High Yield Usmle Pharm

Front 1

Treatment for Acute Mania

Back 1

(Lithium or Valproic acid or Carbamazepine) + Olazapine

Front 2

Teratogenic effects of Valproic Acid

Back 2

Neural Tube defects

- spina bifida

- meningocele

Front 3

Why Valproic acid causes neural tube effect?

Back 3

Because it inhibits intestinal folic acid absoption

Front 4

Side effects of Litium

Back 4

L-Luekocytosis
I-Insipidus (Nephrogenic - treated with Ameloride)
T-Tremor/Teratogen (Ebsteins anomoly- displacement of Tricuspid valve atrialization of the RV)
H-Hypothyroidism
(I)A-Acne/Athetosis
(U)V-Vomiting
M- Misc - EKG abnormalities

Front 5

Basal Long acting insulin

Back 5

1- NPH

Front 6

Basal long acting insulin (2)

Back 6

1- NPH

twice daily

12-18 hr

2- Glargine

one daily

24 hr

Front 7

Short acting insulin (3)

Back 7

1- Regular

2-3 hr

tx for: DKA

2-Lis, Aspart

30-90 min

post-meal hyperglycemia

Front 8

Most common side effect of BUPROPRION

Back 8

seizures (don't use in bulimics)

Front 9

drugs that may cause seizures

Back 9

1- Buproprion

2- Isoniazid (anti- tuberculosis)

3- Imipenem (antibiotic)

Front 10

MOA of indinavir

Back 10

protease inhibitor

Front 11

Side effects of indinavir

Back 11

(Looks like iatrogenic cushings)
lypodystrophy
hyperglycemia
inhibition of CYT P450
Nephroxicity
nephrolithiasis

Front 12

What is the use of TMP-SMX in a HIV pt?

Back 12

Prevention and treatment of Pneumocystis carinii

Front 13

Zolpedem

Back 13

Short acting hypnotic medication chemically unrelated to benzodiazepines

Front 14

Clinical use of Zolpedem?

Back 14

short term treatment of insomnia

Front 15

Tx of septic arthritis caused by Gonococcus?

Back 15

Ceftriaxone (plus azythromycin or tetracycline for concomitant Chlamydia infx)

Front 16

Pioglitazone

what monitoring test you have to do?

Back 16

Liver Function test

Front 17

Side effect of Hydralazine, procaimide

Back 17

Systemic Lupus Like syndrome= slow acetylators

Front 18

Statins

Side effects

Back 18

hepatotoxicity

myopathy

Front 19

You want to switch a Phenilzine treatment to Sertraline, how may weeks you must wait to begin Sertraline treatment?

Back 19

2 weeks

Front 20

why you have to wait 2 weeks to change treatment from MAO inhibitor to SSRI?

Back 20

Phenelzine is a MAO inhibitor= Ser, NORE, DOPA

Sertraline is a SSRI= Ser

Co administration can cause Serotonin Syndrome

Front 21

MAO of Verapamil

Back 21

Blocks SA and AV node calcium channels

- slows phase 0 deporalization decr rate of SA node firing decr AV node conduction

Front 22

Do not mix Diazepam with?

Back 22

First generation Antihistaminines Ex: Diphenhydramine, Chlorpheniramine

Front 23

Why you do not mix Diazepam with antihistaminine?

Back 23

Sedation

Front 24

Tx for Rheumatoid arthritis

Back 24

Chronic: Glucocorticoids
- quick relief
- short term tx
Acute: NSAIDs

Front 25

Tx for Giardia lamblia?

Back 25

Metronidazole

Front 26

Wilson's Disease tx?

Back 26

Penincillamine- removes excess copper

Front 27

Hemocromatosis tx?

Back 27

Deferoxamine

Front 28

Rituximab

Back 28

monoclonal antibody used in lymphoma immunotherapy targets CD20

Front 29

Cilostozol

Back 29

inhibits PDE 3 increasing cAMP which platelet aggregation
vasodilatation - used for claudication

Front 30

Effect of Beta blockers in renin

Back 30

inhibits renin release

Front 31

Hydroxyurea

Back 31

Increases HbF synthesis= protection against polymerization of sickle cells

Also known as Hydroxycarbamide
-Blocks Ribonucleotide reductase used in cancers

Front 32

Thyroid peroxidase

Back 32

Catalizes iodine oxidation
-See anti-thyroid peroxidase and anti-thyroglobulin antibodies in Hoshimoto's

Front 33

Simvastatin effects

Back 33

decrease LDL
decrease TGs
increase HDL

Front 34

MOA of pioglitazone

Back 34

Thiazolidinediones (works via PPAR-gamma a nuclear receptor - transcription)
↓ blood glucose levels by improving the target cell response to insulin, decreases gluconeogenesis, Increases adiponectin

Front 35

How pioglitazone works on target cell?

