta lactam drug is a resistance mechanism against which drugs
5733
Penicillins and cephalosporins
5734
Q2868:Modification via acetylation; adenylation; or phosphorylation is resistance mechanism against which drugs
5735
Aminoglycosides
5736
Q2869:Terminal D ala component of cell wall replaced with D lac; decreases affinity - resistance mechanism against which drug
5737
Vancomycin
5738
Q2870:Modification via acetylation - resistance mechanism against which drug
5739
Chloramphenicol
5740
Q2871:Decreased uptake or increased transport out of cell is resistance mechanism against which drugs
5741
Tetracyclines
5742
Q2872:Altered enzyme (bacterial dihdropteorate synthetase); decreased uptake or increased PABA synthesis is resistance against which drugs
5743
Sulfonamides
5744
Q2873:Drug of choice for prophylaxis of meningococcal infections;Alternative?
5745
Rifampin;Minocyclin
5746
Q2874:Prophylaxis of gonorrhea
5747
Ceftriaxone
5748
Q2875:Prophylaxis of syphillis
5749
Benzathine penicillin G
5750
Q2876:Prophylaxis in patients with history of recurrent UTI
5751
TMP-SMX
5752
Q2877:Drug of choice for prophylaxis for pneumocystic carinii pneumonia;Alternative
5753
TMP-SMX;Aerosolized pentamidine
5754
Q2878:Binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes and disrupt homeostasis
5755
Amphotericin B
5756
Q2879:Used for wide spectrum of systemic mycoses (Cryptococcus; Blastomyces; Coccidioides; Aspergillus; Histoplasma; Candida; Mucor). Intrathecally for fungal meningitis; does NOT cross BBB
5757
Amphotericin B
5758
Q2880:Toxicity of Amphotericin B
5759
NEPHROTOXICITY;Arrhythmias (amphoterrible);Fever/chills (shake and bake);Hypotension
5760
Q2881:Binds to ergosterol; disrupting fungal membranes; used as "swish and swallow" for oral candidiasis (thrush)
5761
NYSTATIN
5762
Q2882:Inhibit fungal steroid (ergosterol) synthesis
5763
AZOLES
5764
Q2883:Drug of choice for cryptococcal meningitis in AIDS patients and candidal infections of all types (i.e yeast infections)
5765
FLuconazole
5766
Q2884:Drug of choice for Blastomyces; Coccidioides; Histoplasma; Candida albicans; hypercortisolism
5767
Ketoconazole
5768
Q2885:Toxicity of azoles
5769
Hormone synthesis inhibition (gynecomastia);Liver dysfuntion (inhibits cytochrome P450);Fever; chills
5770
Q2886:Inhibits DNA synthesis by conversion to fluorouracil which competes with uracil; used in systemic fungal infections (Candida; Cryptococcus); causes bone marrow suppression; n/v/d
5771
FLUCYTOSINE
5772
Q2887:Antifungal medication; inhibits cell wall synthesis; clinically used for invasive aspergillosis; can cause GI upset and flushing
5773
CASPOFUNGIN
5774
Q2888:Antifungal; inhibits fungal enzyme squalene epoxidase; used to treat dermatophytoses (especially onychomycosis)
5775
TERBINAFINE
5776
Q2889:Anti fungal; interferes with microtubule function; disrupts mitosis; deposits in keratin containing tissues (nails) - oral treatment of superficial infections; inhibits growth of dermatophytes (tinea; ringworm)
5777
GRISEOFULVIN
5778
Q2890:Toxicity Griseofulvin
5779
Teratogenic;Carcinogenic;Confusion';Headache;Increased warfarin metabolism
5780
Q2891:Antiviral drug used for prophylaxis for influenza A and treatment of Parkinsons
5781
Amantadine
5782
Q2892:Derivative of Amantadine with fewer CNS side effects
5783
Rimantidine
5784
Q2893:Anti viral medication; blocks biral penetration/uncoating; may buffer pH of endosome; also causes release of dopamine from intact nerve terminals
5785
Amantadien
5786
Q2894:Toxicity of amantadine
5787
Ataxia + dizziness+ slurred speech;Amantadine causes problems with cerebellA
5788
Q2895:Two antiviral medications that inhibits influenza neuraminidase; both used for influenza A and B
5789
Zanamivir;Oseltamivir
5790
Q2896:Antiviral - inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase; used for treatment of RSV and chronic hep C
5791
Ribavirin
5792
Q2897:Toxicity for Ribavirin
5793
Severe teratogen;Hemolytic anemia
5794
Q2898:THis antiviral medication preferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase
5795
Acyclovir
5796
Q2899:Antiviral medication used for treatment of VZV; HSV; EBV; mucocutaneous and genital herpes lesions; prophylaxis in immunocompromised patients
5797
Acyclovir
5798
Q2900:Toxicity for acyclovir
5799
Delirium;Tremor;Nephrotoxicity
5800
Q2901:Antiviral drug - works by phosphorylation viral kinase; preferentially inhibits CMV DNA polymerase; drug of choice for CMV especialy in immunocopromised patients
5801
Ganciclovir
5802
Q2902:Which drug is more toxic - acyclovir or ganciclovir to host enzymes
5803
Ganciclovir
5804
Q2903:Ganciclovir toxicity
5805
Leukopenia;Neutropenia;Thrombocytopenia;Renal toxicity
5806
Q2904:Viral DNA polymerase inhibitor that binds to the pyrophosphate binding site of the enzyme. Does not require activation by viral kinase
5807
FOSCARNET = pyroFOSphate analog
5808
Q2905:Antiviral drug used for treatment of CMV retinitis in immunocompromised patients when ganciclovir fails
5809
FOSCARNET
5810
Q2906:Patient is on foscarnet for CMV retinitis; which toxicity could be suspected?
5811
Nephrotoxicity
5812
Q2907:Saquinavir; ritonavir; indinavir; nelfinavir; aprenavir class of drugs
5813
HIV therapy; protease inhibitors - inhibit assembly of new virus by blocking protease enzyme
5814
Q2908:HIV patient is taking anti HIV drugs; develops GI intolerance - nausea; diarrhea; hyperglycemia; lipid abnormalities; thrombocytopenia - which drugs was he taking
5815
PROTEASE INHIBITORS
5816
Q2909:Zidovudine (AZT); didanosine; zalcitobine; stavudine; lamivudine; abacavir - what class of drugs
5817
Reverse transcriptase inhibitors; nucleosides
5818
Q2910:Name non-nucleosides reverse transcriptase inhibitors
5819
Nevirapine;Delavirdine;Efavirenz
5820
Q2911:Toxicity associated with reverse transcriptase inhibitors
5821
Bone marrow suppression (neutropenia; anemia);Peripheral neuropathy;Lactic acidosis (nucleosides);Megaloblastic anemia;Rash (non-nucleosides)
5822
Q2912:Highly active antiretroviral therapy (HAART) generally entails combination of?
5823
Protease inhibitors + reverse transcriptase inhibitors
5824
Q2913:Which antiretroviral drug is used during pregnancy to reduce risk of fetal transmission
5825
AZT
5826
Q2914:Patient on anti HIV therapy develops megaloblastic anemia - which drug most likely caused it
5827
AZT
5828
Q2915:When is HAART initiated?
5829
When patients have low CD4 counts (<500 cell/mm3) or high viral load
5830
Q2916:Glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis; used for treatment of chronic hep B and C; Kaposis sarcoma;Name drug and what toxicity associated with it
5831
Interferons;Neutropenia
5832
Q2917:Antiparasitic drug from onchocerciasis
5833
Ivermectin (rIVER blindness treated with IVERmectin)
5834
Q2918:Antiparasitic drug used to treat nematode/roundworm (pinworm; whipworm) infections
5835
Mebendazole/thiabendazole
5836
Q2919:Antiparasitic drugs used to treat gian roundowrm (ascaris); hookworm (Necator/Ancylostoma) and pinworm (Enterobius)
5837
Pyrantel pamoate
5838
Q2920:Antiparasitic used to treat trematode/fluke (shistosomes; Paragonimus; Clonorchis) and cysticercosis
5839
Praziquantel
5840
Q2921:Niclosamide is used to treat?
5841
Cestode/tapeworm infections except cysticercosis
5842
Q2922:Drug of choice for leishmaniasis
5843
Pentavalent antimony
5844
Q2923:Name anti malaria drugs
5845
Chloroquine;Quinine;Mefloquine;Atovaquone;Proguanil
5846
Q2924:Name drug used for treatment of latent hypnozoite (liver) forms of malaria (Plasmodium vivax; P.ovale)
5847
Primaquine
5848
Q2925:Drug of choice agains giardiasis; amebic dysentery; bacteria vaginitis; Trichomonas
5849
Metronidazole
5850
Q2926:Drug of choice for Chagas disease; American trypanosomiasis (trypanosoma cruzi)
5851
Nifurtimox
5852
Q2927:Drug of choice for African trypanosomiasis (sleeping sickness)
5853
Suramin
5854
Q2928:Cholinomimetic used for postoperative and neurogenic ileus and urinary retention - activates bowel and bladder smooth muscle
5855
BETHANECHOL
5856
Q2929:Direct agonist; cholinomimetic used for treatment of glaucoma; activates ciliary muscle of eye (open angle); pupillary sphincter (narrow angle)
5857
Carbachol; pilocarpine
5858
Q2930:Anticholinesterase; used in treatment of postoperative and neurogenic ileus and urinary retention; myasthenia gravis; reversal of neuromuscular junction blockade (postoperative); increases endogenous Ach
5859
Neostigmine
5860
Q2931:Anticholinesterase used in treatment of myasthenia gravis - increases endogenous Ach; increases strength
5861
Pyridostigmine
5862
Q2932:This anticholinesterase is used for diagnosis of myasthenia gravis (extremely short acting); increases endogenous Ach
5863
Edrophonium
5864
Q2933:Anticholinesterase; used in treatment of glaucoma (crosses BBB to CNS) and atropine overdose; increases endogenous Ach
5865
Physostigmine
5866
Q2934:Anticholinergic; used for treatment of glaucoma; increases endogenous Ach
5867
Echothiophate
5868
Q2935:Name symptoms of cholinesterase inhibitor poisoning
5869
DUMBBELSS;Diarrhea;Urination;Miosis;Bronchospasm;Bra dycardia;Excitation of skeletal muscle;Lacrimation;Sweating ;Salivation (also abdominal cramping)
5870
Q2936:Name substances that can lead to cholinesterase inhibitor poisoning
5871
Parathion and other organophosphates
5872
Q2937:Antidote used in treatment of organophosphate poisoning
5873
Atropine (muscarinic antagonist) plus pralidoxime (chemical antagonist used to regenerate active cholinesterase)
5874
Q2938:What do you develop w/ benzodiazepines use? What receptors?
5875
Tolerance;down-regulation of B2 receptors
5876
Q2939:Initial Tx for Status Epilepticus?
5877
1) Diazepam;2) Lorazepam
5878
Q2940:What drug causes sedation; ataxia and diplopia?
5879
Phenytoin;SAD Sx.
5880
Q2941:What is SAD Sx and who produces it?
5881
sedation; ataxia and diplopia;Phenytoin
5882
Q2942:What drugs causes gingival hyperplasia?
5883
1) Phenytoin;2) Nifedipine;3) Cyclosporin
5884
Q2943:CNS drugs
5885
CNS drugs;
5886
Q2944:Name the anticonvulsant that is degraded in zeroorder?
5887
Phenytoin
5888
Q2945:What drug is used for tx of abscence seizure?
5889
Ethosuximide
5890
Q2946:What is the mechanism of action of ethosuximide?
5891
blocks Ca+ in thalamic neurons
5892
Q2947:What drug do you use for preop sedation i.v.? It causes amnesia;
5893
Midazolam
5894
Q2948:Name the drug that causes megaloblastic anemia and decreases folic acid?
5895
Phenytoin
5896
Q2949:What anticovulsant causes SIADH?
5897
Carbamazepine
5898
Q2950:What effect does carbamazepine have on the liver?
5899
it induces cyt P450 (+)
5900
Q2951:What is the formula for minimal alveolar anesthetic concentration?
5901
MAC= 1/(potency[lipid solubility]);Lipid = potency = 1/MAC
5902
Q2952:What anticonvulsant causes drug induced Ricketts or ostemalacia?
5903
Phenytoin
5904
Q2953:DOC for trigeminal neuralgia?
5905
Carbamazepine
5906
Q2954:What are 3 Side/Effects (S/E)of Carbamazepine?
5907
1) Cyt. P450 inducer (+);2) Hematotoxicity;3) increase ADH (retains water)
5908
Q2955:What is the effect of carbamazepine and Oral Contraceptives?
5909
inactivates sex steroids and O.C;lowers estriol
5910
Q2956:What is carbamazepine the DOC for?
5911
Trigeminal Neuralgia
5912
Q2957:What effect does carbamazepine have on P450?
5913
induces it
5914
Q2958:Name two important Side/Effects (S/E) of Carbamazepine?
5915
1) hematotoxicity;2) SIADH
5916
Q2959:Drug used for Anxiety/Panic?
5917
A/P AlPrazolam
5918
Q2960:Patien w/ depression needs to be treated but has liver failure? Tx pt. w/ which benzos;
5919
1) Oxazepam;2) Temazepam;3) Lorazepam;Out The Liver
5920
Q2961:What are the three OUT THE LIVER Benzodiazepines?
5921
Oxazepam;Temazepam;Lorazepam
5922
Q2962:Tx for Status Epilepticus (I.V.)?
5923
Lorazepam
5924
Q2963:What drug is used for relaxation and detoxification for withdrawal states?
5925
diazepam
5926
Q2964:Antidote for Zolpidem overdose?
5927
Flumazenil
5928
Q2965:Where do benzodiazepines work?
5929
GABAa receptor;gama binding site;BZ1 hypnotic (sleep);increases frecuency of Cl- channel
5930
Q2966:What site do benzodiazepines act in?
5931
gama binding site;BZ 1
5932
Q2967:What drug is antagonist at the BZ receptor?
5933
flumazenil
5934
Q2968:What drug acts in the BZ1 receptor but it's not a benzodiazepine?
5935
Zolpidem
5936
Q2969:What is the action of barbiturates [high dose]?
5937
increase duration Cl-;opens Cl- channels;blocks Na+ channels;barbiDURATES;increases duration of Cl- open
5938
Q2970:What is the mechanism of Buspirone?
5939
- no gaba;- partial agonist at 5HT1a;-nonsedating
5940
Q2971:What is the action of disulfiram? Whic cell compartment does it work on?;Increase what?
5941
inhibits acetaldehyde dehydrogenase;- mitochondria;increases NADH
5942
Q2972:What is Methanol used for? (Tx)
5943
- Ehtanol intoxication;- fomepizole
5944
Q2973:What is the definite Tx for ethanol/fomepizole intoxication?
5945
Dialysis
5946
Q2974:What is methanol degraded to?;Enzyme?
5947
formaldehyde;- alcohol dehydrogenase
5948
Q2975:What is the lethal dose of methanol?
5949
5 ounces
5950
Q2976:What is the toxic retinal dose of methanol?
5951
5cc
5952
Q2977:What does the Disulfiram Reaction consists of?
5953
1) Nausea;2) Vomiting;3) Vertigo;4) Hypotension/Shock
5954
Q2978:What causes a 3/sec spike pattern on EEG?
5955
Abscence seizure ;Petite Mal
5956
Q2979:What is indicated in neuropathic pain?
5957
1) Felbamate;2) Lamotrigine;3) Gabapentin
5958
Q2980:What are the S/E of Felbamate?
5959
Aplastic Anemia;Acute Liver Failure
5960
Q2981:What are the S/E of Lamotrigine?
5961
Steven-Jonhson Sx;Rash
5962
Q2982:What are felbamate; lamotrigine and gabapentin used for?
5963
Neuropathic pain
5964
Q2983:Name the 3 new Anticovulsants?
5965
Felbamate;Lamotrigine;Gabapentin
5966
Q2984:Name 3 drugs used in complex seizure tx?
5967
Valproic Acid;Phenytoin;Carbamazepine
5968
Q2985:Tx for Generalized Anxiety States (GAS)?
5969
Buspirone
5970
Q2986:How long do you wait for buspirone to take effect?
5971
1-2 weeks
5972
Q2987:What is divalproex used for?
5973
Bipolar Disorder (backup)
5974
Q2988:What is the mech. of action (M/A) for Divalproex?
5975
Ca+ block;inhibits GABA transaminase;axonal Na+ block
5976
Q2989:What are the A/E of Valproic Acid?
5977
1) hePAtotoxicity;2) PAncreatitis;3) aloPEcia;4) sPIna Bifida (Teratogenic);PA PE PI;VALPA PE PI
5978
Q2990:What combination w/ anticonvulsants have additive CNS depression?
5979
1) antihistamines;2) ethanol;3) sedative-hypnotics;4) opioids
5980
Q2991:What happens if you withdrawal anticonvulsants abruptly?
5981
Seizure might be precipitated
5982
Q2992:What is the Tx for Tonic-clonic seizure?
5983
- Valproic Acid;- Phenytoin;- Carbamazepine
5984
Q2993:This is unique to collagen?
5985
hydroxyproline
5986
Q2994:What is the defect in Ehlers-Danlos? name the gene
5987
mutation of collagen gene;- lysine hydroxylase gene
5988
Q2995:What are the symptoms of Ehlers-Danlos
5989
hyperextensible; hypermobile joints; dislocations
5990
Q2996:What is the defect in Menkes Dz?
5991
inhibition of lysyl oxidase;Copper (Cu+) deficiency
5992
Q2997:What are the symptoms in Menkes Dz?
5993
depigmented steely hair;decrease urinary Cu+
5994
Q2998:What disease has mutation in collagen I?
5995
Osteogenesis Imperfecta
5996
Q2999:What are the symptoms for Osteogenesis Imperfecta?
5997
Pathologic Fractures;blue sclera;collagen problems
5998
Q3000:Patient with coarse facial features; gingival hyperplasia and macroglosia? Dx?
5999
I-Cell Dz
6000
Q3001:What enzyme is deficient in I-Cell Dz?
6001
phosphotransferase
6002
Q3002:Where in the cell is the problem in I-Cell Dz?
6003
Golgi apparatus;Manose-6 Residues
6004
Q3003:What are the symptoms of I-cell Dz?
6005
coarse facial features;gingival hyperplasia;macroglosia
6006
Q3004:Patient with deficiency in Leu; Ile and Val amino acids?
6007
Maple Syrup Dz
6008
Q3005:What type of amino acids are Leu; Ile and Val?
6009
Branched Amino Acids
6010
Q3006:What drug inhibits activation? binds to t-RNA with ribosome?
6011
blocks initiation;Aminoglycosdies;A first letter of the alphabet
6012
Q3007:What drug has the mechanism of inhibiting peptidyl transferase?
6013
Chloramphenicol
6014
Q3008:What drug inhibits aminoacyl-tRNA binding to A site?;Elongation
6015
Tetracycline;t is for tRNA
6016
Q3009:What drug inhibits the translocation of tRNA?;E.F.3
6017
Macr(ol)ides
6018
Q3010:What bacteria have the same mechanism of action as macrolides?
6019
diphtheria toxin;pseduomonas toxin
6020
Q3011:What drug is an Angiotensin II blocker?
6021
SARTANS
6022
Q3012:What are the effects of Sartans on aldosterone; bradykinin; AT-1
6023
decrease aldosterone;decrease bradykinin;increase AT-1
6024
Q3013:What is the DOC (drug of choice) for CHF (Cardiac Heart Failure)?
6025
ACE inhibitor
6026
Q3014:What effect does ACE have on ATII; bradykinin; aldosterone; fluid; preload; afterload?
6027
decrease ATII;increase bradykinin;decrease aldosterone;decrease fluid;increase vasodilation;decrease preload;decrease afterload
6028
Q3015:What it the drug used for HTN causes dry cough and angioedema?
6029
PRILS [Ace(-)]
6030
Q3016:Why do ACE(-) cause cough?
6031
increases bradykinin and causes edema in the pharynx
6032
Q3017:What drug causes disorientation; visual effects (halos); hallucinations; SVTs; AV block?
6033
Digitalis Toxicity
6034
Q3018:What enzymes increase cAMP in cardiac cells?
6035
(+) adenylyl cyclase;(-) phosphodiesterase III
6036
Q3019:What is the mechanism of action of sildenafil?
6037
blocks PDE V;(-) phosphodiesterase V;increases cGMP
6038
Q3020:What drug interacts with sildenafil?
6039
Nitrous Oxide;since NO also increases cGMP
6040
Q3021:What is the mechanism of phosphodiesterase III? What cells are involved?
6041
inhibits conversion of cAMP to AMP ;so increase in cAMP;Cardiac Cell
6042
Q3022:What two drugs inhibit PDE III?
6043
theophylline;inamirone
6044
Q3023:What is the mechanism of action of inamirone?
6045
blocks cAMP to AMP;incrases cAMP inside cardiac cell;increases force of contractilily
6046
Q3024:What enzymes are deficient in vitamin C def?
6047
(-) prolyl and lysyl hydroxylase
6048
Q3025:What part of the cell are prolyl and lysyl hydroxylase?
6049
inside the R.E.R.
6050
Q3026:What is the mechanism of action of dobutamine and dopamine?
6051
B1 receptor;increase adenylyl cyclase (+);ATP----> increases cAMP;cAMP---> Protein Kinase;Protein Kinase opens Ca2+ channels;increase in Ca2+
6052
Q3027:What is the mechanism of action of digoxin?
6053
inhibits Na+/K+ ATPase;decreases sodium/Ca+ exchange;Ca+ stays inside the cell;to increase contraction force;inhibited by K+ increase
6054
Q3028:What 5 drugs/states cause digitalis toxicity?
6055
1) quinidine;2) NSAIDS;3) Amiodarone;4) Verapamil;5) hypokalemia
6056
Q3029:What is the mechanism of phosphodiesterase V?
6057
increases cGMP;blocks breakdown of cGMP--> GMP
6058
Q3030:What drugs/compounds stimulate Gq to IP3?
6059
Acetylcholine (Ach);Bradykinin;5HT
6060
Q3031:What happens to Gq after it is converted to IP3?
6061
releases Calcium
6062
Q3032:What is Calciums effect on Nitrous Oxide?
6063
it stimulates the conversion of L-arg to NO
6064
Q3033:What amino acid does Nitrous Oxide derive from?
6065
L-Arginine
6066
Q3034:Where is does the reaction L-Arg to NO take place?
6067
endothelium
6068
Q3035:What does NO do inside the smooth muscle?
6069
stimulates guanylate cyclase
6070
Q3036:What does guanulate cyclase stimulate?
6071
Conversion of GTP to cGMP;so increase cGMP
6072
Q3037:What other amino acid is involved in making NO?
6073
cysteine
6074
Q3038:What does NO stimulate?
6075
guanylate cyclase;and conversion of GTP to cGMP;increases cGMP
6076
Q3039:Where in the nephron does acetazolamide act?
6077
proximal convoluted tube
6078
Q3040:What are the effects of acetazolamide?
6079
decreases HCO3-
6080
Q3041:What are the toxic effects of acetazolamide?
6081
metabollic acidosis;neuropathy; sulfa allergy
6082
Q3042:What happens to the urine with acetazolamide?
6083
increase Na+ excresion;increases HCO3- excresion
6084
Q3043:What diuretic works in the collecting ducts?
6085
Potassium Sparing (K+) diuretics
6086
Q3044:What are the K+ sparing diuretics?
6087
Spirinolactone;Amiloride;Triamterene
6088
Q3045:How is Spirinolactone different from Amiloride and triamterene?
6089
Spirinolactone is an Aldosterone receptor inhibitor;the other two are Na+ Channel blockers
6090
Q3046:What drug blocks Na+/Cl- symport in the renal system?
6091
Thiazides
6092
Q3047:What part of the nephron do thiazides act in?
6093
Distal Convoluted Tube;DCT
6094
Q3048:What is used in HTN and Heart Failure (CHF)?
6095
Thiazides
6096
Q3049:What happens to ions in blood after thiazide administration?
6097
Hypokalemia;Alkalosis;HyperCAlcemia
6098
Q3050:What are thiazides used for?
6099
HTN and CHF
6100
Q3051:What are the toxicities of hydrochorothiazides?
6101
hyperGLUC;sulfa allergies
6102
Q3052:What does hyperGLUC stand for?
6103
hyperGlycemia;hyperLipidemia;hyperUricemia;hyperCalcem ia;Sulfa Allergies
6104
Q3053:What is the potential toxicity of K+-Sparing Diuretics?
6105
Hyperkalemia;endocrine effects like GYNECOMASTIA!;Anti-Androgen
6106
Q3054:Diuretic that causes hyperglycemia?
6107
Thiazide
6108
Q3055:What is the mechanism for thiazide acting as hyperglycemia?
6109
blocks insulin release;opens K+ Channels;keeps insulin inside b-cells
6110
Q3056:What diurectic causes alkalosis and hypoCalcemia?
6111
Loop diuretics
6112
Q3057:What diuretic causes alkalosis and hyperCalcemia?
6113
Thiazide
6114
Q3058:What diuretic causes acidosis and hyperKalemia?
