Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
736 Cards in this Set
- Front
- Back
REVIEW:
|
|
|
If 87.5% of a drug has been eliminated from the body, how many half-lifes have occurred?
|
"3 half-lifes
|
|
If 50% of a drug remains in the body, how many half-lifes have occurred?
|
1 half-life
|
|
How is half-life calculated?
|
T1/2 = Vd/Cl x 0.7
|
|
How is Loading Dose calculated?
|
LD = (Css x Vd) / f
|
|
How is Maintenance Dose calculated?
|
MD = (Css x Cl) / f
|
|
How is Clearance calculated?
|
Cl = Amount eliminated / Css
|
|
What are 3 drugs that undergo zero-order elimination?
|
"*EPA-Ethanol, Phenytoin, Aspirin (high dose)
|
|
What are the Phase II elimination reactions?
|
*GAS
Glucoronidation Acetylation Sulfonation |
|
What are the Phase I elimination reactions?
|
*HOR
Hydrolysis Oxidation Reduction |
|
Which elimination phase (I or II) is lost first?
|
Phase I
|
|
What question is answered by Phase I drug development?
|
Is it safe?
|
|
What question is answered by Phase II drug development?
|
Does it work?
|
|
What question is answered by Phase III drug development?
|
FDA double-blind study
|
|
What question is answered by Phase IV drug development?
|
Post-market surveillance: What SE's exist?
|
|
How do we calculate Therapeutic Index?
|
*TILE
TI = LD50/ ED50 |
|
What direction does a noncompetitive antagonist shift the potency curve (right, left, up, or down)?
|
It doesn't: potency (Km) is not affected
|
|
What direction does a competitive antagonist shift the efficacy curve (right, left, up, or down)?
|
It doesn't: efficacy (Vmax) is not affected
|
|
What are the peptidoglycan synthesis inhib's?
|
Bacitracin
Vancomycin Cycloserine |
|
What are the 50s Inhib's?
|
CCELLS (Buys AT 30 CCELLS at 50)
Chloramphenicol Clindamycin Erythromycin Lincomycin Linezolid Streptogramins |
|
What are the Macrolides?
|
*ACE
Azithromycin Clarithromycin Erythromycin |
|
What are the Streptogramins?
|
Dalfopristin
Quinopristin |
|
What are the 30s Inhib's?
|
*AT (Buys AT 30 CCELLS at 50)
Aminoglycosides (AMG's) Tetracyclines |
|
"
|
|
|
What are the AMG's?
|
*STANG
Streptomycin Tobramycin Amikacin Neomycin Gentamicin |
|
"
|
|
|
What are the Nucleotide Synthesis Inhib's?
|
Sulfonamides
Trimethoprim Methotrexate Pyrimethamine |
|
"
|
|
|
What blocks mRNA Synthesis
|
Rifampin
|
|
What blocks DNA Topoisomerase II?
|
Quinolones
|
|
What drugs destroy fungal AND bacterial membranes?
|
Polymixins (Polymixin B & Polymixin E)
|
|
What is the toxicity of Polymyxins?
|
ATN (acute tubular necrosis)
Neurotoxicity |
|
What is the MOA of Penicillins?
|
1. Bind PBP's
2. Activates autolytic enzymes 3. Inhibits transpeptidase x-linking |
|
"
|
|
|
What is the c/u of Penicillins?
|
G+ rods, G+ cocci
G- cocci Spirochetes |
|
What does Penicillin toxicity cause?
|
Hypersensitivity
Hemolytic Anemia |
|
"
|
|
|
What does Methicillin toxicity cause?
|
Interstitial nephritis
|
|
What is the c/u for Methicillin?
|
Staph Aureus
|
|
What are the anti-Staph Penicillins?
|
*CONDM
Cloxacillin Oxacillin Nafcillin Dicloxacillin Methicillin |
|
What are the anti-Pseudomonas Penicillins?
|
*PTC of Pseudomonas in the AM
Piperacillin Ticarcillin Carbenicillin Azlocillin Mezlocillin |
|
What is the c/u of Ampicillin/Amoxicillin?
|
*HELPS Enterococci
H. Influenza E. Coli Listeria Proteus Salmonella Enterococci |
|
What does Ampicillin/Amoxicillin toxicity cause?
|
Hypersensitivity
Ampicillin Rash Pseudomembranous Colitis |
|
Which antibiotics cause Pseudomembranous Colitis?
|
Ampicillin/Amoxicillin
Clindamycin |
|
What is the MOA of Clindamycin?
|
Inhibition of bond formation between nucleotides at the P site
|
|
What is the c/u of Clindamycin?
|
Anaerobes above the diaphram
|
|
What is the tx for Pseudomembranous Colitis?
|
Metronidazole
Vancomycin |
|
What is the MOA of Metronidazole?
|
Form toxic metabolites in the bacterial cell wall that damage DNA
|
|
What is the c/u for Metronidazole?
|
*GET GAP on the Metro
Giardia Entomeba Trichamonas Gardnerella Anaerobes (below diaphragm?) H. Pylori |
|
What is the toxicity of Metronidazole?
|
Disulfram-like reaction with alcohol
Dysguzia Drug-induced Pancreatitis Teratogenic |
|
What is the tx for bacterial vaginosis for pregnant pt's?
|
Metro cream
Clindamycin cream |
|
What is the DOC for Gardnerella Vaginosis?
|
Tinidazole
|
|
What is the MOA of Vancomycin?
|
Blocks peptidoglycan synthesis by inhibiting D-ala D-ala
|
|
What is the c/u for Vancomycin?
|
MRSA
Pseudomembranous Colitis (C. Difficile) Any Nosocomial infection |
|
"
|
|
|
What is the toxicity of Vancomycin?
|
*There is NOT toxicity
Neurotoxic Ototoxic Thrombophlebitis |
|
What is the tx for VRSA?
|
Linezolid
Streptogramins (-pristins) |
|
What is the tx for local impetigo?
|
Topical Mupirocin
Oral Erythromycin |
|
What is the c/u for 2nd Gen Ceph's?
