Pharm Cns

Front 1

Commonly used analgesic and antipyretic, but unlike NSAID's, has no anti-inflammatory properties?

Back 1

Acetaminophen.
Weak COX, it inhibits prostaglandin synthesis in the CNS
a related prodrug, phenacetin, is no longer available due to nephrotoxicity.

Front 2

Drug used in the treatment of severe rheumatoid arthritis, because it decreases lysosomal and macrophage function?

Back 2

Gold salts.
Side effects include, dermatitis, hematotoxicity and nephrotoxicity

Front 3

Given to Rh-negative mothers within 72 hours of giving birth to an Rh-positive child, to prevent the development of hemolytic disease of the newborn (erythroblastosis fetalis) in subsequent RH-positive pregnancies?

Back 3

RhoGAM.
Fetal Rh-positive red blood cells that enter maternal circulation are opsonized by these antibodies, preventing the mother from producing anti-Rh antibodies.

Front 4

High-potency NSAID used in the treatment of gout and arthritis, and for closure of a patent ductus arteriosus?

Back 4

Indomethacin.
Conversely, PGE can be used to maintain a patent ductus arteriosis in congenital cyanotic heart disease.

Front 5

Monoclonal antibody used in the management of patients with renal allografts?

Back 5

Daclizumab.
Binds to the high affinity IL-2 receptor expressed on activated T-cells
the side effects are minimal compared to agents such as cyclosporin or tacrolimus.

Front 6

Newly available NSAID, used in the treatment of rheumatoid arthritis and other chronic conditions, which decrease the risk of ulcers and GI bleeds?

Back 6

Celecoxib.
Similar to rofecoxib. It selectively blocks COX-2 present only in leukocytes
these agents do not block COX-1 that produces protective gastric prostaglandins
as sulfa drugs, they both cause hypersensitivity.

Front 7

Nonsteroidal anti-inflammatory drug (NSAID) with analgesic, antipyretic, antiplatelet, and anti-inflammatory properties that irreversibly inhibits COX?

Back 7

Aspirin (acetylsalicylic acid).
Inhibits the formation of PGE, decreases pain and fever, and decreases the synthesis of PGE in the stomach, predisposing to acute gastritis.

Front 8

Notorious for causing teratogenic effects, such as phocomelia
has gained attention as a potent immunosuppressant?

Back 8

Thalidomide.
Used in the treatment of SLE, multiple myeloma, and leprosy, its effects are due to its ability to suppress the production of TNF-alpha.

Front 9

Reversible inhibitors of COX widely used as OTC pain relievers?

Back 9

Ibuprofen, naproxen, piroxicam.
Same side effects as aspirin, but more effective analgesics and anti-inflammatories, however they lack aspirin's long duration and anti-platelet effects.

Front 10

Serotonin agonist used in the treatment of acute migraines and cluster headaches?

Back 10

Sumatriptan.
Binds to the HT1d receptor, causing vasoconstriction of the cerebral vasculature.

Front 11

The only parenteral NSAID, used primarily for its analgesic (rather than anti-inflammatory) properties?

Back 11

Ketorolac.
Its systemic route of delivery substantially decreases GI irritation.

Front 12

Unlike most opioid agonists, this derivative does not cause biliary spasms, and is preferred, therefore, as an analgesic for pancreatitis and cholecystitis?

Back 12

Meperidine.
Causes relaxation of the sphincter of Oddi
all opioids are contraindicated in the case of head injury, because of increased intracranial pressure.

Front 13

Uricosuric agent used in the treatment of chronic gout, and also to increase the effective concentration of weakly acidic drugs such as penicillins?

Back 13

Probenecid.
Both probenecid and sulfinpyrazone compete with uric acid for reabsorbsion in the proximal tubules of the kidney, and also inhibit the secretion of weak acids.

Front 14

Used in the management of chronic gout and as an adjunct to cancer chemotherapy, to slow the production of uric acid?

Back 14

Allopurinol.
Results in suicide inhibition of xanthine oxidase with the resultant increase of xanthine and hypoxanthine, both of which are more soluable and less likely to form crystals than uric acid.

Front 15

Used in the prevention of migraine headaches, this ergot has no value in the treatment of migraine headaches?

Back 15

Methylsergide.
This agent blocks serotonin (5-HT) receptors, it can be used in the treatment of carcinoid tumors, notable side effects include retroperitoneal and subendocardial fibroplasia.

Front 16

Used in the treatment of acute attacks of gouty arthritis, because it impairs leukocyte function?

Back 16

Colchicine.
Inhibits microtubule assembly, and, therefore, leukocyte migration and phagocytosis of uric acid crystals.

Front 17

Used in the treatment of rheumatoid arthritis and inflammatory bowel disease, a recombinant protein product that inhibits the effects of TNF-alpha?

Back 17

Etanercept (IV).
This drug is a fusion between the extracellular domain of TNF-alpha receptor and the Fc portion of an antibody
similar monoclonal antibody, infliximab, also binds and inhibits TNF-alpha.

Front 18

Used in treatment of transplant patients and patients with autoimmune diseases, as it impairs T-cell production of IL-2?

Back 18

Cyclosporin.
Binds cyclophilins and inhibits the transcription of cytokine genes. Tracrolimus, binds to immunophilin FK-binding protein and functions similarly
Both have dose limiting nephrotoxicity.

Front 19

Used topically for the treatment of rheumatoid arthritis because it depletes substance P?

Back 19

Capsaicin.
Component of chili peppers that impairs the release of substance P, the potent neurotransmitter for pain sensation.

Front 20

1.blocks bacterial dHFR and can cause megaloblastic anemia
2.blocks dihydropteroate synthase and can cause hypersensitivity reactions and hemolysis in patients with G6PDH deficiency

Back 20

1.Trimethoprim 2. sulfamethoxazole

Front 21

3rd generation cephalosporin
coverage against Bacterial meningitis- Strep pneumoniae, Neisseria meningitides, and H. influenzae

Back 21

ceftriaxone

Front 22

acts as a cationic detergent that disrupts the membrane
systemic use causes neurotoxicity and acute tubular necrosis

Back 22

polymixin B

Front 23

administered as an aerosol, this drug is used for the treatment of RSV

Back 23

ribavirin

Front 24

administered with penicillins to enhance their antimicrobial effects

Back 24

Clindamycin

Front 25

agents inhibit the protease encoded by HIV pol gene and required for the production of infectious virions
metabolized by CYP450

Back 25

Indinavir, Ritonavir, Saquinavir, Nelfinavir

Front 26

Amantadine binds this protein- which is why it is NOT effective against influenza B

Back 26

M2 protein

Front 27

aminoglycoside given orally for prophylaxis in bowel surgery, and also used to treat hepatic encephalopathy

Back 27

neomycin

Front 28

antihelminthic agent used for the treatment of river blindness (caused by onchocerca volvulus) and threadworm infection (strongyloides stercoralis)

Back 28

ivermectin

Front 29

antihelminthic agent, often used with mebendazole for the treatment of roundworm, pinworm, and hookworm infections

Back 29

pyrantel pamoate

Front 30

antiprotozoal agent used in the treatment of amebiasis, trichomoniasis, and giardiasis, as well as for pseudomembranous colitis

Back 30

metronidazole

Front 31

Associated myelosuppression, and rarely an idiosyncratic, irreversible aplastic anemia

Back 31

chloramphenicol

Front 32

backup drug used for treatment of CMV infection in immunocompromised patients, when resistance to ganciclovir develops

Back 32

foscarnet

Front 33

bactericidal inhibitor of DNA gyrase, used for GNR, neisseria

Back 33

Flouroquinolones (ciprofloxacin/norfloxacin)

Front 34

Bactericidal inhibitors of mRNA translation at the 30S ribosome
these agents are associated with significant nephrotoxicity and ototoxicity

Back 34

Aminoglycosides (gentamicin/streptomycin/tobramycin/amikacin/neomycin)

Front 35

bacteriostatic inhibitor of protein synthesis- blocking peptidyl transferase activity at 50S ribosome

Back 35

chloramphenicol

Front 36

Bacteriostatic inhibitor of protein synthesis, functioning on 50S ribosome

Back 36

Erythromycin

Front 37

bacteriostatic inhibitor of protein synthesis, methylating the 50S ribosomal unit, used in treatment of serious anaerobic infections due to Bacteroides

Back 37

Clindamycin

Front 38

binds tubulin, interfering with MT function, inhibity mitosis

Back 38

griseofulvin

Front 39

blocks DNA replication and RNA transcription in P.falciparum within erythrocytes
a common SE is cinchonism, a constellation of symptoms including headache, vertigo, blurred vision, and tinnitus
a related drug, mefloquine, has fewer SE and is used as prophylaxis in chloroquine-resistant areas

Back 39

Quinine

Front 40

Broad-spectrum B-lactamase-resistant carbapenem, given in conjunction with cilastatin

Back 40

Imipenem

Front 41

broad spectrum bacteriostatic drug that inhibits the 30S ribosome and thus protein synthesis
provides good coverage against mycoplasma, Chlamydia, rickettsia, and vibrio

Back 41

tetracycline

Front 42

Bulkier R-groups on the penicillin backbone prevent degradation by penicillinases

Back 42

methicillin, nafcillin, dicloxacillin

Front 43

can be used with penicillinase inhibitors and work synergistically with aminoglycosides

Back 43

Carbencillin, Piperacillin, Ticarcillin

Front 44

can cause GI side effects, rash, and hemolysis in G6PD deficiency patients

Back 44

nitrofurantoin

Front 45

can cause tendon damage in adults, is contraindicated in children and pregnant women because of damage to developing cartilage

Back 45

fluoroquinolones (ciprofloxacin/norfloxacin)

Front 46

commonly used as part of HAART, this HIV drug is used for prophylaxis of needlestick tramsmission and of transmission to neonates from infected mothers during birth

Back 46

Zidovudine (ZDT)

Front 47

contraindicated in pregnant women and children, because it causes bone dysplasia and defects in dental enamel

Back 47

tetracycline

Front 48

cyanosis and CV collapse in premature neonates deficient in hepatic gluconosyltransferase (gray baby syndrome)

Back 48

chloramphenicol

Front 49

disrupts fungal membrane permeability by binding to ergosterol

Back 49

nystatin

Front 50

disrupts fungal membranes by binding to ergosterol, which induces pore formation. SE: chills, fever, hypotension, dose-limiting nephrotoxicity (all of which are less severe when using liposomal formulations)

Back 50

Amphotericin B

Front 51

does not require phosphorylation by viral kinases and inhibits viral DNA polymerase at different site than ganciclovir
not metabolized by viral transferases, which render ganciclovir ineffective

Back 51

foscarnet

Front 52

drugs bind to a unique site on reverse transcriptase, there is no cross-resistance with the NRTIs
the NNRTIs are all metabolized by the P450 system

Back 52

nevirapine, delavirdine, efavirenz

Front 53

drugs used to treat African trypanosomiasis include pentamidine, suramin, melarsoprol

Back 53

nifurtimox

Front 54

extended-spectrum penicillins- useful against Pseudomonas and Enterobacter

Back 54

Carbenicillin, Piperacillin, Ticarcillin

Front 55

extended spectrum penicillin used to treat infections with GN organisms such as Haemophilus, E. coli, Listeria, Proteus, and Salmonella
often administered with penicillinase inhibitors

Back 55

Ampicillin

Front 56

formerly known as AZT, phosphorylation of this agent by host cell enzymes results in inhibiting viral reverse transcriptase, as well as functioning as a chain terminator

Back 56

Zidovudine (ZDT)

Front 57

functions by inhibiting microtubule synthesis and glucose uptake in helminthes
related drugs such as albendazole and thiabendazole and alternatives

Back 57

mebendazole

Front 58

Gaunosine analog converted by CMV to a triphosphorylated form which inhibits the viral polymerase
given IV- good penetration to the eye and CNS- causes neutropenia, leucopenia, thrombocytopenia

Back 58

Ganciclovir

Front 59

given orally, antifungal that accumulates in keratinized tissue and is effective against dermatophyte infections, such as ringworm (tinea)

Back 59

Griseofulvin

Front 60

good coverage against mycoplasma, corynebacterium, Chlamydia, legionella, and bordetella

Back 60

macrolides (erythromycin, azithromycin, clarithromycin)

Front 61

Guanosine analog is activated by thymidine kinase of herpes virus (HSV, VZV, EBV) and function as chain terminator when incorporated into viral DNA during replication

Back 61

Acyclovir

Front 62

guanosine analog that inhibits formation, the capping of viral mRNA, and viral RNA-dependent RNA pol activity
also used for the management of viral hemorrhagic fevers and hepatitis C infection

Back 62

Ribavirin

Front 63

Imidazole antifungal used for the treatment of fungal meningitis, because it can cross the blood-brain barrier

Back 63

Fluconazole

Front 64

increases calcium permeability in the worm, resulting in paralysis
niclosamide, which functions by uncoupling oxidative phosphorylation (inhibiting ATP production) or by activating ATPases, often is used with this drug in cestode infections

Back 64

praziquantel

Front 65

increases GABA-mediated neourotransmission, but since it does not cross the human blood-brain barrier, it selectively affects the nematode, resulting in paralysis of the worm

Back 65

ivermectin

Front 66

Ineffective against anaerobes, due to the requirement for oxygen to be taken up by the organism

Back 66

Aminoglycosides (gentamicin/streptomycin/tobramycin/amikacin/neomycin)

Front 67

ineffective against GP or anaerobic bacteria- works synergistically with aminoglycosides against GNR

Back 67

Aztreonam

Front 68

inhibit fusion of viral particles within an endosome in a cell (2)

Back 68

amantadine and rimantadine

Front 69

inhibitor of bacterial cell wall synthesis, is available as a topical preparation in many OTC antibacterial ointments

Back 69

Bacitracin

Front 70

inhibits DNA-dependent RNA pol
often used in a combined drug regimen for Mycobacterium tuberculosis because of rapid resistance if used alone

Back 70

rifampin

Front 71

inhibits the formation of ergosterol, lacks the antiendocrine effects seen with ketoconazole

Back 71

Fluconazole

Front 72

inhibits the synthesis of mycolic acid in the mycobacterial cell wall
because it is acetylated by the liver, side effects include peripheral neuritis in slow acetylators and hepatitis in fast acetylators. Due to the emergence of multidrug-resistant strains of Mycobacterium tuberculosis, multidrug regimens also include ethambuto, pyrazinamide, rifampin, and streptomycin.

Back 72

isoniazid (INH)

Front 73

kills parasites within erythrocytes (schizonticidal)
it disrupts hemoglobin breakdown, with the accumulation of heme, which is toxic to the organism

Back 73

Chloroquine

Front 74

Longer half life than amantidine with same action

Back 74

rimantidine

Front 75

mechanism is similar to cephalosporins is nearly identical
major side effects: hypersensitivity with urticaria, and rarely, anaphylaxis leading to life-threatening asphyxiation

Back 75

penicillins

Front 76

narrow-spectrum, penicillinase-resistant B-lactam antibiotics, used to treat penicillin- resistant Staph aureus

Back 76

Methicillin, Nafcillin, Dicloxacillin

Front 77

Nonnucleoside reverse-transcriptase inhibitors used in the management of HIV infection

Back 77

nevirapine, delavirdine, efavirenz

Front 78

NRTI that also inhibits reverse transcriptase of HBV

Back 78

lamivudine (3TC)

Front 79

Nucleoside reverse transcriptase inhibitors (NRTI)

Back 79

zidovudine (ZDT), salcitabine (ddC), lamivudine (3TC), stavudine (d4T)

Front 80

Oral, topical, and IV preps are available, used to reduce symptomatology of HSV infection, although it does not inhibit the reactivation of herpes

Back 80

Acyclovir

Front 81

orally active antiviral drug used to decrease the duration and symptoms of influenza A symptoms

Back 81

oseltamivir

Front 82

peptide antibiotic inhibits cell wall synthesis in GP organisms
causes severe nephrotoxicity if used systematically

Back 82

bacitracin

Front 83

Polyene antifungal agent used for the treatment of systemic mycosis and intrathecally for the treatment of fungal meningitis

Back 83

Amphotericin B

Front 84

polymixin B

Back 84

this antibiotic disrupts bacterial membranes and is often too toxic to be administered systematically, although it is safe topically

Front 85

prevents the growth of GI flora and accumulation of nitrogenous microbial metabolites, which contribute to the development of hepatic encephalopathy
too toxic to be administered IV, but often used topically in the OTC antibiotic ointments

Back 85

neomycin

Front 86

Primary drug used for acute attacks and prophylaxis of malarial infection
resistance is common

Back 86

Chloroquine

Front 87

primary drug used for the treatment of trematode (fluke) and cestode (tapeworm) infections

Back 87

praziquantel

Front 88

prophylaxis against Cryptococcus neoformans, effective in the treatment of esophageal and oropharyngeal candidiasis

Back 88

fluconazole

Front 89

protease inhibitors used in combined treatment regimens for HIV infection

Back 89

Indinavir, Ritonavir, Saquinavir, Nelfinavir

Front 90

rapid IV infusion is associated with diffuse flushing (red man syndrome)

Back 90

vancomycin

Front 91

rarely used alone, except for the treatment of meningococcal carrier state, this drug imparts a red-orange color secretions

Back 91

rifampin

Front 92

rarely used systematically due to inhibition of RBC maturation
available as topical

Back 92

chloramphenicol

Front 93

similar to ampicillin, but greater oral bioavailability and decreased GI irritability

Back 93

amoxicillin

Front 94

stimulates nicotinic receptors in the nematode, resulting in a spastic paralysis

Back 94

pyrantel pamoate

Front 95

swish and swallow treatment for oral candidiasis, or topically for the treatment of diaper rash

Back 95

nystatin

Front 96

synercid is a mixture of quinupristin and dalfopristin
use associated with arthralgias and myalgias, as well as inhibition P450 enzymes

Back 96

streptogramins

Front 97

these drugs interfere with fungal cell wall synthesis by inhibiting the 14?-demethylation of lanosterol
the demethylation is catalyzed by the cytochrome P450 system

Back 97

azoles (keto/itra/flu)

Front 98

these two drugs create a block in successive reactions for folate synthesis
also often used to treat UTI

Back 98

trimethoprin and sulfamethoxazole

Front 99

this agent is recommended for prophylaxis of tuberculosis in skin test converters and in people who have close contact with patients with active disease. It is also the primary drug in most multidrug regimens for the treatment of active tuberculosis

Back 99

Isoniazid (INH)

Front 100

this class of antibiotics that inhibits protein synthesis and is effective in the treatment of MRSA and Vancomycin-resistant enterococci (VRE)

Back 100

Streptogramins

Front 101

this group of bactericidal antibiotics inhibits the transpeptidaiton step during cell wall synthesis, resulting in the activation of autolytic enzymes, which destroy bacteria

Back 101

penicillin

Front 102

treatment of MRSA, pseudomembranous colitis due to C.diff
SE can be limited by infusion over prolonged period and coadministration of antihistamines

Back 102

vancomycin

Front 103

trypanosomicidal drug used for the treatment of chagas disease

Back 103

nifurtimox

Front 104

undergoes activation by anaerobes and parasites, to create products that interfere with mucleic acid synthesis, resulting in cytotoxicity

Back 104

metronidazole

Front 105

urinary antiseptic that requires acidification and therefore, is ineffective systematically, although toxic levels can accumulate in patients with renal failure

Back 105

nitrofurantoin

Front 106

used against GPC, GNR, anaerobes
metabolized by renal dihydropeptidase, which is blocked by coadministration of cilastatin

Back 106

Imipenem

Front 107

Used for prophylaxis of influenza A and rubella viral infection if given within 48 hr of exposure, also used in treatment of Parkinsons
not effective against influenza B

Back 107

Amantadine

Front 108

used for the treatment of chloroquine-resistant malarial infection due to plasmodium falciparum

Back 108

Quinine

Front 109

used for the treatment of many helminth infections, it is the drug of choice for pinworms, the most common helminth infection in the United States

Back 109

mebendazole

Front 110

used for the treatment of mycotic infections, these agents inhibit hormone production and result in gynecomastia

Back 110

azoles (keto/itra/fluconazole)

Front 111

used for the treatment of retinitis and other infections associated with CMV

Back 111

Ganciclovir

Front 112

used for treatment of septic meningitis- this cephalosporin has good penetration into CNS

Back 112

Ceftriaxone

Front 113

used in combined regimens for treatment of HIV infection, associated with a dose-limiting pancreatitis

Back 113

Didanosine (ddI)

Front 114

widely used antibiotic
SE include GI irritation and hypersensitivity-based acute cholestatic hepatitis

Back 114

Erythromycin

Front 115

works similarly to penicillins and cephalosporins, this monobactam is resistant to B-lactamases, and displays no cross-allergenicity with penicillins

Back 115

aztreonam

Front 116

zanamivir is a similar drug, but administered intranasally
both drugs function as neuraminidase inhibitors, preventing the spread of virus from cell to cell

Back 116

oseltamivir

Front 117

Adrenergic antagonist used in the Tx of benign prostatic hyperplasia and in the mgmt of hypertension caused by pheochromocytoma

Back 117

Phenoxybenzamine
- An IRREVERSIBLE ALPHA 1,2 ANTAGONIST
- A similar short-acting REVERSIBLE antagonist, PHENTOLAMINE, is used in the Dx of PHEOCHROMOCYTOMA

Front 118

Adrengeric agonist used for acute asthma, anaphylactic shock, open-angle glaucoma, and cardiac resuscitation

Back 118

Epinephrine
- ADRENERGIC AGONIST w/ affinity for ALPHA 1,2 and BETA 1,2 receptors
- At LOW CONCENTRATIONS the effects of the BETA RECEPTORS PREDOMINATE
- B2 RECEPTORS cause VASODILATION w/ DECREASED TPR and DECREASED DIASTOLIC

