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518 Cards in this Set
- Front
- Back
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If 87.5% of a drug has been eliminated from the body, how many half-lifes have occurred?
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3 half-lifes
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If 50% of a drug remains in the body, how many half-lifes have occurred?
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1 half-life
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How is half-life calculated?
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T1/2 = Vd/Cl x 0.7
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How is Loading Dose calculated?
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LD = (Css x Vd) / f
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How is Maintenance Dose calculated?
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MD = (Css x Cl) / f
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How is Clearance calculated?
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Cl = Amount eliminated / Css
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What are 3 drugs that undergo zero-order elimination?
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*EPA
Ethanol Phenytoin Aspirin (high dose) |
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What are the Phase II elimination reactions?
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*GAS (you get flatualance when you have to go #2)
Glucoronidation Acetylation Sulfonation |
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What are the Phase I elimination reactions?
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*HOR
Hydrolysis Oxidation Reduction |
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Which elimination phase (I or II) is lost first?
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Phase I
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What question is answered by Phase I drug development?
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Is it safe?
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What question is answered by Phase II drug development?
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Does it work?
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What question is answered by Phase III drug development?
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FDA double-blind study
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What question is answered by Phase IV drug development?
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Post-market surveillance: What SE's exist?
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How do we calculate Therapeutic Index?
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*TILE
TI = LD50 / ED50 |
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What direction does a noncompetitive antagonist shift the potency curve (right, left, up, or down)?
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It doesn't: potency (Km) is not affected
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What direction does a competitive antagonist shift the efficacy curve (right, left, up, or down)?
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It doesn't: efficacy (Vmax) is not affected
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What are the peptidoglycan synthesis inhib's?
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Bacitracin
Vancomycin Cycloserine |
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What are the 50s Inhib's?
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*CCELLS (Buys AT 30 CCELLS at 50)
Chloramphenicol Clindamycin Erythromycin (macrolides) Lincomycin Linezolid Streptogramins |
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What are the Macrolides?
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*ACE
Azithromycin Clarithromycin Erythromycin |
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What are the Streptogramins?
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Dalfopristin
Quinopristin |
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What are the 30s Inhib's?
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*AT (Buys AT 30 CCELLS at 50)
AMG's Tetracyclines |
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What are the AMG's?
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*STANG
Streptomycin Tobramycin Amikacin Neomycin Gentamicin |
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What are the Nucleotide Synthesis Inhib's?
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Sulfonamides
Trimethoprim Methotrexate Pyrimethamine |
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What blocks mRNA Synthesis
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Rifampin
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What blocks DNA Topoisomerase II?
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Quinolones
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What drugs destroy fungal AND bacterial membranes?
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Polymixins (Polymixin B & Polymixin E)
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What is the toxicity of Polymyxins?
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ATN (acute tubular necrosis)
Neurotoxicity |
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What is the MOA of Penicillins?
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1) Bind PBP's
2) Activate autolytic enzymes 3) Inhibits transpeptidase cross-linking (does NOT block PG synthesis --> Q #1) |
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What is the c/u of Penicillins?
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G+ rods & cocci
G- cocci Spirochetes |
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What does Penicillin toxicity cause?
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Hypersensitivity
Hemolytic anemia |
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What does Methicillin toxicity cause?
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Interstitial nephritis
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What is the c/u for Methicillin?
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Staph Aureus
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What are the anti-Staph Penicillins?
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*CONDM
Cloxacillin Oxacillin Nafcillin Dicloxacillin Methicillin |
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What are the anti-Pseudomonas Penicillins?
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*PTC of Pseudomonas in the AM
Piperacillin Ticarcillin Carbenicillin Azlocillin Mezlocillin |
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What is the c/u of Ampicillin/Amoxicillin?
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*HELPS Enterococci
H. Influenza E. Coli Listeria Proteus Salmonella Enterococci |
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What does Ampicillin/Amoxicillin toxicity cause?
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Hypersensitivity
Ampicillin rash Pseudomembranous Colitis |
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Which antibiotics cause Pseudomembranous Colitis?
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Ampicillin/Amoxicillin
Clindamycin |
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What is the MOA of Clindamycin?
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Inhibition of bond formation between nucleotides at the P site
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What is the c/u of Clindamycin?
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Anaerobes above the diaphram
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What is the tx for Pseudomembranous Colitis?
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Metronidazole
Vancomycin |
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What is the MOA of Metronidazole?
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Form toxic metabolites in the bacterial cell wall that damage DNA
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What is the c/u for Metronidazole?
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*GET GAP
Giardia Entomeba Trichamonas Gardnerella Anaerobes H. Pylori |
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What is the toxicity of Metronidazole?
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Disulfram-like reaction with alcohol
Dysguzia Drug-induced pancreatitis Teratogenic |
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What is the tx for bacterial vaginosis for pregnant pt's?
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Metro cream
Clindamycin cream |
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What is the DOC for Gardnerella Vaginosis?
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Tinidazole
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What is the MOA of Vancomycin?
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Blocks peptidoglycan synthesis by inhibiting D-ala D-ala
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What is the c/u for Vancomycin?
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MRSA
Pseudomembranous Colitis (C. Difficile) Any nosocomial infection |
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What is the toxicity of Vancomycin?
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*There is NOT toxicity
Neurotoxic Ototoxic Thrombophlebitis |
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What is the tx for VRSA?
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Linezolid
Streptogramins |
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What is the tx for local impetigo?
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Topical Mupirocin
Oral Erythromycin |
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What is the c/u for 2nd Gen Ceph's?
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*HEN PEcKS (c = cocci)
H. Influenza Enterobacter Neisseria Proteus E. Coli Klebsiella Serratia G+ cocci |
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What is a 3rd Gen Ceph used for the tx of Pseudomona?
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Ceftazidime
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What is a 3rd Gen Ceph used for the tx of Gonorrhea?
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Ceftriaxone & Cefixime
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What are the Ceph's used for the tx of Gonorrhea?
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*TRI to FIX a FOX
Ceftriaxone (3rd Gen) Cefixime (3rd Gen) Cefoxitin (2nd Gen) |
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What is the one-dose tx for Chlamydia?
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Azithromycin
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What is the MOA of Azithromycin?
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*Inhibits "Macroslide" (macro = 50s; slide = translocation)
Blocks translocation from the A --> P site by binding the 23s subunit of the 50s ribosome |
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What is the c/u of Azithromycin?
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*UPS Lost My Brand New Car
URI's (caused by G+ cocci) Pneumonia (caused by G+ cocci) STD's (caused by G+ cocci) Legionella Mycoplasma Bordatella Neisseria Chlamydia |
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What are the SE's of Azithromycin?
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Acute Cholestatic Hepatitis
Eosinophilia |
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What is a 3rd Gen Ceph that cause a Disulfram-like reaction with Etoh?
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*PAIR of FAMily "TETS" (tits)
Cefeparazone (3rd gen) Cefamandole (2nd gen) Cefotetan (2nd gen) |
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What is the MOA of Aztreonam?
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*AzTHREEonam
Binds to PBP #3 |
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What is the c/u of Aztreonam?
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G- rods in pt's who cannot tolerate AMG's
OR Pt's allergic to Penicillin OR Pt's with Renal Failure |
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What is the DOC for G- rods?
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AMG's
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What is the MOA of AMG's?
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Inhibits initiation complex of N-acetyl formation causing misreading of mRNA
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What is the toxicity of AMG's?
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*There is NNO toxicity
Neurotoxic (teratogenic) Nephrotoxic Ototoxic |
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With what is imipenem co-administered? Why?
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Cilistatin
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What is the MOA of Cilistatin?
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Inhibits renal dihydropeptidase-1
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What is the c/u of imipenem/cilistatin?
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Enterobacter (DOC)
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What are the Ototoxicity-causing drugs?
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AMG's
Loops (Furosemide) Vancomycin Quinidine Chloroquine |
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MOA of Tetracyclines?
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Protein synthesis inhibition by preventing amino acyl tRNA attachment
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What is the c/u for Tetracyclines?