|
*HEN PEcKS (c = cocci)
H. Influenza Enterobacter Neisseria Proteus E. Coli Klebsiella Serratia G+ cocci |
|
What is a 3rd Gen Ceph used for the tx of Pseudomona?
|
Ceftazidime
|
|
What is a 3rd Gen Ceph used for the tx of Gonorrhea?
|
Ceftriaxone
|
|
What are the Ceph's used for the tx of Gonorrhea?
|
*TRI to FIX a FOX
CefTRIaxone CeFIXitine CeFOXitime |
|
What is the one-dose tx for Clamydia?
|
Azithromycin
|
|
What is the MOA of Azithromycin?
|
*Inhibits ""Macroslide"" (macro = 50s; slide = translocation)
Blocks translocation from the A-->P site by binding the 23s subunit of the 50s ribosome |
|
What is the c/u of Azithromycin?
|
*UPS Lost My Brand New Car
URI's (caused by G+ cocci) Pneumonia (caused by G+ cocci) STD's (caused by G+ coci) Legionella Mycoplasma Bordatella Pertussis Neisseria Chlamydia |
|
What are the SE's of Azithromycin?
|
Acute Cholestatic Hepatitis
Eosinophilia |
|
What is a 3rd Gen Ceph that cause a Disulfram-like reaction with Etoh?
|
"*PAIR of FAMily ""TETS"" (tits)
***Cefaparazone (3rd gen) Cefemandole (2nd gen) Cefetetan (2nd gen) |
|
What is the MOA of Aztreonam?
|
*AzTHREEonam
Binds to PBP #3 |
|
What is the c/u of Aztreonam?
|
G- rods in pt's who cannot tolerate AMG's
OR Pt's allergic to Penicillin OR Pt's with Renal Failure |
|
What is the DOC for G- rods?
|
AMG's
|
|
What is the MOA of AMG's?
|
Inhibits initiation complex of N-acetyl formation causing misreading of mRNA
|
|
What is the toxicity of AMG's?
|
*There is NNO toxicity
Neurotoxic (teratogenic) Nephrotoxic Ototoxic |
|
With what is imipenem co-administered? Why?
|
Cilistatin
|
|
What is the MOA of Cilistatin?
|
Inhibits renal dihydropeptidase-1
|
|
What is the c/u of imipenem/cilistatin?
|
Enterobacter (DOC)
|
|
What are the Ototoxicity-causing drugs?
|
AminOglycides (AMG's)
LOops (Furosimide VancOmycin ChlOroquine Quinidine |
|
MOA of Tetracyclines?
|
Protein synthesis inhibition by preventing amino acyl tRNA attachment
|
|
What is the c/u for Tetracyclines?
|
*VACUuM The BR
Vibrio Cholerea Acne (Propionibacterium Acnes) Chlamydia Ureaplasma Urealyticum Mycoplasm Tularemia H. Pylori Bordetella Rickettsia |
|
What is the toxicity of Tetracyclines?
|
Discoloration of teeth (children)
Abnormal bone growth (children) Photosensitivity Drug-induced Hepatitis Fanconi Syndrome (old Tetracyclines) |
|
"
|
|
|
What is the tx of Cat-Scratch Fever?
|
"Bug = Bartonella Henselae
Tx = Azithromycin |
|
|
|
|
What is an alternative MOA of Dimiclocycline?
|
Blocks ADH receptors
|
|
What drugs block ADH receptors?
|
Dimiclocycline
Lithium |
|
"
|
|
|
What is an alternative MOA of Erythromycin?
|
Binds to motilin receptors, causing hypermotility motility --> GI upset
|
|
What is the MOA of Chloramphenicol?
|
"Inhibits Peptidyltransferase, the enzyme responsible for transferring nucleotides from A --> P site
|
|
"
|
|
|
What is the c/u of Chloramphenicol?
|
Bacterial Meningitis
|
|
What is the toxicity of Chloramphenicol?
|
Dose-dependent Anemia
Dose-Independent Aplastic Anemia Grey Baby Syndrome (premature infants that lack UDP-glucuronyl transferase) |
|
"
|
|
|
What is the MOA of Sulfonamides?
|
Inhibition of Dihydropterate Synthase
|
|
What is the MOA of Trimethoprim?
|
Inhibition of Dihydrofolate Reductase
|
|
What drugs inhibit DHF Reductase?
|
TriMETHoprim
PyroMETHamine METHotrexate |
|
"
|
|
|
What is the toxicity of Sulfonamides?
|
Displaces drugs from albumin (e.g. Warfarin)
Hemolytic Anemia (G6PD def pt's) Hypersensitivity Kernicteris (kids) Tubulointerstitial Nephritis Photosensitivity |
|
"
|
|
|
What is the c/u for Trimethoprim?
|
*NUPSS
Norcardia UTI PCP Salmonella Shigella |
|
"
|
|
|
What is the toxicity of Trimethoprim?
|
Megaloblastic Anemia
|
|
What is the c/u for Fluoroquinolones?
|
"G- rods in GI/GU track
|
|
|
|
|
What is the toxicity of Fluoroquinolones?
|
Tendonitis (adults)
Cartilage rupture (kids) Torsades de Pointes w/ Moxifloxicin |
|
|
|
|
If a pt has a positive PPD test but negative CXR, what is the next step mgmt?
|
INH for 6 - 9 months
+ Vit B6 (b/c INH depletes B6) |
|
"
|
|
|
What is the MOA of INH?
|
Decreases synthesis of mycolic acid
|
|
What is the toxicity of INH?
|
Drug-induced SLE
Neurotoxicity (that's why we give B6) Hepatotoxicity Hemolytic anemia (G6PD pt's) |
|
"
|
|
|
If a pt has a positive PPD test and positive CXR, what is the next step mgmt?
|
*RESPI
Rifampin Ethambutol Streptomycin (added if necessary) Pyrazinamide INH |
|
"
|
|
|
What is the 2nd line tx of TB?
|
Cycloserine
|
|
What is the MOA of Cycloserine?
|
Inhibition of peptidoglycan synthesis
|
|
What is the MOA of Ethambutol?