Back 35

Transcription modulation

Front 36

MAO of Aspirin

Back 36

IRREVERSIBILY inhibits COX 1 and COX 2

Front 37

Clinical use of Aspirin

Back 37

↓ platelet aggregation (<300 mg/day)

antipyretic and analgesic(300-2400 mg/day)

anti-inflammatory (>2400 mg/day)

Front 38

Cinical use of Reserpine

Back 38

↓ BP

Front 39

Side effects of Reserpine

Back 39

Depression and suicidal ideation= due to NORE and SER depletion

Front 40

MOA of Reserpine

Back 40

Blocks the storage of adrenergic mediator in presynaptic neuron

Front 41

Tx for Toxoplasmosis?

Back 41

Pyrimethamine and sulfasaliazine

Front 42

Tx for CMV?

Back 42

GANCICLOVIR, foscarnet (no activation required), cidofovir (no activation required)

Front 43

Tx for Listeria?

Back 43

Ampicillin

Front 44

Tx for Crytococcus neoformans?

Back 44

Amphotericin

Front 45

Which nitrates has 100% of bioavailability?

Back 45

Isosorbide mononitrate

Front 46

Risperidone

Back 46

Atypical antipsycotic

Front 47

Clinical use of Warfarin

Back 47

Long term anticuagulation
1- prevent venous thrombosis
2- prevent resultant pulmonary embolism

Front 48

MOA of Warfarin

Back 48

inhibits vit K dependent gamma carboxylation of glutamic acid residues of clotting factor 2, 7, 9, 10, C and S

Front 49

Clinical use of Heparin

Back 49

Acute management of venous thrombosis or thromboembolism (Binds ATIII enhances binding to Xa AND Thrombin - affects factors 2, 7, 9, 10, 11, 12)

Front 50

MOA of Acarbose

Back 50

inhibitor of α- glucoside (brush border enzyme)

↓activity of the membrane bound disaccharidase on the intestine brush border

Front 51

Side Effects of Acarbose

Back 51

Flatulence
GI bleeding
Abdominal pain
Rash

Front 52

MOA of Etoposide

Back 52

inhibits Topoisomerase II→ chromosomal breaks to accumulate → cell death

Front 53

Clinical uses of Etoposide

Back 53

Testicular CA

Small cell lung CA

Front 54

MOA of milrinone/inamrinone

Back 54

inhibitor of phosphodiesterase → ↑CAMP
1- ↑Ca in cardiac myocytes
2- vasodilation in smooth muscle

Front 55

What drug is resistant to degradation by adenosine deaminase?

Back 55

Cladribine (adenosine analog looks like autosomal recessive SCID)

Front 56

DOC for hairy cell leukemia

Back 56

Cladribine

Front 57

Characteristic for High hepatic clearance

Back 57

high lipophilicity= poorly eliminate through kidneys

Front 58

Intracellular consequence of nitroglycerin

Back 58

inc NO --> inc cGMP --> inc PKG --> Phosphatase activation --> myosin dephosphorylation

Front 59

Side effect of propylthiouracil

Back 59

Agranulocytosis (MAO inhibits thyroid hormone synth by blocking oxidation of Iodine in gland, also inhibits peripheral conversion of T4 to T3)
(Beta blockers also inhibit peripheral conversion)

Front 60

Is perfered in pregnancy methimazole?

Back 60

No, More Teratogenic than PTU b/c less protein bound

Front 61

MOA of finastride

Back 61

inhibits 5α- reductase
decreases peripheral androgen conversion to DTH

Front 62

Prevention for the increase of myocardial O2 demand due to nitrates use

Back 62

Metoprolol

Front 63

Esmolol

Back 63

Beta blocker
increases PR interval

Front 64

which vessel is more succeptible to nitroglycerin?

Back 64

Large veins

Front 65

Cholestyramine

Back 65

Bile acid resins= binds negative charged bile acids in the SI → insolubles complexes→feces

Front 66

Side effect of bile acid resins

Back 66

incr TGs
GI discomfort
Gritty taste
impedes absorption of fat soluble vitamins (A, D, E, K)

Front 67

Warfarin overdose tx?

Back 67

Fresh frozen plasma (rapid)
Vit K

Front 68

Cisplatin toxicity?

Back 68

Nephrotoxicity/Ototoxic

Front 69

Prevention of nephrotoxicity due to Ciplastin use

Back 69

Amifostine

Front 70

5-Fluorouracil overdose tx?

Back 70

Uridine diphosphoglucose (NOT Leucovorin)

Front 71

Methotrexate overdose tx?

Back 71

Leucovorin

Front 72

Methanol or ethylene glycol poisoning tx

Back 72

Fomepizole (or ethanol)

Front 73

Doxorubicin cardiotocity tx?

Back 73

Dexrazoxane

Front 74

Colecoxib

Back 74

selective COX 2 inhibitor

Front 75

Can Colecoxib impair platelet function?

