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125 Cards in this Set

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Saquinavir, ritonavir, indinavir
se
Protease inhibitors
stops pol -
leads to nonfxl virus
metabolised by p450
hyperglycemia,
NRTI (6)
zidovudine, didanosine, zalcitabine, stavudine, lamivudine, abacavir
inhibits reverse transcriptase of HIV preventing viral incorporation
NNRTI (3)
Nevirapine, delavirdine, efavirenz
inhibits reverse transcriptase of HIV preventing viral incorpation
Interferon alpha
(3)
SE
Chronic HBV + HCV
kaposi sarcoma
SE: depression
Interferon beta treatment
MS
Interferon gamma treatment
NADP oxidase deficiency
Zidovudine
NRTI
AZT
pregnancy - reduces fetal transmission
competitive inhibitor of deoxythymidine triphosphate, terminates DNA synth
Didanosine
SE(2)
NRTI
pancreatitis, periph neuropathy
Stavudine
NRTI
good CNS penetration
thymidine analogue
Lamivudine
NRTI
also used in HBV
used in combo with AZT
terminates synth of proviral DNA chain and reverse transcriptase
Tolbutamide
sulfonorea - DM
Miglitol
alpha glucosidase inhibitor
ascarbose
Biguanides
metformin
decr hepatic gluconeogenesis
Methimazole, PTU
SE (2)
tx (1)
inhibits organification, and coupling of thyoid synth
PTU also inhibits periph conversion of T4
Thus inhibits Peroxidase
SE immunosuppresion - agranulocytosis + aplastic anemia
TX: give recombinant human granulocyte colony stim factor
Causes of diabetes insipidus
2 drugs
1 metabolic
(ADH rec blockers) Lithium + demeclocycline
hypercalcemia
Tx for central diabetes insipidus
Desmopressin
Tx for nephrogenic diabetes insipidus
(3)
Thiazides
indomethacin
amiloride
Tx for SIADH
Demeclocycline + lithium (but much higher toxicity)
H2O restriction
Causes of SIADH
1. Tumor
2. CNS d/o head trauma
3. Pulmonary dz - small cell adenocarcinoma
4. Drugs (cyclophosphamide,)
Orlistat
inhibits pancreatic lipase
steatorrhea- fat mgmt
Sibutramine
NE and Seratonin reuptake inhibitor
used in fattys
inhibits appetite
Glucocorticoid
actions
decr production of leukotrienes, and PGs by inhibiting PLPA2 (lipocortin
expression of COX2
Zanamivir
inhibition of viral neuraminidase - thus inhibiting viral maturation
clips off sialic acid and aids in release of virus.
if inhibited the hemagglutin binds the sialic acids of other virus particles leading to their clumping and preventing rls
Amantidine, rimantidine
Inhibit viral uncoating
Influenza A or B - target M2 protein (makes proton channels in membrane and promotes uncoating and rls of viral genome)
Imatinib
Gleevac
selectively inhibits tyr kinase activity of c-kit (bcr-abl fusion gene) and PDGFR.

Used in CML, ALL, GI stromal tumas
Buprenorphine
partial agonist at mu opioid receptors
less efficacious than morphine - also prevents full morphine effects and dissociates slow from rec as well
Magnesium Sulfate
use
mechanism
Drug of choice for eclampsia
inhibts rls of Ach at motor endplate by directly inhibiting via compettive effects with ca.

2nd line phenytoin + diazepam
Sumitriptan - contraindication
used in migraines
partial agonist 5HT1D -
contraindicated in prinzmetals, and coronary spasm.
(can cause coronary spasm)
Side effect of sulfasalazine
sulfa drug
reversible oligospermia
Phenytoin (4) SE
1. Hirsuitism
2. Gingival Hyperplasia
3. Osteomalacia
4. Megaloblastic Anemia
Valproic acid SE
Hepatotoxicity
Amiodarone SE (4)
Class III K+ channel blocker
1.thyroid dysfx
2. paresthesias
3. corneal dz
4. pulmonary dz
Where does Amiloride work
acts by blocking Na channels in the collecting tubules
Principal cells
COMT blocker
COMT - breaks down catecholamines tp 3OMD
Tolcapone, entacapone
good for keeping L-DOPA from breaking down before BBB - syndergistic with carbidopa
MAO-B inhibitor
selegiline
used for parkinsons dz to maintain dopamine levels
PNMT
converts NE to EPI
Tyrosine hydroxylase
rate limiting step for synthesis of catecholamines
Opioid contraindicated with MAOi
Meperidine blocks 5HT reuptake

therefore contributing to possible seratonin syndrome.
