Pharmacology Shelf Exam All Drugs

Front 1

A common side effects of Interferon (INF) treatment is?

Back 1

Neutropenia

Front 2

Antimicrobial prophylaxis for a history of recurrent UTIs

Back 2

TMP-SMZ

Front 3

Antimicrobial prophylaxis for Gonorrhea

Back 3

Ceftriaxone

Front 4

Antimicrobial prophylaxis for Meningococcal infection

Back 4

Rifampin (DOC), minocycline

Front 5

Antimicrobial prophylaxis for PCP

Back 5

TMP-SMZ (DOC), aerosolized pentamidine

Front 6

Antimicrobial prophylaxis for Syphilis

Back 6

Benzathine penicillin G

Front 7

Are Aminoglycosides Teratogenic?

Back 7

Yes

Front 8

Are Ampicillin and Amoxicillin penicillinase resistant?

Back 8

No

Front 9

Are Carbenicillin, Piperacillin, and Ticarcillin penicillinase resistant?

Back 9

No

Front 10

Are Cephalosporins resistant to penicillinase?

Back 10

No, but they are less susceptible than the other Beta lactams

Front 11

Are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant?

Back 11

Yes

Front 12

Clinical use of Isoniazid (INH)?

Back 12

Mycobacterium tuberculosis, the only agent used as solo prophylaxis against TB

Front 13

Common side effects associated with Clindamycin include?

Back 13

Pseudomembranous colitis (C. difficile), fever, diarrhea

Front 14

Common toxicities associated with Fluoroquinolones?

Back 14

GI upset, Superinfections, Skin rashes, Headache, Dizziness

Front 15

Common toxicities associated with Griseofulvin?

Back 15

Teratogenic, Carcinogenic, Confusion, Headaches

Front 16

Describe the MOA of Interferons (INF)

Back 16

Glycoproteins from leukocytes that block various stages of viral RNA and DNA synthesis

Front 17

Do Tetracyclines penetrate the CNS?

Back 17

Only in limited amounts

Front 18

Does Ampicillin or Amoxicillin have a greater oral bioavailability?

Back 18

AmOxicillin has greater Oral bioavailability

Front 19

Does Amprotericin B cross the BBB?

Back 19

No

Front 20

Does Foscarnet require activation by a viral kinase?

Back 20

No

Front 21

Foscarnet toxicity?

Back 21

Nephrotoxicity

Front 22

Ganciclovir associated toxicities?

Back 22

Leukopenia, Neutropenia, Thrombocytopenia, Renal toxicity

Front 23

How are Interferons (INF) used clinically?

Back 23

Chronic Hepatitis A and B, Kaposi's Sarcoma

Front 24

How are Sulfonamides employed clinically?

Back 24

Gram +, Gram -, Norcardia, Chlamydia

Front 25

How are the HIV drugs used clinically?

Back 25

Triple Therapy' 2 Nucleoside RT Inhibitors with a Protease Inhibitor

Front 26

How are the Latent Hypnozoite (Liver) forms of Malaria (P. vivax, P.ovale) treated?

Back 26

Primaquine

Front 27

How can Isoniazid (INH)-induced neurotoxicity be prevented?

Back 27

Pyridoxine (B6) administration

Front 28

How can the t1/2 of INH be altered?

Back 28

Fast vs. Slow Acetylators

Front 29

How can the toxic effects of TMP be ameliorated?

Back 29

With supplemental Folic Acid

Front 30

How can Vancomycin-induced 'Red Man Syndrome' be prevented?

Back 30

Pretreat with antihistamines and a slow infusion rate

Front 31

How do Sulfonamides act on bacteria?

Back 31

As PABA antimetabolites that inhibit Dihydropteroate Synthase, Bacteriostatic

Front 32

How do the Protease Inhibitors work?

Back 32

Inhibt Assembly of new virus by Blocking Protease Enzyme

Front 33

How does Ganciclovir's toxicity relate to that of Acyclovir?

Back 33

Ganciclovir is more toxic to host enzymes

Front 34

How does resistance to Vancomycin occur?

Back 34

With an amino acid change of D-ala D-ala to D-ala D-lac

Front 35

How is Acyclovir used clinically?

Back 35

HSV, VZV, EBV, Mucocutaneous and Genital Herpes Lesions, Prophylaxis in Immunocompromised pts

Front 36

How is Amantadine used clinically?

Back 36

Prophylaxis for Influenza A, Rubella; Parkinson's disease

Front 37

How is Amphotericin B administered for fungal meningitis?