Back 75

NO

Front 76

tPA MAO

Back 76

Stimulates plasminogen→ plasmin
(side note: severe tissue damage exposes collagen and releases tissue factor which can activate the cascade, DIC risk)

Front 77

At the begining of tPA tx, what side effect can be observed?

Back 77

Reperfusion Arrhythmias on arterial re-opening

Front 78

Agatroban

Back 78

direct thrombin inhibitor

Front 79

clinical uses of agatroban?

Back 79

Heparin induced thrombocytopenia

Front 80

Closes PDA

Back 80

INDOMENTACIN

Front 81

Keeps open PDA

Back 81

PGE1 (Alprostadil, Misoprostol)

Front 82

Tx for HTN that have minimal effect on AV conduction?

Back 82

Nifedipine

Front 83

Co administration of Erythromicin and statin cause...

Back 83

Myopathy (Erythromicin is a P450 inhibitor)

Front 84

Methicillin resistant strains of Staphylococcus epidermidis

Back 84

Vancomycin + rifampin or aminoglycoside

Front 85

Fondaparinux

Back 85

Direct Factor Xa inhibitor

Front 86

Enoxaparin

Back 86

low molecular weight heparin (Bind ATIII but inhibits Xa more than Thromin, not monitoring required)

Front 87

Clinical use of Enoxaparin

Back 87

↓ in death and recurrent MI

Front 88

MOA of Heparin

Back 88

Binds to antithrombin III

Front 89

MOA of Etarnacept

Back 89

TNF-α decoy receptor

Front 90

Clinical uses of Etarnacept

Back 90

Rheumatoid Arthritis that do not respond to metothrexate tx

Front 91

Side effect of Etarnacept

Back 91

Reactivation of latent tuberculosis

Front 92

MOA of Ergonovine

Back 92

Ergot alkaloid
=constricts vascular smooth muscle by stimulating α- adrenergic receptor and serotonergic receptors

Front 93

Use of Ergonovine

Back 93

Diagnosis of Prizmental's angina chest pain at rest and ST elevation
Also with oxytocin to deliver placenta

Front 94

How benzodiazepines increases GABA action?

Back 94

Binding to GABA receptor and increases frequency of Cl channel opening

Front 95

How barbituates increases GABA action?

Back 95

Binding to GABA receptor and increases duration of Cl channel opening

Front 96

Clinical use of Cilostozol?

Back 96

Interminet Claudication

Front 97

Nitroglycerin

Back 97

↓ cardiac preload= ↓ Left ventricular diastolic volumen
↓ cardiac work
↓ myocardial O2 demand

Front 98

Side effects of Thiazides

Back 98

HyperGLUC= hyperglycemia, hyperlypidemia, hyperuremia, hypercalcemia
Hyponatremia= hypotention
HypoKalemia
(Also increases Lithium toxicity)

Front 99

Common side effect of Metformin

Back 99

LACTIC ACIDOSIS
-Don't use in renal failure

Front 100

Phentolamine

Back 100

Reversible α- receptor blocker= vasodilation (vs Phenoxybenzamine irreversible)
-prevents local tissue necrosis induced by NE intravenous leakage

Front 101

Drugs that ↓LDL

Back 101

1- STATINS
2- Ezetimibe

Front 102

drugs that ↓ TGs

Back 102

1- Fibrate
2- Niacin

Front 103

drug that has the most ↑ HDL

Back 103

NIACIN

Front 104

Side effects of Ace inhibitors

Back 104

CAPTOPRIL
cough
angioedema (esp w/ C1 esterase def.)
tenuria
taste changes
hypOtention
pregnancy problems
rash
increases renin
low angiotensin II

Front 105

Side effect of Spinolactone

Back 105

Gynecomastia
hypekalemia, acidosis

Front 106

Side effect of Niacins

Back 106

Flushing, Insuline resistence (possible acanthosis nigricans, increases DM meds), mild vasodilation (dec HTN meds)

Front 107

Carvedilol

Back 107

Beta and alpha blocker= ↓ CHF mortality

Front 108

Drugs that decreases MI mortality?

Back 108

↓ Aldosterone and ↓ Sympathetics
-ACEi, Spironolactone, Aliskarin (renin inhibitor), Beta blockers

Front 109

Amiloride can not be mix with?

Back 109

ACE inhibitors= cause hyperkalemia

Front 110

Adrenal crisis tx?

Back 110

Decreased cortisol so give Corticosteroids

Front 111

Propanolol and hypoglycemia?

Back 111

masks adrenergic symptoms (tachycardia) of hypoglycemia, Beta blockers decreases insulin secretion as well

Front 112

Proptosis tx?

Back 112

AKA Exopthalmos, Corticosteroids (cause by lymphocyte infiltration of extraocular muscles, TH1 cells release cytokine which stimulate fibroblasts to produce excess GAGs)

Front 113

What can cause a co admistration of ACE inhibitors and thiazide or loops diuretics?