Metoclopramide
D2 antagonist in CTZ: antiemesis
nausea and prokinetic for gastric emptying
good for diabetic gastroparesis
5HT3 antagonism as well at higher doses contributing to antiemesis.
5HT4 agonism - prokinetic quality
SE: parkinsonism, hyperprolactinemia
Antihistamine SE
antimuscarinic
1st gen contraindicated in narrow angle glaucoma
Acetazolamide in altitude sickness
By causing bicarb dumping you create a metabolic acidosis to counteract the respiratory alkalosis.
Donepezil
cholinesterase inhibitor
used in AD
Tacrine
cholinesterase inhibitor used in AD
Parkinsons drugs
4 types
1. Agonize dopamine rec - bromocriptine, pramipexole, ropirinole
2. Incr Dopamine: Amantadine, L-dopa
3. Prevent breakdown: MAOBi - selegiline
4. Curb excess ach: benztropine improves tremor and rigidity - no effect on bradykinesia
Parkinsons drugs
4 types
1. Agonize dopamine rec - bromocriptine, pramipexole, ropirinole
2. Incr Dopamine: Amantadine, L-dopa
3. Prevent breakdown: MAOBi - selegiline
4. Curb excess ach: benztropine improves tremor and rigidity - no effect on bradykinesia
Parkinsons drugs
4 types
1. Agonize dopamine rec - bromocriptine, pramipexole, ropirinole
2. Incr Dopamine: Amantadine, L-dopa
3. Prevent breakdown: MAOBi - selegiline
4. Curb excess ach: benztropine improves tremor and rigidity - no effect on bradykinesia
Disulfiram rxn (4)
1. Metronidazole
2. Ceftriaxone
3. Procarbazine
4. Sulfonoreas
Nephrotoxic/neurotoxic
polymyxins
Nephrotoxic/ototoxic (3)
A/G, loops, cisplatin
P450 Inducers
Queen Barb takes Phen-phen and Refuses Greasy Carb Salad
quinidine
barbiturates
phenytoin
rifampin
griesofulvin
Carbamazepine
St. Johns Wort
P450 inhibitors
Inhibitors Stop Cyber-Kidss from Eating Grapefuit
INH
Sulfonamides
Cimetidine
Ketoconazole
Erythromycin
Grapefruit juice
Disulfirim rxn mechanism
Disulfirim inhibits acetaldehyde DH - which breaks acetaldehyde down to acetic acid
drugs cause torsades de pointes
(3)
Class III: sotalol
Class IA: quinidine
Cisapride
Agranulocytosis (3)
clozapine, carbamazepine, colchicine
Aplastic anemia drug rxn
(3)
NSAIDS
Benzene
Chloramphenicol
Pulmonary Fibrosis (3)
Bleomycin
Amiodorone
Busulfan
drug cause of Acute cholestatic hepatitis
macrolides
Focal to massive hepatic necrosis
3 drugs
1 organism
Halothane
APAP
Valproic Acid
Amanita Phalloides
Drug cause pseudomembranous colitis
clindamycin
ampicillin
Drug cause of hepatitis
INH
Drug cause of osteoporosis
heparin
corticosteroids
Photosensitivity (3)
sulfonamides
tetracycline
amiodorone
SLE like syndrome
(4)
Hydralazine
INH
Phenytoin
Procainamide
drug cause of Fanconi Syndrome
expired tetracycline
antidote for beta blocker overdose
glucagon
antidote for Iron overload
deferoxamine
dimercaprol succimer (4)
antidote for arsenic, mercury and gold
lead
antidote for CN poisoning (3)
nitrite, hydroxocobalamin, thiosulfate
antidote for methemaglobinemia
methylene blue
treatment for heparin OD
protamine sulfate
antidote for tPA and streptokinase OD
aminocaproic acid
Muromonab CD3
binds CD3 ag on the surface of thymocytes. Blocks killing action of CTL and interferes with other Tcell action.
