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450 Cards in this Set
- Front
- Back
What drugs are effective in treating Pseudomonas?
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FAT CAP = Ticercillin/Carbenacillin/Piperacillin, Cefipime, Aztreonam, Aminoglycosides, Fluoroquinolones, Polymyxins (topical agent)
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Ceftazadime good for...
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Pseudomonas
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Ceftriaxone good for...
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Neisseria
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Drugs that cause a disulfuram-like rxn?
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Metronidazole, Cephalosporins, Procarbazine, 1st gen Sulfonylureas (MCPS)
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Drugs that cause photosensitivity?
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SAT for photo (Sulfonamides, Amiodarone, Tetracycline)
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Drugs that cause Stevens-Johnson syndrome?
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PASS to Steve Johnson (Penicillins, Allopurinol, anti-Seizure drugs, Sulfonamides)
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gray man syndrome?
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amiodarone
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red man syndrome?
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vancomycin
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linezolid
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bind 23s rRNA; USE = MRSA, VRE
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Aminoglycosides
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bind 30s on initiation complex --> misreading; USE = Gram- rods; AE = Nephrotoxic (w/ cephs), Ototoxic (w/ loop diuretics), Teratogen
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Which drugs have oto-/nephrotoxicity as side effects?
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CLAV (Cisplatin, Loop diuretics, Aminoglycosides, Vancomycin)
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What important side effects do patients on tetracycline experience?
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discoloration of teeth/bone growth halting (children), photosensitivity, GI upset
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Tetracycline
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bind to 30S (prevent aa-tRNA attach); USE = VACUUM THe BedRoom
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Macrolides
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Bind 23s rRNA (of 50S); USE = PUS (atypical Pneumonia, URIs, STDs); AE = GI upset, QT prolongation, eosinophilia
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Chloramphenicol
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Binds 50S peptidyltransferase; USE = meningitis; AE = gray-baby, anemia (dose-dep), aplastic anemia (dose-ind)
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Clindamycin
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Binds 50S; USE = anaerobic ABOVE diaphragm; AE = C. diff overgrowth, fever, diarrhea
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TMP-SMX
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Inhibit dihydropteroate synthetase & DHFR; USE = UTI, PCP, Salmonella, Shigella; AE = leukopenia, megaloblastic anemia
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Which drugs elicit sulfa allergy?
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celecoxib, probenicid, thiazide diuretics, sulfa drugs, acetazolamide, furosemide
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Fluoroquinolones
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inhibit DNA gyrase; USE = Pseudomonas, Neisseria, Gram- rod UTIs/GI infections; AE = tendonitis, tendon rupture, damages cartilage (children/fetus), GI upset, superinfection
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Which antibiotics should you not take with milk or antacids?
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fluoroquinolones & tetracyclines
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Metronidazole
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creates free radicals; USE = GET GAP; AE = disulfuram-like, metallic taste
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Polymyxins
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disrupt osmotic properties of membrane; USE = Gram- resistant (topical only); AE = neurotoxic/nephrotoxic
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Nitrofurantoin
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reduced by bacteria to toxic intermediates; USE = UTIs (E. coli, S. saprophyticus); AE = nausea, flatulence (safe in pregnancy)
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Streptogramins
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A binds 50S & B prevents protein extension (premature termination); USE = MRSA, VRE; AE = hepatotoxic, C. diff overgrowth
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What drugs affect anaerobes?
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MIC (metronidazole, Imipenem/cilistatin, Clindamycin)
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What drug increases nephrotoxicity of aminoglycosides? how about ototoxicity?
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cephalosporins; loop diuretics
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Penicillin G
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[IV] binds PBP and inhibit transpeptidase; USE = Gram+, syphilis; AE = hypersensitivity
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Methicillin
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binds PBP --> weakens wall; USE = S. aureus; AE = interstitial nephritis
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Ampicillin
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binds PBP --> weakens wall; USE = HELPS (H. flu, E. coli/Enterococci, Listeria, Proteus, Salmonella); AE = ampicillin rash (w/ EBV), C. diff overgrowth
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Amoxicillin
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[greater ORAL] binds PBP --> weakens wall; USE = HELPS (H. flu, E. coli/Enterococci, Listeria, Proteus, Salmonella); AE = ampicillin rash (w/ EBV), C. diff overgrowth
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Ticarcillin
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binds PBP --> weakens wall; USE = Pseudomonas; AE = hypersensitivity rxn
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What drug do you use with antipseudomonals?
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Clavulonate/sulbactam/tazobactam (B-lactamase inhibitor) --> w/ ticarcillin, carbenicillin, piperacillin
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How might you treat syphilis?
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Penicillin G (IV)
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Toxicity caused by cephalosporins?
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disulfuram-like rxn, vit K deficiency, hypersensitivity rxn
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1st gen cephs
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cefazolin, cephalexin; USE = Gram+ cocci, PEcK
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2nd gen cephs
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cefoxitin, cefuroxime; USE = Gram+ cocci, HEN PEcKS
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3rd gen cephs
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ceftazadime, ceftriaxone, cefdinir; USE = Pseudomonas, Neisseria, otitis media (cefdinir)
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4th gen cephs
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cefipime; USE = Pseudomonas, Gram+
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Aztreonam
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binds PBP3 (inhibits cell wall); USE = Gram- rods; good for penicillin allergy or renal-insufficiency
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Imipenem
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binds PBP; USE = Gram+ cocci, Gram- rods, anaerobes; AE = seizures, GI upset, skin rash
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Vancomycin
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binds D-ala D-ala; USE = Gram+ only; AE = Nephro-/Ototoxic, Thrombophlebitis, red-man syndrome
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30S inhibitors
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buy AT 30 (aminoglycosides, tetracyclines)
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50S inhibitors
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CCELL at 50 (clindamycin, chloramphenical, erythromycin, linezolid, lincomycin)
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Neurotransmitter changes in Alzhemiers
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dec ACh
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|
bacteriostatic
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ECSTaTiC (erythromycin, clindamycin, SMX, TMP, tetracyclines, Chloramphenicol)
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Neurotransmitter changes in Huntingtons
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dec ACh & GABA
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bactericidal
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Very Fucking Proficient At Cell Murder (Vanc, Fluoroquinolones, Penicillins, Aminoglycosides, Cephs, Metronidazole)
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Neurotransmitter changes in mania
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inc NE, dopamine, 5HT
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How do you reduce red-man syndrome?