Back 113

First dose hypotension
2dary hyponatremia due to diuretics tx

Front 114

Can ACE inhibitor be use in renal artey stenosis?

Back 114

NO b/c these kidneys rely on efferent vasoconstriction to maintain GFR (ACEi --> Dec AII --> efferent vasodilation)

Front 115

Co administration of Verapamil with Beta adrenergic can cause..(2 SE)

Back 115

Sinus Bradycardia
Hypotension

Front 116

What are the 2 metabolites formed from Primidone's metabolization?

Back 116

Phenobarbital + PEMA (both are barbituates)

Front 117

Muscarinic agonist action on endothelial cells

Back 117

Bind to endothelial surface--> NO synthase → NO from arginine → inc cGMP → leads to Myosin light chain dephosphorylation → smooth muscle relaxation

Front 118

Molecular weight of COX 2

Back 118

72 kD

Front 119

Cystitis tx?

Back 119

Fluoroquinole or TMP-SMX

Front 120

A 37 weeks pregnant woman is positive for GBS, what is the treatment?

Back 120

Intapartum prophylaxis

- Penincillin or ampicillin

Front 121

Hartnup Disease tx?

Back 121

Inability to absorb Tryptophan → may lead to Niacin def.

Front 122

Effects of glucocorticoids in white blood cells differential

Back 122

Increases: neutrophil (demargination)
Decreases: basophil, eosiniphils, monocytes, lymphocytes

Front 123

Lansoprazole

Back 123

inhibits H/K ATPase pump at parietal cells
= block final common pathway of gastric acid secretion, which is stimulated by Ach, hist, gastrin

Front 124

DOC of heroin addition and abuse

Back 124

Methadone
Can also use Buprenophine or Pentazocine (partial antagonists)

Front 125

what is the principal characteristic of Methadone that justifies its substitution for heroin?

Back 125

Long half life

Front 126

MOA of sulfonylureas

Back 126

Opens K channels in beta cells hyperpolarizing them and preventing insulin release

Front 127

MOA of Flucytosine

Back 127

Converted to 5-fluorouracil in fungus and blocks DNA and RNA synthesis

Front 128

MOA of Caspofungin

Back 128

Blocks Beta 1,3-D-Glucan synthase - inhibits fungi cell wall

Front 129

MOA of Amphotericin B

Back 129

binds to ergosol → punches holes in cell membrane

Front 130

MOA of Azoles

Back 130

Blocks fungal P450 14-alpha demethylase - inhibits ergosterol synthesis from lanosterol

Front 131

Cyt P 450 inducers (8)

Back 131

Queen Barb Steals Phen-phen and refuses greasy carbs chronically

Q- Quinidine
B- Barbituates
S- St. John's warts
P- Phenytoin
R- Rifampin
G- Griseofulvin
C- Carbamazepine
Chronic alcohol use

Front 132

Cyt P 450 inhibitors (7)

Back 132

KEG is Acutely SICk

K- Ketoconazole
E- Erythromycin
G- Grapefruit
Acute alcohol use
S- Sulfonamides
I- Isoniazide
C- Cimetidine

Front 133

How does Pyrazinamide work?

Back 133

TB drug, Converted to pyrazinoic acid and increases the pH of the cell

Front 134

MOA of Abciximab

Back 134

Monoclonal antibody Blocks of GP IIb/IIIa, inhibits fibrinogen binding

Front 135

What disease do Abciximab mimic

Back 135

Glanzmann thrombastenia

Front 136

Effect of Timolol in aqueous humor

Back 136

↓secretion of aqueous humor by ciliary epithelium

Front 137

Side effect of gancyclovir

Back 137

Neutropenia, don’t use with Zidovudine in HIV

Front 138

Side effect of Forscarnet

Back 138

Celates Ca and Mg
Hypomagnesemia, HypoCa
Impaired PTH release

Front 139

Lyme disease tx?

Back 139

Doxycycline or penincillin derivates (Ex. Ceftriaxzone)

Front 140

MOA of Nystatin

Back 140

Works just like Ampho

Front 141

Clinical use of Nystatin

Back 141

Candidiasis (swish and swallow)
Side note pts who are Myeloperoxidase def. have inc susceptiblity to Candida, Neutrophils prevent the HEMATOGENOUS spread of candida

Front 142

Rifampin is used as chemophylaxis for?

Back 142

N. meningitidis

Front 143

Common side effect of Rifampin

Back 143

Orange discoloration of secretions

Front 144

Tx for Trigeminal neuralgia?

Back 144

Carbamazepine

Front 145

Carbamazepine side effects

Back 145

aplastic anemia
P 450 inducer

Front 146

what drug can be use against gram (-), gram (+), and bacteriodes?