6115
K+ sparing
6116
Q3059:What diuretic causes acidosis and hypoKalemia?
6117
Carbonic Anahydrase inhibitors
6118
Q3060:All diuretics cause what?
6119
hypokalemia to a degree;except K+ sparing
6120
Q3061:What is the mechanism of CA(-) Carbonic anahydrase inhibitors?
6121
NaHCO3 diuresis;HCO3- decreases in blood so causes H+ to be unbalanced;Acidosis
6122
Q3062:What is the only lipid friendly thiazide?
6123
Indapamide
6124
Q3063:What diuretics are in the sulfa family?
6125
CA(-);Loops
6126
Q3064:What diuretic works on ATII? Aldosterone receptor blocker?
6127
Spironolactone
6128
Q3065:What mechanism does Spirinolactone use? (protein)
6129
acts via Zinc Finger Protein;increases gene expression;increases Na+ Channels to open
6130
Q3066:What diuretic causes ginecomastia?
6131
Spirinolactone
6132
Q3067:Diuretic that causes hypoCAlcemia?
6133
Loops;Loops Loose Calcium;Tx malignancies with it!
6134
Q3068:Diuretic that causes hyperCalcemia?
6135
Thiazides!
6136
Q3069:Question
6137
Answer
6138
Q3070:Pharmacology Kaplan
6139
Pharm
6140
Q3071:What drug do Loop diuretics interfere with?
6141
Lithium decreases clearance and increases lithium in serum
6142
Q3072:What drug potentiates OTOtoxicity w/ Loop diuretics?
6143
Aminoglycosides
6144
Q3073:What drug interacts w/ Gemfibrozil?
6145
HMG-coA reductase inhibitors (statin drugs)
6146
Q3074:What is the result of the DDI (drug drug interaction) of Gemfibrozil and Statin drugs?
6147
Rhabdomyolisis increases
6148
Q3075:What drug potentiates Gemfibrozil?
6149
Warfarin and Sulfonylurea
6150
Q3076:What drugs inhibit HMG-coA reductase?
6151
Statin drugs
6152
Q3077:What effect do statin drugs have on cytochrome p450?
6153
increases p450 activity p450(+) inducer
6154
Q3078:What is the effect of stain drugs on HDL and TGs?
6155
HDL increase and decrease in TGs (triclyerides)
6156
Q3079:What are the A/E (adverse/effects) of statin drugs?
6157
myalgia/myopathy; rhabdomyolysis; p450(+) renal failure; death
6158
Q3080:What antilipid drug causes flushing and pruritus (hepatotoxicity)?
6159
Nicotinic Acid
6160
Q3081:What is the mechanism of action of Cholestipol and Cholestyramine?
6161
they are bile acid sequestrants that prevent reabsorption of bile salts in the GI tract
6162
Q3082:What is the effect of decrease in bile acid?
6163
increase synthesis of new bile salts; decrease liver cholesterol; increase LDL receptors; decrease plasma LDL
6164
Q3083:What is contraindicated w/ bile acid sequestrants?
6165
concomitant use with hypertriglyceridemias because they increase VLDL and TGs
6166
Q3084:What do bile acid sequestrants DDI with?
6167
DDI digoxin and warfarin; decrease their absorption
6168
Q3085:Does HMG-coA reductase cause SLE Sx?
6169
yes
6170
Q3086:What ist the mechanism of action of nicotinic acid?
6171
inhibits VLDL synthesis and apoprotein synthesis
6172
Q3087:What is good about nicotinic acid?
6173
increase HDL
6174
Q3088:How do you treat the flushing and pruritus w/ nicotinic acid?
6175
ASA (aspirin)
6176
Q3089:What is another adverse effect of nicotinic acid?
6177
hepatotoxicity
6178
Q3090:What drug causes flushing; sedation; dyspnea and only acts for t1/2 30 sec?
6179
adenosine
6180
Q3091:Adenosine is antagonized by?
6181
theophilline and caffeine
6182
Q3092:Pharmacologist refer to adenosine as?
6183
Reset Button Dead for 30 seconds and then heart starts again
6184
Q3093:DOC for PSVTs?
6185
adenosine
6186
Q3094:What are the effects of adenosine on SA and AV?
6187
decrease SA and AV; increases AV refractory period
6188
Q3095:What drug is an M blocker and is used for asthma and COPD? It has no CNS entry
6189
Ipratropium
6190
Q3096:It's a cholinomimetic; AchE inhibitor; contracts ciliary m; increases outflow?
6191
Pilocarpine and ECHOthiopate
6192
Q3097:What are Pilocarpine and Echothiopate used for?
6193
Glaucoma
6194
Q3098:What are the three K+ channel blockers?
6195
Amiodarone; Bretylium and Sotalol ABS system
6196
Q3099:What do K+ channel blockers do?
6197
slow phase 3; increase APD
6198
Q3100:What is the mechanism of action of Quinidine?
6199
blocks Na+ channels (decrease I Na); increase APD and ERP; M blocker; alpha block
6200
Q3101:DOC for arrythmias following cardioversion? I.V. use
6201
Lidocaine
6202
Q3102:What is amiodarone used for?
6203
Atrial and Ventricular Arrythmias
6204
Q3103:What are the S/E of Amiodarone?
6205
hepatic necrosis; PULMONARY FIBROSIS; Corneal Deposits; BLUE Pigmentation (SMURF) Skin; Photoxocity; Thyroid Dysfunction
6206
Q3104:What is the t1/2 life of Amiodarone?
6207
40 days; Largest Vd
6208
Q3105:What is Manitol used for?
6209
1) maintain renal function; 2) close angle glaucoma; 3) decrease intracraneal pressure (tumor; hematoma)
6210
Q3106:Newborn w/ strabysmus; decrease growth; midfacil hypoplasia; microcephaly; CNS Dysfunction; Thin Upperlip (Phyltrum)
6211
Fetal Alcohol Syndrome
6212
Q3107:What is Benztropine and Trihexyphenidyl used for?
6213
Parkinson's; Drug-Induced Extrapyramidal Dysfunction
6214
Q3108:Mechanism of action of Benztropine and Trixehyphenidyl?
6215
M Blocker
6216
Q3109:Drug used in organophosphate poisoning?
6217
Pralidoxime
6218
Q3110:What does Pralidoxime do w/ symptoms?
6219
corrects patients labored breathing and decreases muscle weakness
6220
Q3111:What is pralidoxime used for?
6221
Organophosphate Poisoning
6222
Q3112:What drug is used for Parkinson and Drug-Induced Extrapyramidal Dysfunction?
6223
Benztropine and Trihexyphnidyl
6224
Q3113:How does alcohol produce gout?
6225
Alcohol decreases NADH and increases NAD; increases conversion of reversible reaction pyr ---> Lactate; Lactate increases and competes w/ uric acid excrecion causing gout
6226
Q3114:What biochemical compound is increased in alcoholism?
6227
NAD+
6228
Q3115:What 2 drugs interact with digoxin (DDI)?
6229
Quinidine and Verapamil (the queen and the rapper always interfere)
6230
Q3116:Drug that causes phototoxicity?
6231
Amiodarone
6232
Q3117:Name 3 drugs used in AchE inhibitor poisoning?
6233
Malathion; Parathion and Sarin (nerve gas)
6234
Q3118:What is the MOA of Hydralazine?
6235
increase NO;increase Guanylate Cyclase;increase cGMP;relaxes vascular musculature
6236
Q3119:What is the effect of Hydralazine on TPR?
6237
decreases TPR;involves NO/EDRF pathway;decreases resistnace in coronary; renal and cerebral beds
6238
Q3120:What is hydralazine used for?
6239
Tx for moderate to severe HTN
6240
Q3121:What is Hydralazine metabolized by?
6241
N-acetyltransferase
6242
Q3122:What are A/E of hydralazine?
6243
headache; flushing; sweating and fluid retention;part of HIP;so SLE-like symptoms
6244
Q3123:What is used in HT emergency?
6245
Nitroprusside
6246
Q3124:What is the effect of nitroprusside on TPR?
6247
decrease TRP via dilation of arterioles and venules
6248
Q3125:What happens when there is venule dilation after nitroprusside use?
6249
Orthostatic Hypotension
6250
Q3126:What are by-products of nitroprusside?
6251
thiocyanate and cyanide ions
6252
Q3127:What part of the mitochrondria is damaged with cyanide compounds?
6253
Comple IV (looks like N);cyt. a/a3
6254
Q3128:What is ethylene glycol?
6255
Anti-freeze
6256
Q3129:What happens to ethylene glycol once ingested?
6257
it is degraded to gycoaldehyde;- Alcohol Dehydrogenase is the enzyme
6258
Q3130:What comes after degradation of glycoaldehyde?
6259
glycolic acid and oxalic acid;latter is nephrotoxic
6260
Q3131:What causes drug induced SIADH?
6261
1) Carbamazepine;2) Chlorpropamide
6262
Q3132:What are the symptoms in Phenytoin Intoxication?
6263
SAD Sx;;Sedation;Ataxia;Diplopia
6264
Q3133:Name an anticonvulsant that is Zero-Order?
6265
Phenytoin
6266
Q3134:What condition has an EEG with 3/sec spike pattern?
6267
Generalized Abscence Seizure
6268
Q3135:What is the Tx for Generalized Abscence Seizure?
6269
Ethosuximide
6270
Q3136:Name 4 drugs that block voltage gated axonal Na+ influx of fast channels?
6271
1) Carbamazepine;2) Phenytoin;high dose;3) Barbiturates;4) Valproic Acid
6272
Q3137:What drug decreases Ca2+ influx through T channels in thalamic neurons?
6273
Ethosuximide;Valproic Acid
6274
Q3138:What is the action on alpha 2 receptors?;1) NE;2) trasmitter release;3) platelets;4) Pancreas
6275
1) decrease NE synthesis;2) decrease transmitter release at prejunctional nerve terminals;3) increase aggregation of platelets;4) decrease insulin secretion;catabolism
6276
Q3139:Effect of B1 receptors on renin?
6277
increase renin release
6278
Q3140:What adrenoreceptor increases insulin secretion?
6279
beta 2 receptor stimulation
6280
Q3141:What adrenoreceptor induces glycogenolysis?
6281
B2 stimulation
6282
Q3142:What adrenoreceptor causes uterine relaxation?
6283
B2 stimulation
6284
Q3143:amount of drug in body/_______ = Vd
6285
plasma drug concentration (note: Vd is Volume of Distribution)
6286
Q3144:rate of elimination of drug/[plasma drug] = ?
6287
CL (Clearance)
6288
Q3145:(.7)(Vd)/CL = ?
6289
T 1/2
6290
Q3146:A drug infused at a constant rate reaches about 94% of steady state after _______ t 1/2s.
6291
6292
Q3147:A loading dose is calculated using this formula.
6293
(Cp)(Vd)/F (note: Cp = target plasma concentration; and F = bioavailability)
6294
Q3148:A maintenance dose is calculated using this formula.
6295
(Cp)(CL)/F
6296
Q3149:Rate of elimination is proportional to _______ ______ in 1st order elimination.
6297
drug concentration
6298
Q3150:In the case of EtOH; which is elimated by _____ order elimination; a constant amount of drug is eliminated per unit time.
6299
zero
6300
Q3151:Phase ____ (I or II) reactions yield slightly polar metabolites that are often _____ (active or inactive)
6301
I; active
6302
Q3152:Phase ____ (I or II) reactions yield very polar metabolites that are often _____ (active or inactive) and are excreted by the _______.
6303
II; inactive; kidney
6304
Q3153:Phase II reactions are often of this type.
6305
conjugation
6306
Q3154:Cytochrome P-450 is involved in _____ phase (I or II) reactions.
6307
6308
Q3155:A patent lasts for _____ years after filing for application.
6309
20
6310
Q3156:How many phases are there in drug development?
6311
6312
Q3157:Drugs are first tested in patients in phase _____ of clinical testing; pharmacokinetic safety is determined in phase ______ of clinical testing; double blind tests are done in phase ____ and post-market surveillance is done in phase _____.
6313
2;1;3;4
6314
Q3158:In a dose response curve; a competitive antagonist shifts the curve _____; while a non-competitive antagonist shifts the curve ______.
6315
right; down
6316
Q3159:What pharmacologic relationship would determine the existence of spare receptors?
6317
EC50 < Kd
6318
Q3160:What does it mean if EC50 and Kd are equal?
6319
The system does not have spare receptors
6320
Q3161:A partial agonist acts on the same receptor system as a full agonist? T/F
6321
TRUE
6322
Q3162:What's the main difference between a partial agonist and a full agonist?
6323
A partial agonist has a lower maximal efficacy.
6324
Q3163:Is a partial agonist less potent than a full agonist?
6325
Not necessarily. It can be less; more or equally potent as a full agonist.
6326
Q3164:The penicillin type drugs work by blocking -----synthesis; specifically by inhibiting this molecule from crosslinking?
6327
blocks bacterial cell wall synthesis by inhibition of peptidoglycan synthesis.
6328
Q3165:Which other drugs (aside from penicillin) have this same mechanism of action?
6329
Imipenem; aztreonam and cephalosporins
6330
Q3166:Bacitracin; vancomycin and cycloserine block the synthesis of this molecule; preventing cell wall synthesis
6331
peptidoglycans
6332
Q3167:These drugs block the 50s ribosomal subunit
6333
clindamycin; chloramphenicol; erythromycin; lincomycin; linezolid; streptogramins "Buy AT 30; CELL at 50"
6334
Q3168:These drugs block the 30s ribosomal subunit
6335
Aminoglycosides and tetracyclines "Buy AT 30; CELL at 50"
6336
Q3169:These drugs block nucleotide synthesis by interfering with the folate pathway
6337
Sulfonamides (e.g. Bactrim); trimethoprim
6338
Q3170:These drugs block DNA topoisomerases
6339
Quinolones (e.g. Cipro)
6340
Q3171:Which drug blocks mRNA synthesis
6341
rifampin
6342
Q3172:Which are the bacteriacidal Abx
6343
Penicillin; cephalosporin; vancomycin; aminoglycosides; fluoroquinolones; metronidazole
6344
Q3173:These drugs disrupt the bacterial/fungal cell membranes
6345
polymyxins
6346
Q3174:These specific disrupt fungal cell membranes
6347
amphotericin B; nystatin; fluconazole/azoles (FAN the fungal cell membranes)
6348
Q3175:What is the mechanism of action of Pentamidine
6349
Unknown
6350
Q3176:Which is the IV form and which is the oral form
6351
G = IV; V=oral
6352
Q3177:Which of these is not a mechanism of penicillin action: (1) binds penicillin-binding protein; (2) blocks peptidoglycan synthesis; (3) blocks transpeptidase catalyzed cross-linking of cell wall and (4) activates autolytic enzymes
6353
Penicillin does not block peptioglycan synthesis; bacitracin; vancomycin and cycloserine do that
6354
Q3178:T or F: penicillin is effective against gram pos and gram neg rods
6355
False: penicillin is used to treat common streptococci (but not staph); meningococci; gram pos bacilli and spirochetes (i.e. syphilis; treponema). Not used to treat gram neg rods.
6356
Q3179:What should you watch out for when giving penicillin?
6357
Hypersensitivity rxn (urticaria;severe pruritus) and hemolytic anemia
6358
Q3180:These drugs are used mainly for what type of infection
6359
Staphlococcal infection (hence very narrow spectrum)
6360
Q3181:T or F: these drugs have the same mechanism of action as penicillin
6361
TRUE
6362
Q3182:Are these drugs penicillinase resistant? If so why?
6363
Bulkier R group makes these drugs resistant to penicillinase
6364
Q3183:What should you watch out for when giving these drugs?
6365
Hypersensitivity rxn (urticaria;severe pruritus); methicillin can cuase interstitial nephritis
6366
Q3184:T or F: these drugs have the same mechanism of action as penicillin
6367
TRUE
6368
Q3185:Which has greater oral bioavailability?
6369
amOxicillin (O for Oral)
6370
Q3186:What do you use these for?
6371
Ampicillin/amoxicillin HELPS to kill enterococci (H. influenzae; E. coli; Listeria monocytogenes; Proteus mirabilis; Salmonella)
6372
Q3187:Can penicillinase effect these drugs efficacy?
6373
Yes; they are penicillinase sensitive
6374
Q3188:Why not give these drugs with a penicillinase inhibitor. Name one.
6375
clavulanic acid
6376
6377
Hypersensitivity rxn (ampicillin rash); pseudomembranous colitis
6378
Q3190:Why are these Carbenicillin; piperacillin; ticarcillin considered to have an extended spectrum?
6379
Because they are effective against pseudomonas and other gram neg rods (enterobacter and some species of klebsiella)
6380
6381
Hypersensitivity rxn
6382
Q3192:Why does concomitant administration with clavulanic acid increase the efficacy of these drugs?
6383
Because they are penicillinase sensitive. (only piperacillin and ticarcillin)
6384
Q3193:What is the mechanism of action of Cephalosporins?
6385
inhibit cell wall synthesis
6386
Q3194:How are they similar/different from penicillin?
6387
both have a beta-lactam ring structure but cephalosporins are less susceptible to penicillinases
6388
Q3195:What are the main similarities/difference between 1st and 2nd generation cephalosporins?
6389
2nd gen has extensive gram neg coverage but weaker gram pos coverage
6390
Q3196:1st gen covers what bugs?
6391
gram positives (staph and strep); Proteus mirabilis; E. coli; Klebsiella (PEcK)
6392
Q3197:2nd gen covers what bugs?
6393
gram positives (staph and strep) though less so; H. influenzae; Enterobacter aerogenes; Neisseria; Proteus mirabilis; E. coli; Klebsiella (HEN PEcK)
6394
Q3198:What can 3rd generation drugs do that 1st and 2nd generation can't?
6395
Cross the blood brain barrier
6396
Q3199:What are some other benefits of 3rd gen?
6397
better activity against gram neg bugs resistant to beta-lactam drugs. Ceftazidime for Pseudomonas and ceftriaxone for N. gonorrhea
6398
Q3200:What are the benefits of 4th gen (e.g. Cefipime)?
6399
increased activity against Pseudomonas; gram pos organisms and more beta-lactamase resistant (i.e. 4th gen combines 1st gen and 3rd gen characteristics into super drug)
6400
Q3201:What drugs should you avoid taking with cephalosporins?
6401
Aminoglycosides (increases nephrotoxicity) and ethanol (causes a disulfiram-like rxn -- headache; nausea; flushing; hypotension)
6402
Q3202:When would you use aztreonam?
6403
Only to treat Klebsiella; Pseudomonas and Serratia spp.
6404
Q3203:Is it beta-lactamase resistant?
6405
Yes; this is one of the huge benefits of the drug; and it is not cross-reactive with PCN!
6406
Q3204:Which population of pt. is this drug good for?
6407
The PCN-allergic patient that can't take aminoglycosides b/c of renal insufficiency
6408
Q3205:Are there any toxicity issues with this drug?
6409
Not really. Generally well tolerated with occasional GI upset. Vertigo; Headache and rare hepatotoxicity have been reported.
6410
Q3206:What is imipenem?
6411
broad spectrum beta-lactamase-resistant abx
6412
Q3207:What do you always administer it with and why?
6413
cilastatin -- it decreases inactivation of imipenem in renal tubules
6414
Q3208:What do you use it for?
6415
Gram pos cocci; gram neg rods and anaerobes (broad spectrum)
6416
Q3209:What bug is it the drug of choice for?
6417
Enterobacter
6418
Q3210:What are its side-effects
6419
GI distress; skin rash; seizures at high conc.
6420
Q3211:Is Vancomycin bactericidal or bacteriastatic and why?
6421
Bactericidal because it blocks cross linkage and elongation of peptidoglycan by binding D-ala D-ala protion of cell wall.
6422
Q3212:How does resistance to Vanco occur?
6423
D-ala D-ala is replaced with D-ala D-lactate which vanco does not block
6424
Q3213:What is it used for?
6425
Used for serious infection that is resistant to other drugs (e.g. gram pos multi-drug resistant organisms like S. aureus and C. difficile; methicillin resistant staph (MRSA))
6426
Q3214:What are the important toxicities of vanco?
6427
generally NOT many problems except; Nephrotoxicity; Ototoxicity and Thrombophlebitis
6428
Q3215:What can happen with rapid infusion of vanco?
6429
"Red man's" syndrome. Diffuse flushing which can be controlled by pretreatment with anti-histamines and with slow infusion rate
6430
Q3216:Which drugs target bacterial protein synthesis by blocking the 30S unit vs 50S unit?
6431
Buy AT 30; CELL at 50
6432
Q3217:What does AT stand for?
6433
A = Aminoglycosides (streptomycin; gentamicin; tobramycin an damikacin. And T = Tetracyclines
6434
Q3218:What does CELL stand for?
6435
C = Chloramphenicol; E= Erythromycin; L= Lincomycin and L= cLindamycin
6436
Q3219:Which of the above are bactericidal?
6437
Only the aminoglycosides are; the rest are bacteriostatic
6438
Q3220:Name some aminoglycosides?
6439
Gentamicin; neomycin; amikacin; tobramycin and streptomycin
6440
Q3221:How do these drugs work?
6441
They inhibit formation of the initiation complex in mRNA translation
6442
Q3222:Why are they ineffective against anaerobes?
6443
They require oxygen for uptake into bacteria
6444
Q3223:When would you use aminoglycosides?
6445
against severe gram-negative rod infections
6446
Q3224:What drugs can you use aminoglycosides with for synergy?
6447
the drugs that inhibit cell wall synthesis (e.g. penicillin and cephalosporins -- the beta-lactam antibiotics). Presumably this allows the drug to get in with out reliance on oxygen transport
6448
Q3225:What drug in this class is commonly used for bowel surgery?
6449
Neomycin
6450
Q3226:What are the two major toxicities?
6451
Nephrotoxicity (esp. when used with cephalosporins) and Ototoxicity (esp. when used with loop diuretics). amiNOglycosides
6452
Q3227:Name some tetracylcines
6453
Tetracycline; doxycycline; demeclocycline; minocycline
6454
Q3228:How does it work?
6455
Blocks t-RNA attachment to 30S subunit
6456
Q3229:Which tetracycline can you use in patients with renal failure and why?
6457
Can use doxycycline because its elimination is fecal
6458
Q3230:Should you take these drugs with a glass of milk?
6459
NO; because it intereferes with absorption in the gut as does antacids and iron-containing preparations
6460
Q3231:What are tetracyclines used for?
6461
VACUUM your Bed Room -- Vibrio cholerae; Acne; Chlamydia; Ureaplasma; Urealyticum; Mycoplasma pneumoniae; Borrelia burgdorferi; Rickettsia; tularemia
6462
Q3232:What are the common toxicities
6463
GI distress; teeth discoloration; inhibition of bone growth in children; Fanconi's syndrome and photosensitivity
6464
Q3233:Name some macrolides?
6465
Erythromycin; azithromycin; clarithromycin
6466
Q3234:How do these drugs work?
6467
inhibit protein synthesis
6468
Q3235:What are they used for?
6469
URIs; pneumonias; STDs -- gram pos cocci in patients that are allergic to PNC --- Mycoplasm; Legionella; Chlamydia; Neisseria.
6470
Q3236:Pneumonic for macrolide use?
6471
Eryc's Nipple is at his Mid Clavicular Line (Eryc is brand name for erythromycin). Mycoplasm; Legionella; Chlamydia; Neisseria.
6472
Q3237:What are the major toxicities?
6473
GI discomfort; acute cholestatic hepatitis; eosinophilia; skin rashes
6474
Q3238:What is the most common cause for non-compliance to macrolides?
6475
GI discomfort
6476
Q3239:How does Chloramphenicol work?
6477
inhibits 50S peptidyltransferase
6478
Q3240:Main use?
6479
Meningitis (H. influenzae; N. meningitides; S. pneumo). Used conservatively b/c of toxicity
