Pharm

Front 1

Mechanism of action of Ethambutol? Side effect?

Back 1

Blocks carb polymerization (TB). Visual acuity issues, color blindness.

Front 2

Side effect of chloramphenicol

Back 2

aplastic anemia

Front 3

Side effect of dapsone

Back 3

agranulocytosis

Front 4

Side effect of bactram

Back 4

megaloblastic anemia (folate)

Front 5

Mechanism of action and side effect of rifampin

Back 5

Inhibit bacterial DNA dependent RNA polymerase. Side effects = orange body secretions.

Front 6

Mech of action and Side effect of Cipro.

Back 6

Fluoroquinolones mess with DNA unwinding-winding by blocking DNA gyrase.

Front 7

Mechanism of Amphotericin B?

Back 7

Interferes with egosterol binding and causes pore formation and lysis

Front 8

Mechanism of Itraconazole?

Back 8

Inhibits ergosterol synthesis

Front 9

Mechanism of Terbinafine?

Back 9

For fungal nail infections. Inhibits squalene 2,3-epoxidase causing decreased ergosterol synthesis

Front 10

Mechanism of Griseofulvin?

Back 10

blocks microtubules stopping mitosis - only dermatophyte fungi

Front 11

Mechanism of Flucytosine?

Back 11

targets DNA and RNA in fungal cells. Synergistic with amp B. Good for coccidio meningitis.

Front 12

Mechanism of echinocandins? Capsofungin?

Back 12

Blocks polysacchardie glucan in CELL WALL

Front 13

Mechanism of Leuprolide?

Back 13

GnRH analog - for prostate cancer.

Front 14

Function of Norepinephrine?

Back 14

Acts alpha 1 - increase SVR. Acts B1 - increase contractility.

Front 15

Function of Isoproterenol?

Back 15

Activates B1 and B2. B1 does increased contractility. B2 does decreased SVR.

Front 16

Function of Phentolamine?

Back 16

peripheral alpha blocker - vasodilation

Front 17

Function of Labetalol?

Back 17

Beta blocker - decrease contractility. A1 blocker - decrease SVR.

Front 18

Phenylephrine effects?

Back 18

Alpha1>alpha2

Increase SVR.

Front 19

What is the function of Anastrazole?

Back 19

Blocks aromatase conversion. For breast cancer treatment. Similar to Letrozole and exemestane

Front 20

What is the function of Ketoconazole?

Back 20

Decreases androgen synthesis. An antifungal.

Front 21

What is Tamoxifen?

Back 21

Blocks ligand-receptor interaction of estrogen in breast tissue. Can cause endometrial hyperplasia.

Front 22

What is Trastuzumab?

Back 22

Blocks EGF-HER/neu-2 interactions. For Breast cancer.

Front 23

What do Beta Blockers inhibit?

Back 23

Renin

Front 24

What are the teratogenic effects of Lithium?

Back 24

Ebstein's anomaly

Front 25

What is the function of Zileuton?

Back 25

Lipoxygenase inhibitor. For allergic rhinitis and asthma.

Front 26

What does finasteride do?

Back 26

Inhibits 5alpha reductase. Stopping conversion of testosterone to DHT.

Front 27

What is Rifampin tell tale sign? How is resistance to it mediated?

Back 27

Orange body secretions. Inhibits DNA dependent RNA synthesis.

Resistance - altering structure for RNA synthesis.

Front 28

What does Isoniazid require for functioning? How does TB develop resistance?

Back 28

Blocks mycolic acid syntehsis.

Needs bacterial catalase-peroxidase. Requires this for functioning. Decreasing this activity = resistance.

Front 29

What is reserpine?

Back 29

Blocks adrenergic mediator storage in presynaptic vesicles!

Decreased NE, dopamine, 5HT

Front 30

What is pyrimethamine used to treat?

Back 30

malaria and toxo

Front 31

What is used to treat listeria meningitis?

Back 31

Ampicillin

Front 32

What antibacterial activity do 1st generation cephalosporins cover?

Back 32

Gram positive cocci, E coli

Front 33

What bacteria do 2nd generation cephalosporins cover?

Back 33

gram positive coccci, some anaerobes, H flu

Front 34

What bacteria do 3rd generation cephalosporins cover?

Back 34

Gram negative bacteria - pseudomonas, enterobacter, h flu, neisseria

Front 35

What bacteria do 4th generation cephalosporins cover?

Back 35

Gram neg bacteria, gram positive bacteria

Front 36

Mechanism of aminoglycoside?

Back 36

30S subunit. Inhibits formation of initiation complex, causing misreading of mRNA

Front 37

Mechanism for tetracyclines?

Back 37

30S inhibitor. Prevents attachment of aminoacyl-tRNA to acceptor site

Front 38

Mechanism for chloramphenicol?

Back 38

50S inhibitor. Inhibits peptidyl trasnferase. Enzyme that incorporates new amino acid into growing peptide strand

Front 39

Mechanism for erythromycin?

Back 39

50S inhibitor. Blocks aminoacyl-tRNA complex translocation step.

Front 40

Mechanism for Lindomycin?

Back 40

50S inhibitor. Blocks aminoacyl-tRNA complex translocation step.

Front 41

Mechanism for Clindamycin?

Back 41

50S inhibitor. Blocks initiation complex formation and inhibits aminoacyl-tRNA complex translocation step.

Front 42

Mechanism for sulfonamides?

Back 42

Block dihydropteroate synthase. Structural analog of PABA, precursor for dihydrofolic acid.

Front 43

Mechanism for trimethoprim?

Back 43

Inhibits bacterial dihydrofolic acid reductase.

Front 44

Mechanism for gamma Globulins?

Back 44

block adsorption and penetration

Front 45

Mechanism for amantadine?

Back 45

Blocks uncoating of viral nucleic acid.

Front 46

Mechanism for reverse transcriptase inhibitors?

Back 46

Block synthesis of nucleic acids

Front 47

Mechanism for rifampin?

Back 47

Blocks assembly of viral particles

Front 48

Mechanism for neuraminidase inhibitors?

Back 48

Block release of viral particles from the host cell.

Front 49

Mechanism for amphotericin B?

Back 49

Binds ergosterol and causes the formation of holes in the fungal cell membrane

Front 50

Mechanism for flucytosine?

Back 50

Converted to nucleotide analogues by fungal enzymes and then acts to inhibit DNA and RNA synthesis

Front 51

Mechanism for miconazole, fluconazole, clotrimazole?

Back 51

Reduces ergosterol synthesis by inhibiting fungal cytochrome p-450 enzymes

Front 52

Mechanism for caspofungin?

Back 52

Disrupts fungal cell wall synthesis

Front 53

Uses for pentamidine?

Back 53

PCP prophylaxis, alternative treatment for Trypanosoma brucei and Leishmaniasis

Front 54

Uses for nifurtimox?

Back 54

Chagas disease

Front 55

Use for suramin?

Back 55

T brucei infection pre CNS

Front 56

Use for melarsoprol?

Back 56

T brucei after CNS

Front 57

Use for sodium stibogluconate?

Back 57

Leishmaniasis

Front 58

Use for Ivermectin?

Back 58

Onchocerciasis

Front 59

Use for Mebendazole/Albendazole/thiabendazole?

Back 59

Roundworm (ascaris), whipworm, hookworm, pinworm

Front 60

Use for pyrantel pamoate?

Back 60

Roundworm, hookworm, pinworm

Front 61

Use for praziquantel?

Back 61

Fluke (schistosomes), agent of choice for cysticercosis

Front 62

Use for niclosamide?

Back 62

Tapeworm, except cysticercosis

Front 63

Pencillin Mechanism of action?

Back 63

Binds penicillin binding proteins, blocking peptidoglycan cross linking.

Front 64

Clinical uses for penicillin?

Back 64

Gram positive cocci (step, enterococci), gram neg like Neisseria, and spirochetes like syphilis

Front 65

Side effects of PCN?

Back 65

Allergic reaction, Coombs positive hemolytic anemia

Front 66

Mechanism of ampicillin?

Back 66

Binds PBPs, blocking peptidoglycan cross linking.

Front 67

Clinical uses for ampicillin?

Back 67

Treats infections by gram negative rods - H flu, e coli, listeria, proteus, salmonella

as well as gram positive and negative cocci

Front 68

Side effects of amoxicillin/ampicillin?

Back 68

Nonallergenic skin rash

Front 69

Functions of clavulanic acid and sulbactam?

Back 69

Inactivate bacterial B-lactamases. Added to broaden coverage for ampicillin and amoxicillin.

Front 70

Drugs similar to methicillin?

Back 70

Nafcillin, oxacillin, dicloxacillin

Front 71

Mechanism of methicillin

Back 71

Bind PBPs, blocking peptidoglycan cross-linking.

Front 72

Clinical uses of methicillin?

Back 72

Used for Staph infections. Inactive against enterococci, anaerobic bacteria, gram-negatives.

Front 73

Side effects of methicillin?

Back 73

Interstitial nephritis.

Front 74

Side effect of nafcillin?

Back 74

Neutropenia

Front 75

Side effect of oxacillin?

Back 75

hepatitis

Front 76

What is methicillin's special feature?

Back 76

B lactamase resistant

Front 77

Mechanism of piperacillin?

Back 77

Binds PBPs, blocking peptidoglycan crosslinking

Front 78

Clinical use of piperacillin?

Back 78

Treats Pseudomonas. and other gram negative rods like Klebsiella

Front 79

Function of tazobactam?

Back 79

Acts to inactivate bacterial Beta lactamases. Added to piperacillin to extend coverage to other gram neg organisms and Staph aureus.

Front 80

Mechanism of aztreonam?

Back 80

Monocyclic Beta-lactam ring binds PBPs, blocking peptidoglycan cross-linking.

Front 81

Coverage for aztreonam?

Back 81

GRAM NEGATIVE RODS - klebsiella and serratia.

Front 82

Uses for aztreonam?

Back 82

Pts allergic to PCN. Patients who are renally insufficient with gram negative infections who can't take aminoglycosides.

Front 83

What is the mechanism of imipenem?

Back 83

Binds PBPs, thereby blocking peptidoglycan cross linking.

Front 84

Clinical uses for imipenem?

Back 84

Broad spectrum antibiotic, used to treat infections from Enterobacter, anaerobes, pseudomonas. Enterococci, gram negative rods esp Klebsiella. Can't treat VRE or MRSA.

Front 85

Side effects of imipenem?

Back 85

Seizures at high serum levels esp renal insufficient patients.

Front 86

What is cilastatin?

Back 86

Inhibits renal dihydropeptidase I - so imipenem isn't inactivated in renal tubules.

Front 87

Side effects of cephalosporins?

Back 87

hypersensitivity rxn (10% of pts with PCN allergy)

Disulfiram-like activity with EtOH

Front 88

Mechanism for gentamicin?

Back 88

30S inhibitor. Inhibits formation of initiation complex - mRNA misreading.

Front 89

Drugs similar to gentamicin?

Back 89

aminoglycosides - streptomycin, amikacin, neomycin, tobramycin

Front 90

Clinical uses for aminoglycosides?

Back 90

Severe gram negative rod - sepsis, chronic UTI, endocarditis, pneumonia, Pseudomonas.

Front 91

Use for neomycin?

Back 91

Prep for bowel surgery

Front 92

Use for streptomycin?

Back 92

TB regimen. Tularemia.

Front 93

Side effects of aminoglycosides?

Back 93

Nephrotoxicity, ototoxicity.

Front 94

What do aminoglycosides require to function?

Back 94

O2. not good against anaerobes

Front 95

Uses of clindamycin?

Back 95

Anaerobes - B fragilis, C perfringens. Some gram positive cocci like strep and staph.

Severe anaerobic infections above the diaphragm.

Front 96

Side effects of clindamycin?

Back 96

Pseudomembranous colitis from C diff.

Front 97

What is linezolid?

Back 97

other 50S inhibitor to prevent formation of ribosomal complex. Treats MRSA and VRE.

Front 98

clinical uses for chloramphenicol?

Back 98

Broad spectrum - gram positive and negative like rickettsia, H flu, Neisseria, pneumoccocus, bacteriodes.

alternative treament for bacterial meningitis in pts intolerant of penicillins

Front 99

Side effects for chloramphenicol?

Back 99

dose dependent anemia. Dose independent aplastic anemia.

Gray baby syndrome - due to lack of UDP-glucuronyl transferase in newborn liver.

Front 100

What drugs are like erythromycin?

Back 100

Macrolides. Azithromycin, clarithromycin.

Front 101

Uses for erythromycin?

Back 101

Gram positive cocci, Corynebacteria like diphtheria, atypical pneumo.

atypical URIs, some stds like chlamydia, H pylori.

Front 102

Side effects for erythromycin?

Back 102

GI upset. Acute cholestatic hepatitis. Eosinophilia.

Front 103

Special notes for erythromycin?

Back 103

Inhibits cyt p-450. Increased levels of warfarin, cyclosporine, theophylline.

Front 104

Drugs like tetracycline?

Back 104

Doxycycline, minocycline, demeclocycline.

Front 105

Uses for tetracycline?

Back 105

Mycoplasma, Chlamydia pneumonia. Lyme disease. Rocky mountain spotted fever. Cholera. STD chlamydia. Tularemia, brucellosis.

Front 106

Side effects for tetracycline?

Back 106

Fanconi syndrome. Teeth discoloration and bone deformity in children. Photosensitivity.

Front 107

Who can doxycycline be used with?

Back 107

Renal insufficient. Fecal elimination.

Front 108

What should you not take tetracyclines with?

Back 108

Divalent cations inhibiting absorption of tetracyclines - antacids, milk, iron containing substances.

Front 109

What can demeclocycline also be used for?

Back 109

Binds V2 receptors. Treatment of SIADH.

Front 110

Clinical uses of TMP-SMX?

Back 110

E coli, Nocardia, P carinii.

Used for UTIs like for E coli, PCP.

Front 111

Side effects of TMP-SMX?

