5-29 Pharm

Front 1

mode of administration of all aminoglycosides

Back 1

parenteral

Front 2

activation of INH

Back 2

must be converted to active metabolite within mycobacterial cells by mycobacterial catalase-peroxidase

Front 3

mechanism of INH

Back 3

decreased mycolic acid synthesis

Front 4

mech of ethambutol

Back 4

interferes with mycobacterial peptidoglycan cell wall synthesis

Front 5

theophylline mech of action

Back 5

inhibits PDE ==> inc cAMP, prevents degranulation; v. narrow TI: acts as a general stimulator --> seizures, arrythmias, GI diarrhea/vom

Front 6

tx for theophylline tox

Back 6

tox is overstimulation, so give beta-blockers (eg esmolol) for arrythmias, benzos for seizures

Front 7

etanercept

Back 7

humanized monoclonal AB; binds TNF (anti-inflam); used in RA, psoriasis/psoriatic arthritis

Front 8

capsofungin mech, use

Back 8

blocks cell WALL synthesis, aspergillis/candida

Hint 8

None

Front 9

amphotericin B mech

Back 9

"punches holes" in fungal cell MEMBRANE

Front 10

azoles mech

Back 10

inhibit fungal cell MEMBRANE synthesis (ergosterols)

Front 11

nystatin mech

Back 11

binds ergosterol, disrupts fungal MEMBRANES

Front 12

terbinafine mech, use

Back 12

inhibits membrane synthesis one step down (--| squalene epoxidase); tx dermatophytes (along w/ griseofulvin)

Front 13

flucytosine mech, use, tox

Back 13

inhibits DNA synth (nucleotide analog); used for systemic fungal infections (esp candida and cryptococcus); can cause BM suppression

Front 14

rifampin propylaxis used for ______

Back 14

neisseria or HIB

Front 15

Griseofulvin mech

Back 15

binds microtubules, inhibits mitosis (other drugs that act on microtubules: taxol, vincristine/vinblastine, colchicine, mebendazole/thiabendazole)

Front 16

omalizumab

Back 16

monoclonal antibody against IgE (prevents IgE from binding to mast cells)

Front 17

muscarinic effects in airways

Back 17

bronchoconstriction (that’s why ipratroprium, antimuscarinic, helps in asthma)

Front 18

drugs contraindicated with cations (eg antacids)

Back 18

tetracycline (chelates cations) and fluoroquinolones (reduced absoroption too?)

Front 19

trastuzumab

Back 19

monoclonal Ab against HER-2 (useful against some breast cancers)

Front 20

warfarin vs heparin in pregnant women

Back 20

warfarin crosses placenta, heparin doesn't

Front 21

ticlopidine

Back 21

like clopidegril -- blocks ADP-mediated aggregation

Front 22

main tox of cyclophosphamide

Back 22

hemorrhagic cystitis

Front 23

how to prevent main tox of cyclophosphamide

Back 23

give Mesna as adjunct tx

Front 24

uses of N-Acetylcysteine

Back 24

1) Acetominophen antidote (increases glutathione reserves); 2) mucolytic agent (eg CF, bronchitis); 3) reno-protective agent (in pts with renal insufficiency who need radio contrast)

Front 25

main use of ondansetron

Back 25

inhibits 5-HT3 receptors, tx n/v following chemo

Front 26

Two drugs that inhibit thymidylate formation + differences

Back 26

MTX + 5-FU; MTX can be recovered by Folinic acid, 5-FU cannot, b/c 5-FU blocks further down pathway (beyond folinic acid entry)

Front 27

role of HIV gp41 and gp120

Back 27

gp120 facilitates attachment, gp41 facilitates fusion via conformational change

Front 28

low crit in elderly woman -- what's the deficiency?

Back 28

usu B12: elderly patients become achloridic --> impaired B12 absorption; adminster B12 parenterally

Front 29

4 main classes of antifungals

Back 29

1) polyenes: bind ergosterol in cell membrane(nystatin, amphotericin B); 2) Triazoles: inhibit ergosterol synth (ketoconazole, itraconozole); 3) Echinocandins: inhibit glucan synthesis -- component of fungal cell wall (capsofungin, micafungin); 4) pyrimidines: flucytosine -- converted to 5-FU in fungal membrane;

Front 30

Ethambutol

Back 30

inhibits carbohydrate polymerization; can cause optic neuritis --> decreased visual acuity, central scotoma (the ethan butane torch! It burns my eyes!)