Back 146

Piperacillin- Tazabatam (Psuedomonas penecilin derivative with a beta lactamase inhibitor)

Front 147

MOA of Isoniazid

Back 147

inhibition of mycolic acid synthesis
mycolic acid= make mycobacterium acid fast
(Requires activation by TB heat sensitive Catalase)

Front 148

t 1/2 Formula

Back 148

t 1/2= (Vd x 0.7)/CL

Front 149

Loading Dose formula

Back 149

LD=Vd x (Peak concentration)/Bioavailability

Front 150

Maintainance Dose formula

Back 150

MD=(Peak concentration) x CL/Bioavailablity

Front 151

Clinical uses of Valproate

Back 151

Absence + tonic-clonic seizures, Can use for main different seizure types

Front 152

Clinical use of Ethosuximade

Back 152

Absence seizures

Front 153

MOA of pentazocine/buprenophrine

Back 153

partial agonist activity and weak antagonist activity at mu receptor

Front 154

Pentazocine and morphine can cause…

Back 154

Precipitate opioid withdrawal

Front 155

Ceftriaxone does not work in C. Trachomatic and U. Urealyticum. Why?

Back 155

Because they lack of peptidoglycan cell wall

Front 156

C. Trachomatic and U. Urealyticum tx?

Back 156

Macrolides
Tetracyclines

Front 157

Anesthesics

Back 157

↓MAC, ↑potency (Im MACing so much ass Im impotent)
↑solubility, ↑anesthetic is needed to saturate the blood (Blood:Gas coeffiecient is the ratio of protein/dissolved gas over the diffusable gas)
↑solubility, slow onset of action
↑[Arteriovenous] gradient, slow onset of action

Front 158

Cyproheptadine

Back 158

H1 blocker with Serotonin receptor antagonist activity (Used in Serotonin sickness)

Front 159

MOA of Colchicine

Back 159

Binds to IC protein tubulin→ inhibits polymerization into microtubules, blocks chemotaxis

Front 160

SE of Colchicine

Back 160

Nausea
Abdominal pain
diarrhea

Front 161

Clinical use of Fenoldopam

Back 161

D1 agonist, Emergency hypertension
Only drug that improves RPF and ↓BP

Front 162

Isoniazid Resistance

Back 162

non-expression of the catalase peroxidase enzyme

Front 163

Arsenic poisoning tx?

Back 163

Dimercaprol

Front 164

Cyanide poisoning tx?

Back 164

Amyl nitrate (creates methemoglobin), Thiosulfate binds it and makes it more soluble - Methylene blue converts back to hemoglobin
-Cyanide shifts the O2-Hb curve left b/c in inc affinity for O2, Also inhibits Cytochrome c oxidase in ETC

Front 165

Acute lead and mercury poisoning?

Back 165

CaNa2EDTA

Front 166

Essential tremor tx?

Back 166

Propanolol

Front 167

Enfuvirtide

Back 167

inhibits viral penetration into target cells via gp41 binding

Front 168

Initial tx for hypoglycemia

- non-medical setting

- medical setting

Back 168

- non-medical setting= IM glucagon
- medical setting= IV Dextrose

Front 169

MOA of Rifampin

Back 169

inhibits DNA dependent RNA synthesis

Front 170

benzodiazepines that causes day time drowsiness

Back 170

Long acting (due to active metabolite)

Chlordiazepoxide (used for withdrawing Alcoholics in DTs)
Diazepam
Flurazepam

Front 171

Short acting benzos

Back 171

Midazolam
Tiazolam

Front 172

Intermediate acting benzos

Back 172

Alprazolam
Clonazapam
Lorazepam
Oxazepam

Front 173

Benzodiazepine side note

Back 173

Citalopram is NOT a benzo it’s an SSRi (**** the pharmacutical companies)

Front 174

Which benzos are not hepatically excreted?

Back 174

Oxazepam, Temazepam, Lorazepam
"Outside The Liver"

Front 175

How can be prevented the hemorragic cystitis caused by Cyclophosphamide?

Back 175

MESNA (binds acroline the toxic metabolite)

Front 176

Clinical use of Ribavirin

Back 176

Infants w confirmed RSV broncholitis (Palivizumab is a monoclonal antibody against F protein used for prophylaxis)
HCV (with alpha-IFN)

Front 177

MOA of Ribavirin

Back 177

Guanosine analog causes mutations in RNA and inhibits RNA dependent RNA pol, Inhibits IMP Dehydrogenase depleting the GTP pool and inhibiting DNA synth

Front 178

Amantadine

Back 178

impairs uncoating of Influenzae A
-Also used in Parkinsons to increase Dopamine release)

Front 179

BNP (brain naturetic peptide)

Back 179

vasodilatation
diuresis/natiuresis
↓BP
(Secreted by ventricles in response to excessive stretch, hypertrophy)

Front 180

Is Nafcillin resistant to degradation by bacterial B- lactamase?