Back 111

SJS, hemolytic anemia, kernicterus in newborns. Granulocytopenia from folic acid drop.

Front 112

Mechanism of ciprofloxacin?

Back 112

Inhibits DNA topoisomerase II. Induces DNA strand breakage and death.

Front 113

Clinical uses for fluoroquinolones?

Back 113

Gram negs and newer ones like gatifloxacin, moxifloxacin, and levofloxacin have increased activit with gram positive like pneumococcus.

Used for UTIS, Pneumonias and gonococcal.

Front 114

Side effects of fluoroquinolones?

Back 114

Tendonitis, tendon rupture.

Front 115

Contraindications for fluoroquinolones?

Back 115

Pregnant women and chilren.

Front 116

What is nitrofurantoin?

Back 116

Used for recurrent UTIs. Side effects - anemia in G6PD patients.

Front 117

What is vancomycin's mechanism?

Back 117

Binds D-ala D-ala terminus inhibiting transglycosylase. Results in weakened peptidoglycans in cell wall.

Front 118

Clinical uses for vancomycin?

Back 118

Gram positive bacteria. MRSA infections. C diff.

Front 119

Side effects of vancomycin?

Back 119

Ototoxicity, Nephrotoxicity, Red Man syndrome.

Front 120

What are polymyxins?

Back 120

Bind bacterial cell membranes and increase permeability of cell membrane to polar molecules. Only used topically to treat infected skin lesions due to high nephrotoxicity and neurotoxicity.

Front 121

What is mechanism of action of metronidazole?

Back 121

Metabolized by bacterial proteins into reduced reactive compounds that damage DNA, protein, and membranes LEADING TO CELL DEATH

Front 122

Uses for metronidazole?

Back 122

Anaerobic below the diaphragm
Trich
Giardia
Ameba
H pylori (with tetracyline or amoxicillin)

Front 123

Side effects of metronidazole?

Back 123

disulfiram like activity, metallic taste. Potentiates anticoagulants like warfarin.

Front 124

Mechanism of rifampin?

Back 124

Inhibits bacterial DNA-dependent RNA polymerase, decreasing NRA synth.

Front 125

Uses for Rifampin?

Back 125

Mycobacteria. TB and leprosy.

Prophylaxis for contacts for meningococcus and H flu type B

Front 126

Side effects of rifampin?

Back 126

harmless orange color to urine and sweat. Hepatitis. Thrombocytopenia. Nephritis.

Induces cytochrome p-450 system - increasing metab of warfarin, OCs, prednisone, digoxin, glyburide

Front 127

Mechanism of Isoniazid?

Back 127

Inhibits the synthesis of mycolic acids.

Front 128

Uses for Isoniazid?

Back 128

Treatment of mycobacterium tb.

Prophylaxis against active TB

Front 129

Side effects of Isoniazid?

Back 129

Peripheral neuropathy. Drug-induced lupus, hepatitis. Give B6 (pyridoxine) for the peripheral neuropathy.

Metabolism varies depending on rate of N-acetyltransferase in liver.

Front 130

Medications other than rifampin and isoniazid used to treat TB?

Back 130

ethambutol, pyrazinamide, dapsone

Front 131

Mechanism of action of dapsone?

Back 131

PABA antagonist inhibits folic acid synthesis

Front 132

Mechanism of action of Ethambutol?

Back 132

Inhibits mycobacterial arabinosyl transferase, enzyme part of cell wall.

Front 133

Mechanism of action of pyrazinamide?

Back 133

unknown

Front 134

Use for dapsone?

Back 134

Used in combination with rifampin and clofazimine to treat M leprae.

PCP prophylaxis in HIV pts

Front 135

Use for ethambutol and pyrazinamide?

Back 135

TB

Front 136

Side effects of dapsone?

Back 136

G6PD deficient hemolytic anemia

Front 137

Side effects of ethambutol?

Back 137

Retrobulbar neuritis - red/green color blindness

Front 138

Side effects of pyrazinamide?

Back 138

Hepatotoxicity! Gout

Front 139

Drugs that are nucleoside reverse transcriptase inhibitors?

Back 139

Zidovudine (AZT), didanosine, zalcitabine, lamivudine, stavudine, emtricitabine, abacavir

Front 140

Mechanism of action of NRTIs?

Back 140

Inhibit HIV reverse transcriptase inhibiting DNA synthesis. Also compete with nucleoside triphosphates to be added to the newly synthesized viral DNA strand.

Front 141

Uses for NRTIs?

Back 141

treatment of HIV

Front 142

Use for lamivudine?

Back 142

Chronic hep B

Front 143

Side effects of zidovudine?

Back 143

Megaloblastic anemia

Front 144

Side effects of didanosine?

Back 144

pancreatitis

Front 145

What are examples of nucleotide analg reverse transcriptase inhibitors?

Back 145

tenofovir, adefovir. Treat HIV infection. Inhibit reverse transcriptase.

Adefovir - hep B too

Front 146

Examples of non-nucleoside reverse transcriptase inhibitors?

Back 146

Nevirapine, efavirenz, delavirdine

Front 147

Mechanism of non-nucleoside reverse transcriptase inhibitors?

Back 147

speficially to HIV reverse transcriptase

Front 148

Uses for NNRTIs?

Back 148

HIV

Front 149

Side effects of nevirapine?

Back 149

SJS, inudction of cytochrome p-450 - increased metab of OCs, warfarin, ketoconazole, metronidazole

Front 150

Side effects of efavirenz?

Back 150

CNS disturbances

Front 151

What are some protease inhibitors?

Back 151

Saquinivir, ritonavir, indinavir, nelfinatvir, lopinavir, atazanavir, fosamprenavir, tipranavir, darunavir, amprenavir

Front 152

Mechanism of action of protease inhibitors?

Back 152

Inhibit the HIV protease enzyme - virus is unable to replicate

Front 153

Clinical use for protease inhibitors?

Back 153

HIV

Front 154

Side effects of protease inhibitors?

Back 154

Altered distribution of body fat (buffalo hump), hyperlipidemia

Ritonavir inhibits cytochrome p-450 - increased levels of ketoconazole, rifampin, erythromycin

Front 155

Mechanism of action of acyclovir?

Back 155

Phosphorylated by viral thymidine kinase into an analogue of dGTP. After conversion, this drug acts to inhibit DNA synthesis through incorporation into the growing viral DNA strand. Chain termination.

Front 156

Uses for acyclovir?

Back 156

active against HSV 1, 2, VZV, EBV

genital herpes, herpes encephalitis

Front 157

Side effects of acyclovir?

Back 157

Neurotoxicity

can crystallize if given really quickly in kidneys so hydrate

Front 158

Mechanism of action of ganciclovir?

Back 158

Guanosine analog. After phosphorylation by a viral kinase into a nucleotide analogue, acts to preferentially inhibit CMV DNA polymerase.

Front 159

Drugs like acyclovir?

Back 159

valacyclovir, penciclovir, famciclovir

Front 160

Uses for Ganciclovir?

Back 160

CMV infections. Especially retinitis.

Front 161

Side effects of ganciclovir?

Back 161

Pancytopenia.

Front 162

Mechanism of foscarnet?

Back 162

Pyrophosphate analog inhibits viral DNA polymerase.


(can also affect reverse transcriptase)

Front 163

Uses for foscarnet?

Back 163

second line treamtnet of CMV retinitis and other CMV infections and acyclovir-resistant HSV and VZV.

Front 164

Side effect of foscarnet?

Back 164

Nephrotoxicity Mg wasting, leading to low Ca

Front 165

Mechanism of action of amantadine?

Back 165

Binds to the M2 surface protein proton channel on influenza A viral particles. Blocks uncoating of viral RNA.

Stimulates the release of dopamine from neurons of the nigra striatum

Front 166

Uses for amantadine?

Back 166

Reduces duration of influenza A symptoms.

Parksinon's

Front 167

Side effects of amantadine?

Back 167

CNS symptoms - ataxia, slurred speech, dizziness

Front 168

What is zanamivir?

Back 168

Inhibits neruaminidase. Viral enzyme necessary for viral replication and release of viral particles.

Front 169

Uses for zanamivir?

Back 169

Treatment and prophylaxis of both influenza A and B

Front 170

Mechanism of ribavirin?

Back 170

Guanosine analog. Inhibits guanine nucleotide synthesis and inhibits viral RNA polymerase. Inhibits viral replication.

Front 171

Uses for ribavirin?

Back 171

RSV bronchiolitis

Front 172

When is ribavirin contraindicated?

Back 172

Pregnancy and pts with renal insufficiency

Front 173

What is entecavir?

Back 173

Guanosine nucleoside analog - inhibits hep B viral polymerase. Treats hep B infection.

Front 174

Mechanism of Amphotericin B?

Back 174

Binds to ergosterol, alters permeability of the fungal cell membrane

Front 175

Clinical uses for amphotericin B?

Back 175

Systemic mycotic infections.

Intrathecally for meningitis since doesn't cross BBB

Front 176

side effects of amphotericin B?

Back 176

Nephrotoxicity

Front 177

What is nystatin?

Back 177

Similar mode of action to amp B. Treats oral and cutaneous candidiasis. Too many side effects for systemic.

Front 178

Mechanism of flucytosine?

Back 178

converted into nucleotide analogues within fungal cell, inhibits thymidylate synthetase, inhibits fungal DNA and RNA synthesis

Front 179

Uses for flucytosine?

Back 179

In combo with other antifungal agents usually amp B for treatment of systemic mycotic infections and fungal meningitis (crypto/candida)

Front 180

Mechanism of Caspofungin? Use?

Back 180

Inhibits enzyme B(1,3)-D-glucan synthase, disruption of cell wall. Treats candidemia, aspergillosis.

Front 181

Mechanism of Ketoconazole?

Back 181

Inhibits formation of ergosterol by inhibiting fungal cytochrome p-450 enzymes.

Affect gonadal and adrenal steroid synth

Front 182

Use for Ketoconzole?

Back 182

broad-spectrum antifungal agent. Blast, Coccidio, Hiisto, Aspergillus, Mucor, Candida.

Also Cushing syndrome

Front 183

Side effects of ketoconazole?

Back 183

Gynecomastia.

Inhibits cytochrome p-450 - higher levels of warfarin, phenytoin

Front 184

What are miconazole and clotrimazole?

Back 184

Like ketoconzole. Limited to treat cutaneous fungal infections due to high levels of toxicity.

Front 185

Mechanism of fluconazole?

Back 185

Inhibits formation of ergosterol by inhibiting fungal cytochrome p-450. Not as much effect on gonadal and adrenal steroid synthesis are minimal.

Front 186

Use for fluconazole?

Back 186

Crypto meningitis. Treatment for Candidal sepsis.

Front 187

Mechanism of Griseofulvin?

Back 187

Interferes with microtubule function in fungal cells in keratin-rich tissues.

Front 188

Uses for griseofulvin?

Back 188

Oral antifungal agent for treatment of topical dermatophytic infections.

Front 189

What is terbinafine? Use?

Back 189

Inhibits qualene epoxidase (involved in ergosterol synth)

Treats topical dermatophytic infections

Front 190

Mechanism of action of chloroquine?

Back 190

concentrates in parasite food vacuoles and prevents heme metabolism; leading to toxicity and cell death from buildup of soluble heme

Front 191

Use for chloroquine?

Back 191

Treatment of p falciparum malaria. Prophylaxis.

Front 192

Use of quinine?

Back 192

Treatment of drug resistant P falciparum

Front 193

Use of mefloquine?

Back 193

Treatment of drug resistant P falciparum

Front 194

Side effects of mefloquine?

Back 194

Mental status changes

Front 195

Side effects of quinine?

Back 195

cinchonism (tinnitus, headache, dizziness, nausea). coombs positive hemolytic anemia.

CONTRAINDICATED IN PREGNANCY

Front 196

Side effects of chloroquine?

Back 196

GI upset, visual disturbances

Front 197

Use for primaquine?

Back 197

Hepatic forms of p vivax and ovale. G6PD anemia.

Front 198

Mechanism of nifurtimox?

Back 198

Generates oxygen radicals. Damages parasite.

Front 199

What drugs provides prophylaxis for PCP and alternative treatment of T brucei?

Back 199

Pentamidine

Front 200

Mechanism of Ivermectin?

Back 200

Activates GABA receptor sleading to worm paralysis and death

Front 201

Mechanism for Mebendazole/albendazole/thiabnediazole?

Back 201

Inhibits microtubule synthesis and function

Front 202

Mechanism of pyrantel pamoate?

Back 202

Activates parasitic nictoninic receptors, causing worm paralysis

Front 203

Mechanism of praziquantel?

Back 203

Increases cell Ca uptake, causing parasitic contraction and paralysis

Front 204

Mechanism of Niclosamide?

Back 204

Inhibits worm production of ATP

Front 205

Action of alpha1 adrenergic receptor?

Back 205

PLC activated --> IP3 and DAG --> Ca

Induce heart contractiliy. Vasoconstriction.

Eye dilation

Front 206

Action of alpha 2 adrenergic receptor?

Back 206

AC inhibited --> decreased cAMP

Inhibit release of neurotransmitters for nerve terminals

Front 207

Action of Beta 1 adrenergic receptor?

Back 207

AC activated --> increase cAMP

Heart rate and contractility improve

Front 208

Action of Beta 2 adrenergic receptor?

Back 208

AC activated --> increased cAMP. Smooth muscle of respiratory, vascular, and uterine tissue.

Bronchodilation, vasodilation.

Front 209

Action of D1 adrenergic recetpros?

Back 209

AC activated --> increased cAMP

Vasodilation of renal blood vessels

Front 210

Action of D2 adrenergic receptor?

Back 210

Nerve terminals of CNS neurons - regulating nt release

Front 211

Epinephrine actions?

Back 211

Low doses - B agonist - increases heart rate and contractility = B1
B2 = bronchodilation

high dose - alpha agonist - vasconstriction

Cardiac arrest, severe hypotension, bronchospasm and anaphylaxis.