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*VACUuM The BR
Vibrio Cholerea Acne (Propionibacterium Acnes) Chlamydia Ureaplasma Urealyticum Mycoplasm Tularemia H. Pylori Bordetella Rickettsia |
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What is the toxicity of Tetracyclines?
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Discoloration of teeth (children)
Abnormal bone growth (children) Photosensitivity Drug-induced Hepatitis Fanconi Syndrome (old Tetracyclines) |
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What is the tx of Cat-Scratch Fever?
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Bug = Bartonella Henselae
Tx = Azithromycin |
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What is an alternative MOA of Demeclocycline?
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Blocks ADH receptors
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What drugs block ADH receptors?
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Demeclocycline
Lithium |
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What is an alternative MOA of Erythromycin?
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Binds to motilin receptors, causing hypermotility motility --> GI upset
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What is the MOA of Chloramphenicol?
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Inhibits Peptidyltransferase, the enzyme responsible for transferring nucleotides from A --> P site
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What is the c/u of Chloramphenicol?
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Bacterial Meningitis
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What is the toxicity of Chloramphenicol?
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Dose-dependent Anemia
Dose-independent Aplastic anemia Grey Baby Syndrome (premature infants that lack UDP-glucuronyl transferase) |
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What is the MOA of Sulfonamides?
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Inhibition of Dihydropterate Synthase
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What is the MOA of Trimethoprim?
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Inhibition of Dihydrofolate Reductase
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What drugs inhibit DHF Reductase?
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Trimethoprim
Methotrexate Pyromethamine |
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What is the toxicity of Sulfonamides?
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Displaces drugs from albumin (e.g. Warfarin)
Hemolytic Anemia (G6PD Def Pt's) Kernicteris (children) Hypersensitivity Photosensitivity Tubulointerstitial Nephritis |
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What is the c/u for Trimethoprim?
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Norcardia
UTI PCP Salmonella Shigella |
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What is the toxicity of Trimethoprim?
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Megaloblastic Anemia
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What is the c/u for Fluoroquinolones?
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G- rods in GI/GU track
CAP |
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What is the toxicity of Fluoroquinolones?
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Tendonitis (adults)
Cartilage rupture (kids) Torsades de Pointes with Moxifloxicin |
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If a pt has a positive PPD test but negative CXR, what is the next step mgmt?
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INH for 6 - 9 months
& Vit B6 (b/c INH depletes B6) |
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What is the MOA of INH?
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Decreases synthesis of mycolic acid
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What is the toxicity of INH?
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*INHH
Induces SLE Neurotoxicity (that's why we give concomittant Vit B6) Hepatotoxicity Hemolytic anemia (G6PD Pt's) |
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If a pt has a positive PPD test and positive CXR, what is the next step mgmt?
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*RIPES
Rifampin INH Pyrazinamide Ethambutol Streptomycin (added, if necessary) |
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What is the 2nd line tx of TB?
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Cycloserine
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What is the MOA of Cycloserine?
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Inhibition of peptidoglycan synthesis
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What is the MOA of Ethambutol?
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Inhibits Arabinosyl Tranferase
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What is the toxicity of Ethambutol?
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Optic Neuritis
Central Scotoma |
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What is the MOA of Rifampin?
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Blocks mRNA synthesis by inhibiting DNA-Dependent RNA Polymerase
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What is the c/u of Rifampin?
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TB
Meningiococcal Prophylaxis Close contacts of Pt's with Hib Delays Dapsone resistence in the tx of Leprosy |
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What is the MOA of Dapsone?
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Inhibition of bacterial DHF synthesis by binding Dihydropteroate Synthetase
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What is the c/u of Dapsone?
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Leprosy
Dermatitis Hepatoformis (Celiac Sprue) Delays Rifampin resistence in the tx of TB 3rd-line tx for PCP |
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What is the toxicity of Dapsone?
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*HAMbone from Dapsone
Hemolytic Anemia Agranulocytosis Methemoglobinemia |
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What are the drugs that cause Agranulocytosis?
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Clozapine
Colchicine Carbamazepine PTU Dapsone Ticlopidine Methimazole |
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What drugs inhibit Fungal DNA Synthesis?
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Flucytosine
Griseofulvin (interfers with microtubule formation thereby inhibiting mitosis) |
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What drugs INHIBIT Fungal Membrane Synthesis?
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*CAT
Caspofungin "Azoles" Terbinafine |
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What drugs DESTROY fungal Membranes?
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Amphotericin B
Nystatin |
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What is the "specific" MOA for Flucytosine?
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Changes uracil to fluro-uracil
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What is the MOA of Caspofungin?
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Inhibits Beta-13 Delta-Glucan
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What is the MOA of Terbinafine?
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Inhibits cell wall synthesis by blocking squaline epoxidase
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What is the MOA of Griseofulvin?
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Binds microtubules, arresting the cell in mitosis
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What is the MOA of Amantidine?
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Prevents viral "uncoating"
Prevents viral penetration Increases DA |
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What is the c/u for Amantidine?
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*Influenza A, RubellA & the CerebellA
Influenza A RubellA Parkinson's (the CerebellA) |
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What is the MOA of Oseltamivir and Zanamivir?
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Inhibits viral influenza neuraminidase, decreasing the release of viral progeny
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What is the c/u of Oseltamivir and Zanamivir?
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Influenza A and B
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What is the MOA of Ribavirin?
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Inhibits Guanine nucleotide synthesis by competitively inhibiting IMP Dehydrogenase
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What is the c/u of Ribavirin?
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Chronic Hepatitis C
RSV |
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What is the tx for chronic Hepatitis C?
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Ribavirin
INF-alpha |
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What is the tx for Hepatitis B?
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INF-alpha
Lamuvidine |
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What are the SE's of the Lamuvidine?
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Lactic acidosis
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What are the 3 letters for Lamuvidine?
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3TC
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What is the MOA of Acyclovir?
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Inhibition of viral DNA polymerase when phosporylated by the VIRAL thymidine kinase
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What is the c/u of Acyclovir?
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Any HSV except HSV III and HSV V
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What are HSV I thru HSV VIII?
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HSV I = Oral herpes
HSV II = Genital herpes HSV III = VZV HSV IV = EBV HSV V = CMV HSV VI = Roseola HSV VII = Pyteriasis Rosie HSV VIII = Kaposi's Sarcoma |
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What is the tx for CMV
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Ganciclovir or Foscarnet
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What is the MOA of Foscarnet?
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Binds to pyrophosphate binding site;
Does NOT REQUIRE phosphorylation by VIRAL thymidine kinase |
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Name all the protease inhibitors?
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*SIR AN (NAVIR tease a protease)
Saquinavir Indinavir Rotinavir Amprenavir Nelfinavir |
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What is the MOA of the protease inhibitors?
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Inhibition of aspartate protease
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What is the Toxicity of Indinavir?
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Crystal-induced nephropathy
Thrombocytopenia |
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What are the NNRTI's?
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*Nevada/Deleware/E-Fuck Virus or NEVIR Efir (ever) DELiver nucleosides
Nevirapine Delavirdine Efavirenz |
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What is the SE of Nevirapine?
|
SJS
Hepatotoxicity |
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What are the SE's of the NRTI's?
|
Ziduvidine (AZT/ZDV)
--Lactic Acidosis --Aplastic anemia --Megaloblastic anemia Didanosine (DDI) --Lactic Acidosis --Drug-induced pancreatitis Zalcytobine (DDC) --Lactic Acidosis --SJS --Peripheral neuropathy Lamuvidine (3TC) --Lactic Acidosis Stavudine (D4T) --Lactic Acidosis --Peripheral neuropathy Abacavir (ABC) --Lactic Acidosis --Hypersensitivity syndrome |
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What is the MOA of Enfurvitide?
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Binds to GP41 & prevents VIRAL & CELLULAR membrane fusion
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What is the tx for African Trypanosomiasis (aka African Sleeping Sickness)?
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Suramin
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What is the tx for Chagas?
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Nifurtimox
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What is the 2nd line tx for PCP?
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Aerosolized Pentamidine
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What is the tx for Entamoeba Histolytica?
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Metronidazole
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What is the tx for latent hypnozyte?
|
Primaquine
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How do you tx for Chloraquine-resistent malaria?