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pretreat with antihistamines or slow infusion rate
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Neurotransmitter changes in depression
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dec NE, dopamine, 5HT
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Neurotransmitter changes in Parksinons
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dec dopamine, inc ACh & 5HT
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Neurotransmitter changes in anxiety
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inc NE, dec GABA, 5HT
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Neurotransmitter changes in Schizophrenia
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inc dopamine
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high potency typical antipsychotics
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haloperidol, fluphenazine, thiothixene (extrapyramidal SEs)
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low potency typical antipsychotics
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chlorpromazine, thoridazone (anticholinergic/antihistamine/a blockade SEs)
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Typical antipsychotics
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block D2; USE = schizophrenia (+), Tourettes, psychosis; AE = hyperprolactinemia, EPS (high potency), anticholinergic/antihistamine/a-blockade (low potency), NMS, tardive dyskinesia
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What is Neuroleptic Malignant Syndrome?
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FEVER: Fever, Encephalopathy, Vitals unstable (autonomic), Elevated enzymes (myoglobinuria), Rigidity (-->hyperpyrexia)
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How do you treat NMS?
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dantrolene, bromocriptine
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Atypical antipsychotics
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blocks 5HT2/D2/a/H1; USE = schizophrenia (+/-), Tourettes, OCD, depression, anxiety disorder, mania; AE = agranulocytosis (clozapine)
|
|
Rx: prostate cancer
|
leuprolide (continuous), flutamide
|
|
What drugs cause agranulocytosis?
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Carbamazepine, Clozapine, Colchicine, PTU, Methimazole, Dapsone
|
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Lithium
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USE = mood stabilizer (bipolar)
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What are the potential SEs from lithium?
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LMNOP: Lithium use, Movement (tremor), Nephrogenic DI, hypOthyroid, Pregnancy (ebsteins anomaly)
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Finasteride
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5a-reductase inhibitor; USE = BPH, baldness
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TCAs
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block NE reuptake; USE = depression, bedwetting (imipramine), OCD (clomipramine), fibromyalgia
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Flutamide
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androgen receptor inhibitor; USE = prostate cancer
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What are the side effects of TCAs?
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anticholinergic, a-blockade, sedation; Tri-Cs (cardiotoxic, coma, convulsion) & hyperpyrexia
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What non-traditional drugs can be used to treat PCOS?
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ketoconazole & spironolactone
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Buspirone
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5HT1A agonist; USE = GAD
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Tamsulosin
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a1(A,D) antagonist; USE = BPH
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SSRIs
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5HT reuptake inhibitor; USE = depression, OCD, bulimia, social phobias
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sildenafil
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inhibits cGMP-phosphodiesterase; USE = erectile dysfunction, primary pulmonary HTN; AE = flushing, headache, dyspepsia, blue-green color blindness
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What are the side effects of SSRIs?
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GI upset, sexual dysfunction, serotonin syndrome (w/ MAOIs, cocaine, amphetamines)
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What do you NOT want to take with sildenafil?
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nitrates (cause hypotension!)
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What is serotonin syndrome?
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muscle rigidity, hyperthermia, flushing, seizures
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Cyroheptadine
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5HT2 receptor antagonist; USE = serotonin syndrome
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If someone shows signs of serotonin syndrome, what would you give them?
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cyproheptadine
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SNRIs
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5HT/NE reuptake inhibitors; USE = depression, GAD (venlafaxine), diabetic peripheral neuropathy (duloxetine)
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MAOIs
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inc neurotransmitter levels; USE = atypical depression, anxiety, hypochondriacs
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What is contraindicated in MAOI use?
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tyramine or B-agonist (both cause HTN crisis)
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Buproprion
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NDRI; USE = smoking cessation; AE = decrease seizure threshold in bulemics, tachycardia, insomnia
|
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Mirtazapine
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a2/5HT2/5HT3 antagonist; USE = depression; AE = sedation, inc appetite, dry mouth
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Maprotiline
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NE reuptake inhibitor; USE = depression; AE = orthostasis
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Trazodone
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SSRI (of sorts); USE = insomnia; AE = priapism, postural hypotension
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fluoxetine
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SSRI
|
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citalopram
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SSRI
|
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sertraline
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SSRI
|
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paroxetine
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SSRI
|
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nortriptyline
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TCA
|
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clomipramine
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TCA
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imipramine
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TCA
|
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amitriptyline
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TCA
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desipramine
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TCA
|
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doxepin
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TCA
|
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selegiline
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MAOI
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phenylzine
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MAOI
|
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tranylcypromine
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MAOI
|
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venlafaxin
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SNRI
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duloxetine
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SNRI
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milnacipran
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SNRI
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nefazodone
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SNRI
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desvenlafaxine
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SNRI
|
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Treatment for leprosy
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dapsone; rifampin/dapsone/clofazimine
|
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Prophylaxis for MAC
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azithromycin
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How would you treat a chlamydia reaction?
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azithromycin or doxycycline
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How do you treat neonatal chlamydia?
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azithromycin
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Prophylaxis for TB?
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INH
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What drug causes red-green blindness?
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Ethambutol
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Anti-TB drugs
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Streptomycin, Pyrazinamde, INH, Rifampin, Ethambutol
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INH
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INHibit mycolic acid synthesis; USE = TB (solo prophylaxis); AE = neuro/hepatotoxic, drug-induced lupus
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How can you reduce the side-effects of INH?