Front 119

Depolarizing neuromuscular blocker used to facilitate intubation, and as a skeletal muscle relaxant for general anesthesia

Back 119

Succinylcholine
- Fxns as a CHOLINERGIC NICOTINIC AGONIST, facilitating the opening of SODIUM CHANNELS
- A rare but significant side effect, MALIGNANT HYPERTHERMIA, can occur in some pts when used with HALOTHANE

Front 120

Indirect-acting sympathomimetic used in OTC nasal decongestants

Back 120

Ephedrine
- It has many of the same actions as AMPHETAMINES, with LESS CNS STIMULATION
- It is found in Chinese herbs such as MA-HUANG
- One enantiomer, PSEUDOEPHEDRINE, is found in many COLD-RELIEF MEDICATIONS

Front 121

long-acting anticholinesterase used in the chronic Tx of myasthenia gravis

Back 121

Pyridostigmine
- Also used as an antidote to TUBOCURARINE TOXICITY
- NEOSTIGMINE is a similar substance, although is has a SHORTER DURATION of action

Front 122

muscarinic agonist used to treat postoperative urinary retention and atonic ileus

Back 122

Bethanechol
- a related drug, CARBACHOL, has both MUSCARINIC & NICOTINIC AGONIST properties and is primarily used in the mgmt of GLAUCOMA.
- Both drugs are resistant to metabolism by ACETYLCHOLINESTERASES

Front 123

Nondepolarizing neuromuscular ganglionic blockers used in surgical anesthesia (3)

Back 123

Tubocurarine, Pancuronium, Mivacurium
- NEOSTIGMINE, PHYSOSTIGMINE AND EDROPHONIUM can reverse the paralysis caused by these drugs.
- TUBOCURARINE is the most likely of this class to cause the RELEASE OF HISTAMINE, leading to VASODILATION AND HYPOTENSTION

Front 124

Prototypic B agonist used for the Tx of both acute heart failure and acute asthma

Back 124

Isoproterenol
- This agent has equivalent affinities for B1,2 receptors
- The B1 ACTIVITY causes an increase in CARDIAC CONTRACTILITY and INCREASED HR, resulting in increased SV and CO
- The B2 ACTIVITY induces BRONCHODILATION

Front 125

Prototypical B antagonist used in the TX of hypertension, glaucoma, migraines, and angina - As a prophylaxis for MI?s - At low doses to prevent performance anxiety

Back 125

Propanolol
- Nonselective B1,2 BLOCKER
- Not to be used in pts with COPD AND ASTHMA, due to significant BRONCHOCONSTRICTION

Front 126

Short-acting anticholinesterase used to confirm the diagnosis of myasthenia gravis

Back 126

Edrophonium
- IV injection of this rapidly absorbed drug results in an appreciable increase in muscle strength

Front 127

side effects include cycloplegia, flushing, confusion, increased body temperature, dry mouth, tachycardia, and constipation

Back 127

Atropine
- The side effects for this COMPETITIVE MUSCARINIC ANTAGONIST, as well as for all anticholinergics, are remembered as BLIND AS A BAT, RED AS A BEET, MAD AS A HATTER, HOT AS A HARE, and DRY AS A BONE

Front 128

Used in emergency situations for the Tx of both open- and narrow-angle glaucoma

Back 128

Pilocarpine
- Activation of MUSCARINIC CHOLINERGIC RECEPTORS causes contraction of the CILIARY MUSCLES w/ opening of SCHLEMM?S CANAL, allowing drainage of aqueous humor and a subsequent DECREASE IN INTRAOCULAR PRESSURE

Front 129

used to prevent motion sickness and delivered by a transdermal patch

Back 129

Scopolamine
- COMPETITIVE CHOLINERGIC ANTAGONIST W/ SEDATING AND AMNESTIC effects

Front 130

Used to Tx hypertension and urinary retention - First-dose syncope is a significant side effect associated with this drug

Back 130

Prazosin
- A competitive ALPHA 1 ANTAGONIST
- The use of this drug can lead to POSTURAL HYPOTENSION, INHIBITION OF EJACULATION, REFLEX TACHYCARDIA, nasal congestion, and MIOSIS

Front 131

A bacterial product of Strep pyogenes, used in the treatment of coronary artery thrombosis?

Back 131

Streptokinase
(Complexes with and catalyzes the conversion of plasminogen to plasmin
it is significantly cheaper, although debatably equivalent, agent to [TPA])

Front 132

Created through the use of recombinant DNA technology, this agent is used or coronary artery thrombosis and ischemic stroke?

Back 132

Tissue plasminogen Activator (t-PA) .
converts fibrin-bound plasminogen to plasmin, resulting in dissolution of thrombi

Front 133

Monoclonal antibody used as an anticoagulant, preventing restenosis after coronary angioplasty?

Back 133

Abciximab.
Antibody against glycoprotein IIb/IIIa receptor on platelets, preventing platelet aggregation.

Front 134

Orally administrated anticoagulant, used in the management and prophylaxis of venous thrombosis, myocardial infarction, and stroke?

Back 134

Warfarin.
Coumadin compound that interferes with the vitamin K-dependent carboxylation of clotting factors II, VII, IX, X.

Front 135

Platelet antiaggregation, used for the prevention of transient ischemic attacks (TIA) in patients with aspirin sensitivity?

Back 135

Ticlopidine
Interferes with the binding of fibrin to the glycoprotein IIb/IIIa receptor on platelets.

Front 136

Rapid-acting, intravenously administered anticoagulant, used for acute myocardial infarction and prevention of DVT following prolonged immobilization?

Back 136

Heparin.
Binds and activated antithrombin III, resulting in inactivation of thrombin and other clotting factors. Does not cross the placenta and can be used during pregnancy. Protamine sulfate reverses its effects.

Front 137

Recombinant product used in the treatment of anemia associated with renal failure?

Back 137

Erythropoietin.
Also used to treat anemia associated with bone marrow transplants or toxic drug reactions.

Front 138

Recombinately produced granulocyte-macrophage colony-stimulating factor (GM-CSF), used in the management of patients undergoing chemotherapy?

Back 138

Sargramostim.
A similar agent, G-CSF (e.g.,filgrastim), is used for similar applications, but affects only granulocytes.

Front 139

Used in the acute bleeding in patients with hemophilia and other coagulopathies?

Back 139

Aminocaproic acid.
An orally active inhibitor of plasminogen activation, thereby inhibiting fibrinolysis
tranexamic acid is a similar agent.

Front 140

Used in the management of sickle cell anemia, as well as for various myeloid neoplasms?

Back 140

hydroxurea.
May decrease the incidence of sickle cell crisis, by increasing levels of HbF
it also inhibits DNA synthesis by blocking the conversion of ribonucleotides to deoxyribonucleotides.

Front 141

Will correct the anemia but not the neurologic deficits caused by B12 deficiency?

Back 141

Folic acid.
Vitamin B12 deficiency must be ruled out before treating megaloblastic anemia with folic acid.

Front 142

Inhibits the enzyem aromatase and is used for the treatment of estrogen-dependent breast cancer

Back 142

Anastrozole.
(An inhibitor of steroid synthesis, it inhibits the conversion of androstenedione to estrone. Aminoglutethimide is a similar drug that inhibits the conversion of cholesterol to pregnenolone, and is used for the same types of cancers)

Front 143

This antineoplastic agent is used for the treatment of testicular carcinoma and squamous cell carcinoma
it can cause life-threatening pulmonary fibrosis

Back 143

Bleomycin.
(The drug is a mixture of glycoproteins that results in the production of free radicals after binding to DNA, creating single-& double-stranded breaks.
This G2 phase inhibitor is part of the ABVD regimen [adriamycin, bleomycin, vinblastine, & decarbazine] for Hodgkin disease.)

Front 144

Highly lipophilic nitrosoureas that readily cross the blood-brain barrier and are used for the treatment of many brain tumors

Back 144

Carmustine (BCNU), Lomustine (CCNU).
(These alkylating agents result in DNA cross-linking and strand breaks)

Front 145

Platinum-containing compound used in the treatment of testicular and lung carcinomas.

Back 145

Cisplatin.
(Acts as an alkylating agent and causes nephrotoxicity and acoustic nerve damage
a similar agent, carboplatin, has less nephrotoxicity and neurotoxicity, but greater myelosuppression)

Front 146

Alkylating agent used for the treatment of non-Hodgkin lymphoma and breast and ovarian carcinomas

Back 146

Cyclophosphamide.
(The major side effect, hemorrhagic cystitis, may be decreased by vigorous hydration and the use of mesna)

Front 147

Part of the AVBD regimen, an antibiotic-type compound used in the treatment of myelomas, sarcomas, and lymphomas

Back 147

Doxorubicin (Adriamycin).
(Intercalates in DNA to decrease replication and transcription
this drug is associated with significant cardiotoxicity and dilated cardiomyopathy.
Daunorubicin is a similar drug and is used primarily for the treatment of acute myelogenous leukemia [AML].)

Front 148

Inhibitor of topoisomerase II used for the treatment of small cell carcinoma of the lung and prostate, and testicular cancers.

Back 148

Etoposide.
(G2 phase-specific inhibition, resulting in double-stranded DNA breaks and degradation)

Front 149

Inhibits thymidylate synthase, resulting in thymineless death, and is used for the treatment of colon cancer and superficial tumors, such as basal cell carcinoma.

Back 149

Fluorouracil (5-FU).
(This S-phase antimetabolite causes myelosuppression)

Front 150

Androgen receptor antagonist, used for the treatment of carcinoma of the prostate

Back 150

Flutamide.
(Used to antagonize residual androgens after orchiectomy
side effects include gynecomastia and libido changes)

Front 151

Recombinantly produced cytokine, used for the treatment of hairy cell leukemia

Back 151

Interferon Alpha.
(Also used for the treatment of chronic myelogenous leukemia [CML], malignant melanoma, and Kaposi sarcoma
it normally is produced by virally infected cells to prevent infection of adjacent cells).

Front 152

Gonadotropin-releasing hormone (GnRH) agonists, used for the treatment of metastatic carcinoma of the prostate

Back 152

Leuprolide, Goserelin, Nafarelin.
(May also be used for the treatment of endometriosis, benign prostatic hyperplasia, and precocious puberty

if administered in a pulsatile manner, they stimulate the release of follicle-stimulating hormone [FSH] and luteinizing hormone [LH], and can thus be used in the management of infertility)

Front 153

Purine metabolites, used for the treatment of leukemias and lymphomas

Back 153

Mercaptopurine (6-MP), Thioguanine (6-TG).
(Requires activation by hypoxanthine-guanine phosphoribosyltransferase [HGPRT], and inhibits many enzmes involved in purine metabolism)

Front 154

Folic acid analog, used for the treatment of leukemias, non-Hodgkin lymphoma, rheumatoid arthritis, and therapeutic abortions.

Back 154

Methotrexate.
(S phase inhibitor of dihydrofolate reductase, leading to decreased DNA and protein synthesis
the accompanying myelosuppression can be treated with leucovorin).

Front 155

Microtubule stabilizing agent, used for the treatment of ovarian and breast carcinomas.

Back 155

Paclitaxel.
(Derived from the yew tree, this M phase agent prevents the mitotic spindle from breaking down and thus inhibits completion of anaphase).

Front 156

Glucocorticoid used for the treatment of leukemias and lymphomas, as well for rheumatoid arthritis and asthma.

Back 156

Prednisone.
(Triggers apoptosis and can lead to hypercortisolism with Cushing-like symptoms. Drug must be tapered gradually to prevent life-threatening adrenal insufficiency).

Front 157

Monoclonal antibody used for the treatment of low-grade non-Hodgkin lymphoma.

Back 157

Rituximab.
(Binds to the CD20 antigen on B cells
adverse reactions are associated with infusion, and include fever, chills, headache, and nausea).

Front 158

Primary agent used in the treatment of estrogen receptor-positive breast cancer.

Back 158

Tamoxifen.
(An estrogen receptor partial agonist, which may increase the risk of endometrial carcinoma).

Front 159

Monoclonal antibody used for the treatment of metastatic breast cancer.

Back 159

Trastuzumab.
(Binds to the receptor tyrosine kinase Erb-B2 [HER-2], overexpressed on some breast cancers).

Front 160

Vinca alkaloid used as part of the MOPP regimen for lymphomas, Wilms tumor, and choriocarcinomas.

Back 160

Vincristine (Oncovin).
(M phase inhibitor that blocks microtubule polymerization and spindle formation
a similar agent, vinblastine, is part of the ABVD regimen.
The ABVD regimen includes the combined use of adriamycin, bleomycin, vinblastine, and dacarbazine whereas the MOPP regimen includes the use of mechlorethamine, Oncovin [vincristine], procarbazine, and prednisone.)

Front 161

Agents that decrease tryglycerides dramatically by stimulating lipoprotein lipase

Back 161

Gemfibrozil, Fenofibrate, Clofibrate
- CLOFIBRATE has been associated with GALLSTONES and HEPATOBILIARY NEOPLASMS

Front 162

Antihyperlipidemic agent that may prevent atherosclerosis by acting as an antioxidant

Back 162

Probucol

Rarely used for the Tx of hyperlipidemia because it DECREASES HDLs AS WELL AS LDLs
May be efficacious in PREVENTING RESTENOSIS after angioplasty

Front 163

Antihypertensives drug that blocks the release or norepi by displacing it from intracellular vesicles

Back 163

Guanethidine
- Side effects include serious ORTHOSTATIC HYPOTENSION
The effects of the drug are ANTAGONIZED BY TRYCYCLIC ANTIDEPRESSANTS

Front 164

Bile acid-binding resins used in the mgmt of hyperlipidemia (2)

Back 164

Cholestyramine, Colestipol
- BIND BILE ACIDS, PREVENTING ENTEROHEPATIC RECYCLING, thus diverting hepatic efforts to renew bile acids, INSTEAD OF PRODUCING PLASMA LIPIDS

Front 165

Causes an increase in cGMP within vascular smooth muscle, resulting in decreased preload to the heart and decreased blood pressure

Back 165

Nitroglycerin

Administered as a SUBLINGUAL PATCH to DECREASE FIRST-PASS METABOLISM
Potential side effects include CYANIDE POISONING, POSTURAL HYPOTENSION, HEADACHE, AND FLUSHING

Front 166

Centrally-acting Alpha-2 agonist that reduces sympathetic ANS outflow, resulting in decreased blood pressure

Back 166

Clonidine
-A major side effect of this drug is REBOUND HYPERTENSION, in the event of ABRUPT DISCONTINUATION

Front 167

Extremely short-acting agent (15-20 seconds) administered IV for the control of AV nodal arrhythmias

Back 167

Adenosine
- The side effects of FLUSHING AND HYPOTENSION are short-lived as well, and do not limit the use of this agent

Front 168

Fxn to decrease the action potential duration by shortening the repolarization phase

Back 168

Class IB Antiarrhythmics (Lidocaine, Mexiletine, Tocainide, Phenytoin)
- These agents are used for the Tx of VENTRICULAR ARRHYTHMIAS, as well as for DIGITOXIN-INDUCED ARRHYTHMIAS

Front 169

Inhibits the rate-limiting enzyme of cholesterol synthesis, HMG-CoA reductase, resulting in dramatically decreased LDL levels

Back 169

Statins (Lovastatin, Pravastatin, Simvastatin, Atorvastatin)

May cause ELEVATED LIVER ENZYMES, MYOSITIS with INCREASED CREATINE KINASE from skeletal muscle, and, rarely, RHABDOMYOLYSIS

Front 170

Lipid-lowering agent that causes cutaneous flushing, which can be avoided by administering concurrently w/ aspirin

Back 170

Niacin

Directly REDUCES THE SECRETION OF VLDLs from and apolipoprotein synthesis by the liver, while INCREASING HDLs

Front 171

Long-acting class III antiarrhythmic associated w/ pulmonary fibrosis, thyroid dysfunction, and corneal microdeposits

Back 171

Amiodarone
- This agent also blocks SODIUM CHANNELS, such as the CLASS IA antiarrhythmics

Front 172

These agents decrease the automaticity of the pacemaker tissue of the heart, resulting in prolonged AV conduction and slower HR

Back 172

Class II Antiarrhythmics (Propanolol, Esmolol)
- These B blockers DECREASE cAMP levels, resulting in REDUCED SODIUM AND CALCIUM CURRENTS. - These agents are NOT to be used in causes of CHF

Front 173

These agents fxn to slow conduction velocity by slowing the rate and rise of the action potential

Back 173

Class IA Antiarrhythmics (Quinidine, Procainamide, Disopyramide) poisoning that causes headache, vertigo, and tinnitus
- These agents help MAINTAIN SA RHYTHM AFTER CARDIOVERSION FOR ATRIAL FIBRILLATION, and may cause TORSADE DE POINTES arrhythmias. QUINIDINE may cause CINCHONISM, a type of

Front 174

This alpha-2 agonist decreases adrenergic outflow from the CNS, resulting in decreased peripheral resistance and decreased blood pressure

Back 174

Methyldopa

This drug can haptenate RBC proteins, resulting in an AUTOIMMUNE HEMOLYTIC ANEMIA

Front 175

This rarely used antihypertensive agent blocks the storage and release of catecholamines and serotonin from neurons

Back 175

Reserpine

The drug readily ENTERS THE CNS and can cause SUICIDAL DEPRESSION and PARKINSONIAN SYMPTOMS

Front 176

Used for atrial arrhythmias and nodal re-entry, as well as hypertension and angina, these agents inhibit Ca2+ voltage channels

Back 176

Class IV Antiarrhthmics (Verapamil, Diltiazem)
- Note: NIFEDIPINE has a similar mechanism of action, but it is used only for HYPERTENSION AND ANGINA
As it has no effect on heart tissue, it is not a class IV agent

Front 177

Used for the Tx of CHF, this agent contains 2 isomers, one with nonselective B blocking activity and one with alpha 1 blocking activity

Back 177

Carvedilol
- LABETALOL has similar properties and has 4 diastereomers - The RR enantiomer is a NONSELECTIVE B BLOCKER, and the SR enantiomer is an alpha 1 BLOCKER

Front 178

Used for the Tx of recurrent ventricular arrhythmias - Many of these agents can precipitate torsade de pointe arrhythmias

Back 178

Class III Antiarrhythmics (Solatol, Ibutulide, Bretylium, Amiodarone)
- These agents prolong the action potential by BLOCKING POTASSIUM CHANNELS

Front 179

Used for the Tx of ventricular arrhythmias, especially following MI, because it works only ischemic tissue

Back 179

Lidocaine
- This class IB antiarrhythmic has LITTLE EFFECT on the ECG of NORMAL [NON-ISCHEMIC] HEART tissue. It is given IV, although similar agents [MEXILETINE and TOCAINIDE] are given orally

Front 180

Used for Tx of refractory ventricular arrhythmias, as well as for rapid atrial arrhythmias associated with Wolff-Parkinson-White syndrome

Back 180

Class IC Antiarrhythmics (Flecainide, Propafenone)
- Fxn to SLOW CONDUCTION VELOCITY in the atrial and ventricular cells but DO NOT AFFECT THE AP - They typically are used as a LAST RESORT, as their use is associated with DRUG-INDUCED ARRHYTHMIAS.