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Methloquine
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What is the tx for Leishmaniasis?
|
Pentavir Antimony
Na+ Stipigluconate |
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What is the tx for Diphyllobothrium Latum?
|
Niclosamide
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What is the tx for Paragonimus Westermani?
|
Praziquental
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What is the tx for Enterobius Vermacularis?
|
Pyrantal Pamoate & Mebendazole (on day 11 he says Praziquental & Mebendazole)
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What is the tx for Nematodes?
|
Mebendazole
|
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What is the tx for Onchocerca (River Blindness)?
|
Ivermectin
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What is the tx for Clonorchis Sinensis?
|
Praziquental
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What is the drug that inhibits the conversion of Acetyl CoA to ACh?
|
Vesimicol
|
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What drug inhibits the uptake of choline?
|
Hemicholinium
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What drug inhibits the release of ACh?
|
Botulinum Toxin
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What drug inhibits the conversion of DA to NE?
|
Reserpine
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What drug inhibits the release of NE?
|
Guanethidine
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What drug stimulates the release of NE?
|
Amphetamine
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What drug inhibits the re-uptake of NE?
|
Cocaine
TCA's |
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What receptor stimulates NE release?
|
Angiotensin II
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What receptor inhibits NE release?
|
M1 & a2
|
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What are the direct-acting cholinomimetics?
|
Methanacol
Bethanacol Carbichol Pilocarpine |
|
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What are the indirect-acting cholinomimetics?
|
Neostigmine
Pyridostigmine Physostigmine Edrophonium Echothiophate Rivastigmine Galantamine Tacrine Donepezil |
|
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How does AChE-I poisoning present?
|
*ADDUMBBELSS
Abdominal cramping Diaphoresis Diarrhea Urination Miosis Bradycardia Bronchospasm Excitation of skeletal muscle Lacrimation Secretion Salvation |
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What is the tx for AChE-I poisoning?
|
Atropine followed by...
Pralidoxime (2-PAM) |
|
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What is the tx for Type III Heart Block?
|
Atropine
|
|
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What is the surgical tx for Type III Heart Block?
|
Pacemaker
|
|
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What are the AFFECTS of Atropine?
|
Blocks SLUD (anti-PS):
Salivation Lacrimation Urination Defication |
|
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What is TOXICITY of Atropine?
|
*Dry as a Bone, Hot as a Hare, Red as a Beet, Blind as a Bat, & Mad as a Hatter
Decreased Sweating/Lacrimation --> dry eyes/skin Hyperthermia --> warm skin Flushing --> red skin Mydriasis & Cycloplegia --> blurred vision Disorientation & Confusion |
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What is the MOA of Fenoldopam
|
D1 Agonist
|
|
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What is the MOA of Epinephrine?
|
B1 > B2 > a1 > a2
|
|
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What is the MOA of NE?
|
a1/a2 > B1
|
|
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What is the MOA of Isoproterenol?
|
B1 = B2
|
|
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What is the MOA of Dobutamine?
|
*Dobutamine has a "B"
B1 > B2 |
|
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What is the MOA of DA?
|
*DA has a "D"
D1 = D2 > B > a |
|
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What is the MOA of Methyphenidate?
|
Amphetamines: Stimulates the release of stored Catecholamines
|
|
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What is the MOA of PE?
|
a1 > a2
|
|
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What is the MOA of Terbutaline?
|
B2 > B1
|
|
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What is the MOA of a-Methyldopa?
|
Centrally acting a-AGONIST decreases central adrenergic outflow
|
|
|
What are the non-selective a-blockers?
|
Phenoxybenzamine
Phentolamine |
|
|
How do you tell the non-selective a-blockers apart?
|
Phenoxybenzine is irreversible
Phentolamine is reversible |
|
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What is the c/u of the non-selective a-blockers?
|
Pheochromacytoma
|
|
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What is the SE's of the non-selective a-blockers?
|
Orthostatic Hypotension
Reflex Tachycardia |
|
|
What are the a1-blockers?
|
Prazosin
Terazosin Doxazosin Tamsulosin (a1-A blocker) |
|
|
What is the c/u of a1-blockers?
|
HTN
Smooth muscle-predominant BPH |
|
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What is the SE's of the a1-blockers?
|
Priapism (Prazosin)
1st-dose Orthostatic Hypotension |
|
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What are the a2-blockers?
|
Mirtazipine
Yohimbine |
|
|
What is the MOA of Mirtazapine?
|
a2, 5-HT2, & 5-HT3 receptor antagonist
|
|
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What is the c/u of Mirtazapine?
|
Depression
|
|
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What is the toxicity of Mirtazapine?
|
*1 causes 2 causes 3 causes 4 (not literally; just a mnemonic)
1. Increased appetite 2. Wt gain 3. Increased cholesterol 4. Sedation |
|
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What is the tx for epithelial-predominant BPH?
|
Finasteride
|
|
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What is the MOA of Finasteride?
|
5a-Reductase inhibitor
|
|
|
What is/are the SE(s) of B-Blockers?
|
Impotence
Exacerbates asthma Masks hypoglycemia in DM Cardiovascular efffects (bradycardia, AV block, CHF) CNS effects (sedation, sleep alteration) |
|
|
What are the B1-selective blockers?
|
*A BEAM
Atenolol Butaxolol Esmolol Acebutolol Metoprolol *Also: A-M except C & L (Carvedilol & Labetalol), but notice they don't end in "-olol" (most PURE B1 blockers end in "-olol" not just "-lol) |
|
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Which B-Blockers have intrinsic sympathomimetic activity
|
B-Blockers that "partially" block beta receptors AND are also a-agonists (incr'd SS's):
Oxprenolol Acebutolol Pindolol Penbutolol |
|
|
What is the tx of B-blocker toxicity?
|
Atropine followed by…
Glucagon |
|
|
What drugs decrease the secretion of aqueous humor?
|
*ABC-T
Acetazolamide Butaxolol Carteolol Timolol |
|
|
What drugs increase aqueous humor outflow?
|
*PP-CEEL (if there is no "pee-pee" there is no "outflow")
P = Pilocarpine (direct cholinomimetic) P = Physostigmine (indirect cholinomimetic) C = Carbachol (direct cholinomimetic) E = Epinephrine (a-agonist) E = Echothiophate (indirect cholinomimetic) L = Latanoprost (Prostaglandin = PGF-2a) Note: direct cholinomimetics = ACh rec agonist; indirect cholinomimetics = AChE-Inhibitors |
|
|
What drugs that decrease the synthesis of aqueous humor?
|
Briminodine
|
|
|
What are the DA Agonists?
|
*CPR LAB
Cabergoline Promipexole Ropinerole Levadopa/Carbidopa Amantidine Bromocriptine |
|
|
What drugs inhibit MAO-B?
|
Selegiline
|
|
|
What are the anti-Muscarinics?
|
Benztropine
|
|
|
What drugs inhibit COMT?
|
Talcapone
Entacapone |
|
|
What is the toxicity of Levadopa?
|
Arrythmia
Dyskinesia |
|
|
What is the MOA of Sumatriptan?
|
5HT-1D Agonist
|
|
|
What is the c/u of Sumatriptan?
|
Migraines
Cluster headaches |
|
|
What is the SE's of Sumatriptan?
|
Vasospasm
|
|
|
When & Why is Sumatriptan contraindicated?
|
Due to risk of vasospasm, Sumatriptan is contraindicated in:
Prinzmetal angina CAD Pregnancy (must order pregnacy test first) |
|
|
What is the tx for Trigeminal Neuralgia?
|
Carbamazepine
|
|
|
What is the tx for Peripheral Neuropathy?
|
Gabapentin
|
|
|
What is the DOC in children with Epilepsy?
|
Phenobarbital
|
|
|
What is the DOC for Myoclonic Seizures?
|
Valproic Acid
|
|
|
What is the DOC for Pre-Eclampsia?
|
Decrease BP by administering:
Labetolol a-Methyldopa |
|
|
What is the DOC for Eclampsia?
|
Mg2+ Sulfate followed by...