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B6
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drug-induced lupus
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SHIPP (sulfonamides, Hydralazine, INH, procainamide, phenytoin)
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Rifampin
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inhibits DDRP; USE = TB, leprosy (w/ dapsone), meningococcal & HiB prophylaxis; AE = inc P450, orange body fluids
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meningococcal prophylaxis
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rifampin, minocycline
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gonorrhea prophylaxis
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ceftriaxone
|
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syphilis prophylaxis
|
penicillin G
|
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recurrent UTI prophylaxis
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TMP-SMX
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PCP prophylaxis
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TMP-SMX, pentamide, dapsone
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MRSA Rx
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vancomycin
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VRE Rx
|
linezolid, streptogramins
|
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How do you treat Toxoplasmosis?
|
Sulfadiazine & pyrimethamine
|
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Rx for Leishmaniasis
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Sodium stibogluconate
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Rx for T. cruzi?
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Nifurtimox
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How would you treat ringworms, hookworms, and pinworms?
|
-bendazoles or pyrantel pamoate
|
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How do you treat Strongyloides?
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-bendazole or ivermectin
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Rx for tapeworms?
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Praziquantel
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How do you treat onchocerca?
|
Ivermectin
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Rx for W. bancrofti?
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Diethylcarbamazine
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Amphotericin B
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bind ergosterol (pores); USE = serious, systemic mycoses; AE = nephrotoxic, IV phlebitis, fevers, chills
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Nystatin
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binds ergosterol (pores); USE = "swish and swallow" for oral candidiasis, topical for vaginal/diaper rash candida
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Fluconazole
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inhibits formation of ergosterol; USE = cryptococcal meningitis & candidiasis; AE = gynecomastia, liver dysfunction, inhibits P450
|
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Itraconazole
|
inhibits formation of ergosterol; USE = Sporothrix; AE = gynecomastia, liver dysfunction, inhibits P450
|
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Ketoconazole
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inhibits formation of ergosterol; USE = blasto, histo, coccidioides, candida; AE = gynecomastia, liver dysfunction, inhibits P450
|
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Flucytosine
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inhibits DNA synthesis; USE = candida, cryptococcus; AE = NVD, BM suppression
|
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Caspofungin
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inhibits B-glucan synthesis; USE = invasive aspergillus; AE = flushing, GI upset
|
|
Terbinafine
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inhibit squalene epoxidase; USE = dermatophytes (nail especially)
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Griseofulvin
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interfere with microtubule formation; USE = dermatophytes; AE = carcinogenic, teratogenic, inc P450
|
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TERATOGEN: lithium
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ebstein's anomaly (atrialization of RV)
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TERATOGEN: iodide
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congenital hypothyroidism
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TERATOGEN: maternal diabetes
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transposition of great vessels, caudal regression syndrome
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TERATOGEN: vitamin A
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spontaneous abortion, cleft palate, cardiac abnormalities
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TERATOGEN: tetracycline
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discolored teeth
|
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TERATOGEN: thalidomide
|
limb defects
|
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TERATOGEN: aminoglycosides
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CN VIII toxicity
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TERATOGEN: DES
|
vaginal adenocarcinoma & abnormalities
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TERATOGEN: alkylating agents
|
absence of digits
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TERATOGEN: ACE-Is
|
renal damage
|
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TERATOGEN: valproate
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inhibit folate --> NTDs
|
|
Rx: torsades de pointes
|
Mg+2
|
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Rx: A-fib
|
B-blockers, CCBs
|
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Rx: Prinzmetals angina?
|
dihydropyridine CCBs (nifedipine)
|
|
Digoxin
|
inhibit Na+K+ ATPase --> indirect inhibition of Na/Ca exchanger (inc intracellular Ca); USE = CHF, A-fib; AE = blurry yellow vision, NVD, hyperkalemia, bradycardia, inc PR, dec QT, T-wave inversion
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What factors increase digoxin toxicity?
|
quinidine, hypokalemia, renal failure
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Class I antiarrhythmics (name them)
|
A = quinidine, procainamide, disopyramide; B = lidocaine, Mexiletine, Tocainide; C = flecainide, encainide, propafenone
|
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Class IA antiarrhythmic
|
block Na+ channels (active); USE = reentry/ectopic SVT and V-tach; AE = cinchonism (quinidine), SLE-like (procainamide), torsades
|
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How do the class I antiarrhythmics affect the conduction of the cells?
|
A = increase AP duration, QT interval, and ERP; B = dec AP duration; C = no effect
|
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Class IB antiarrhythmics
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block Na+ channels (ischemic/depolarized); USE = acute ventricular arrhythmias & digoxin toxicity (lidocaine); AE = CV depression
|
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Class IC antiarrhythmics
|
blocks Na+ channel; USE = V-tachs, SVT; AE = pro-arrhythmic
|
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Class II antiarrhythmics
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B-blockers; USE = V-tach, SVT, A-fib, atrial flutter; AE = impotence, exacerbate asthma/CHF, sedation, mask hypoglycemia in diabetics
|
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What effects do class II antiarrhythmics have on the nodal phases?
|
inc PR interval, decrease slope of phase 4
|
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Class III antiarrhythmics
|
block K+ channels; USE = when others fail; AE = sotalol (torsades), amiodarone (LFT, TFT, PFT, skin deposits, photosensitive), bretylium (hypotension)
|
|
What effects do class III antiarrhythmics have on the nodal phases?
|
inc AP duration, ERP, & QT interval (just like Class IA)
|
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Class IV antiarrhythmics
|
non-dihydropyridine CCBs; USE = nodal arrhythmias; AE = constipation, flushing, edema, AV block, sinus node depression
|
|
What effects do class IV antiarrhythmics have on the nodal phases?