|
Inhibits Arabinosyl Tranferase
|
|
What is the toxicity of Ethambutol?
|
Optic Neuritis
Central Scotoma |
|
"
|
|
|
What is the MOA of Rifampin?
|
Blocks mRNA synthesis by inhibiting DNA-Dependent RNA Polymerase
|
|
What is the c/u of Rifampin?
|
TB
Meningiococcal Prophylaxis (close contacts of Pt's with Hib) Delays Dapsone resistence in the tx of Leprosy |
|
"
|
|
|
What is the MOA of Dapsone?
|
Inhibition of bacterial DHF synthesis by binding Dihydropteroate Synthetase
|
|
What is the c/u of Dapsone?
|
Leprosy
Dermatitis Herpetoformis (Celiac Sprue) Delays Rifampin resistence in tx of TB 3rd line tx for PCP |
|
"
|
|
|
What is the toxicity of Dapsone?
|
*HAM (that ham bone)
Hemolytic Anemia Agranulocytosis Methemoglobinemia |
|
"
|
|
|
What are the drugs that cause Agranulocytosis?
|
*Come Carry Cloe, you Dumb Part Time Mom..AGgravating"
Colchicine Carbamazapine Clozapine Dapsone PTU Ticlopidine Methimazole |
|
"
|
|
|
What drugs inhibit Fungal DNA Synthesis?
|
Griseofulvin (microtubules)
Flucytosine (changes uracil to fluro-uricil) |
|
"
|
|
|
What drugs INHIBIT Fungal Membrane Synthesis?
|
*CAT stops the membrane
Caspofungin 'Azoles' Terbinafine |
|
"
|
|
|
What drugs DESTROY fungal Membranes?
|
Amphotericin B
Nystatin |
|
Nystatin"
|
|
|
What is the "specific" MOA for Flucytosine?
|
Changes uracil to fluro-uracil
|
|
What is the MOA of Caspofungin?
|
Inhibits Theta-13 Delta-Glucan
|
|
What is the MOA of Terbinafine?
|
Inhibits cell wall synthesis by blocking squaline epoxidase
|
|
What is the MOA of Griseofulvin?
|
Binds microtubules, arresting the cell in mitosis
|
|
What is the MOA of Amantidine?
|
Prevents viral ""uncoating""
Prevents viral "penetration" Increases DA |
|
"
|
|
|
What is the c/u for Amantidine?
|
*Influenza A, RubellA & the CerebellA
Influenza A RubellA Parkinson's (CerebellA) |
|
"
|
|
|
What is the MOA of Oseltamivir and Zanamivir?
|
Inhibits viral influenza neuraminidase, decreasing the release of viral progeny
|
|
What is the c/u of Oseltamivir and Zanamivir?
|
Influenza A and B
|
|
What is the MOA of Ribavirin?
|
Inhibits Guanine nucleotide synthesis by competitively inhibiting IMP Dehydrogenase
|
|
What is the c/u of Ribavirin?
|
Chronic Hepatitis C
RSV |
|
"
|
|
|
What is the tx for chronic Hepatitis C?
|
Ribavirin
INF-Alpha |
|
|
|
|
What is the tx for Hepatitis B?
|
INF-alpha
Lamuvidine |
|
"
|
|
|
What are the SE's of the Lamuvidine?
|
Lactic acidosis
|
|
What are the 3 letters for Lamuvidine?
|
3TC
|
|
What is the MOA of Acyclovir?
|
Inhibition of viral DNA polymerase when phosporylated by the VIRAL thymidine kinase
|
|
What is the c/u of Acyclovir?
|
Any HSV except HSV III (shingles) and HSV V (CMV)
|
|
What are HSV I thru HSV VIII?
|
HSV I = Oral herpes
HSV II = Genital herpes HSV III = VZV (shingles) HSV IV = EBV HSV V = CMV HSV VI = Roseola HSV VII = Pyteriasis Rosie HSV VIII = Kaposi's Sarcoma |
|
"
|
|
|
What is the tx for CMV
|
Ganciclovir or Foscarnet
|
|
What is the MOA of Foscarnet?
|
Binds to pyrophosphate binding site; does NOT require phosphorylation by viral Thymidine Kinase
|
|
"
|
|
|
Name all the protease inhibitors?
|
*SIR AN (NAVIR tease a protease)
Saquinavir Indinavir Rotinavir Amprenavir Nelfinavir |
|
"
|
|
|
What is the MOA of the protease inhibitors?
|
Inhibition of aspartate protease
|
|
What is the Toxicity of Indinavir?
|
Crystal-induced nephropathy
Thrombocytopenia (dec platelets) |
|
"
|
|
|
What are the NNRTI's?
|
*Nevada/Deleware/E-Fuck Virus or NEVIR Efir (ever) DELiver nucleosides
Nevirapine Delaviridine Efavirenz |
|
"
|
|
|
What is the SE of Nevirapine?
|
SJS
Hepatotoxicity |
|
|
|
|
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 Acidois * SJS *Peripheral Neuropathy Lamuvidine (3TC) *Lactic Acidosis Stavudine (D4T) *Lactic Acidosis *Peripheral neuropathy Abacavir (ABC) *Lactic Acidosis *Hypersensitivity Syndrome |
|
"
|
|
|
What is the MOA of Enfurvitide?
|
Binds to GP41 & prevents VIRAL & CELLULAR membrane fusion
|
|
What is the tx for African Trypanosomiasis (aka African Sleeping Sickness)?
|
Suramin
|
|
What is the tx for Chagas?
|
Nifurtimox
|
|
What is the 2nd line tx for PCP?
|
Aerosolized Pentamidine
|
|
What is the tx for Entamoeba Histolytica?
|
Metronidazole
|
|
What is the tx for latent hypnozyte?
|
Primaquine
|
|
How do you tx for Chloraquine-resistent malaria?
|
Methloquine
|
|
What is the tx for Leishmaniasis?
|
Pentavir Antimony
Na+ Stipigluconate |
|
"
|
|
|
What is the tx for Diphyllobothrium Latum?