Benzodiazepines |
|
|
What is the tx for Status Epilepticus?
|
Treatment:
Benzodiazepines (DOC) & Intubation Prophylaxis: Phenytoin |
|
|
What is the DOC for Absence Seizures?
|
1. Ethosuximide
2. Valproic Acid |
|
|
What is the DOC for Tonic-Clonic Seizures?
|
1. Carbamazepine (#2) ??
2. Valproic Acid (#1) ?? 3. Phenytoin |
|
|
What is the tx for Febrile Seizures?
|
Anti-Pyretic
|
|
|
What is the tx for Infantile Spasms (US)?
|
Intermuscular ACTH
|
|
|
What is the DOC for a pt with upper limb spasticity and lower limb flaccidity?
|
Riluzole
|
|
|
What is the MOA of Riluzole?
|
Glutamate Inhibitor
|
|
|
What is/are the SE(s) of Topiramate?
|
Mental dulling
Renal stones Wt loss |
|
|
What is/are the SE(s) of Gabapentin?
|
Movement disorders
Nystagmus Wt loss |
|
|
What is/are the SE(s) of Lamotrigine?
|
SJS
|
|
|
What is/are the SE(s) of Ethosuxamide?
|
SJS
SLE Urticaria = mild form of SJS |
|
|
What is/are the SE(s) of Phenobarbital?
|
Sedation
Tolerance Dependence Induces P-450 |
|
|
What are the SE's of Phenytoin (one of the top 10 drugs tested on USMLE)?
|
*Indian men want a wife who is "LIGHT-skinned AND MMPSS"
Lymphadenopathy Induces P450 Gingival Hyperplasia Hirsutism Teratogenic (Fetal Hydantoin Syndrome) Ataxia Nystagmus Diplopia Megaloblastic anemia Malignant Hyperthermia Peripheral Neuropathy SLE Sedation |
|
|
What is the MOA of Phenobarbital?
|
Increase duration of Cl- Channel opening --> Increased GABA
|
|
|
What are the contraindications of Barbiturates?
|
Porphyrias
|
|
|
What is the MOA of Benzodiazepines?
|
Increase frequency of Cl- Channel opening --> Increased GABA
|
|
|
What are the short-acting Benzodiazepines?
|
*ATOM
Alprazolam Triazolam Oxazepam Madazepam |
|
|
What can abrupt cessation of Olprazelam cause?
|
Generalized seizures
|
|
|
What is the initial tx for an acute panic attack?
|
Motrazepam
|
|
|
What is the tx for Temazepam toxicity?
|
Flumazenil
|
|
|
What is the tx for alcohol withdrawal?
|
Chlordiazepoxide
|
|
|
What are the D2 Antagonists?
|
D2 Antagonists = Neuroleptics:
Fluphenazine Thioridazine Haloperidol Chlorpromazine Promazine |
|
|
What are the SE(s) of D2 Antagonists?
|
EPS Sx's
Neuroleptic Malignant Syndrome |
|
|
What are 3 features of Neuroleptic Malignant Syndrome?
|
Autonomic Instability
Hyperthermia Muscle Rigidity |
|
|
What are 3 features of Serotonin Syndrome?
|
CV Collapse
Hyperparexia Muscle Rigidity |
|
|
What is the Tx for Neuroleptic Syndrome?
|
Dantrolene AND Dopamine Agonist
|
|
|
What is the MOA of Dantrolene?
|
Inhibition of Ca2+ release by blocking Rhanidodine receptors at the cytoplasmic reticulum
|
|
|
What are 4 features of EPS and the timeline involved for each feature?
|
4 Hrs: Dystonia
4 Days: Akinesia 4 Wks: Akathisia 4 Mos: Tardive Dyskinesia |
|
|
What is the tx for Acute Dystonia?
|
Diphenhydramine
Benztropine Trihexyphenidyl |
|
|
What is the toxicity of Fluphenazine?
|
Hyperthermia due to disruption of the thermo-regulatory center
|
|
|
What are the atypical anti-psychotics?
|
*Its "ATIPical" for OLd CLOZets to "Risper" QUiETly
(they usually squeak loudly!) ATIPamezole OLanzapine CLOZapine RISPERidone QUETiapine Ziprasidone |
|
|
What is the MOA of atypical anti-psychotics?
|
Block 5-HT-2 & D2 receptors?
|
|
|
What drug blocks 5HT-3 receptors?
|
Ondansetron
|
|
|
What drug blocks 5-HT-2, 5-HT-3, & a2 receptors?
|
Mirtazipine
|
|
|
What drug is a 5HT-1D antagonist?
|
There is none
|
|
|
What drug is a 5HT-1D agonist?
|
Sumatriptan
|
|
|
What is/are the SE(s) of Clozapine?
|
Agranulocytosis
|
|
|
What is/are the SE(s) of Quetiapine?
|
Cataracts
|
|
|
What is/are the SE(s) of Olanzapine?
|
Weight gain
|
|
|
What is the MOA of Lithium?
|
Inhibition of Phosphoinositol Cascade
|
|
|
What is an alternative MOA of Lithium?
|
ADH receptor antagonist
|
|
|
What is the c/u for Lithium?
|
Mood Stabilizer
|
|
|
What are the "mood stabilizer" drugs?
|
Lithium
Valproic Acid Carbamazepine |
|
|
What is the toxicity of Lithium?
|
*LMNOP
L = Lithium M = Muscle rigidity = tremors N = Nephrogenic Diabetes Insipidus O = HyOthyroidism P = Pregnancy = Ebstein's Anomaly P = Psoriasis Exacerbation |
|
|
What are the SSRI's?
|
Sertraline
Fluoxetine Citalopram Paroxetine |
|
|
What is the DOC for OCD?
|
Paroxetine
|
|
|
What is the 2nd line tx for OCD?
|
Chlormipramine
|
|
|
What is the MOA of Chlormipramine?
|
Block the reuptake of NE & 5-HT (TCA's)
|
|
|
What are the TCA's?
|
*CANDID (PASS Program uses DD CAIN)
Clomipramine Amitriptyline Nortriptyline Desipramine Imipramine Doxepin |
|
|
Which TCA is LEAST sedating?
|
Desipramine
|
|
|
Which TCA has the MOST anti-cholinergic SE's?
|
Amitriptyline
|
|
|
Which TCA has the LEAST anti-cholinergic SE's?
|
Nortriptyline
|
|
|
What is the tx for enuresis (bedwetting)?
|
DOC = Desmopressin
TCA = Imipramine |
|
|
What is the DOC for a enuresis (bedwetting) in a pt > 5 y/o?
|
Desmopressin
|
|
|
What is the toxicity of TCA's?
|
*The 4 C's
Cardiotoxicity Confusion Convulsion Coma |
|
|
What is a heterocyclic that inhibits the reuptake of NE?
|
Maprotiline
|
|
|
What is the MOA of Trazadone?
|
Inhibition of 5-HT re-uptake?
|
|
|
What is the MOA of Venlafaxine?
|
Block the reuptake of NE, 5-HT, & DA
|
|
|
What is the tx for generalized anxiety?
|
Buspirone
Benzodiazapines |
|
|
What is the tx for generalized anxiety in a pt with a hx of Etoh addiction?
|
Buspirone
|
|
|
What ia the DOC for depression with sleep disturbances?
|
Trazodone
|
|
|
What is the DOC for depression with sexual dysfunction?
|
Bupropion
|
|
|
What is the DOC for smoking cessation?
|
Bupropion
|
|
|
What is a heterocyclic used for generalized anxiety?
|
Venlafaxine
|
|
|
What is the MOA for Phenelzine
|
Non-selective MAO-I
|
|
|
What are the contraindications for Phenelzine?
|
SSRI's
Meperidine |
|
|
MAO-I's cause hypertensive crisis when taken with what?
|
Foods with tyramine (e.g. cheese & wine)
B1-agonists (B1 --> Gs --> Incr'd cAMP --> Incr'd SS outflow --> Incr'd NE) |
|
|
If Nitrous Oxide has decr'd blood solublity & therefore it does not easily go into tissues, is the induction time fast or slow?