|
dec conduction velocity; inc ERP & PR interval
|
|
Adenosine
|
Increase K+ efflux; USE = SVT; AE = flushing, hypotension, chest pain
|
|
Potassium use
|
USE = ectopic pacemakers
|
|
Magnesium use
|
USE = digitoxin toxicity, torsades de pointes
|
|
Hydralazine
|
inc cGMP --> vasodilate arterioles; USE = severe HTN, CHF; AE = compensatory tachy, fluid retention, SLE-like, headache
|
|
Nifedipine
|
dihydropyridine CCB; USE = HTN, angina, arrhythmias, Prinzmetals angina, Raynauds; AE = flushing, dizziness, constipation, peripheral edema
|
|
Nitroglycerin
|
release NO from endothelia --> vasodilate veins; USE = angina, pulm edema; AE = reflex tachy, hypotension, flushing, headache
|
|
What typically happens with constant use of nitrates?
|
tolerance is built up...space out use
|
|
Nitroprusside
|
release of NO; USE = malignant HTN; AE = CN toxicity
|
|
Fenoldopam
|
D1 agonist (inc renal blood flow & natriuresis); USE = malignant HTN
|
|
Diazoxide
|
K+ opener; USE = malignant HTN
|
|
Minoxidil
|
K+ channel opener; USE = HTN; AE = hypertrichosis, salt retention, pericardial effusion
|
|
Statins
|
HMG-CoA reductase inhibitors; USE = decrease LDL mainly; AE = hepatotoxic, rhabdomyolysis, myositis
|
|
Niacin
|
inhibits adipose lipolysis & reduces VLDL secretion; USE = increase HDL; AE = flushing, hyperglycemia, hyperuricemia
|
|
Bile acid resins
|
inhibits bile acid reabsorption (need to use more cholesterol); USE = lipid-lowering; AE = tastes bad, GI discomfort, cholesterol gallstones, fat-vitamin decreased
|
|
Which cardiac drug binds up C. difficile toxin?
|
cholestyramine
|
|
Ezetimibe
|
prevent cholesterol absorption; USE = lipid-lowering; AE = LFTs
|
|
Fibrates
|
upregulate LPL; USE = hypertriglyceridemia; AE = myositis, hepatotoxicity, cholesterol gallstones
|
|
SE: myositis, elevated LFTs
|
statins, fibrates
|
|
SE: flushing
|
niacin
|
|
SE: bad taste, GI discomfort
|
bile acid resins
|
|
antihypertensives that cause reflex tachycardia?
|
nitrates, hydralazine, nifedipine
|
|
antihypertensives that cause dry mouth, sedation, rebound HTN
|
clonidine
|
|
Which diuretic is contraindicated in kidney stones?
|
loop diuretics (loops LOSE calcium)
|
|
Short acting Benzos
|
OAT (Oxazepam, Alprazolam, Triazolam) --> increased risk of addiction
|
|
Medium acting Benzos
|
LET (lorazepam, Estazolam, Temazepam)
|
|
Long acting Benzos
|
Chlordiazepoxide, Clorazepate, Diazepam, Flurazepam
|
|
Amantadine
|
block viral penetration/uncoating (M2 protein) & causes dopamine release; USE = influenza A, Parkinsons
|
|
Zanamivir
|
block neuroaminidase function; USE = influenza A & B
|
|
Oseltamivir
|
block neuroaminidase function; USE = influenza A & B
|
|
Ribavirin
|
inhibits IMP DH (no guanine nucleotides made); USE = RSV (adults only), HCV; AE = teratogenic
|
|
What would you use to treat HCV?
|
ribavirin & IFN-a
|
|
Acyclovir
|
phosphorylated by (HSV/VZV) thymidine kinase --> inhibit viral DNA pol; USE = HSV, VZV, EBV
|
|
Ganciclovir
|
phosphorylated by (HSV/VZV) thymidine kinase & (CMV) viral kinase --> inhibit viral DNA pol; USE = CMV; AE = leukopenia, thrombocytopenia
|
|
Foscarnet
|
don't require activation --> inhibit viral DNA pol; USE = CMV retinitis & when ganciclovir fails; AE = nephrotoxic
|
|
protease inhibitors
|
end in -navir
|
|
NRTIs
|
zidovudine, didanosine, zalcitabine, stavudine, lamivudine, abacavir
|
|
NNRTIs
|
nevirapine, efavirenz, declaviridine
|
|
Fusion inhibitors
|
Enfuvirtide
|
|
Maraviroc
|
gp120 inhibitor; USE = only for R5 phenotype of HIV
|
|
Raltegravir
|
HIV-1 integrase inhibitor; USE = HIV; AE = unfavorable lipid profile
|
|
[ANTIRETROVIRAL/CLASS] SE: lactic acidosis
|
NRTIs
|
|
[ANTIRETROVIRAL/CLASS] SE: GI intolerance
|
protease inhibitors
|
|
[ANTIRETROVIRAL/CLASS] SE: pancreatitis
|
ritonavir, didanosine, stavudine, zalcitabine
|
|
[ANTIRETROVIRAL/CLASS] SE: peripheral neuropathy
|
didanosine, stavudine
|
|
[ANTIRETROVIRAL/CLASS] SE: megaloblastic anemia
|
zidovudine
|
|
[ANTIRETROVIRAL/CLASS] SE: rash
|
NNRTIs (declavirdine, efavirenz, nevirapine)
|
|
[ANTIRETROVIRAL/CLASS] SE: hyperglycemia & lipdystrophy
|
saquinavir, indinavir, amprenavir
|
|
[ANTIRETROVIRAL/CLASS] SE: BM suppression
|
zidovudine
|
|
If a health care worker was stuck with a high-risk HIV needle, what would he be put on?
|
lamuvidine/zidovudine
|
|
TCAs - list drugs
|
imipramine, desipramine, nortriptyline, amitriptyline, climipramine, doxepin, amoxapine
|
|
SSRIs - list drugs
|
fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine
|
|
SNRIs - list drugs
|
venlafaxine, duloxetine, nefazodone, desvenlafaxine, milnacipram
|
|
MAOIs - list drugs
|
phenelzine, tranylcypromine, selegiline,
|
|
NDRIs - list drugs
|
buproprion
|
|
Tetracyclic antidepressants - list drugs
|
mirtazapine, trazodone
|
|
atypical antipsychotics - list drugs
|
olanzapine, quetiapine, aripiprazole, ziprasidone, clozapine, risperidone
|
|
Methotrexate
|
inhibits DHFR; USE = abortion, choriocarcinoma, leukemia/lymphomas & as anti-inflammatory; AE = teratogen (NTDs), stomatitis, hepatotoxic
|
|
What is leucovorin?