Front 31

Wilms Tumor sx

Back 31

WAGR complex (Wilms tumor, Aniridia, GU malformation, mental and motor Retardation)

Front 32

prazosin

Back 32

competitive alpha 1 antagonist

Front 33

phenoxybenzamine

Back 33

only non-competitive alpha 1 blocker (used to tx pheo and malignant htn)

Front 34

which tetracycline in renal failure?

Back 34

doxycycline or minocycline -- excreted in feces

Front 35

mycophenolate mofetil (MMF)

Back 35

converted to mycophenolic acid (MPA) --| de novo guanine synth ==> blocks lymphocyte proliferation

Front 36

early presentation of salicylate tox

Back 36

tinnitus (followed by: acidosis, gastric irritation, elevated BT, and hyperventilation, not necessarily in that order)

Front 37

warfarin tox:

Back 37

can cause necrosis of the skin (by depletion of protein C --> aberrent thrombosis in cutaneous microvasculature): sharply demarcated, erythematous, purpuric lesions which either resolve or progress to large, irregular hemorrhagic bullae

Front 38

acute tx of amphetamine-induced agitated/psychotic state

Back 38

ammonium chloride (hastens amphetamine excretion, b/c amphetamine is a weak base and ammonium chloride acidifies the urine)

Front 39

tx of CF mucus plugs

Back 39

N-acetylcysteine (mucolytic, splits disulfide linkages)

Front 40

clubbing

Back 40

a/w heart and lung dz, incl: cancer, cf, interstitial lung dz., NOT COPD

Front 41

warfarin: monitor PT or PTT?

Back 41

"the EX-PaTriot went to WAR(farin)" --> monitor PT, extrinsic pathway

Front 42

lepirudin

Back 42

direct thrombin inhibitor; used in HIT; (hirudin class)

Front 43

tx for HIT

Back 43

lepirudin or other members of hirudin class (direct thrombin inhibitor)

Front 44

vincristine vs paclitaxel

Back 44

vincristine prevents microtubule formation, paclitaxel prevents microtuble degradation

Front 45

eqn for half life

Back 45

halflife= 0.7Vd/CL

Front 46

tx for AML

Back 46

"caramel": c-ara AML (cytarabine) + daunorubicin

Front 47

omalizumab

Back 47

monoclonal Ab that binds to IgE -- used in asthma that is not well controlled by steroids

Front 48

infliximab

Back 48

binds TNF-alpha; used in crohn's and RA

Front 49

ipratropium

Back 49

muscaranic antagonist with minimal systemic side effects; usedin asthma (esp with COPD)

Front 50

theophylline

Back 50

inhibits PDE --> increases cAMP; narrow TI (cardiotox, neurotox)

Front 51

antineoplastics with cardiac tox

Back 51

doxorubicin, daunorubicin

Front 52

antineoplastics with pulm fibrosis

Back 52

bleomycin, busulfan

Front 53

antineoplastics with CNS Tox (periph neuropathy, ileus)

Back 53

vincristine

Front 54

antineoplastics with renal and acoustic nerve tox

Back 54

cisplatin

Front 55

tx of klebsiella

Back 55

cephalosporins

Front 56

tx for legionella

Back 56

erythromycin ("a wreath on legionairre's grave")

Front 57

tx for anaerobes above the diaphragm

Back 57

clindamycin

Front 58

tx for anaerobes below the diaphragm

Back 58

metronidazole

Front 59

tx of oral candidiasis

Back 59

"nystatin, swish and swallow" + fluconazole

Front 60

nystatin

Back 60

antifungal, punches holes in ergosterol (like amphoteicin-B); too toxic for IV, but not absorbed thru GI; main use: CANDIDIASIS

Front 61

penicillin cross allergy

Back 61

amoxicillin, cephalosporins

Front 62

cyclosporine + {tacrolimus | sacrolimus}

Back 62

NEPHROTOXICITY! Additive toxicity, so don’t give within 24 hrs

Front 63

OC metabolism

Back 63

p450

Front 64

avoid OCs with

Back 64

p450 inducers (Quinidine, Barbiturates, Phenytoin, Rifampin, Griseofulvin, Carbemazepine)

Front 65

cyclophosphamide mech, use

Back 65

alkylating agent, causes dna cross-linking; used for non-hodgkin's lymphoma (C in CHOP)

Front 66

6-mp mech

Back 66

inhibits purine synthesis (6-mercaptoPURINE), requires conversion by HGPRT

Front 67

vinca alkaloids

Back 67

bind tubuilin, prevent polymerization (unlike taxol: prevents degradation)

Front 68

dna intercalators

Back 68

bleomycin, doxorobucin

Front 69

6-MP contraindicated with what drug?