Also given with local anesthetics due to its vasoconstriction so other parts of body not affected

Front 212

Functions of Norepinephrine?

Back 212

Alpha 1, alpha 2, Beta 1 agonist.

Increased vasoconstriction with increased contractility - no change in heart rate.

Treatment of severe hypotension and shock.

See decrease in renal blood flow

Front 213

Function of dopamine as sympathomimetic?

Back 213

B and D agonist at low doses.

Renal perfusion, increase in contractility and heart rate

Alpha high - vasoconstriction.

Pressor for treatment of severe hypotension and shock

Front 214

What is dobutamine?

Back 214

B1 receptor agonist - increases CO. Side effects - peripheral vasodilation. Used for CHF or cardiogenic shock

Front 215

Function of ephedrine?

Back 215

Stimulates release of NE and epinephrine from neurons.

Increases systolic and diastolic blood pressure. Increases cardiac output. Bronchodilation. CNS - insomnia, decreases appetite, improved athletics.

Nasal decongestant.

Front 216

How does amphetamine operate?

Back 216

CNS entrance - stimulates release of NE, epinephrine, and Dopamine

see insomnia and decreased appetite.

Front 217

Functions of cocaine?

Back 217

Inhibit Na/K ATPase responsible for reuptake of NE, serotonin, and dopamine. Can also block voltage gated Na channels.

can be used for local anesthetic

Front 218

Side effects of cocaine?

Back 218

HTN, drug of abuse, cardiac ischemia, cardiac arrhtyhmias

Front 219

What is Reserpine?

Back 219

Inhibits neuron's ability to store NE, dopamine, serotonin. Used earlier to treat HTN, now rarely used bc causes depression and parkisonism.

Front 220

What is Guanethidine?

Back 220

Inhibits NE release from sympathetic neurons. Used to treat hypertension in the past. Rare due to orthostatic htn.

Front 221

What is phenylephrine?

Back 221

Alpha 1 agonist. Systemic vasoconstriction. Decrease in mucosal secretions. Pupil dilation.

Used for severe hypotension and shock. Nasal congestion. Produce mydriasis for retinal exam.

Front 222

Side effects for phenylephrine?

Back 222

reflex bradycardia from vasoconstriction

Front 223

What is Midodrine?

Back 223

Alpha 1 agonist for hepatorenal syndrome and orthostatic hypotension.

Front 224

What is clonidine?

Back 224

Alpha 2 agonist. Stimulating these - the release of NE and other nts is reduced. Decreased central adrenergic activity - decrease in vasoconstriction and decrease in CO and HR.

Used for HTN

Front 225

Clonidine side effect?

Back 225

Rebound HTN if withdrawn!

Front 226

What is Isoproterenol?

Back 226

B1 and B2 receptor agonist. Increases heart rate and contractility. Slightly increaseing systolic pressure.

B2 receptor - peripheral vasodilation and bronchodilation

Front 227

Uses for Isoproterenol?

Back 227

Torsade de points with Mg

Treatment of cardiac arrest or complete heart block.

Front 228

What is Fenoldopam?

Back 228

D1 receptor agonist - for splanchnic and renal vasodilation of severe htn.

Front 229

What is Albuterol?

Back 229

B2 receptor agonist - bronchodilation. Can also lead to K shifting into cell.

Front 230

Uses for Albuterol?

Back 230

Asthma.

Treating Hyperkalemia

Front 231

What is salmeterol?

Back 231

Long acting B2 agonist - prevents asthmatic attacks.

Front 232

What are terbutaline and ritodrine?

Back 232

B2 receptor agonists - reduce uterine contractions during preterm labor.

Front 233

What is methyldopa?

Back 233

Alpha 2 agonist - reduces release of NE. Decreased central adrenergic activity with resulting decrease in vasoconstriction.

Front 234

Use of methyldopa? Side effects?

Back 234

Used for HTN

Can cause sedation and didzziness.

Front 235

What is phenoxybenzamine?

Back 235

Irreversible alpha-receptor antagonist. Decrease in vasoconstriction.

Front 236

Use for phenoxybenzamine?

Back 236

Prevent HTN crisis in pheochromoctyoma.

Front 237

What is phentolamine?

Back 237

Reversible alpha receptor antagonist. Can dx pheochromocytoma if values far larger than expected.

Front 238

Function of prazosin?

Back 238

Selective alpha 1 antagonist. Blocking that - decrease in blood pressure. Also decreases prostatic and bladder neck contraction.

Front 239

Use of prazosin?

Back 239

HTN and BPH

Front 240

Side effects of prazosin?

Back 240

First dose syncope.

Front 241

What is propranolol?

Back 241

B1 and B2 receptor antagonist. Decreases HR and contractility. Reflex peripheral vasoconstriction. Total decreased blood pressure. Resultant bronchoconstriction from unopposed B2 blocking.

Front 242

Clinical use of propranolol?

Back 242

HTN, CAD CV disorders. Treatment of High HR with thyroid problems. Chronic migraines (cerebral vasodilation).

TREATS ESSENTIAL TREMOR

Front 243

Side effects of propranolol?

Back 243

Bronchoconstriction; fasting hypoglycemia (decreased glycogenolysis from B2 blockage)

Really high toxicity, treat with glucagon

Front 244

What is pindolol?

Back 244

weak B receptor agonist and B receptor antagonist. Treats pts with HTN and bradycardia.

Front 245

What is timolol?

Back 245

B1 and B2 receptor antagonist used for wide angle glaucoma. Decreases aqueous humor secretion.

Front 246

What is carvedilol and labetalol?

Back 246

Alpha receptor blockers as well as B receptor blockers. Used for CHF and refractory HTN respectively.

Front 247

What is metoprolol?

Back 247

Selective B1 receptor antagonist. Decreasing heart rate and contractility.

Front 248

Uswe for metoprolol?

Back 248

CAD and HTN. Esp in DM pts.

Front 249

What is betaxolol?

Back 249

Selective B1 receptor antagonist. Wide angle glaucoma - reducing aqueous humor production.

Front 250

What is esmolol?

Back 250

short acting B1 receptor antagonist. Critically ill pts with arrhythmias, htn, MI.

Front 251

What is acebutolol?

Back 251

B1 receptor antagonist with small agonist powers. Hyptertension and bradycardia

Front 252

What are hexamethonium, mecamylamine, and trimethaphan?

Back 252

antinicotinic drugs.

Competitively inhibit activation of Nn receptors on postsynaptic neuron of the autonomic ganglia.

Front 253

Uses for hexamethonium, mecamylamine, and trimethaphan?

Back 253

Treat HTN emergencies in the past.

Front 254

Side effects of hexamethonium, mecamylamine, and trimethaphan?

Back 254

Hypotension, tachycardia, sedation, urinary retention.

Front 255

What is pilocarpine?

Back 255

muscarinic receptor agonist. Applied topically at eye = M3 receptor.

contraction of sphincter muscle of iris - opening canal of Schlemm. Also opens trabecular muscle by contracting the ciliary muscle.

Front 256

Clinical uses for pilocarpine?

Back 256

Narrow and wide angle glaucoma

Front 257

What is carbachol?

Back 257

Muscarinic and nicotinic receptor agonist. M3 stimulation in eye = miosis. Treats wide angle glaucoma or producing pupillary constriction.

Front 258

What is bethanechol?

Back 258

Muscarinic M2 and M3 agonist. Bladder contraction increased with relaxation of bladder sphincter. Promotes urination.

Front 259

Use of bethanechol?

Back 259

Treat bladder atony

Front 260

Side effects of bethanechol?

Back 260

M2 - bradycardia, hypotension

M3 - sweating salivation diarrhea

Front 261

What is atropine?

Back 261

Competitive muscarinic receptor antagonist.

Blocking M1 - atropine can cause sedation and psychosis

Blocking M2 - Tachycardia, mild vasdilation

Blocking M3 - decreased GI tract motility, cycloplegia

Front 262

Uses for atropine?

Back 262

Antidote for cholinesterase inhibitor poisoning (nerve gas, insecticide)

Treatment of bradycardia

Front 263

Side effects of atropine?

Back 263

Hyperthermia, decreased salivation, flushing, psychosis

Front 264

Treatment of atropine poisoning?

Back 264

Cholinesterase inhibitor. Physostigmine or pralidoxime.

Front 265

What is scopolamine?

Back 265

Muscarinic antagonist at M1 receptors. Prevents motion sickness.

Front 266

What are homatropine and tropicamide?

Back 266

Atropine analogs used in ophthalmic solution --> mydriasis.

Front 267

M1 receptor is?

Back 267

CNS stimulation. ACh substrate.

PLC activated - IP3 and DAG - increased Ca

Front 268

M2 receptor is?

Back 268

Heart. Decreases heart rate and contractility.

AC inhibited - decreased cAMP, increase in K conductance

Front 269

M3 receptor is?

Back 269

PLC activated - increased IP3 DAG - increased intracellular Ca.

Increases gut peristalsis, increases bladder contraction, relaxes bladder sphincter, increases bronchoconstriction and respiratory secretions.

contracts sphincter muscle - pupil constriction. loss of far off vision from ciliary muscle contraction.

Front 270

Nm receptor?

Back 270

NMJ. Activates Na/K channel. Promotes muscle contraction.

Front 271

Nn receptor?

Back 271

Activation of Na/K channel.

ANS ganglia - vasodilation of renal blood vessels

Adrenal medulla - stimulates epinephrine release.

Front 272

What does sulcralfate do?

Back 272

Binds mucosal ulcers and provides physical protection against acid

Front 273

What does cilostazol do?

Back 273

for PAD. Stops platelet aggregation and is a direct arterial vasodilator.

Front 274

What drug factor is related to drug-associated lupus? Which drugs?

Back 274

N-acetylation in the liver. Procainamide and hydralazine.

Front 275

What is Benztropine?

Back 275

Muscarinic (M1, M2, M3) receptor antagonist. Acts on M1 receptors in corpus striatum to stop cholinergic activity, restoring dopaminergic-cholinergic balance.

Front 276

What is benztropine used for?

Back 276

Treatment for Parkinson Disease

ALSO MEDICALLY INDUCED PARKINSON

Front 277

For what is benztropine contraindicated?

Back 277

narrow-angle glaucoma

Front 278

What is ipratropium?

Back 278

Muscarinic receptor antagonist. Mostly M3 = bronchodilation.

Front 279

Uses for ipratropium?

Back 279

COPD and asthma

Front 280

What is propantheline?

Back 280

Muscarinic receptor antagonist. primarily M3 - increasing bladder sphincter tone and decreases GI motility and secretions. Used for urinary incontinence and duodenal ulcers.

Front 281

What is oxybutynin?

Back 281

Muscarinic receptor antagonist. By blocking M3, increases bladder sphincter tone and decreases bladder spasm. Used for urinary incontinence.

Front 282

What is neostigmine?

Back 282

Reversibly inhibits acetylcholinesterase. Increasing stimulation of both nicotinic and muscarinic receptors.

Front 283

What is use for neostigmine?

Back 283

Treatment of myasthenia gravis.

Stimulating GI tract and bladder

Overcomes nondepolarizing neuromusclar blockade

Front 284

What is physostigmine?

Back 284

Another acetylcholinesterase inhibitor. Used for atropine poisoning. Also for treatment of glaucoma - producing miosis and stimulating outflow of aqueous humor.

Front 285

What are edrophonium and pyridostigmine?

Back 285

Reversibly inhibit acetylcholinesterase. Increase stimulation of both nicotinic and muscarinic receptors.

Front 286

What does edrophonium do?

Back 286

Used to dx myasthenia gravis

Can differentiate overmedication from under. Overmedication will get worse.

Front 287

What does pyridostigmine do?

Back 287

Long term treatment of myasthenia gravis

Front 288

What is tacrine? Same as donepezil

Back 288

Reversibly inhibits acetylcholinesterase. Increase stimulation of both nicotinic and muscarinic receptors.

Front 289

Use for tacrine?

Back 289

Treatment of Alzheimer's.

Front 290

What is echothiophate?

Back 290

Inhibits acetylcholinesterase. Increases stimulation of both nicotinic and muscarinic receptors.

Front 291

What is echothiophate and isofluorophate use?

Back 291

Treat wide angle glaucoma through M3 receptor

Front 292

What are side effects from echothiophate use?

Back 292

Seizures, psychosis, GI upset, salivation , blurry vision, bradycardia.

Front 293

What is pralidoxime?

Back 293

Antidote for acetylcholinesterase inhibitors, reactivates acetylcholinesterase.

Front 294

What drugs are like fluoxetine?

Back 294

Paroxetine, sertraline, fluvoxamine, escitalopram, citalopram

Front 295

Mechanism of fluoxetine?

Back 295

Prevents reuptake of serotonin from synaptic cleft

Front 296

Clinical use for fluoxetine?

Back 296

Treat major depression, anxiety disorders, OCD, eating disorders

Front 297

Side effects for fluoxetine?

Back 297

sexual dysfunction (decreased libido, difficulty with libido)

also inhibits cyt450 - TCAs, haloperidol, antiarrhythmics

if with MAOs - serotonin syndrome

Front 298

What drugs are TCAs?

Back 298

Desipramine, nortriptyline, imipramine, amitrptyline, doxepin.

second generation - amoxapine, trazodone, bupropion

Front 299

What is the action of nortriptyline/amitryptiline/trazodone/bupropion?

Back 299

block the reuptake of NE and 5HT

Front 300

Clinical uses for TCAs?

Back 300

Major depression, panic disorder, enuresis, chronic pain syndromes.

Front 301

TCA for insomnia?

Back 301

trazodone

Front 302

Use for amitriptyline?

Back 302

neuropathic pain

Front 303

Use for bupropion?

Back 303

Smoking cessation

Front 304

Side effects of TCAs?

Back 304

Inhibited muscarinic, histamine, alpha-adrenergic receptors.