6480
Q3241:What are the main toxicities?
6481
Anemia and aplastic anemia (both dose dependent); gray baby syndrome (in premes b/c they lack UDP-glucoronyl transferase)
6482
Q3242:How does Clindamycin work?
6483
blocks peptide bond formation at 50S
6484
Q3243:When do you use it?
6485
Anaerobic infections (e.g. Bacteroides fragilis and C.perfringens)
6486
Q3244:Toxicities?
6487
Pseudomembranous colitis; fever; diarrhea
6488
Q3245:Name some sulfonamides
6489
Sulfamethoxazole (SMX); sulfisoxazole; triple sulfa and sulfadiazine
6490
6491
Inhibits bacterial folic acid synthesis from PABA by blocking dihydropteroate synthase.
6492
Q3247:What are its uses?
6493
Gram-positive; gram-negative; Nocardia; Chlamydia. Triple sulfas and SMX for simple UTIs
6494
Q3248:Toxicities?
6495
hypersensitivity rxn; hemolysis if G6PD deficient; nephorotoxicity (tubulointerstitial nephritis); kernicterus in infants; displace other drugs from albumin (e.g. warfarin)
6496
Q3249:How does Trimethoprim work?
6497
inhibits folic acid pathway by blocking dihydrofolate reductase which humans have as well
6498
6499
used in combo with Sulfamethoxazole (TMP-SMX) causing a sequential block of folate synthesis. Used for recurrent UTIs; Shigella; Salmonella; and prophylaxis for PCP in AIDS patients
6500
Q3251:Toxicities?
6501
Megaloblastic anemia; pancytopenia (may be alleviated with supplemental folinic acid)
6502
Q3252:What the most famous floroquinolone?
6503
Ciprfloxacin (treatment for Anthrax)
6504
6505
inhibits DNA gyrase (topoisomerase II)
6506
6507
Gram neg rods or urinary and GI tract (incl. pseudomonas); Neisseria; some gram pos spp
6508
Q3255:What population is contraindicated for use?
6509
pregnancy and children
6510
Q3256:What are its toxicities?
6511
GI upset; superinfection; skin rashes; headache; dizziness and tendonitis and tendon rupture in adults. FluoroquinoLONES hurt attachment to BONES.
6512
Q3257:How does Metronidazole work?
6513
forms toxic metabolites in the bacteria. Bactericidal.
6514
6515
anti-protozoal: Giardia; Entamoeba; Trichomonas; Gardnerella vaginalis; anaerobes (bacteroides; clostridium)
6516
Q3259:What is the role of Metronidazole in H. pylori infection?
6517
Used as part of triple therapy: bismuth; amoxicillin and metronidazole
6518
Q3260:Main toxicity?
6519
disulfiram-like (antabuse) reaction to alcohol and headache
6520
Q3261:Which drug do you use to treat anaerobic infections above the diaphram and below the diaphram
6521
anaerobes above diaphram: Clindamycin; and anaerobes below diaphram: metronidazole
6522
Q3262:How does polymyxin work?
6523
disrupts osmotic properties of bacteria; acts like a detergent
6524
6525
resistant gram negative infections
6526
Q3264:Toxicities?
6527
neurotoxicity; ATN
6528
Q3265:How does INH work?
6529
decreases synthesis of mycolic acid
6530
6531
MTB (mycobacterium tuberculosis). The only agent used as solo prophylaxis against TB
6532
Q3267:Toxicities?
6533
Hemolysis if G6PD deficient; neurotoxicity; hepatotoxicitiy; drug induced SLE. INH; Injures Neurons and Hepatocytes
6534
Q3268:What vitamin prevents neurotoxicity
6535
Vitamin B6 (pyridoxine)
6536
Q3269:Why are toxicities particularly important to monitor in patients taking INH?
6537
INH half-lives are different in fast versus slow acetylators!
6538
6539
inhibits DNA-dependent RNA polymerase
6540
6541
MTB; meningococcal prophylaxis
6542
Q3272:Toxicities?
6543
Minor hepatotoxicity and increases P-450
6544
Q3273:How can it be used for leprosy?
6545
rifampin delays resistance to dapsone when used for leprosy
6546
Q3274:What would happen if you used rifampin alone?
6547
get rapid resistance
6548
Q3275:What does it do to bodily fluids?
6549
makes them red/orange in color
6550
Q3276:What are the 4 R's of Rifampin
6551
RNA polymerase inhibitor; Revs up microsomal p-450; Red/Orange body fluids; Resistance is rapid
6552
Q3277:What are the anti-TB drugs?
6553
Rifampin; Ethambutol; Streptomycin; Pyrazinamide; Isoniazid (INH) -- RESPIre
6554
Q3278:What do you use for TB prophylaxis?
6555
INH
6556
Q3279:What toxicity is common to all?
6557
hepatotoxicity
6558
Q3280:name the enzyme that liberates AA from the cell membrane
6559
phospholipase A2
6560
Q3281:what does the lipoxygenase pathway yield
6561
leukotrienes (L for Lipoxygenase and Leukotrienes)
6562
Q3282:LTB4 is a____
6563
neutrophil chemotactic agent
6564
Q3283:which leukotrienes are involved in bronchoconstriction; vasoconstriction; smooth muscle contraction; and increased vascular permeability
6565
LT C4; D4; E4 (SRS-A)
6566
Q3284:what are the 3 products of the cyclooxygenase pathway?
6567
thromboxane; prostacyclin; prostaglandin
6568
Q3285:what are the 2 functions of TxA2
6569
platelet aggregation; vasoconstricion
6570
Q3286:what are the 2 functions of PGI2
6571
inhibition of platelet aggregation; vasodilation (Platelet Gathering Inhibitor)
6572
Q3287:what are the shape and dimensions of a microtubule?
6573
cylindrical; 24 nm in diameter; variable length.
6574
Q3288:what are the components of a microtubule
6575
polymerized dimers of alpha and beta tubulin (+2 GTPs per dimer)
6576
Q3289:where are microtubules found
6577
cilia; flagella; mitotic spindles; neuronal axons (slow axoplasmic transport)
6578
Q3290:antihelminthic drug that acts on microtubules
6579
mebendazole/thiabendazole
6580
Q3291:anti breast cancer drug that acts on microtubules (prevent disassembly)
6581
taxol
6582
Q3292:antifungal drug that acts on microtubules
6583
griseofluvin
6584
Q3293:anti cancer drug that acts on microtubules (prevent assembly)
6585
vincristine/vinblastine
6586
Q3294:anti gout drug that acts on microtubules
6587
cholchicine
6588
Q3295:Most common resistance mechanism for penicillins / cephalosporins.
6589
Beta-lactamase cleavage of beta-lactam ring.
6590
Q3296:Most common resistance mechanism for aminoglycosides.
6591
Modification via acetylation; adenylation; or phosphorylation.
6592
Q3297:Most common resistance mechanism for vancomycin.
6593
Terminal D-ala of cell wall component replaced with D-lac; decrease affinity.
6594
Q3298:Most common resistance mechanism for Chlorampenicol.
6595
Modification via acetylation.
6596
Q3299:Most common resistance mechanism for macrolides.
6597
Methylation of rRNA near erythromycin's ribosome-binding site.
6598
Q3300:Most common resistance mechanism for tetracycline.
6599
Decrease uptake or increase transport out of cell.
6600
Q3301:Most common resistance mechanism for sulfonamides.
6601
Altered enzyme (bacterial dihydropteroate synthetase); decrease uptake; or increase PABA synthesis.
6602
Q3302:Drug of choice for meningococcal infection.
6603
Rifampin (drug of choice); minocycline.
6604
Q3303:Drug of choice for gonorrhea.
6605
Cefriaxone.
6606
Q3304:Drug of choice for syphilis.
6607
Benzathine penicillin G.
6608
Q3305:Drug of choice for history of recurrent UTIs.
6609
TMP-SMX.
6610
Q3306:Drug of choice for Pneumocystis carinii pneumonia.
6611
TMP-SMX (drug of choice); aerosolized pentamindine.
6612
Q3307:Mechanism of action of the anti-fungal therapy polyenes.
6613
Form artificial pores in the cytoplasmic membrane.
6614
Q3308:Mechanism of action of the anti-fungal therapies terbinafine and azoles.
6615
Terbinafine blocks the conversion of squalene to lanosterol. Azoles block the conversion of lanosterol to ergosterol.
6616
Q3309:Mechanism of action of the anti-fungal therapy flucytosine.
6617
Blocks the production of purines from the precurors.
6618
Q3310:Mechanism of action of the anti-fungal therapy griseofulvin.
6619
Disrupts microtubles.
6620
Q3311:Mechanism of action of Amphotericin B.
6621
Binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes and disrupt homeostasis. "Amphotericin 'tears' holes in the fungal membrane by forming pores."
6622
Q3312:Clinical uses of Amphotericin B.
6623
Used for a wide spectrum of sytemic mycoses. Cryptococcus; Blastomyces; Coccidioides; Aspergillus; Histoplasma; Candida; Mucor (systemic mycoses). Intrathecally for fungal meningitis; does not cross blood-brain barrier.
6624
Q3313:Symptoms of Amphotericin B toxicity.
6625
Fever/chills ("shake and bake"); hypotension; nephrotoxicity; arrhythmias ("amphoterrible").
6626
Q3314:Mechanism of action of Nystatin.
6627
Binds to ergosterol; disrupting fungal membranes.
6628
Q3315:Clinical use of Nystatin.
6629
"Swish and swallow" for oral candidiasis (thrush).
6630
Q3316:Mechanism of action for fluconazole; ketoconazole; clotrimazole; miconazole; itraconazole; voriconazole.
6631
Inhibits fungal steroid (ergosterol) synthesis.
6632
Q3317:Clinical uses of fluconazole; ketoconazole; clotrimazole; miconazole; itraconazole; voriconazole.
6633
Systemic mycoses. Fluconazole for cryptococcal meningitis in AIDS patients and candidal infections of all types (i.e; yeast infections). Ketoconazole for Blastomyces; coccidioides; Histoplasma; Candida albicans; hypercortisolism.
6634
Q3318:Symptoms of fluconazole; ketoconazole; clotrimazole; miconazole; itraconazole; voriconazole toxicity.
6635
Hormone synthesis inhibition (gynecomastia); liver dysfunction (inhibits cytochrome P-450); fever; chills.
6636
Q3319:Mechanism of action of Flucytosine.
6637
Inhibits DNA synthesis byconversion to fluorouracil; which competes with uracil.
6638
Q3320:Clinical uses of Flucytosine.
6639
Used in sytemic fungal infections (e.g. Candida; Cryptococcus).
6640
Q3321:Symptoms of Flucytosine toxicity.
6641
Nausea; vomitting; diarrhea; bone marrow suppression.
6642
Q3322:Mechanism of action for Caspofungin.
6643
Inhibits cell wall synthesis.
6644
Q3323:Clinical use of Caspofungin.
6645
Invasive aepergillosis.
6646
Q3324:Symptoms of Caspofungin toxicity.
6647
GI upset; flushing.
6648
Q3325:Mechanism of action of Terbinafine.
6649
Inhibits the fungal enzyme squalene epoxidase.
6650
Q3326:Clinical use of Terbinafinel.
6651
Used to treat dermatophytoses (especially onychomycosis).
6652
Q3327:Mechanism of action of Griseofulvin.
6653
Interfers with microtubule function; disrupts mitosis. Deposits in keratin-contianing tissues (e.g. nails).
6654
Q3328:Clinical use of Griseofulvin.
6655
Oral treatment of superficial infections; inhibits growth of dermatophytes (tinea; ringworm).
6656
Q3329:Symptoms of Griseofulvin toxicity.
6657
Teratogenic; carcinogenic; confusion; headaches; increase warfarin metabolism.
6658
Q3330:Viral adsorption and penetration into the cell is blocked by ---------.
6659
Gama-globulins (non-specific).
6660
Q3331:Uncoating of the virus after its penetration into the cell is blocked by --------.
6661
Amantadine (influenza A).
6662
Q3332:Early viral protein synthesis is blocked by --------.
6663
Fomivirsen (CMV).
6664
Q3333:Viral nuclei acid synthesis is blocked by --------.
6665
Purine; pyrimidine analogs; reverse transcriptase inhibitors.
6666
Q3334:Late viral protein synthesis and processing is blocked by --------.
6667
Methimazole (variola); protease inhibitors.
6668
Q3335:Packaging and assembly of new viron is blocked by -------.
6669
Rifampin (vaccinia).
6670
Q3336:Mechanism of action of Amantadine.
6671
Blocks viral penetration/uncoating; may buffer pH of endosome. Also causes the release of dopamine from intact nerve terminals. "Amantadine blocks influenza A and rubellA and causes problems with the cerebellA."
6672
Q3337:Clinical uses of Amantadine.
6673
Prophylaxis for influenza A; Parkinson's disease.
6674
Q3338:Symptoms of Amantadine toxicity.
6675
Ataxia; dizziness; slurred speech. (Rimantidine is a derivative with fewer CNS side effects.)
6676
Q3339:Zanamivir
6677
p299
6678
Q3340:Mechanism of action of Zanamivir.
6679
Inhibits influenza neuraminidase.
6680
Q3341:Clinical use of Zanamivir.
6681
Both influenza A and B.
6682
Q3342:Mechanism of action of Ribavirin.
6683
Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase.
6684
Q3343:Clinical use of Ribavirin.
6685
RSV (respiratory syncytial virus).
6686
Q3344:Symptoms of Ribavirin toxicity.
6687
Hemolytic anemia. Severe teratogen.
6688
Q3345:Mechanism of aciton of Acyclovir.
6689
Perferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase.
6690
Q3346:Clinical use of Acyclovir.
6691
HSV; VZV; EBV. Mucocutaneous and genital herpes lesions. Prophylaxis in immunocompromised patients.
6692
Q3347:Symptoms of Acyclovir toxicity.
6693
Delirium; tremor; nephrotoxicity.
6694
Q3348:Mechanism of action of Ganciclovir.
6695
Phosphorlation by viral kinase; perferentially inhibits CMV DNA polymerase.
6696
Q3349:Clinical use of Ganciclovir.
6697
CMV; especially in immunocompromised patients.
6698
Q3350:Symptoms of Ganciclovir toxicity.
6699
Leukopenia; neutropenia; thrombocytopenia; renal toxicity. More toxic to host enzymes than acyclovir.
6700
Q3351:Mechanism of action of Foscarnet.
6701
Viral DNA polymerase inhibitor that binds to the pyrophophate binding site of the enzyme. Does not require activation by viral kinase. "FOScarnet = pyroFOSphate analog."
6702
Q3352:Clinical use of Foscarnet.
6703
CMV retinitis in immunocompromised patients when ganciclovir fails.
6704
Q3353:Symptoms of Foscarnet toxicity.
6705
Nephrotoxicity.
6706
Q3354:Saquinavir; ritonavir; indinavir; nelfinavir; amprenavir are example of this type of anti-HIV drug.
6707
Protease inhibitor.
6708
Q3355:Mechanism of action of protease inhibitors.
6709
Inhibit assembly of new virus by blocking protease enzyme.
6710
Q3356:Symptoms of protease inhibitor toxicity.
6711
GI intolerance (nausea; diarrhea); hyperglycemia; lipid abnormalities; thrombocytopenia (indinavir).
6712
Q3357:Zidovudine (AZT); didanosine (ddI); zalcitabine (ddC); stavudine (d4T); lamivudine (3TC); and abacavir are examples of --------- reverse transcriptase inhibitors.
6713
Nucleoside.
6714
Q3358:Nevirapine; delavirdine; and efavirenz are examples of --------- reverse transcriptase inhibitors.
6715
Non-nucleoside.
6716
Q3359:Mechanism of action of reverse transcriptase inhibitors.
6717
Preferentially inhibit reverse transcriptase of HIV; prevent incorporation of viral genome into host DNA.
6718
Q3360:Symptoms of reverse transcriptase inhibitor toxicity.
6719
Bone marrow supression (neutropenia; anemia); periphral neuropathy; lactic acidosis (nucleosides); rash (nonnucleosides); megaloblastic anemia (AZT).
6720
Q3361:Highly active antiretroviral therapy (HAART) generally entails combination therapy with ---------- and ----------.
6721
Protease inhibitors; reverse transcriptase inhibitors.
6722
Q3362:When should HIV therapy be initiated?
6723
When patients have low CD4 counts (<500 cells/mm3) or high viral load.
6724
#NAME?
6725
AZT.
6726
Q3364:Mechanism of action of Interferons.
6727
Glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis.
6728
Q3365:Clinical use of Interferons.
6729
Chronic hepatitis B and C; Kaposi's sarcoma.
6730
Q3366:Symptoms of Interferon toxicity.
6731
Neutropenia.
6732
Q3367:Clinical uses of Ivermectin.
6733
Onchocerciasis "rIVER blindness treated with IVERmectin"
6734
Q3368:Clinical uses of Mebendazole / thiabendazole.
6735
Nematode/roundworm (e.g; pinworm; whipworm) infections.
6736
Q3369:Clinical uses of Pyrantel pamoate.
6737
Giant roundworm (Ascaris); hookworm (Necator/Ancylostoma); pinworm (Enterobius).
6738
Q3370:Clinical uses of Praziquantel.
6739
Trematode/fluke (e.g; schistosomes; Paragonimus; Clonorchis) and cysticercosis.
6740
Q3371:Clinical uss of Niclosamide
6741
Cestode/tapeworm (e.g; Diphyllobothrium latum; Taenia species) infections except cysticercosis.
6742
Q3372:Clinical uses of Pentavalent antimony.
6743
Leishmaniasis.
6744
Q3373:Clinical uses of Chloroquine; quinine; mefloquine; atovaquone; proguanil.
6745
Malaria.
6746
Q3374:Clinical uses of Primaquine.
6747
Latent hypnozoite (liver) forms of malaria (Plasmodium vivax; P.ovale).
6748
Q3375:Clinical uses of Metronidazole.
6749
Giardiasis; amebic dysentery (Entamoeba histolytica); bacterial vaginitis (Gardnerella vaginalis); Trichomonas.
6750
Q3376:Clinical uses of Pentamidine.
6751
Pneumocystis carinii pneumonia prophylaxis.
6752
Q3377:Clinical uses of Nifurtimox.
6753
Chagas' disease; American trypanosomiasis (Trypanosoma cruzi).
6754
Q3378:Clinical uses of Suramin.
6755
African trypanosomiasis (sleeping sickness).
6756
Q3379:Parasympathetic preganglionic neurons release the neurotransmitter -------- which act on -------- receptors.
6757
Ach; nicotinic.
6758
Q3380:Sympathetic preganglionic neurons to sweat glands release the neurotransmitter ------- which act on ------receptors.
6759
Ach; nicotinic.
6760
Q3381:Ach is synthesized from acetyl-CoA and choline by the enzyme ---------.
6761
Choline acetyltransferase.
6762
Q3382:In the noradrenergic nerve terminal; tyrosine is hydroxylated to -------; which is decarboxylated to --------; which is finally hydroxylated to NE.
6763
DOPA; dopamine.
6764
Q3383:The action of NE and DA is terminated by --------and ----------.
6765
Reuptake; diffusion (different than for Ach).
6766
Q3384:The drugs --------- and ---------- inhibit the reuptake of NE.
6767
Cocaine; TCA.
6768
Q3385:Ach inhibits the release of NE from the noradrenergic nerve terminal by binding to --------- receptors.
6769
M1.
6770
Q3386:Clinical application and action of Carbachol and Pilocarpine.
6771
Glaucoma. / Activates ciliary muscle of eye (open angle); pupillary sphincter (narrow angle).
6772
Q3387:Clinical application / action of Neostigmine.
6773
Postoperative and neurogenic ileus and urinary retention; myasthenia gravis; reversal of neuromuscular junction blockade (postoperative). / Increase endogenous Ach.
6774
Q3388:Clinical application / action of Pyridostigmine.
6775
Myasthenia gravis. / Increase Ach; increase strength.
6776
Q3389:Clinical application / action of Physostigmine.
6777
Glaucoma (crosses blood-brain barrier) and atropine overdose. / Increase endogenous Ach.
6778
Q3390:Clinical application / action of Echothiophate.
6779
Glaucoma. / Increase endogenous Ach.
6780
Q3391:Symptoms of cholinesterase inhibitor poisoning.
6781
Diarrhea; Urination; Miosis; Bronchospasm; Bradycardia; Excitation of skeletal muscle and CNS; Lacrimation; Sweating; Salivation (also abdominal cramping). "DUMBBELSS"
6782
Q3392:Cholinesterase inhibitor poisoning may be caused by --------.
6783
Parathion and other organophosphates.
6784
Q3393:The cholinesterase regenerator ------- can be used as an antidote for cholinesterase inhibitor poisoning.
6785
Pralidoxime.
6786
Q3394:Mechanism of action of Pralidoxime.
6787
Regenerates active cholinesterase; chemical antagonist; used to treat organophosphate exposure.
6788
Q3395:Clinical uses of the muscarinic antagonist Atropine.
6789
Dilate pupils; decrease acid secretion in peptic ulcer disease; decrease urgency in mild cystitis; decrease GI motility; reduce airway secretions; and treat organophosphate poisoning. "Blocks SLUD: Salivation; Lacrimation; Urination; Defecation."
6790
Q3396:Side effects of Atropine.
6791
Increase body temp; rapid pulse; dry mouth; dry/flushed skin; disorientation; mydriasis with cycloplegia; and constipation. "Atropine parasympathetic block side effects: Blind as bat; Red as a beet; Mad as a hatter; Hot as a hare; Dry as a bone."
6792
Q3397:Hexamethonium (ganglionic blocker) blocks -------receptors.
6793
Nicotinic.
6794
Q3398:"tropi" are anti-muscarinic
6795
while vacationing in the tropics you lie on a beach and your muscles waste away!
6796
Q3399:benztropine is used to treat
6797
Parkinson's disease
6798
Q3400:scopolamine is used to treat
6799
motion sickness
6800
Q3401:name 2 antimuscarinic drugs that act on the CNS
6801
benztropine; scopolamine
6802
Q3402:name a muscarinic used to treat motion sickness
6803
scopolamine
6804
Q3403:name a muscarinic used to treat Parkinson's disease
6805
benztropine
6806
Q3404:mechanism of action of benztropine
6807
antimuscarinic
6808
Q3405:mechanism of action of scopolamine
6809
antimuscarinic
6810
Q3406:name three antimuscarinics that act on eye
6811
atropine; homatropine; tropicamide
6812
Q3407:the action of atropine is ______
6813
6814
Q3408:mechanism of atropine is
6815
antimuscarinic
6816
Q3409:the action of homatropine is ______
6817
6818
Q3410:mechanism of homatropine is
6819
antimuscarinic
6820
Q3411:the action of tropicamide is
6821
6822
Q3412:mechanism of tropicamide is
6823
antimuscarinic
6824
Q3413:ipatropium is used to treat
6825
asthma; COPD
6826
Q3414:mechanism of ipatropium is
6827
antimuscarinic
6828
Q3415:name an antimuscarinic used to treat asthma and COPD
6829
ipatropium
6830
Q3416:neuromuscular blocking drugs are used for
6831
muscle paralysis in surgery or mechanical ventilation
6832
Q3417:name a depolarising neurmuscular blocking drug
6833
succinylcholine
6834
Q3418:name 6 nondepolarizing neuromuscular blocking drugs
6835
tubocurarine
6836
Q3419:*mnemonic -- the "cur" drugs are nondepolarizing neuromuscular blocking agents
6837
Atracurium; mivacurium; pancuronium; vecuronium; rapacuronium
6838
Q3420:is succinylcholine depolarizing or nondepolarizing?
6839
depolarizing
6840
Q3421:is tubocurarine depolarizing or nondepolarizing?
6841
nondepolarizing
6842
Q3422:is atracurium depolarizing or nondepolarizing?
6843
nondepolarizing
6844
Q3423:is mivacurium depolarizing or nondepolarizing?
6845
nondepolarizing
6846
Q3424:is pancuronium depolarizing or nondepolarizing?
6847
nondepolarizing
6848
Q3425:is vacuronium depolarizing or nondepolarizing?
6849
nondepolarizing
6850
Q3426:is rapacuronium depolarizing or nondepolarizing?
6851
nondepolarizing
6852
Q3427:what is tubocurarine used for
6853
nondepolarizing neuromuscular blockade
6854