|
provides folinic acid rescue in MTX usage
|
|
What is a clinical use for thymidine?
|
rescue of 5-FU overdose?
|
|
5FU
|
inhibits thymidylate synthase; USE = colon cancer, basal cell carcinoma (topical); AE = photosensitivity
|
|
6MP
|
inhibit PRPP synthetase; USE = leukemia/lymphoma; AE = GI, liver toxicity
|
|
What is contraindicated with 6MP?
|
allopurinol --> because 6MP is metabolized by xanthine oxidase
|
|
6FP
|
inhibit PRPP synthetase; USE = ALL
|
|
Cytarabine
|
inhibit DNA pol; USE = AML, ALL; AE = megaloblastic anemia w/ pancytopenia
|
|
What drugs inhibit the S-phase of the cell cycle?
|
Etoposide, 5FU, MTX, 6MP, 6TG, cytarabine
|
|
What drugs are used to treat testicular cancer?
|
Eradicate Ball Cancer (Etoposide, Bleomycin, Cisplatin)
|
|
Dactinomycin
|
DNA intercalates; USE = childhood tumors
|
|
Doxorubicin/Daunorubisin
|
generate free radicals --> intercalates and makes breaks; USE = HL; AE = cardiotoxic
|
|
Bleomycin
|
introduced free radicals --> breaks; USE = testicular cancer, HL; AE = pulm fibrosis
|
|
Drugs that cause pulm fibrosis?
|
BLAB (BLeomycin, Amiodarone, Busulfan)
|
|
Etoposide
|
inhibit DNA topoisomerase II; USE = testicular cancer, small cell of lung; AE = alopecia
|
|
Cyclophosphamide
|
crosslink DNA @ guanine N-7; USE = Non-HL, breast, ovarian, Wegener's, PAN; AE = hemorrhagic cystitis
|
|
What is a particularly worrisome side-effect of cyclophosphamide? What can you do to help prevent it?
|
hemorrhagic cystitis (give MESNA)
|
|
Nitrosureas
|
cross BBB; USE = brain tumors
|
|
Busulfan
|
DNA alkylates; USE = CML; AE = hyperpigmentation, pulm fibrosis
|
|
Vincristine
|
blocks tubulin polymerization; USE = HL, Wilms, choriocarcinoma; AE = neurotoxic, ileus
|
|
What drugs can be used to treat Wilm's tumor?
|
Dactinomycin, Vincristine/Vinblastine
|
|
What drugs can be used for choriocarcinoma?
|
MTX, Vincristine/Vinblastine
|
|
Vinblastine
|
prevents tubulin polymerization; USE = HL, Wilms, choriocarcinoma; AE = BLASTS bone marrow
|
|
Taxols
|
hyperstabilizes tubulin polymers; USE = breast & ovarian carcinoma
|
|
Cisplatin
|
cross-link DNA; USE = testicular, bladder, ovary, lung cancer; AE = nephrotoxic & ototoxic
|
|
Hydroxyurea
|
inhibits ribonucleotide reductase; USE = sickle cell, melanoma, CML
|
|
Prednisone
|
triggers cell apoptosis; USE = CLL, HL, autoimmune
|
|
What are the side-effects of prednisone?
|
CHEAP COPS = Cushings, HTN, eyes (cataracts), acne, PUD, confusion, osteoporosis, psychosis, sugar (hyperglycemia)
|
|
tamoxifen
|
SERM; USE = ER+ breast cancer; AE = risk of endometrial carcinoma (antagonistic to endometrium)
|
|
raloxifene
|
SERM; USE = ER+ breast cancer & osteporosis (agonist @ bone)
|
|
Trastuzumab
|
antibody against HER-2; USE = metastatic breast cancer; AE = cardiotoxic
|
|
Imatinib
|
bcr-abl tyrosine kinase inhibitor; USE = CML, GIST
|
|
Rituximab
|
monoclonal ab against CD20; USE = RA
|
|
Bisphosphonates
|
inhibits osteoclastic activity; USE = postmenopausal osteoporosis, Pagets; AE = esophagitis, jaw osteonecrosis
|
|
Drugs used to treat gout:
|
acute = NSAIDs & colchicine; chronic = probenecid & allopurinol
|
|
Probenecid
|
inhibits uric acid reabsorption in PCT; USE = chronic gout
|
|
Colchicine
|
stabilizes tubulin --> inhibit polymerization; USE = acute gout
|
|
Allopurinol
|
inhibit xanthine oxidase; USE = chronic gout, prevent urate nephropathy (leukemia/lymphoma treatments)
|
|
Celecoxib
|
selective COX-2 inhibitor (only inflammation); USE = RA & osteoarthritis; AE = risk of thrombosis, sulfa allergy
|
|
Acetaminophen
|
reversibly inhibit COX; USE = antipyretic, analgesic; AE = hepatic necrosis (in overdose)
|
|
How do you treat acetaminophen overdose and what is the mechanism is uses?