|
Niclosamide
|
|
What is the tx for Paragonimus Westermani?
|
Praziquental
|
|
What is the tx for Enterobius Vermacularis?
|
Pyrantal Pamoate & Mebendazole (on day 11 he says Praziquental & Mebendazole)
|
|
What is the tx for Nematodes?
|
Mebendazole
|
|
What is the tx for Onchocerca (River Blindness)?
|
Ivermectin
|
|
What is the tx for Clonorchis Sinensis?
|
Praziquental
|
|
What is the drug that inhibits the conversion of Acetyl CoA to ACh?
|
Vesimicol
|
|
What drug inhibits the uptake of choline?
|
Hemicholinium
|
|
What drug inhibits the release of ACh?
|
Botulinum Toxin
|
|
What drug inhibits the conversion of DA to NE?
|
Reserpine
|
|
What drug inhibits the release of NE?
|
Guanethidine
|
|
What drug stimulates the release of NE?
|
Amphetamine
|
|
What drug inhibits the re-uptake of NE?
|
Cocaine
TCA's |
|
"
|
|
|
What receptor stimulates NE release?
|
Angiotensin II
|
|
What receptor inhibits NE release?
|
M1 & a2
|
|
What are the direct-acting cholinomimetics?
|
Bethanacol
Carbichol Methanacol Pilocarpine |
|
"
|
|
|
What are the indirect-acting cholinomimetics?
|
Neostigmine
Pyridostigmine Physostigmine Edrophonium Echothiophate Rivastigmine Galantamine Tacrine Donepezil |
|
"
|
|
|
How does AChE-I poisoning present?
|
*ADDUMBBELSS
Abdominal cramping Diaphoresis Diarrhea Urination Miosis Bradycardia Bronchospasm Excitation of skeletal muscle Lacrimation Secretion Salivation |
|
"
|
|
|
What is the tx for AChE-I poisoning?
|
Atropine followed by...
Pralidoxime (2-PAM) |
|
"
|
|
|
What is the tx for Type III Heart Block?
|
Atropine
|
|
What is the surgical tx for Type III Heart Block?
|
Pacemaker
|
|
What are the AFFECTS of Atropine?
|
"Blocks SLUD (anti-PS):
Salivation Lacrimation Urination Defication |
|
"
|
|
|
What is TOXICITY of Atropine?
|
"*Hot as a Hare, Dry as a Bone, Red as a Beet, Blind as a Bat, Mad as a Hatter"
Hyperthermia Decreased Sweating/Lacrimation Flushing Mydriasis & Cycloplegia Disorientation & confusion |
|
"
|
|
|
What is the MOA of Fenoldopam
|
D1 Agonist
|
|
What is the MOA of Epinephrine?
|
B1 > B2 > a1 > a2
|
|
What is the MOA of NE?
|
a1/a2 > B1
|
|
What is the MOA of Isoproterenol?
|
B1 = B2
|
|
What is the MOA of Dobutamine?
|
"*Dobutamine has a ""B""
B1>B2 |
|
"
|
|
|
What is the MOA of DA?
|
"*DA has a ""D""
D1 = D2 > B > a |
|
"
|
|
|
What is the MOA of Methyphenidate?
|
Amphetamines: Stimulates the release of stored Catecholamines
|
|
What is the MOA of PE?
|
a1 > a2
|
|
What is the MOA of Terbutaline?
|
B2 > B1
|
|
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 |
|
"
|
|
|
What is the c/u of the non-selective a-blockers?
|
Pheochromacytoma
|
|
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 |
|
"
|
|
|
What is the SE's of the a1-blockers?
|
Priapism (Prazosin)
1st dose Orthostatic Hypotension |
|
"
|
|
|
What are the a2-blockers?
|
Mirtazipine
Yohimbine |
|
"
|
|
|
What is the MOA of Mirtazapine?
|
a2, 5-HT2, & 5-HT3 receptors
|
|
What is the c/u of Mirtazapine?
|
Depression
|
|
What is the toxicity of Mirtazapine?
|
"*1 causes 2 causes 3 causes 4
1. Increased appetite 2. Weight Gain 3. Increased cholesterol 4. Sedation |
|
"
|
|
|
What is the tx for epithelial-predominant BPH?
|
Finasteride
|
|
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 effects (bradycardia, AV block, CHF) CNS effects (sedation, sleep alteration) |
|
"
|
|
|
What are the B1-selective blockers?
|
"*A BEAM
Atenolol Butaxolol Esmolol Asbutelol Metoprolol |
|
"
|
|
|
Which B-Blockers have intrinsic sympathomimetic activity
|
"B-Blockers that ""partially"" block beta receptors AND are also a-agonists (incr'd SS's):
**POAP Pindolol Oxprenolol Acebutolol Penbutolol |
|
"
|
|
|
What is the tx of B-blocker toxicity?
|
"Atropine followed by…
Glucagon |
|
"
|
|
|
What drugs decrease the secretion of aqueous humor?
|
"*ABC-T
Acetazolamide Betaxolol Carteolol Timolol |
|
"
|
|
|
What drugs increase aqueous humor outflow?
|
*C PEEPL
Carbicol Pilocarpine Epinephrine Echothiophate Physostigmine Latanoprost |
|
"
|
|
|
What drugs that decrease the synthesis of aqueous humor?
|
Briminodine
|
|
What are the DA Agonists?
|
"*CPR LAB
Carbamylcholine Pramipexole Ropinerole Levadopa/Carbidopa Amantidine Bromocriptine |
|
"
|
|
|
What drugs inhibit MAO-B?
|
Selegiline
|
|
What are the anti-Muscarinics?
|
Benztropine
|
|
What drugs inhibit COMT?
|
* -capones
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 Headache |
|
"
|
|
|
What is the SE's of Sumatriptan?
|
Vasospasm
|
|
When & Why is Sumatriptan contraindicated?
|
Due to risk of vasospasm, Sumatriptan is contraindicated in:
Pregnancy (must order pg test first) Praziquental Angina Coronary Artery Disease |
|
"
|
|
|
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 alpha-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 Weight Loss |
|
"
|
|
|
What is/are the SE(s) of Gabapentin?