|
Fast
|
|
|
If Halothane has incr'd lipid solublity & therefore it easily enters tissues, is the recovery time fast or slow?
|
Cannot be determined
|
|
|
What is/are the SE(s) of Methoxyflurane?
|
Nephrotoxic
|
|
|
What is/are the SE(s) of Halothane?
|
Hepatotoxic
|
|
|
What is/are the SE(s) of Enflurane?
|
Convulsions (lowers seizure threshhold)
|
|
|
What is/are the SE(s) of Sevoflurane?
|
Malignant Hyperthermia
|
|
|
Why do we use Midazolam as an anesthetic?
|
B/c it causes anterograde amnesia
|
|
|
What is the c/u for Midazolam?
|
Endoscopic anesthesia
|
|
|
Why do we use Ketamine as an anesthetic?
|
Causes:
Incr'd cereberal blood flow Incr'd cardiac output and HR Dissociative amnesia |
|
|
What is the c/u for Ketamine?
|
Anytime you don't want to decrease the pt's HR and/or cardiac output:
e.g. Diastolic Coronary Dysfunction (HR) e.g. Neonate requiring surgery (CO) |
|
|
How is Phase I of Succinylcholine depolaring muscular blockade reversed? Why?
|
It CAN'T be reversed b/c post synaptic membranes are "stuck in" depolarization
|
|
|
How is Phase II of Succinylcholine depolaring muscular blockade reversed? Why?
|
Neostigmine
|
|
|
What is the toxicity of SuccinylCholine?
|
Fatal HyperKalemia
|
|
|
What Non-Depolarizing muscular blocker should be used in a pt with Renal Failure & Hepatic Failure? Why?
|
Atracurium b/c spontaneously degenerates in the blood, therefore it is neither renally nor hepatically excreted
|
|
|
With a nerve blocking agent, what nerve fiber is blocked last?
|
Large myelinated fibers
|
|
|
With a nerve blocking agent, what is the order of nerve fiber blockade by size AND myelination?
|
1st: small unmyelinated
2nd: small myelinated 3rd: large myelinated 4th: none* |
|
|
What is an atypical opiod used to control pain?
|
Tramadole
|
|
|
What drug binds to Delta receptors?
|
Enkaphalin
|
|
|
What drug binds to Kappa receptors?
|
Dynorphin
|
|
|
What drug binds to Mu receptors
|
Morphine
|
|
|
What Mu antagonist is used clinically to treat cough suppression?
|
DextroMethorphan (Robitussin DM ring a bell?)
|
|
|
What Mu antagonist is used clinically to treat Diarrhea?
|
Loperimide
Diphenoxylate |
|
|
What are the SE's of opiod toxicity?
|
Miosis
Constipation CNS depression Respiratory depression |
|
|
What is the tx for Fentanyl toxicity?
|
Naloxone
Naltrexone |
|
|
What drug is used for long-term maintenance tx for opiods?
|
Methadone
|
|
|
What is the MOA of Naproxin?
|
REVERSIBLY blocks Cox I & Cox II
|
|
|
What are the COX II Inhib's?
|
Valdecoxib
Celecoxib |
|
|
What is the c/u of COX II Inhib's?
|
Joint pain:
Osteoarthritis Rheumatoid Arthritis |
|
|
What is the MOA of Acetaminophen?
|
REVERSIBLY blocks Cox I & Cox II
|
|
|
What is the tx for Acetaminophen toxicity?
|
N-Acetylcysteine
|
|
|
What is the MOA of N-Acetylcysteine?
|
Regenerates glutithione & binds toxic metabolite NAPQI
|
|
|
What is the MOA of Aspirin?
|
Acetylates & IRRIVERSIBLY blocks Cox I & Cox II
|
|
|
What is/are the SE(s) of Indapamide?
|
*Hyper-GLUC:
HyperGlycemia HyperLipidemia HyperUricemia HyperCalcemia |
|
|
What is/are the SE(s) of Quinidine?
|
Severe rebound HTN
|
|
|
What is/are the SE(s) of Methyldopa?
|
Positive Coomb's Test
|
|
|
What is/are the SE(s) of Hexamethonium?
|
Sympatholytic
Severe orthostatic Hypotension Sexual Dysfunction Parasympatholytic Constipation Blurred Vision |
|
|
What is/are the SE(s) of Reserpine?
|
Depression
Diarrhea |
|
|
What is/are the SE(s) of Guanethidine?
|
Sexual Dysfunction
Diarrhea |
|
|
What is/are the SE(s) of Prazosin?
|
1st-dose Orthostatic Hypotension
Priapism |
|
|
What is/are the SE(s) of Hydralazine?
|
*SARS
SLE-like sx's Angina Reflex tachycardia Salt retention |
|
|
What is/are the SE(s) of Minoxidil (OTC Rogaine)?
|
*SHARP
Salt retention Hypertrichosis (too much hair) Angina Reflex tachycardia Pericardial effusion |
|
|
What is/are the SE(s) of Verapimil?
|
Constipation
|
|
|
What is/are the SE(s) of Nitroprusside?
|
Cyanide poisoning
|
|
|
What is/are the SE(s) of Captopril?
|
*CHAPTOPRIL where "H" = Hyperkalemia
C = Cough H = Hyperkalemia (b/c decr'd aldosterone) A = Angioedema P = Proteinuria T = Taste change O = HypOtension P = Pregnancy problems (fetal renal damage) R = Rash I = Incr'd renin L = Lowers Ang II & Aldosterone |
|
|
What is/are the SE(s) of Losartan?
|
Fetal renal toxicity
Hyperkalemia |
|
|
Which diuretic works in PCT?
|
Mannitol
Acetazolamide |
|
|
What is the MOA of Mannitol?
|
Osmotic Diuretic --> Incr'd tubular fluid osmolarity --> water follows --> therefore it "pulls water out" (i.e. into the urine)
|
|
|
What is the MOA of Acetazolamide?
|
CA inhibitor in the PCT
Pushes out HCO3- Pulls in Cl- |
|
|
Which diuretics work in the Loops?
|
Furosemide
Torasemide Bumetanide |
|
|
What is the MOA of Loop Diuretic?
|
Na+/K+/2Cl- reuptake inhibitor in TALLOH
Secondarily inhibits Na+/Ca2+ exchange --> throws pt into electrolyte abnormalities |
|
|
What is the c/u for Furosemide?
|
HTN
Edematous States: SEVERE (only) CHF Cirrhosis Renal Nephrotic Syndrome (secondary to CHF &/or Cirrhosis) Hypercalcemia |
|
|
What the hydrochlorothiazides?
|
Hydrochlorothiazide
Indapamide Metolazone Chlortalidone |
|
|
What is the MOA of Thiazides?
|
Na+ Cl- reabsorption in the DCT
|
|
|
What is the MOA of K+ Sparing drugs?
|
*SEAT
Aldosterone antagonists = Inhibiton of Aldosterone receptors in the CORTICAL collecting tubules Spironolactone Eplerenone Epithelial sodium channel blockers = Inhibition of Na+ Channels in the CORTICAL collecting duct Amiloride Triamterene |
|
|
What happens to BP when Nitrates are given?
|
Decreased
|
|
|
What happens to Contractility when Nitrates are given?
|
Reflexively Increased
|
|
|
What happens to Ejection time when Nitrates are given?
|
Decreased
|
|
|
What happens to Contractility when B-Blockers are given?
|
Decreased
|
|
|
What happens to HR when B-Blockers are given?
|
Decreased
|
|
|
What happens to Ejection Time when B-Blockers are given?
|
Increased
|
|
|
What happens to MVO2 when B-Blockers are given?
|
Decreased
|
|
|
What is the MOA and physiology leading to the effects of Digoxin?
|
1) Digoxin binds the K+ on the Na+/K+ pump preventing Na+/K+ exchange; K+ therefore stays outside the cell while Na+ accumulates inside the cell;
2) Na+ is then no longer exchanged with Ca2+; Ca2+ accumulates inside the cell; 3) Intracellular Ca2+ accumulations results in incr'd contractility |
|
|
What is the c/u for Digoxin?
|
CHF
Atrial Fibrillation |
|
|
What is the toxicity of Digoxin?
|
Torsades De Pointes Arrhythmia (i.e. prolonged QT) b/c of its effects on K+
Yellow vision |
|
|
What is the tx for Digoxin toxicity?
|
1) STOP DIGOXIN ADMINISTRATION!