Q3428:what agents are used to reverse neuromuscular blockade by succinylcholine?
6855
cholinesterase inhibitors in phase II (ex -- neostigmine)
6856
Q3429:what phase of succinylcholine neuomuscular bloackade is reversible?
6857
phase II (repolarized but blocked)
6858
Q3430:what agents are used to reverse pahse I neuromuscular blockade by succinylcholine?
6859
phase I Succinylcholine neuromuscular blockade cannot be reversed
6860
Q3431:what phase of succinylcholine neuomuscular bloackade is irreversible?
6861
phase I Succinylcholine neuromuscular blockade cannot be reversed
6862
Q3432:what is atracurium used for
6863
6864
Q3433:what is the effect of cholinesterase inhibitors on succinylcholine neuromuscular blockade?
6865
phase I: cholinesterase inhibitors potentiates the blockade phase II: cholinesterase inhibitors reverse the blockade
6866
Q3434:what cholinesterase inhibitor is used to reverse phase II of succinylcholine neuromuscular blockade?
6867
neostigmine
6868
Q3435:what is mivacurium used for
6869
6870
6871
treat malignant hyperthermia
6872
Q3437:what causes malignant hyperthermia
6873
use inhalation anesthetics and succinylcholine together
6874
Q3438:what inhalation anesthetic DOES NOT cause malignanat hyperthermia?
6875
N2O
6876
6877
neuroleptic malignant syndrome
6878
Q3440:what is neuroleptic malignant syndrome
6879
a toxicity of antipsychotic drugs
6880
Q3441:what drug is used to treat malignant hyperthermia
6881
dantrolene
6882
Q3442:what is the mechanism of dantrolene
6883
prevents release of Ca++ from saarcoplasmic reticulum of skeletal muscle
6884
Q3443:epinephrine; NE; isoproterenol; dopamine; and dobutamine are all________________
6885
catecholamines
6886
Q3444:catecholamines are_____________________
6887
sympathomimetics
6888
Q3445:name 5 catecholamines
6889
EPI; NE; Isoproterenol; dopamine; dobutamine
6890
Q3446:what receptors does epinephrine act on?
6891
alpha-1; alpha-2; beta-1; beta-2 adrenergics
6892
Q3447:what receptors does NE work on?
6893
alpha-1; alpha-2; beta-1 adrenergics
6894
Q3448:what receptors does isoproterenol work on?
6895
beta-1 = beta-2 adrenergics
6896
Q3449:what receptors does dopamine work on?
6897
D1 = D2; D1 and D2 more than beta; beta more than alpha
6898
Q3450:what receptors does dobutamine work on?
6899
beta-1 > beta-2
6900
Q3451:which catecholamines are agonists to alpha-adrenergic receptors
6901
EPI; NE > dopamine
6902
Q3452:which catecholamines are agonists to beta-1 adrenergic receptors
6903
EPI; NE; Isoproterenol; dopamine; dobutamine
6904
Q3453:which catecholamines are agonists to beta-2 adrenergic receptors
6905
EPI; isoproterenol; dopamine and dobutamine (less)
6906
Q3454:what is epinephrine used to treat?
6907
anaphylaxis; open-angle glaucoma; asthma; hypotension
6908
Q3455:what is norepinephrine used to treat?
6909
hypotension (but decreases renal perfusion)
6910
Q3456:what is isoproterenol used to treat?
6911
AV block
6912
Q3457:what is dopamine used to treat
6913
shock with renal failure; heart failure
6914
Q3458:what is dobutamine used to treat
6915
shock; heart failure
6916
Q3459:what catecholamine is used to treat anaphylaxis
6917
epinephrine ("EPI-pen")
6918
Q3460:what catecholamines are used to treat hypotension
6919
EPI; NE
6920
Q3461:what catecholamine is used to treat asthma
6921
epinephrine
6922
Q3462:what catecholamine is used to treat AV block
6923
isoproterenol
6924
Q3463:what catecholamines are used to treat shock
6925
doapmine; dobutamine
6926
Q3464:what is the action of amphetamine
6927
indirect general adrenergic agonist; releases stored catecholamines
6928
Q3465:what is the action of ephedrine
6929
indirect general adrenergic agonist; releases stored catecholamines
6930
Q3466:what is amphetamine used to treat
6931
narcolepsy; obesity; attention deficit disorder
6932
Q3467:what is ephedrine used to treat
6933
nasal decongestion; urinary incontinence; hypotension
6934
Q3468:name three sympathomimetic drugs used to treat hypotension
6935
epinephrine; norepinephrin; ephedrine
6936
Q3469:what is the action of phenylephrine
6937
adrenergic agonist; alpha-1 > alpha-2
6938
Q3470:what is the action of albuterol
6939
adrenergic agonist; beta-2 >beta-1
6940
Q3471:what is the action of terbutaline
6941
adrenergic agonist; beta-2 >beta-2
6942
Q3472:what is phenylephrine used for?
6943
pupil dilator; vasoconstriction; nasal decongestion
6944
Q3473:what sympathomimetics are used to treat nasal congestion
6945
ephedrine; phenylephrine
6946
Q3474:what is the mechanism of cocaine
6947
indirect general adrenergic agonist; catecholamine uptake inhibitor
6948
Q3475:what is the action of cocaine
6949
vasoconstriction; local anesthesia
6950
Q3476:what is the mechanism of clonidine
6951
centrally acting alpha-adrenergic agonist; decreases central adrenergic outflow
6952
Q3477:what drug has the same mechanism as amphetamine
6953
ephedrine
6954
Q3478:what is the mechanism of alpha-methyldopa
6955
centrally acting alpha-adrenergic agonist; decreases central adrenergic outflow
6956
Q3479:what drug has the same mechanism as clonidine
6957
alpha-methyldopa
6958
Q3480:what are clonidine and alpha-methyldopa used to treat
6959
hypertension; especially in renal disease because they do not decreased blood flow to the kidney
6960
Q3481:what sympathomimetic is used to treat urinary incontinence
6961
ephedrine
6962
Q3482:what sympathomimetic is used to treat attention deficit disorder
6963
amphetamine
6964
Q3483:what sympathomimetic is used to treat narcolepsy
6965
amphetamine
6966
Q3484:name a nonselective irreversible alpha blocker
6967
phenoxybenzamine
6968
Q3485:name a nonselective reversible alpha blocker
6969
phentolamine
6970
Q3486:what is the mechanism of phenoxybenzamine
6971
nonselective irreversible alpha blocker
6972
Q3487:what is the mechanism of phentolamine
6973
nonselective reversible alpha blocker
6974
Q3488:what are phenoxybenzamine and phentolamine used for
6975
pheochromocytoma
6976
Q3489:what are the side effects of nonselective alpha blockers
6977
orthostatic hypotension; reflex tachycardia
6978
Q3490:name 3 alpha-1 selective adrenergic blockers
6979
prazosin; terazosin; doxazosin
6980
Q3491:what is the mechanism of prazosin
6981
alpha-1 selective adrenergic blocker
6982
Q3492:what is the mechanism of terazosin
6983
6984
Q3493:what is the mechanism of doxazosin
6985
6986
Q3494:what are alpha-1 selective adrenergic alpha blockers used for
6987
hypertension; urinary retention in BPH
6988
Q3495:what are the side effects of alpha-1 blockers
6989
orthostatic hypotension; dizziness; headache
6990
Q3496:what is prazosin used for?
6991
hypertension; urinary retention in BPH
6992
Q3497:what drugs have the same action as prazosin
6993
terazosin; doxazosin
6994
Q3498:what are the side effects of terazosin?
6995
orthostatic hypotension; dizziness; headache
6996
Q3499:what selective alpha blockers cause orthostatic hypotension
6997
phenoxybenzamine; phentolamine; terazosin; prazosin; doxazosin
6998
Q3500:name an alpha-2 selective adrenergic blocker
6999
yohimbine
7000
Q3501:what is yohimbine used for
7001
impotence (effectiveness controversial)
7002
Q3502:what alpha blockers are used to treat pheochromocytoma
7003
phenoxybenzamine; phentolamine
7004
Q3503:name some beta-blockers
7005
propranolol; metoprolol; atenolol; nadolol; timolol; pindolol; esmolol; labetalol
7006
Q3504:what is the mechanism of propanolol
7007
selective beta-adrenergic blocker
7008
Q3505:what is the mechanism of metoprolol
7009
7010
Q3506:what is the mechanism of esmolol
7011
7012
Q3507:what is the mechanism of pindolol
7013
7014
Q3508:what are beta-blockers used to treat
7015
hypertension; angina; MI; SVT; CHF; glaucoma
7016
Q3509:how do beta blockers treat hypertension
7017
decrease cardiac output; decrease renin secretion
7018
Q3510:how do beta blockers treat angina
7019
decrease heart rate; decrease cardiac contractility; decreased O2 consumption
7020
Q3511:why are beta blockers used to treat MI
7021
decrease MI mortality
7022
Q3512:which beta blockers are used to treat SVT
7023
propanolol; esmolol
7024
Q3513:how do propanolol and esmolol treat SVT
7025
decrease AV conduction velocity
7026
Q3514:how do beta blockers treat CHF
7027
slow progression of chronic failure
7028
Q3515:which beta blocker is used to treat glaucoma
7029
timolol
7030
Q3516:what is timolol used to treat glaucoma
7031
decrease secretion of aqueous humor
7032
Q3517:what are the toxic effects of beta blockers
7033
impotence; exacerbation of asthma; caution in diabetes
7034
Q3518:what are the cardiovascular toxic effects of beta blockers
7035
bradychardia; AV block; CHF
7036
Q3519:what are the CNS adverse effects of beta blockers
7037
sedation; sleep alterations
7038
Q3520:which beta blockers are beta-1 selective
7039
acebutolol; betaxolol; esmolol; atenolol; metaprolol (A BEAM of beta-1 blockers)
7040
Q3521:which beta-1 blocker is short-acting
7041
esmolol
7042
Q3522:which beta blockers are non-selective
7043
propanolol; timolol; pindolol; nadolol; labetalol
7044
Q3523:which beta blocker also blocks alpha receptors
7045
labetalol (all others are spelled "olol")
7046
Q3524:which alpha agonists are used to treat glaucoma
7047
epinephrine; brimonidine
7048
Q3525:which beta blockers are used to treat glaucoma
7049
timolol; betxolol; carteolol
7050
Q3526:which cholinomimetics are used to treat glaucoma
7051
pilocarpine; carbachol; physostigmine; echothiophate
7052
Q3527:which diuretics are used to treat glaucoma
7053
acetazolamide; dorzolamide; brinzolamide
7054
Q3528:which prostaglandin is used to treat glaucoma
7055
latanoprost
7056
Q3529:what classes of drugs are used to treat glaucoma
7057
alpha agonists; beta blockers; cholinomimetics; diuretics; prostaglandins (*mnemonic -- treating glaucoma is easy as ABCD)
7058
Q3530:what is the effect of epinephrine in glaucoma
7059
increase outflow of aqueous humor
7060
Q3531:what are the side effects of epinephrine treatment in glaucoma
7061
mydriasis; stinging
7062
Q3532:what glaucoma should epinephrine NOT be used for
7063
closed-angle glaucoma
7064
Q3533:what is the effect of brimonidine in glaucoma
7065
decreased aqueous humor synthesis
7066
Q3534:what are the side effects of brimonidine treatment in glaucoma
7067
no pupillary or vision changes
7068
Q3535:what is the effect of beta-blocker treatment in glaucoma
7069
decrease aqueous humor secretion
7070
Q3536:what are the side effects of beta blocker treatment in glauzoma
7071
7072
Q3537:what is the effect of cholinomimetics in glaucoma
7073
ciliary muscle contraction; opening of trabecular meshwork; increase outflow of aqueous humor
7074
Q3538:what are the side effects of cholinomimetics in glaucoma
7075
miosis; cyclospasm
7076
Q3539:what is the effect of diuretic treatment in glaucoma
7077
inhibition of carbonic anhydrase --> decrease HCO3 secretion --> decrease aqueous humor secretion
7078
Q3540:what are the side effects of diuretics in glaucoma
7079
7080
Q3541:what is the effect of prostaglandin (latanoprost) treatment in glaucoma
7081
increase outflow of aqueous humor
7082
Q3542:what is the side effect of prostaglandin treatment in glaucoma
7083
darkens color of iris (browning)
7084
Q3543:which drugs used to treat glaucoma increase outflow of aqueous humor
7085
cholinomimetics; prostaglandin; epinephrine
7086
Q3544:can you use epinephrine in closed-angle glaucoma
7087
NO
7088
Q3545:brimonidine is used to treat what eye disease
7089
glaucoma
7090
Q3546:what kind of drug is latanoprost
7091
prostaglandin
7092
Q3547:latanoprost is used to treat what eye disease
7093
glaucoma
7094
Q3548:which glaucoma drugs decrease aqueous secretion
7095
beta blockers; diuretics
7096
Q3549:what does L-dopa stand for
7097
levodopa
7098
Q3550:what is the mechanism of action of L-dopa/carbidopa
7099
increase dopamine level in brain
7100
Q3551:what is L-dopa/carbidopa used to treat
7101
Parkinson's disease
7102
Q3552:how is L-dopa different from dopamine
7103
L-dopa can cross the blood-brain barrier; dopamine cannot
7104
Q3553:what happens to L-dopa after it crosses the BBB
7105
converted to dopamine by dopa decarboxylase
7106
Q3554:what enzyme convertes L-dopa to dopamine
7107
dopa decarboxylase
7108
Q3555:what is the function of carbidopa
7109
peripheral decarboxylase inhibitor
7110
Q3556:why is carbidopa given with L-dopa
7111
increase L-dopa availability in CNS by inhibiting decarboxylase in periphery; also limits peripheral side effects
7112
Q3557:what are the side effects of L-dopa.carbidopa treatment
7113
arrhythmias; dyskinesias
7114
Q3558:why do patients taking L-dopa get arrhythmias
7115
peripheral effects of dopamine
7116
Q3559:why do patients taking L-dopa get dyskinesias
7117
excess dopamine stimulation in CNS
7118
Q3560:what drugs are used to treat Parkinson's disease
7119
dopamine agonists; MAO inhibitors; antimuscarinics
7120
Q3561:specifically; which drugs are used to treat Parkinson's
7121
Bromocriptine; Amantadine; Levodopa; Selegiline; Antimuscarinics (BALSA)
7122
Q3562:which dopamine agosts are used to treat Parkinson's
7123
L-dopa/carbidopa; bromocriptine; pramipexole; ropinirole; amantadine
7124
Q3563:what is the action of bromocriptine in Parkinson's
7125
ergot alkaloid; partial dopamine agonist
7126
Q3564:what is the action of amantadine in Parkinson's
7127
enhances dopamine release
7128
Q3565:what MAOI is used to treat Parkinson's
7129
selegiline
7130
Q3566:what is the mechanism of selegiline
7131
selective MAO type B inhibitor
7132
Q3567:what antimuscarinic is used to treat Parkinson's
7133
benztropine
7134
Q3568:what is the effect of benztropine in Parkinson's
7135
improves tremor; rigidity; little effect on bradykinesia
7136
Q3569:what is sumatriptan used for
7137
acute migraine; cluster headache attacks
7138
Q3570:what is the mechanism of sumatriptan
7139
5-HT1D agonist
7140
Q3571:what is the half life of sumatriptan
7141
less than 2 hours
7142
Q3572:what are the side effects of sumatriptan
7143
chest discomfort; mild tingling
7144
Q3573:what are the contraindications for sumatriptan
7145
patients with CAD or Prinzmetal's angina
7146
Q3574:which drugs are used for simple and complex partial seizures
7147
phenytoin; carbamazapine; lamotrigine; gabapentin; topiramate; phenobarbital
7148
Q3575:what types of seizures is phenytoin indicated for
7149
simple and complex partial; tonic-clonic; status epilepticus
7150
Q3576:what types of seizures is carbamazepine indicated for
7151
simple and complex partial; tonic-clonic
7152
Q3577:what types of seizures is lamotrigine indicated for
7153
7154
Q3578:what types of seizures is gabapentin indicated for
7155
7156
Q3579:what types of seizures is topiramate indicated for
7157
simple and complex partial
7158
Q3580:what types of seizures is phenobarbital indicated for
7159
7160
Q3581:what drugs can be used for tonic-clonic seizures
7161
phenytoin; carbamazapine; lamotrigine; gabapentin; phenobarbital; valproate
7162
Q3582:what drugs can be used for absence seizures
7163
valproate; ethosuximide
7164
Q3583:what drugs can be used for status epilepticus
7165
phenytoin; benzodiazapines (diazepam; lorazepam)
7166
Q3584:what types of seizure is valproate indicated for
7167
tonic-clonic; absence
7168
Q3585:what types of seizure is ethosuximide inidcated for
7169
absence
7170
Q3586:what type of seizure are benzodiazepines indicated for
7171
status epilepticus
7172
Q3587:other than anti-seizure; what else is phenytoin used for
7173
class 1B anti-arrhythmic
7174
Q3588:how should a patient taking carbamazepine be followed
7175
monitor LFT's weekly
7176
Q3589:which seizure drugs have adjunct use
7177
gabapentin; topiramate
7178
Q3590:which seizure drug is safest in pregnant women
7179
phenobarbital
7180
Q3591:which seizure drug is used in Crigler-Najjar II
7181
phenobarbital
7182
Q3592:what are the advantages of phenobarbital
7183
can be used in pregnant women; Crigler Najjar II
7184
Q3593:what are the side effects of benzodiazepines
7185
sedation; tolerance; dependence
7186
Q3594:what are the side effects of carbamazepine
7187
diplopia; ataxia; CYP induction; blood dyscrasias; liver toxicity
7188
Q3595:what are the side effects of ethosuximide
7189
GI distress; lethargy; headache; urticaria; Stevens-Johnson syndrome
7190
Q3596:what are the side effects of phenobarbital
7191
sedation; CYP induction; tolerance; dependence
7192
Q3597:what are the side effects of phenytoin
7193
nystagmus; diplopia; ataxia; sedation; ginigival hyperplasia; hirsutism; anemias; teratogenic
7194
Q3598:what are the side effects of valproate
7195
GI distress; rare by fatal hepatotoxicity; neural tube defects (spina bifida)
7196
Q3599:what are the side effects of lamotrigine
7197
life-threatening rash; Stevens-Johnson syndrome
7198
Q3600:what are the side effects of gabapentin
7199
sedation; movement disorders
7200
Q3601:what are the side effects of topiramate
7201
sedation; mental dulling; kidney stones; weight loss
7202
Q3602:which anti-epileptic drug is teratogenic
7203
phenytoin
7204
Q3603:which anti-epileptic drug can cause dependence
7205
benzodiazepines; phenobarbital
7206
Q3604:which anti-epileptic drug can cause neural tube defects
7207
valproate
7208
Q3605:which anti-epileptic drugs can cause GI distress
7209
valproate; ethosuximide
7210
Q3606:it is necessary to check LFT's with which antiepileptic drugs
7211
carbamazepine; valproate
7212
Q3607:which anti-epileptic drugs cause CYP induction
7213
phenobarbital; carbamazepine
7214
Q3608:which anti-epileptic drugs can cause blood problems
7215
carbamazepine; phenytoin
7216
Q3609:which anti-epileptic drugs can cause Stevens-Johnson syndrome
7217
lamotrigine; ethosuximide
7218
Q3610:which anti-epileptic drugs can cause diplopia
7219
carbamazepine; phenytoin
7220
Q3611:what is the mechanism of phenytoin action
7221
use-dependent blockade of Na+ channels
7222
Q3612:what is the clinical application of phenytoin
7223
grand mal seizures
7224
Q3613:what are the toxicities of phenytoin
7225
nystagmus; ataxia; diplopia; lethargy
7226
Q3614:what are the chronic toxicities of phenytoin
7227
gingival hyperplasia in children; peripheral neuropathy; hirsutism; megaloblastic anemia; malignant hyperthermia (rare)
7228
Q3615:should pregnant women take phenytoin
7229
NO -- teratogenic
7230
Q3616:why does phenytoin cause megaloblastic anemia
7231
causes decreased vitamin B-12
7232
Q3617:name 4 barbiturates
7233
phenobarbital; pentobarbital; thiopental; secobarbital
7234
Q3618:what is the mechanism of barbiturate action
7235
increase duration of Cl channel opening --> decreased neuron firing --> facilitate GABA-A action
7236
Q3619:how do barbiturates facilitate GABA-A action
7237
increase duration of Cl channel opening which decreases neuron firing (Barbidurate increases duration
7238
Q3620:is barbiturate action on the CNS stimulatory or inhibitory
7239
inhibitory
7240
Q3621:what is the clinical application of barbiturates
7241
sedative for anxiety; seizures; insomnia; anesthesia induction (thiopental)
7242
Q3622:which barbiturate is used for anesthesia induction
7243
thiopental
7244
Q3623:what are the side effects of barbiturates
7245
dependence; additive CNS depression effects with alcohol; respiratory or CV depression (death); drug interactions due to CYP induction
7246
Q3624:what should you find out before giving a patient barbiturates
7247
what other medications they take; because of CYP induction and many drug interactions
7248
Q3625:what happens if you give barbiturates to a patient in alcohol-induced coma or DT's
7249
they might DIE!! Because of additive effect of barbiturates and alcohol --> respiratory depression
7250
Q3626:when are barbiturates contra-indicated
7251
porphyria
7252
Q3627:can barbiturates cause dependence
7253
YES
7254
Q3628:My friend Barb was very anxious so her doctor gave her barbiturates to increase the duration of the time she could speak in public without freaking out and having a seizure. She became so dependent on it that she recommended it to her friend Portia who couldn't take it because of porphyria. One day Barb drank too much alcohol and took her barbiturates and never woke up! THE END
7255
clinical pharmacology made ridiculous. Period
7256
Q3629:name a bunch of benzodiazepines
7257
diazepam; lorazepam; triazolam; temazepam; oxazepam; midazolam; chlordiazepoxide (all have ZZZ in them)
7258
Q3630:what is the mechanism of benzodiazepines
7259
increase frequency of Cl channel opening --> facilitate GABA-A action (Frenzodiazepines increase frequency)
7260
Q3631:which GABA receptors are facilitated by barbiturates and bezodiazepines
7261
GABA-A
7262
Q3632:what are the clinical applications of benzodiazepines
7263
anxiety; spasticity; status epilepticus (diazepam); detoxification (alcohol withdrawal; DT's)
7264
Q3633:which benzodiazepine can be used for status epilepticus
7265
diazepam
7266
Q3634:what drugs can be used to treat alcohol withdrawal
7267
benzodiazepines
7268
Q3635:which benzodiazepines are short-acting
7269
TOM thumb: Triazolam; Oxazepam; Midazolam
7270
Q3636:what are the toxic effects of benzos
7271
dependence; additive CNS depression effects with alcohol
7272
Q3637:how are benzos better than barbiturates
7273
less respiratory depression and coma risk
7274
Q3638:how do you treat benzo overdose
7275
flumazenil
7276
Q3639:what is flumzenil used for
7277
benzo overdose
7278
Q3640:how does flumazenil work
7279
competitive antagonist at GABA receptor
7280
Q3641:can a patient become benzodiazepine dependent
7281
YES
7282
