Pharm Step 1 First Aid 2010

Front 1

What drug gives a lupus-like syndrome

Back 1

hydralazine

Front 2

What is the first line of therapy for HTN in pregnancy (and what other drug is given in conjunction with it)

Back 2

hydralazine, w/methyldopa

Front 3

When is hydralazine contraindicated

Back 3

in angina/CAD b/c of compensatory tachycardia

Front 4

What class of drug is given for Prinzmetal's angina

Back 4

Ca-channel blockers

Front 5

What drugs are used for malignant HTN

Back 5

Nitroprusside, Fenoldopam (D1-receptor agonist), Diazoxide

Front 6

Fenoldopam

Back 6

D1-receptor agonist

for malignant HTN

relaxes renal vascular smooth muscle

Front 7

What drugs are K+-channel openers (for cardio)

Back 7

Minoxidil (for severe HTN) and diazoxide (for malignant HTN)

Front 8

What is a side effect of diazoxide that is clinically significant

Back 8

hyperglycemia (reduces insulin release)

Front 9

What drug causes the "Monday disease"

what are the side effects

Back 9

Nitroglycerin, isosorbide dinitrate

develop tolerance over the week

Side effects: reflex tachycardia, hypotension, flushing, HA

Front 10

What are the partial B-agonists and when are they contraindicated

Back 10

Acebutolol and Pindolol

contraindicated in angina

Front 11

What are nitroglycerin, isosorbide dinitrate used for

Back 11

angina, pulmonary edema

Front 12

What is the main effects of these drugs:

statins
Niacin
Fibrates

Back 12

Statins: decrease LDL
Niacin: increase HDL
Fibrates: decrease triglycerides

Front 13

What is the mechanism of action for Niacin

Back 13

inhibits lipolysis in adipose tissue
reduces hepatic VLDL secretion into circulation

Front 14

How do fibrates work

Back 14

upregulate LPL -> increased TG clearance

Front 15

What lipid-lowering agent causes decrease absorption of fat-soluble vitamins

Back 15

bile acid resins (cholestyramine)

Front 16

What is digoxin used for

Back 16

CHF (increase contractility)
AFib (decrease conduction at AV node and SA node depression)

Front 17

What drug increases digoxin toxicity

Back 17

quinidine
displaces digoxin from tissue-binding sites

Front 18

What conditions affect volume distribution of plasma protein-bound drugs

Back 18

liver and kidney disease

Front 19

What is a property of first-order elimination in terms of half-life

Back 19

a drug infused at a constant rate reaches ~94% of steady state at 4 t(1/2) (half-lives)

Front 20

What is the equation for loading dose

for maintenance dose

Back 20

Loading: Cp x (Vd / F)
Maintenance: Cp x (CL/F)

Cp = target plasma [ ]
F = bioavailability
CL = clearance

Front 21

What happens to loading/maintenance dose in impaired liver and kidney disease

Back 21

loading dose same
maintenance dose decreases

Front 22

What drugs have zero-order elimination

Back 22

PEA
Phenytoin, Ethanol, Aspirin (at high or toxic concentrations)

Front 23

How do you treat a weak acid overdose

Back 23

trx w/bicarbonate
-ion is trapped in a basic environment

ex: phenobarbital, methotrexate, TCAs, aspirin

Front 24

How do you treat a weak base overdose

Back 24

trx w/ammonium chloride
-ion trapped in an acidic env't

ex: amphetamines

Front 25

What is Phase 1 metabolism
Phase 2?

Which one is lost first in geriatric patients

Back 25

Phase 1 - cytochrome P450
Phase 2- conjugation

Phase 1 lost first in geriatrics

Front 26

What effect does a competitive antagonist have

Back 26

decreases potency and increases EC50 (effective concentration for producing a given effect)

Front 27

What effect does a noncompetitive antagonist have

Back 27

decreases efficacy

Front 28

Compare a full and partial agonist

Back 28

partial agonist acts on the same receptor system, but has a lower maximal efficacy (regardless of dose)

but potency is independent (can be higher, lower or the same)

Front 29

How do you calculate therapeutic index

Back 29

LD50/ED50

measures drug safety. Drugs w/higher TI values are safer

Front 30

Describe Nicotinic ACh receptors

Describe Muscarinic ACh receptors

Back 30

Nicotinic: ligand-gated Na/K channels
(Nn found in autonomic ganglia; Nm found at the NMJ)

Muscarinic: G-protein-coupled receptors acting thru 2nd messengers

Front 31

What is the sympathetic receptor on renal vascular smooth muscle

Back 31

D1 receptors

Front 32

What is cinchonism?

What drug causes this?

Back 32

HA, tinnitus, thrombocytopenia, torsades de pointes from increased QT interval

Quinidine can cause this; a Class IA antiarrhythmic

Front 33

What drug has a reversible SLE-like syndrome

Back 33

Procainamide (Class IA antiarrhythmic)

Hydralazine has a lupus-like syndrome

Front 34

Which antiarrhythmics are best post-MI?

contraindicated post-MI?

Back 34

Class IB Best post-MI

Class IC Contraindicated post-MI

Front 35

What class of antiarrhythmics are useful in digitalis-induced arrhythmias

Back 35

Class IB

Front 36

What is a toxicity of all Class 1 antiarrthythmic drugs

Back 36

hyperkalemia

Front 37

What are some toxicities of amiodarone

Back 37

pulmonary fibrosis, hepatotoxicity, hyper/hypothyroidism

check PFTs, LFTs, TFTs when give amiodarone

also blue/gray skin deposits resulting in photodermatitis and corneal deposits

Front 38

When are Ca-channel blockers used

Back 38

prevention of nodal arrhythmias

Front 39

What is the drug of choice in stopping/diagnosing SVT

Back 39

Adenosine

(effects blocked by theophylline)

Front 40

How does K+ act as an antiarrhythmic

Back 40

depresses ectopic pacemakers in hypokalemia (like in digoxin toxicity)