|
Movement disorders
Nystagmus Weight 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 Megaloplastic 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 |
|
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?
|
Extrapyramidal symptoms
Neuroleptic Mlignant 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 Extra-Pyramidal Symptoms 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 speak loudly) ATIPamezole OLanzapine CLOZapine RISPERidone Ziprasidone QUETiapine |
|
"
|
|
|
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 Diabets Insipidus O = HypOthyroidism P = pregnant pt fetus = Ebstein's Anomaly or Total Anomalous Plmonary Venous Return P = Psoriasis Exacerbation |
|
"
|
|
|
What are the SSRI's?
|
Sertaline
Fluoxetine Paroxetine Citalopram |
|
"
|
|
|
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 (children) |
|
"
|
|
|
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 |
|
"
|
|
|
When taken with what, MAO-I's cause hypertensive crisis?
|
Foods with tyramine (e.g. cheese & wine)
B1-agonists (B1-->Gs-->Incr'd cAMP--> Incrs'd SS outflow--> Incrs'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?
|
Endoscopic anesthesia b/c it causes anterograde amnesia
|
|
What is the c/u for Midazolam?
|
Endoscopic anesthesia
|
|
Why do we use Ketamine as an anesthetic?
|
It Causes:
Increased cerebral blood flow Increased 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:
Diastolic Coronary Sysfunction (HR) 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?
|
Dinorphin
|
|
What drug binds to Mu receptors
|
Morphine
|
|
What Mu antagonist is used clinically to treat cough suppression?
|
DextraMorphine (Robitussin DM ring a bell?)
|
|
What Mu antagonist is used clinically to treat Diarrhea?
|
Deferimide
Dyphenoxylate |
|
"
|
|
|
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 (pulled)
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
Salt retention Angina Reflex Tachycardia SLE-like symptoms |
|
"
|
|
|
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 Captopril?
|
*CHAPTOPRIL where ""H"" = Hyperkalemia
C = cough H = Hyperkalemia A = Angioedema P = Proteinuria T = Taste change O = HypOtension P = Pregnancy problems (fetal renal ?) R = Rash I = Increased Renin L = Lowers Angiotensin II |
|
"
|
|
|
What is/are the SE(s) of Nitroprusside?
|
Cyanide poisoning
|
|
What is/are the SE(s) of Captopril?
|
"*CHAPTOPRIL where ""H"" = Hyperkalemia
|
|
"
|
|
|
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 thick ascending limb of the loop of henle
Pushes out HCO3- Pulls in Cl- |
|
"
|
|
|
Which diuretics work in the Loops?
|
Furosemide
Torasemide Bumetanide |
|
Bumetanide"
|
|
|
What is the MOA of Loop Diuretic?
|
Na+/K+/2Cl- reuptake inhibitor in Thick Ascending Loop
Secondarily inhibits Na+/Ca2+ exchange --> throws pt into electrolyte abnormalities |
|
"
|
|
|
What is the c/u for Furosemide?
|
1.HTN
2. Edematous States: ie Severe (only) CHF ie Cirrhosis ie Renal Nephrotic Syndrome (secondary to CHF &/or Cirrhosis) Hypercalcemia ??? |
|
|
|
|
Name the hydrochlorothiazides?
|
Hydrochlorothiazide
Indapamide Metolazone Chloritinidine?? |
|
|
|
|
What is the MOA of Thiazides?
|
Na+ Cl- reabsorption in the DCT
|
|
What are the K+ sparing drugs and what is the MOA of K+ Sparing drugs?
|
*SEAT
Spironolactone Eplerenone (Aldosterone antagonists = inhibition of Aldosterone receptors in the CORTICAL collecting tubules) Amiloride Triamterene (Epithelial sodium channel blockers = Inhibition of Na+ channels in the Cortical Collecting Duct) |
|
"
|
|
|
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+--> Ca accumulates inside the cell 3) Intracellular Ca2+ accumulations--> increased contractility |
|
"
|
|
|
What is the c/u for Digoxin?
|
CHF
Atrial Fibrillation |
|
Atrial Fibrillation "
|
|
|
What is the toxicity of Digoxin?
|
1.Torsades De Pointes Arrhythmia (i.e. prolonged QT) b/c of its effects on K+
2. 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 pt is stable (~2 wks) |
|
"
|
|
|
What are the Class III anti-arrhythmics?
|
*I iS BAD
Ibutilide Sotalol Bretylium Amiodarone Dofetilide |
|
"
|
|
|
What is the MOA of Class III Anti-arrhythmics?
|
K+ IS BAD: Blocks K+ leading to-->
Increased AP duration Increased QT Interval Increased ERP (Effective Refractory Period) |
|
"
|
|
|
What are the Class IA anti-arrhythmics?
|
*Quite A Provocative Display of heart beats
Quinidine Amiodarone Procainamide Disopyramide |
|
"
|
|
|
What is the MOA & effects of Class IA Anti-arrhythmics?
|
Blocks Na+ and K+ Channels leading to:
Increased AP Duration Increased firing threshold of pace-maker cells Increased QT Interval Decreased slope of Phase 4 (inc. ERP) |
|
"
|
|
|
What are the Class IB Anti-arrhythmics?
|
Lidocaine
Mexlotine Tocainmide 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. Lidocaine: 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!! (last resort drugs)
AP Duration: no more AP's after "first fire" QT Interval: no change (repolarization requires K+ and there is no change in 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 Ventricular Fibrillation Intractable SVT (SupraVentricular Tachycardia) |
|
"
|
|
|
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 Calcium Channel Blockers
|
|
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 (they work in the periphery) |
|
|
|
|
What is the MOA of Adenosine?
|
Hyperpolarizing AV nodal tissue by increasing K+ conductance and decreasing Ca2+ current:
*Opens Ca2+ channels--> decreased Ca2+ *Opens K+ channels--> increased K+ (repolarization --> hyperpolarizes AV node) |
|
"
|
|
|
What effect do Statins have on LDL, HDL, & TG's?
