Board Review: Pharm: Drug Names

Front 1

Ramipril

Back 1

ACEI

NB: also increases [bradykinin] because ACE's break down bradykinin

Front 2

Clopidogrel

Back 2

clopidogrel: blocks surface ADP receptors, essential for platelet activation and fibrin binding

synergistic with aspirin and DOC: preventing thromboemboli in pts with aspirin intolerance

Front 3

DOC: preventing thromboemboli in pts with aspirin intolerance

Back 3

clopidogrel: blocks surface ADP receptors, essential for platelet activation and fibrin binding

Front 4

DOC: DVT prophylaxis

Mechanism?

Back 4

Warfarin

blocks the glutamate residue on factors 2, 7, 9 and X

prevents kitamin K dependent carboxylation

[takes a few days to build up: use heparin for immediate treatment]

Front 5

Warfarin

Back 5

blocks the glutamate residue on factors 2, 7, 9 and X

prevents kitamin K dependent carboxylation

DOC: DVT prophylaxis

[takes a few days to build up: use heparin for immediate treatment]

Front 6

DOC: HIT

Back 6

Heparin Induced Thrombocytopenia: Antibodies to heparin which cross react with platelet factor 4

Usual presents as thrombus formation rather than bleeding

First Stop All Forms of Heparin
DOC: Direct Thrombin inhibitors ie Argatroban

Front 7

Argatroban

Back 7

Heparin Induced Thrombocytopenia: Antibodies to heparin which cross react with platelet factor 4

Usual presents as thrombus formation rather than bleeding

First Stop All Forms of Heparin
DOC: Direct Thrombin inhibitors ie Argatroban

Front 8

Abcixumab

Back 8

antibody vs. glycoprotein IIB/IIIa important for platelet binding with fibrinogen and fibronectin

Front 9

Probenecid

Back 9

↓ proximal tubular uric acid reabosprtion

NB: contraindicated in gouty attack, may precipitate/worsen

Front 10

Rx: ↓ proximal tubular uric acid reabsorption

Back 10

Probenecid

NB: contraindicated in gouty attack, may precipitate/worsen

Front 11

Rx: inhibition of xanthine oxidase

Back 11

allopurinol, ↓ serum [uric acid]

NB: contraindicated in gouty attack, may precipitate/worsen

Front 12

Allopurinol

Back 12

inhibition of xanthine oxidase

NB: contraindicated in gouty attack, may precipitate/worsen

Front 13

Tiagabine

Back 13

inhibitor of GABA uptake

anticonvulsant predominatnly used for refractory partial seizures

Front 14

Topiramate

Back 14

anticonvulsant used predominantly for refractory partial seizures

blocks Na channels and enhances effect of GABA

Front 15

Vigabatrin

Back 15

inhibits GABA transaminase and increases GABA concentration

anticonvulsant preodminantly used for refractory partial sieuzres

Front 16

Gabapentin

Back 16

increases brain GABA concentration

used for refractory partial seizures

Front 17

Lamotrigine

Back 17

anticonvulsant used for refractory partial seizures

life threatening skin rash

Front 18

Anticonvulsants used for refractory partial seizrues

Back 18

lamotrigine: life threatening skin rash

TiaGABine: inhibits GABA uptake
Topiramate: blocks Na channels and ↑ GABA effect
ViGABAtrin: inhiibts GABA transaminase and ↑ [GABA]
GABApentin: ↑ [GABA]

Front 19

β1 selective blockers

Back 19

primarily affect the heart

used in pts with both heart condition and Lung condition (ie for whom non-selective β blockers are contraindicated)

metoprolol
atenolol
acebutolol
esmolol

Front 20

metoprolol

Back 20

β1 selective blocker: primarily affects the heart
-no bronchocontriction

used in pts with both heart condition and Lung condition (ie for whom non-selective β blockers are contraindicated)

metoprolol
atenolol
acebutolol
esmolol

Front 21

atenolol

Back 21

primarily affect the heart
-no bronchocontriction

used in pts with both heart condition and Lung condition (ie for whom non-selective β blockers are contraindicated)

metoprolol
atenolol
acebutolol
esmolol

Front 22

acebutolol

Back 22

primarily affect the heart
-no bronchocontriction

used in pts with both heart condition and Lung condition (ie for whom non-selective β blockers are contraindicated)

metoprolol
atenolol
acebutolol
esmolol

Front 23

esmolol

Back 23

primarily affect the heart
-no bronchocontriction

used in pts with both heart condition and Lung condition (ie for whom non-selective β blockers are contraindicated)

metoprolol
atenolol
acebutolol
esmolol

Front 24

Metformin

Back 24

↑ glycolysis
↓ GI glucose abosrption
↓ GnG
∅ risk hypoglycemia

Major side effect: GI upset & Lactic acidosis ( ↑ Glycolysis)