Front 181

Used in the mgmt of CHF, these drugs are reversible inhibitors of Na/K ATPase

Back 181

Digitoxin, Digoxin
- Unlike digitoxin, DIGOXIN IS SHORTER-ACTING and EXCRETED BY THE KIDNEYS
Pts w/ LOW K+, LOW Mg, HIGH Na+, or high Ca2+ can EXPERIENCE ARRYTHMIAS w/ either agent

Front 182

Although not a benzodiazepine, it has similar effects and is used as a hypnotic with less dependence liability

Back 182

Zolpidem

Fxns by binding to benzodiazepine [BDZ] RECEPTORS and thus results in similar actions with LESS AMNESIA AND LESS MUSCLE RELAXATION
Also like benzodiazepines, its actions are ANTAGONIZED BY FLUMAZENIL

Front 183

Amphetamine used in the mgmt of attention deficit disorder (ADD) and narcolepsy

Back 183

Methylphenidate

INCREASES ALERTNESS and DECREASES APPETITE by stimulating the RELEASE OF CATECHOLAMINES
It is a controlled substance with ABUSE POTENTIAL

Front 184

Antidepressant used in the mgmt of nicotine withdrawal in pts seeking to stop cigarette smoking with minimal sedation

Back 184

Bupropion

This second-generation HETEROCYCLIC ANTIDEPRESSANT inhibits the REUPTAKE OF NOREPI. Newer third-generation agents used for depression, such as VENLAFAXINE, inhibit the reuptake of SEROTONIN as well

Front 185

Because of its low toxicity, this local anesthetic can be used on large surface areas and is available over the counter as an ointment

Back 185

Benzocaine

This ESTER-type compound, like cocaine, has SURFACE ACTIVITY, or the ability to work on superficial nerves WHEN APPLIED TO MUCOUS MEMBRANES. Other ester-type compounds include the SHORT-ACTING PROCAINE and the LONG-ACTING TETRACAINE

Front 186

Dissociative anesthetic that causes hallucinations and disorientation on recovery

Back 186

Ketamine

Side effects are due to an INCREASE IN CEREBRAL BLOOD FLOW, and can be reduced by preoperative use of benzodiazepines

Front 187

Drug used for the Tx of partial and tonic-clonic seizures and status epilipticus, as well as being a class IB antiarrhythmic

Back 187

Phenytoin

Side effects include GINGIVAL HYPERPLASIA, HIRSUTISM, ANEMIA, AND BIRTH DEFECTS, because it INTERFERES WITH FOLATE ABSORPTION

Front 188

Drug used in the Tx of Parkinson disease as well as in the Tx of prolactinoma

Back 188

Bromocriptine

This ergot derivative acts as a D2 AGONIST, improving extrapyramidal fxn, and also INHIBITS THE RELEASE OF PROLACTIN from the pituitary gland
Unlike a similar agent, PERGOLIDE, bromocriptine maintains its effectiveness over time

Front 189

Inhaled anesthetic that never reaches the level of surgical anesthesia without the addition of another agent, it is safe and the induction and recovery are extremely rapid

Back 189

Nitrous Oxide

This gas has a HIGH MINIMAL ALVEOLAR CONCENTRATION [MAC] and a low blood/gas partition. It usually is ADMINISTERED WITH AN IV ANESTHETIC such as THIOPENTAL, and is commonly used in DENTAL PROCEDURES

Front 190

Inhibits the degradation of dopamine in the CNS and is used as an adjuvant to levodopa in the Tx of Parkinson disease

Back 190

Selegiline

Inhibits MAO-B, which selectively degrades DOPAMINE

Front 191

Intermediate-acting benzodiazepine used for the Tx of panic disorder and phobias

Back 191

Alprazolam

Both ALPRAZOLAM and CLONAZEPAM have SEDATIVE effects and can cause physiologic DEPENDENCE
BUSPIRONE is an alternative drug that binds 5-HT(1A) RECEPTORS w/ MINIMAL ABUSE POTENTIAL

Front 192

Mood stabilizer that is a first-line drug for the Tx of bipolar affective disorder

Back 192

Lithium

INHIBITS the secondary messengers inositol triphosphate [IP3] and diacylglycerol [DAG] and causes TREMOR, HYPOTHYROIDISM, POLYDIPSIA, AND POLYURIA

Front 193

Newly available agent used in the Tx of Parkinson disease that forestalls the use of levodopa

Back 193

Ropirinole

This agent has a lower incidence of postural hypotension, dyskinesia, vomiting, and hallucination, unlike most dopamine agonists. It is NOT AN ERGOT DERIVATIVE
A similar agent, PRAMIPEXOL, also used

Front 194

Opioid used in the induction of anesthesia, and also for postoperative analgesia

Back 194

Fentanyl

If used in conjunction with DROPERIDOL and NITROUS OXIDE, it can produce a state of NEUROLEPTANESTHESIA, resulting in both ANALGESIA AND AMNESIA

Front 195

Orally active antispasmotic agent

Back 195

Baclofen

GABA(B) RECEPTOR AGONIST that functions on inhibitory pathways in the spinal cord

Front 196

Popular drug used for the Tx of depression, it is the prototype of the selective serotonin reuptake inhibitors (SSRI)

Back 196

Fluoxetine

Common side effects of this and other SSRIs, such as SERTRALINE, PAROXETINE, AND CITALOPRAM, include headache, INSOMNIA, nausea, and SEXUAL DYSFUNCTION

These agents also are used in the mgmt of OBSESSIVE COMPULSIVE DISORDER [OCD], SOCIAL PHOBIAS, bulimia, and alcohol dependence

Front 197

Preferred agent in the Tx of absence seizures

Back 197

Ethosuxamide

Postulated to fxn by INHIBITING T-TYPE CALCIUM CHANNELS in thalamic neurons.Use has been associated with the development of STEVENS-JOHNSON SYNDROME

Front 198

Second-line Tx for schizophrenia that is better for the negative symptoms of the disease

Back 198

Clozapine

ATYPICAL ANTIPSYCHOTIC, associated with AGRANULOCYTOSIS, that blocks the D4 RECEPTOR

Front 199

Side effects of this antipsychotic include torsade de pointes arrhythmias and retinal deposits

Back 199

Thioridazine

This LOW-POTENCY antipsychotic BLOCKS MOST DOPAMINE RECEPTORS in the CNS, and can cause postural hypotension, sedation, and CNS depression

Front 200

The most potent inhaled halogenated anesthetic, with the lowest minimal alveolar concentration (MAC), used for surgical anesthesia in children and asthmatics

Back 200

Halothane

Rare but significant side effects include the development of MALIGNANT HYPERTHERMIA and FULMINANT HEPATITIS

Front 201

The only local anesthetic with vasoconstrictor activity

Back 201

Cocaine

OTHER local anesthetics are ADMINISTERED WITH EPI to increase the duration of action and LOWER THE EFFECTIVE DOSE

Front 202

This agent has the largest number of extrapyramidal side effects of all the atypical antipsychotics

Back 202

Risperidone

ATYPICAL ANTIPSYCHOTICS block the D2 and 5-HT2 RECEPTORS, contributing to HIGH SEDATION. More Recently introduced agents such as OLANZAPINE have NO EXTRAPYRAMIDAL SIDE EFFECTS

Front 203

This agent is used in the Tx of partial and generalized seizures, and is the primary agent used in the Tx of neuralgia

Back 203

Carbamazepine

INHIBITS SODIUM CHANNELS on neurons
its use may result in IDIOSYNCRATIC BLOOD DISORDERS such as ASPLASTIC ANEMIA and AGRANULOCYTOSIS

Front 204

This analog of GABA used in the Tx of partial seizures, as well as in the mgmt of peripheral neuropathy

Back 204

Gabapentin

Other available agents for seizures include LAMOTRIGINE, which may cause life-threatening STEVENS-JOHNSON SYNDROME and epidermal necrolysis, and VIGABATRIN, which INHIBITS GABA TRANSAMINASES

Front 205

This antimuscarinic is used in the mgmt of Parkinson disease, improving tremors and rigidity, but does little for bradykinesia

Back 205

Benztropine

As for all ANTIMUSCARINICS, contraindications include PROSTATIC HYPERPLASIA, GI OBSTRUCTION, and closed-angle GLAUCOMA, and are more common in older pts

Front 206

This long-acting amide-type local anesthetic can cause severe hypotension and arrythmias if inadvertently given IV

Back 206

Bupivicaine

Local anesthetics BIND TO SODIUM CHANNELS in the OPEN AND INACTIVE STATE, SLOWING RECOVERY from depolarization 10- to 1000-fold

Front 207

This older agent used in the Tx of depression increases levels of amine neurotransmitters by inhibiting their breakdown

Back 207

Monamine oxidase inhibitors (MAOI) ? Phenelzine, Tranylcypromine, Isocarboxazid

Consumption of foods such as CHEESE, which contain TYRAMINE (an INDIRECT-ACTING SYMPATHOMIMETIC) while on MAOIs can result in HYPERTENSIVE CRISIS
If taken with SSRIs, life-threatening SEROTONIN SYNDROME can result

Front 208

Ultra-short-acting barbiturate used IV for the induction of surgical anesthesia

Back 208

Thiopental

Due to its HIGH LIPID SOLUBILITY, this agent enters the CNS within 1 minute
It can be used only for SHORT SURGICAL PROCEDURES, because it RAPIDLY REDISTRIBUTES to other tissues

Front 209

Used as a sedative
also is a first line drug for tonic-clonic seizures in children and in the Tx pts with Crigler-Najjar syndrome type II

Back 209

Phenobarbital

As a long acting, prototypic BARBITUATE, it binds to GABA RECEPTORS, increasing the DURATION OF CHLORIDE CHANNEL OPENING with neuronal INHIBITION

Front 210

Used for Tx of anxiety and ethanol dependence
Also a primary agent in the Tx of status epilipticus

Back 210

Diazepam

This long-acting, prototypic BENZODIAZEPINE binds to the GABA(A) RECEPTOR, increasing the FREQUENCY OF CHLORIDE CHANNEL OPENING

Front 211

Used in the mgmt of depression, it inhibits the reabsorption of both norepi and serotonin within the synapse

Back 211

Amitriptyline

Other TRICYCLIC ANTIDEPRESSANTS include NORTRIPTYLINE, IMIPRAMINE and DESIPRAMINE. Major side effects of this class include SEDATION, ORTHOSTATIC HYPOTENSION, and CARDIAC ARRHYTHMIAS

Front 212

Used in the Tx of most forms of epilepsy, includeing generalized tonic-clonic, partial absence, and myoclonic seizures, and in the Tx of bipolar disorder

Back 212

Valproic Acid

This agent has been associated with the development of NEURAL TUBE DEFECTS when administered to PREGNANT WOMEN

Front 213

Used in the Tx of Parkinson disease, it inhibits the enzyme catechol-O-methyltransferase (COMT)

Back 213

Entacapone

This agent inhibits the conversion of LEVODOPA TO 3-O-METHYLDOPA in the periphery. A similar agent, TOLCAPONE, has been associated with ACUTE LIVER FAILURE

Front 214

Used in the Tx of Parkinson disease, this precursor crosses the BBB and is converted to dopamine

Back 214

L-dopa (Levodopa)

Administered with the DECARBOXYLASE INHIBITOR CARBIDOPA [which does not cross the BBB] to increase bioavailability and to LIMIT PERIPHERAL SIDE EFFECTS

Front 215

Angiotensin II receptor antagonist used as an antihypertensive drug

Back 215

Losartan
- Fxns at the COLLECTING TUBULES, like ACE inhibitors, but NO COUGH as side effect. Again, like ACE inhibitors, this drug is TERATOGENIC and, therefore, CONTRAINDICATED IN PREGNANCY

Front 216

Cough is a major side effect of this group of antihypertensive drugs

Back 216

ACE inhibitors (Captopril, Enalapril, Lisinopril)
- INHIBIT the conversion of ANGIOTENSIN I to ANGIOTENSIN II
Inhibit breakdown of BRADYKININ, resulting in cough and POTENT VASODILATION

Front 217

Diuretic that fxns early in the DCT by inhibiting NaCl reabsorption

Back 217

Hydrochlorothiazide
- Major side effects include HYPOKALEMIA, ALKALOSIS, HYPERURICEMA, AND HYPERLIPIDEMIA

Front 218

Diuretic used in the management of chronic glaucoma and acute mountain sickness
Also used to alkalinize the urine in aspirin toxicity

Back 218

Acetazolamide
- Inhibits CARBONIC ANHYDRASE in the PCT
METABOLIC ACIDOSIS is a potential side effect

Front 219

Most potent class of diuretics that inhibit the Na/K/Cl cotransporter in the thick ascending loop of Henle

Back 219

Loop Diuretics (Furosemide, Butamide)
- These SULFA DRUGS can cause HYPERCALCEMIA, OTOTOXICITY, HYPERURICEMIA, HYPOKALEMIA, AND METABOLIC ALKALOSIS
ETHACRYNIC ACID is a NON-SULFA DRUG with similar effects

Front 220

Originally developed as an antihypertensive agent, it is used topically because of the beneficial side effect of hypertrichosis (growth of hair in excess of normal)

Back 220

Minoxidil
- Fxns as a direct-acting vasodilator, as do NITROPRUSSIDE and HYDRALAZINE

Front 221

Osmotic diuretic that works by extracting water from tissues into the blood
Used in the Tx of hydrocephalus and increased intracranial pressure

Back 221

Mannitol
- This diuretic fxns primarily WITHIN THE PCT?s and is used to maintain HIGH URINE OUTPUT in cases of severe HEMOLYSIS or RHABDOMYOLYSIS

Front 222

Potassium-sparing diuretics that do not have anti-androgenic effects (2)

Back 222

Amiloride, Triamterene
- Block SODIUM CHANNELS in the cortical COLLECTING TUBULES
May cause hyperkalemic metabolic acidosis

Front 223

This potassium-sparing diuretic is an aldosterone antagonis that fxns at the collecting tubule

Back 223

Spironolactone
- Increases P450 activity and causes GYNECOMASTIA and other ANTIANDROGENIC EFFECTS

Front 224

This potent vasodilator, used in the Tx of malignant hypertension, can cause significant postural hypotension

Back 224

Nitroprusside
- Fxns to STIMULATE GUANYL CYCLASE with an INCREASE IN cGMP within smooth muscle of the vasculature - Prolonged infusion can result in CYANIDE POISONING due to RELEASE OF CN-

Front 225

"High" is associated with euphoria, disinhibition, laughter, changes in perception, and hunger?

Back 225

Marijuana.
(The active ingredient, tetrahydrocannabinol (THC) can be used medically to lower intraocular pressure in glaucoma.)

Front 226

A by-product of incorrectly synthesized illicit street opioids, this contaminant can cause irreversible parkinsonism?

Back 226

MPTP
(1-methyl-4phenyl-1,2,3,6-tetrahydropyridine) Causes the destruction of dopaminergic neurons of the nigrostriatal tract).

Front 227

Causes feelings of euphoria and self-confidence, and, at chronic high doses, delusions and paranoia?

Back 227

Amphetamines.
(Function as an indirect sympathomimetic by releasing stored catecholamines).

Front 228

Congener of amphetamine that results in increased intrapersonal communications and increased sexual drive?

Back 228

Ecstasy.
Methylene dioxymethamphetamine (MDMA) use is on the rise in teenagers of higher socioeconomic status and often associated with "rave" parties).

Front 229

Hallucinogen that often cause psychotic reactions and impaired judgement leading to reckless behavior?

Back 229

Phencyclidine (PCP)
Also known as "angel dust"
overdose leads to nystagmus, life-threatening hypertension, and seizures.

Front 230

Hallucinogenic agent that causes "psychedelic" perceptual effects and can lead to a "bad trip" or panic attack?

Back 230

Lysergic Acid Diethylamide (LSD).
"Highs" also associated with somatic effects, such as nausea, paresthesias, and weakness
such effects are also seen with the use of mescaline and psilocybin.

Front 231

Overdose causes constricted pupils, clammy skin, nausea, drowsiness, and respiratory depression with possible coma and death?

Back 231

Opioids (heroin/Morphine/meperidine/fentanyl)
Modulate synaptic transmission by binding mu (morphine), delta (enkephalin), and kappa (dynorphin) receptors.

Front 232

Overdose often results in fatalities from arrhythmias, myocardial infarctions, or seizures?

Back 232

Cocaine
(inhibits catecholamine reuptake, resulting in cardiotoxicity and hypertensive episodes)

Front 233

Rapidly acting benzodiazepine used as a "date-rape" drug?

Back 233

Flunitrazepam.
(Due to its amnestic properties, this drug is often added to alcohol, making the victim incapable of resisting or remembering being raped.)

Front 234

Used in the management of opioid withdrawl and maintenance programs for addicts?

Back 234

Methadone.
(Used to treat nausea, chills, sweats, lacrimation, cramps, rhinorrhea, yawning, piloerection, diarrhea and tremor due to opiod withdrawl.)

Front 235

Used in the treatment of alcoholism in compliant patients, causing flushing, vomiting, and hypertension when alcohol is consumed?

Back 235

Disulfiram.
(Inhibits aldehyde dehydrogenase, resulting in toxic accumulation of acetaldehyde. Drugs with similar side effects are said to have disulfiram-like reaction.)

Front 236

?HRT? shown to decrease the risk of coronary artery disease, to slow the progression of osteoporosis, and to ameliorate hot flashes in postmenopausal women
ameliorates hot flases in postmenopausal women
risk of breast and ovarian cancer

Back 236

ethinyl estradiol mestranol

Front 237

1. V2-selective agonist that facilitates water reabsorption from the collecting tubules. 2. V1&V2 agonist- its V1 activity increases vascular smooth muscle tone and therefore is used for tx of esophageal varices

Back 237

1. desmopressin, 2. vasopressin

Front 238

a synthetic analog of ACTH used to diagnose patients with abnormalities of cortisol production (Addison?s)

Back 238

cosyntropin

Front 239

a synthetic analog of somatostatin, used in the treatment of many endocrine tumors, including carcinoid, gastrinoma, and somatropic pituitary adenoma

Back 239

ocreotide

Front 240

abortifacient steroid receptor antagonist known as the ?morning after? pill

Back 240

mifepristone (RU486)

Front 241

active form of thyroid hormone
synthetic, faster acting, but more expensive and used less frequently

Back 241

liothyronine (t3)

Front 242

aldtered form of insulin that enters the circulation more rapidly than crystalline zinc (regular insulin)

Back 242

insulin lispro

Front 243

an antidiuretic hormone (ADH) receptor agonist used for the treatment of pituitary diabetes insipidus

Back 243

vasopressin, desmopressin

Front 244

antiandrogenic compound used in the treatment of BPH and alopecial

Back 244

finasteride

Front 245

belongs to a class of drugs known as meglitinides, which facilitate insulin release from pancreatic B cells by binding to K channels

Back 245

repaglinide

Front 246

biguanide compound that functions by increasing peripheral glycolysis, and therefore hepatic gluconeogenesis, resulting in a decrease in serum glucose levels

Back 246

metformin

Front 247

Blocks negative feedback to the pituitary, increasing the release of FSH and LH to stimulate ovulation

Back 247

clomiphene

Front 248

blocks the binding of progesterone to cytoplasmic receptors, preventing successful implantation

Back 248

mifepristone (RU486)

Front 249

characterized by poor oral availability and cannot be taken with food
may cause esophageal ulcerations, so must be taken with large amounts of water, and the patient must remain uproight for at least 30 minutes afterward

Back 249

bisphosphonates (alendronate/etidronate/pamidronate/risedronate)

Front 250

ergot alkaloid with dopaminergic activity, inhibiting the release of prolactin

Back 250

bromocriptine

Front 251

estrogen partial agonist is used to prevent osteoporosis in postmenopausal women

Back 251

raloxifine

Front 252

fertility drug used to induce ovulation in anoulatory women, although its use may be associated with multiple births

Back 252

Clomiphene

Front 253

form of insulin is given in the morning and in the evening, to maintain basal levels of insulin for 12 to 24 hours

Back 253

ultralente insulin

Front 254

increases serum HDL, protecting against atherosclerosis and heart disease- unlike other SERMs and tamoxifen- it does not increase the risk of endometrial carcinoma

Back 254

raloxifene

Front 255

inhibits ?-galactosidase, an enzyme required for rapid absorption of most dietary sugars

Back 255

acarbose

Front 256

inhibits 5?-reductase, thust conversion of testosterone to DHT

Back 256

finasteride

Front 257

inhibits several P450 enzymes involved in gonadal steroid synthesis

Back 257

danazol

Front 258

inhibits the iodination and coupling reactions of thyroid hormone synthesis. Another agent is methimazole- which crosses the placenta and enters breast milk

Back 258

propylthiouracil

Front 259

insulin secretagogue has rapid onset, but shorter duration of action than sulfonylureas

Back 259

repaglinide

Front 260

normally produced in the posterior pituitary, this hormone is used to stimulate and reinforce labor, as well as stimulate milk ejection from nursing mothers

Back 260

oxytocin

Front 261

octapeptide that is used instead of somatostatin, because it half-life

Back 261

octreotide

Front 262

oral agent used in the treatment of hyperthyroidism

Back 262

propylthiouracil

Front 263

oral hypoglycemic agent that does not require functional pancreatic islet cells and decreases postprandial glucose levels without resultant hypoglycemia or wt gain

Back 263

metformin

Front 264

Oral hypoglycemic agent that functions within the intestinal lumen, decreasing postprandial hyperglycemia, although there are no effects on fasting sugar

Back 264

Acarbose

Front 265

oral hypoglycemic agents used to stimulate the release of endogenous insulin from B cells

Back 265

sulfonylureas (glyburide/glipizide)

Front 266

PPAR gamma regulates a number of genes involved in carbohydrate metabolism. The first member of this class, troglitazone, was removed from the market because it caused hepatotoxicity

Back 266

rosiglitazone, pioglitazone

Front 267

proteolytic cleavage of POMC forms ACT and MSH, as well as B-endorphin and metenkephalin

Back 267

cosyntropin

Front 268

stimulate the closure of K channels, resulting in depolarization of B cells and release of preformed insulin in vesicles

Back 268

sulfonylureas (glyburide/ glipizide)

Front 269

stimulates contraction of uterine smooth muscle for labor
stimulates contraction of the myoepithelial cells of the mamry glands to eject milk

Back 269

oxytocin

Front 270

supplemented throughout the day with insulin lispro
modified version of human insulin, insulin glargine, has even longer duration of action

Back 270

ultralente insulin

Front 271

synthetic estrogen with high oral availability, used in contraceptive pills as well as in HRT

Back 271

Ethinyl Estradiol Mestranol

Front 272

synthetic progesterone analog used in oral contraceptives and implantable contraceptive devices

Back 272

norgestrel

Front 273

synthetic thyroid hormone used in the treatment of hypothyroidism (hashimoto?s thyroiditis, myxedema, lithium treatment)

Back 273

levothyroxine (T4)

Front 274

these agents increase cell sensitivity to insulin, by stimulating the peroxisomal proliferator gamma (PPARgamma)nuclear receptor

Back 274

Rosiglitazone, pioglitazone

Front 275

these compounds reduce bone resorption and formation, and are used in the treatment of osteoporosis (postmenopausal, senile, or glucocorticoid-induced) and Paget disease

Back 275

bisphosphonates

Front 276

ultra-rapid-acting human insulin administered immediately before meals

Back 276

insulin lispro

Front 277

use of theis estrogen compound by pregnant women has been associated with development of clear cell adenocarcinoma of the bagina in their daughters

Back 277

DES (diethylstilbestrol)

Front 278

used as postcoital birth control, and for the treatment of testicular tumors

Back 278

DES

Front 279

used for mineralcorticoid deficiency, this agent has a long duration of action, and is a naturally occurring precursor to aldosterone

Back 279

fludrocortisone

Front 280

used for the treatment of osteoporosis, this hormone produced by the thyroid decreases bone breakdown, and decreases serum calcium and phosphate levels

Back 280

calcitonin

Front 281

used in conjunction with glucocorticoids in postadrenalectomy therapy

Back 281

fludrocortisone

Front 282

used in HRT, and to prevent abnormal uterine bleeding

Back 282

norgestrel (norethidrone, medroxyprogestrone)

Front 283

used in the treatment of acute hypercalcemia and paget disease
administered intranasally or by injection
(salmon type has longer t1/2)

Back 283

calcitonin

Front 284

used in the treatment of endometriosis and fibrocystic disease of the breast

Back 284

danazol

Front 285

used in the treatment of hyperprolactinemia (ie. pituitary adenoma)

Back 285

bromocriptine

Front 286

Among the most popular antacids used in the United States, neither is absorbed and, therefore, neither causes systemic effects?