|
LDL: Decreased
HDL: INCREASED TG: 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 it works in gut) TG's: slightly increased (indirect action) b/c decreased GI absorption = Low Energy State --> increased lipolysis --> increased VLDL --> increased TG's |
|
|
|
|
What effect do Fibrates have on LDL, HDL, & TG's?
|
LDL: Decreased
HDL: Increased (1st line drug) TG: Decreased |
|
"
|
|
|
What effect does Probocal have on LDL, HDL, & TG's?
|
LDL: Decreased (increases LDL metabolism in last step of ch'ol elimination)
HDL: No effect TG: 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 |
|
|
|
|
What are the 2nd Gen H1 blocker drugs?
|
*-adine
Fexofenadine Loratadine Desloratadine |
|
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. Whatis 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 and he has already received one dose of Albuterol. What is thenext 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 and he has already received 2nd dose of Albuterol. What is the next step in management?
|
Give a 3rd dose of Albuterol
|
|
A pt comes to your office with mild prsistent asthma. the pt is currently taking Albuterol and low-dose prednisone. he is currently having an acute exacerbation and he has already received 3 doses of Albuterol. 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?
|
Switch to Salmeterol, a long-acting B-agonist (prophylaxis)
|
|
What is the MOA of Cromolyn Sodium?
|
Inhibits mast cell degranulation
|
|
What is the MOA of Methyxanthines?
|
"Inhibition of PDE --> decr'd cAMP hydrolysis --> incr'd cAMP --> incr'd SS outflow (& decr'd PS ouflow) --> BRONCHODILATION (e.g. Theophylline)
|
|
"
|
|
|
What is the MOA of Zileuton?
|
Inhibits 5-Lipoxygenase pathway thereby inhibiting the Leukotriene pathway
|
|
What is the MOA of Zafirlukast/Montelukast?
|
Inhibits Leukotriene receptors
|
|
What is the tx for hepatic encephalopathy?
|
Lactulose (synthetic sugar)
|
|
What is the MC drug used to tx primary biliary cirrhosis?
|
Ursodeoxycholic Acid (UDCA) or Ursodiol
|
|
What are the SE's of Cimetidine?
|
Impotence
Gynecomastia |
|
"
|
|
|
What are the MOA of Cimetidine?
|
REVERSIBLY blocks H2
|
|
What is the c/u for Cimetidine?
|
Peptic ulcers
Gastritis Mild Esophageal Reflux |
|
"
|
|
|
What is the MOA of Lansoprazole?
|
Proton Pump Inhibitor: IRREVERSIBLY inhibits the H+/K+ ATPase in gastric parietal cells
|
|
"
|
|
|
What is the c/u for Lansoprazole?
|
Peptic ulcers
Gastritis Esophageal Reflux Zollinger-Ellison Syndrome |
|
"
|
|
|
What is the MOA of Bismuth?
|
"Allows HCO3- secretion to reastablish pH by covering the base of the ulcer & inhibiting gastric acid secretion
|
|
"
|
|
|
What is the MOA of Mifepristone?
|
Mifepristone = RU-486 aka the morning after pill
Progesterone antagonist used as an abortifactant |
|
"
|
|
|
What is the MOA of Misoprostol?
|
PGE-1 analog:
Decreased acid production Increased musous production/secretion |
|
"
|
|
|
What is the tx for Gastric MALT with no "mets" (metatasis)?
|
Clarithromycin (Macrolide)
Amoxicillin (G-) Omeprazole (PPI) NOTE: lymphoma in the GI tract is normally due to chronic H. Pylori infxn. Successfuly tx H. Pylori & the lymphoma goes away |
|
"
|
|
|
What is the tx for Gastric MALT with no "mets" (metatasis) that doesn't respond to 1st line tx?
|
*CHOPP:
C = Cyclophosphamide H = Hydroxydaunorubicin (aka Adriamycin/Doxorubicin) O = Oncovin (aka Vincristine) P = Prednisone P= Procarbazine |
|
"
|
|
|
What is the 1st Line tx for Rheumatoid Arthritis?
|
Methotrexate
Hydroxychloroquine TNF-a inhibitors |
|
"
|
|
|
What is the MOA of Abciximab?
|
"Monoclonal antibody to glycoprotein IIb/IIIa which REVERSIBLY inhibits the GP IIb/IIIa receptor
|
|
"
|
|
|
What is the MOA of Infliximab?
|
Monoclonal antibody to TNF-a
|
|
What is the c/u of Infliximab?
|
* CARS
Crohn's Ankylosing Spondylitis Rheumatoid Arthritis Sclerotic Arthritis |
|
"
|
|
|
What is the MOA of Sulfasalazine?
|
Sulfasalazine = sulfa drug (antibiotic) + mesalazine (anti-inflammatory)
|
|
What is the c/u of Sulfasalazine?
|
Inflammatory Bowel Diseases (IBD's):
Ulcerative Colitis (UC) Chron's Disease |
|
"
|
|
|
What is the toxicity of Sulfasalazine?
|
Oligospermia (Reversible)
Drug-induced pancreatitis |
|
"
|
|
|
What is the MOA of Heparin?
|
Activates Anti-thrombin-III:
Decreases III Decreases Xa |
|
"
|
|
|
What is the MOA of Enoxaparin?
|
Activates AT-III --> decreased Xa
|
|
"
|
|
|
Which needs monitored with Enoxaparin (pT or pTT)?
|
Neither with a LMWH
|
|
What is the worst SE that we worry about with the use of Heparin?
|
Thrombocytopenia (Heparin Induced Thrombocytopenia)
|
|
What is the tx for HIT?
|
Argatroban
Lepirudin |
|
"
|
|
|
What is the tx for Heparin toxicity?
|
1. Stop Heparin administration
2. Protamine Sulfate |
|
Protamine Sulfate"
|
|
|
What is the MOA of Warfarin?
|
Inhibits gamma-carboxylation of Vitamin K dependent coagulation factors:
II, VII, IX, X, Protein C, & Protein S |
|
"
|
|
|
Which Coagulation Factor is lost first when Warfarin is administered (i.e. which one has the shortest T 1/2)?