Used to manage renal homograft refejection.
Atropine side effects
Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter
Bethanechol
cholinomimetic
used for post op and neurogenic ileus
as well as urinary retention
Organophosphate poisoning
sx
antidote
anticholinesterase poisoining
DUMBBELSS
diarrhea, urination, miosis, bronchospasm, bradycardia, Excitation (skeletal muscle and CNS), Lacrimation, Sweating, Salivation
Antidote - pralidoxime + atropine
Gq receptors (5)
PLPC -> incr PKC and Ca++
alpha 1, M1, M3, V1, H1
Gs receptors (5)
activate adenylate cyclase->incr cAMP -> incr PKA
beta1,2, D1, V2, H2
Gi receptors
(3)
decr cAMP and decr PKA
alpha2, M2, D2
Chenodiol/ursodiol
bile acid derivatives
Inhibit the formation of gallstones
reduce the secr of bile acids by liver
trastuzumab
ab to surface protein HER2 in breast cancer
Infliximab
targeted against TNF alpha - induces remissions in Crohns and RA.
Etanercept
TNF receptor. Binds TNF alpha leading to decr immune response.
RA,
H1 blockers
1st gen (2)
2nd gen (3)
1st gen: diphenhydramine, doxylamine
(less sedating) Chlorpheniramine, cyclizine
2nd gen: fexofenadine, loratadine, certirizine
Ondansetron vs Alosetron
5-HT3 blockers
ondansetron: chemotherapy N+V
alosetron: IBS diarrhea
Ergot alkaloids
Partial agonist at alpha and antagonist at 5HT receptors
1. Uterine bleeds- ergotamine, ergonavine
2. Migraines - methysergide, ergonavine
3. Brain hallucinations - LSD
Theophylline
phosphodiesterase inhibitor (incr cAMP)
and adenosine (bronchoconstriction) inhibitor
Nitrogen mustards
se
tx
cyclophosphamide, ifosamide
hemorrhagic cystitis
mesna
Thiazolidinediones vs niacin
TG, HDL, CRP, Glucose, BP
Thiazolidinediones: decr TG, incr HDL, decr CRP, decr GLucose, in some pts decr BP
Niacin: decr TG, incr HDL, incr glucose
M3 rec
Gq
on pupillae sphincter - constriction
noninnervated M3 foudn in blood vessels.
Terazosin
Alpha 1 blocker
vasc smooth muscle relaxation
Tx for HTN and BPH
Ammonium chloride
Used for tx of hypochloremic states and metabolic alkalosis
acidified urine
would lead to decr excretion of acid and acidic drugs
like salycilates
Sodium lactate
alkalinizing agents for tx metabolic acidosis
Treatment for toxoplasma infection
tx with pyrimethamine and sulfadizine
ie - synthetic pathway for folates
Antibiotics to avoid in pregnancy
SAFE Moms Take Really Good Care
Sulfonamides (TMP/SMX)
A/G - ototoxicity
F/Q
Erythromycin - acute cholestatic hepatitis in mom
Metronidazole- mutagenesis
Tetracycline - inhibition of bone growth, teeth
Ribvarin - teratogenic
Griesofulvin - teratogenic
Chloramphenicol - gray baby
Tx for incr ammonia levels
Lactulose
Colonic metbolism of lactulose generates short chain FA - which lowers pH. Ammonia gets protonated to form ammonium ion - trapping it in the GI tract.