|
N-acetylcysteine --> regenerates glutathione
|
|
Rx: central DI
|
desmopressin (intranasal)
|
|
Rx: nephrogenic DI
|
hydrochlorothiazide, indomethacin, amiloride
|
|
Rx: acromegaly
|
octreotide
|
|
Sitagliptin
|
inhibits dipeptidyl peptidase IV --> increases GLP-1 (increased insulin)
|
|
Exenatide
|
GLP-1 analog --> increases insulin; AE = acute pancreatitis
|
|
Pramlintide
|
amylin analog --> decreased glucagon
|
|
[Type II DM agents] SE = lactic acidosis
|
metformin
|
|
[Type II DM agents] SE = hypoglycemia
|
2nd gen sulfonylureas
|
|
[Type II DM agents] helps lower TG & LDL
|
metformin
|
|
[Type II DM agents] not safe in hepatic dysfunction or CHF
|
TZDs or metformin
|
|
[Type II DM agents] not used in renal failure
|
metformin
|
|
[Type II DM agents] not used in renal failure, cirrhosis, or IBD
|
acarbose or miglitol
|
|
[Type II DM agents] SE = hepatotoxic
|
TZDs or metformin
|
|
[Type II DM agents] excellent for renal dz
|
TZDs
|
|
[Type II DM agents] decreased postprandial hyperglycemia
|
acarbose or miglitol
|
|
[Type II DM agents] SE = lipodystrophy, weight gain, hypoglycemia
|
exogenous insulin
|
|
[Type II DM agents] SE = disulfuram-like rxn
|
1st gen sulfonylurea
|
|
1st gen sulfonylureas
|
Tolbutamide, Chlorpropamide
|
|
2nd gen sulfonylureas
|
glyburide, glimepiride, glipizide
|
|
sulfonylureas MOA
|
close K+ channels --> increase insulin release
|
|
Metform MOA
|
decrease gluconeogenesis, increase glycolysis & peripheral uptake
|
|
What are the TZDs? MOA?
|
rosiglitazone, pioglitazone --> bind PPAR-gamma and upregulate GLUT4 (increased insulin sensitivity)
|
|
[Type II DM agents] SE = cardiotoxic
|
TZDs
|
|
Acarbose
|
inhibit intestinal a-glucosidases (decrease absorption of glucose)
|
|
Miglitol
|
inhibit intestinal a-glucosidases (decrease absorption of glucose)
|
|
PTU
|
inhibit organification of iodide & decrease T4 --> T3; USE = hyperthyroidism; AE = agranulocytosis, aplastic anemia
|
|
Rx: Parkinsons
|
bromocriptin/ropinirole/pramipexole (dopamine receptor agonist), amantadine, L-dopa/carbidopa, selegiline (MAOI type B), entecapone (COMT-i), Benztropine (antimuscarinic)
|
|
Methimazole
|
inhibit organification of iodide; USE = hyperthyroidism; AE = agranulocytosis, aplastic anemia
|
|
L-dopa
|
crosses BBB --> converted to dopamine; USE = Parkinson's; AE = arrhythmia, dyskinesia, akinesia
|
|
Levothyroxine
|
thyroxine replacement; USE = hypothyroidism, myxedema; AE = heat intolerance, tachycardia, tremors
|
|
Carbidopa
|
inhibit peripheral decarboxylase; USE = Parksinons w/ L-dopa
|
|
Octreotide
|
somatostatin analog; USE = acromegaly, carcinoid, glucagonoma, VIPoma, gastrinoma
|
|
Memantine
|
NMDA receptor antagonist (prevents excitation); USE == Alzheimers; AE = hallucinations, confusion
|
|
Demeclocycline
|
ADH antagonist; USE = SIADH; AE = nephrogenic DI, photosensitivity
|
|
Donepezil/Galantamine/Rivastigmine
|
AChE inhibitors; USE = Alzheimers; AE = insomnia, dizziness
|
|
What happens when glucocorticoids are stopped suddenly?
|
tertiary adrenal insufficiency
|
|
Rx: Huntingtons
|
haloperidol (dopamine receptor antagonist)
|
|
Orlistat
|
inhibits pancreatic lipase; USE = obesity; AE = steatorrhea, GI upset, reduced absorption of fat-soluble vitamins
|
|
Sumatriptan
|
5HT(1B/D) agonist --> vasoconstriction; USE = acute migraine, cluster headaches; AE = coronary vasospasm, tingling
|
|
Sibutramine
|
SNRI (peripheral only); USE = obesity; AE = HTN, tachycardia
|
|
What is generally not recommended with sibutramine?
|
MAOIs or SSRIs
|
|
What medication inhibits PRPP synthetase?
|
6MP & 6TG
|
|
What medication inhibits IMP DH?
|
mycophenylate
|
|
clomiphene
|
partial agonist @ ER --> increase LH/FSH release; USE = infertility, PCOS; AE = ovarian enlargement, hot flashes, simultaneous pregnancies
|
|
Anastrozole
|
aromatase inhibitors; USE = postmenopausal breast cancer
|
|
Mifepristone
|
inhibits progestins; USE = pregnancy termination; AE = heavy bleding
|
|
Misprostol
|
PGE1 analog; USE = terminate pregnancy
|
|
Dinoprostone
|
PGE2 analog; USE = induce labor
|
|
Ritodrine
|
B2 agonist; USE = reduce premature uterine contractions
|
|
Terbutaline
|
B2 agonist; USE = reduce premature uterine contractions
|
|
What is the main function of OCPs?
|
prevent estrogen surge --> no LH surge --> no ovulation
|
|
Rx: trigeminal neuralgia
|
carbamazepine
|
|
Rx: pyruvate DH deficiency
|
lysine & leucine
|
|
Rx: ALS
|
riluzole (decrease glutamate)
|
|
Rx: MS
|
IFN-B
|
|
Rx: absence seizures
|
Ethosuxomide
|
|
Rx: status epilepticus
|
lorazepam, diazepam, phenytoin
|
|
increase frequency Cl- opening --> inc GABAa
|
benzodiazepines
|
|
increases duration Cl- opening --> inc GABAa
|
barbituates
|
|
Rx: both clonic tonic & partial seizures
|
valproate, carbamazepine, phenytoin
|
|
SE: phenytoin
|
gingival hyperplasia, fetal hydantoin syndrome, hirsuitism, induce P450, SLE-like, megaloblastic anemia
|
|
SE: antiseizures
|
nystagmus, diplopia, dizziness, ataxia, sedation
|
|
Rx: ONLY partial seizures
|
lamotrigine, gabapentin, topiramate, phenobarbital
|
|
Rx: eclampsia
|
lorazepam, diazepam
|
|
Which antiepileptics are teratogenic?