Sedation - histamine
Postural hypotension and cardiac arrhythmias - adrenergic
Anticholinergic effect - dry mouth retention, blurred vision

Priapism = trazodone

Front 305

What happens with simultaneous use of MAOis and TCAs?

Back 305

seizures!

Front 306

Overdosing on TCAs looks like?

Back 306

EKG changes - widening of QRS complex

arrhythmias, mental status changes, seizures

fix cardiac abnormalities - Sodium bicarb

Front 307

What are nefazodone, mirtazapine, venlafaxine, and maprotiline?

Back 307

Heterocyclic antidepressants

Front 308

What is the mechanism of nefazodone, maprotiline, and venlafaxine?

Back 308

Block the reuptake of NE, 5HT from the synaptic cleft.

Front 309

What is the mechanism of mirtazapine?

Back 309

inhibits activation at alpha2-adrenergic receptors and at 5-HT2 receptors. Thereby increasing release of NE and 5HT.

Front 310

Clinical uses for heterocyclic antidepressants?

Back 310

depressive disorders and generalized anxiety disorder

Front 311

Side effects for heterocyclic antidepressants?

Back 311

sedation;

Front 312

Side effect for mirtazapine?

Back 312

Weight gain with increased appetite

Front 313

Side effect for venlaxafine?

Back 313

Elevated blood pressure and heart rate

Front 314

What are some MAOIs?

Back 314

tranycypromine, phenelzine, and isocarboxazid

Front 315

Mechanism of action of MAOIs?

Back 315

Levels of 5HT, dopamine, and NE increase in presynaptic neuron.

MAO A- 5HT and NE
MAO B - dopamine

Front 316

Clinical uses for MAOIs?

Back 316

treatment of atypical depression, specific phobias, and panic disorder

Front 317

Side effects of MAOIs?

Back 317

sedation, hypotension, blurred vision, weight gain

Front 318

What is selegiline?

Back 318

selectively inhibits mao B, increased dopamine for neuron. Good for Parkinson.

Front 319

What is a risk for all MAOIs?

Back 319

Hypertensive crises with tyramine contianing foods

Front 320

What does serotonin syndrome look like?

Back 320

changes in mental status, muscle stiffness, hyperthermia

treat with cyproheptadine

Front 321

Mechanism of Lithium?

Back 321

Inhibits phosphoinositol second messenger cascade, may interfere with synthesis, storage, release, and reuptake of 5HT, dopamine, and NE.

Front 322

Clinical use for Lithium?

Back 322

Bipolar disorder

Front 323

Side effects for Lithium?

Back 323

tremor, hypothyroidism; nephrogenic diabetes insipidus (ADH antagonism) [hypernatremia, polyuria, polydipsia]

MONITOR LI LEVELS
NOT IN PREGNANCY

Front 324

What are some typical antipsychotic agents?

Back 324

Haloperidol and fluphenazine (high potency)

Chlorpromazine and thioridazine (low-potency)

Front 325

What is the mechanism of typical antipsychotics?

Back 325

Block postsynaptic dopamine D2 receptors in the limbic system of the brain, decreasing response of postsynaptic neuron to dopamine excitation.

Front 326

Clinical uses of typical antipsychotic agents?

Back 326

positive symptoms of schizophrenia (delusions, hallucinations), Tourette syndrome, delirium and agitation

Front 327

Side effects of typical antipsychotic agents?

Back 327

Sedation - histamine blockade
Anticohlinergic
Extrapyramidal side effects - acute dystonia, akinesia, akathisia, tardive dyskinesia

Galactorrhea and amennorhea from dopamine inhibition

Front 328

What causes neuroleptic malignant syndrome?

Back 328

antipsychotic agents = muscle rigidity, change in mental status, elevated temperature, autonomic instability.

Can be treated with Dantrolene (muscle relaxant) and dopamine agonists

Front 329

What are some atypical antipsychotic agents?

Back 329

clozapine, risperidone, olanzapine, ziprasidone, aripriprazole, quetiapine

Front 330

Mechanism of action of clozapine/risperidone?

Back 330

Block both 5HT and dopamine receptors. Decreasing response of postsynaptic neuron to dopamine and 5HT excitation.

Some inhibition at H1 histamine receptor, cholinergic receptors, and alpha adrenergic receptors. But less than typical.

Front 331

Uses for clozapine/olanzapine/risperidone?

Back 331

treat positive and NEGATIVE symptoms of schizophrenia.

Olanzapine, risperidone, and quetiapine can be used for delirium.

Front 332

Side effects of atypical antipsychotics?

Back 332

mild weight gain

fewer anticholinergic and extrapyramidal side effects than regular psychotics

Front 333

Side effect of clozapine?

Back 333

Agranulocytosis

Front 334

What are the short acting benzodiazepines?

Back 334

triazolam alprazolam, oxazepam

Front 335

What are the intermediate acting benzodiazepines?

Back 335

lorazepam, temazepam, estrazolam

Front 336

What are the long-acting benzodiazepines?

Back 336

diazepam, clonazepam, flurazepam, chlordiazepoxide

Front 337

Mechanism of action of the benzodiazepines?

Back 337

enhanced GABAa receptor activation - increase flow of chloride ion through adjacent chloride channels - hyperpolarization - decreased activity of the neurons of the limbic, thalamic, and hypothalamic regions of CNS

Front 338

Use for Benzodiazepines?

Back 338

Anxiety, seizures, status epilepticus

Alcohol withdrawal

Front 339

What are other uses for midazolam and diazepam?

Back 339

anesthetics

Front 340

What are side effects of benzodiazepines?

Back 340

sedation; altered mental status; ataxia

Withdrawal symptoms - seen with dependence

Avoid with barbiturates, EtOH, depressants

Front 341

What is benzo overdose like? Treat it?

Back 341

Cardiac and respiratory depression. Treat with flumazenil - competitive antagonist of benzos at the GABA receptor.

Front 342

What are some barbiturates?

Back 342

phenobarbital, thiopental, secobarbital, amobarbital, pentobarbitol

Front 343

Mechanism of action of barbiturates?

Back 343

Potentiate GABAa receptor activity in the brain

decreases activity of CNS neurons

Front 344

Use for barbiturates?

Back 344

sedative (anxiety and insomnia)

Front 345

Use of thiopental?

Back 345

induction of anesthesia

Front 346

Use of phenobarbitol?

Back 346

Management of seizures and in treatment of neonatal hyperbilirubinemia

Front 347

How do you treat overdose of barbiturates? What does it look like?

Back 347

cardiac and respiratory depression. Treatment with ventilation, hemodialysis, and alkalinization of the urine.

Front 348

Side effects of barbiturates?

Back 348

P-450 induction
withdrawal
avoid in pregnancy, liver disease, porphyria, alcohol, benzos

Front 349

Mechanism of phenytoin?

Back 349

decreases flow of Na and Ca across cell membrane. Decreased depolarization.

Front 350

Uses for phenytoin?

Back 350

simple and complex partial seizures; grand mal seizures, status epilepticus.

Trigeminal neuralgia and torsades de pointes

Front 351

Side effects of phenytoin?

Back 351

Nystagmus, gingival hyperplasia, drug-induced lupus, fetal hydantoin syndrome (prenatal growth deficiency and congenital cardiac and palate malformations)

Front 352

What is Lamotrigine?

Back 352

Inhibits Na channels on neurons and release of glutamate from tissue.

for simple and complex partial seizures and generalized tonic-clonic seizures

Front 353

What is Valproic acid's mechanism?

Back 353

Unknown. May increases GABA concentrations. Also has effects on Na and K conductance.

Front 354

Clinical uses of valproic acid?

Back 354

generalized tonic-clonic seizures, myoclonic seizures, absence seizures

Treatment of mania associated with bipolar disorder

Front 355

Side effects of valproic acid?

Back 355

Hepatotoxicity; neural tube defects

Front 356

What is ethosuximide?

Back 356

Decreases Ca currents across neuronal cells. Inhibits GABA metabolis.
For absence seizures.

Front 357

What is Carbamazepine's mechanism of action?

Back 357

Inhibits flow of sodium ions through sodium channels. Hyperpolarization.

Front 358

What are clinical uses for carbamazepine?

Back 358

Partial seizures

Trigeminal neuralgia

Front 359

Side effects of carbamazepine?

Back 359

hepatotoxicity, agranulocytosis, aplastic anemia

induces p-450, like phenytoin metabolism

Front 360

What is topiramate?

Back 360

inhibits neural cell sodium channels. Adjunct treatment for simple and complex partial seizures.

Front 361

Mechanism of tiagabine?

Back 361

inhibits reuptake of GABA

Front 362

Use for tiagabine?

Back 362

Partial seizures

Front 363

What is vigabatrin?

Back 363

inhibits breakdown of GABA. For partial seizures.

Front 364

What is levetiracetam?

Back 364

adjunct for epilepsy and neuropathic pain.

Front 365

What is succinylcholine's mech of action?

Back 365

DEPOLARIZING neuromuscular blocker that competes with ACh to reversibly bind nicotinic receptors.

Phase I blockade - continuous depolarization with muscle fasciculations. Irreversible.

Phase II - repolarization but desensitization with continuous interaction with succinylcholine = phase II = not transmitting an AP. Reverse by physostigmine

Front 366

What is clinical use for succinylcholine?

Back 366

Muscle paralysis for endotracheal intubation

Front 367

What happpens if succinylcholine is adminstered with halothane?

Back 367

Malignant hyperthermia.

Cx by muscle rigidity and elevated body temp.

Rx: dantrolene (releases Ca from SR, decreasing muscle contraction)

Front 368

What is pancuronium's mechanism of action?

Back 368

Nondepolarizaing neuromuscular blocker that acts to competitively bind nicotinic receptors at NMJ.

Prevents ACh from binding. Inhibition of muscle contraction.

Front 369

What is clinical use of pancuronium?

Back 369

Adjunct to general anesthesia induction - reducing skeletal muscle contraction for traching

Front 370

Side effects of pancuronium?

Back 370

Hypotension

Front 371

How can you reverse pancuronium?

Back 371

Cholinesterase inhibitor

Front 372

Drugs like pancuronium?

Back 372

Vecuronium, atracurium, cisatracurium, tubocurarine, mivacurium, rapacuronium

Front 373

Two types of local anesthetics?

Back 373

Amides - lidocaine, bupivacaine

Esters - procaine, cocaine, tetracaine, benzocaine

Esters generally shorter duration

Front 374

Mechanism of action for local anesthetics?

Back 374

Block Na channels. Most rapidly seen in myelinated fibers of small diameter.

Give epinephrine to avoid systemic spread

Front 375

Clinical use for local anesthetics?

Back 375

Minor surgical procedures

Front 376

Side effects of local anesthetics?

Back 376

Seizures

Front 377

Side effects of bupivacaine?

Back 377

myocardial depression, hypotension

Front 378

Side effects of cocaine?

Back 378

HTN, cardiac arrhythmias

Front 379

What are examples of some general inhaled anesthetic agents?

Back 379

Halothane, isoflurane, desflurane, sevoflurane, enflurane, methoxyflurane

Front 380

Mechanism of action for general inhaled anesthetic agents?

Back 380

directly activate GABAa receptors, decreased neuronal activity.

Front 381

Uses for general inhaled anesthetic agents?

Back 381

General anesthetic induction and maintenance

Front 382

Side effects for general inhaled anesthetic agents?

Back 382

Myocardial and respiratory depression

Front 383

Halothane side effects?

Back 383

fulminant hepatic necrosis and cardiac arrhythmias

increased PT time

Front 384

Side effects for methoxyflurane and enflurane?

Back 384

nephrotoxic.

Front 385

What are some general IV anesthetic agents?

Back 385

Propofol, etomidate, ketamine, benzodiazepines, barbiturates, opioids

Front 386

Mechanism of propofol?

Back 386

May prolong activity at GABAa receptor

Front 387

Mechanism of etomidate?

Back 387

prolongs activity at GABA receptor

Front 388

Ketamine mechanism?

Back 388

NDMA receptor antagonist

Front 389

Clinical use for propofol?

Back 389

Induction and maintenance of anesthesia

Front 390

Clinical use for etomidate?

Back 390

Induction of anesthesia

Front 391

Clinical use for ketamine?

Back 391

rarely used for side effects

Front 392

Side effects for propofol?

Back 392

Hypotension; chemical pancreatitis

Front 393

Side effects for etomidate?

Back 393

Vomiting; myoclonus; adrenal suppression

Front 394

Side effects for ketamine?

Back 394

Hallucinations, cardiac and respiratory depressant

Front 395

What are some opioids?

Back 395

morphine, codeine, oxycodone, hydrocodone, hydromorphone, heroin, meperidine, fentanyl, dextromethorphan

Front 396

Mechanism of opioids?

Back 396

Bindings specific opioid receptors. Hyperpolarization and decreased activity w/interaction of Ca and K ion channels.

Morphine causes K efflux with mu - GPCR

Front 397

Clinical uses for opioids?

Back 397

Pain control

cough suppression = codeine and dextromethorphan

Diarrhea - diphenoxylate = meperidine analog

Acute pulmonary edema - morphine

PENTAZOCINE = opioid antag/agonist - doesn't get withdrawal

Front 398

Side effects for opioids?

Back 398

cardiac and respiratory depression; constipation

watch out for tolerance and dependence

treat withdrawal in kids WITH TINCTURE OF OPIUM

Front 399

What are naloxone and naltrexone?

Back 399

opioid receptor antagonists or overdoses

Front 400

What is methadone?

Back 400

Opioid for maintenance programs and eases withdrawal symptoms

Front 401

Mechanism of levodopa?

Back 401

converted into dopamine by DOPA-decarboxylase in the brain

Front 402

Use for levodopa?

Back 402

Parkinsonism

Front 403

Side effects for levodopa?

Back 403

Dyskinesia; cardiac arrhythmias;

Front 404

What is carbidopa?

Back 404

Inhibits DOPA-decarboxylase only in the periphery, since carbidopa doesn't cross BBB.