Q3642:are barbiturates or benzodiazepines used for alcohol withdrawal
7283
benzodiazepines
7284
Q3643:what is another name for antipsychotics
7285
neuroleptics
7286
Q3644:name 4 antipsychotic drugs
7287
thioridazine; haloperidol; fluphenazine; chlorpromazine
7288
Q3645:how do you keep benzos straight from antipsychotics
7289
Benzos help 3rd year Jon Kazam be less anxious around patients: Shazam Kazam! Without antipsychotics patients talk like a crazy 'zine (well; not perfect; but I'm working on it)
7290
Q3646:what is the mechanism of most antipsychotics
7291
block dopamine D2 receptors
7292
Q3647:what is the clinical application of antipsychotics
7293
schizophrenia; psychosis
7294
Q3648:what are the side effects of antipsychotics
7295
extrapyramidal side effects (EPS); sedation; endocrine; muscarinic blockade; alpha blockade; histamine blockade
7296
Q3649:what is a long-term effect of antipsychotic use
7297
tardive dyskinesia
7298
Q3650:what is neuroleptic malignant syndrome
7299
a side effect of antipsychotics; rigidity; autonomic instability; hyperpyrexia
7300
Q3651:how do you treat neuroleptic malignant syndrome
7301
dantrolene; dopamine agonists
7302
Q3652:what is tardive dyskinesia
7303
side effect of neuroleptics; stereotypic oral-facial movements; may be due to dopamine receptor sensitization
7304
Q3653:what is the "rule of 4" with EPS side effects from antipsychotic drugs
7305
evolution of EPS side effects: 4 hours -- acite dystonia; 4 days -- akinesia; 4 weeks -- akasthesia; 4 months -- tardvie dyskinesia
7306
Q3654:is tardvie dyskinesia reversible
7307
often irreversible
7308
Q3655:what is fluphenazine used for
7309
schizophrenia; psychosis
7310
Q3656:name 3 atypical antipsychotics
7311
clozapine; olanzapine; risperidone
7312
Q3657:what type of antipsychotic is clozapine
7313
atypical
7314
Q3658:what type of antipsychotic is olanzapine
7315
atypical
7316
Q3659:what type of antipsychotic is risperidone
7317
atypical
7318
Q3660:what is the mechanism of atypical antipsychotics
7319
block 5-HT2 and dopamine receptors
7320
Q3661:what is the mechanism of clozapine
7321
7322
Q3662:what is the mechanism of olanzapine
7323
7324
Q3663:what is the mechanism of risperidone
7325
7326
Q3664:what is the clinical application of clozapine
7327
schizophrenia positive and negative symptoms
7328
Q3665:what is the clinical application of olanzapine
7329
schizophrenia positive and negative symptoms; OCD; anxiety disorder; depression
7330
Q3666:what is the clinical application of risperidone
7331
schizophrenia positive and negative symptoms
7332
Q3667:how are atypical antipsychotics different from classic ones
7333
atypicals treat positive and negative symptoms of schizophrenia; fewer extrapyramidal and anticholinergic side effects than classic antipsychotics
7334
Q3668:which antipsychotics should be used to treat positive and negative symptoms of schizophrenia
7335
atypical ones -- clozapine; olanzapine; risperidone
7336
Q3669:which antipsychotics should be used for fewer side effects
7337
atypical ones -- clozapine; olanzapine; risperidone
7338
Q3670:what is a potential toxicity of clozapine
7339
agranulocytosis
7340
Q3671:which antipsychotic drug can cause agranulocytosis
7341
clozapine
7342
Q3672:what test must be done weekly on patients taking clozapine
7343
WBC count because of potential agranulocytosis
7344
Q3673:what is the mechanism of action of lithium
7345
unknown; may be related to inhibition of phosphoinositol cascade
7346
Q3674:what is the clinical application of lithium
7347
mood stabilizer for bipolar disorder
7348
Q3675:how does lithium help people with bipolar disorder
7349
prevents relapse and acute manic episodes
7350
Q3676:what are the side effects of lithium
7351
tremor; hypothyroidism; polyuria; teratogenic
7352
Q3677:is it OK for women taking lithium to get pregnant
7353
NO -- teratogenic
7354
Q3678:what does lithium cause polyuria
7355
ADH antagonist --> nephrogenic diabetes insipidus
7356
Q3679:What do the following drugs inhibit: 1. MAO inhibitors; 2. Desipramine/maprotilline; 3. Mirtazapine and 4. Fluoxetine/trazodone?
7357
1. MAO 2. NE reuptake 3. Alpha 2-R 4. 5HT reuptake
7358
Q3680:All of the above actions are ------synaptic
7359
PRE
7360
Q3681:List the Tricyclic Antidepressants
7361
pg 311 Imipramine; amitriptyline; desipramine; nortriptyline; clomipramine; doxepin
7362
Q3682:What are the three C's of their toxicity?
7363
Convulsions; Coma; Cardiotoxicity (arrythmias). Also respiratory depression; hypyrexia.
7364
Q3683:How about toxicity in the eldery?
7365
confusion and hallucinations due to anticholinergic SE
7366
Q3684:What is the mechanism of TCA?
7367
block reuptake of NE and 5HT
7368
Q3685:What is the clinical uses of TCAs?
7369
Endogenous depresion. Bed wetting - imipramine. OCDclomipramine.
7370
Q3686:How are tertiary TCA's different than secondary in terms of side effects?
7371
Amitriptyline (tertiary) has more anti-cholinergic effects than do secondary (nortriptyline). Desipramine is the least sedating.
7372
Q3687:what are the SE of TCAs?
7373
sedation; alpha blocking effects; atropine-like anti cholinergic side effects (tachycardia; urinary retention)
7374
Q3688:Fluoxetine; sertraline; paroxetine; citalopram are what class of drugs?
7375
pg 311 SSRI's for endogenous depression
7376
Q3689:How long does it take an anti-depressant to have an effect?
7377
2-3weeks
7378
Q3690:How does the toxicity differ fromTCA's and what are they?
7379
Fewer than TCA's. CNS stimulation - anxiety; insomnia; tremor; anorexia; nausea; and vomiting.
7380
Q3691:What toxicity happens with SSRI's and MAO inhibitors given together?
7381
Seratonin Syndrome! Hyperthermia; muscle rigidity; cardiovascular collapse
7382
Q3692:What are heterocyclics?
7383
pg 312 2nd and 3rd generation antidepressants with varied and mixed mechanisms of action. Used major depression.
7384
Q3693:Examples of heterocyclics?
7385
trazodone; buproprion; venlafaxine; mirtazapine; maprotiline
7386
Q3694:Which one is used for smoking cessation?
7387
Buproprion. Mechanism not known. Toxicity - stimulant effects; dry mouth; aggrevation of pyschosis
7388
Q3695:Which one used in GAD?
7389
Venlafaxine - inhibits 5HT and DA reuptake. Toxicity stimulant effects
7390
Q3696:which one blocks NE reuptake
7391
maprotiline
7392
Q3697:Which one increases release of NE and 5HT via alpha 2 antagonism?
7393
mirtazapine. Also potent 5HT Rantagonist. Toxicity sedation; increase serum cholesterol; increase appetite
7394
Q3698:What is trazodone and it' SE?
7395
primarily inhibits seratonin reuptake. Toxicity - sedation; nausea; priapism; postural hypotension
7396
Q3699:Give 2 examples of MAO
7397
pg 312 phenelzine. Tranylcypromine
7398
Q3700:Mechanism and Clinical Uses?
7399
non selevtive MAO inhibition. Atypical antidepressant; anxiety; hypochondriasis
7400
Q3701:What is the toxicity with tyramine ingestion (in foods) and meperidine?
7401
Hypertensive crisis
7402
Q3702:Other toxicities?
7403
CNS stimulation; contraindicated with SSRI's or B-agonists
7404
Q3703:What is the mechanims of selgiline (deprenyl)?
7405
pg 312 Selectively inhibits MAO-B; increasing DA
7406
Q3704:what is the clinical use and toxicity?
7407
adjunctive agent to L-dopa for Parkinsons. May enhance adverse effects of L-dopa
7408
Q3705:What is the significance of drugs with decreased solubility in blood?
7409
rapid induction and recovery times . Ie. N20
7410
Q3706:What is the significance of drugs with increased solubility in blood?
7411
increased potency = I/ MAC. Ie. Halothane
7412
Q3707:list Inhaled Anesthetics
7413
halothane; enflurane; isoflurane; sevoflurane; methoxyflurane; nitrous oxide
7414
Q3708:What is good about lower solubility?
7415
the quicker the anesthetic response; and the quicker the recovery
7416
Q3709:What are these drug's effects?
7417
myocardial depression; respiratory depression; nausea/emesis; increase cerebral blood flow
7418
Q3710:What toxicity mactches the following drugs 1. Halothane 2. Methoxyflurane 3. Enflurane 4. Rare
7419
1. Hepatotoxcity 2. Nephrotoxicty 3. Proconvulsant 4. Malignant hyperthermia
7420
Q3711:What do barbituates; benzodiazepines; arylcyclohexylamines and narcotic analgesics have in common?
7421
they are IV anesthetics
7422
Q3712:What the pharmacokinetics and uses of thiopental?
7423
high lipid solubility; rapid entry into brain. Used for induction of anesthesia for short surgical procedures. Terminated by redistribution from brain. Decreased cerebral blood flow
7424
Q3713:Give an example of a benzo and what is this class's shortcoming?
7425
midazolam used for endoscopy. Used with gaseous anesthetics and narcotics. May cause severe post-op respiratory depressio and amnesia
7426
Q3714:What does Ketamine (PCP analog and an arylcyclohexylamine) do?
7427
dissociative anesthetic. Cardiovascular stimulant. Causes disorientation; hallucination; bad dreams. Increases cerebral blood flow.
7428
Q3715:How are narcotic analgesics used? Examples?
7429
Morphone and fentanyl are used with CNS depressant during general anesthesia.
7430
Q3716:What is the advantage of propofol
7431
used for rapid anesthesia induction and short procedures. Less post-op nausea than thiopental
7432
Q3717:Name some Local ester anesthetics?
7433
procaine; cocaine; tetracaine;
7434
Q3718:Name some amides?
7435
lidocaine; bupivacaine; (amides have two I's in name!)
7436
Q3719:What is the mechanism and clinical use?
7437
bind receptor and block Na channels. Tertiary amine local anesthetics penetrate membrane in uncharge form; then bind charged form. Use for minor surgical procedures; spinal anesthesia.
7438
Q3720:How do you decide to use ester or amides?
7439
if allergic to esters; give amides
7440
Q3721:what is the toxicity
7441
CNS excitation; severe cardiovascular toxicity (bupivacaine); hypertension; arrhythmias (cocaine)
7442
Q3722:In infected ________ tissue; anesthetics are charged and cannot penetrate membrane. Therefore; ______ anesthetics are needed.
7443
acidic; more
7444
Q3723:What is the order of nerve blockade for size and myelination? Which factor predominates?
7445
small diameter> large diameter. Myelinated fibers> unmyelinated fibers. Size factor predominates
7446
Q3724:what is the order of loss of sensation?
7447
pain first; then temp; then touch; then pressure
7448
Q3725:Why would you give these drugs with vasoconstrictors?
7449
to enhance local action
7450
Q3726:List as many Opiod analgesics as you can.
7451
morphine; fentanyl; codeine; heroin; methadone; meperidine; dextromethorphan
7452
Q3727:Mechanism: They act as _____ for opiod receptors to modulate synaptic transmission
7453
agonists
7454
Q3728:which drugs act at the mu; delta; kappa receptors?
7455
morphine enkephalin; dynorphin
7456
Q3729:Clinical use?
7457
pain; cough supression (dex); diarrhea (loperamide); acute pulmonary edema; methadone maintenance programs
7458
Q3730:What are the major toxicities?
7459
addiction; respiratory depression; constipation; miosis; additive CNS depression wth other drugs
7460
Q3731:Tolerance does not develop to __________and ______
7461
miosis and constipation
7462
Q3732:How would you treat toxicity?
7463
naloxone; naltrexone (opiod R antagonist)
7464
Q3733:List three NSAIDS?
7465
ibuprofen; naproxen; indomethacin
7466
Q3734:What is their mechanism?
7467
reversibly inhibit COX 1 and 2. Blocks PG synthesis
7468
Q3735:What is their clinical use (3As)?
7469
Antipyretic; analgesic; anti-inflammatory. Indomethacin is used to close a PDA.
7470
Q3736:What are common toxicities?
7471
renal damage; aplastic anemia; GI distress; ulcers
7472
Q3737:Where is cox2 found?
7473
in inflammatory cells and mediates inflammation and pain
7474
Q3738:Why is cox2 inhibition better than cox1?
7475
cox1 helps to maintain gastric mucosa; thus; should not have the corrosive effects of other NSAIDs on the GI lining (less incidence of ulcers and bleeding)
7476
Q3739:Clinical Use?
7477
RA and osteoarthritis
7478
Q3740:What is Acetaminophen mechanism and where does it work?
7479
reversibly inhibits cox; mostly in CNS. Inactivated peripherally.
7480
Q3741:What are its 2 As?
7481
antipyretic; analgesic but NOT anti-inflammatory.
7482
Q3742:Overdose effects?
7483
hepatic necrosis; acetaminophen metabolites depletes glutathine and forms toxic tissue adducts in the liver
7484
Q3743:Changes in CO affect two major cardiovascular pathways?
7485
1. Carotid sinus firing; sympa discharge 2. Renal blood flow; renin-ang pathway
7486
Q3744:What is the effect of the following drugs: 1. Positive inotropic drugs 2. Beta blockers 3. Ace inhibitors 4. AII antagonists 5. Vasodilators and 6. Diuretics
7487
1. Increases cardiac output. 2. Inhibit renin release. 3. Inhibit ACE 4. Inhibits effects of AngII including increasing the preload; increasing the afterload and remodelling. 5. Decrease the preload and afterload. 6. Decrease the preload and afterload
7488
Q3745:What are the adverse effects of these two diueretics: hydrochlorothiazide; loop diuretics
7489
1. Hypokalemia; hyperlipidemia; hyperuricemia; lassitude; hypercalcemia; hyperglycemia 2. Hypokalemia; met alk; hypotension; ototoxicity
7490
Q3746:These are what class of drugs: clonidine; methyldopa; ganglionic blockers; reserpine; guanethidine; prazosin; beta blockers?
7491
sympathoplegics
7492
Q3747:Adverse effects of clonidine?
7493
dry mouth; sedation; severe rebound HTN
7494
Q3748:Adverse effects of methyldopa?
7495
sedation; positive coombs test
7496
Q3749:Adverse effects of ganglionic blockers?
7497
orthostatic HTN; blurred vision; constitpation; sexual dysfuncction
7498
Q3750:Adverse effects of reserpine?
7499
sedation; depression; nasal stuffiness; diarrhea
7500
Q3751:adverse effects of beta blockers?
7501
impotence; asthma; cardiovascular; cns
7502
Q3752:Adverse effects of guanethidine?
7503
orthostatic and exercise Hypotension; sex dysfxn; diarrhea
7504
Q3753:Adverse effects of prazosin?
7505
1st dose orthostatic hypotension; dizzy; headache
7506
Q3754:The following are what class: hydralazine; minoxidil; nifedipine; verapamil; nitroprusside
7507
vasodilators
7508
Q3755:which one causes lupus like syndrome? Other toxicities?
7509
hydralazine; nausea; headache; reflex tachycardia; angina; salt retention
7510
Q3756:adverse effets of minoxidil?
7511
hypertrichosis (hair growth - think Rogaine with minoxidil!); pericardial effusion; reflex tachycardia; angina; salt retention
7512
Q3757:Side effects of nifedipine; verapamil?
7513
dizziness; flushing; constipation; nausea
7514
Q3758:which one causes cynide toxicity?
7515
nitroprusside
7516
Q3759:Adverse effects of ACE-I Captorpil? Think CAPTOPRIL
7517
C: cough; A: angioedema; P: proteinuria; T: taste changes; O: hypOtension; P: pregnancy problems like fetal renal damage; R: rash; I: increased renin; L: lower angiotensin. Also hyperkalemia.
7518
Q3760:Losartan is a ----------- R-Inhibitor? With ____toxicity and ____kalemia
7519
angiotensin II; fetal renal; hyper
7520
Q3761:Which two anti-HTN drugs do you use with B blockers to prevent reflex tachycardia; diuretic to block salt retention?
7521
hydralizine; minoxidil
7522
Q3762:What is hydralizine's mechanims and clinical use?
7523
increase cGMP --> smooth muscle relaxation. Vasodilates arteries > veins. Reduces afterload. Used for severe HTN or CHF
7524
Q3763:Calcium channel blockers; name three
7525
pg. 315 - nifedipine; verapamil; diltiazem
7526
Q3764:Mechanism: block _____ chanels of cardiac and smooth muscles to reduce contractility
7527
voltage dependednt L type Ca
7528
Q3765:Rank their effects on vascular smooth muscle ad on the heart.
7529
smooth muscle nifed> diltia > verapamil heart: vera> diltia> nifedepine
7530
Q3766:What is the calcium channel blockers use?
7531
HTN; angina; arrythmias (not nifedipine)
7532
Q3767:ACE -I; name three
7533
pg 316 - captopril; enalapril; lisinopril
7534
Q3768:Mechanim considering bradykinin and renin release?
7535
reduce lvels of ang II; prevent inactivation of bradykinin; renin release is increased to to loss of feedback inhibition
7536
Q3769:what is the clinical use of these?
7537
HTN; CHF; diabetic renal disease
7538
Q3770:What is the site of action of 1. Acetazolamide; 2. Osmotic agents; 3. Loop agents; 4. Thiazides; 5. Potassium sparing; 6. ADH antagonists
7539
1. PCT 2. PCT; thin desc limb; CD 3. Thick ascending limb 4. Distal conv tubule 5. DCT a bit later 6. CD in inner medulla
7540
Q3771:How does mannitol an osmotic diuretic work?
7541
increase tubular fluid osmolarity; producing increased urine flow
7542
Q3772:what is the use and toxicity?
7543
Use: shock; drug overdose; decrease intracranial pressure. Toxicity - pulmonary edema; dehydration. Contraindicated in anuria; CHF
7544
Q3773:Acetazolamide Is a ______inhibitor. Causes ______diuresis and _____ in total body HC03 stores.
7545
Carbonic anhydrase; self-limited NaHCO3; reduction.
7546
Q3774:What electrolye disturbace does it treat? Does it cause?
7547
treats met alk; causes in toxicity hyperchloremic met acidosis. ACIDazolamide caues ACIDosis.
7548
Q3775:Other toxicity?
7549
neuropathy; NH3 toxicity; sulfa allergy
7550
Q3776:uses?
7551
glaucoma; urinary alk; met alk; altitude sickeness
7552
Q3777:This sulfonamide loop diuretic Furosemide inhibits _______cotransport
7553
NA; K; 2CL
7554
Q3778:Furosemide also works by?
7555
abolishes hypertonicit y of medulla; prevent concentration of urine. Increase Caexcertion. Loops Lose calcium
7556
Q3779:The three uses for this loop diuretic?
7557
edematous states; htn; hypercalcemia
7558
Q3780:Toxicity using the OH DANG?
7559
ototoxicity; hypokalemia; dehydration; allergy; nephritis interstitial; gout
7560
Q3781:How is Ethacrynic Acid different from furosemide? And how does that affect its use?
7561
Although both have the same action; ethacrynic is a phenoxyacetic acid derivative not a sulfonamide. Therefore use this drug when you are allergic to sulfa.
7562
Q3782:What drug can be used to treat acute gout?
7563
ethacrynic acid
7564
Q3783:Hydrochlorothiazide is a thiazide diuretic that inhibits the reabsorption of ----- in the ---- tubule
7565
NaCl; early distal tubule
7566
Q3784:Does hydrochlorothiazide increase or decrease the excretion of calcium ion?
7567
decrease
7568
Q3785:A toxic dose of hydrochlorathiazide will do what to the blood levels of these electrolites: potassium; sodium; glucose; lipid; uric acid; calcium
7569
hypokalemic metabolic alkalosis; hyponatremia; hyperGlycemia; hyperLipidemia; hyperUricemia; hyperCalcemia (hyperGLUC)
7570
Q3786:Spironolactone is a competitive antagonist to the --receptor in the ---- tubule
7571
aldosterone; cortical collecting tubule
7572
Q3787:Name two K+-sparing diuretics that block Na+ channels in the cortical collecting duct
7573
Triamterine and amiloride
7574
Q3788:Besides causing hyperkalemia; a toxic dose of spironolactone will cause this endocrine effect
7575
Gynecomastia (antiandrogen effect)
7576
Q3789:Name three K+-sparing diuretics
7577
Spironolactone; Triamterene; Amiloride (The K+ STAys.)
7578
Q3790:Diuretics are classified as carbonic anhydrase inhibitors; loop diuretics; thiazides; and K+-sparing diuretics. Which of these causes in increase in urine NaCl?
7579
All of them!
7580
Q3791:Which types of diuretucs increase urine K+?
7581
All except K+-sparing diuretics. Carbonic anhydrase inhibitors; loop diuretics; thiazides.
7582
Q3792:Do carbonic anhydrase inhibitors increase or decrease blood pH?
7583
Decrease; cause acidosis
7584
Q3793:Do K+-sparing diuretics cause acidosis or alkalosis?
7585
Acidosis; decreases pH
7586
Q3794:Do loop diuretics cause acidosis or alkalosis?
7587
Alkalosis; increases pH
7588
Q3795:Do thiazide diuretics cause an increase or decrease in blood pH?
7589
Increase; cause alkalosis
7590
Q3796:Do loop diuretics increase or decrease levels of urine calcium ion?
7591
Increase
7592
Q3797:Do thiazide diuretics increase or decrease levels of urine calcium ion?
7593
Decrease
7594
Q3798:Name four determinants of the level of myocardial oxygen consumption
7595
There are five: end diastolic volume; blood pressure; heart rate; contractility; ejection time
7596
Q3799:Do nitrates affect preload or afterload?
7597
preload
7598
Q3800:Do Beta-blockers affect preload or afterload?
7599
afterload
7600
Q3801:What is the effect of nitrates on: diastolic volume; blood pressure; contractility; heart rate; ejection time?
7601
decrease EDV; decrease BP; increase contractility (reflex response); increase HR (reflex response); decrease ejection time
7602
Q3802:What is the effect of Beta-blockers on: diastolic volume; blood pressure; contractility; heart rate; ejection time?
7603
increase EDV; decrease BP; decrease contractility; decreased HR; increase ejection time
7604
Q3803:The effects of using nitrates and Beta-blockers together will: a) decrease myocardial oxygen demands by the same amount as using either alone; b) decrease myocardial oxygen demands by an amount greater than if each were used alone; or c) have no effect on myocardial oxygen demand
7605
b) Decrease myocardial oxygen demands by an amount greater that if each were used alone
7606
Q3804:Nifedipine blocks -- channels
7607
calcium
7608
Q3805:In its effects on myocardial oxygen consumption; is Nifedipine similar to Nitrates or B-blockers?
7609
Nitrates (Nifedipine is similar to Nitrates)
7610
Q3806:In its effects on myocardial oxygen consumption; is Verapamil similar to Nitrates or B-blockers?
7611
B-blockers
7612
Q3807:Dose nitroglycerin dilate arteries or veins more?
7613
Veins>>arteries
7614