Back 286

Magnesium hydroxide/ Aluminum hydroxide.
Magnesium hydroxide also has a strong laxative effect, whereas aluminum hydroxide causes constipation.

Front 287

Central-acting antiemetic used to control postopeative vomiting and vomiting in chemotherapy patients?

Back 287

Ondansetron.
(5-HT3 inhibitor that functions at the chemoreceptive area of the area postrema.)

Front 288

Chronic ingestion of this antacid with milk can induce the milk-alkali syndrome?

Back 288

Calcium carbonate.
Can result in hypercalcemic alkalosis with the development of renal calculi.

Front 289

Commenly used proemetic agent used in cases of ingestion of caustic substances or mineral oils?

Back 289

Ipecac Syrup.
Orally administered substances that act directly on the chemoreceptor trigger zone in the medulla.

Front 290

Eicosanoid preparation used to prevent peptic ulcers in patients taking high doses of NSAIDs for conditions such as rheumatoid arthritis?

Back 290

Misoprostol.
This prostaglandin (PGE) analog decreases gastric acid production and increases mucous production, protecting the lining of the stomach.

Front 291

Opioid derivatives used in the treatment of diarrhea because they suppress gastrointestinal motility?

Back 291

Diphenoxylate, loperamide.
Whereas diphenoxylate is formulated with antimuscarinic alkaloids
both preparations have minimal abuse potential.

Front 292

Prokinetic agent used in the treatment of upper gastrointestinal dysfunction such as GERD or gastroparesis with delayed gastric emptying?

Back 292

Cisapride.
Stimulates peristalsis by promoting the release of acetylcholine from postganglionic nerves of the myenteric plexus. High doses have been associated with long QT syndrome.

Front 293

Proton pump inhibitor used in the treatment of GERD, gastric and duodenal ulcers, H. pylori gastritis, and Zollinger-Ellison syndrome (gastrinoma)?

Back 293

Omeprazole.
Irreversibly inhibits the H+/K+ ATPase on the luminal side of parietal cells.

Front 294

This preparation is used to treat emesis and nausea associated with chemotherapy, and contains the active ingredient in marijuna?

Back 294

Dronabinol.
This schedule III drug, which contains ttrahydrocannabinol (THC), is a controlled substance with approved medical use and moderate potential for dependence.

Front 295

This prokinetic agent is used to prevent emesis (e.g. postanesthesia or due to cancer chemotherapy), because it blocks D2 receptors in the area postrema that trigger vomiting?

Back 295

Metoclopramide
(functions to facilitate ACh, while antagonizing the action of dopamine on the enteric nervous system. Side effects include sedation, diarrhea and extrapyramidal symptoms.)

Front 296

Used for the treatment of traveler's diarrhea?

Back 296

Bismuth subsalicylate.
Helps decrease fluid secretion by the bowel
also used with metronidazole and tetracycline for the treatment of H. pylori-associated peptic ulcer disease.

Front 297

Used in the treatment of GERD, this histamine blocker is associated with gynecomastia and galactorrhea?

Back 297

Cimetidine.
The stronger H2 blockers, ranitidine and famotidine do not inhibit the hepatic P-450 system and therefore do no not cause antiandrogenic effects.

Front 298

Used in the treatment of peptic ulcers, because it polymerizes and selectively coats necrotic ulcerated tissue?

Back 298

Sucralfate.
Requires an acidic environment to polymerize, and, therefore, cannot be used in the presence of antacids or H2 blockers.

Front 299

First generation H1 histamine receptor blockers- clinical uses?

Back 299

Allergy, motion sickness, sleep aid

Front 300

First generation H1 histamine receptor blockers- toxicities?

Back 300

Sedation, antimuscarinic, anti-alpha-adrenergic

Front 301

Is toxicity rare or common whith Cromolyn used in Asthma prevention?

Back 301

Rare.

Front 302

Name 3 First generation H1 histamine receptor blockers.

Back 302

Diphenhydramine, Dimenhydrinate, Chlorpheniramine

Front 303

Name 3 Second generation H1 histamine receptor blockers?

Back 303

Loratadine, Fexofenadine, Desloratadine

Front 304

Second generation H1 histamine receptor blockers- clinical uses?

Back 304

Allergy

Front 305

Second generation H1 histamine receptor blockers- toxicities?

Back 305

Much less sedating than 1st generation H1 blockers

Front 306

What does the Lipoxygenase pathway yield?

Back 306

Leukotrienes

Front 307

What is LTB4?

Back 307

Neutrophil chemotactic agent

Front 308

What is LTC4,D4,E4?

Back 308

Function is broncoconstriction, vasoconstriction, smooth muscle contraction, inc. vascular permeability

Front 309

What is PGI2?

Back 309

Inhibits platelet aggregation and promotes vasodilation

Front 310

What is the category and mechanism of action of Zafirlukast in Asthma treatment?

Back 310

Blocks leukotriene receptors.

Front 311

What is the category and mechanism of action of Zileuton in Asthma treatment?

Back 311

5-lipoxygenase pathway inhibitor

blocks conversion of arachidonic acid to leukotrienes

Front 312

What is the category, desired effect, and adverse effect of Isoproterenol in the treatment of Asthma?

Back 312

Nonspecific beta-agonist

desired effect is the relaxation of bronchial smooth muscle (B2)
Adverse effect is tachycardia (B1).

Front 313

What is the category, desired effect, and period of use of Albuterol in the treatment of Asthma?

Back 313

Beta 2 agonist
.
Relaxation of bronchial smooth muscle (Beta 2)
Use during acute exacerbation

Front 314

What is the category, desired effect, and possible mechanism of Theophylline in treating Asthma?

Back 314

Methylxanthine

desired effect is bronchodilation by inhibiting phosphodiesterase.

Front 315

What is the category, mechanism of action, and effect of Ipratroprium in Asthma treatment?

Back 315

Muscarinic antagonist

competatively blocks muscarinic receptors, preventing bronchoconstriction.

Front 316

What is the category, mechanism of action, and particular use of Beclomethasone and Prednisone in Asthma treatment?

Back 316

Corticosteroids

prevent production of virtually all cytokines
drugs of choice in a patient with status asthmaticus (in combination with albuterol.)

Front 317

What is the category, method of use, and adverse effects of Salmeterol in Asthma treatment?

Back 317

Beta 2 agonist

used as a long-acting agent for prophylaxis
Adverse effects are tremor and arrhythmia.

Front 318

What is the mecanism of action, effective period, and ineffective period of use for Cromolyn in treating Asthma?

Back 318

Prevents release of mediators from mast cells. Effective only for prophylaxis of asthma. Not effective during an acute attack.

Front 319

Acetaldehyde is metabolized by Acetaldehyde dehydrogenase, which drug inhibits this enzyme?

Back 319

Disulfiram & also sulfonylureas, metronidazole

Front 320

Explain pH dependent urinary drug elimination?

Back 320

Weak Acids=Alkinalize urine(CO3) to remove more -Weak bases=acidify urine (give NH4Cl) to remove more

Front 321

How do you treat coma in the ER (4)?

Back 321

Airway -Breathing -Circulation -Dextrose(thiamine & narcan) -ABCD

Front 322

In coma situations you rule out what (7)?

Back 322

Infections -Trauma -Seizures -CO -Overdose -Metabolic -Alcohol (IT'S COMA)

Front 323

List some specifics of lead poisoning(4)?

Back 323

Blue lead lines in gingiva& long bones epiphyses -Encephalopathy/Erythrocyte basophilic stippling -Wrist/Foot drop -Abdominal colic -Sideroblastic anemia

Front 324

List the specific antidote for this toxin: Acetaminophen

Back 324

N-acetylcysteine

Front 325

List the specific antidote for this toxin: Amphetamine

Back 325

Ammonium Chloride

Front 326

List the specific antidote for this toxin: Anticholinesterases (organophosphate.)

Back 326

Atropine & pralidoxime

Front 327

List the specific antidote for this toxin: Antimuscarinic (anticholinergic)

Back 327

Physostigmine salicylate

Front 328

List the specific antidote for this toxin: Arsenic, Mercury, Gold

Back 328

Dimercaprol, succimer

Front 329

List the specific antidote for this toxin: Benzodiazepines

Back 329

Flumazenil

Front 330

List the specific antidote for this toxin: Beta Blockers

Back 330

Glucagon

Front 331

List the specific antidote for this toxin: Carbon monoxide

Back 331

100% oxygen, hyperbaric O2

Front 332

List the specific antidote for this toxin: Copper, arsenic, Gold

Back 332

Penicillamine

Front 333

List the specific antidote for this toxin: Cyanide

Back 333

Nitrite, hydroxocobalamin thiosulfate

Front 334

List the specific antidote for this toxin: Digitalis

Back 334

Normalize K+, Lidocaine, & Anti-dig Fab fragments, Mg2+

Front 335

List the specific antidote for this toxin: Heparin

Back 335

Protamine

Front 336

List the specific antidote for this toxin: Iron

Back 336

Deferoxamine

Front 337

List the specific antidote for this toxin: Lead

Back 337

EDTA, Dimercaprol, succimer, & penicillamine

Front 338

List the specific antidote for this toxin: Methanol & Ethylene glycol

Back 338

Ethanol, dialysis, & fomepizole

Front 339

List the specific antidote for this toxin: Methemoglobin

Back 339

Methylene blue

Front 340

List the specific antidote for this toxin: Opioids

Back 340

Naloxone / Naltrexone (Narcan)

Front 341

List the specific antidote for this toxin: Salicylates

Back 341

Alkalinize urine & dialysis

Front 342

List the specific antidote for this toxin: tPA & Streptokinase

Back 342

Aminocaproic acid

Front 343

List the specific antidote for this toxin: Tricyclic antidepressants (TCAs)

Back 343

NaHCO3

Front 344

List the specific antidote for this toxin: Warfarin

Back 344

Vitamin K & fresh frozen plasma

Front 345

What are some toxicities for Dehydroepiandrosterone?

Back 345

Androgenization (premenopausal women), estrogenic effects (postmenopausal), feminization (young men)

Front 346

What are some toxicities for Echinacea?

Back 346

GI distress, dizziness, headaches

Front 347

What are some toxicities for Ephedra?

Back 347

CNS and cardiovascular stimulation: arrhythmias, stroke, and seizures at high doses

Front 348

What are some toxicities for Feverfew?

Back 348

GI distress, mouth ulcers, antiplatelet actions

Front 349

What are some toxicities for Ginkgo?

Back 349

GI distress, Anxiety, Insomnia, headache, antiplatelet action

Front 350

What are some toxicities for Kava?

Back 350

GI distress, sedation, ataxia, hepatotoxicity, phototoxicity, dermatotoxicity

Front 351

What are some toxicities for Melatonin?

Back 351

Sedation, suppresses midcycle LH, hypoprolactinemia

Front 352

What are some toxicities for Milk Thistle?

Back 352

Loose stools

Front 353

What are some toxicities for Saw Palmetto?

Back 353

GI distress, dec. libido, HTN

Front 354

What are some toxicities for St. John's Wart?

Back 354

GI distress, phototoxicity, Serotonin syndrome with SSRIs

Front 355

What are the products and their toxicities of the metabolism of ethanol by alcohol dehydrogenase?

Back 355

Acetaldehyde -N/V, headache, & hypotension

Front 356

What are the products and their toxicities of the metabolism of Ethylene Glycol by alcohol dehydrogenase?

Back 356

Oxalic acid -Acidosis & nephrotoxicity

Front 357

What are the products and their toxicities of the metabolism of Methanol by alcohol dehydrogenase?

Back 357

Formaldehyde & formic acid -severe acidosis & retinal damage

Front 358

What category of drugs: -afil

Back 358

Erectile dysfunction (ep Sildenafil)

Front 359

What category of drugs: -ane

Back 359

Inhalational general anesthetic (ep Halothane)

Front 360

What category of drugs: -azepam

Back 360

Benzodiazepine (ep Diazepam)

Front 361

What category of drugs: -azine

Back 361

Phenothiazine (neuroleptic, antiemetic) (ep Chlorpromazine)

Front 362

What category of drugs: -azole

Back 362

Antifungal (ep Ketoconazole)

Front 363

What category of drugs: -barbital

Back 363

Barbiturate (ep Phenobarbital)

Front 364

What category of drugs: -caine

Back 364

Local anesthetic (ep Lidocaine)

Front 365

What category of drugs: -cillin

Back 365

Penicillin (ep Methicillin)

Front 366

What category of drugs: -cycline

Back 366

Antibiotic, protein synthesis inhibitor (ep Tetracycline)

Front 367

What category of drugs: -ipramine

Back 367

TCA (ep Imipramine)

Front 368

What category of drugs: -navir

Back 368

Protease inhibitor (ep Saquinavir)

Front 369

What category of drugs: -olol

Back 369

Beta-antagonist (ep Propranolol)

Front 370

What category of drugs: -operidol

Back 370

Butyrophenone (neuroleptic) (ep Haloperidol)

Front 371

What category of drugs: -oxin

Back 371

Cardiac glycoside (inotropic agent) (ep Digoxin)

Front 372

What category of drugs: -phylline

Back 372

Methylxanthine (ep Theophylline)

Front 373

What category of drugs: -pril

Back 373

ACE inhibitor (ep Captopril)

Front 374

What category of drugs: -terol

Back 374

B2 agonist (ep Albuterol)

Front 375

What category of drugs: -tidine

Back 375

H2 antagonist (ep Cimetidine)

Front 376

What category of drugs: -triptyline

Back 376

TCA (ep Amitriptyline)

Front 377

What category of drugs: -tropin

Back 377

Pituitary hormone (ep Somatotropin)

Front 378

What category of drugs: -zosin

Back 378

Alpha 1 antagonist (ep Prazosin)

Front 379

What is a clinical use for Dehydroepiandrosterone?

Back 379

Symptomatic improvement in females with SLE or AIDS

Front 380

What is a clinical use for Echinacea?

Back 380

Common Cold

Front 381

What is a clinical use for Ephedra?

Back 381

As for ephedrine

Front 382

What is a clinical use for Feverfew?

Back 382

Migraine

Front 383

What is a clinical use for Ginkgo?

Back 383

Intermittent claudication

Front 384

What is a clinical use for Kava?

Back 384

Chronic anxiety

Front 385

What is a clinical use for Melatonin?

Back 385

Jet lag, insomnia

Front 386

What is a clinical use for Milk Thistle?

Back 386

Viral Hepatitis

Front 387

What is a clinical use for Saw Palmetto?

Back 387

Benign prostatic hyperplasia

Front 388

What is a clinical use for St. John's Wart?

Back 388

Mild to moderate depression

Front 389

What is the treatment for lead poisoning?

Back 389

Dimercaprol and EDTA

Front 390

Which drug(s) cause this reaction: Adrenocortical Insufficiency

Back 390

Glucocorticoid withdrawal (HPA suppression)

Front 391

Which drug(s) cause this reaction: Agranulocytosis (3)?

Back 391

Cloazapine -Carbamazapine -Colchicine

Front 392

Which drug(s) cause this reaction: Anaphylaxis?

Back 392

Penicillin

Front 393

Which drug(s) cause this reaction: Aplastic anemia (5)?

Back 393

Chloramphenicol -Benzene -NSAIDS

Front 394

Which drug(s) cause this reaction: Atropine-like side effects?

Back 394

Tricyclic antidepressants

Front 395

Which drug(s) cause this reaction: Cardiac toxicity?

Back 395

Doxorubicin & Daunorubicin

Front 396

Which drug(s) cause this reaction: Cinchonism (2)?

Back 396

Quinidine -Quinine

Front 397

Which drug(s) cause this reaction: Coronary Spasm?

Back 397

Cocaine

Front 398

Which drug(s) cause this reaction: Cough?

Back 398

ACE inhibitors (Losartan=no cough)

Front 399

Which drug(s) cause this reaction: Cutaneous flushing (4)?

Back 399

Niacin -Ca2+ channel blockers -Adenosine -Vancomycin

Front 400

Which drug(s) cause this reaction: Diabetes insipidus?

Back 400

Lithium

Front 401

Which drug(s) cause this reaction: Disulfram-like reaction (4)?

Back 401

Metronidazole -certain Cephalosporins -Procarbazine -Sulfonylureas

Front 402

Which drug(s) cause this reaction: Drug induced Parkinson's (4)?

Back 402

Haloperidol -Chlorpromazine -Reserpine -MPTP

Front 403

Which drug(s) cause this reaction: Extrapyramidal side effects (3)?

Back 403

Chlorpromazine -Thioridazine -Haloperidol

Front 404

Which drug(s) cause this reaction: Fanconi's syndrome?

Back 404

Expired Tetracycline

Front 405

Which drug(s) cause this reaction: Focal to massive hepatic necrosis (4)?

Back 405

Halothane, Valproic acid, Acetaminophen, Amanita phalloides

Front 406

Which drug(s) cause this reaction: G6PD hemolysis(8)?

Back 406

Sulfonamides, INH, ASA, Ibuprofen, Primaquine, Nitrofurantoin, Pyrimethamine, Chloramphenicol

Front 407

Which drug(s) cause this reaction: Gingival hyperplasia?

Back 407

Phenytoin

Front 408

Which drug(s) cause this reaction: Gray baby syndrome?

Back 408

Chloramphenicol

Front 409

Which drug(s) cause this reaction: Gynecomastia (6) ?

Back 409

Spironolactone -Digitalis -Cimetidine -EtOH (alcohol) -Estrogens -Ketoconazole
(Some Drugs Create Awesome Knockers)

Front 410

Which drug(s) cause this reaction: Hepatitis?

Back 410

Isoniazid(INH), Halothane

Front 411

Which drug(s) cause this reaction: Hot flashes?

Back 411

Tamoxifen

Front 412

Which drug(s) cause this reaction: Neuro and Nephrotoxic?

Back 412

Polymyxins

Front 413

Which drug(s) cause this reaction: Osteoporosis (2)?

Back 413

Corticosteroids -Heparin

Front 414

Which drug(s) cause this reaction: Oto and Nephrotoxicity (3)?

Back 414

Aminoglycosides -Loop diuretics -Cisplatin

Front 415

Which drug(s) cause this reaction: P450 induction(6)?

Back 415

Barbiturates -Phenytoin -Carbamazipine -Rifampin -griseofulvin -Quinidine

Front 416

Which drug(s) cause this reaction: P450 inhibition(6)?

Back 416

Cimetidine -Ketoconazole -Grapefruit juice -Erythromycin -INH -Sulfonamides

Front 417

Which drug(s) cause this reaction: Photosensitivity(3)?

Back 417

Sulfonamides -Amiodarone -Tetracycline (SAT for a photo)

Front 418

Which drug(s) cause this reaction: Pseudomembranous colitis?

Back 418

Clindamycin, Ampicillin

Front 419

Which drug(s) cause this reaction: Pulmonary fibrosis(3)?

Back 419

Bleomycin, Amiodarone, Busulfan

Front 420

Which drug(s) cause this reaction: SLE-like syndrome

Back 420

Hydralazine, INH, Procainamide, Phenytoin (HIPP)

Front 421

Which drug(s) cause this reaction: Stevens-Johnson Syn. (3) ?

Back 421

Ethosuxamide -Sulfonamides -Lamotrigine

Front 422

Which drug(s) cause this reaction: Tardive dyskinesia?

Back 422

Antipsychotics

Front 423

Which drug(s) cause this reaction: Tendonitis and rupture?

Back 423

Fluoroquinolones

Front 424

Which drug(s) cause this reaction: Thrombotic complications?

Back 424

Oral Contraceptives (estrogens and progestins)

Front 425

Which drug(s) cause this reaction: Torsade de pointes (2)?

Back 425

Class III antiarrhythmics (sotalol) -Class IA (quinidine) antiarrhythmics

Front 426

Which drug(s) cause this reaction: Tubulointerstitial Nephritis (5)?

Back 426

Sulfonamides -Furosemide -Methicillin -Rifampin -NSAIDS (ex. ASA)

Front 427

A methylxanthine used in the treatment of asthma for its brochodilatory effects?

Back 427

Theophylline.
Inhibits phosphodiesterase, thereby inhibiting the degredation of cAMP to AMP
other methylxanthines include caffeine and theobromine found in cocoa.

Front 428

Aerosolized antimuscarinic agent, used in the treaqtment of COPD and asthma?

Back 428

Ipratroprium
Not as effective as B2 agonists
dry mouth is a major side effect.

Front 429

Antihistaminics used for treatment of allergic conditions (hay fever, uticaria, atopy), as well as for the treatment of motion sickness?

Back 429

Diphenhydramine, chlorpheniramine.
Inhibit the binding of histamine to H1 receptors
such as older agents have anticholinergic effects, contributing to sedative side effects/.

Front 430

B-adrenergic antagonists used in the treatment of hypertension for patients with asthmma or COPD, and smokers?

Back 430

Acebutolol, Atenolol, Metoprolol.
Selective B1 blockers that decrease blood pressure, with no bronchoconstriction at low doses.

Front 431

Long acting B2 agonist used for prophylaxis of asthma?

Back 431

Salmeterol.
This agent works for 12 hours or more
it may cause tremors and arrhythmias.

Front 432

Nonsedating antihistaminics used in the treatment of allergy?

Back 432

Fexofenadine, loratadine.
These second-generation antihistaminics do not readily enter the CNS, preventing sedation.