2) Slowly normalize K+ 3) Lidocaine 4) Mg2+ 5) Digifab/Digibind 6) Pacemaker once stable (~2wks later) |
|
|
What are the Class III anti-arrhythmics?
|
Ibutilide
Sotalol Bretylium Amiodarone Dofetilide |
|
|
What is the MOA of Class III Anti-arrhythmics?
|
Blocks K+ leading to:
AP duration: Increased QT interval: Increased (i.e longer/slower) b/c intracellular K+ is incr'd & repolarization requires K+ ERP: Increased (b/c blocked K+) |
|
|
What are the Class IA anti-arrhythmics?
|
Quinidine
Amiodarone Procainamide Disopyramide |
|
|
What is the MOA & effects of Class IA Anti-arrhythmics?
|
Blocks Na+ AND K+ [leak] Channels leading to:
AP duration: Increased QT interval: Increased (i.e longer/slower) b/c repolarization requires K+ ERP: Increased (b/c blocked K+) |
|
|
What are the Class IB Anti-arrhythmics?
|
Lidicaine
Mexlotine Tocanimide Phenytoin |
|
|
What is the SE's of Tocanimide?
|
Pulmonary Fibrosis
|
|
|
What drugs cause Pulmonary Fibrosis?
|
*BBAT+
Bleomycin Busulfan Amiodarone Tocainide +Methotrexate & Cormustine |
|
|
What is the c/u for Class IB Anti-arrhythmics?
|
1) Post-MI Ventricular Arrhythmias
2) Lidicaine: 3rd step in tx for digioxin toxicity |
|
|
What is the toxicity of Lidicaine?
|
ASYSTOLE --> DEATH
(MOA = blocks Na+ Channels in the heart) |
|
|
What are the Class IC drugs?
|
Cainide
Flecainide Propafenone |
|
|
What is the MOA and effects of Class IC Anti-arrhythmics?
|
Class IC Anti-arrhythmics block Na+ channels EVERYWHERE!!
AP duration: No more AP's after "first fire" QT interval: No change b/c K+ didn't change &repolarization requires K+ ERP: No change (b/c no change in K+) |
|
|
What are the indications for Class IC Anti-arrhythmics?
|
When everything else fails:
Ventricular Tachycardia becomes Ventricutlar Fibrillation Intractable SVT |
|
|
What is the DOC for SVT?
|
DOC: Adenosine
2nd Line: Verapamil |
|
|
What class of anti-arrhythmic is Verapamil?
|
Class IV Anti-Arrhythmic
|
|
|
What is the MOA of Class IV Anti-arrhythmics?
|
Class IV = Cardio-selective CCB's:
|
|
|
What are the Class IV Anti-arrhythmics?
|
Verapimil
Diltiazam |
|
|
What are two other CCB's? Why aren't they anti-arrhythmics?
|
Nefidapine
Amlodipine They are NOT anti-arrhythmics b/c they are NOT cardio-selective (work in periphery) |
|
|
What is the MOA of Adenosine?
|
Hyperpolarizing AV nodal tissue by increasing K+ conductance and decreasing Ca2+ current:
Opens Ca2+ channels: decr'd Ca2+ Opens K+ [leak] channels: incr'd K+ (repolarization --> "hyperpolarizes" AV node) |
|
|
What effect do Statins have on LDL, HDL, & TG's?
|
LDL: Decreased
HDL: Increased TG's: Decreased |
|
|
What effect does Niacin have on LDL, HDL, & TG's?
|
LDL: Decreased
HDL: Increased TG's: Decreased |
|
|
What effect does Cholestepol have on LDL, HDL, & TG's?
|
LDL: Decreased
HDL: No effect (b/c works in gut) TG's: Slightly incr'd (indirect action: b/c decr'd GI absorption = LES --> incr'd lipolysis --> incr'd vLDL --> incr'd TG's) |
|
|
What effect do Fibrates have on LDL, HDL, & TG's?
|
LDL: Decreased
HDL: Increased (1st line drug) TG's: Decreased |
|
|
What effect do Probucol have on LDL, HDL, & TG's?
|
LDL: Decreased (increases LDL metabolism in last step of ch'ol elimination)
HDL: No effect TG's: No effect |
|
|
What is the MOA of Doxylamine?
|
REVERSIBLY inhibits H1 receptors
|
|
|
What is the c/u for Doxylamine?
|
Hyperemesis Gravidarum
Morning sickness |
|
|
With what drug is Doxylamine co-administered?
|
B6
|
|
|
What are the 1st Gen H1 blocker drugs?
|
Diphenhydramine
Dimenhydrinate Chlorpheniramine (aka Chlorphenamine) |
|
|
What are the 2nd Gen H1 blocker drugs?
|
Fexofenadine
Loratadine Desloratadine |
|
|
What is the c/u for 2nd Gen H1 blockers?
|
Allergies
|
|
|
A pt comes to your office with mild intermittent asthma; What is the 1st line tx?
|
Albuterol
|
|
|
What is the MOA of Albuterol?
|
B2 agonist leading to bronchidilation
|
|
|
A pt comes to your office with mild intermittent asthma & is having night-time flare-ups; the pt is currently taking Albuterol; What is the next step in management?
|
Add Prednisone
|
|
|
A pt comes to your office with mild persistent asthma and is currently having an acute exacerbation; the pt is currently taking Albuterol and low-dose prednisone; what is the next step in management?
|
Give a dose of Albuterol
|
|
|
A pt comes to your office with mild persistent asthma; the pt is currently taking Albuterol and low-dose prednisone; he is currently having an acute exacerbation & he has already rec'd ONE dose of Abluterol; what is the next step in management?
|
Give a 2nd dose of Albuterol
|
|
|
A pt comes to your office with mild persistent asthma; the pt is currently taking Albuterol and low-dose prednisone; he is currently having an acute exacerbation & he has already rec'd TWO doses of Abluterol; what is the next step in management?
|
Give a 3rd dose of Albuterol
|
|
|
A pt comes to your office with mild persistent asthma; the pt is currently taking Albuterol and low-dose prednisone; he is currently having an acute exacerbation & he has already rec'd THREE doses of Abluterol; what is the next step in management?
|
Give high-dose inhaled corticosteroids
|
|
|
An asthmatic pt with mild intermittient asthma currently on Albuterol who has not had a flare-up in two years comes to your office; what is the 1st step in management?
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Switch to Salmeterol, a long-acting B-agonist (prophylaxis)
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What is the MOA of Cromolyn Sodium?
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Inhibits mast cell degranulation
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What is the MOA of Methyxanthines?
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Inhibition of PDE --> decr'd cAMP hydrolysis --> incr'd cAMP --> incr'd SS outflow (& decr'd PS ouflow) --> BRONCHODILATION (e.g. Theophylline)
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What is the MOA of Zileuton?
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Inhibits 5-Lipoxygenase pathway thereby inhibiting the Leukotriene pathway
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What is the MOA of Zafirlukast/Montelukast?
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Inhibits Leukotriene receptors
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What is the tx for hepatic encephalopathy?
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Lactulose (synthetic sugar)
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What is the MC drug used to tx primary biliary cirrhosis?
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Ursodeoxycholic Acid (UDCA) or Ursodiol
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What are the SE's of Cimetidine?
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Impotence
Gynacomastia |
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What are the MOA of Cimetidine?
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REVERSIBLY blocks H2
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What is the c/u for Cimetidine?
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Peptic ulcers
Gastritis Mild esophogeal reflux |
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What is the MOA of Lansoprazole?
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PPI: IRREVERSIBLY inhibits the H+/K+ ATPase in gastric parietal cells
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What is the c/u for Lansoprazole?
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Peptic ulcers
Gastritis Esophageal reflux Zollinger-Ellison syndrome |
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What is the MOA of Bismuth?