Front 405

What is bromocriptine?

Back 405

partial dopamine receptor agonist used as adjunct for parkinsonism and for treatment for hyperprolactinemia

Front 406

What is sumatriptan?

Back 406

Acts to stimulate presynaptic 5-HTD receptors. Inhibits vasodilation and inflammation of the dura.

Maybe stimulates 5-HTB - vasoconstriction of intracranial vessels

Front 407

Clinical uses for sumatriptan?

Back 407

Migraines and cluster headaches

Front 408

Side effects from sumatriptan?

Back 408

coronary vasospasm, contraindicated in pts with CAD

Front 409

Action of bupropion?

Back 409

inhibits reuptake of NE and DA, also nicotinic antagonist

Front 410

Action of varenicline?

Back 410

partial agonist and antagonist at alpha4B2 nicotinic acetylcholine receptors subtype

Front 411

Side effects for bupropion?

Back 411

psychosis, szs

Front 412

What is buspirone?

Back 412

5-HT presynaptic receptor patial agonist.

Front 413

Uses for buspirone?

Back 413

Generalized anxiety disorder. Maybe conjunction with SSRIs

Front 414

Mechanism of Gabapentin?

Back 414

GABA analogue.

Front 415

Uses for gabapentin?

Back 415

postherpetic neuralgia, partial seizures

Front 416

Side effects for gabapentin?

Back 416

Peripheral edema

Front 417

What is pregabalin?

Back 417

Binds Ca ion channels in CNS, decreasing glutamate and NE release.

Used now to treat neuropathic pain, fibromyalgia.

Front 418

Class IA antiarrythmics?

Back 418

Procainamide, quinidine, disopyramide

Front 419

Action of class IA antiarrythmics?

Back 419

Block active Na channels. Some K activity.
Increasing AP, ERP, QT.
Prolong Phase 0, some Phase 3.

Front 420

Use of Class IA antiarrhythmics?

Back 420

A fib, V Tach.

Front 421

Toxicity of Quinidine?

Back 421

Cinchonism

Front 422

Toxicity of Procainamide?

Back 422

SLE drug induced

Front 423

Class IB antiarrhythmics?

Back 423

Lidocaine, Mexiletine, Tocainide

Front 424

Action of class IB antiarrhythmics?

Back 424

Block active and inactive Na channels.
Shorten phase 3. Decreased AP.
Good for ischemic myocardium.

Front 425

Use for class IB antiarrhythmics?

Back 425

post MI ventricular arrhythmias. Digitalis induced arrhythmias.

Front 426

Side effects of Class 1B antiarrhythmics?

Back 426

Local anesthetic. CNS stimulation/depression. CV depression

Front 427

Class IC antiarrhythmics?

Back 427

Flecainide, Encainide, Propafenone.

Front 428

Action of Class IC antiarrhythmics?

Back 428

Block Na channels.
Prolong Phase 0.

Front 429

Use of Class IC antiarrhythmics?

Back 429

Refractory supraventricular arrhythmias.

For pts without structural abnormalities.

Front 430

Side effects of Class IC antiarrhythmics?

Back 430

Pro arrhtyhmic. Prolong refractory period in AV node.

Front 431

Class II antiarrhythmics?

Back 431

B blockers.

Front 432

Action of Class II antiarrhythmics?

Back 432

Decrease slope of phase 4. Increasing PR interval.

Front 433

Use of Class II antiarrhythmics?

Back 433

A fib. A flutter.

Front 434

Side effect of Metoprolol?

Back 434

Dyslipidemia from hypoglycemia.

Front 435

Class III antiarrhythmics?

Back 435

Sotalol, ibutilide, dofetilide, amiodarone

Front 436

Action of Class III antiarrhythmics?

Back 436

Inactivate K channels.
Prolong AP, Prolong ERP. Prolong Phase III. Increase QT interval.

Front 437

Use of Class III antiarrhythmics?

Back 437

Atrial arrhythmias when others fail.

Front 438

Side effects of Class III antiarrhythmics?

Back 438

Torsades de pointes.

Front 439

Amiodarone actions?

Back 439

Has class I, II, III, IV effects because it alters the lipid membrane.

Front 440

Amiodarone side effects?

Back 440

Pulmonary fibrosis, Hepatotoxicity, Thyroid dysfunction

Front 441

Mechanism Class IV antiarrhythmics?

Back 441

Primarily affects AV nodal cells

Block Ca channels, decreasing slope of phase IV.
Increase ERP, Increase PR.

Front 442

Use for Class IV antiarrhythmics?

Back 442

Prevention of nodal arrhythmias. SVT. A fib.

Front 443

Side effects of Class IV antiarrhythmics?

Back 443

Hypotension. Heart block.

Front 444

Use of adenosine?

Back 444

Dx and treatment of SVTs

Front 445

Action of adenosine?

Back 445

Increases K outside of cells. Hyperpolarizing the cell.

Front 446

Side effects of adenosine?

Back 446

Hypotension, heart block, flushing. Effects blocked by theophylline.

Front 447

K as antiarrhythmics?

Back 447

Depresses ectopic pacemakers; especially those with digoxin toxicity.

Front 448

Mg as antiarrhythmic?

Back 448

For torsades de points, also for digoxin toxicity.

Front 449

Action of digoxin?

Back 449

Inhibiting Na/K ATPase and leading to indirect inhibition of Na/Ca exchanger/antiport. Increasing intracellular Ca. Increased contractility. Stimulates Vagus too. Decreasing heart rates.

super careful with renal clearance

Front 450

Uses for digoxin?

Back 450

CHF. A fib.

Front 451

Side effects of digoxin?

Back 451

GI upset; Blurry yellow vision; ECG changes - prolonged PR, decreased QT, ST scooping, T wave inversion.

Front 452

What exacerbates side effects of amiodarone?

Back 452

Renal failure
Hypokalemima
Quinidine

Front 453

Antidote for digoxin toxicity?

Back 453

correcting hypokalemia, administering anti-dig Fab fragments, Mg. Possible lidocaine.

Front 454

Action of nitroglycerin or isosorbide dintrate?

Back 454

Vasodilate by releasing nitric oxide in smooth muscle, increasing cGMP and smooth muscle relaxation. Reduction of preload as venodilator.

Front 455

Use for nitroglycerin?

Back 455

Angina, pulm edema.

Front 456

Side effects of nitroglycerin?

Back 456

Reflex tachycardia, Monday disease, hypotension, flushing, headache

Front 457

Action of Nitroprusside?

Back 457

Metabolized into nitric oxide in blood stream. Increase cGMP, smooth muscle relaxation of peripheral veins and arteries. Reduction in preload and afterload.

Front 458

Use of nitroprusside?

Back 458

Acute management of HTN crisis. Severe heart failure.

Front 459

Side effects of nitroprusside?

Back 459

CN toxicity.
can only be given IV becasue of this.
Thiosulfate can treat toxicity.

Front 460

ACEi actions?

Back 460

Inhibit ACE, peptidyl dipeptidase.Increases bradykinin, a vasdilator. Blocks vasoconstriction of AII and its activation of aldosterone. Decreases PVR and volume of fluid.

Front 461

Use of ACEis?

Back 461

treatment of HTN and CHF. Treat and prevent diabetic nephropathy.

Decreases mortality in post MI pts.

Front 462

Side effects of ACEis?

Back 462

Cough, teratogen, angioedema.

High K in renal insufficient people

Front 463

Actions for angiotensin receptor blockers?

Back 463

Block AT1 receptor. Decreases SVR from vasoconstriction prevention and decreases fluid volume in body.

Front 464

Uses for angiotensin receptor blockers?

Back 464

HTN and CHF. Treat and prevent diabetic nephropathy.

Front 465

Side effects of angiotensin receptor blockers?

Back 465

high K and renal failure in renal insufficient patients.

Teratogen

NO RESULTANT COUGH OR ANGIOEDEMA

Front 466

Action of Hydralazine?

Back 466

Increases cGMP --> smooth muscle relaxation. VASODILATES ARTERIOLAR SMOOTH MUSCLE.

Front 467

Use for Hydralazine?

Back 467

HTN as well as CHF. First line therapy for HTN in pregnancy with methyldopa. Frequently coadministered with B-blocker to prevent reflex tach.

Front 468

Side effects for Hydralazine?

Back 468

Reflex tach.

LUPUS LIKE SYNDROME

Front 469

Action of Minoxidil?

Back 469

K channel opener --> hyperpolarizes and relaxes vascular smooth muscle. VASODILATOR.

Front 470

Use for Minoxidil?

Back 470

HTN.

Front 471

Side effects for Minoxidil?

Back 471

Hypertrichosis (hair growth), pericardial effusion.

Front 472

Calcium Channel blocker action?

Back 472

Block voltage gated (L-type) Ca channels of cardiac and smooth muscle, reducing muscle contraction = peripheral vasodilation. Decreased myocardial contractility?

Front 473

Calcium Channel blockers?

Back 473

Nifedipine, Nicardipine, Amlodipine.

Verapamil, diltiazem

Front 474

Uses for Ca channel blockers?

Back 474

HTN. Prionzmetal angina. Raynaud's.

Front 475

Toxicity of Ca channel blocerks?

Back 475

Cardiac depression, AV block, peripheral edema

Amlodipine - flushing and peripheral edema

Verapamil - gingival hyperplasia, constipation, HEART BLOCK

Front 476

Mannitol action?

Back 476

osmotic diuretic, acts at PT and descending loop of Henle, increase tubular osmolarity drawing water into lumen. Increase urine outflow and decrease volume of body.

Front 477

Drugs like mannitol?

Back 477

urea, glycerin, isosorbide

Front 478

Use of mannitol?

Back 478

decrease ICP, intraocular pressure. Prevent ARF following shock or toxins.

Isosorbide and glycerin = intraocular pressure

Front 479

For whom is mannitol contraindicated?

Back 479

patients with CHF, can cause expansion of volume before decrease.

Front 480

Side effects of mannitol?

Back 480

Pulm edema, dehydration

Front 481

Drugs like acetazolamide?

Back 481

Dorzolamide, brinzolamide.

Front 482

Mechanism of acetazolamide?

Back 482

Inhibits Carbonic Anhydrase in cells of PCT.

Less bicarb resorbed, more Na lost in lumen. (CA is also in the eye w/production of aqueous humor)

Front 483

Use for acetazolamide?

Back 483

glaucoma, alkalinize urine for toxin ingestion like salicylate or barbiturates, treatment and prophylaxis of high altitude sickness (decreases CSF), metabolic alkalosis,

Front 484

Side effects of acetazolamide?

Back 484

hyperchloremic metabolic acidosis, hypokalemia

Front 485

Loop diuretics?

Back 485

furosemide, bumetanide, torsemide

Front 486

Actions of furosemide?

Back 486

Sulfonamide derivative. Inhibits coupled Na/K/2Cl transport in thick ascending loop. Retention of NaCl, K, and H2O in lumen. can't concentrate urine. Increased Ca excretion.

Causes PG release - increases RBF. (afferent)

Front 487

Uses for furosemide?

Back 487

CHF with pulmonary edema, HTN, Hypercalcemia

Front 488

Side effects of furosemide/loop diuretics?

Back 488

Hypokalemia, Ototoxicity, Hyperuricemia/Gout, Allergic reaction with sulfa patients, Interstitial nephritis

Front 489

What is ethacrynic acid?

Back 489

Diuretic with same action as furosemide. For patients who can't tolerate solfa drugs. Or prone to gouty attacks.

Front 490

Thiazides?

Back 490

HCTZ, Chlorothiazide, chlorthalidone, indapamide

Front 491

Mechanism of action of HCTZ?

Back 491

inhibits Na/Cl cotransporter in early DCT of nephron. Reduces diluting capacity of nephron.

Front 492

Uses of HCTZ?

Back 492

HTN, nephrogenic Diabetes insipidus, recurrent kidney Ca stones, CHF

Front 493

Side effects of HCTZ?

Back 493

Hypokalemia, hyperuricemia, hypercalcemia, hyperglycemia, hyperlipidemia

Increased secretion of Na and K in urine

Front 494

K sparing diuretics?

Back 494

Spirinolactone, triamterene, amiloride, eplerenone

Front 495

Mechanism of spironolactone?

Back 495

Competitive aldosterone receptor antagonist. Na and water retention is decreased at collecting tubule and late distal tubule. K excretion decreased.

Front 496

Uses for spironolactone?

Back 496

hyperaldosteronism, heart failure, K depletion

Front 497

Side effects of spironolactone?

Back 497

High K, gynecomastia

Front 498

Mechanism of triameterene and amiloride?

Back 498

Block Na channels in DCT of nephron. Used for sprionoloactone pts who lack endogenous aldosterone (Addison disease). Can be used for HTN.

Front 499

What class of drugs are milrinone and amrinone?

Back 499

PDE inhibitors

Front 500

Action of milrinone and amrinone?

Back 500

Inhibite PDE isozyme III. Increased cAMP. Opens Ca channels on surface of cell. Ca flows in = increased contractility.

Front 501

When are milrinone and amrinone used?

Back 501

acute decompensated CHF

Front 502

Side effects of milrinone and amrinone?

Back 502

Nausea and vomiting

Front 503

Action of Sildenafil?

Back 503

PDE inhibitor for ED. cGMP-type 5. In corpus cavernosum of penis. Relaxation of smooth muscle - increased blood flow. Contraindicated in pts on nitrates.

Front 504

Mechanism of action of heparin?

Back 504

binds to antithrombin III, inhibiting thrombin and factor Xa.

Front 505

Clinical uses of heparin?

Back 505

Treat and prevent DVTs, pulm embolism, myocardial ifarction.

Follow PTT

Short half life and rapid onset of action

Front 506

Side effects of heparin usage?

Back 506

Bleeding, (treated with protamine sulfate [pos charge binding neg charge])

HIT

Front 507

Pathogenesis of Heparin Induced Thrombocytopenia?