Q3808:Does nitroglycerin increase or decrease cGMP in smooth muscle?
7615
Increase
7616
Q3809:In industrial exposure to nitroglycerine; weekend withdrawal is characterized by which three symptoms?
7617
Tachycardia; dizziness ; and headache ("Monday disease")
7618
Q3810:Toxic dosage of nitroglycerine causes which three symptoms?
7619
Tachycardia; hypotension; headache
7620
Q3811:Digitalis has its action on which cell membrane transporter?
7621
Na/K ATPase
7622
Q3812:Ryanodine has its action on which channel?
7623
Calcium release channel in the sarcoplasmic receptor
7624
Q3813:Calcium enters cardiac cells through which channel?
7625
Voltage-gated calcium channel
7626
Q3814:Cytoplasmic calcium concentrations in cardiac cells can be decreased by sequestering calcium in the sarcoplasmic reticulum. Calcium enters the SR through which transporter?
7627
Calcium pump in the wall of the SR
7628
Q3815:Calcium channel blockers have their effect on which calcium transporters?
7629
Voltage-gated calcium channel
7630
Q3816:What is digoxin's effect on the intracellular Na+ level?
7631
Increase
7632
Q3817:What is digoxin's effect on the intracellular calcium level?
7633
Increase
7634
Q3818:Name two ECG changes ellicited by digoxin administration
7635
There are 4: increase PR; decrease QT; scooping of ST segment; T-wave inversion
7636
Q3819:Name three symptoms of digoxin toxicity
7637
Nausea; vomiting; diarrhea; blurry vision; arrhythmia
7638
Q3820:Which potentiates the effects of digoxin- hypo- or hyperkalemia?
7639
hypokalemia
7640
Q3821:Which phase of the cardiac action potential do antiarrhythmics decrease the slope of?
7641
Phase 4 depolarization
7642
Q3822:What type of antiarrhythmic is Amiodarone?
7643
Class 1A (Class 1A includes Quinidine; Amiodarone; Procainamide; Disopyramide; "Queen Amy Proclaims Diso's pyramid."
7644
Q3823:Do class 1A antiarrhythmics increase or decrease the effective refractory period; AP duration; and QT interval?
7645
Increase ERP; increase AP duration; increase QT interval
7646
Q3824:What do class 1B antiarrhythmics do to the AP duration?
7647
Decrease AP duration
7648
Q3825:What type of antiarrhythmic is mexiletine?
7649
Class 1B (includes Lidocaine; mexiletine; tocainide)
7650
Q3826:What type of antiarrhythmic is encainide?
7651
Class IC (includes flecainide; encainide; propafenone)
7652
Q3827:What effect do class 1C antiarrhythmics have on the AP duration?
7653
No effect!
7654
Q3828:What does esmolol do to the cAMP in cardiac cells?
7655
decreases cAMP (a beta-blocker)
7656
Q3829:What does atenolol do the calcium currents in cardiac cells?
7657
decreases calcium current (beta-blocker)
7658
Q3830:Timolol decreases the slope of which phase of the cardiac AP cycle?
7659
Phase 4 (a beta-blocker)
7660
Q3831:What does propanolol do the the PR interval?
7661
Increases interval (beta-blocker)
7662
Q3832:Is esmolol a short- or long-acting beta blocker?
7663
short-acting
7664
Q3833:Does amiodarone increase or decrease AP duration?
7665
Increase (K+ channel blocker)
7666
Q3834:Does sotalol increase or decrease the effective refractory period?
7667
7668
Q3835:Does bretylium increase or decrease the QT interval?
7669
7670
Q3836:Name a symptom of sotalol toxicity.
7671
Torsades de pointes (K+ channel blocker)
7672
Q3837:Name three of the symptoms of amiodarone toxicity.
7673
Pulmonary fibrosis; corneal deposits; hepatoxicity; skin deposits resulting in photodermatitis; neurologic effects; constipation; bradychardia; heart block; CHF; hypothyroidism/hyperthyroidism. (Therefore; should check PFTs; LFTs; and TFTs)
7674
Q3838:Does verapamil increase or decrease the conduction velocity of the AV nodal cells?
7675
Decrease (calcium channel blocker)
7676
Q3839:How does diltiazem affect the effective refractory period and the PR interval?
7677
Increases ERP; increases PR (calcium channel blocker)
7678
Q3840:Name a potential use of Mg+ to treat arrhythmias.
7679
To treat torsades de pointes and digoxin toxicity
7680
Q3841:Name a potential use of K+ to treat arrhythmias.
7681
Depress ectopic pacemakers; especially in digoxin toxicity
7682
Q3842:Name a use of adenosine in treating arrhythmias.
7683
To diagnose and abolish AV nodal arrhythmias.
7684
Q3843:What is the effect of cholestyramine on the serum triglyceride level?
7685
Slight increase (cholestyramine is a bile acid resin)
7686
Q3844:What is the effect of colestipol on HDL?
7687
No effect! (colestipol is a bile acid resin)
7688
Q3845:What is the effect of lovastatin on HDL?
7689
Increase (lovastatin is an HMG-CoA reductase inhibitor)
7690
Q3846:Name 2 side effects of pravastatin.
7691
Increase LFTs and cause myositis (prevastatin is an HMGCoA reductase inhibitor)
7692
Q3847:What is the effect of Niacin on HDL?
7693
Increase
7694
Q3848:What are the side effects of clofibrate?
7695
Incease LFTs and cause myositis (Clofibrate is a "Fibrate")
7696
Q3849:Which increases HDL most: simvastatin; niacin; or gemfibrozil?
7697
Niacin
7698
Q3850:Which decreases triglyceride level most: colestipol; Atorvastatin; niacin; or bezafibrate?
7699
Bezafibrate
7700
Q3851:What is the main effect of ezetimibe?
7701
decrease serum LDL (a cholesterol absorption inhibitor)
7702
Q3852:Gemfibrozil increases the activity of which enzyme?
7703
Lipoprotein lipase (which converts VLDL to IDL)
7704
Q3853:What enzyme breaks down membrane lipid into arachidonic acid?
7705
Phospholipase A2
7706
Q3854:What two enzymes are responsible for the production of Hydroperoxides (HPETEs) and Endoperoxidases; respectively from arachidonate?
7707
Lipoxygenase= HPETE; Cyclooxygenases=endoperoxidases
7708
Q3855:What major class of products do HPETEs give rise to?
7709
Leukotrienes
7710
Q3856:What are the 3 major products of Endoperoxidases?
7711
Prostacyclin (PGI); Prostaglandins (PGE; PGF); Thromboxane (TXA)
7712
Q3857:In general what effect do leukotrienes have on bronchial tone?
7713
Leukotrienes in general increase bronchial tone
7714
Q3858:In the arachodonic acid pathway; what two enzymes do corticosteroids block?
7715
Phospholipase A2; COX-2
7716
Q3859:NSAIDs; Acetaminophen and COX-2 inhibitors block which arachadonic acid pathway enzymes
7717
NSAIDs-non-selectively block COX-1 and COX-2; acetaminophen doesn't block COX-1 or COX-2; but instead it may block COX-3 in found in the brain; COX-2 inhibitors block COX-2
7718
Q3860:What are the 4 major effects of Prostacyclin
7719
decrease platelet aggregation; decrease vascular tone; decrease bronchial tone; decrease uterine tone
7720
Q3861:What are the 3 major effects of Prostaglandins
7721
increased uterine tone; decrease vascular tone; decrease bronchial tone
7722
Q3862:What are the 3 major effects of Thromboxane
7723
increase platelet aggregation; increase vascular tone; increase bronchial tone
7724
Q3863:Zileuton is a ________ pathway inhibitor?
7725
Lipoxygenase
7726
Q3864:Zariflukast is associated with what enzymes?
7727
Lekukotrienes
7728
Q3865:Bronchodilation is mediated by what molecule
7729
cAMP
7730
Q3866:Bronchoconstriction is mediated by _________ and ___________
7731
Ach and adenosine
7732
Q3867:How many asthma drug categories are there?
7733
7- (1) nonspecific B-agonists; (2) B2 agonists; (3) Methylxanthines; (4) muscarinic antagonist; (5) cromolyn; (6) corticosteroids; (7) Antileukotrienes
7734
Q3868:What is the only nonspecific B-agonist drug and what are its effects?
7735
Isoprotenerol-relaxes bronchial smooth muscle (B2) and tachycardia (B1) (adverse effect).
7736
Q3869:What are the two B2 selective agonist asthma drugs?
7737
Albuterol- relaxes bronchial smooth muscle (B2); Salmetrol
7738
Q3870:What are the indications for Albuterol and Salmetrol; respectively?
7739
Albuterol- use during acute exarcebation; Salmetrol- longacting agent for prophylaxis
7740
Q3871:what are the notable adverse effects of B2 agonist?
7741
arythmias and tremor
7742
Q3872:B2-agonists activate this enzyme in bronchial smooth muscle that leads to an increase in ________ = bronchodilation
7743
B2 agonists activate adenylate cyclase and increase conversion of ATP to cAMP
7744
Q3873:What are the likely mechanism of action theophylline?
7745
bronchodialation by inhibition phosphodiesterase (PDE); decreasing cAMP hydrolysis and antagnonizing adenosine action
7746
Q3874:Why is usage of theophylline limited?
7747
limited b/c narrow therapeutic index (cardiotoxicity; neurotxicity)
7748
Q3875:What kind of drug is Ipratropium?
7749
muscarinic antagonist
7750
Q3876:How does mechanism of action of Ipratropium?
7751
competitive block of muscarinic receptors= prevention of bronchoconstriction
7752
Q3877:cromolyn works by inhibiting the release of _______ from ______ cell?
7753
prevents release of medicators from mast cells
7754
Q3878:Cromolyn is mainly used for the ______ of athsma and it is not indicated for _______ treatment of athsma?
7755
Used only for prophylaxis; not effective during acute episode. Also; toxicity rare
7756
Q3879:__________and ________ are two major corticosteroids used for treatment of what kind of asthma?
7757
Beclomethasone and prednisone are 1st line therapy for chronic asthma
7758
Q3880:What is the mechanism of action of corticosteroids?
7759
inhibits the synthesis of virtually of cytokines->inactivates NF-KB; the transcription factor that induces the production of TNF-a; amonth other inflammatory agents.
7760
Q3881:Zileuton blocks the conversion of _______ to ________.
7761
zileuton is a 5-lipoxygenase pathway inhibitior. Blocks the conversion of arachidonic acti to leukotrienes
7762
Q3882:Zafirlukast works by_______ ________ ________
7763
bloking leukotriene receptors
7764
Q3883:What the most basic asthma treatment strategy?
7765
avoidance of exposure to antingen (dust; pollen; etc)
7766
Q3884:After exposure to antigen crosslinks IgE on mast cells. This is prevented by the following drugs: _________ and ________
7767
cromolyn and steroids
7768
Q3885:Following allergen exposure mediators are released (ex. _______ and _________). This triggers an ______ asthmatic response characterized by ________ and may be treated with the following 3 asthmatic drug categories to treat the symptoms.
7769
examples of mediators are leukotrienes and histamine. Following allergen exposure an early asthmatic response characterized by bronchoconstriction that can be treated with B-agonsists; methylxanthines; and muscarinic antagonists.
7770
Q3886:Also; mediators elicit a ________ response is which leads to bronchial __________ and is treated with __________.
7771
mediators elicit a late response and this leads to bronchial hyperactivity. This is best treated with steroids.
7772
Q3887:the following questions are from the diagram at the top of the page
7773
7774
Q3888:_____ cells are predominatly found in the antrum and _________ cells are predominatly found in the fundus.
7775
Gastrin cells are predominant in the antrum and parietal cells are predominant in the fundus.
7776
Q3889:What are the 3 main stimuli of acid secretion?
7777
Ach; histamine; gastrin
7778
Q3890:Gastrin stimulates the ECL cells to secrete histamine that stimulates ______ cells. Gastrin also activate the ______ cells to increase expression of _______ that increases ______secretion.
7779
Gastrin stimulates the ECL cells to secrese histamine that stimulates parietal cells. Parietal cells are also activated by gastrin to increase the expression of the H;K ATPase that increases acid secretion.
7780
Q3891:This type of drug acts by inhibiting M1 and M3 receptors on ECL cells and Parietal cells; respectively.
7781
muscarinic antagonists block M1 receptors in ECL cells and M3 receptors in parietal cells.
7782
Q3892:This type of drug inhibits the ability of the ECL cell to stimulate acid secretion by interfering with the _____ receptor.
7783
H2 blocker inhibits the ability of the ECL cell to stimulate acid secretion by interfering with the parietal H2 receptor.
7784
Q3893:The most direct way of inhibiting acid secretion is by using this type of drug which acts on this enzyme.
7785
the most direct way of inhibiting acid secretion is by using proton pump blockers which inhibit the H;K ATPase on parietal cells.
7786
Q3894:____________ acts by binding to the ulcer and increasing its healing. It may interfere with drug absorption in the stomach.
7787
sucralfate binds to the ulcer base and provides physical protection. It allows HCO3- secretion to reestablish pH gradient in the mucus layer.
7788
Q3895:What hormone binds ECL cells and decreases acid secretion?
7789
somatostatin
7790
Q3896:These type of drugs used to decrease pH in the stomach.
7791
antacids.duh.jk. (I was instructed to make a question of every word)
7792
Q3897:____________; ___________; ___________; and ___________ are examples of H2 blockers and they act by (reversibly/irreversibly)
7793
cimetedine; ranitidine; famotidine; nizatidine reversilbly block H2 receptors.
7794
Q3898:This H2 blocker is the only one that has many side effects which include potent inhibition of ______; _____ effects; and _____ renal excretion of creatinine.
7795
cimetedine is a potent inhibitor of P450; it has antiandrogenic effect and decrease renal excretion of creatinine. Other H2 blockers are relatively free of these effects.
7796
Q3899:_________ and _________ (reversibly/irreversibly) inhibit the H/K ATPase in the stomach _______cells.
7797
Omeprazole and Iansoprazole irreversibly inhibit the H/K ATPase in stomach parietal cells
7798
Q3900:Proton pump inhibitors are indicated for peptic ulcer; ________; _______; and _________ syndrome
7799
peptic ulcer; gastritis; esophageal reflux; and Zollinger-Ellison syndrome
7800
Q3901:T/F: Bismuth and sucralfate allow HCO3- secretion.
7801
True: bismuth and sucralfate bind to ulcer base and provide physical protection; and allow HCO3- secretion to reestablish pH gradient in the mucus layer=increased ulcer healing
7802
Q3902:T/F: misoprostol is a PGE2 analog and increases the production and secretion of gastric mucous barrier.
7803
False: misoprostol is a PGE1 analog and it increases the production and secretion of gastric mucous barrier.
7804
Q3903:What are the 3 indications for misoprosol?
7805
prevention of NSAID-induced peptic ulcers; maintains a PDA and used to induce labor
7806
Q3904:In what population is misoprostol contraindicated?
7807
women of childbearing potential (abortifacient). It also casues diarrhea
7808
Q3905:Infliximab is ___________ against ______.
7809
monoclonal antibody to TNFa
7810
Q3906:The clinical indication for Infliximab is:
7811
Crohn's; along with fistula healing
7812
Q3907:T/F: Infliximab can cause respiratory infection; fever; hypotension
7813
TRUE
7814
Q3908:This drug offers both anitbacterial action and antiinflamatory effects. It is used for 2 inflammatory GI diseases ______ and _______.
7815
sulfasalazine: combination of sulfapyridine (antibacterial) and mesalamine (anti-inflammatory effects). It is used for Ulcerative colitis and remission of Crohn's.
7816
Q3909:T/F: Side effects of the above include: malaise; sulfonamide toxicity; neutropenia
7817
false: side effects: malaise; nausea; sulfonamide toxicity
7818
Q3910:___________ is a powerful central-acting antiemetic. It acts by antagonizing the______ receptor.
7819
Ondansetron: is a powerful antiemetic. Think: you will not vomit with ondansetron; so you can go on dancing.
7820
Q3911:T/F used to treat vomiting preoperatively and for cancer chemo therapy pts.
7821
False: it is used to treat vomiting postoperatively.
7822
Q3912:Headache and __________ are side effects
7823
constipation (can't vomit or poop)
7824
Q3913:Antacid overuse can affect:_________; __________; or ______ excretion of other drugs by altering ______ and ______ pH or by delaying gastric _________.
7825
Antacid overuse can affect absorption; bioavailability; or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.
7826
Q3914:Constipation and (hypo/hyper) phosphatemia is seen with overuse of ________________
7827
aluminum hydroxide - Aluminimum amt. of feces
7828
Q3915:Magnesium hydroxide overuse = ___________
7829
diarhea; Mg = Must go to the bathroom
7830
Q3916:Calicium carbonate= hypercalcemia and (increase/decreased) acid
7831
causes hypercalcemia and increased acid.
7832
Q3917:T/F: hyperkalemia can be seen with AlOH; MgOH; CaCO2
7833
False! hypokalemia
7834
Q3918:heparin Catalyzes activation of ____________; decreases ________ and __________. It has a ____t1/2. check PTT
7835
catalyzes the activation of antithrombin III; decreases thrombin and Xa. It has a short t1/2
7836
Q3919:It is used for immediated anticoagulation for pulmonary embolism;_______; _______; MI; and ________. Follow PTT
7837
used for pulmonary embolism; stroke; angina; MI; and DVT.
7838
Q3920:T/F: Is used during pregnancy
7839
true: it is used during pregnancy because it does not cross the placenta.
7840
Q3921:It can cause bleeding;___________; and drug-drug interactions.
7841
thrombocytopenia
7842
Q3922:___________ is used for rapid reversal of heparization (it is a _______ charged molecule that binds the ________ charged heparin)
7843
protamine sulfate is used for rapid reversal of heparinization (it is a positively charged molecule that binds the negatively charged heparin).
7844
Q3923:Newer________________ (enoxaparin) act more on _____; have better bioavailability and 2-4 times longer t1/2. Can be administered subcut and (with/without) lab monitoring.
7845
lower-molecular-weight heparins (enoxaparin) act more on Xa; have better bioavailabitlity and 2-4 times longer half-life. Can be adm. Subcut and without lab monitoring.
7846
Q3924:warfirin (coumandin) Interferes with normal synthesis and gamma-carboxylation of vitamin K-dependent factors ___; ___; ___; and ___; also; ___ and ___ via ______ antagonism.
7847
Interferes with normal synthesis and gamma-carboxylation of vitamin K-dependent clotting factors II; VII; IX; and X; protein C and S via vitamin K antagonism.
7848
Q3925:t1/2 (short/long)
7849
long
7850
Q3926:Used for _______ anticoagulation. Follow PT
7851
WEPT - Warfirin affects the Extrinsic pathway and prolongs PT
7852
Q3927:T/F: is used during pregnacy
7853
False! (warfarin; unlike heparin; can cross the placenta).
7854
Q3928:Toxicity: bleeding; _________; drug-drug interactions
7855
teratogenic
7856
Q3929:Heparin is a (large/small) _____charged acicid polymer while Warfarin is (large/small) (charged/neutral) molecule
7857
Heparin is a large negatively charged acidic polymer while Warfarin is a small neutral charged lipid-soluble molecule
7858
Q3930:T/F: Heparin is given orally while warfarin is given SC/IV
7859
False! Heparin is given IV/SC and warfarin is give oral
7860
Q3931:Site of action: heparin _________; warfarin ______
7861
heparin's site of action is the blood; warfarin's site of action is the liver (synthesises clotting factors)
7862
Q3932:Onset of action of _________ is slow; the onset of action of ______ is rapid
7863
onset of action of heparin is rapid (secs) and the onset of action of warfarin is slow; limitd by t1/2 of normal clotting factors.
7864
Q3933:Warfarin works by imparing the synthesis of _______ dependent factors __; ___; ___; and ___ also _____; and ____; heparin activates _____; ____ and ___
7865
Warfarin works by imparing the synthesis of vitamin K dependent factors II; VII; IX; and X also protein S and protein C; heparin activates ATIII; Iia (thrombin) and Xa.
7866
Q3934:Heparin 's duration of action is (acute/chronic); warfarin's duration of action is (actue/chronic)
7867
Heparin's duration of action is actute and warfarin's duration of action is chronic.
7868
Q3935:Tx of acute OD: Heparin = _________; warfarin=______
7869
Tx of heparin OD is protamine sulfate; Tx of warfarin= IV vit. K and fresh frozen plasma.
7870
Q3936:Warfarin is monitored by _________ while Heparin is monitored by ___________.
7871
Warfrin is monitored by PT (extrinsic pathway) (WEPT) and heparin is monitored by PTT (intrinsic pathway)
7872
Q3937:plasmin is the major ___________ enzyme. It breaks down both _______ and _______
7873
fibrinolytic enzyme. It accelerates breaks down of both fribin and fibrinogen yielding fibrin splip products and degradation products; respectively.
7874
Q3938:Fibrinogen is converted to fibrin by _________
7875
thrombin
7876
Q3939:tPA and urokinase promote the converson of ______ to ________ thereby increasing fibrinolysis.
7877
plasminogen to plasmin
7878
Q3940:Various stimuli activate a blood proactivator to a blood activator that promotes conversion of _________ to blank thereby increasing fibrinolysis
7879
plasminogen to plasmin
7880
Q3941:Aminocaproic acid:____________ fibrinolysis.
7881
inhibits fibrinolysis by inhibition of plasminogen conversion to plasmin.
7882
Q3942:4 examples of thrombolytics include: ________; _________; _____________; and ___________
7883
Streptokinase; urokinase; tPA(altepalse); APSAC (anistreplase)
7884
Q3943:work by directly or indirectly aiding the conversion of ___________ to __________; which cleaves ______ and ________ clots. tPA specifically coverts _______________ to plasmin
7885
Directly or indirectly aid conversion of plaminogen to plasmin; which cleaves thrombin and fribrin clots. It is claimed that tPA specifically coverts fribrin-bound plasminogen to plasmin.
7886
Q3944:T/F: clinical use is for DVTs
7887
False: used for early MI
7888
Q3945:pts. receiving this medication are at most risk for: ______
7889
bleeding
7890
Q3946:When a break in the endothelium occurs _________ and _________ are exposed.