Tx for acute bacterial prostatitis
ampicillin
fluorquinolong
or
TMX/SMP
Tx for leshmaniasis
Antimony: sodium stibogluconate, meglumine antimonate, pentamidine, ampho b
Pyrazinamide
short course TB tx
Acyclovir
Herpes
Ganciclovir
CMV
Mebendazole
Enterobius Vermicularis
Trichuris
Ascaris Lumbricoides
(nematodes, roundworms)
Minoxidil
mechanism
Opens Katp channels on vasc smooth muscle -leading to hyperpolarizatoin and dilation
Also decr pancreatic insulin response to glucose
Nitric oxide overdose in newborn with ARDs
leads to methemaglobinemia
Botulinum toxicity
Decr Ach transmission in all parasym jxs and decr sym cholinergic transmission in sweat glands.
Tach, mydriasis, elevated body temp from decr muscarinic action on psym and sym sweat glands
Skeletal muscle weakness form decr nic receptor activaton
Chloramphenicol mechanism
inhibits ribosomal peptidyl transferase
Drugs causing SIADH
agents that incr ADH production
TCA, SSRI, MAOi, antineoplastics, neuroleptics and carbamazepine
Jarisch-Herxheimer rxn
spirochetal dz
bc they are GN when they get lysed with penacillins they will rls endotoxin - leading to endotoxic shock via direct stim of M/P -> too much Il-1,6, TNFalpha,
Hydroxyurea
antineoplastic drug used in hematological malignancies. It is also used as an antiretroviral agent (e.g., against HIV). Its mechanism of action is believed to be based on its inhibition of the enzyme ribonucleotide reductase by scavenging tyrosyl free radicals[1] as they are involved in the reduction NDPs.[2]
In Sickle cell: destroys sickle cells leading to incr
HbF
streptomycin
hits 30s ribosome interfering with initiation complex
tetracyclines
blocks aminoacyl-tRNA from binding to mRNA-ribosome complex
thus no elongation
chloramphenicol
messes with the peptidyl transferase (part of 50s) transfers the AA or peptide from P-site onto the AA on the A site
Puromycin
gets incorpated as an aminoacyl-tRNA and blocks the growing peptide chain
Clindamycin
Erythromycin
Bind irreversibly at 50s subunit inhibiting translocation
Diptheria toxin - at molecular protein level.
inactivates eukaryotic elongation factor - eEF-2 preventing translocation
Inducible operon (Lac)
repressible operon (tryptophan)
Lac - repressor is bound to promoter =no transcription. When inducer, lactose is around it binds the repressor - it can no longer bind now transcription can occur
Repressible: Repressor is not bound so transcription occurs, when co-repressor, tryptophan is around, it binds repressor and together they bind DNA and no transcription occurs.
Bactericidal abx
6
pen, cephs, vanco, A/G, F/Q, metronidazole
Anaerobe treament
Cefotetan
(bacteroides etc)
Penicillin
cidal
GPC, GPR, GNC, spirochetes
Methicillin, nafcicillin, dicloxacillin
narrow spectrum - pen
S. Aureus
Ampicillin, amoxicillin
Give with clavulanic acide (penicillinase inhibitor)
Extended spectrum - some GP, GNR
H. FLu, E. Coli, Listeria, Proteus, Salmonella, enterococci
Cephs
1st gen - cefazolin, cephalexin
2nd gen - fur, fac, fox
3rd gen - triax, tax, taz
4th gen - cefepime, cefpiramide
1st: GPC, Proteus, E. Coli, Klebsiella
2nd: GPC, H flu, enterobacter, Neisseria, proteus, E. Coli, Klebsiella, Serratia
3rd: serious GN, CNS penetration,
Ceftazidime - pseudomonas
Ceftriaxone - gonorrhea
4th: incr activity against Pseduomonas and GP.
Azoteonam
monobactam - resistant to beta lactamases
inhibits cell wall synth
synergistic with A/G
GNR - klebsiella, pseduomonas, serratia
No activity for GP or ANAEROBES
Good for pen allergy and renal insuff (can't have A/G)
Cilastatin
inhibits renal dihydropeptidase
used with imipenem
Imipenem/cilastatin
broad spectrum - beta lactamase resistant
GPC, GNR, anaerobes
*ENTEROBACTER
Vancomycin
binds D-ala D-ala cell wall precursors
CIdal
For serious GP
S. Aureus C. Diff etc
Nephrotoxi, Ototoxic, Thrombophlebitis
diffuse flusing -red man syndrome