Back 180

yes, used for MSSA my cause interstitial nephritis

Front 181

Clinical use of nafcillin

Back 181

Skin infections of S. aureus

Front 182

Quetiapine

Back 182

Atypical antipsycotic that treat negative and positive symptoms
Anti-dopamine, Anti-5-HT, Anti-Serotonin, Anti-alpha, minimal antimuscarinic

Front 183

Which vitamin is Isoniazid chemical similar to?

Back 183

Vit B6 (leads to peripheral neuropathy)

Front 184

Why is atropine dangerous when used in the eyes

Back 184

MYDRIASIS --> ↑IOP--> GLAUCOMA
especially in African americans

Front 185

Resistance to streptomycin

Back 185

altered structure of bacterial ribosomes proteins
MC- enzymatic modification of aminoglycoside (acetylation [Enterococcus], adenylation, phosphorylation)

Front 186

Most specific effect of Dobutamine

Back 186

↑ cardiac conduction velocity

Front 187

MOA of digoxin

Back 187

slow conduction through AV node via ↑parasympathetic tone --> ↓AV conduct (affects Na/K pumps in neurons)
Also increases contractility by indirectly inc Ca concentration

Front 188

S. epidermidis tx?

Back 188

Vancomycin

Front 189

Dose dependant characteristics of Isoproterenol

Back 189

Beta agonist
↑cardiac contractility
↓vascular resistance

Front 190

Clavulinic acid

Back 190

B- lactamase inhibitor

Front 191

Why amoxillin is co-administrated with clavulinic acid?

Back 191

Clavulinic acid ↓amoxillin cleavege by bacterial cells

Front 192

Tx of opioid withdrawal in neonates?

Back 192

Opioid solution= tincture of opium
Symptoms - excessive sucking (sympathetic hyperactivity), high pitch cry, tremor, rhinorrhia, sneezing, diarrhea

Front 193

MOA of Ethosuximide

Back 193

↓ Ca current in thalamic neurons
Blocks T- type Ca

Front 194

Phenytoin

Back 194

↓Na in fast firing cortical neurons

Front 195

Long term tx for duodenal ulcers

Back 195

Antibiotics (kill H. pylori, Metronidazole, Bismuth and Tetracycline OR Clarithromycin, Amoxicillin and Omeprazole)
-Side note also the treatment for MALT lymphoma

Front 196

Prevention of crystalline neupathy due to Acyclovir

Back 196

Acute Hydratation

Front 197

Dobutamine

Back 197

B1>B2
↑HR, CONDUCTION, CONTRACTILITY, myocardial O2 consumption

Front 198

Thiopental redistribution?

Back 198

Muscle and fat tissue (fast onset but also short duration)

Front 199

Tx for drug induced parkinson disease?

Back 199

trihexyphenidyl
benztropine
-Muscarinic antagonists that enter the brain

Front 200

Disopyrimide

Back 200

Class IA
slows phase 0 depolarization
longed phase 3 reporalization of ventricular myocyte

Front 201

What vitamin can not be mixed with Levodopa?

Back 201

VIT B6 (Don’t use mutivitamin pills with levadopa)
incr levodopa peripheral metabolism (via Dopamine (amino acid) decarboxylase)--> decr enter to CNS

Front 202

2 types of exacerbation of Mysthenia Gravis

Back 202

1- myathetic gravis= subtherapeutic , there is low Ach to compite with antibodies
2- Cholinergic crisis= inappropriate high doses of acetylcholinesterase inhibitors can cause paralysis

Front 203

Prevention of thrombotic events in homocystenuria

Back 203

Vit B6 (via increased activity of Cystathionine sythase which combines HomoC with serine to make cystathionine which is degraded to cysteine)

Front 204

Anticonvulsant and mood stabilizer

Back 204

Valproic acid
Also lamatrogine

Front 205

ARBs

Back 205

decr aldosterone
no change bradykin
incr AT I, AT II, renin

Front 206

tx for malaria- chloroquine resistant

Back 206

mefloquine

Front 207

Drugs used for plasmodium vivax and ovale

Back 207

Chloroquine and Primaquine (for liver cysts)

Front 208

tx for acute gouty arthritis

Back 208

NSAIDs

Front 209

Side effect of Amitryptyline in BPH pts

Back 209

urinary retention (antimuscarinic)

Front 210

Steps for status epilepticus tx

Back 210

1- IV lorazepam
2- Phenytoin (simultaneously)
3- continues seizures= Give phenobarbital
4- if seizures persists= intubation and anesthesics

Front 211

Menotropin and hCG uses

Back 211

menotropin= human menopausal gonadotropin (gonadotropins LH and FSH extracted from the urine of postmenopausal women - used for fertility treatment)

hCG induces ovulation

Front 212

Dofetlilde

Back 212

Class III antiarrhrytmic
affects phase 3 (K channel blocker)

Front 213

Which classes of antiarrhythmics are best for SVTs?