7891
collagen and vWF
7892
Q3947:Platelets are activated by binding to the above macromolecules. The two structures expressed by the platelets involved in this process are __________ and _________ and they bind to _________ and __________; repectively
7893
Platelets bind to collagen and vWF. The two structures expressed by platelets that are involved in this process are GP 1a and GP 1b. GP 1a and GP 1b bind to collagen and vWF; respectively.
7894
Q3948:After platelet activation _________ is expressed on their surface. What is the role of this structure?
7895
after platelets are activated they express GP IIb/IIIa. This molecule is important in platlelet-platelet aggregation.
7896
Q3949:_________ and _________ interaction is needed in order for platelet aggregation to occur.
7897
GP IIb/IIIa and fribinogen
7898
Q3950:5-HT; _______; and ________ are molecules that play a role in the glycoprotein expression of activated platelets.
7899
5-HT; ADP; and TxA2 are molecules that play a role in the glycoprotein expression of activated platelets.
7900
Q3951:Aspirin acts by inhibiting production of ________ that in turn inhibits glycoprotein expression in activated platelets.
7901
TxA2
7902
Q3952:ADP production is inhibited by the drug _________.
7903
ticlopidine
7904
Q3953:This antibody drug targets the _______ on platelets.
7905
Abciximab
7906
Q3954:Copidogrel; ticlopidine T/F: inhibits platele aggregation by irreversibly inhibiting the ADP pathway involved in the binding of fibrinogen
7907
TRUE
7908
Q3955:It is used for ______ ________ syndrome; coronary _______; and it has been shown to decrease the incidence or recurrence of___ ____.
7909
it is used for acute coronary syndrome; coronary stenting. Decreases incidence or recurrence of thrombotic stroke
7910
Q3956:Ticlopidine is associated with_________ as a side effect.
7911
Ticlopidine causes neutropenia and it is reserved for those who cannot tolerate aspirin.
7912
Q3957:Abciximab binds to __________ on activated platelets.
7913
gp IIb/Iia
7914
Q3958:It is used for ___________ and ________ _________ ___________ ___________
7915
acute coronary syndromes and percutanous transluminal coronary angioplasty
7916
Q3959:toxiciites are _______ and ________
7917
bleeding and thrombocytopenia
7918
Q3960:It ________ and (reversibly/irreversibly) inhibits COX1 and COX2 to prevent the conversion of _______ to prostaglandins.
7919
acetilates and irreversably inhibits COX-1 and COX-2
7920
Q3961:T/F: aspirin has an effect of PT; PTT
7921
false it has no effect
7922
Q3962:What are the 4 A's of aspirin and NSAIDS in general
7923
Antipyretic; Analgesic; Anti-inflam; antiplatelet
7924
Q3963:Important toxicities include _________; bleeding; hyperventilation; __________- in children; and CN ____ toxicity
7925
gastric ulceration; bleeding; hyperventilation; Reyes syndrome and tinnitus (CNVIII).
7926
Q3964:Hydrocortisone; prednisone; triamcinolone; dexamtasone; bleclomethasone are examples of what kind of drugs?
7927
Glucocorticoid
7928
Q3965:Glucocorticoids decrease the production of ___ and ____
7929
Leukotrienes and prostanglandins
7930
Q3966:To treat Addison's disease; inflammation; immune suppression; asthma; use ____
7931
Glucocorticoids
7932
Q3967:An important side-effect of Glucocortioid usage is ____
7933
Iatrogenic Cushing's Syndrome
7934
Q3968:Buffalo hump; moon facies; truncal obesity; muscles wasting; thin skin; easy bruisability; osteoporosis; adrenocortical atrophy; peptic ulcers characterize what syndrome?
7935
Cushing's Syndrome
7936
Q3969:Which two drugs inhibit cGMP phosphodiesterase; leading to smooth muscle relaxation in the corpus cavernosum and penile erection?
7937
Sildenafil and Verdenafil --they fill the penis
7938
Q3970:What class of drugs are used tto treat erectile dysfunction
7939
cGMP Inhibitors
7940
Q3971:CGMP inibitors taken with ____have a high risk of liofe-threeatening hypotension
7941
nitrates
7942
Q3972:Which drugs is a partial agonist of estrogen recpetors in the pituitary gland; stimulating increase in LH and FSH; which stimulates ovulation to treat infertility
7943
clomiphene
7944
Q3973:Clomiphene's side effects include:
7945
Hotflashes; ovarian enlargment; multiple simultaneous pregnancies; visual disturbances
7946
Q3974:What abortifacient is a competitite inhibitor of preogestins at progesterone recpetor and may lead to heavy menstrual-like bleeding?
7947
Mifepristone (RU486)
7948
Q3975:The advantage of this drug is that it is reliable; decreases incidence of ectopic pregnancy; decreases risk of pelvic infections; and regulates menses; however it also puts you in a hypercoagulable stat and may increase your trigylcerides; weight; and blood pressure
7949
Oral Contracpetices - syntheitc progestins/estrogen
7950
Q3976:____is converted to uric acid which leads to gout
7951
Xanthine (converted from excess purines)
7952
Q3977:This drug depolymerizes microtubules; impairing leukocyte chemotaxis and degranulation; and used to treat acute gout
7953
Colchicine
7954
Q3978:This drugs inhibits reabsorption of uric acid and used to treat chronic gout
7955
Probenecid
7956
Q3979:This drug is used to treat chronic gout; but also inhbits secretion of penicillin
7957
Probenecid
7958
Q3980:This drugs inhibits xanthine oxidase decreasing the conversion fo xanthine to uric acid
7959
Allopurinol
7960
Q3981:What are the cell cycle specific oncologic drugs
7961
antimetabolites; plant alkaloids; stroid hormones; bleomycin; paclitaxel; etoposide
7962
Q3982:What are the cell cycle Nonspecific oncologic drugs?
7963
alkylating agents and antibiotics
7964
Q3983:____is an S-phase-specific anti-metabolite that is an folic acid analog that inhibits dihydrofolate reducate decreasing dTMP(thymidine and purines) and decreaing DNA/prtein synthesis.
7965
Methotrexate
7966
Q3984:____is an S-phase-specific anti-metabolite that is a pyrmidine analog which complexed to folic acid; inhibiting thymidylate synthase; decreasing dTMP and decreasing DNA/protein synthesis
7967
5-Fluorouracil (5-FU)
7968
Q3985:Myelosuppression by methotrxate is reversible with ____
7969
leucovorin (folinic acid) rescue
7970
Q3986:Which drug blocks purine synthesis and is used to treat leukemias; lymphomas (not CLL or Hodgkins)
7971
6-mercaptopurine (6-MP)
7972
Q3987:Which drug alkylates DNA and is used to treat CML?
7973
Busulfan
7974
Q3988:Which drug inhibits DNA polymerase and is used to treat AML?
7975
cytarabine
7976
Q3989:This drug used to treat Leukemias and Lymphomas is metaboilized by xanthine oxidase
7977
6-mercaptopurine (6-MP)
7978
Q3990:Used to treat leukemias; lymphomas; choricarcinoma; sacromas; rheumatoid arthritis; psoriasis; and can be an abortifacient; it may lead to myelosuppression
7979
Methotrexate
7980
Q3991:Used to treat colon cancer and other solid tumors; basal cell carcinoma (topically)
7981
5-Fluorouracil (5-FU)
7982
Q3992:Myelosuppression by 5-FU is ______
7983
Not reversible
7984
Q3993:This drug used to treat AML may lead to leukopenia; thrombocytopenia; megaloblastic anemia?
7985
cytarabine
7986
Q3994:This drugs used to treat CML may lead to pulmonary fibrosis and hyperpigmentation?
7987
Busulfan
7988
Q3995:____is an alkylating agent acivated by liver that covalently x-links DNA at guanine N-7; and is used to treat non-hodgkin's lymphoma; breast/ovarian carcinomas
7989
cyclophosphamides
7990
Q3996:____ alkylates DNA after bioactivation and can cross the BBB and treats brain tumors (glioblastoma multiforme)
7991
Nitrosoureas (Carmustine; lomustine; semustine; streptozocin)
7992
Q3997:____acts like an alkylating agent; x-linking via hyrdolysis of Cl and platinum; used to treat testicular; bladder; lung carcinomas
7993
Cisplatin
7994
Q3998:This alkylating agent can cause myelosuppression and hemorhagic cystitis
7995
cyclophosphamides
7996
Q3999:This combination of drugs is used to treat Hodgkin's and myelomas; sarcomas; and solid tumors (breast; ovary; lung)
7997
ABVD: Adriamycin; Bleomycin; Vinblastine; Dacarbazine
7998
Q4000:____noncovalently intercalates in DNA; creating breaks to decrease replication and transcription
7999
Doxorubicin (adriamycin)
8000
Q4001:____intercalates DNA strands and induces free radical fromation which causes strand breaks
8001
Bleomycin; Dactinomycin
8002
Q4002:Which drugs causes cardiotoxicity; alopecia; and myelosuppression?
8003
Doxorubicin (adriamycin)
8004
Q4003:Which drug is used to trat oat cell carcinoma of the lung and prostate/testicular carcinoma?
8005
Etoposide
8006
Q4004:This combination of drugs is used to treat lymphoma; CLL; Hodgkin's; Wilm's tumor; choriocarcinoma
8007
MOPP (Mustargen; Oncovin (Vincristine); Procarbazine (Matulane); Prednisone)
8008
Q4005:Which glucocorticoid may trigger apoptosis and may even work on nondividing cells
8009
Prednisone
8010
Q4006:This drug is a G2-phase specific inhibitor of Topisiomerase II; leaving double strand breaks in DNA following DNA replication
8011
Etoposide
8012
Q4007:This drug used to treat testicular cancer and lymphomas may cayse pulmonary fibrosis; skin chnages; and myelosuppression
8013
Bleomycin; Dactinomycin
8014
Q4008:This drugs used as an immunosuppressant and in lymphomas may cause acne; osteoporosis; hypertension; peptic ulcers; hyperglycemia; psychosis?
8015
Prednisone
8016
Q4009:____is an estrogen receptor mixed agonist/antagonist that blocks the binding of estrogen to ER+ cells.
8017
Tomoxifen/Raloxifene
8018
Q4010:____is n M-phase-specific alkaloid that binds to tubulin and blocks polymerization of microtubules; preventing spindle formation
8019
Vincristine and Vinblastine
8020
Q4011:____is an M-phase-specific agen that binds to tubulin and hyperstabilizes the polymerized microtubules; so that the mitotic spindle cannot break down
8021
Paclitaxel
8022
Q4012:What drugs is used to treat breast cancer; but may increas the risk of endometrial carcinomas and hot flashes
8023
Tomoxifen
8024
Q4013:Side-effects of Vinblastine include.
8025
VinBASTine BLASTs Bone Morraow; causing myelosuppression; as well as neurotoxicity and paralutic ileus.
8026
Q4014:Side effects of Paclitaxel include.
8027
Myelosuppression and hypersensitivity
8028
Q4015:Which drug binds to cyclophilins; blocking differentiation and activation of T cells mainly by inhibiting IL2 production
8029
cyclosporine
8030
Q4016:This antimetabolite derivative of 6-mercaptopurine interferes with the metabolism and synthesis of nucleic acid; therefore toxic to proliferating lymphocytes
8031
azathioprine
8032
Q4017:This potent immunosuppressive drug binds to the FK-binding protein and inhibits secretion of IL2 and other cytokines
8033
tacrolimus (FK506)
8034
Q4018:This drug is used to suppress organ rejection after transplantation; but may predispose patient to viral infections and lymphoma
8035
cyclosporine
8036
Q4019:Azaothioprine is used to in what setting?
8037
Kidney transplants; autoimmune disorders (glomerulonephritis; hemolytic anemia)
8038
Q4020:Recombinant Cytokine- Aldesleukin (interleukin-2) is used for?
8039
Renal cell carcinoma; metastatic melanoma
8040
Q4021:Recombinant Cytokine- Erythropoietin (epoetin) is used for?
8041
anemia
8042
Q4022:Recombinant Cytokine- Filgrastim is used for?
8043
Recovery of Bone Marrow; it is a granulocyte colony stimulating factor
8044
Q4023:Recombinant Cytokine- alpha interferon is used for?
8045
Hep B/C; Kaposi's sarcoma; leukemia; malgnant melanoma
8046
Q4024:Recombinant Cytokine- beta interferon is used for?
8047
Multiple Sclerosis
8048
Q4025:Recombinant Cytokine- gamma interferon is used for?
8049
Chronic Granulomatous disease
8050
Q4026:Recombinant Cytokine- oprelvekin (interleukin2) is used for?
8051
Thrombocytopenia
8052
Q4027:Recombinant Cytokine- sargamostim is used for?
8053
Recovery of Bone Marrow (it is a granulocyte-macrophage colony stimulating factor)
8054
Q4028:Recombinant Cytokine- thrombopoietin is used for?
8055
Thrombocytopenia
8056
Q4029:What is the antidote for acetaminophen toxicity/overdose
8057
N-acetylcysteine
8058
Q4030:What is the antidote for salicylates toxicity/overdose
8059
Alkanize urine/dialysis
8060
Q4031:What is the antidote for antichoinesterase toxicity/overdose
8061
Atropine; pralidoxime
8062
Q4032:What is the antidote for antimuscarinic/anticholinergic agents toxicity/overdose
8063
physostigimine salicylate
8064
Q4033:What is the antidote for Beta-blockers toxicity/overdose
8065
glucagon
8066
Q4034:What is the antidote fordigitalis toxicity/overdose
8067
Stop digitalis; Normalize K+; lodpcaine; anti-digitialis Fab Fragments; Magnesium
8068
Q4035:What is the antidote for lead toxicity/overdose
8069
CaEDTA; dimercaprol; succimer; penicillamine
8070
Q4036:What is the antidote for iron toxicity/overdose
8071
Deferoxamine
8072
Q4037:What is the antidote for aresnic/mercury/gold toxicity/overdose
8073
Dimercaprol (BAL); succimer
8074
Q4038:What is the antidote for copper; arsenic; gold toxicity/overdose
8075
Penicillamine
8076
Q4039:What is the antidote N-acetylcysteine used to treat?
8077
Acetaminophen toxicity/overdose
8078
Q4040:What is the antidote for cyanide toxicity/overdose
8079
nitrite; hydroxocobalamin; thiosoulfate
8080
Q4041:What is the antidote for methemoglobin toxicity/overdose
8081
methylene blue
8082
Q4042:What is the antidote glucagon used to treat?
8083
Beta-blocker toxicity/overdose
8084
Q4043:What is the antidote for carbon monoxide toxicity/overdose
8085
100% oxygen; hyperbaric oxygen
8086
Q4044:What is the antidote atropine used to treat?
8087
anticholinesterase toxicity/overdose
8088
Q4045:What is the antidote for methanol toxicity/overdose
8089
Ethanol; dialusis; fomepizole
8090
Q4046:What is the antidote for opiods toxicity/overdose
8091
Nalozone/naltrexone
8092
Q4047:What is the antidote for ethylene glycol toxicity/overdose
8093
Ethanol; dialusis; fomepizole
8094
Q4048:What is the antidote for benzodiazepines toxicity/overdose
8095
Flumazenil
8096
Q4049:What is the antidote for (TCA) Tricyclic Antidepressants toxicity/overdose
8097
NaHCO3
8098
Q4050:What is the antidote for Heparin toxicity/overdose
8099
Protamine
8100
Q4051:What is the antidote Deferoxamine used to treat?
8101
Iron toxicity/overdose
8102
Q4052:What is the antidote for warfarin toxicity/overdose
8103
vitamin K; fresh frozen plasma
8104
Q4053:What is the antidote Naloxone/naltrexone used to treat?
8105
opioid toxicity/overdose
8106
Q4054:What is the antidote for tPA/streptokinase toxicity/overdose
8107
aminocaproic acid
8108
Q4055:What is the antidote Physostigmine salicylate used to treat?
8109
Antimuscarinic/anticholinergic agents toxicity/overdose
8110
Q4056:What is the antidote Flumazenil used to treat?
8111
Benzodiazepine toxicity/overdose
8112
Q4057:What is the antidote Protamine used to treat
8113
Heparin toxicity/overdose
8114
Q4058:Children living in old houses might eat the paint chips which could cause ____
8115
Lead Poisoning
8116
Q4059:Signs of Lead poisoning include:
8117
Lead Lines on gingivae and epiphyses of Long bones; Encephalopathy and Erythrocyte Basophilic stippling; Abdominal colic and sideroblastic Anemia; Wrist and Foot Drop
8118
Q4060:1st line of Treatment for Lead Poisoning include
8119
Dimercaprol and EDTA
8120
Q4061:Weak acids; such as phenobarbitol; methotreaxate; aspirin; alkanize urine with ____ to increase clearance
8121
bicarbonate
8122
Q4062:Weak bases; such as amphetamines; acidify urine with NH4Cl to ____ clearance
8123
increase
8124
Q4063:AUTHOR
8125
Lakshmi Swamy
8126
Q4064:Drugs causing Pulmonary fibrosis (3)
8127
bleomycin; amiodarone; busulfan
8128
Q4065:Drugs causing Hepatitis (2)
8129
isoniazid; halothane
8130
Q4066:Drugs causing Focal to massive hepatic necrosis (4)
8131
halothane; valproic acid; acetaminophen; amanita phalloides
8132
Q4067:Drugs causing Anaphylaxis (1)
8133
penicillin
8134
Q4068:Drugs causing SLE-like syndrome (4). [mnemonic: it's not HIPP to have lupus]
8135
hydralazine; INH; procainamide; phenytoin
8136
Q4069:Drugs causing Hemolysis in G6PD-deficient patients (8)
8137
sulfonamides; INH; aspirin; ibuprofen; primaquine; nitrofurantoin; pyrimethamine; chloramphenicol
8138
Q4070:Drugs causing Thrombotic complications (1 class)
8139
OCPs (e.g. estrogens and progestins)
8140
Q4071:Drugs causing Adrenocortical insufficiency (withdrawal of what class of drugs causes adrenocortical insufficiency?)
8141
withdrawal of glucocorticoids causes hypothalamic-pituitaryaxis suppression
8142
Q4072:Drugs causing Photosensitivity reactions (3) [mnemonic: SAT for a photo]
8143
Sulfonamides; amiodarone; tetracycline
8144
Q4073:Drugs causing Induce P-450 system (6)
8145
barbiturates; phenytoin; carbamazepine; rifampin; griseofulvin; quinidine
8146
Q4074:Drugs causing Inhibit P-450 system (6; including one fruit)
8147
cimetidine; ketoconazole; grapefruit; erythromycin; INH; sulfonamides
8148
Q4075:Drugs causing Tubulointerstitial nephritis (5)
8149
sulfonamides; furosemide; methicillin; rifampin; NSAIDs (except aspirin)
8150
Q4076:Drugs causing Hot flashes (1)
8151
Tamoxifen
8152
Q4077:Drugs causing Cutaneous flushing (4)
8153
niacin; Ca++ channel blockers; adenosine; vancomycin
8154
Q4078:Drugs causing Cardiac toxicity (2)
8155
doxorubicin (adriamycin); daunorubicin
8156
Q4079:Drugs causing Agranulocytosis (3; all start with letter C)
8157
clozapine; carbamazepine; colchicine
8158
Q4080:Drugs causing Stevens-Johnson syndrome (3)
8159
ethosuximide; sulfonamides; lamotrigine
8160
Q4081:Drugs causing Cinchonism (2)
8161
quinidine; quinine
8162
Q4082:Drugs causing Tendonitis; tendon rupture and cartilage damage (kids) (1)
8163
fluoroquinolones
8164
Q4083:Drugs causing Disulfiram-like reaction (4)
8165
metronidazole; certain cephalosporins; procarbazine; sulfonylureas
8166
Q4084:Drugs causing Otoxicity and nephrotoxicity (3)
8167
aminoglycosides; loop diuretics; cisplatin
8168
Q4085:Drugs causing Drug-induced Parkinson's (4)
8169
haloperidol; chlorpromazine; resperine; MPTP
8170
Q4086:Drugs causing Torsades de pointes (two subclasses of antiarrhythmics)
8171
Class III (sotalol); class IA (quinidine) antiarrhythmics
8172
Q4087:Drugs causing Aplastic anemia (3)
8173
chloramphenicol; benzene; NSAIDs
8174
Q4088:Drugs causing Neuro/nephrotoxicity (1)
8175
polymyxins
8176
Q4089:Drugs causing Pseudomembranous colitis (2)
8177
clindamycin; ampicillin
8178
Q4090:Drugs causing Gynecomastia (5) [mnemonic: Some Drugs Create Awesome Knockers]
8179
spironolactone; digitalis; cimetidine; chronic Alcohol use; estrogens; ketoconazole
8180
Q4091:Drugs causing Atropine-like side effects (1)
8181
tricyclics
8182
Q4092:Drugs causing Cough (1)
8183
ACE inhibitors (losartan --> no cough)
8184
Q4093:Drugs causing Gingival hyperplasia (1)
8185
phenytoin
8186
Q4094:Drugs causing Diabetes insipidus (1)
8187
lithium
8188
Q4095:Drugs causing Tardive dyskinesia (1)
8189
antipsychotics
8190
Q4096:Drugs causing Fanconi's syndrome (1)
8191
tetracycline
8192
Q4097:Drugs causing Gray baby syndrome (1)
8193
chloramphenicol
8194
Q4098:Drugs causing Extrapyramidal side effects (3)
8195
chlorpromazine; thioridazine; haloperidol
8196
Q4099:Drugs causing Osteoporosis (2)
8197
corticosteroids; heparin
8198
Q4100:Ethylene glycol is converted to ------- ------ by alcohol dehydrogenase. This product can lead to acidosis and nephrotoxicity.
8199
oxalic acid.
8200
Q4101:Alcohol dehyrogenase also converts methanol to formaldehyde and formic acid; which can cause severe ----and damage to the -------.
8201
acidosis. retina
8202
Q4102:Ethanol competes with ethylene glycol and methanol (if present) for alcohol dehydrogenase. ADH action on EtOH produces -------.
8203
acetaldehyde
8204
Q4103:What symptoms does acetaldehyde cause?
8205
nausea; vomiting; headache; hypotension
8206
Q4104:Acetaldehyde itself can be metabolized by acetaldehyde dehydrogenase to ----- -----.
8207
acetic acid.
8208
Q4105:Acetaldehyde dehydrogenase is inhibited by what drug?
8209
disulfiram.
8210
Q4106:Clinical use of echinacea
8211
common cold
8212
Q4107:Clinical use of ephedra
8213
as for ephedrine
8214
Q4108:Clinical use of feverfew
8215
migraine
8216
Q4109:Clinical use of ginko
8217
intermittent claudication
8218
Q4110:Clinical use of kava
8219
chronic anxiety
8220
Q4111:Clinical use of milk thistle
8221
viral hepatitis
8222
Q4112:Clinical use of saw palmetto
8223
benign prostatic hyperplasia
8224
Q4113:Clinical use of St. John's wort
8225
mild to moderate depression
8226
Q4114:Clinical use of dehyroepiandrosterone
8227
symptomatic improvement in females with SLE or AIDS
8228
Q4115:Clinical use of Melatonin
8229
jet lag; insomnia
8230
Q4116:echinacea toxicity
8231
GI distress; dizziness; and headache
8232
Q4117:ephedra toxicity
8233
CNS and cardiovascular stimulation; arrhythmias; stroke and seizures at high doses.
8234
Q4118:feverfew toxicity
8235
GI distress; mouth ulcers; antiplatelet actions
8236
Q4119:ginko toxicity
8237
GI distress; anxiety; insomnia; headache; and antiplatelet actions
8238
Q4120:kava toxicity
8239
GI distress; sedation; ataxia; hepatotoxicity; phototoxicity; dermatotoxicity
8240
Q4121:milk thistle toxicity
8241
loose stools
8242
Q4122:saw palmetto toxicity
8243
GI distress; decreased libido; hypertension
8244
Q4123:St. John's wort toxicity
8245
GI distress and phototoxicity; serotonin syndrome with SSRIs
8246
Q4124:dehyroepiandrosterone toxicity
8247
Androgenization (premenopausal women); estrogenic effects (postmenopausal); feminization (young men)
8248
Q4125:Melatonin toxicity
8249
Sedation; suppresses midcycle LH; hypoprolactinemia
8250