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Allows HCO3- secretion to reastablish pH by covering the base of the ulcer & inhibiting gastric acid secretion
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What is the MOA of Mifepristone?
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Mifepristone = RU-486 aka the morning after pill
Progesterone antagonist used as an abortifacient |
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What is the MOA of Misoprostol?
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PGE-1 analog:
Decr'd acid production Incr'd mucous production/secretion |
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What is the tx for Gastric MALT with no "mets" (metatasis)?
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Clarithromycin (Macrolide)
Amoxicillin (G-) Omeprazole (PPI) NOTE: Lymphoma in the GI tract is normally due to Chronic H. Pylori infection; successfully tx H. Pylori & the Lymphoma goes away |
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What is the tx for Gastric MALT with no "mets" (metatasis) that doesn't respond to 1st line tx?
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*CHOP
C = Cyclophosphamide H = Hydroxydaunorubicin (aka Adriamycin/Doxorubicin) O = Oncovin (aka Vincristine) P = Procarbazine |
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What is the 1st Line tx for Rheumatoid Arthritis?
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Methotrexate
Hydroxychloroquine TNF-a inhibitors |
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What is the MOA of Abciximab?
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Monoclonal antibody to glycoprotein IIb/IIIa which REVERSIBLY inhibits the GP IIb/IIIa receptor
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What is the MOA of Infliximab?
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Monoclonal antibody to TNF-a
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What is the c/u of Infliximab?
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* CARS
Crohn's Ankylosing Spondylitis Rheumatoid Arthritis Scerotic Arthritis |
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What is the MOA of Sulfasalazine?
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Sulfasalazine = sulfa drug (antibiotic) + mesalazine (anti-inflammatory)
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What is the c/u of Sulfasalazine?
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Irritable Bowel Diseases (IBD's):
Ulcerative Colitis (UC) Crohn's Disease |
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What is the toxicity of Sulfasalazine?
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Reversible oligospermia
Drug-induced pancreatitis |
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What is the MOA of Heparin?
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Activates AT-III:
Decreases CF II (Thrombin) Decreases CF Xa |
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What is the MOA of Enoxaparin?
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Activates AT-III:
Decreases CF Xa |
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Which needs monitored with Enoxaparin (pT or pTT)?
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Neither with a LMWH
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What is the worst SE that we worry about with the use of Heparin?
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Thrombocytopenia (HIT)
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What is the tx for HIT?
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Argatroban
Lepirudin |
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What is the tx for Heparin toxicity?
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Stop Heparin administration
Protamine Sulfate |
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What is the MOA of Warfarin?
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Inhibits gamma-carboxylation of Vitamin K dependent coagulation factors:
II, VII, IX, X, Protein C, & Protein S |
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Which CF is lost first when Warfarin is administered (i.e. which one has the shortest T 1/2)?
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Protein C
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Which CF is lost last when Warfarin is administered (i.e. which one has the longest T 1/2)?
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CF II
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Pt comes to your office, he's on coumadin (i.e warfarin); he had a GI bleed last night; he is bleeding this morning; what is next step in management?
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1) STOP the Drug
2) Give FFP 3) Give Vitamin K |
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What are 4 drugs that inhibit the conversion of plasminogen to plasmin?
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There is only one:
Amino Caproic Acid |
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What is the tx of uremic coagulopathy seen in chronic renal failure?
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Desmopressin
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What is the MOA of Desmopressin?
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Increases the release of vWF & CF VIII from the endothelium
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What is the MOA of Clopidogrel?
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Inhibits plt aggregation by IRREVERSIBLY blocking ADP receptors on plt's which inhibits fibrinogen conversion in the formation of GP IIb/IIIa (i.e. GP IIb/IIIa isn't even formed)
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What is the MOA of Infliximab?
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Monoclonal antibody to TNF-a
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What is the MOA of Abciximab?
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*Spell it this way: ABcixAmAB --> that way it has 2 b's and 3 a's (IIb/IIIa)
Monoclonal antibody to glycoprotein IIb/IIIa which REVERSIBLY inhibits the GP IIb/IIIa receptor |
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What are the 1st Gen Sulfonylureas?
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Tolbutamide
Chlorpropamide |
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What are the 2nd Gen Sulfonylureas?
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Glyburide
Glipizide |
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What are the SE(s) of 1st Gen Sulfonylureas?
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Disulfiram-like reaction
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What are the SE(s) of 2nd Gen Sulfonylureas?
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Hypoglycemia
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What is the MOA of Sulfonylureas?
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Blocks K+ Channels leading to depolarization, therefore insulin release is increased due to increase in Ca2+
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What is the MOA of Sulfonylureas in IDDM pt's?
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It doesn't work in type I diabetics, b/c they don't have B-cells to make insulin
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What is the MOA of Metformin?
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Inhibits gluconeogenesis
Stimulates glycogenolysis |
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What is the SE(s) of Metformin?
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Lactic Acidosis
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What are the Glitazone drugs?
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Rosiglitazone
Pioglitazone |
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What is the MOA of Pioglitazone?
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Increases target cell receptor response to insulin via binding PPAR-gamma receptors
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What are the Alpha-glucosidase inhibitors ?
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Acarbose
Miglitol |
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What is the MOA of Leuprolide?
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GnRH Agonist (pulsatile fashion)
GnRH Antagonist (continuous fashion) |
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What is the c/u of Leuprolide (pulsatile fashion)?
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Infertility
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What is the c/u of Leuprolide (continous fashion)?
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Prostate cancer
Uterine fibroids Idopathic precocious puberty |
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What drugs tx precocious puberty?
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Leuprolide (continous fashion)
Danazol |
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What is the MOA of Danazol?
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Synthetically-modified testosterone
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What is the MOA of Methimazole?
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Inhibits thyroid peroxidase (central only) therefore it inhibits organification & coupling
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What is the MOA of PTU?
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Central: Inhibits thyroid peroxidase therefore it inhibits organification & coupling
Peripheral: Blocks conversion of T4 to T3 |
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What is the MOA of Flutamide?
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Non-steroidal androgen antagonist at the testosterone receptor (i.e. testosterone antagonist)
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What is the c/u of Flutamide?
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Prostate cancer
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What is the MOA of Sildenafil?
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Inhibits cGMP phosphodiesterase (PDE) leading to incr'd cGMP
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What is the c/u of Sildenafil?
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Erectile Dysfunction
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What is the SE(s) of Sildenafil?
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Blue-Green color vison
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What are the contraindications of Sildenafil?
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Currently taking Nitroglycerides
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What is the MOA of Clomifene Citrate?
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Partial estrogen receptor agonist in the pituitary, increasing LH & FSH
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What is the c/u of Clomifene Citrate?
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Infertility
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What is the SE(s) of Clomifene Citrate?
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Ovarian hyperstimulation syndrome (OHSS) --> Ovarian torsion --> ovarian infarction --> OVARIAN FAILURE!!!
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What is the tx for Lichen Sclerosis?
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High-Dose Steroids:
Clobetasol Halobetasol |
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What is the tx for Hypertrophic Dystrophy of the Vulva?
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1% Corticosteroid cream
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What is the tx for Atrophic Vaginitis in a woman without a uterus?
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Estrogen cream
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What is the tx for Atrophic Vaginitis in a woman with a uterus?
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Estrogen-Progesterone (estrogen cream alone can lead to cervical cancer)
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What is the tx for Luteal Phase Defects?
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1st Line: Progesterone
2nd Line: Clomiphene Citrate or Human Menopausal Gonadotropin (hMG) |
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What is the tx for dysfunctional uterine bleeding (DUB)?
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High-Dose IV Estrogen
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What is the MOA of Misoprostol?
|
PGE-1 analog:
Decr'd acid production Incr'd mucous production/secretion |
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What is the MOA of Mifepristone?
|
Mifepristone = RU-486 aka the morning after pill
Progesterone antagonist used as an abortifacient |
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What is the tx for Acute Gout?
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Colchicine
Indomethacin |
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What is the MOA of Indomethacin?
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REVERSIBLY inhibits the Cox I & Cox II
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What is the MOA of Colchicine?