Back 213

Class I and III, adenosine and digoxin

Front 214

Which classes of antiarrhythmics are best for Ventricular arrhythmias?

Back 214

Class II and IV

Front 215

Cefuroxime

Back 215

inhibits cell wall synthesis
Only 2nd gen of cephalosporins that enters the brain

Front 216

MOA of desmopressin (DDAVP) in endothelial cells

Back 216

stimulates the release of von Willebrand factor (with Factor VIII)

Front 217

MOA of N- acetylcysteine

Back 217

Mucolytic agent for CF that loosens the thick sputum by cleaving disulfide bonds

Front 218

Tx for motion sickness?

Most common side effect

Back 218

Antihistaminics
Scopolamine
SE: dry mouth

Front 219

Prophylaxis for MAC infection in HIV patient

Back 219

Azithromycin

Front 220

Side effect of B-blockers in lungs

Back 220

Bronchoconstriction
Asthma exacerbation

Front 221

Medication- induced body fat redistribution syndrome is caused by (2)

Back 221

Glucocorticoids

HIV-1 protease inhibitors

Front 222

Cryptococus neoformans meningitis tx?

Back 222

Amphotericin B (intrathecal) + Fluorocytosine OR Fluconazole (enters CNS)

Front 223

MOA of isotretinoin

Back 223

Retinoid (like Vitamin A)

binds eukaryotic nuclear receptors changes gene expression
-Birth defects DO A PREGNANCY TEST

Front 224

MOA of paclitaxel

Back 224

Prevents depolymerization of microtubules

Front 225

Psoriasis tx?

Back 225

Calcitrine
-synthetic vit D3 analog that binds DNA and acts as a transcription factor --> stimulates cell proliferation and induce normal cell diferentiation
TNF-alpha inhibitors - Infliximab, Adalimumab

Front 226

MOA of Cyclosporine

Back 226

inhibitor of IL-2 transcription

binds to cyclophilin--> forms comples--> inhibits calcineurin--> ↓IL-2
-Tacrolimus has a similar mechanism

Front 227

Which drugs cause gingival hyperplasia?

Back 227

Cyclosporin, phenytoin, nifedipine

Front 228

Antibiotics that act on 50S

Back 228

chloramphenicol (inhibits peptidyl transferase)
clindamycin (inhibits translocation)
linezoid (binds 23S rRNA and inhibits initiation complex)
erythromicin (prevents release of uncharged tRNA)

Front 229

Antibiotics that act on 30S

Back 229

Tetracylines (block the acceptor site)
Aminoglycosides (Inhibits initiation comples and induces misreading = bacteriacidal)

Front 230

Tx of vomiting or gastric stasis?

Back 230

Metoclopramide

Front 231

side effect of Metoclopramide

Back 231

exarcebate or cause Parkinsoniam symptoms (tardive dyskinesia)

Front 232

Phenylephrine

Back 232

Reversible alpha 1 agonist
↑vascular resistance--> ↑BP--> activates baroreceptors-->↓SV, ↓ HR

Front 233

Atropine overdose tx?

Back 233

Physostigmine (can enter the brain)

Front 234

opioid effect resistance to tolerance

Back 234

Constipation
miosis

Front 235

MOA of Pramipexole

Back 235

stimulates DOPA receptors

Front 236

Side effect of Cisplatin/Carboplatin

Back 236

Acoustic nerve damage and nephrotoxic

Front 237

Side effect of Bleomycin

Back 237

Pulmonary fibrosis

Front 238

Side effect of Doxorubicin

Back 238

Dilated cardiomyopathy

Front 239

Side effect of Transtuzumab

Back 239

Cardiotoxic

Front 240

Side effect of 5-FU and 6-MP

Back 240

Myelosuppression

Front 241

What drug increases the toxicity of 6-mercaptopurine

Back 241

Allopurinol (its metabolized by xanthine oxidase)

Front 242

Side effect of Vincristine

Back 242

Peripheral neuropathy

Front 243

MOA OF Osteltamir

Back 243

Impair viron particle release, neuraminidase inhibitor

Front 244

tx for the recurrence of genital herpes

Back 244

daily oral acyclovir, valacyclovir, or fanciclovir after the first episode

Front 245

How spironolactone benefit overall survival in CHF?

Back 245

↓ALDOSTERONE
B/C CHF stimulates RAA system

Front 246

protect against UVB

Back 246

PABA esters

Front 247

protect against UVB and UVA

Back 247

Zinc-oxide containing suncreens

Front 248

most common side effect of aspirin

Back 248

fecal blood loss

Front 249

which reverse trancriptase causes pancriatitis?

Back 249

Didanosine (an NRTi)

Front 250

which reverse trancriptase is active against Hep B?