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IVMS Pharmacology Flash Facts

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Pharmacology Flash Facts

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Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Q0003:Drug Metabolism: Phase I v II

Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Q0005:Elimination constant (Ke)

Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Q0007:Stead State Plasma Concentration (Css)

Pharmacology Flash Facts

elimination = rate of administration;Css = R/(Vd x Ke) = R/CL;R = infusion rate (amount/time)

Pharmacology Flash Facts

Q0008:Loading & Maintenances doses

Pharmacology Flash Facts

Loading dose = Vd x Cp/F;Maintenance = Cp x CL/F;Cp = target plasma Css

Pharmacology Flash Facts

Q0009:Pharmacodynamics: Efficacy v. Potency

Pharmacology Flash Facts

Pharmacology Flash Facts

Q0010:Pharmacodynamics: antagonists and partial agonists

Pharmacology Flash Facts

Pharmacology Flash Facts

Q0011:Urine pH - fx on drug elimination

Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Q0013:Maximum dosing interval (tau-max)

Pharmacology Flash Facts

Concentration constrained dosing;tau-max = ln(Cmax/Cmin)/k

Pharmacology Flash Facts

Q0014:(amount of drug)/(fluid compartment concentration)

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Pharmacology Flash Facts

Q0015:protein bound drugs;liver and kidney disease;pharmacodynamic variable altered?

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Pharmacology Flash Facts

Pharmacology Flash Facts

Vd = drug amount/drug concentration

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Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Pharmacology Flash Facts

Q0019:10% remaining concentration;# half lives?

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Pharmacology Flash Facts

Q0020:12.5% remaining concentration;# half lives?

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Pharmacology Flash Facts

Q0021:25% remaining concentration;# half lives?

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Pharmacology Flash Facts

Pharmacology Flash Facts

Loading dose = Cp*Vd/F

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Pharmacology Flash Facts

Maintanence Dose = Cp*CL/F;Cp= target [drug];F = bioavailability

Pharmacology Flash Facts

Q0024:change in loading dose with renal/hepatic disease