Contraindications: Renal Failure, Hepatic Dysfnx, Hypersensitivity
Lactic Acidosis Prone: Alcoholics, CHF

Front 25

Tx for allergic rhinitis causes flushed cheeks and dilated pupils

what is the physiologic mechanism

Back 25

Muscarinic antagonism

Atropine
TCA's
H1 antagonists like diphenylhydramine
Neuroleptics
Antiparkinsonian drugs

Front 26

IL2 Tx

Back 26

FDA approved for Renal Cell Carcinoma and Melanoma

Front 27

Hydroxyurea

Back 27

↑ HgF synthesis (α2γ2)

used for sickle cell anemia

Front 28

Gardos Channel Blockers

Back 28

Gardos Channels: Ca2+ dependent K+ channels

when blocked K+ and water efflux is ↓

prevents cell dehydration and reduces polymerization of HbS

(used for sickle cell anemia)

Front 29

Rx: Sickle Cell Anemia

Back 29

Hydroxyurea: ↑ HgF synthesis (α2γ2)

Gardos Channel Blockers:
--Gardos Channels: Ca2+ dependent K+ channels;
when blocked K+ and water efflux is ↓, prevents cell dehydration and reduces polymerization of HbS

Front 30

Ketamine

Mechanism of Action

Back 30

NMDA Antagonist

Front 31

Phenelzine

Back 31

a MAOI

phenelzine, tranylcypromine, selegiline

DOC: atypical depression [hyperphagia, hypersomnia, rejection hypersensitivity, leaden fatigue] & tx-resistant depression

Front 32

Tranylcypromine

Back 32

MAOI

phenelzine, tranylcypromine, selegiline

DOC: atypical depression[hyperphagia, hypersomnia, rejection hypersensitivity, leaden fatigue] & tx-resistant depression

Front 33

DOC: Atypical Depression

Back 33

[hyperphagia, hypersomnia, rejection hypersensitivity, leaden fatigue]

MAOI's

phenelzine, tranylcypromine, selegiline

also used for Tx-Resistant Depression

Front 34

Tx: Opiod Tolerance

Back 34

Opiod tolernace through unknown mechanism

tolerance seems to be enhanced by glutamate-NMDA action

rx: Ketamine, blocks Glutamate-NMDA

Front 35

Brain Natriuretic Peptide

Back 35

Nesiritide is a recombinant BNP

like ANP, activates guanylate cyclase → vasodilation, diruesis/natriureses, and a decrease in BP

Front 36

Nesiritide

Back 36

recombinant Brain Natriuretic Peptide

like ANP, activates guanylate cyclase → vasodilation, diruesis/natriureses, and a decrease in BP

Front 37

Bradykinin

Back 37

hormoned produced by the Kidney when RAAS activated

bradykinin causes angioedema

ACE metzm Bradykinin to its inactive product

Pts with ACEI's predisposed to angioedema

Front 38

Endothelin

Back 38

potent vasoconstrictor

endothelin release mediated by AT2, ↓ by ACEI's

Front 39

Foscarnet

Back 39

pyrophosphate analoge which fnx vs. Herpesvirus

particularly useful in salvage therapy vs. CMV retinitis

Chelates calcium and induces magneium wasting

hypomagenia → ↓PTH (?) → worsened hypocalcemia

hypocalcemia & hypomagensia both ↑ seizures

Front 40

Toxicity of Acyclovir

Back 40

Crystal nephropathy
Delerium/Tremor Neurotoxicity

Front 41

beta blockers and glaucoma

Back 41

act on ciliary epithlium to ↓ aqueous humor prodxn

Front 42

pilocarpine

Back 42

cholinergic agonist used for glaucoam induces miosis making trabecular meshwork more accesible

like pilocarpine

Front 43

carbachol

Back 43

cholinergic agonist used for glaucoam induces miosis making trabecular meshwork more accesible

like carbachol

Front 44

Prostaglandins vs glaucoma

Back 44

F2α agonists

latanoprost
unoprostone
travoprost

Front 45

Carvedilol

Back 45

nonsepcific antagonist of β1, β2 and α1 receptors

Front 46

Benztropine

Back 46

centrally acting anti-cholinergic used for drug induced parkinson's dz

Front 47

centrally acting anti-cholinergic used for drug induced parkinson's dz

Back 47

Benztropine

Front 48

Physostigmine

Back 48

cholinesterase inhibitor used to correct atropine OD

Front 49

Theophylline toxicity & Tx

Back 49

vomitting, tachyarrhytmias, & fatal seizures

tx: gastric lavage + activated charcoal
β-blockers vs tachyarrhytmias
BZDs/barbituates vs Seizures