Back 69

allopurinol --| xanthine oxidase, which is needed for metabolism of 6-MP ==> allopurinol causes increased 6-MP levels --> hepatotox

Front 70

Chvostek sign

Back 70

tapping face in front of ear elicits tetany --> hypocalcemia

Front 71

trousseau sign

Back 71

BP cuff occludes brachial artery --> carpal spasm (indicates hypocalcemia)

Front 72

ergocalciferol

Back 72

vit d2 (used for hypocalcemia)

Front 73

cyclosporine mech

Back 73

ihbits production and release of IL-2 by binding cyclophillin, inhibtiting calcineurin, thereby inhibiting NF-kB activity

Front 74

bethanechol

Back 74

muscarinic agonists (like methacholine, carbachol, pilocarpine) -- Bethnechol stimulates Bowel and Bladder; AChE resistant

Front 75

glaucoma drugs

Back 75

PETA: Pilocarpine (ACh agonist), Echothiophate (AChEi), Timilol (Beta blocker), Acetazolamide (CA inhibitor)

Front 76

ACh agonist and AChEi combinations

Back 76

Carbechol/Pilocarpine + Echothiophate/Physostigmine for Glaucoma; Bethanechol + Neostigmine for post-surgical/neurological ileus or urinary retention

Front 77

tx for myasthenia gravis

Back 77

AChEi (neostigmine, pyridostigmine)

Front 78

physostigmine

Back 78

AChEi used for glaucoma; has good CNS penetrance, so also used for atropine overdose

Front 79

benztropine

Back 79

Centrally acting anticholinergic --> used for parkinsons

Front 80

scopolamine

Back 80

Centrally acting anticholinergic --> used for motion sickness

Front 81

dx of myasthenia gravis

Back 81

edrophonium: extremely short acting AChEi (10mins), see if it relieves sx

Front 82

nervous control of ciliary muscle

Back 82

cholinergic (carbechol/pilocarpine = cholinomimetics, activate ciliary muscle --> relieve openangle glaucoma; also, atropine causes ciliary muscle paralysis --> cycloplegia:no accomodation)

Front 83

NE selectivity

Back 83

a1,a2 > B1

Front 84

Epi selectivity

Back 84

B1,B2 (low dose) > a1,a2 (high dose)

Front 85

Dopamine Selectivity

Back 85

D1=D2>B>a AGONIST

Front 86

dobutamine

Back 86

B1>B2 (no alpha activity) AGONIST

Front 87

isoproterenol

Back 87

B1=B2 AGONIST

Front 88

phenylephrine

Back 88

a1>a2 AGONIST

Front 89

terbutaline

Back 89

like albuterol, b2>b1 AGONIST; used to reduce contractions in premature labor

Front 90

drug used for hypertension with renal disease

Back 90

a2 agonist (clonidine or alpha-methyldopa) b/c no decrease in blood flow to renal vasculature

Front 91

adrenergic agent used in pregnancy-induced hypertension

Back 91

alpha-methyldopa

Front 92

nonselective alpha antagonists (2) + uses and differences

Back 92

phenoxybenzmine (irreversible) and phentolamine (reversible); both used for pheo

Front 93

alpha1 blocker

Back 93

prazosin, terazosin, doxazosin -- used for BPH urinary retention or HTN

Front 94

alpha2 blocker

Back 94

mirtazapine: anti-depressent; causes weight gain (inc appetite, inc cholesterol)

Front 95

drug of choice for shock

Back 95

Dopamine: inc BP via B1/a1, while D1 and D2 also vasoconstricts (but vasodilates renal vasculature, preserves renal function)

Front 96

beta blockers used in SVT

Back 96

propanolol, esmolol

Front 97

lead poisoning

Back 97

LEAD (Lead lines on gingivae and epypheses on xray; Encephalopathy and Erythrocyte basophilic stippling; Anemia (sideroblastic) and Abdominal colic; Drop (foot, wrist), eDta and Dimercaprol = firstline tx)

Front 98

alkalinization of urine helps clearance of which drugs?

Back 98

weak acids -- aspirin, phenobarbital, methotrexate

Front 99

acidification of urine helps clearance of which drugs?

Back 99

weak bases -- amphetamines

Front 100

misoprostol

Back 100

PGE1 analog; used to protect GI, maintain *patent* PDA, and induce labor (increases uterine tone -- opposite of terbutaline)

Front 101

how to close PDA

Back 101

give indomethacin (NSAID --| PGE --> sustains PDA, along with hypoxia)