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Depolarizes microtubules:
Impairs leukocyte chemotaxis Impairs mast cell degranulation |
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What is the tx for Chronic Gout?
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Probenecid
Allopurinol |
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What is the MOA of Allopurinol?
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Inhibits Xanthine Oxidase
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What is the alternative use of Allopurinol?
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Tumor Lysis Syndrome (secondary to chemotherapy tx for Lymphomas/Leukemias)
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What is the MOA of Probenecid?
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Inhibits reabsorption of uric acid
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What are the MOPP drugs?
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*MOPP
M = Mechlorethamine* O = Oncovin (aka Vincristine) P = Prednisone P = Procarbazine *aka Mustargen, Mustine, Nitrogen Mustard, or MSD |
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What are the ABVD drugs?
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*ABVD
A = Adriamycin* B = Bleomycin V = Vinblastine D = Dacarbazine *aka Doxorubicin, Hydroxydoxorubicin, or Hydroxydaunorubicin |
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What are the CHOP drugs?
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*CHOP
C = Cyclophosphamide H = Hydroxydaunorubicin (aka Adriamycin/Doxorubicin) O = Oncovin (aka Vincristine) P = Procarbazine |
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What are the Antimetabolites?
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Antimetabolite = Nucleotide Analogues
Methotrexate 5-FU 6-MP Cytarabine (ARA-C) |
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What are the Alkylating Agents?
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Alkylating Agent = binds/breaks dsDNA
Bleomycin Busulfan Cyclophosphamide Nitrosoureas Cisplatin/Carboplatin Procarbazine |
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What are the Plant Alkaloids?
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Plant Alkaloid = Microtubule Inhibitor
Vincristine/Vinblastine Paclitaxel Etoposide |
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What are the non-chemotherapy Plant Alkaloids?
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Plant Alkaloid = Microtubule Inhibitor
Colchicine (used to tx Gout) Griseofulvin (anti-fungal) |
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What are the Leukemia drugs?
|
Methotrexate
6-MP Imantinib |
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What are the Lymphoma drugs?
|
Methotrexate
6-MP Doxorubicin Bleomycin Vincristine Vinblastine |
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What are the Choriocarcinoma drugs?
|
Methotrexate
Vincristine Vinblastine |
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What are the Sarcoma drugs?
|
Methotrexate
Doxorubicin |
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What are the Colon Cancer drugs?
|
5-FU
Imantinab (stromal) |
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What are the Solid Tumor drugs?
|
5-FU
Doxorubicin |
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What are the Basal Cell drugs?
|
5-FU
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What are the CML drugs?
|
Busulfan
Imantinib |
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What are the AML drugs?
|
Cytarabine (aka ARA-C)
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What are the NHL drugs?
|
*CHOP:
C = Cyclophosphamide H = Hydroxydaunorubicin (aka Adriamycin/Doxorubicin) O = Oncovin (aka Vincristine) P = Procarbazine |
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What are the Breast Cancer drugs?
|
Cyclophosphamide
Tamoxifen/Raloxifen Cisplatin/Carboplatin Trastuzumab Paclitaxel Doxorubicin (solid) |
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What are the Ovarian Cancer drugs?
|
Cyclophosphamide
Paclitaxel Doxorubicin (solid) |
|
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What are the Brain Tumor drugs?
|
Nitrosureas
|
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What are the Bladder Cancer drugs?
|
Cisplatin/Carboplatin
|
|
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What are the Testicular Cancer drugs?
|
Cisplatin/Carboplatin
Bleomycin Etoposide |
|
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What are the Lung Cancer drugs?
|
Cisplatin/Carboplatin
Etoposide Doxorubicin |
|
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What are the Wilms Tumor drugs?
|
Dactinomycin
Vincristine/Vinblastine |
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What are the Ewing's Sarcoma drugs?
|
Dactinomycin
|
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What are the Rabdomyosarcoma drugs?
|
Dactinomycin
|
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What are the Prostate Cancer drugs?
|
Etoposide
|
|
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What are the GI Stromal Tumor drugs?
|
Imatinib
|
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What are the Hairy Cell Leumkemia drugs?
|
Cladribine
|
|
|
What does the complex of 5-FU-DMP inhibit?
|
Thymidylate Synthase
|
|
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By what is 6-MP activated?
|
HGPTRase
|
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What is the SE(s) of Busulfan?
|
Pulmonary Fibrosis
|
|
|
What is the tx for ifosfamide toxicity?
|
MESNA (for ifosfamide/cyclophosphamide toxicity)
|
|
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What is the MOA of MESNA?
|
Traps acrolein
|
|
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What is the SE's of Adriamycin toxicity?
|
Cardiotoxic
Alopecia |
|
|
What is the treatment of Adriamycin toxicity?
|
(Adriamycin = Doxorubicin)
Tx = Dexrazoxane |
|
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What is the MOA of Cisplatin/Carboplatin?
|
Cisplatin is a platinum-based chemo drug that crosslinks DNA (source = Wikipedia):
1) Hydrolysis of chloride ligands from the platinum complex 2) H2O is easily displaced, allowing the platinum to coordinate to a basic site in DNA 3) Crosslinking of 2 Guanine bases occurs via displacement of the other chloride ligand 4) Crosslinking ultimately triggers apoptosis |
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|
What is the DOC for Cancer-associated anorexia?
|
Megestrol Acetate
|
|
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What is the DOC for mild/moderate hypercalcemia seen in malignancy (e.g. Multiple Myeloma)?
|
Zoledronic Acid
|
|
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What phase of the cell cycle does Etoposide work?
|
G2 & late S phases
|
|
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What is the MOA of Tamoxifen?
|
Partial estrogen receptor agonist (endometrium) AND antagonist (breast)
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|
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What is the MOA of Trastusumab?
|
Monoclonal antibody to HER-2 receptors
|
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What phase of the cell cycle will not be complete with Vincristine/Vinblastine?
|
M-Phase
|
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What phase of the cell cycle will not be complete with Paclitaxel?
|
M-Phase
|
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What phase of the cell cycle will not occur with Paclitaxel?
|
Anaphase
|
|
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What is the MOA of Paclitaxel?
|
Hyperstablizes the microtubles so that they cannot be breaken down
|
|
|
What is the MOA of Cyclosporine?
|
Inhibits Calcineurin, therefore IL-2 (which comes from Th-1 cells) is not made
|
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What is the MOA of Tacrolimus?
|
Tacrolimus binds FK binding protein, forming a complex which interacts with and inhibits Calcineurin, therefore IL-2 (which comes from Th-1 cells) is not made
|
|
|
What is the MOA of Azathioprine?
|
DNA synthesis inhibitor: Anti-metabolite derivative of 6-MP
|
|
|
What is the SE(s) of Azathioprine?
|
Drug-Induced Pancreatitis
|
|
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What is the "specific" c/u for Azathioprine?
|
Renal transplants
|
|
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What is the c/u for Aldesleukin?
|
Renal cell carcinoma and metestatic melenoma
|
|
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What is the MOA of Aldesleukin?
|
IL-2 Analogue
|
|
|
What is the MOA of Epoetin?
|
Erythropoetin Analogue
|
|
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What is the c/u for Epoetin?
|
Anemias
|
|
|
What is the MOA of Sargramostim?
|
GM-CSF (Granulocyte/Macrophage - Colony Stimulating Factor)
|
|
|
What is the c/u of Sargramostim?
|
BM Suppression
|
|
|
What is the c/u of INF-a?
|
Hepatitis B
Hepatitis C Kaposi's Leukemia Malignant Melanoma Carcinoid |
|
|
What is the c/u of INF-B?
|
MS
|
|
|
What is the c/u of INF-gamma?
|
CGD (NADPH oxidase deficiency)
|
|
|
What is the MOA of Oprelvekin?
|
IL-11 Analogue
|
|
|
What is the c/u of Oprelvekin?
|
Thrombocytopenia
|
|
|
What drugs cause Drug-Induced Pancreatitis?
|
Tetracyclines
Metronidazole Valproic Acid Didanosine (DDI) Aerosolized Pentamidine Loop Diuretics Sulfasalazine Azothioprine |