Front 50

Oral Iron Poisoning

Back 50

Directly toxic to gastric mucosa

hemetemesis and melena

Front 51

6 Mercaptopurine is metabolized by what?

Back 51

Converted to active cytotoxic purine analogue by HGPRT (X linked)

removed/detoxed by xanthine oxidase (inhibited by allopurinol)

Front 52

Nicardipine

Back 52

dihydropyridine ca2+ channel blocker works on VSMC and Myocardium

arterial dilation w/ rebound tachy, flushing, HA

Front 53

Diazoxide

Back 53

like Hydralazine, arterial vasodilator w/ reflex SNS upregulation (Tachy/RAAS)

Not recommended for hypertensive emergencies

Hydralazine at least considered safe in pregnant hypertensive emergencies

Front 54

Nitroprusside

Back 54

Potent arterial and venous vasodilator

most effective agent for hypertensive emergencies

metabolized to cyanide and thiocyanate, limiting factor is cyanide toxicity

Front 55

Hydralazine

Back 55

like Diazoxide, arterial vasodilator w/ reflex SNS upregulation (Tachy/RAAS)

Not recommended for hypertensive emergencies

Hydralazine considered safe in pregnant hypertensive emergencies

Front 56

Fenoldopam

Back 56

Dopamine derivative, but selective for D1 receptor with no effect on α or β receptors

↑ cAMP → vasodilation
& also ↑ GFR w/o ↑ RAAS activation

(normally vasodilation → reflex SNS activation → ↑ RAAS)

Can safely be used in all hypertensive emergencies.

Front 57

Most orally bioavailable nitrite

Back 57

Isosorbide Mononitrite nearly 100% bioavailable

Front 58

Adenosine vs. Arrhythmias

Back 58

Phase 4: ↓ If

Phase 3: ↑ K+ flux & duration

Phase 0: inhibits L type Ca2_ channels: prolonging phase 0

Front 59

Treating DVT in Pregnant Women

Back 59

Heparin

[warfarin = teratogenic
asprin, clopidogril ≠ anti-DVT]

Front 60

DOC: Heroine Addiction

Back 60

Methadone

mu agonist with extremely long λ prevents withdrawal sx

Front 61

Ribavirin

Back 61

guanine nucleoside analogue

RSV & HepC

used in RSV pts with complicating conditions as RSV is normally self limiting

Front 62

Oseltamvir

Back 62

taimful

vs. influenza A and B neuraminidases

Front 63

Dofetilide

Back 63

Class 3 antiarrhytmic: K+ blocking, prolongs phase 3 (repolarization)

Front 64

Anti-seizure med with gingival hyperplasia

Back 64

phenytoin
via PDGF mediator

Front 65

Thiopental pharmacokinetics

Back 65

Highly lipid soluble
rapidly enters brain from blood
rapidly redistributes out of brain to skeletal muscles

rapid ↓ in fnx ≠ metzm

fast on-fast off
used for induction

Front 66

Dopamine Effects

Back 66

Low doses stimulate D1 receptors → vasodilation in renal & mesenteric vasculature

Medium Doses: Stimulate β1 receptors

High Doses: Stimulate α1 receptors

Front 67

Antidote for Rat Poisoning

Back 67

Most Rat Poisons contain a coumadin derivative

2, 7, 9 and X

Antidote: Fresh frozen plasma

Front 68

Protamine

Back 68

antidote for heparin OD

Front 69

P glycoprotein

Back 69

MDR1 in humans

transmembrane ATP dpendent pump, thwarts chemotheraputics

Front 70

Aspirin Poisoning

Back 70

Initially causes respiratory alkalosis via direct CNS stimulation

after a few hours produces metablic acidosis from metabolic processes activated

combined respiratory alkalosis + metabolic acidosis: ↓ pCO2, ↓ HCO3, ↑↓ pH (unpredictable)