Back 507

Heparin binds to platelets - autoantibody production destroying platelets and overactivating the remaining ones, resulting in a thrombocytopenic, hypercoagulable state

Front 508

What are enoxaprin and dalteparin?

Back 508

Low m-w forms of heparin. Focus more on degrading factor X. Longer duration of action, requiring less dosing. Doesn't need as much monitoring.

Front 509

Action of warfarin/dicumarol?

Back 509

Inhibits vit K-dependent gamma-carboxylation of factors II, VII, IX, and X and protein C and S.

Front 510

Use for warfarin?

Back 510

chronic anticoagulation. Like a fib.

Long half life; takes long to act.

Front 511

Which drugs affect warfarin?

Back 511

Increase - cimetidine, metronidazole, Bactram

Decrease - barbiturates, rifampin, cholestyramine

Front 512

Side effects of warfarin?

Back 512

Not used in pregnant women. Teratogenic. Follow PT/INR values. Bleeding

Front 513

What drugs are the direct thrombin inhibitors?

Back 513

Hirudin, bivalirudin, lepirudin, desirudin, argatroban, melagatran, dabigatran

Front 514

Mechanism of action of hirudin/argatroban?

Back 514

Direct thrombin inhibition.

Front 515

Use for hirudin?

Back 515

Anticoagulation in patients who are unable to take heparin - DVTs, acute coronary syndrome.

PT and PTT will be increased with these drugs

Front 516

What is used to treat HIT?

Back 516

Argatroban

Front 517

Side effects of hirudin/argatroban?

Back 517

Bleeding

Front 518

Action of aspirin?

Back 518

Inhibits Cox-1 and Cox-2. Decreasing PG synthesis. W/o PGE2, analgesia, antipyretic, decreased synth of protective gastric mucus.

W/o TXA2, decreased platelet aggregation.
W/o PGI2, increased gastric secretion.

Front 519

Uses for aspirin?

Back 519

Antipyretic, analgesic, anti-inflammatory, antiplalatelet (risk for CV or cerebrovascular disease)

Front 520

Side effects of aspirin?

Back 520

Bleeding, gastric ulcers, hyperventilation, Reye's syndrome, tinnitus [resp/metabolic acidosis]

Front 521

Mechanism of clopidogrel/ticlopidine?

Back 521

Decreased platelet aggregation by inhibiting the ADP pathway. Decreases expression of GPIIb/IIIa

Front 522

Uses for clopidogrel?

Back 522

Treat ACS with apsirin, coronary stinitng, alternative antiplatelet for those unable to tolerate aspirin

Front 523

Side effects of clopidogrel?

Back 523

Bleeding

Front 524

Ticlopidine specific side effects?

Back 524

Neutropenia and TTP

Front 525

What is dipyridamole?

Back 525

Used to perform cardiac stress tests and secondary prevention of stroke with aspirin.

Inhibits cyclic PDE, increasing cAMP. Inhibits TXA2 synth and promote prostacyclin action.

Front 526

Drugs like abciximab?

Back 526

Eptifibatide, tirofiban

Front 527

Mechanism of abciximab?

Back 527

Bind to GPIIB/IIIa receptor. Inhibits binding of fibrinogen and vWF to the receptor.

Inhibits cross linking of fibrinogen - impeding platelet aggregation.

Front 528

Uses for abciximab?

Back 528

Treatment of ACS. Percutaneous coronary intervention.

Front 529

Side effects of abciximab?

Back 529

bleeding, thrombocytopenia

Front 530

What are some fibrinolytic agents?

Back 530

streptokinase, urokinase, anistreplase, alteplase (tPA), reteplase

Front 531

Action of fibrinolytic agents?

Back 531

Directly or indirectly aid conversion of plasminogen to plasmin, cleaves thrombin and fibrin clots. Increases PT, PTT.

Front 532

Use for fibrinolytic agents?

Back 532

pulm embolism, stroke, acute MI

Front 533

Toxicity for fibrinolytic agents?

Back 533

Bleeding. Treat toxicity with aminocaproic acid.

Front 534

What is aminocaproic acid?

Back 534

Similar to tranexamic acid.

Front 535

Mechanism of aminocaproic acid?

Back 535

Inhibit plasminogen activation. Inhibition of fibrinolysis results.

Front 536

Uses for aminocaproic acid?

Back 536

Bleeding treatment. Maybe hemophilia.

Front 537

Side effects of aminocaproic acid?

Back 537

Thrombosis

Front 538

Drugs like synthetic EPO?

Back 538

Epoetin, darbepoetin

Front 539

Mechanism of action of EPO?

Back 539

Stimulates the bone marrow to enhance erythroid proliferation and differentiation, thereby increasing HCT.

Front 540

Clinical use for EPO?

Back 540

Anemia associated with CKD, chemo

Front 541

Side effects of EPO?

Back 541

CV events and thromboses. HTN

Front 542

What drugs are sulfonylureas?

Back 542

1st = Chlorpropamide, tolbutamide, tolazamide

2nd = glyburide, glipizide

3rd = glimepiride

Front 543

Action of Sulfonylureas?

Back 543

Stimulate insulin release by closing K channels on B cell membrane so the cell depolarizes - triggering of insulin release via increased Ca influx

2) prolong binding of insulin to target tissue receptors

3) reduce glucagon from direct inhibition of insulin on glucagon

Front 544

Use for Sulfonylureas?

Back 544

non-insulin dependent type 2 DM

Front 545

Side effects of sulfonylureas?

Back 545

Hypoglycemia

not for pregnancy or renal/hepatic patients

Chlorpropamide causes disulfiram like effects

Front 546

What is the biguanide prototype?

Back 546

Metformin

Front 547

Action of metformin?

Back 547

Inhibits hepatic gluconeogenesis, increase peripheral utilization of glucose

Front 548

Uses for Metformin?

Back 548

type 2 DM.
[also PCOS]

Front 549

Side effects of metformin?

Back 549

Lactic acidosis; GI upset.

Contraindicated in renal insufficiency

Front 550

Which drugs are thiazolidinediones?

Back 550

Rosiglitazone, pioglitazone, troglitazone

Front 551

Mechanism of rosiglitazone?

Back 551

bind to PPAR-gamma, upregulation of multiple genes. Decrease in insulin resistance.

Front 552

Clinical uses of rosiglitazone?

Back 552

Treatment of non-insulin-dependent type 2DM

Monitor LFTs

Front 553

Side effects of rosiglitazone?

Back 553

Hypglycemia, edema

Front 554

Side effects of trogltiazone?

Back 554

Liver damage

Front 555

Which drugs are alpha-glucosidase inhibitors?

Back 555

Acarbose, miglitol

Front 556

Mechanism of action of acarbose?

Back 556

Inhibit intestinal brush border alpha-glucosidase. Can't breakdown sugarys. Absorption of postprandial carbohydrates is decreased.

Front 557

Uses for acarbose/miglitol?

Back 557

Non-insulin-dependent type 2 DM.

Front 558

Side effects of acarbose?

Back 558

flatulence/diarrhea

Front 559

What are the meglitinides?

Back 559

Repaglinide, nateglinide

Front 560

What are the DDP-4 inhibitors?

Back 560

Sitagliptin, vildagliptin

Front 561

Action of repaglinide/nateglinide?

Back 561

Binds to a K channel on pancreatic Beta cells, stimulating release of insulin from the pancreas

Front 562

What is the Glucagon-like peptide-1 analog?

Back 562

Exanatide

Front 563

What is the action of sitagliptin, vildagliptin?

Back 563

DDP-4 degrades GLP-1 which acts to increase insulin secretion and decrease glucagon secretion. By inhibiting DPP-4, GLP-1 increases, leading to increased insulin secretion.

Front 564

What is action of exanatide?

Back 564

Increases insulin secretion and decrease glucagon secretion.

Front 565

Side effects of repaglinide?

Back 565

weight gain; hypoglycemia

Front 566

Side effects of Sitagliptin?

Back 566

Nausea

Front 567

Side effect of exanatide?

Back 567

Pancreatitis; hypoglycemia

Front 568

Statin action?

Back 568

Inhibit HMG-CoA reductase. Enzyme that catalyzes first step in chol biosynthesis in liver. Increase in conc of LDLr on hepatocytes.

Front 569

Use for statins?

Back 569

Decrease total cholesterol and LDL levels. Triglycerides mildly decrease and HDL mildly increase

Front 570

Side effects of statins?

Back 570

Myopathy and abnormal LFTs

Front 571

What is ezetimibe?

Back 571

Cholesterol lowering medication decreases chol absorption in GI tract. Decreased LDL levels.

Front 572

Which drugs are bile acid resins?

Back 572

Cholestyramine, colestipol, colesevelam

Front 573

Mechanism of cholestyramine?

Back 573

Inhibit reabsorption of bile acids in jejunum and ileum. Lower levels of bile acid result in increased conversion of cholesterol to bile acids, leading to lower levels of IC cholesterol. Cells increase LDLR.

Front 574

Uses for cholestyramine?

Back 574

Decrease LDL levels. No effect on HDL. Also treats pruritus associated with liver failure and diarrhea after gallbladder removal.

Front 575

Side effects of cholestyramine?

Back 575

GI upset. Bad taste of medication.

Front 576

Which drugs are fibrates?

Back 576

Gemfibrozil, ciprofibrate, bezafibrate, fenofibrate

Front 577

Action of gemfibrozil?

Back 577

Stimulates lipoprotein lipase. Enzyme responsible for breaking down triglycerides into VLDL and chylomicrons. Decreasee hepatic chol biosynth.

Front 578

Uses of gemfibrozil?

Back 578

decrease triglyceride levels. Mildly decrease LDL. Mildly increase HDL.

Front 579

Gemfibrozil side effects?

Back 579

GI upset; more gallstone formation.

compete with plasma proteins; may increase warfarin effects

Front 580

What is Niacin?

Back 580

lipid-lowering agent increases HDL levels. Decreases LDL (HEPATIC VLDL PRODUCTION). Decreases lipolysis in adipose tissue. Flushing = side effect.

Front 581

Which drugs are bisphophonates?

Back 581

Alendronate. - dronate

Front 582

Action of alendronate?

Back 582

Decrease osteoclastic bone reabsorption. Inhibit osteoclastic activity and increasing osteoclastic cellular death.

Front 583

Uses for alendronate?

Back 583

prevention and treatment of osteoporosis; Paget disease of the bone; bone metastasis with hypercalcemia, multiple myeloma

Front 584

Side effects of alendronate?

Back 584

GI upset (esophageal erosions); osteonecrosis of the jaw

Front 585

Drug like propylthiouracil?

Back 585

Methimazole

Front 586

Mechanism of action of propylthiouracil?

Back 586

Inhibits thyroid peroxidase, enzyme involved in iodine organification, inhibiting the coupling of iodotyrosines. Results in inhibition of thyroid hormone synth in thyroid gland and peripheral conversion of T4 to T3.

Front 587

Use of propylthiouracil?

Back 587

Hyperthyroidism

Front 588

Side effects of propylthiouracil?

Back 588

Skin rash, AGRANULOCYTOSIS, aplastic anemia

Front 589

Gout agents?

Back 589

Colchicine, probenecid, allopurinol

Front 590

Mechanism of action of colchicine?

Back 590

Induced microtubular depolymerization binding tubulin. Decreased migration of leukocytes to affected site. Colchicine blocks formation of leukotriene B4 too.

Front 591

Action of probenecid?

Back 591

Decreases reabsorption of uric acid in PT. Blocks active transport of uric acid.

Front 592

Action of allopurinol?

Back 592

Inhibits xanthine oxidase.

Front 593

Clinical use of colchicine?

Back 593

Acute gouty attack. Also Behcet disease and scleroderma.

Front 594

Clinical use of probenecid and allopurinol?

Back 594

Prevention of further gouty attacks; prevention and treatment of hyperuricemia (tumor lysis syndrome)

Front 595

Side effects of colchicine?

Back 595

Diarrhea; bone marrow suppression

Front 596

Side effects of probenecid?

Back 596

GI upset; inhibition of renal excretion of PCN and NSAIDs

Front 597

Side effects of allopurinol?

Back 597

GI upset; hypersensitivity reactions; decreased metabolism of 6-MP and Azathioprine

Front 598

Mechanism of prednisone?

Back 598

Mimics actions of endogenous glucocorticoids. Vasoconstriction, stimulation of gluconeogenesis, protein catabolism, decrease of circulating leukocytes, inhibition of PG and leukotriene formation through inhibition of PLA2, stimulation of gastric acid and pepsin production.

Front 599

Clinical uses of prednisone?

Back 599

Adrenocortical insufficiency, collagen vascular disorders (SLE, RA, polymyositis), inflammatory bowel dz, asthma, spinal ocrd compression.

Front 600

Side effects of prednisone?

Back 600

symptoms of Cushing syndrome. Osteoporosis, irritability, hyperglycemia, fat redistribituion, impaired wound healing, thin skin, peptic ulcers

Front 601

What is beclomethasone?

Back 601

Inhaled glucocorticoid for asthma.

Front 602

Action of orlistat?

Back 602

Inhibits pancreatic lipase. Reducing intestinal fat absorption.

Front 603

Action of sibutramine?

Back 603

Neurotransmitter reuptake inhibitor (5HT, NE, Dopamine) at synpatic clefts

Front 604

Uses for orlistat and sibutramine?

Back 604

Obesity

Front 605

Side effects of orlistat?

Back 605

Fecal incontinence; steatorrhea

Front 606

Side effects of sibutramine?

Back 606

Nausea, sexual dysfunction

Front 607

What is action of flutamide?

Back 607

Competitive antagonist at the androgen receptor. Decreases growth effects of testosterone on prostate. Higher LH will result so counteract with leuprolide.

Front 608

Uses of flutamide?

Back 608

Prostate cancer

Front 609

Side effects of flutamide?

Back 609

GI upset; gynecomastia

Front 610

What is Danazol?