Front 433

Opioid agonist available in many over-the-counter cough syrups?

Back 433

Dextromethorphan.
Antitussive agent that depresses the cough center in the medulla
unlike dextromethorphan, codeine provides analgesia and has a higher abuse potential.

Front 434

Prototypic adrenergic agonist, available as an inhaler, used for the management of bronchospasm in asthmatics?

Back 434

Albuterol.
Other selective B2 agonists include metaproterenol, terbutaline, and salmeterol.

Front 435

Stabilizes mast cell and basophil membranes, preventing the release of histamine in asthmatics?

Back 435

Cromolyn Sodium.
Used in prophylaxis only, not for the treatment of acute asthma attacks.

Front 436

Synthetic glucocorticoid that readily penetrates the airway mucosa
used in the management of asthma?

Back 436

Beclomethasone.
Beclamethasone and a related agent, budesonide, have very short half-lives in the bloodstream, and, therefore, cause less systemic effects than other glucocorticoids.

Front 437

Used in the treatment of asthma, selectively inhibiting leukotriene synthesis?

Back 437

Zileutin.
Leukotrienes can also be inhibited by the LTD4 and LTE4 antagonists zafirlukast and montelukast.

Front 438

Bactericidal antibiotics.

Back 438

Penicillins, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metronidazole.
(Most of the other antibiotics are bacteriostatic).

Front 439

Common drugs that inhibit hepatic P450 system.

Back 439

Cimetidine (Antiulcer), Ketoconazole (Antifungal), Erythromycin (Antibiotic).
(Such drugs potentiate the action of other drugs which are normally metabolized by the P450
often doses must be lowered when such drugs are used together).

Front 440

Drugs that can cause hemolysis in patients with glucose-6 phosphate dehydrogenase (G6PDH) deficiency.

Back 440

Sulfonamides (Antibiotic), Isoniazid (Antituberculoid), Primaquine (Antimalarial).
(In patients with G6PDH deficiency, these agents cause oxidative stress on RBCs because of a deficit of reducing equivalents of nicotinamide adenine dinucleotide phosphate [NADPH], normally generated by the hexose monophosphate shunt).

Front 441

Drugs that can cause massive hepatic necrosis.

Back 441

Halothane (Anesthetic), Acetaminophen (Analgesic), Valproic Acid (Anticonvulsant)
(Histologically, damage to the liver is indistinguishable from that caused by chronic viral hepatitis).

Front 442

Drugs that cause a disulfram-like reaction.

Back 442

Metronidazole (Antibiotic), Certain Cephalosporins (Antibiotic), Procarbazine (Antineoplastic).
(Cause flushing, headache, nausea, sweats, hypotension, and confusion).

Front 443

Drugs that cause a Stevens-Johnson syndrome, a febrile, erosive hemorrhagic crusting on the lips and oral mucosa of children.

Back 443

Sulfonamides (Antibiotic), Ethosuximide (Anticonvulsant), Lamotrigine (Anticonvulsant).
(Other agents such as penicillins, barbiturates, salicylates, hydantoins, and antimalarials may be associated with a less severe form of erytheme multiforme, with macules, papules, vesicles and bullae).

Front 444

Drugs that cause a systemic lupus erythematosus (SLE)-like syndrome.

Back 444

Hydralazine (Vasodilator), Procainamide (Class 1A Antiarrhythmic), Isoniazid (Antituberculoid), Phenytoin (Anticonvulsant).
(Symptoms include arthralgias, myalgias, skin rashes, and fever).

Front 445

Drugs that cause cutaneous flushing on administration.

Back 445

Niacin (Antihyperlipidemic), Calcium Channel Blockers, Adenosine (Antiarrhythmic), Vancomycin (Antibiotic).
(Often this side effect can be controlled by slow infusion or coadministration with histamine blockers).

Front 446

Drugs that cause gynecomastia.

Back 446

Cimetidine (Antiulcer), Ketoconazole (Antifungal), Spironolactone (Antihypertensive).
(All compete for androgen receptors, leading to antiandrogenic effects).

Front 447

Drugs that cause photosensitivity.

Back 447

Tetracycline (Antibiotics), Amiodarone (Class 1A Antiarrhythmic), Sulfonamides (Antibiotics).
(Barbiturates can precipitate photosensitivity in patients with acute intermittent porphyria).

Front 448

Drugs that cause significant ototoxicity and nephrotoxicity.

Back 448

Aminoglycosides (antibiotics), Loop Diuretics, Cisplatin (Antineoplastic).
(Vancomycin rarely is associated with mild ototoxicity and nephrotoxicity, although both may become significant when used in conjunction with aminoglycosides).

Front 449

Drugs that induce the hepatic P450 system.

Back 449

Phenytoin (Anticonvulsant), Carbamazepine (Anticonvulsant), Griseofulvin (Antifungal), Rifampin (Antituberculoid), Barbiturates, Chronic Ethanol Use.
(The hepatic P450 microsomal mixed function oxidase system is involved in phase I metabolism of many drugs).

Front 450

Drugs that inhibit microtubule function.

Back 450

Mebendazole (Antihelminthic), Thiabendazole (Antihelminthic), Paclitaxel (Antineoplastic), Vincristine (Antineoplastic), Colchicine (Antigout), Griseofulvin (Antifungal).
(These agents either block intracellular transport, interfere with locomotion, or disrupt the formation of the mitotic spindle.)

Front 451

Drugs that lead to pulmonary fibrosis and subsequent restrictive lung disease.

Back 451

Bleomycin (Antineoplastic), Amiodarone (Class 1A Antiarrhythmic), Busulfan (Antineoplastic).
(Patients may manifest with dyspnea, tachypnea, and eventual cyanosis, with a decreased forced expiratory volume at 1 second [FEV1] and a decreased forced vital capacity [FVC]).

Front 452

Agent used to treat heavy metal poisoning due to lead, arsenic, and mercury.

Back 452

Dimercaprol.
(Given parenterally, it chelates metals, preventing them from damaging proteins
succimer is an orally available derivative used for similar applications).

Front 453

Anticholinesterases used as insecticides and as possible agents of chemical warfare, inducing motor paralysis, respiratory depression and convulsions.

Back 453

Organophosphates (Isoflurophate/Echothiophate/Parathion).
(Antidote includes the use of atropine and acetylcholinesterase regenerators, such as pralidoxime).

Front 454

Antispasmodic used for the treatment of malignant hyperthermia and neuroleptic malignant syndrome.

Back 454

Dantrolene.
(Decreases the release of calcium from the sarcoplasmic reticulum).

Front 455

Derivative of penicillin with the ability to chelate copper ions, used for the treatment of copper toxicity.

Back 455

Penicillamine.
(Also used for the treatment of Wilson disease, and an adjunct therapy for rheumatoid arthritis).

Front 456

Fab fragment antibody used for the treatment of digitalis toxicity.

Back 456

Digibind.
(Treatment also includes the correction of Mg2+ and K+, as well as lidocaine for induced arrhythmias).

Front 457

Ingestion, industrial inhalation, or absorption through the skin causes metabolic acidosis and the precipitation of damaging oxalate crystals in the kidney.

Back 457

Ethylene Glycol.
(A major component of antifreeze, toxicity is managed by the administration of ethanol).

Front 458

Intoxicant that can cause retinal damage and blindness along with metabolic acidosis and coma.

Back 458

Methanol.
(Damage is due to the conversion to formaldehyde by the liver
the treatment includes ethanol, which competes for alcohol dehydrogenase).

Front 459

Used for the treatment of acute iron toxicity.

Back 459

Deferoxamine.
(Rapid infusion has been associated with hypotensive shock).

Front 460

Used in the event of benzodiazepine overdose.

Back 460

Flumazenil.
(This benzodiazepine derivative antagonizes the actions of benzodiazepines and zolpidem, although it does not block the actions of barbiturates).

Front 461

Used to treat the ingestion of suicidal doses of acetaminophen.

Back 461

N-acetylcysteine.
(Given early, it may protect from the development of fulminant hepatic failure).

Front 462

Used to treat the symptoms of opioid overdose.

Back 462

Naltrexone, Naloxone.
(Pure antagonists, primarily of mu opioid receptors).

Front 463

"High" is associated with euphoria, disinhibition, laughter, changes in perception, and hunger?

Back 463

Marijuana.
(The active ingredient, tetrahydrocannabinol (THC) can be used medically to lower intraocular pressure in glaucoma.)

Front 464

?HRT? shown to decrease the risk of coronary artery disease, to slow the progression of osteoporosis, and to ameliorate hot flashes in postmenopausal women
ameliorates hot flases in postmenopausal women
risk of breast and ovarian cancer

Back 464

Ethinyl Estradiol Mestranol

Front 465

1. V2-selective agonist that facilitates water reabsorption from the collecting tubules. 2. V1&V2 agonist- its V1 activity increases vascular smooth muscle tone and therefore is used for tx of esophageal varices

Back 465

1. desmopressin, 2. vasopressin

Front 466

1.blocks bacterial dHFR and can cause megaloblastic anemia
2.blocks dihydropteroate synthase and can cause hypersensitivity reactions and hemolysis in patients with G6PDH deficiency

Back 466

1.Trimethoprim 2. sulfamethoxazole

Front 467

3rd generation cephalosporin
coverage against Bacterial meningitis- Strep pneumoniae, Neisseria meningitides, and H. influenzae

Back 467

Ceftriaxone

Front 468

A bacterial product of Strep pyogenes, used in the treatment of coronary artery thrombosis?

Back 468

Streptokinase
Complexes with and catalyzes the conversion of plasminogen to plasmin

it is significantly cheaper, although debatably equivalent, agent to TPA?

Front 469

A by-product of incorrectly synthesized illicit street opioids, this contaminant can cause irreversible parkinsonism?

Back 469

MPTP
(1-methyl-4phenyl-1,2,3,6-tetrahydropyridine)
(Causes the destruction of dopaminergic neurons of the nigrostriatal tract).

Front 470

A methylxanthine used in the treatment of asthma for its brochodilatory effects?

Back 470

Theophylline.
Inhibits phosphodiesterase, thereby inhibiting the degredation of cAMP to AMP

other methylxanthines include caffeine and theobromine found in cocoa.

Front 471

a synthetic analog of ACTH used to diagnose patients with abnormalities of cortisol production (Addison?s)

Back 471

Cosyntropin

Front 472

a synthetic analog of somatostatin, used in the treatment of many endocrine tumors, including carcinoid, gastrinoma, and somatropic pituitary adenoma

Back 472

Ocreotide

Front 473

abortifacient steroid receptor antagonist known as the ?morning after? pill

Back 473

Mifepristone (RU486)

Front 474

active form of thyroid hormone
synthetic, faster acting, but more expensive and used less frequently

Back 474

Liothyronine (t3)

Front 475

acts as a cationic detergent that disrupts the membrane
systemic use causes neurotoxicity and acute tubular necrosis

Back 475

Polymixin B

Front 476

administered as an aerosol, this drug is used for the treatment of RSV

Back 476

Ribavirin

Front 477

administered with penicillins to enhance their antimicrobial effects

Back 477

Clindamycin

Front 478

Adrenergic antagonist used in the Tx of benign prostatic hyperplasia and in the mgmt of hypertension caused by pheochromocytoma

Back 478

Phenoxybenzamine
- An IRREVERSIBLE ALPHA 1,2 ANTAGONIST
- A similar short-acting REVERSIBLE antagonist, PHENTOLAMINE, is used in the Dx of PHEOCHROMOCYTOMA

Front 479

Adrengeric agonist used for acute asthma, anaphylactic shock, open-angle glaucoma, and cardiac resuscitation

Back 479

Epinephrine
- ADRENERGIC AGONIST w/ affinity for ALPHA 1,2 and BETA 1,2 receptors
- At LOW CONCENTRATIONS the effects of the BETA RECEPTORS PREDOMINATE
- B2 RECEPTORS cause VASODILATION w/ DECREASED TPR and DECREASED DIASTOLIC PRESSURE
- At higher concentrations, B1 RECEPTORS lead to INCREASED CARDIAC CONTRACTILITY and INCREASED HR

Front 480

Aerosolized antimuscarinic agent, used in the treaqtment of COPD and asthma?

Back 480

Ipratroprium
Not as effective as B2 agonists
dry mouth is a major side effect.

Front 481

Agent used to treat heavy metal poisoning due to lead, arsenic, and mercury.

Back 481

Dimercaprol.
(Given parenterally, it chelates metals, preventing them from damaging proteins
succimer is an orally available derivative used for similar applications).

Front 482

agents inhibit the protease encoded by HIV pol gene and required for the production of infectious virions
metabolized by CYP450

Back 482

Indinavir, Ritonavir, Saquinavir, Nelfinavir

Front 483

Agents that decrease tryglycerides dramatically by stimulating lipoprotein lipase

Back 483

Gemfibrozil, Fenofibrate, Clofibrate
- CLOFIBRATE has been associated with GALLSTONES and HEPATOBILIARY NEOPLASMS

Front 484

aldtered form of insulin that enters the circulation more rapidly than crystalline zinc (regular insulin)

Back 484

Insulin lispro

Front 485

Alkylating agent used for the treatment of non-Hodgkin lymphoma and breast and ovarian carcinomas

Back 485

Cyclophosphamide.
(The major side effect, hemorrhagic cystitis, may be decreased by vigorous hydration and the use of mesna)

Front 486

Although not a benzodiazepine, it has similar effects and is used as a hypnotic with less dependence liability

Back 486

Zolpidem

Fxns by binding to benzodiazepine [BDZ] RECEPTORS and thus results in similar actions with LESS AMNESIA AND LESS MUSCLE RELAXATION

Also like benzodiazepines, its actions are ANTAGONIZED BY FLUMAZENIL

Front 487

Amantadine binds this protein- which is why it is NOT effective against influenza B

Back 487

M2 protein

Front 488

aminoglycoside given orally for prophylaxis in bowel surgery, and also used to treat hepatic encephalopathy

Back 488

Neomycin

Front 489

Among the most popular antacids used in the United States, neither is absorbed and, therefore, neither causes systemic effects?

Back 489

Magnesium hydroxide/ Aluminum hydroxide.
Magnesium hydroxide also has a strong laxative effect, whereas aluminum hydroxide causes constipation.

Front 490

Amphetamine used in the mgmt of attention deficit disorder (ADD) and narcolepsy

Back 490

Methylphenidate

INCREASES ALERTNESS and DECREASES APPETITE by stimulating the RELEASE OF CATECHOLAMINES

It is a controlled substance with ABUSE POTENTIAL

Front 491

an antidiuretic hormone (ADH) receptor agonist used for the treatment of pituitary diabetes insipidus

Back 491

Vasopressin, Desmopressin

Front 492

Androgen receptor antagonist, used for the treatment of carcinoma of the prostate

Back 492

Flutamide.
(Used to antagonize residual androgens after orchiectomy
side effects include gynecomastia and libido changes)

Front 493

Angiotensin II receptor antagonist used as an antihypertensive drug

Back 493

Losartan
- Fxns at the COLLECTING TUBULES, like ACE inhibitors, but NO COUGH as side effect. Again, like ACE inhibitors, this drug is TERATOGENIC and, therefore, CONTRAINDICATED IN PREGNANCY

Front 494

antiandrogenic compound used in the treatment of BPH and alopecial

Back 494

Finasteride

Front 495

Anticholinesterases used as insecticides and as possible agents of chemical warfare, inducing motor paralysis, respiratory depression and convulsions.

Back 495

Organophosphates (Isoflurophate/Echothiophate/Parathion).
(Antidote includes the use of atropine and acetylcholinesterase regenerators, such as pralidoxime).

Front 496

Antidepressant used in the mgmt of nicotine withdrawal in pts seeking to stop cigarette smoking with minimal sedation

Back 496

Bupropion

This second-generation HETEROCYCLIC ANTIDEPRESSANT inhibits the REUPTAKE OF NOREPI.
Newer third-generation agents used for depression, such as VENLAFAXINE, inhibit the reuptake of SEROTONIN as well

Front 497

antihelminthic agent used for the treatment of river blindness (caused by onchocerca volvulus) and threadworm infection (strongyloides stercoralis)

Back 497

Ivermectin

Front 498

antihelminthic agent, often used with mebendazole for the treatment of roundworm, pinworm, and hookworm infections

Back 498

Pyrantel Pamoate

Front 499

Antihistaminics used for treatment of allergic conditions (hay fever, uticaria, atopy), as well as for the treatment of motion sickness?

Back 499

Diphenhydramine, chlorpheniramine.
Inhibit the binding of histamine to H1 receptors
such as older agents have anticholinergic effects, contributing to sedative side effects/.

Front 500

Antihyperlipidemic agent that may prevent atherosclerosis by acting as an antioxidant

Back 500

Probucol

Rarely used for the Tx of hyperlipidemia because it DECREASES HDLs AS WELL AS LDLs

May be efficacious in PREVENTING RESTENOSIS after angioplasty

Front 501

Antihypertensives drug that blocks the release or norepi by displacing it from intracellular vesicles

Back 501

Guanethidine
- Side effects include serious ORTHOSTATIC HYPOTENSION
The effects of the drug are ANTAGONIZED BY TRYCYCLIC ANTIDEPRESSANTS

Front 502

antiprotozoal agent used in the treatment of amebiasis, trichomoniasis, and giardiasis, as well as for pseudomembranous colitis

Back 502

Metronidazole

Front 503

Antispasmodic used for the treatment of malignant hyperthermia and neuroleptic malignant syndrome.

Back 503

Dantrolene.
(Decreases the release of calcium from the sarcoplasmic reticulum).

Front 504

Associated myelosuppression, and rarely an idiosyncratic, irreversible aplastic anemia

Back 504

Chloramphenicol

Front 505

B-adrenergic antagonists used in the treatment of hypertension for patients with asthmma or COPD, and smokers?

Back 505

Acebutolol, Atenolol, Metoprolol.
Selective B1 blockers that decrease blood pressure, with no bronchoconstriction at low doses.

Front 506

backup drug used for treatment of CMV infection in immunocompromised patients, when resistance to ganciclovir develops

Back 506

Foscarnet

Front 507

Bactericidal antibiotics.

Back 507

Penicillins, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metronidazole.
(Most of the other antibiotics are bacteriostatic).

Front 508

bactericidal inhibitor of DNA gyrase, used for GNR, neisseria

Back 508

Flouroquinolones (ciprofloxacin/norfloxacin)

Front 509

Bactericidal inhibitors of mRNA translation at the 30S ribosome
these agents are associated with significant nephrotoxicity and ototoxicity

Back 509

Aminoglycosides
(gentamicin/streptomycin/tobramycin/amikacin/neomycin)

Front 510

bacteriostatic inhibitor of protein synthesis- blocking peptidyl transferase activity at 50S ribosome

Back 510

Chloramphenicol

Front 511

Bacteriostatic inhibitor of protein synthesis, functioning on 50S ribosome

Back 511

Erythromycin

Front 512

bacteriostatic inhibitor of protein synthesis, methylating the 50S ribosomal unit, used in treatment of serious anaerobic infections due to Bacteroides

Back 512

Clindamycin

Front 513

Because of its low toxicity, this local anesthetic can be used on large surface areas and is available over the counter as an ointment

Back 513

Benzocaine

This ESTER-type compound, like cocaine, has SURFACE ACTIVITY, or the ability to work on superficial nerves WHEN APPLIED TO MUCOUS MEMBRANES. Other ester-type compounds include the SHORT-ACTING PROCAINE and the LONG-ACTING TETRACAINE

Front 514

belongs to a class of drugs known as meglitinides, which facilitate insulin release from pancreatic B cells by binding to K channels

Back 514

Repaglinide

Front 515

biguanide compound that functions by increasing peripheral glycolysis, and therefore hepatic gluconeogenesis, resulting in a decrease in serum glucose levels

Back 515

Metformin

Front 516

Bile acid-binding resins used in the mgmt of hyperlipidemia (2)

Back 516

Cholestyramine, Colestipol
- BIND BILE ACIDS, PREVENTING ENTEROHEPATIC RECYCLING, thus diverting hepatic efforts to renew bile acids, INSTEAD OF PRODUCING PLASMA LIPIDS

Front 517

binds tubulin, interfering with MT function, inhibity mitosis

Back 517

Griseofulvin

Front 518

blocks DNA replication and RNA transcription in P.falciparum within erythrocytes
a common SE is cinchonism, a constellation of symptoms including headache, vertigo, blurred vision, and tinnitus
a related drug, mefloquine, has fewer SE and is used as prophylaxis in chloroquine-resistant areas

Back 518

Quinine

Front 519

Blocks negative feedback to the pituitary, increasing the release of FSH and LH to stimulate ovulation

Back 519

Clomiphene

Front 520

blocks the binding of progesterone to cytoplasmic receptors, preventing successful implantation

Back 520

Mifepristone (RU486)

Front 521

Broad-spectrum B-lactamase-resistant carbapenem, given in conjunction with cilastatin

Back 521

Imipenem

Front 522

broad spectrum bacteriostatic drug that inhibits the 30S ribosome and thus protein synthesis
provides good coverage against mycoplasma, Chlamydia, rickettsia, and vibrio

Back 522

Tetracycline

Front 523

Bulkier R-groups on the penicillin backbone prevent degradation by penicillinases

Back 523

Methicillin, Nafcillin, Dicloxacillin

Front 524

can be used with penicillinase inhibitors and work synergistically with aminoglycosides

Back 524

Carbencillin, Piperacillin, Ticarcillin

Front 525

can cause GI side effects, rash, and hemolysis in G6PD deficiency patients

Back 525

Nitrofurantoin

Front 526

can cause tendon damage in adults, is contraindicated in children and pregnant women because of damage to developing cartilage

Back 526

Fluoroquinolones (ciprofloxacin/norfloxacin)

Front 527

Causes an increase in cGMP within vascular smooth muscle, resulting in decreased preload to the heart and decreased blood pressure

Back 527

Nitroglycerin

Administered as a SUBLINGUAL PATCH to DECREASE FIRST-PASS METABOLISM

Potential side effects include CYANIDE POISONING, POSTURAL HYPOTENSION, HEADACHE, AND FLUSHING

Front 528

Causes feelings of euphoria and self-confidence, and, at chronic high doses, delusions and paranoia?