|
Protein C
|
|
Which Coagulation Factor is lost last when Warfarin is administered (i.e. which one has the longest T 1/2)?
|
CF II
|
|
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?
|
1. STOP the Drug
2. give Fresh Frozen Plasma 3. Give Vitamin K |
|
"
|
|
|
What are drugs that inhibit the conversion of plasminogen to plasmin?
|
There is only one: Amino Caproic Acid
|
|
"
|
|
|
What is the tx of uremic coagulopathy seen in chronic renal failure?
|
Desmopressin
|
|
What is the MOA of Desmopressin?
|
Increases the release of vWF & CF VIII from the endothelium
|
|
What is the MOA of Clopidogrel?
|
"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)
|
|
"
|
|
|
What is the MOA of Infliximab?
|
Monoclonal antibody to TNF-a
|
|
What is the MOA of Abciximab?
|
*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 GB IIb/IIIa receptor |
|
"
|
|
|
What are the 1st generation Sulfonylureas?
|
Tolbutamide
Chlorpropamide |
|
"
|
|
|
What are the 2nd generation Sulfonylureas?
|
Glyburide
Glipizide |
|
"
|
|
|
What are the SE(s) of 1st Gen Sulfonylureas?
|
Disulfiram-like reaction
|
|
What are the SE(s) of 2nd Gen Sulfonylureas?
|
Hypoglycemia
|
|
What is the MOA of Sulfonylureas?
|
"Blocks K+ Channels leading to depolarization, therefore insulin release is increased due to increase in Ca2+
|
|
"
|
|
|
What is the MOA of Sulfonylureas in IDDM pt's?
|
It doesn't work in type I diabetics, b/c they don't have B-cells to make insulin
|
|
What is the MOA of Metformin?
|
Inhibits gluconeogenesis
Stimulates glycogenolysis |
|
"
|
|
|
What is the SE(s) of Metformin?
|
Lactic Acidosis
|
|
What are the Glitazone drugs?
|
Rosiglitazone
Pioglitazone |
|
"
|
|
|
What is the MOA of Pioglitazone?
|
Increases target cell receptor response to insulin via binding PPAR-gamma receptors
|
|
What are the Alpha-glucosidase inhibitors ?
|
Acarbose
Miglitol |
|
"
|
|
|
What is the MOA of Leuprolide?
|
GnRH Agonist (pulsatile)
GnRH Antagonist (continuous) |
|
"
|
|
|
What is the c/u of Leuprolide (pulsatile fashion)?
|
Infertility
|
|
What is the c/u of Leuprolide (continous fashion)?
|
Prostate cancer
Uterine Fibroids Idiopathic Precocious Puberty |
|
"
|
|
|
What drugs tx precocious puberty?
|
Leuprolide (continous fashion)
Danazol |
|
"
|
|
|
What is the MOA of Danazol?
|
Synthetically-modified testosterone
|
|
What is the MOA of Methimazole?
|
Inhibits thyroid peroxidase (central only) therefore it inhibits organification & coupling (tx for hyperthyroidism)
|
|
What is the MOA of PTU?
|
Central: Inhibits thyroid peroxidase therefore it inhibits organification & coupling
Peripheral: Blocks conversion of T4 to T3 |
|
"
|
|
|
What is the MOA of Flutamide?
|
"Non-steroidal androgen antagonist at the testosterone receptor (i.e. testosterone antagonist)
|
|
"
|
|
|
What is the c/u of Flutamide?
|
Prostate cancer
|
|
What is the MOA of Sildenafil?
|
Inhibits cGMP phosphodiesterase (PDE) leading to incr'd cGMP
|
|
What is the c/u of Sildenafil?
|
Erectile Dysfunction
|
|
What is the SE(s) of Sildenafil?
|
Blue-Green color vison
|
|
What are the contraindications of Sildenafil?
|
Currently taking Nitroglycerides
|
|
What is the MOA of Clomifene Citrate?
|
Partial estrogen receptor agonist in the pituitary, increasing LH & FSH
|
|
What is the c/u of Clomifene Citrate?
|
Infertility
|
|
What is the SE(s) of Clomifene Citrate?
|
"Ovarian hyperstimulation syndrome (OHSS) --> Ovarian torsion --> ovarian infarction --> OVARIAN FAILURE!!!
|
|
"
|
|
|
What is the tx for Lichen Sclerosis?
|
High-Dose Steroids:
Clobetasol Halobetasol |
|
"
|
|
|
What is the tx for Hypertrophic Dystrophy of the Vulva?
|
1% Corticosteroid cream
|
|
What is the tx for Atrophic Vaginitis in a woman without a uterus?
|
Estrogen cream
|
|
What is the tx for Atrophic Vaginitis in a woman with a uterus?
|
Estrogen-Progesterone (estrogen cream alone can lead to cervical cancer)
|
|
What is the tx for Luteal Phase Defects?
|
1st Line: Progesterone
2nd Line: Clomiphene Citrate or Human Menopausal Gonadotropin (hMG) |
|
"
|
|
|
What is the tx for dysfunctional uterine bleeding (DUB)?
|
High-Dose IV Estrogen
|
|
What is the MOA of Misoprostol?
|
PGE-1 analog:
Decreased acid production Increased mucous production/secretion |
|
"
|
|
|
What is the MOA of Mifepristone?
|
Mifepristone = RU-486 aka the morning after pill
Progesterone antagonist used as an abortifactant |
|
"
|
|
|
What is the tx for Acute Gout?
|
Colchicine
Indomethacin |
|
"
|
|
|
What is the MOA of Indomethacin?
|
REVERSIBLY inhibits the Cox I & Cox II
|
|
What is the MOA of Colchicine?
|
Depolarizes microtubules-->
Impairs leukocyte chemotaxis Impairs mast cell degranulation |
|
"
|
|
|
What is the tx for Chronic Gout?
|
Probenecid
Allopurinol |
|
"
|
|
|
What is the MOA of Allopurinol?
|
Inhibits Xanthine Oxidase
|
|
What is the alternative use of Allopurinol?
