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736 Cards in this Set

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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
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What are the ABVD drugs?
A = Adriamycin
B = Bleomycin
V = Vinblastine
D = Decarbazine
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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
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What are the Alkylating Agents?