Back 528

Amphetamines.
(Function as an indirect sympathomimetic by releasing stored catecholamines).

Front 529

Central-acting antiemetic used to control postopeative vomiting and vomiting in chemotherapy patients?

Back 529

Ondansetron.
(5-HT3 inhibitor that functions at the chemoreceptive area of the area postrema.)

Front 530

Centrally-acting Alpha-2 agonist that reduces sympathetic ANS outflow, resulting in decreased blood pressure

Back 530

Clonidine
-A major side effect of this drug is REBOUND HYPERTENSION, in the event of ABRUPT DISCONTINUATION

Front 531

characterized by poor oral availability and cannot be taken with food
may cause esophageal ulcerations, so must be taken with large amounts of water, and the patient must remain uproight for at least 30 minutes afterward

Back 531

Bisphosphonates (alendronate/etidronate/pamidronate/risedronate)

Front 532

Chronic ingestion of this antacid with milk can induce the milk-alkali syndrome?

Back 532

Calcium carbonate.
Can result in hypercalcemic alkalosis with the development of renal calculi.

Front 533

Commenly used proemetic agent used in cases of ingestion of caustic substances or mineral oils?

Back 533

Ipecac Syrup.
Orally administered substances that act directly on the chemoreceptor trigger zone in the medulla.

Front 534

Common drugs that inhibit hepatic P450 system.

Back 534

Cimetidine (Antiulcer), Ketoconazole (Antifungal), Erythromycin (Antibiotic).
(Such drugs potentiate the action of other drugs which are normally metabolized by the P450
often doses must be lowered when such drugs are used together).

Front 535

Commonly used analgesic and antipyretic, but unlike NSAID's, has no anti-inflammatory properties?

Back 535

Acetaminophen.
Weak COX, it inhibits prostaglandin synthesis in the CNS
a related prodrug, phenacetin, is no longer available due to nephrotoxicity.

Front 536

commonly used as part of HAART, this HIV drug is used for prophylaxis of needlestick tramsmission and of transmission to neonates from infected mothers during birth

Back 536

Zidovudine (ZDT)

Front 537

Congener of amphetamine that results in increased intrapersonal communications and increased sexual drive?

Back 537

Ecstasy.
Methylene dioxymethamphetamine (MDMA) use is on the rise in teenagers of higher socioeconomic status and often associated with "rave" parties).

Front 538

contraindicated in pregnant women and children, because it causes bone dysplasia and defects in dental enamel

Back 538

Tetracycline

Front 539

Cough is a major side effect of this group of antihypertensive drugs

Back 539

ACE inhibitors (Captopril, Enalapril, Lisinopril)
- INHIBIT the conversion of ANGIOTENSIN I to ANGIOTENSIN II
Inhibit breakdown of BRADYKININ, resulting in cough and POTENT VASODILATION

Front 540

Created through the use of recombinant DNA technology, this agent is used or coronary artery thrombosis and ischemic stroke?

Back 540

Tissue plasminogen Activator (t-PA)
converts fibrin-bound plasminogen to plasmin, resulting in dissolution of thrombi.

Front 541

cyanosis and CV collapse in premature neonates deficient in hepatic gluconosyltransferase (gray baby syndrome)

Back 541

Chloramphenicol

Front 542

Depolarizing neuromuscular blocker used to facilitate intubation, and as a skeletal muscle relaxant for general anesthesia

Back 542

Succinylcholine
- Fxns as a CHOLINERGIC NICOTINIC AGONIST, facilitating the opening of SODIUM CHANNELS
- A rare but significant side effect, MALIGNANT HYPERTHERMIA, can occur in some pts when used with HALOTHANE

Front 543

Derivative of penicillin with the ability to chelate copper ions, used for the treatment of copper toxicity.

Back 543

Penicillamine.
(Also used for the treatment of Wilson disease, and an adjunct therapy for rheumatoid arthritis).

Front 544

disrupts fungal membrane permeability by binding to ergosterol

Back 544

Nystatin

Front 545

disrupts fungal membranes by binding to ergosterol, which induces pore formation. SE: chills, fever, hypotension, dose-limiting nephrotoxicity (all of which are less severe when using liposomal formulations)

Back 545

Amphotericin B

Front 546

Dissociative anesthetic that causes hallucinations and disorientation on recovery

Back 546

Ketamine

Side effects are due to an INCREASE IN CEREBRAL BLOOD FLOW, and can be reduced by preoperative use of benzodiazepines

Front 547

Diuretic that fxns early in the DCT by inhibiting NaCl reabsorption

Back 547

Hydrochlorothiazide
- Major side effects include HYPOKALEMIA, ALKALOSIS, HYPERURICEMA, AND HYPERLIPIDEMIA

Front 548

Diuretic used in the management of chronic glaucoma and acute mountain sickness
Also used to alkalinize the urine in aspirin toxicity

Back 548

Acetazolamide
- Inhibits CARBONIC ANHYDRASE in the PCT
METABOLIC ACIDOSIS is a potential side effect

Front 549

does not require phosphorylation by viral kinases and inhibits viral DNA polymerase at different site than ganciclovir
not metabolized by viral transferases, which render ganciclovir ineffective

Back 549

Foscarnet

Front 550

Drug used for the Tx of partial and tonic-clonic seizures and status epilipticus, as well as being a class IB antiarrhythmic

Back 550

Phenytoin

Side effects include GINGIVAL HYPERPLASIA, HIRSUTISM, ANEMIA, AND BIRTH DEFECTS, because it INTERFERES WITH FOLATE ABSORPTION

Front 551

Drug used in the treatment of severe rheumatoid arthritis, because it decreases lysosomal and macrophage function?

Back 551

Gold salts.
Side effects include, dermatitis, hematotoxicity and nephrotoxicity.

Front 552

Drug used in the Tx of Parkinson disease as well as in the Tx of prolactinoma

Back 552

Bromocriptine

This ergot derivative acts as a D2 AGONIST, improving extrapyramidal fxn, and also INHIBITS THE RELEASE OF PROLACTIN from the pituitary gland
Unlike a similar agent, PERGOLIDE, bromocriptine maintains its effectiveness over time

Front 553

drugs bind to a unique site on reverse transcriptase, there is no cross-resistance with the NRTIs
the NNRTIs are all metabolized by the P450 system

Back 553

Nevirapine, Delavirdine, Efavirenz

Front 554

Drugs that can cause hemolysis in patients with glucose-6 phosphate dehydrogenase (G6PDH) deficiency.

Back 554

Sulfonamides (Antibiotic), Isoniazid (Antituberculoid), Primaquine (Antimalarial).
(In patients with G6PDH deficiency, these agents cause oxidative stress on RBCs because of a deficit of reducing equivalents of nicotinamide adenine dinucleotide phosphate [NADPH], normally generated by the hexose monophosphate shunt).

Front 555

Drugs that can cause massive hepatic necrosis.

Back 555

Halothane (Anesthetic), Acetaminophen (Analgesic), Valproic Acid (Anticonvulsant)
(Histologically, damage to the liver is indistinguishable from that caused by chronic viral hepatitis).

Front 556

Drugs that cause a disulfram-like reaction.

Back 556

Metronidazole (Antibiotic), Certain Cephalosporins (Antibiotic), Procarbazine (Antineoplastic).
(Cause flushing, headache, nausea, sweats, hypotension, and confusion).

Front 557

Drugs that cause a Stevens-Johnson syndrome, a febrile, erosive hemorrhagic crusting on the lips and oral mucosa of children.

Back 557

Sulfonamides (Antibiotic), Ethosuximide (Anticonvulsant), Lamotrigine (Anticonvulsant).
(Other agents such as penicillins, barbiturates, salicylates, hydantoins, and antimalarials may be associated with a less severe form of erytheme multiforme, with macules, papules, vesicles and bullae).

Front 558

Drugs that cause a systemic lupus erythematosus (SLE)-like syndrome.

Back 558

Hydralazine (Vasodilator), Procainamide (Class 1A Antiarrhythmic), Isoniazid (Antituberculoid), Phenytoin (Anticonvulsant).
(Symptoms include arthralgias, myalgias, skin rashes, and fever).

Front 559

Drugs that cause cutaneous flushing on administration.

Back 559

Niacin (Antihyperlipidemic), Calcium Channel Blockers, Adenosine (Antiarrhythmic), Vancomycin (Antibiotic).
(Often this side effect can be controlled by slow infusion or coadministration with histamine blockers).

Front 560

Drugs that cause gynecomastia.

Back 560

Cimetidine (Antiulcer), Ketoconazole (Antifungal), Spironolactone (Antihypertensive).
(All compete for androgen receptors, leading to antiandrogenic effects).

Front 561

Drugs that cause photosensitivity.

Back 561

Tetracycline (Antibiotics), Amiodarone (Class 1A Antiarrhythmic), Sulfonamides (Antibiotics).
(Barbiturates can precipitate photosensitivity in patients with acute intermittent porphyria).

Front 562

Drugs that cause significant ototoxicity and nephrotoxicity.

Back 562

Aminoglycosides (antibiotics), Loop Diuretics, Cisplatin (Antineoplastic).
(Vancomycin rarely is associated with mild ototoxicity and nephrotoxicity, although both may become significant when used in conjunction with aminoglycosides).

Front 563

Drugs that induce the hepatic P450 system.

Back 563

Phenytoin (Anticonvulsant), Carbamazepine (Anticonvulsant), Griseofulvin (Antifungal), Rifampin (Antituberculoid), Barbiturates, Chronic Ethanol Use.
(The hepatic P450 microsomal mixed function oxidase system is involved in phase I metabolism of many drugs).

Front 564

Drugs that inhibit microtubule function.

Back 564

Mebendazole (Antihelminthic), Thiabendazole (Antihelminthic), Paclitaxel (Antineoplastic), Vincristine (Antineoplastic), Colchicine (Antigout), Griseofulvin (Antifungal).
(These agents either block intracellular transport, interfere with locomotion, or disrupt the formation of the mitotic spindle.)

Front 565

Drugs that lead to pulmonary fibrosis and subsequent restrictive lung disease.

Back 565

Bleomycin (Antineoplastic), Amiodarone (Class 1A Antiarrhythmic), Busulfan (Antineoplastic).
(Patients may manifest with dyspnea, tachypnea, and eventual cyanosis, with a decreased forced expiratory volume at 1 second [FEV1] and a decreased forced vital capacity [FVC]).

Front 566

drugs used to treat African trypanosomiasis include pentamidine, suramin, melarsoprol

Back 566

Nifurtimox

Front 567

Eicosanoid preparation used to prevent peptic ulcers in patients taking high doses of NSAIDs for conditions such as rheumatoid arthritis?

Back 567

Misoprostol.
This prostaglandin (PGE) analog decreases gastric acid production and increases mucous production, protecting the lining of the stomach.

Front 568

ergot alkaloid with dopaminergic activity, inhibiting the release of prolactin

Back 568

Bromocriptine

Front 569

estrogen partial agonist is used to prevent osteoporosis in postmenopausal women

Back 569

Raloxifine

Front 570

extended-spectrum penicillins- useful against Pseudomonas and Enterobacter

Back 570

Carbenicillin, Piperacillin, Ticarcillin

Front 571

extended spectrum penicillin used to treat infections with GN organisms such as Haemophilus, E. coli, Listeria, Proteus, and Salmonella
often administered with penicillinase inhibitors

Back 571

Ampicillin

Front 572

Extremely short-acting agent (15-20 seconds) administered IV for the control of AV nodal arrhythmias

Back 572

Adenosine
- The side effects of FLUSHING AND HYPOTENSION are short-lived as well, and do not limit the use of this agent

Front 573

Fab fragment antibody used for the treatment of digitalis toxicity.

Back 573

Digibind.
(Treatment also includes the correction of Mg2+ and K+, as well as lidocaine for induced arrhythmias).

Front 574

fertility drug used to induce ovulation in anoulatory women, although its use may be associated with multiple births

Back 574

Clomiphene

Front 575

Folic acid analog, used for the treatment of leukemias, non-Hodgkin lymphoma, rheumatoid arthritis, and therapeutic abortions.

Back 575

Methotrexate.
(S phase inhibitor of dihydrofolate reductase, leading to decreased DNA and protein synthesis
the accompanying myelosuppression can be treated with leucovorin).

Front 576

form of insulin is given in the morning and in the evening, to maintain basal levels of insulin for 12 to 24 hours

Back 576

Ultralente Insulin

Front 577

formerly known as AZT, phosphorylation of this agent by host cell enzymes results in inhibiting viral reverse transcriptase, as well as functioning as a chain terminator

Back 577

Zidovudine (ZDT)

Front 578

functions by inhibiting microtubule synthesis and glucose uptake in helminthes
related drugs such as albendazole and thiabendazole and alternatives

Back 578

Mebendazole

Front 579

Fxn to decrease the action potential duration by shortening the repolarization phase

Back 579

Class IB Antiarrhythmics (Lidocaine, Mexiletine, Tocainide, Phenytoin)
- These agents are used for the Tx of VENTRICULAR ARRHYTHMIAS, as well as for DIGITOXIN-INDUCED ARRHYTHMIAS

Front 580

Gaunosine analog converted by CMV to a triphosphorylated form which inhibits the viral polymerase
given IV- good penetration to the eye and CNS- causes neutropenia, leucopenia, thrombocytopenia

Back 580

Ganciclovir

Front 581

given orally, antifungal that accumulates in keratinized tissue and is effective against dermatophyte infections, such as ringworm (tinea)

Back 581

Griseofulvin

Front 582

Given to Rh-negative mothers within 72 hours of giving birth to an Rh-positive child, to prevent the development of hemolytic disease of the newborn (erythroblastosis fetalis) in subsequent RH-positive pregnancies?

Back 582

RhoGAM.
Fetal Rh-positive red blood cells that enter maternal circulation are opsonized by these antibodies, preventing the mother from producing anti-Rh antibodies.

Front 583

Glucocorticoid used for the treatment of leukemias and lymphomas, as well for rheumatoid arthritis and asthma.

Back 583

Prednisone.
(Triggers apoptosis and can lead to hypercortisolism with Cushing-like symptoms. Drug must be tapered gradually to prevent life-threatening adrenal insufficiency).

Front 584

Gonadotropin-releasing hormone (GnRH) agonists, used for the treatment of metastatic carcinoma of the prostate

Back 584

Leuprolide, Goserelin, Nafarelin.
(May also be used for the treatment of endometriosis, benign prostatic hyperplasia, and precocious puberty

if administered in a pulsatile manner, they stimulate the release of follicle-stimulating hormone [FSH] and luteinizing hormone [LH], and can thus be used in the management of infertility)

Front 585

good coverage against mycoplasma, corynebacterium, Chlamydia, legionella, and bordetella

Back 585

Macrolides (erythromycin, azithromycin, clarithromycin)

Front 586

Guanosine analog is activated by thymidine kinase of herpes virus (HSV, VZV, EBV) and function as chain terminator when incorporated into viral DNA during replication

Back 586

Acyclovir

Front 587

guanosine analog that inhibits formation, the capping of viral mRNA, and viral RNA-dependent RNA pol activity
also used for the management of viral hemorrhagic fevers and hepatitis C infection

Back 587

Ribavirin

Front 588

Hallucinogen that often cause psychotic reactions and impaired judgement leading to reckless behavior?

Back 588

Phencyclidine (PCP)
Also known as "angel dust"
overdose leads to nystagmus, life-threatening hypertension, and seizures.

Front 589

Hallucinogenic agent that causes "psychedelic" perceptual effects and can lead to a "bad trip" or panic attack?

Back 589

Lysergic Acid Diethylamide (LSD).
"Highs" also associated with somatic effects, such as nausea, paresthesias, and weakness
such effects are also seen with the use of mescaline and psilocybin.

Front 590

High-potency NSAID used in the treatment of gout and arthritis, and for closure of a patent ductus arteriosus?

Back 590

Indomethacin.
Conversely, PGE can be used to maintain a patent ductus arteriosis in congenital cyanotic heart disease.

Front 591

Highly lipophilic nitrosoureas that readily cross the blood-brain barrier and are used for the treatment of many brain tumors

Back 591

Carmustine (BCNU), Lomustine (CCNU).
(These alkylating agents result in DNA cross-linking and strand breaks)

Front 592

Imidazole antifungal used for the treatment of fungal meningitis, because it can cross the blood-brain barrier

Back 592

Fluconazole

Front 593

increases calcium permeability in the worm, resulting in paralysis
niclosamide, which functions by uncoupling oxidative phosphorylation (inhibiting ATP production) or by activating ATPases, often is used with this drug in cestode infections

Back 593

Praziquantel

Front 594

increases GABA-mediated neourotransmission, but since it does not cross the human blood-brain barrier, it selectively affects the nematode, resulting in paralysis of the worm

Back 594

Ivermectin

Front 595

increases serum HDL, protecting against atherosclerosis and heart disease- unlike other SERMs and tamoxifen- it does not increase the risk of endometrial carcinoma

Back 595

Raloxifene

Front 596

Indirect-acting sympathomimetic used in OTC nasal decongestants

Back 596

Ephedrine
- It has many of the same actions as AMPHETAMINES, with LESS CNS STIMULATION
- It is found in Chinese herbs such as MA-HUANG
- One enantiomer, PSEUDOEPHEDRINE, is found in many COLD-RELIEF MEDICATIONS

Front 597

Ineffective against anaerobes, due to the requirement for oxygen to be taken up by the organism

Back 597

Aminoglycosides
(gentamicin/streptomycin/tobramycin/amikacin/neomycin)

Front 598

ineffective against GP or anaerobic bacteria- works synergistically with aminoglycosides against GNR

Back 598

Aztreonam

Front 599

Ingestion, industrial inhalation, or absorption through the skin causes metabolic acidosis and the precipitation of damaging oxalate crystals in the kidney.

Back 599

Ethylene Glycol.
(A major component of antifreeze, toxicity is managed by the administration of ethanol).

Front 600

Inhaled anesthetic that never reaches the level of surgical anesthesia without the addition of another agent, it is safe and the induction and recovery are extremely rapid

Back 600

Nitrous Oxide

This gas has a HIGH MINIMAL ALVEOLAR CONCENTRATION [MAC] and a low blood/gas partition.
It usually is ADMINISTERED WITH AN IV ANESTHETIC such as THIOPENTAL, and is commonly used in DENTAL PROCEDURES

Front 601

inhibit fusion of viral particles within an endosome in a cell (2)

Back 601

Amantadine and Rimantadine

Front 602

inhibitor of bacterial cell wall synthesis, is available as a topical preparation in many OTC antibacterial ointments

Back 602

Bacitracin

Front 603

Inhibitor of topoisomerase II used for the treatment of small cell carcinoma of the lung and prostate, and testicular cancers.

Back 603

Etoposide.
(G2 phase-specific inhibition, resulting in double-stranded DNA breaks and degradation)

Front 604

inhibits ?-galactosidase, an enzyme required for rapid absorption of most dietary sugars

Back 604

Acarbose

Front 605

inhibits 5?-reductase, thust conversion of testosterone to DHT

Back 605

Finasteride

Front 606

inhibits DNA-dependent RNA pol
often used in a combined drug regimen for Mycobacterium tuberculosis because of rapid resistance if used alone

Back 606

Rifampin

Front 607

inhibits several P450 enzymes involved in gonadal steroid synthesis

Back 607

Danazol

Front 608

Inhibits the degradation of dopamine in the CNS and is used as an adjuvant to levodopa in the Tx of Parkinson disease

Back 608

Selegiline

Inhibits MAO-B, which selectively degrades DOPAMINE

Front 609

Inhibits the enzyem aromatase and is used for the treatment of estrogen-dependent breast cancer

Back 609

Anastrozole.
(An inhibitor of steroid synthesis, it inhibits the conversion of androstenedione to estrone. Aminoglutethimide is a similar drug that inhibits the conversion of cholesterol to pregnenolone, and is used for the same types of cancers)

Front 610

inhibits the formation of ergosterol, lacks the antiendocrine effects seen with ketoconazole

Back 610

Fluconazole

Front 611

inhibits the iodination and coupling reactions of thyroid hormone synthesis. Another agent is methimazole- which crosses the placenta and enters breast milk

Back 611

Propylthiouracil

Front 612

Inhibits the rate-limiting enzyme of cholesterol synthesis, HMG-CoA reductase, resulting in dramatically decreased LDL levels

Back 612

Statins (Lovastatin, Pravastatin, Simvastatin, Atorvastatin)

May cause ELEVATED LIVER ENZYMES, MYOSITIS with INCREASED CREATINE KINASE from skeletal muscle, and, rarely, RHABDOMYOLYSIS

Front 613

inhibits the synthesis of mycolic acid in the mycobacterial cell wall
because it is acetylated by the liver, side effects include peripheral neuritis in slow acetylators and hepatitis in fast acetylators. Due to the emergence of multidrug-resistant strains of Mycobacterium tuberculosis, multidrug regimens also include ethambuto, pyrazinamide, rifampin, and streptomycin.

Back 613

Isoniazid (INH)

Front 614

Inhibits thymidylate synthase, resulting in thymineless death, and is used for the treatment of colon cancer and superficial tumors, such as basal cell carcinoma.