Back 610

Mild agonist at androgen and progesterone receptors, decrease of LH and FSH secretion. Treats endometriosis and fibrocystic disease of the breast.

Front 611

What is finasteride?

Back 611

Inhibits 5-alpha reductase. Enzyme responsible for Test--> DHT.

Front 612

Uses of finasteride?

Back 612

BPH, prostate cancer, early male-pattern baldness.

Front 613

Side effects of finasteride?

Back 613

Decreased libido, ED

Front 614

What is anastrozole?

Back 614

Inhibits aromatase. Use for Estrogen receptor positive Breast Ca.

Front 615

What drugs are GnRH agonists?

Back 615

Leuprolide, nafarelin, goserelin

Front 616

Action of Leuprolide/nafareline/goserelin?

Back 616

binds GnRH receptors - with continuous stimulation blocks levels of LH and FSH w/downregulation of GnRH receptors.

Front 617

Uses of leuprolide?

Back 617

Metastatic prostate cancer, leiomyomas, emdometriosis w/continuous fashion.

Infertility - intermittent

Front 618

What is clomiphene?

Back 618

Partial agonist at estrogen receptors in pituitary - increasing release of gonadotropins. Induces ovulation - treats infertility. Side effects - hot flushes and multiple pregnancies

Front 619

Side effects of leuprolide/nafarelin/goserelin?

Back 619

impotence, hot flashes; GI upset

Front 620

Mechanism of OCs?

Back 620

Progestins decrease GnRH and decreases FSH and LH.

Estrogen - decreasese FSH and doesn't stim LH release.

Decrease in follicle devo; absence of ovulation

Front 621

Uses for OCs?

Back 621

birth control; dysfunctional uterine bleeding; PCOS; endometriosis, dysmenorrhea

Decrease risk of ovarian and endometrial cancer

Front 622

Side effects of OCPs?

Back 622

Breast fullness; N/v; HA; thromboembolism

Front 623

What is mechanism of Emergency contraception?

Back 623

high dose progestins taken up to 72 hr after sex

Front 624

What is mifepristone?

Back 624

Antagonist at progesterone receptor. Abortifacient at high doses by breaking down endometrial lining and cervical dilation.

Front 625

What is octreotide?

Back 625

somatostain. Inhibits release of many hormones, reduces GI motility, causes vasoconstriction

Front 626

Uses of octreotide?

Back 626

Endocrine disorders like Diarrhea associated with VIPomas, treatment of acromegaly, treatment of Zollinger-Ellison.

Treats esophageal varices associated with cirrhosis-induced portal htn

Front 627

side effects of octreotide?

Back 627

GI upset; cardiac arrhythmias

Front 628

Action of vasopressin?

Back 628

Naturally occurring hormone. Released by posterior pituitary.
V1 - vasoconstriction
V2 - increases permeability of H2O in collecting ducts
V3 - V2 like to facilitate factor VIII activity

Front 629

Uses for Vasopressin?

Back 629

Central DI
Septic shock and cardiac arrest
Increasing factor VIII/vWF for VWD dz or hemophilia A

Front 630

Side effects of vasopressin?

Back 630

Hyponatremia; vasoconstriction with vasopressin

Front 631

What is oxytocin?

Back 631

Induces labor and stimulates breast milk let down

Front 632

What type of drugs are aluminum hydroxide, magnesium hydroxide, calcium carbonate, and sodium bicarbonate?

Back 632

Antacids

Front 633

What is mechanism of action of antacids?

Back 633

Weak bases that form a salt and water upon reaction with HCl. Increase pH and reduce acidity of gastric contents. Furthermore, since pepsin is inactivated at higher pH, antacids may act to decrease peptic activity of protein breakdown.

Front 634

Use of antacids?

Back 634

GERD, promote healing of duodenal ulcers

Front 635

Side effects of antacids?

Back 635

Aluminum hydroxide: Constipation
Magnesium hydroxide: Diarrhea
Calcium Carbonate: Hypercalcemia; milk-alkali syndrome
Sodium bicarb: Flatulence; metabolic alkalosis

Front 636

Mechanism of sucralfate?

Back 636

promotes duodenal ulcer healing, enhances mucosal barrier either through stimulating PG synthesis or by acting as a physical barrier

Front 637

Drugs like Ranitidine?

Back 637

Cimetidine, Famotidine, Nizatidine

Front 638

Mechanism of action of ranitidine?

Back 638

Block binding of histamine to H2 receptor present on parietal cells of the gastric mucosa. cAMP levels decrease, leading to decreased activity of H/K proton pump.

Front 639

Uses for ranitidine?

Back 639

GERD, peptic ulcer disease

Front 640

Side effects of Ranitidine?

Back 640

Gynecomastia, decreased hepatic metab of warfarin (cimetidine)

Front 641

Mechanism of Omeprazole?

Back 641

Inhibits the H/K ATPase pump on parietal cells of the mucosa. Suppresses gastric acid secretion.

Front 642

Use of omeprazole?

Back 642

Treatment of PUD, GERD, Zollinger-Ellison syndrome, esophagitis.

Treat H pylori infection.

Front 643

Side effects of omeprazole?

Back 643

HA, rash, increased risk of fractures in the elderly

Front 644

What drugs are antiemetics?

Back 644

ondansetron, metoclopramide, prochlorperazine, promethazine

Front 645

Mechanism of ondansetron?

Back 645

Blocks 5-HT3 receptors.

Serotonin receptors are present in the chemoreceptor trigger zone in the brainstem, which is part of the vomiting reflex pathway, and in the GI tract. When the 5HT3 receptors are activated in the GI tract by release of 5HT from damaged enterochromaffin cells, signal is sent by vagus nerve to brainstem to activate the vomiting reflex pathway.

Front 646

Mechanism of metoclopramide and prochlorperazine?

Back 646

Dopamine antagonist. Activation of D2 receptors in the chemoreceptor trigger zone can lead to activation of the vomiting reflex pathway.

Front 647

Mechanism of promethazine?

Back 647

H1 receptor antagonist. H1 receptors are present everywhere including GI tract. By blocking these GI receptors, motility is decreased.

Front 648

Uses for Promethazine or Prochlorperazine?

Back 648

n/v

Front 649

Side effects of Ondansetron?

Back 649

HA

Front 650

Side effects of Metoclopramide and prochlorperazine?

Back 650

Sedation, hypotension, diarrhea, extrapyramidal symptoms

Front 651

Side effect of promethazine?

Back 651

Blurry vision; confusion; dry mouth

Front 652

What drugs are laxatives?

Back 652

castor oil, senna, bisacodyl, lactulose, sorbitol, polyethylene glycol, magnesium salts, docusate, mineral oil

Front 653

Mechanism of irritants or stimulants for laxatives?

Back 653

Castor oil, senna, bisacodyl

Increase intestinal peristalsis through mucosal irritation or stimulation - leading to increased gut motility.

Front 654

Mechanism of bulking laxatives?

Back 654

lactulose, sorbitol, polethylene glycol, magnesium salts

Draw water into intestine via osmosis. Distend bowel, resulting in increased intestinal motility.

Front 655

Mechanism of stool softeners?

Back 655

Docusate, mineral oil

Emulsify with stool, softening it.

Front 656

Use for laxatives?

Back 656

Constipation. Bowel prep.

Front 657

Side effects of laxatives?

Back 657

abdominal cramps

Front 658

What drugs are antidiarrheal agents?

Back 658

Diphenoxylate, loperamide, kaolin, bismuth subsalicylate

Front 659

Mechanism of diphenoxylate and loperamide?

Back 659

Bind to opioid receptors in the intestine, leading to inhibition of ACh release, leading to decreased peristalsis.

Front 660

Mechanism of Kaolin?

Back 660

Absorbs potential intestinal toxins

Front 661

Mechanism of bismuth subsalicylate?

Back 661

decreases secretion of fluid into bowel lumen.

Traveler's diarrhea.

Front 662

Mechanism of sulfasalazine?

Back 662

Metabolized to sulfapyridine and 5-ASA. 5-ASA acts as anti-inflammatory inhibiting PG and Leukotriene production through COX inhibition.

Front 663

Uses for sulfasalazine?

Back 663

IBD (RA and juvenile arthritis)

give it with folic acid due to sulfapyridine affects

Front 664

Side effects of sulfasalazine?

Back 664

GI upset; skin rash; bone marrow suppression; infertility

Front 665

What is ursodiol/chenodiol?

Back 665

Decreases incidence of cholesterol gallstones
1) blocking HMG-CoA reductase
2) decrease intestinal reabsorption of cholesterol
3) inhibits secretion of cholesterol into bile

Front 666

Uses for ursodiol?

Back 666

Treatment of primary biliary cirrhosis; also for treating cholesterol gallstones.

Front 667

What drugs are anthracyclines?

Back 667

-rubicins

Front 668

Mechanism of anthracyclines?

Back 668

1) insert between DNA bps, blocking DNA and RNA synth
2) Production of O2 radicals
3) Disrupt fluid and ion transport

Front 669

Uses of anthracyclines?

Back 669

Doxorubicin - Chemo agent for variety of solid tumors and hematologic malignancies

Daunorubicin

Idarubicin - chemo also

Front 670

Side effects of anthracyclines?

Back 670

cardiac toxicity - adminster dexrazoxane with it for decreasing radicals (makes dilated cardiomyopathy)
alopecia; bone marrow suppression

Front 671

What is agent of choice for Wilms tumor?

Back 671

Dactinomycin

Front 672

What is action of dactinomycin?

Back 672

inhibit DNA-dependent RNA polymerase

Front 673

Drugs like dactinomycin?

Back 673

Plicamycin - similar action - testicular and Paget's dz

Mitomycin - alkylating agent damaging DNA via cross linking of strands

Front 674

Action of Bleomycin?

Back 674

Triggers formation of O2 radicals after binding DNA.

Front 675

Uses for bleomycin?

Back 675

Testicular tumors

Front 676

Side effects of Bleomycin?

Back 676

Pulmonary fibrosis. Myelosuppression is RARE

mainly for G2 cell cycle specific

Front 677

What is Busulfan?

Back 677

Alkylating agent. For CML and PV. Pulm fibrosis = side effect. Adrenal insufficiency.

Front 678

Mechanism of Cyclophosphamide/Ifosfamide?

Back 678

Alkylating agent and cross-links DNA, decreasing DNA and RNA synth.

Drug has been implicated in suppression of B and T cell function.

Front 679

Clinical uses for cyclophosphamide?

Back 679

Chemo
Immunosuppressive - RA, SLE, WG, nephrotic

Front 680

Side effects of cyclophosphamide?

Back 680

Hemorrhagic cystitis (acrolein accumulates, decreased with MESNA). Bone marrow suppression.

Front 681

What is Mechlorethamine treatment protocol for?

Back 681

Hodgkin lymphoma

Front 682

What drugs are nitrosureas?

Back 682

Carmustine, lomustine, semustine, streptozocin

Front 683

What is mechanism for nitrosureas?

Back 683

Alkylating agents, cross-link DNA strands.

Front 684

Use for Nitrosureas?

Back 684

-ustines + streptozocin

Brain tumors.

cross BBB

Front 685

Mechanism of platins?

Back 685

Alkylating agent.

Front 686

Use for platin?

Back 686

Chemo for genitourinary tumors.

Front 687

Side effects of platins?

Back 687

Nephrotoxicity. Ototoxicity

Front 688

What is Procarbazine?

Back 688

alkylating agent. Also MOPP protocol for Hodgkin. Metabolite inhibits MAO. Don't ingest tyramine.

Front 689

Mechanism of Methotrexate?

Back 689

Inhibits DHFR, necessary for formation of thymidylate.

Front 690

Use of Methotrexate?

Back 690

Chemo agent
Immunosuppressant - for RA (Crohn, psoriasis)
Abortifacient w/Progstaglandin

Front 691

Side effects for MTX?

Back 691

bone marrow suppression, teratogen, pulm toxicity

stomatitis, hepatotoxicity

give Leucovorin for rescue. Minimizes bone marrow suppression from lack of folate.

Front 692

Action of 6-MP?

Back 692

inhibits purine synthesis when it gets converted to thio-IMP, inhibiting de novo purine sythesis.

Front 693

Clinical uses for 6-MP?

Back 693

Chemo - ALL

Immunosuppressant - IBD, psoriasis

Front 694

Side effects of 6-MP?

Back 694

Bone marrow suppression

metabolized by xanthine oxidase. Don't give it with allopurinol - really increases level.

Front 695

Function of Azathioprine?

Back 695

Immunosuppresant also inhibiting purine synth. Used for SLE,, IBD, RA.

Front 696

Mechanism of 5-FU?

Back 696

inhibits thymidylate synthase. Inhibition leads to disruption of DNA synth. Gets converted to 5-FdUMP

Front 697

Uses for 5-FU?

Back 697

Chemo agent for adenocarcinomas. Like Colon.

Front 698

Side effects of 5-FU?

Back 698

Bone marrow suppression.

Cell cycle specific - S

Front 699

Action of cytarabine?

Back 699

Competitively inhibits DNA polymerase after being converted into araCTP.

Front 700

Use for Cytarabine?

Back 700

Chemo. AML

Front 701

Side effects of cytarabine?

Back 701

Bone marrow suppression w/resulting pancytopenia

Cell cycle specific to S phase

Front 702

Action of etoposide?

Back 702

inhibits topoisomerase II, leading to DNA strand breakage.

Front 703

Uses for etoposide?

Back 703

Chemo agent. Small cell lung.

Front 704

Side effects of etoposide?

Back 704

Bone marrow suppression.

Cell cycle specific - S-G2 phase

Front 705

Mechanism of vincristine/vinblastine?

Back 705

Bind to tubulin - lead to depolymerization of mitotic spindle. Unable to progress past metaphase.

Front 706

Uses for Vincristine? Vinblastine?

Back 706

Vincristine - ALL, lymphoma (hodgkin!)

Vinblastine - Bone marrow suppression

Front 707

Side effects of vincristine?