|
valproate (NTDs), phenytoin (fetal hydantoin), carbamazepine (NTDs)
|
|
which antiepileptics cause SJS?
|
ethosuximide, phenytoin, phenobarbital, carbamazepine, lamotrigine
|
|
What drugs causes agranulocytosis?
|
PTU, methimazole, colchicine, carbamazepine, clozipine
|
|
antiepileptic SE: hepatoxicity
|
valproate, carbamazepine
|
|
antiepileptics that block Na+ channels?
|
carbamazepine, phenytoin, valproate, lamotrigine, topiramate
|
|
antiepileptics that potentiate GABA effects (inhibition)?
|
benzos & barbs, gabapentin, valproate, topiramate
|
|
antiepileptic SE: kidney stones
|
topiramate
|
|
a child "spaces out" during class while talking and moments later, continues the conversation from where she left off
|
absence seizure
|
|
Dantrolene
|
inhibit Ca+2 channels; USE = malignant hyperthermia (succinylcholine + inhaled anesthetics), NMS, serotonin syndrome
|
|
Rx: benzo overdose? barb overdose?
|
benzo = flumazenil; barb = supportive
|
|
zolpidem
|
BZ1 receptor agonist (potentiate GABA); USE = insomnia; AE = headache, confusion
|
|
Tramadol
|
weak opiate agonist & SNRI; USE = chronic pain; AE = decreased seizure threshold
|
|
What drugs decrease the seizure threshold?
|
bupropion & tramadol
|
|
butorphanol
|
opioid mu & kappa agonist; USE = pain; AE = withdrawal
|
|
dextromethorphan
|
opiate agonist; USE = cough suppressant
|
|
loperamide
|
opiate agonist; USE = anti-diarrheal
|
|
diphenoxylate
|
opiate agonist; USE = antidiarrheal
|
|
Rx: acute CHF
|
LMNOP: loops, morphine, nitrates, oxygen, pressors/position
|
|
methadone
|
opiate agonist; USE = maintenance program for addicts
|
|
Rx: opiate overdose
|
naloxone, naltrexone
|
|
inhalational anesthetics: what happens when you increase solubility? decrease solubility?
|
increase = increase potency; decrease = increase induction speed/recovery
|
|
What is MAC?
|
amount of anesthetic in alveoli to get 50% of population anesthetized
|
|
opiate cough suppressant
|
dextromethorphan
|
|
opiate used for diarrhea
|
loperamide, diphenoxylate
|
|
opiate used in acute CHF
|
morphine
|
|
non-addictive opiate
|
tramadol
|
|
which fibers are anesthetized first with local anesthetics?
|
pain (small, myelinated)
|
|
anesthetic SE: hallucinations & bad dreams
|
ketamine
|
|
anesthetic SE: nephrotoxic
|
methoxyflurane
|
|
most common anesthetic used for endoscopy?
|
midazolam
|
|
anesthetic SE: convulsions/seizures
|
Enflurane = epilepsy
|
|
anesthetic SE: hepatotoxic
|
Halothane
|
|
anesthetic used for rapid induction & short procedures
|
propofol
|
|
anesethetic used for induction of anesthesia
|
thiopental (& propofol)
|
|
anesthetic SE: risk of pancreatitis
|
propofol
|
|
inhalational anesthetic used for rapid anesthesia
|
methoxyflurane
|
|
anesthetic that decreases cerebral blood flow
|
thiopental
|
|
which anesthetic would you want to use in brain surgery?
|
thiopental
|
|
Prophylaxis for status epilepticus
|
phenytoin
|
|
treatment for chronic asthma
|
glucocorticoids (prednisone)
|
|
treatment of acute asthma exacerbations
|
albuterol
|
|
blocks conversion of arachidonic acid --> leukotrienes
|
zileuton
|
|
inhibits mast cell release of mediators
|
cromolyn
|
|
asthma treatment that blocks muscarinic receptors
|
ipratropium
|
|
inhaled long-active B2-agonist
|
salmeterol
|
|
blocks leukotriene receptors
|
zafirlukast, montelukast
|
|
Rx: appetite stimulant
|
cyproheptadine
|
|
Rx: vertigo
|
meclizine
|
|
1st gen H1 antagonists
|
Diphenhydramine, dimenhydrinate, chlorpheniramine; USE = motion sickness, sleep aid; AE = antimuscarinic, anti-adrenergic
|
|
2nd gen H1 antagonists
|
loratadine, fexofenadine, cetirizine; USE = allergy
|
|
asthma treatment that inhibits phosphodiesterase
|
theophylline
|
|
Narrow TI asthma treatment
|
theophylline
|
|
What are the expectorants?
|
NAc & guaifenesin
|
|
Bosentan
|
antagonize endothelin-1 receptors; USE = pulm HTN
|
|
Rx: pulm HTN
|
bosentan, nifedipine, sildenafil
|
|
asthma treatment that inactivates NF-kB
|
prednisone
|
|
AE of theophylline
|
cardiotoxicity & neurotoxicity
|
|
Rx: abetalipoproteinemia
|
Vit E
|
|
precursor of 6MP
|
azathioprine
|
|
mannitol diuresis prevents nephrotoxicity caused by this
|
cyclosporine
|
|
antibody that binds CD3 on T cels
|
muromonab
|
|
antibody that binds IL-2r of activated cells
|
daclizumab
|
|
inhibits IMP DH
|
mycophenylate
|
|
MOA of cyclosporine
|
binds cyclophilin --> inhibit calcineurin --> lack of IL-2r
|
|
MOA of tacrolimus
|
binds FK-BP --> inhibit calcineurin --> lack of IL-2r
|
|
MOA of sirolimus
|
binds FK-BP --> inhibit mTOR --> lack of IL-2r
|
|
Rx: lupus nephritis
|
mycophenylate
|
|
metabolized by xanthine oxidase
|
azathioprine, 6MP
|
|
Causes phocomelia
|
flipper arms --> thalidomide
|
|
Rx: acute rejection after organ transplant
|
cyclosporine or OKT3 (muromonab)
|
|
AE: tacrolimus
|
nephrotoxic, peripheral neuropathy, pleural effusion, hyperglycemia
|
|
AE: cyclosporine
|
nephrotoxic (prevent w/ mannitol), rise of lymphoma & viral infection
|
|
recombinant IL-2
|
aldesleukin
|
|
MAB to CD20
|
rituximab
|
|
MAB to Gp IIb/IIIa
|
abciximab
|
|
recombinant IL-11
|
oprelvekin
|
|
post exposure prophylaxis for N. meningitidis
|
Rifampin
|
|
Antacid SE: diarrhea
|
Magnesium-hydroxide
|
|
Antacid SE: constipation
|
aluminum hydroxide
|
|
Antacid SE: rebound hypercalcemia
|
calcium carbonate
|
|
Antacid SE: hypokalemia
|
ALL
|
|
What is the MOA of PPIs?