Back 250

Lamivudine (an NRTi)

Front 251

which reverse trancriptase do not need IC phosphorylation?

Back 251

Nevirapine and efavirenz (NNRTi)

Front 252

Side effect of Ticlopidine

Back 252

neutropenia
fever
mouth ulcers

Front 253

MOA of methothrexate

Back 253

inhibits enzyme dihydrofolate reductase to block folic acid synthesis

Front 254

Side effect of methothrexate

Back 254

stomatitis= painful mouth ulcers
hepatitis, fibrosis, cirrhosis

Front 255

Zidovutine

Back 255

nucleoside reverse transcriptase inhibitor
No 3'- OH group, making 5-3 phosphodisterase linkage impossible

Front 256

effect of diphenoxylate in motility

Back 256

slows it (its an opioid)
(combine with atropine to prevent abuse - Lomotil)

Front 257

Why thiazides increase lithium toxicity?

Back 257

Lithium is excreted by kidneys

thiazides cause volume depletion, kidneys try to retain Na + H2O, lithium reabsorption follows Na reabsorption

Front 258

Gout long term tx?

Back 258

Allopurinol= xanthine oxidase inhibitor

Front 259

monitoring test for warfarin

Back 259

PT/INR

Front 260

monitoring test for heparin

Back 260

PTT

Front 261

Foscarnet

Back 261

pyrophosphate analog that does not require IC activation (Side effect: celates Ca and Mg)

tx for CMV, herpes and HIV

Front 262

Side effect of Thioridazine

Back 262

Retinal deposits (typical antispychotic w/ less eps)

Front 263

Side effect of Chlorpromazine

Back 263

Corneal deposists (typical antispychotic w/ less eps)

Front 264

Side effect of Ziprasidone

Back 264

longed QT

Front 265

Side effect of Clozapine

Back 265

Agranulocytosis

Front 266

Effect of Pilocarpine in pupils

Back 266

cause pupullary constriction

Direct muscarinic cholinergic agents

Front 267

Tetracyclines are bacteriostatic used for?

Back 267

Mycoplasma
Ricketsia
Chlamydia

(can also use macrolides)

Front 268

Hepatic encephalopathy tx?

Back 268

Lactulose--> degraded by colonic bacteria--> lactic acid + acetic acid

Front 269

Red man syndrome

Back 269

Vancomycin

↑ blood [histamine]

Front 270

Bacterial Resistance MOA

Back 270

↓ IC accumulation of drug

1- ↓permeability

2- Pump drug out= saturates w protein--> eliminates the ion [] gradient
-This can be blocked by putting bacteria in an acidic solution

Front 271

What part of the ear does cisplatin damages?

Back 271

the apical sterocilia on hair cells causing hearing loss

Front 272

Side effects of atropine

Back 272

"hot as a hare, dry as bone, blind as a bat, mad as a hatter"
fever

dry skin and mucous membrane

flushing

mydriasis and cycloplegia

altered mental status

Front 273

Reasons for increased effects the diazepam in elderly

Back 273

↓Total body muscle

↓Total body weight

↓HEPATIC SIZE and BF

↑body fat--> ↑volume of distribution, Stays in the body longer



SE: confusion

Front 274

MOA of cocaine

Back 274

inhibits presynaptic reuptake of NORE, DOPA, SER

Front 275

Side effects of cocaine

Back 275

incr BP

vasocontricction--> chest pain
-Nasal ischemia

agitation

mydriasis

Front 276

which diuretic causes most brisk diuresis?

Back 276

LOOPS

Front 277

Bile acid resins increases risk for?

Back 277

Gallbladder stones
-So do fibrates

Front 278

Drug with Quinidine- like effects (QT & QRS longation)

Back 278

TCA

Front 279

Tx for TCA overdose?

Back 279

NaHCO3

Front 280

Drug with Vd= 3-5 L

Back 280

inc MW--> binded to plasma protein

---> hydrophilic

Front 281

Drug with Vd= 41 L

Back 281

decr MW

uncharged

so drug can cross cell membrane and goes to IC compartment

Front 282

Streptokinase side effect

Back 282

intracerrebral hemorrhage

Front 283

TX of acute C. diphteriae

Back 283

1- diphteria anti-toxin= rapid administration good gnosis

2- penincillin or erythromycin

3- DPT vaccine

Front 284

Nimodopine tx for?

Back 284

Ca channel blockers used for prevention of cerebral vascular spam following SAH

Front 285

what you have to monitored in ethambutol tx?

Back 285

Visual acuity
- color blindness

- central scotoma

Front 286

what you have to monitor in aminoglycoside or vancomycin tx?

Back 286

Hearing and vestibular function
Kidney function

Front 287

Tx for myoclonic seizures?

Back 287

Valproic acid

Front 288

MOA of entarcapone?

Back 288

COMT inhibitor

- incr bioavaliability of levodopa