Back 707

Peripheral neuropathy. Not really myelosuppresion.

Front 708

Side effects of vinblastine?

Back 708

Bone marrow suppresion.

Front 709

Mechanism of Paclitaxel/Docetaxel?

Back 709

Binds to tubulin. Promotes stabilization and polymerization of mitotic spindle. Not allowing anaphase.

Front 710

Use of paclitaxel?

Back 710

Ovarian and breast Ca.

Coats coronary artery stents to prevent restenosis.

Front 711

Side effects of paclitaxel?

Back 711

Bone marrow suppression

Front 712

Mechanism of Tamoxifen?

Back 712

Competitive estrogen-receptor antagonist. Lower affinity for estrogen receptor than estrogen. Most effective in post-menopausal women.

Front 713

Use for Tamoxifen?

Back 713

Chemo - breast cancer
(Osteoporosis?)

Front 714

Side effects of tamoxifen?

Back 714

Increased risk for endometrial cancer; increased risk of thromboembolism; hot flashes

Front 715

Use of raloxifene?

Back 715

Doesn't increase risk of endometrial cancer - yes for thromboembolism.

Mixed estrogen agonist/antagonist. Osteoporosis rx

Front 716

Mechanism of hydroxyurea?

Back 716

Inhibits ribonucleotide reductase, resulting in decreased DNA synthesis.

Front 717

Clinical use for hydroxyurea?

Back 717

Chemo agent - CML

SCD

Front 718

Side effects of hydroxyurea?

Back 718

Bone marrow suppression

cell specific to S phase

Front 719

Mechanism of pentostatin?

Back 719

For hairy cell leukemia. Inhibits adenosine deaminase.

Front 720

Action of trastuzumab?

Back 720

Mab against HER-2

Front 721

Use of Trastuzumab?

Back 721

Breast Ca with HER-2 receptor (erb-B2)

Front 722

Side effects of trastuzumab?

Back 722

Cardiac toxicity

Front 723

Action of Imatinib?

Back 723

Competitive inhibitor of tyrosine kinase (abl, c-kit, PDGF-R)

Front 724

Use for imatinib?

Back 724

CML, GIST

Front 725

Action of theophylline?

Back 725

Decrease PDE. Leading to increased cAMP --> bronchodilation

Front 726

How should you treat drug-induced Parkinson's?

Back 726

Antimuscarinic Benztropine

Front 727

Inhaled anesthetic affects on body parameters?

Back 727

Increase cerebral blood flow, decrease cardiac output, decrease RPF, decrease GFR

Front 728

Mechanism differences between Benzos and Barbiturates?

Back 728

Benzos - increase frequency of GABA opening

Barbiturates - increase duration of GABA opening

Front 729

Action of Propranolol for thyroid?

Back 729

Decrease peripheral conversion for T4-->T3

Front 730

Why wait 2 weeks after phenelzine before giving sertraline?

Back 730

wait for enzyme re-synthesis

Front 731

Donepezil use?

Back 731

cholinesterase inhibitor for Alzheimers. In addition with Vit E and NMDA analgo memantine

Front 732

Ibuprofen like drugs?

Back 732

Naproxen, indomethacin, diclofenac, sulindac, oxaprozin

Front 733

Mechanism of ibuprofen?

Back 733

reversible inhibitor of COX 1 and 2, resulting in decreasing prostaglandin synthesis

PGE2 - analgesia, antipyretic, decreased gastric mucus

PGI2 - increased gastric secretion

Front 734

Uses for ibuprofen?

Back 734

Antipyretic, analgesic, anti-inflammatory

no sig antiplatelet effect bc it reversibly inhibits

Front 735

Side effects of ibuprofen?

Back 735

GI bleeding, interstitial nephritis, tinnitus

Front 736

Use for indomethacin?

Back 736

Delaying labor, agent to close PDA, analgesic, antipyretic, antiinflammatory

Front 737

Mechanism of Celecoxib?

Back 737

Irreversibly inhibits Cox-2, decreased PG synth - anti-inflammatory.

Front 738

Use for Celecoxib?

Back 738

RA, osteoarthritis, other acute pain

reduce colonic polyps in FAP

Front 739

Side effects of Celecoxib?

Back 739

GI, interstitial nephritis, increased thrombosis risk, allergic if can't tolerate solfa

Rofecoxib killed with MI and stroke

Front 740

Mechanism of Acetaminophen?

Back 740

Reversibly inhibits Cox 1 and Cox 2 in the nervous system: analgesia, antipyretic w/o Pge2.

Front 741

Use of acetaminophen?

Back 741

Antipyretic and analgesic. Good for those who can't tolerate aspirin or other NSAIDs.

Front 742

Side effects of acetaminophen?

Back 742

Fatal hepatotoxicity with overdose

Front 743

Antidote for acetaminophen overdose?

Back 743

Acetylcysteine

Front 744

Action of Zafirlukast/Montelukast?

Back 744

Reversible inhibitor of cysteinyl leukotriene-1 receptor.

Blocking Lt C4, D4, E4 - bronchoconstriction and increased mucus are blocked

Front 745

Uses of zafkirlukast?

Back 745

Preventative treatment of asthma

potentiates warfarin by inhibiting cyp-450

Front 746

Side effects of zaifrlukast?

Back 746

abnormal LFTs; HA; eosinophilic vasculitis

Front 747

Mechanism of Zileuton?

Back 747

Inhibits 5-lipoxygenase. Decreases Leukotriene leves from arachidonic acids. Downstream products for Leukotriene B decrease too - B4 acts to attract eosinophils and neutrophils.

Front 748

Uses for Zileuton?

Back 748

Preventative treatment of asthma

Front 749

Side effects of zileuton?

Back 749

abnormal LFTs, HA, eosinohpilic vasculitis

Front 750

What is cromolyn?

Back 750

Anti-inflammatory for prevention of asthma exacerbations. Used also for allergic rhinitis or conjunctivitis. Inhibits release of histamine and other compounds from mast cells.

Front 751

Mechanism of cyclosporine?

Back 751

Inhibits calcineurin, which normally activates IL-2. Production decreased, decreased activation of T cells.

Front 752

Uses for cyclosporine?

Back 752

Immunosuppressant in transplant patients; GVHD treatment; RA treatment

metab by cyp p-450 (3A4)

Front 753

Side effects of cyclosporine?

Back 753

Nephrotoxicity; hepatotoxicity

(hyperglycemia, HTN, high K)

Front 754

What is tacrolimus?

Back 754

Binds FKBP - inhibits calcineurin.

Calcineurin then dephosphorylates the transcription factor NF-AT (nuclear factor of activated T-cells), which moves to the nucleus of the T-cell and increases the activity of genes coding for IL-2

Immunosuppressant in transplant pts

Front 755

Mechanism of Mycophenolate mofetil?

Back 755

Acts within B and T lymphocytes to inhibit IMP dehydrogenase for purine synthesis. W/o GMP, DNA is decreased.

Front 756

Uses for mycophenolate mofetil?

Back 756

Immunosuppresant in transplant pts; autoimmune disorders too

Front 757

Side effects of mycophenolate mofetil?

Back 757

increased lymphomas, allergic, pancytopenia

Front 758

Interferon producers?

Back 758

alpha - leukocyte
beta - fibroblasts
gamma - CD4 T cells

Front 759

Mechanism of inteferons?

Back 759

Boost the immune system in response to viral infection. Increase MHC, nK cells, CD8 t cells, increased ribonuclease activitiy, inhibition of EF-2

Front 760

Uses for interferons?

Back 760

Cancer

Chronic hep C
MSclerosis

Front 761

Side effects of interferons?

Back 761

Fatigue; bone marrow suppression

Front 762

Alprostadil action use?

Back 762

PGE1 analog. For erectile dysfunction, maintaining PDA.

Front 763

Misoprostol action use?

Back 763

PGE1 analog. Increases uterine contractions, inhibits gastric acid secretion, and increases mucosal protection in the stomach

prevention of Gastric ulcers; abortifacient with MTX

Front 764

Latanoprost action use?

Back 764

PGF 2alpha - increases aqueous humor drainiage.

For chronic glaucoma

Front 765

Dinoprostone action use?

Back 765

analog of PGE2; increases uterine contractions

Abortifacient

Front 766

Carboprost action use?

Back 766

PGF2alpha, abortifacient

Front 767

Epoprostenol action use?

Back 767

PGI2. Prostacyclin, vasodilator

For Pulm HTN.

Front 768

Action of Etanercept?

Back 768

Inhibits binding of TNF-alpha and TNF-B molecules to their receptors.

TNF stimulates IL-1, IL-6, IL8

Front 769

Etanercept use?

Back 769

Autoimmune disease, RA.

Front 770

Gold salt uses?

Back 770

RA.

Front 771

Mechanism of Infliximab?

Back 771

Chimeric antibody, inhibits binding of TNF-alpha with its receptor.

TNF-alpha is a cytokine produced by macs that stimulates IL-1, 6, 8. So decrease = anti-inflammatory

Front 772

Uses of infliximab?

Back 772

autoimmune diseases - RA, IBD

Front 773

Side effects of infliximab?

Back 773

infusion reaction, abnormal LFTs

Front 774

Adalimumab use?

Back 774

MaB, binds to TNF-alpha and inhibits binding of TNF-alpha with its receptor.

Front 775

Thalidomide action?

Back 775

Believes decreases TNF-alpha production

Front 776

Use of thalidomide?

Back 776

treatment of erythema nodosum leprae; also for multiple myeloma

Front 777

Side effects of thalidomide?

Back 777

Sedation, increased DVTs

Front 778

Special notes for thalidomide?

Back 778

teratogenic and contraindicated during pregnancy

Front 779

First generation antihistamines?

Back 779

Diphenhydramine, promethazine, meclizine, hydroxyzine, doxylamine

Front 780

Mechanism of Diphenhydramine?

Back 780

Block H1 histamine sites. Producing bronchodilation, decreased pruritus, decreased peripheral vascular resistance, decreased GI tract motility, decreased rash formation. Some antagonism on cholinergic and alpha-adrenergic.

Front 781

Uses for diphenhydramine?

Back 781

Urticaria, allergic reactions, motion sickness

Front 782

Use for promethazine?

Back 782

Antiemetic

Front 783

Use for meclizine?

Back 783

Vertigo treatmnet

Front 784

Side effects of diphenhydramine/first generation antihistamines?

Back 784

Sedation; anticholinergic

Front 785

Second generation H1 histamine blockers?

Back 785

Loratadine, cetirizine, fexofenadine

Front 786

Mechanism of fexofenadine?

Back 786

Block H1 histamine receptor sites

doesn't cross BBB - less sedation

Front 787

Uses of fexofenadine?

Back 787

Allergic rhinitis

Front 788

Mechanism of ethanol?

Back 788

Potentiate inhibitory effects of GABA

Front 789

Use for ethanol?

Back 789

Treatment of ethylene glycol and methanol overdose to prevent dangerous metabolites

Front 790

Side effects of ethanol?

Back 790

CNS depression, GI inflammation

Front 791

Disulfiram action?

Back 791

Treats alcohol cessation. Inhibiting acetaldehyde dehydrogenase.

Front 792

Theophylline action?

Back 792

Inhibits PDE (responsible for breaking down cAMP) - keeping bronchodilation

Front 793

Uses for theophylline?

Back 793

Chronic and acute asthma

Front 794

Side effects of theophylline?

Back 794

Cardiac arrhythmias; seizures

narrrow therapeutic index; metab by cyp-450

Front 795

Iron mechanism and clinical signs?

Back 795

forms reactive O2 species

signs - ab pain; bloody diarrhea; unconsciousness

Front 796

Iron treatment?

Back 796

Deferoxamine

Front 797

Lead mechanism and clinical signs?

Back 797

Interferes with heme synthesis; altering cell membrane structure

Clinical signs - ab pain; neuropathy; anemia; basophilic stippling; lead line at the gums

Front 798

Antidote to Pb?

Back 798

Calcium EDTA; dimercaprol; pencillamine

Front 799

Arsenic mechanism and signs?

Back 799

Inhibits several enzymatic processes - esp ox phos

Signs - Garlic odor on breath; bloody diarrhea; hair loss; neuropathy

Front 800

Antidote to arsenic?

Back 800

Dimercaprol; pencillamine

Front 801

Cyanide mechanism and signs?

Back 801

block cytochrome complex in ETC

HA; GI upset; szs; coma

Front 802

Cyanide antidote?

Back 802

Sodium thiosulfate; nitrites

Front 803

Carbon monoxide mechanism and signs?

Back 803

Mechanism: binds to Hb, reducing o2 binding and delivery to tissues

Signs: HA; GI upset; SZs; coma

Front 804

Antidote to CO?

Back 804

100% O2

Front 805

Phentermine and Fenfluramine?

Back 805

Appetite suppressants. CAUSE PULM HTN.

Front 806

OKT3?

Back 806

Anti Cd3 against t lymphocytes

Front 807

Rituximab?

Back 807

anti-cd20 - b cell lymphomas and RA

Front 808

Perchlorate and Pertechnetate?

Back 808

block iodide absorption via comeptitive inhibition

Front 809

Breakdown seizure treatments?

Back 809

Partial - CBZ

Absence - Ethosuximide
Myoclonic or Absence plus others =VPA

Tonic-clonic = Phenytoin, CBZ, VPA

Front 810

T 1/2?

Back 810

Vd x .7 / CL

Front 811

Antidote for platin?

Back 811

Amifostine

Front 812

Antidote for anthracyclins?

Back 812

Dexrazoxane

Front 813

Antidote for methanol/ethylene glycol?

Back 813

Fomepizole

Front 814

Determinants of low Vd?

Back 814

high MW, high binding protein, high charge, hydrophilic

Front 815

Primidone?

Back 815

Anti convulsant. Metabolized to phenobarbitol.

Front 816

Quick waking from thiopental results from?

Back 816

Redistribution of drug to lean body tissue: fat/muscle