Back 614

Fluorouracil (5-FU).
(This S-phase antimetabolite causes myelosuppression)

Front 615

insulin secretagogue has rapid onset, but shorter duration of action than sulfonylureas

Back 615

Repaglinide

Front 616

Intermediate-acting benzodiazepine used for the Tx of panic disorder and phobias

Back 616

Alprazolam

Both ALPRAZOLAM and CLONAZEPAM have SEDATIVE effects and can cause physiologic DEPENDENCE
BUSPIRONE is an alternative drug that binds 5-HT(1A) RECEPTORS w/ MINIMAL ABUSE POTENTIAL

Front 617

Intoxicant that can cause retinal damage and blindness along with metabolic acidosis and coma.

Back 617

Methanol.
(Damage is due to the conversion to formaldehyde by the liver
the treatment includes ethanol, which competes for alcohol dehydrogenase.)

Front 618

kills parasites within erythrocytes (schizonticidal)
it disrupts hemoglobin breakdown, with the accumulation of heme, which is toxic to the organism

Back 618

Chloroquine

Front 619

Lipid-lowering agent that causes cutaneous flushing, which can be avoided by administering concurrently w/ aspirin

Back 619

Niacin

Directly REDUCES THE SECRETION OF VLDLs from and apolipoprotein synthesis by the liver, while INCREASING HDLs

Front 620

long-acting anticholinesterase used in the chronic Tx of myasthenia gravis

Back 620

Pyridostigmine
- Also used as an antidote to TUBOCURARINE TOXICITY
- NEOSTIGMINE is a similar substance, although is has a SHORTER DURATION of action

Front 621

Long-acting class III antiarrhythmic associated w/ pulmonary fibrosis, thyroid dysfunction, and corneal microdeposits

Back 621

Amiodarone
- This agent also blocks SODIUM CHANNELS, such as the CLASS IA antiarrhythmics

Front 622

Long acting B2 agonist used for prophylaxis of asthma?

Back 622

Salmeterol.
This agent works for 12 hours or more
it may cause tremors and arrhythmias.

Front 623

Longer half life than amantidine with same action

Back 623

Rimantidine

Front 624

mechanism is similar to cephalosporins is nearly identical
major side effects: hypersensitivity with urticaria, and rarely, anaphylaxis leading to life-threatening asphyxiation

Back 624

Penicillins

Front 625

Microtubule stabilizing agent, used for the treatment of ovarian and breast carcinomas.

Back 625

Paclitaxel.
(Derived from the yew tree, this M phase agent prevents the mitotic spindle from breaking down and thus inhibits completion of anaphase).

Front 626

Monoclonal antibody used as an anticoagulant, preventing restenosis after coronary angioplasty?

Back 626

Abciximab.
Antibody against glycoprotein IIb/IIIa receptor on platelets, preventing platelet aggregation.

Front 627

Monoclonal antibody used for the treatment of low-grade non-Hodgkin lymphoma.

Back 627

Rituximab.
(Binds to the CD20 antigen on B cells
adverse reactions are associated with infusion, and include fever, chills, headache, and nausea).

Front 628

Monoclonal antibody used for the treatment of metastatic breast cancer.

Back 628

Trastuzumab.
(Binds to the receptor tyrosine kinase Erb-B2 [HER-2], overexpressed on some breast cancers).

Front 629

Monoclonal antibody used in the management of patients with renal allografts?

Back 629

Daclizumab.
Binds to the high affinity IL-2 receptor expressed on activated T-cells
the side effects are minimal compared to agents such as cyclosporin or tacrolimus.

Front 630

Mood stabilizer that is a first-line drug for the Tx of bipolar affective disorder

Back 630

Lithium

INHIBITS the secondary messengers inositol triphosphate [IP3] and diacylglycerol [DAG] and causes TREMOR, HYPOTHYROIDISM, POLYDIPSIA, AND POLYURIA

Front 631

Most potent class of diuretics that inhibit the Na/K/Cl cotransporter in the thick ascending loop of Henle

Back 631

Loop Diuretics (Furosemide, Butamide)
- These SULFA DRUGS can cause HYPERCALCEMIA, OTOTOXICITY, HYPERURICEMIA, HYPOKALEMIA, AND METABOLIC ALKALOSIS

-ETHACRYNIC ACID is a NON-SULFA DRUG with similar effects

Front 632

muscarinic agonist used to treat postoperative urinary retention and atonic ileus

Back 632

Bethanechol
- a related drug, CARBACHOL, has both MUSCARINIC & NICOTINIC AGONIST properties and is primarily used in the mgmt of GLAUCOMA.
- Both drugs are resistant to metabolism by ACETYLCHOLINESTERASES

Front 633

narrow-spectrum, penicillinase-resistant B-lactam antibiotics, used to treat penicillin- resistant Staph aureus

Back 633

Methicillin, Nafcillin, Dicloxacillin

Front 634

Newly available agent used in the Tx of Parkinson disease that forestalls the use of levodopa

Back 634

Ropirinole

This agent has a lower incidence of postural hypotension, dyskinesia, vomiting, and hallucination, unlike most dopamine agonists. It is NOT AN ERGOT DERIVATIVE

A similar agent, PRAMIPEXOL, also used

Front 635

Newly available NSAID, used in the treatment of rheumatoid arthritis and other chronic conditions, which decrease the risk of ulcers and GI bleeds?

Back 635

Celecoxib.
Similar to rofecoxib. It selectively blocks COX-2 present only in leukocytes
these agents do not block COX-1 that produces protective gastric prostaglandins
as sulfa drugs, they both cause hypersensitivity.

Front 636

Nondepolarizing neuromuscular ganglionic blockers used in surgical anesthesia (3)

Back 636

Tubocurarine, Pancuronium, Mivacurium
- NEOSTIGMINE, PHYSOSTIGMINE AND EDROPHONIUM can reverse the paralysis caused by these drugs.
- TUBOCURARINE is the most likely of this class to cause the RELEASE OF HISTAMINE, leading to VASODILATION AND HYPOTENSTION

Front 637

Nonnucleoside reverse-transcriptase inhibitors used in the management of HIV infection

Back 637

Nevirapine, Delavirdine, Efavirenz

Front 638

Nonsedating antihistaminics used in the treatment of allergy?

Back 638

Fexofenadine, loratadine.
These second-generation antihistaminics do not readily enter the CNS, preventing sedation.

Front 639

Nonsteroidal anti-inflammatory drug (NSAID) with analgesic, antipyretic, antiplatelet, and anti-inflammatory properties that irreversibly inhibits COX?

Back 639

Aspirin (acetylsalicylic acid).
Inhibits the formation of PGE, decreases pain and fever, and decreases the synthesis of PGE in the stomach, predisposing to acute gastritis.

Front 640

normally produced in the posterior pituitary, this hormone is used to stimulate and reinforce labor, as well as stimulate milk ejection from nursing mothers

Back 640

Oxytocin

Front 641

Notorious for causing teratogenic effects, such as phocomelia
has gained attention as a potent immunosuppressant?

Back 641

Thalidomide.
Used in the treatment of SLE, multiple myeloma, and leprosy, its effects are due to its ability to suppress the production of TNF-alpha.

Front 642

NRTI that also inhibits reverse transcriptase of HBV

Back 642

lamivudine (3TC)

Front 643

Nucleoside reverse transcriptase inhibitors (NRTI)

Back 643

Zidovudine (ZDT), Salcitabine (ddC), Lamivudine (3TC), Stavudine (d4T)

Front 644

octapeptide that is used instead of somatostatin, because it half-life

Back 644

Octreotide

Front 645

Opioid agonist available in many over-the-counter cough syrups?

Back 645

Dextromethorphan.
Antitussive agent that depresses the cough center in the medulla
unlike dextromethorphan, codeine provides analgesia and has a higher abuse potential.

Front 646

Opioid derivatives used in the treatment of diarrhea because they suppress gastrointestinal motility?

Back 646

Diphenoxylate, loperamide.
Whereas diphenoxylate is formulated with antimuscarinic alkaloids
both preparations have minimal abuse potential.

Front 647

Opioid used in the induction of anesthesia, and also for postoperative analgesia

Back 647

Fentanyl

If used in conjunction with DROPERIDOL and NITROUS OXIDE, it can produce a state of NEUROLEPTANESTHESIA, resulting in both ANALGESIA AND AMNESIA

Front 648

oral agent used in the treatment of hyperthyroidism

Back 648

Propylthiouracil

Front 649

oral hypoglycemic agent that does not require functional pancreatic islet cells and decreases postprandial glucose levels without resultant hypoglycemia or wt gain

Back 649

Metformin

Front 650

Oral hypoglycemic agent that functions within the intestinal lumen, decreasing postprandial hyperglycemia, although there are no effects on fasting sugar

Back 650

Acarbose

Front 651

oral hypoglycemic agents used to stimulate the release of endogenous insulin from B cells

Back 651

Sulfonylureas (glyburide/glipizide)

Front 652

Oral, topical, and IV preps are available, used to reduce symptomatology of HSV infection, although it does not inhibit the reactivation of herpes

Back 652

Acyclovir

Front 653

Orally active antispasmotic agent

Back 653

Baclofen

GABA(B) RECEPTOR AGONIST that functions on inhibitory pathways in the spinal cord

Front 654

orally active antiviral drug used to decrease the duration and symptoms of influenza A symptoms

Back 654

Oseltamivir

Front 655

Orally administrated anticoagulant, used in the management and prophylaxis of venous thrombosis, myocardial infarction, and stroke?

Back 655

Warfarin.
Coumadin compound that interferes with the vitamin K-dependent carboxylation of clotting factors II, VII, IX, X.

Front 656

Originally developed as an antihypertensive agent, it is used topically because of the beneficial side effect of hypertrichosis (growth of hair in excess of normal)

Back 656

Minoxidil
- Fxns as a direct-acting vasodilator, as do NITROPRUSSIDE and HYDRALAZINE

Front 657

Osmotic diuretic that works by extracting water from tissues into the blood
Used in the Tx of hydrocephalus and increased intracranial pressure

Back 657

Mannitol
- This diuretic fxns primarily WITHIN THE PCT?s and is used to maintain HIGH URINE OUTPUT in cases of severe HEMOLYSIS or RHABDOMYOLYSIS

Front 658

Overdose causes constricted pupils, clammy skin, nausea, drowsiness, and respiratory depression with possible coma and death?

Back 658

Opioids (heroin/Morphine/meperidine/fentanyl)
Modulate synaptic transmission by binding mu (morphine), delta (enkephalin), and kappa (dynorphin) receptors.

Front 659

Overdose often results in fatalities from arrhythmias, myocardial infarctions, or seizures?

Back 659

Cocaine
(inhibits catecholamine reuptake, resulting in cardiotoxicity and hypertensive episodes).

Front 660

Part of the AVBD regimen, an antibiotic-type compound used in the treatment of myelomas, sarcomas, and lymphomas

Back 660

Doxorubicin (Adriamycin). leukemia [AML].)
(Intercalates in DNA to decrease replication and transcription
this drug is associated with significant cardiotoxicity and dilated cardiomyopathy. Daunorubicin is a similar drug and is used primarily for the treatment of acute myelogenous )

Front 661

peptide antibiotic inhibits cell wall synthesis in GP organisms
causes severe nephrotoxicity if used systematically

Back 661

Bacitracin

Front 662

Platelet antiaggregation, used for the prevention of transient ischemic attacks (TIA) in patients with aspirin sensitivity?

Back 662

Ticlopidine
Interferes with the binding of fibrin to the glycoprotein IIb/IIIa receptor on platelets.

Front 663

Platinum-containing compound used in the treatment of testicular and lung carcinomas.

Back 663

Cisplatin.
(Acts as an alkylating agent and causes nephrotoxicity and acoustic nerve damage
a similar agent, carboplatin, has less nephrotoxicity and neurotoxicity, but greater myelosuppression)

Front 664

Polyene antifungal agent used for the treatment of systemic mycosis and intrathecally for the treatment of fungal meningitis

Back 664

Amphotericin B

Front 665

Polymixin B

Back 665

this antibiotic disrupts bacterial membranes and is often too toxic to be administered systematically, although it is safe topically

Front 666

Popular drug used for the Tx of depression, it is the prototype of the selective serotonin reuptake inhibitors (SSRI)

Back 666

Fluoxetine

Common side effects of this and other SSRIs, such as SERTRALINE, PAROXETINE, AND CITALOPRAM, include headache, INSOMNIA, nausea, and SEXUAL DYSFUNCTION

These agents also are used in the mgmt of OBSESSIVE COMPULSIVE DISORDER [OCD], SOCIAL PHOBIAS, bulimia, and alcohol dependence

Front 667

Potassium-sparing diuretics that do not have anti-androgenic effects (2)

Back 667

Amiloride, Triamterene
- Block SODIUM CHANNELS in the cortical COLLECTING TUBULES
May cause hyperkalemic metabolic acidosis

Front 668

PPAR gamma regulates a number of genes involved in carbohydrate metabolism. The first member of this class, troglitazone, was removed from the market because it caused hepatotoxicity

Back 668

Rosiglitazone, Pioglitazone

Front 669

Preferred agent in the Tx of absence seizures

Back 669

Ethosuxamide

Postulated to fxn by INHIBITING T-TYPE CALCIUM CHANNELS in thalamic neurons. Use has been associated with the development of STEVENS-JOHNSON SYNDROME

Front 670

prevents the growth of GI flora and accumulation of nitrogenous microbial metabolites, which contribute to the development of hepatic encephalopathy
too toxic to be administered IV, but often used topically in the OTC antibiotic ointments

Back 670

Neomycin

Front 671

Primary agent used in the treatment of estrogen receptor-positive breast cancer.

Back 671

Tamoxifen.
(An estrogen receptor partial agonist, which may increase the risk of endometrial carcinoma).

Front 672

Primary drug used for acute attacks and prophylaxis of malarial infection
resistance is common

Back 672

Chloroquine

Front 673

primary drug used for the treatment of trematode (fluke) and cestode (tapeworm) infections

Back 673

Praziquantel

Front 674

Prokinetic agent used in the treatment of upper gastrointestinal dysfunction such as GERD or gastroparesis with delayed gastric emptying?

Back 674

Cisapride.
Stimulates peristalsis by promoting the release of acetylcholine from postganglionic nerves of the myenteric plexus. High doses have been associated with long QT syndrome.

Front 675

prophylaxis against Cryptococcus neoformans, effective in the treatment of esophageal and oropharyngeal candidiasis

Back 675

Fluconazole

Front 676

protease inhibitors used in combined treatment regimens for HIV infection

Back 676

Indinavir, Ritonavir, Saquinavir, Nelfinavir

Front 677

proteolytic cleavage of POMC forms ACT and MSH, as well as B-endorphin and metenkephalin

Back 677

Cosyntropin

Front 678

Proton pump inhibitor used in the treatment of GERD, gastric and duodenal ulcers, H. pylori gastritis, and Zollinger-Ellison syndrome (gastrinoma)?

Back 678

Omeprazole.
Irreversibly inhibits the H+/K+ ATPase on the luminal side of parietal cells.

Front 679

Prototypic adrenergic agonist, available as an inhaler, used for the management of bronchospasm in asthmatics?

Back 679

Albuterol.
Other selective B2 agonists include metaproterenol, terbutaline, and salmeterol.

Front 680

Prototypic B agonist used for the Tx of both acute heart failure and acute asthma

Back 680

Isoproterenol
- This agent has equivalent affinities for B1,2 receptors
- The B1 ACTIVITY causes an increase in CARDIAC CONTRACTILITY and INCREASED HR, resulting in increased SV and CO
- The B2 ACTIVITY induces BRONCHODILATION

Front 681

Prototypical B antagonist used in the TX of hypertension, glaucoma, migraines, and angina - As a prophylaxis for MI?s - At low doses to prevent performance anxiety

Back 681

Propanolol
- Nonselective B1,2 BLOCKER - Not to be used in pts with COPD AND ASTHMA, due to significant BRONCHOCONSTRICTION

Front 682

Purine metabolites, used for the treatment of leukemias and lymphomas

Back 682

Mercaptopurine (6-MP), Thioguanine (6-TG).
(Requires activation by hypoxanthine-guanine phosphoribosyltransferase [HGPRT], and inhibits many enzmes involved in purine metabolism)

Front 683

Rapid-acting, intravenously administered anticoagulant, used for acute myocardial infarction and prevention of DVT following prolonged immobilization?

Back 683

Heparin.
Binds and activated antithrombin III, resulting in inactivation of thrombin and other clotting factors. Does not cross the placenta and can be used during pregnancy. Protamine sulfate reverses its effects.

Front 684

rapid IV infusion is associated with diffuse flushing (red man syndrome)

Back 684

Vancomycin

Front 685

Rapidly acting benzodiazepine used as a "date-rape" drug?

Back 685

Flunitrazepam.
(Due to its amnestic properties, this drug is often added to alcohol, making the victim incapable of resisting or remembering being raped.)

Front 686

rarely used alone, except for the treatment of meningococcal carrier state, this drug imparts a red-orange color secretions

Back 686

Rifampin

Front 687

rarely used systematically due to inhibition of RBC maturation
available as topical

Back 687

Chloramphenicol

Front 688

Recombinant product used in the treatment of anemia associated with renal failure?

Back 688

Erythropoietin.
Also used to treat anemia associated with bone marrow transplants or toxic drug reactions.

Front 689

Recombinantly produced cytokine, used for the treatment of hairy cell leukemia

Back 689

Interferon Alpha.
(Also used for the treatment of chronic myelogenous leukemia [CML], malignant melanoma, and Kaposi sarcoma
it normally is produced by virally infected cells to prevent infection of adjacent cells).

Front 690

Recombinately produced granulocyte-macrophage colony-stimulating factor (GM-CSF), used in the management of patients undergoing chemotherapy?

Back 690

Sargramostim.
A similar agent, G-CSF (e.g.,filgrastim), is used for similar applications, but affects only granulocytes.

Front 691

Reversible inhibitors of COX widely used as OTC pain relievers?

Back 691

Ibuprofen, Naproxen, Piroxicam.
Same side effects as aspirin, but more effective analgesics and anti-inflammatories, however they lack aspirin's long duration and anti-platelet effects.

Front 692

Second-line Tx for schizophrenia that is better for the negative symptoms of the disease

Back 692

Clozapine

ATYPICAL ANTIPSYCHOTIC, associated with AGRANULOCYTOSIS, that blocks the D4 RECEPTOR

Front 693

Serotonin agonist used in the treatment of acute migraines and cluster headaches?

Back 693

Sumatriptan.
Binds to the HT1d receptor, causing vasoconstriction of the cerebral vasculature.

Front 694

Short-acting anticholinesterase used to confirm the diagnosis of myasthenia gravis

Back 694

Edrophonium
- IV injection of this rapidly absorbed drug results in an appreciable increase in muscle strength

Front 695

side effects include cycloplegia, flushing, confusion, increased body temperature, dry mouth, tachycardia, and constipation

Back 695

Atropine
- The side effects for this COMPETITIVE MUSCARINIC ANTAGONIST, as well as for all anticholinergics, are remembered as BLIND AS A BAT, RED AS A BEET, MAD AS A HATTER, HOT AS A HARE, and DRY AS A BONE

Front 696

Side effects of this antipsychotic include torsade de pointes arrhythmias and retinal deposits

Back 696

Thioridazine

This LOW-POTENCY antipsychotic BLOCKS MOST DOPAMINE RECEPTORS in the CNS, and can cause postural hypotension, sedation, and CNS depression

Front 697

similar to ampicillin, but greater oral bioavailability and decreased GI irritability

Back 697

Amoxicillin

Front 698

Stabilizes mast cell and basophil membranes, preventing the release of histamine in asthmatics?

Back 698

Cromolyn Sodium.
Used in prophylaxis only, not for the treatment of acute asthma attacks.

Front 699

stimulate the closure of K channels, resulting in depolarization of B cells and release of preformed insulin in vesicles

Back 699

Sulfonylureas (glyburide/ glipizide)

Front 700

stimulates contraction of uterine smooth muscle for labor
stimulates contraction of the myoepithelial cells of the mamry glands to eject milk

Back 700

Oxytocin

Front 701

stimulates nicotinic receptors in the nematode, resulting in a spastic paralysis

Back 701

Pyrantel Pamoate

Front 702

supplemented throughout the day with insulin lispro
modified version of human insulin, insulin glargine, has even longer duration of action

Back 702

Ultralente Insulin

Front 703

swish and swallow treatment for oral candidiasis, or topically for the treatment of diaper rash

Back 703

Nystatin

Front 704

synercid is a mixture of quinupristin and dalfopristin
use associated with arthralgias and myalgias, as well as inhibition P450 enzymes

Back 704

Streptogramins

Front 705

synthetic estrogen with high oral availability, used in contraceptive pills as well as in HRT

Back 705

Ethinyl Estradiol Mestranol

Front 706

Synthetic glucocorticoid that readily penetrates the airway mucosa
used in the management of asthma?

Back 706

Beclomethasone.
Beclamethasone and a related agent, budesonide, have very short half-lives in the bloodstream, and, therefore, cause less systemic effects than other glucocorticoids.

Front 707

synthetic progesterone analog used in oral contraceptives and implantable contraceptive devices

Back 707

Norgestrel

Front 708

synthetic thyroid hormone used in the treatment of hypothyroidism (hashimoto?s thyroiditis, myxedema, lithium treatment)

Back 708

Levothyroxine (T4)

Front 709

The most potent inhaled halogenated anesthetic, with the lowest minimal alveolar concentration (MAC), used for surgical anesthesia in children and asthmatics

Back 709

Halothane

Rare but significant side effects include the development of MALIGNANT HYPERTHERMIA and FULMINANT HEPATITIS

Front 710

The only local anesthetic with vasoconstrictor activity

Back 710

Cocaine

OTHER local anesthetics are ADMINISTERED WITH EPI to increase the duration of action and LOWER THE EFFECTIVE DOSE

Front 711

The only parenteral NSAID, used primarily for its analgesic (rather than anti-inflammatory) properties?