|
inhibit H+K+ ATPase (decrease gastric acid secretion)
|
|
Rx: NSAID-induced PUD
|
Misoprostol
|
|
Uses of misoprostol?
|
PGE1 analog = keep PDA open, induce labor, and NSAID-induced PUD
|
|
H2 blockers
|
-tidine; USE = peptic ulcers, gastritis, GERD
|
|
Cimetidine SEs:
|
inhibit P450, antiandrogenic, crosses BBB & placenta
|
|
PPIs
|
-prazole; irreversibly block H/K ATPase; USE = PUD, gastritis, GERD, Z-E syndrome
|
|
Bismuth
|
binds to ulcer base --> allow HCO3 to reestablish pH; USE = ulcer healing, traveler's diarrhea
|
|
Propantheline
|
M1 (ECL) & M3 (parietal) antagonist; USE = PUD; AE = anticholinergic
|
|
Octreotide
|
SST analog; USE = esophageal varices, acromegaly, VIPoma, carcinoid
|
|
Which antacid causes osteodystophy?
|
aluminum hydroxide
|
|
Sulfasalazine
|
antibacterial/anti-inflammatory --> activated by colon bacteria; USE = UC, Crohns
|
|
Ondansetron
|
5HT3 antagonist; USE = postop/chemo vomiting; AE = constipation
|
|
Metoclopramide
|
D2 antagonist; USE = postop/diabetic gastroparesis; AE = parkinsonian, restlessness, diarrhea, decrease seizure threshold
|
|
When would you not give someone metoclopramide?
|
Parksinson or bowel obstruction
|
|
What drugs decrease seizure threshold?
|
tramadol, buproprion, metoclopramide, enflurane
|
|
Rx: diabetic gastroparesis
|
metoclopramide
|
|
Rx: UC
|
sulfasalazine
|
|
Mannitol
|
osmotic diuresis (PCT); USE = shock, dec intracranial/intraocular pressure; AE = dehydration
|
|
Acetazolamide
|
carbonic anhydrase inhibitor (PCT); USE = altitude sickness, metabolic alkalosis, glaucoma; AE = hypochloremic metabolic acidosis, neuropathy
|
|
SE: hypochloremic metabolic acidosis
|
acetazolamide
|
|
Furosemide
|
inhibit Na/K/2Cl co-transporter (ascending LoH); USE = edematous states, hypercalcemia
|
|
SE: loop diuretics
|
OH DANG: ototoxicity, hypokalemia/-calcemia, dehydration, allergy (sulfa), nephrotoxic, gout
|
|
SE: thiazides
|
hypeGLUC (glycemia, lipidemia, uricemia, calcemia); hypokalemic metabolic alkalosis
|
|
SE: hypokalemic metabolic alkalosis
|
Thiazides
|
|
Thiazides
|
inhibit Na+/Cl+ reabsorption (DCT); USE = hypercalciuria, nephrogenic DI, HTN, CHF
|
|
Triamterene
|
inhibit Na+ channels in CCT; USE = Conn's syndrome, CHF; AE = hyperkalemia
|
|
Spironolactone
|
inhibit aldosterone receptor (CCD); USE = Conn's, CHF; AE = hyperkalemia, endocrine (gynecomastia, antiandrogenic)
|
|
Captopril
|
inhibit ACE-I (lung); USE = HTN, CHF, renal disease
|
|
Amiloride
|
inhibit Na+ channels in CCT; USE = Conn's syndrome, CHF; AE = hyperkalemia
|
|
Who do you avoid giving ACE-Is to?
|
bilateral renal artery stenosis
|
|
What are the side effects of ACE-Is?
|
CAPTOPRIL = Cough, Angioedema, Proteinuria, Taste change, hypOtension, Pregnancy prob, Rash, Increased Renin, Lower ATII & hyperkalemia
|
|
What diuretics cause acidemia?
|
Acetazolamide (inhibit HCO3- reabsorption) & K+sparing (prevent K+ & H+ secretion)
|
|
What diuretics cause alkalemia?
|
loops/thiazides
|
|
Rx: acute intermittent porphyria
|
glucose & heme
|
|
Rx: vWF disease
|
DDAVP (desmopressin) --> release vWF stores
|
|
Rx: M3 AML
|
ATRA (vit A)
|
|
Rx: CML
|
Imatinib
|
|
A patient is recently diagnosed w/ CHF and cancer. What should you avoid in your treatment modality?
|
Dauno-/Doxorubicin
|
|
SEs of Heparin
|
HIT, osteoporosis, bleeding
|
|
inhibits gamma-carboxylation
|
warfarin
|
|
Which anticoagulant can you use in pregnancy?
|
heparin --> less likely to cross placenta due to highly anionic charge
|
|
tPA
|
convert plaminogen --> plasmin; USE = early MI & stroke; AE = bleeding
|
|
irreversibly block ADP-receptors
|
clopidogral, ticlopidine
|
|
antibody that blocks GpIIb/IIIa
|
abciximab, tirofiban, eptifibatide
|