|
Tumor Lysis Syndrome (secondary to chemotherapy tx for Lymphomas/Leukemias)
|
|
What is the MOA of Probenecid?
|
Inhibits reabsorption of uric acid
|
|
What are the MOPP drugs?
|
M = Methotrexate
O = Oncovin (aka Vincrisine) P = Prednisone P = Procarbazine |
|
"
|
|
|
What are the ABVD drugs?
|
A = Adriamycin
B = Bleomycin V = Vinblastine D = Decarbazine |
|
"
|
|
|
What are the CHOP drugs?
|
C = Cyclophosphamide
H = Hydroxydaunorubicin (aka Adriamycin/Doxorubicin) O = Oncorvin (aka Vincristine) P = Prednisone P = Procarbazine |
|
"
|
|
|
What are the Antimetabolites?
|
Methotrexate
5-FU 6-MP Cytarabine (ARA-C) Bleomycin |
|
"
|
|
|
What are the Alkylating Agents?
|
Busulfan
Cyclophasphamide Nitrosoureas Cisplatin/Carboplatin Procarbazine |
|
"
|
|
|
What are the Plant Alkaloids?
|
Vincristine/Vinblastine
Paclitaxel Etoposide |
|
"
|
|
|
What are the Leukemia drugs?
|
Methotrexate
6-MP Imantinib |
|
"
|
|
|
What are the Lymphoma drugs?
|
Methotrexate
6-MP Doxorubicin Bleomycin Vincristine Vinblastine |
|
"
|
|
|
What are the Choriocarcinoma drugs?
|
Methotrexate
Vincristine Vinblastine |
|
"
|
|
|
What are the Sarcoma drugs?
|
Methotrexate
Doxorubicin |
|
"
|
|
|
What are the Colon Cancer drugs?
|
5-FU
Imantinab (stromal) |
|
"
|
|
|
What are the Solid Tumor drugs?
|
5-FU
Doxorubicin |
|
"
|
|
|
What are the Basal Cell drugs?
|
5-FU
|
|
What are the CML drugs?
|
Busulfan
Imantinib |
|
"
|
|
|
What are the AML drugs?
|
Cytarabine (aka ARA-C)
|
|
What are the NHL drugs?
|
*CHOPP:
C = Cyclophosphamide H = Hydroxydaunorubicin (aka Adriamycin/Doxurubicin) O = Oncovin (aka Vincristine) P = Prednisone P = Procarbazine |
|
"
|
|
|
What are the Breast Cancer drugs?
|
Cyclophosphamide
Tamoxifen/Raloxifen Cisplatin/Carboplatin Trastuzumab Paclitaxel Doxorubicin (solid) |
|
"
|
|
|
What are the Ovarian Cancer drugs?
|
Cyclophosphamide
Paclitaxel Doxarubicin (solid) |
|
"
|
|
|
What are the Brain Tumor drugs?
|
Nitrosureas
|
|
What are the Bladder Cancer drugs?
|
Cisplatin/Carboplatin
|
|
What are the Testicular Cancer drugs?
|
Cisplatin/Carboplatin
Bleomycin Etoposide |
|
"
|
|
|
What are the Lung Cancer drugs?
|
*CDE
Cisplatin/Carboplatin Doxorubicin Etoposide |
|
"
|
|
|
What are the Wilms Tumor drugs?
|
Dactinomycin
Vincristine/Vinblastine |
|
"
|
|
|
What are the Ewing's Sarcoma drugs?
|
Dactinomycin
|
|
What are the Rabdomyosarcoma drugs?
|
Dactinomycin
|
|
What are the Prostate Cancer drugs?
|
Etoposide
|
|
What are the GI Stromal Tumor drugs?
|
Imatinib
|
|
What are the Hairy Cell Leumkemia drugs?
|
Cladribine
|
|
What does the complex of 5-FU-DMP inhibit?
|
Thymidylate Synthase
|
|
By what is 6-MP activated?
|
HGPRTase
|
|
What is the SE(s) of Busulfan?
|
Pulmonary Fibrosis
|
|
What is the tx for ifosfamide toxicity?
|
MESNA (for ifosfamide/cyclophosphamide toxicity)
|
|
What is the MOA of MESNA?
|
Traps acrolein
|
|
What is the SE's of Adriamycin toxicity?
|
Cardiotoxic
Alopecia |
|
Alopecia"
|
|
|
What is the treatment of Adriamycin toxicity?
|
"Dazroxocin
|
|
"
|
|
|
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 platinum complex 2. H20 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 |
|
"
|
|
|
What is the DOC for Cancer-associated anorexia?
|
Megestrol Acetate
|
|
What is the DOC for mild/moderate hypercalcemia seen in malignancy (e.g. Multiple Myeloma)?
|
Zoledronic Acid
|
|
What phase of the cell cycle does Etoposide work?
|
G2 & late S phases
|
|
What is the MOA of Tamoxifen?
|
Partial estrogen receptor agonist (endometrium) AND antagonist (breast)
|
|
What is the MOA of Trastusumab?
|
Monoclonal antibody to HER-2 receptors
|
|
What phase of the cell cycle will not be complete with Vincristine/Vinblastine?
|
M-Phase
|
|
What phase of the cell cycle will not be complete with Paclitaxel?
|
M-Phase
|
|
What phase of the cell cycle will not occur with Paclitaxel?
|
Anaphase
|
|
What is the MOA of Paclitaxel?
|
Hyperstablizes the microtubles so that they cannot be broken down
|
|
What is the MOA of Cyclosporine?
|
Inhibits Calcineurin, therefore IL-2 (which comes from Th-1 cells) is not made
|
|
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
|
|
What is the "specific" c/u for Azathioprine?
|
Renal transplants
|
|
What is the c/u for Aldesleukin?
|
Renal cell carcinoma and metestatic melenoma
|
|
What is the MOA of Aldesleukin?
|
IL-2 Analogue
|
|
What is the MOA of Epoetin?
|
Erythropoetin Analogue
|
|
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 Syndrome |
|
"
|
|
|
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
|