Back 711

Ketorolac.
Its systemic route of delivery substantially decreases GI irritation.

Front 712

These agents decrease the automaticity of the pacemaker tissue of the heart, resulting in prolonged AV conduction and slower HR

Back 712

Class II Antiarrhythmics (Propanolol, Esmolol)
- These B blockers DECREASE cAMP levels, resulting in REDUCED SODIUM AND CALCIUM CURRENTS.
- These agents are NOT to be used in causes of CHF

Front 713

These agents fxn to slow conduction velocity by slowing the rate and rise of the action potential

Back 713

Class IA Antiarrhythmics (Quinidine, Procainamide, Disopyramide)
- These agents help MAINTAIN SA RHYTHM AFTER CARDIOVERSION FOR ATRIAL FIBRILLATION, and may cause TORSADE DE POINTES arrhythmias.
- QUINIDINE may cause CINCHONISM, a type of poisoning that causes headache, vertigo, and tinnitus

Front 714

these agents increase cell sensitivity to insulin, by stimulating the peroxisomal proliferator gamma (PPARgamma)nuclear receptor

Back 714

Rosiglitazone, Pioglitazone

Front 715

these compounds reduce bone resorption and formation, and are used in the treatment of osteoporosis (postmenopausal, senile, or glucocorticoid-induced) and Paget disease

Back 715

Bisphosphonates

Front 716

these drugs interfere with fungal cell wall synthesis by inhibiting the 14?-demethylation of lanosterol
the demethylation is catalyzed by the cytochrome P450 system

Back 716

Azoles (keto/itra/flu)

Front 717

these two drugs create a block in successive reactions for folate synthesis
also often used to treat UTI

Back 717

Trimethoprin and Sulfamethoxazole

Front 718

This agent has the largest number of extrapyramidal side effects of all the atypical antipsychotics

Back 718

Risperidone

ATYPICAL ANTIPSYCHOTICS block the D2 and 5-HT2 RECEPTORS, contributing to HIGH SEDATION.
More Recently introduced agents such as OLANZAPINE have NO EXTRAPYRAMIDAL SIDE EFFECTS

Front 719

this agent is recommended for prophylaxis of tuberculosis in skin test converters and in people who have close contact with patients with active disease. It is also the primary drug in most multidrug regimens for the treatment of active tuberculosis

Back 719

Isoniazid (INH)

Front 720

This agent is used in the Tx of partial and generalized seizures, and is the primary agent used in the Tx of neuralgia

Back 720

Carbamazepine

INHIBITS SODIUM CHANNELS on neurons
its use may result in IDIOSYNCRATIC BLOOD DISORDERS such as ASPLASTIC ANEMIA and AGRANULOCYTOSIS

Front 721

This alpha-2 agonist decreases adrenergic outflow from the CNS, resulting in decreased peripheral resistance and decreased blood pressure

Back 721

Methyldopa

This drug can haptenate RBC proteins, resulting in an AUTOIMMUNE HEMOLYTIC ANEMIA

Front 722

This analog of GABA used in the Tx of partial seizures, as well as in the mgmt of peripheral neuropathy

Back 722

Gabapentin

Other available agents for seizures include LAMOTRIGINE, which may cause life-threatening STEVENS-JOHNSON SYNDROME and epidermal necrolysis, and VIGABATRIN, which INHIBITS GABA TRANSAMINASES

Front 723

This antimuscarinic is used in the mgmt of Parkinson disease, improving tremors and rigidity, but does little for bradykinesia

Back 723

Benztropine

As for all ANTIMUSCARINICS, contraindications include PROSTATIC HYPERPLASIA, GI OBSTRUCTION, and closed-angle GLAUCOMA, and are more common in older pts

Front 724

This antineoplastic agent is used for the treatment of testicular carcinoma and squamous cell carcinoma
it can cause life-threatening pulmonary fibrosis

Back 724

Bleomycin.
(The drug is a mixture of glycoproteins that results in the production of free radicals after binding to DNA, creating single-& double-stranded breaks.
This G2 phase inhibitor is part of the ABVD regimen [adriamycin, bleomycin, vinblastine, & decarbazine] for Hodgkin disease.)

Front 725

this class of antibiotics that inhibits protein synthesis and is effective in the treatment of MRSA and Vancomycin-resistant enterococci (VRE)

Back 725

Streptogramins

Front 726

this group of bactericidal antibiotics inhibits the transpeptidaiton step during cell wall synthesis, resulting in the activation of autolytic enzymes, which destroy bacteria

Back 726

Penicillin

Front 727

This long-acting amide-type local anesthetic can cause severe hypotension and arrythmias if inadvertently given IV

Back 727

Bupivicaine

Local anesthetics BIND TO SODIUM CHANNELS in the OPEN AND INACTIVE STATE, SLOWING RECOVERY from depolarization 10- to 1000-fold

Front 728

This older agent used in the Tx of depression increases levels of amine neurotransmitters by inhibiting their breakdown

Back 728

Monamine oxidase inhibitors (MAOI) ? Phenelzine, Tranylcypromine, Isocarboxazid

Consumption of foods such as CHEESE, which contain TYRAMINE (an INDIRECT-ACTING SYMPATHOMIMETIC) while on MAOIs can result in HYPERTENSIVE CRISIS

If taken with SSRIs, life-threatening SEROTONIN SYNDROME can result

Front 729

This potassium-sparing diuretic is an aldosterone antagonis that fxns at the collecting tubule

Back 729

Spironolactone
- Increases P450 activity and causes GYNECOMASTIA and other ANTIANDROGENIC EFFECTS

Front 730

This potent vasodilator, used in the Tx of malignant hypertension, can cause significant postural hypotension

Back 730

Nitroprusside
- Fxns to STIMULATE GUANYL CYCLASE with an INCREASE IN cGMP within smooth muscle of the vasculature
- Prolonged infusion can result in CYANIDE POISONING due to RELEASE OF CN-

Front 731

This preparation is used to treat emesis and nausea associated with chemotherapy, and contains the active ingredient in marijuna?

Back 731

Dronabinol.
This schedule III drug, which contains ttrahydrocannabinol (THC), is a controlled substance with approved medical use and moderate potential for dependence.

Front 732

This prokinetic agent is used to prevent emesis (e.g. postanesthesia or due to cancer chemotherapy), because it blocks D2 receptors in the area postrema that trigger vomiting?

Back 732

Metoclopramide
functions to facilitate ACh, while antagonizing the action of dopamine on the enteric nervous system.
Side effects include sedation, diarrhea and extrapyramidal symptoms.

Front 733

This rarely used antihypertensive agent blocks the storage and release of catecholamines and serotonin from neurons

Back 733

Reserpine

The drug readily ENTERS THE CNS and can cause SUICIDAL DEPRESSION and PARKINSONIAN SYMPTOMS

Front 734

treatment of MRSA, pseudomembranous colitis due to C.diff
SE can be limited by infusion over prolonged period and coadministration of antihistamines

Back 734

Vancomycin

Front 735

trypanosomicidal drug used for the treatment of chagas disease

Back 735

Nifurtimox

Front 736

ultra-rapid-acting human insulin administered immediately before meals

Back 736

Insulin lispro

Front 737

Ultra-short-acting barbiturate used IV for the induction of surgical anesthesia

Back 737

Thiopental

Due to its HIGH LIPID SOLUBILITY, this agent enters the CNS within 1 minute

It can be used only for SHORT SURGICAL PROCEDURES, because it RAPIDLY REDISTRIBUTES to other tissues

Front 738

undergoes activation by anaerobes and parasites, to create products that interfere with mucleic acid synthesis, resulting in cytotoxicity

Back 738

Metronidazole

Front 739

Unlike most opioid agonists, this derivative does not cause biliary spasms, and is preferred, therefore, as an analgesic for pancreatitis and cholecystitis?

Back 739

Meperidine.
Causes relaxation of the sphincter of Oddi

all opioids are contraindicated in the case of head injury, because of increased intracranial pressure.

Front 740

Uricosuric agent used in the treatment of chronic gout, and also to increase the effective concentration of weakly acidic drugs such as penicillins?

Back 740

Probenecid.
Both probenecid and sulfinpyrazone compete with uric acid for reabsorbsion in the proximal tubules of the kidney, and also inhibit the secretion of weak acids.

Front 741

urinary antiseptic that requires acidification and therefore, is ineffective systematically, although toxic levels can accumulate in patients with renal failure

Back 741

Nitrofurantoin

Front 742

use of theis estrogen compound by pregnant women has been associated with development of clear cell adenocarcinoma of the bagina in their daughters

Back 742

DES (diethylstilbestrol)

Front 743

used against GPC, GNR, anaerobes
metabolized by renal dihydropeptidase, which is blocked by coadministration of cilastatin

Back 743

Imipenem

Front 744

Used as a sedative
also is a first line drug for tonic-clonic seizures in children and in the Tx pts with Crigler-Najjar syndrome type II

Back 744

Phenobarbital

As a long acting, prototypic BARBITUATE, it binds to GABA RECEPTORS, increasing the DURATION OF CHLORIDE CHANNEL OPENING with neuronal INHIBITION

Front 745

used as postcoital birth control, and for the treatment of testicular tumors

Back 745

DES

Front 746

Used for atrial arrhythmias and nodal re-entry, as well as hypertension and angina, these agents inhibit Ca2+ voltage channels

Back 746

Class IV Antiarrhthmics (Verapamil, Diltiazem)
- Note: NIFEDIPINE has a similar mechanism of action, but it is used only for HYPERTENSION AND ANGINA
As it has no effect on heart tissue, it is not a class IV agent

Front 747

used for mineralcorticoid deficiency, this agent has a long duration of action, and is a naturally occurring precursor to aldosterone

Back 747

Fludrocortisone

Front 748

Used for prophylaxis of influenza A and rubella viral infection if given within 48 hr of exposure, also used in treatment of Parkinsons
not effective against influenza B

Back 748

Amantadine

Front 749

Used for the treatment of acute iron toxicity.

Back 749

Deferoxamine.
(Rapid infusion has been associated with hypotensive shock).

Front 750

used for the treatment of chloroquine-resistant malarial infection due to plasmodium falciparum

Back 750

Quinine

Front 751

used for the treatment of many helminth infections, it is the drug of choice for pinworms, the most common helminth infection in the United States

Back 751

Mebendazole

Front 752

used for the treatment of mycotic infections, these agents inhibit hormone production and result in gynecomastia

Back 752

Azoles (keto/itra/fluconazole)

Front 753

used for the treatment of osteoporosis, this hormone produced by the thyroid decreases bone breakdown, and decreases serum calcium and phosphate levels

Back 753

Calcitonin

Front 754

used for the treatment of retinitis and other infections associated with CMV

Back 754

Ganciclovir

Front 755

Used for the treatment of traveler's diarrhea?

Back 755

Bismuth subsalicylate.
Helps decrease fluid secretion by the bowel
also used with metronidazole and tetracycline for the treatment of H. pylori-associated peptic ulcer disease.

Front 756

Used for the Tx of CHF, this agent contains 2 isomers, one with nonselective B blocking activity and one with alpha 1 blocking activity

Back 756

Carvedilol
- LABETALOL has similar properties and has 4 diastereomers
- The RR enantiomer is a NONSELECTIVE B BLOCKER, and the SR enantiomer is an alpha 1 BLOCKER

Front 757

Used for the Tx of recurrent ventricular arrhythmias - Many of these agents can precipitate torsade de pointe arrhythmias

Back 757

Class III Antiarrhythmics (Solatol, Ibutulide, Bretylium, Amiodarone)
- These agents prolong the action potential by BLOCKING POTASSIUM CHANNELS

Front 758

Used for the Tx of ventricular arrhythmias, especially following MI, because it works only ischemic tissue

Back 758

Lidocaine
- This class IB antiarrhythmic has LITTLE EFFECT on the ECG of NORMAL [NON-ISCHEMIC] HEART tissue. It is given IV, although similar agents [MEXILETINE and TOCAINIDE] are given orally

Front 759

used for treatment of septic meningitis- this cephalosporin has good penetration into CNS

Back 759

Ceftriaxone

Front 760

Used for Tx of anxiety and ethanol dependence
Also a primary agent in the Tx of status epilipticus

Back 760

Diazepam

This long-acting, prototypic BENZODIAZEPINE binds to the GABA(A) RECEPTOR, increasing the FREQUENCY OF CHLORIDE CHANNEL OPENING

Front 761

Used for Tx of refractory ventricular arrhythmias, as well as for rapid atrial arrhythmias associated with Wolff-Parkinson-White syndrome

Back 761

Class IC Antiarrhythmics (Flecainide, Propafenone)
- Fxn to SLOW CONDUCTION VELOCITY in the atrial and ventricular cells but DO NOT AFFECT THE AP
- They typically are used as a LAST RESORT, as their use is associated with DRUG-INDUCED ARRHYTHMIAS.

Front 762

used in combined regimens for treatment of HIV infection, associated with a dose-limiting pancreatitis

Back 762

Didanosine (ddI)

Front 763

used in conjunction with glucocorticoids in postadrenalectomy therapy

Back 763

Fludrocortisone

Front 764

Used in emergency situations for the Tx of both open- and narrow-angle glaucoma

Back 764

Pilocarpine
- Activation of MUSCARINIC CHOLINERGIC RECEPTORS causes contraction of the CILIARY MUSCLES w/ opening of SCHLEMM?S CANAL, allowing drainage of aqueous humor and a subsequent DECREASE IN INTRAOCULAR PRESSURE

Front 765

used in HRT, and to prevent abnormal uterine bleeding

Back 765

Norgestrel (norethidrone, medroxyprogestrone)

Front 766

Used in the acute bleeding in patients with hemophilia and other coagulopathies?

Back 766

Aminocaproic acid.
An orally active inhibitor of plasminogen activation, thereby inhibiting fibrinolysis
tranexamic acid is a similar agent.

Front 767

Used in the event of benzodiazepine overdose.

Back 767

Flumazenil.
(This benzodiazepine derivative antagonizes the actions of benzodiazepines and zolpidem, although it does not block the actions of barbiturates).

Front 768

Used in the management of chronic gout and as an adjunct to cancer chemotherapy, to slow the production of uric acid?

Back 768

Allopurinol.
Results in suicide inhibition of xanthine oxidase with the resultant increase of xanthine and hypoxanthine, both of which are more soluable and less likely to form crystals than uric acid.

Front 769

Used in the management of opioid withdrawl and maintenance programs for addicts?

Back 769

Methadone.
(Used to treat nausea, chills, sweats, lacrimation, cramps, rhinorrhea, yawning, piloerection, diarrhea and tremor due to opiod withdrawl.)

Front 770

Used in the management of sickle cell anemia, as well as for various myeloid neoplasms?

Back 770

Hydroxurea.
May decrease the incidence of sickle cell crisis, by increasing levels of HbF
it also inhibits DNA synthesis by blocking the conversion of ribonucleotides to deoxyribonucleotides.

Front 771

Used in the mgmt of CHF, these drugs are reversible inhibitors of Na/K ATPase

Back 771

Digitoxin, Digoxin
- Unlike digitoxin, DIGOXIN IS SHORTER-ACTING and EXCRETED BY THE KIDNEYS

-Pts w/ LOW K+, LOW Mg, HIGH Na+, or high Ca2+ can EXPERIENCE ARRYTHMIAS w/ either agent

Front 772

Used in the mgmt of depression, it inhibits the reabsorption of both norepi and serotonin within the synapse

Back 772

Amitriptyline

Other TRICYCLIC ANTIDEPRESSANTS include NORTRIPTYLINE, IMIPRAMINE and DESIPRAMINE. Major side effects of this class include SEDATION, ORTHOSTATIC HYPOTENSION, and CARDIAC ARRHYTHMIAS

Front 773

Used in the prevention of migraine headaches, this ergot has no value in the treatment of migraine headaches?

Back 773

Methylsergide.
This agent blocks serotonin (5-HT) receptors, it can be used in the treatment of carcinoid tumors, notable side effects include retroperitoneal and subendocardial fibroplasia.

Front 774

Used in the treatment of acute attacks of gouty arthritis, because it impairs leukocyte function?

Back 774

Colchicine.
Inhibits microtubule assembly, and, therefore, leukocyte migration and phagocytosis of uric acid crystals.

Front 775

used in the treatment of acute hypercalcemia and paget disease
administered intranasally or by injection
(salmon type has longer t1/2)

Back 775

Calcitonin

Front 776

Used in the treatment of alcoholism in compliant patients, causing flushing, vomiting, and hypertension when alcohol is consumed?

Back 776

Disulfiram.
(Inhibits aldehyde dehydrogenase, resulting in toxic accumulation of acetaldehyde. Drugs with similar side effects are said to have disulfiram-like reaction.)

Front 777

Used in the treatment of asthma, selectively inhibiting leukotriene synthesis?

Back 777

Zileutin.
Leukotrienes can also be inhibited by the LTD4 and LTE4 antagonists zafirlukast and montelukast.

Front 778

used in the treatment of endometriosis and fibrocystic disease of the breast

Back 778

Danazol

Front 779

Used in the treatment of GERD, this histamine blocker is associated with gynecomastia and galactorrhea?

Back 779

Cimetidine.
The stronger H2 blockers, ranitidine and famotidine do not inhibit the hepatic P-450 system and therefore do no not cause antiandrogenic effects.

Front 780

used in the treatment of hyperprolactinemia (ie. pituitary adenoma)

Back 780

Bromocriptine

Front 781

Used in the treatment of peptic ulcers, because it polymerizes and selectively coats necrotic ulcerated tissue?

Back 781

Sucralfate.
Requires an acidic environment to polymerize, and, therefore, cannot be used in the presence of antacids or H2 blockers.

Front 782

Used in the treatment of rheumatoid arthritis and inflammatory bowel disease, a recombinant protein product that inhibits the effects of TNF-alpha?

Back 782

Etanercept (IV).
This drug is a fusion between the extracellular domain of TNF-alpha receptor and the Fc portion of an antibody

similar monoclonal antibody, infliximab, also binds and inhibits TNF-alpha.

Front 783

Used in the Tx of most forms of epilepsy, includeing generalized tonic-clonic, partial absence, and myoclonic seizures, and in the Tx of bipolar disorder

Back 783

Valproic Acid

This agent has been associated with the development of NEURAL TUBE DEFECTS when administered to PREGNANT WOMEN

Front 784

Used in the Tx of Parkinson disease, it inhibits the enzyme catechol-O-methyltransferase (COMT)

Back 784

Entacapone

This agent inhibits the conversion of LEVODOPA TO 3-O-METHYLDOPA in the periphery.
A similar agent, TOLCAPONE, has been associated with ACUTE LIVER FAILURE

Front 785

Used in the Tx of Parkinson disease, this precursor crosses the BBB and is converted to dopamine

Back 785

L-dopa (Levodopa)

Administered with the DECARBOXYLASE INHIBITOR CARBIDOPA [which does not cross the BBB] to increase bioavailability and to LIMIT PERIPHERAL SIDE EFFECTS

Front 786

Used in treatment of transplant patients and patients with autoimmune diseases, as it impairs T-cell production of IL-2?

Back 786

Cyclosporin.
Binds cyclophilins and inhibits the transcription of cytokine genes. Tracrolimus, binds to immunophilin FK-binding protein and functions similarly
Both have dose limiting nephrotoxicity.

Front 787

used to prevent motion sickness and delivered by a transdermal patch

Back 787

Scopolamine
- COMPETITIVE CHOLINERGIC ANTAGONIST W/ SEDATING AND AMNESTIC effects

Front 788

Used to treat the ingestion of suicidal doses of acetaminophen.

Back 788

N-acetylcysteine.
(Given early, it may protect from the development of fulminant hepatic failure).

Front 789

Used to treat the symptoms of opioid overdose.

Back 789

Naltrexone, Naloxone.
(Pure antagonists, primarily of mu opioid receptors).

Front 790

Used to Tx hypertension and urinary retention - First-dose syncope is a significant side effect associated with this drug

Back 790

Prazosin
- A competitive ALPHA 1 ANTAGONIST
- The use of this drug can lead to POSTURAL HYPOTENSION, INHIBITION OF EJACULATION, REFLEX TACHYCARDIA, nasal congestion, and MIOSIS

Front 791

Used topically for the treatment of rheumatoid arthritis because it depletes substance P?

Back 791

Capsaicin.
Component of chili peppers that impairs the release of substance P, the potent neurotransmitter for pain sensation.

Front 792

Vinca alkaloid used as part of the MOPP regimen for lymphomas, Wilms tumor, and choriocarcinomas.

Back 792

Vincristine (Oncovin).
(M phase inhibitor that blocks microtubule polymerization and spindle formation
a similar agent, vinblastine, is part of the ABVD regimen.
The ABVD regimen includes the combined use of adriamycin, bleomycin, vinblastine, and dacarbazine whereas the MOPP regimen includes the use of mechlorethamine, Oncovin [vincristine], procarbazine, and prednisone.)

Front 793

widely used antibiotic
SE include GI irritation and hypersensitivity-based acute cholestatic hepatitis

Back 793

Erythromycin

Front 794

Will correct the anemia but not the neurologic deficits caused by B12 deficiency?

Back 794

Folic acid.
Vitamin B12 deficiency must be ruled out before treating megaloblastic anemia with folic acid.

Front 795

works similarly to penicillins and cephalosporins, this monobactam is resistant to B-lactamases, and displays no cross-allergenicity with penicillins

Back 795

Aztreonam

Front 796

zanamivir is a similar drug, but administered intranasally
both drugs function as neuraminidase inhibitors, preventing the spread of virus from cell to cell

Back 796

Oseltamivir