Back 37

Intrathecally

Front 38

How is Amphotericin B used clinically?

Back 38

Wide spectrum of systemic mycoses: Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor

Front 39

How is Chloramphenical used clinically?

Back 39

Meningitis (H. influenza, N. meningitidis, S. pneumoniae), Conserative treatment due to toxicities

Front 40

How is Foscarnet used clinically?

Back 40

CMV Retinitis in IC pts when Ganciclovir fails

Front 41

How is Ganciclovir activated?

Back 41

Phosphorylation by a Viral Kinase

Front 42

How is Ganciclovir used clinically?

Back 42

CMV, esp in Immunocompromised patients

Front 43

How is Griseofulvin used clinically?

Back 43

Oral treatment of superficial infections

Front 44

How is Leishmaniasis treated?

Back 44

Pentavalent Antimony

Front 45

How is Ribavirin used clinically?

Back 45

for RSV

Front 46

How is Rifampin used clinically?

Back 46

1. Mycobacterium tuberculosis 2. Delays resistance to Dapsone when used of Leprosy 3. Used in combination with other drugs

Front 47

How is Trimethoprim used clinically?

Back 47

Used in combination therapy with SMZ to sequentially block folate synthesis

Front 48

How is Vancomycin used clinically?

Back 48

For serious, Gram + multidrug-resistant organisms

Front 49

How would you treat African Trypanosomiasis (sleeping sickness)?

Back 49

Suramin

Front 50

In what population does Gray Baby Syndrome occur? Why?

Back 50

Premature infants, because they lack UDP-glucuronyl transferase

Front 51

Is Aztreonam cross-allergenic with penicillins?

Back 51

No

Front 52

Is Aztreonam resistant to penicillinase?

Back 52

Yes

Front 53

Is Aztreonam usually toxic?

Back 53

No

Front 54

Is Imipenem resistant to penicillinase?

Back 54

Yes

Front 55

Is Penicillin penicillinase resistant?

Back 55

No - duh

Front 56

IV Penicillin

Back 56

Penicillin-G

Front 57

Mnemonic for Foscarnet?

Back 57

Foscarnet = pyroFosphate analog

Front 58

MOA for Penicillin (3 answers)?

Back 58

1)Binds penicillin-binding proteins 2) Blocks transpeptidase cross- linking of cell wall 3) Activates autolytic enzymes

Front 59

MOA: Bactericidal antibiotics

Back 59

Penicillin, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metronidazole

Front 60

MOA: Block cell wall synthesis by inhib. Peptidoglycan cross-linking (7)

Back 60

Penicillin, Ampicillin, Ticarcillin, Pipercillin, Imipenem, Aztreonam, Cephalosporins

Front 61

MOA: Block DNA topoisomerases

Back 61

Quinolones

Front 62

MOA: Block mRNA synthesis

Back 62

Rifampin

Front 63

MOA: Block nucleotide synthesis

Back 63

Sulfonamides, Trimethoprim

Front 64

MOA: Block peptidoglycan synthesis

Back 64

Bacitracin, Vancomycin

Front 65

MOA: Block protein synthesis at 30s subunit

Back 65

Aminoglycosides, Tetracyclines

Front 66

MOA: Block protein synthesis at 50s subunit

Back 66

Chloramphenicol, Erythromycin/macrolides, Lincomycin, Clindamycin, Streptogramins (quinupristin, dalfopristin)

Front 67

MOA: Disrupt bacterial/fungal cell membranes

Back 67

Polymyxins

Front 68

MOA: Disrupt fungal cell membranes

Back 68

Amphotericin B, Nystatin, Fluconazole/azoles

Front 69

Name common Polymyxins

Back 69

Polymyxin B, Polymyxin E

Front 70

Name several common Macrolides (3)

Back 70

Erythromycin, Azithromycin, Clarithromycin

Front 71

Name some common Sulfonamides (4)

Back 71

Sulfamethoxazole (SMZ), Sulfisoxazole, Triple sulfas, Sulfadiazine

Front 72

Name some common Tetracyclines (4)

Back 72

Tetracycline, Doxycycline, Demeclocycline, Minocycline

Front 73

Name the common Aminoglycosides (5)

Back 73

Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

Front 74

Name the common Azoles

Back 74

Fluconazole, Ketoconazole, Clotrimazole, Miconazole, Itraconazole

Front 75

Name the common Fluoroquinolones (6)

Back 75

Ciprofloxacin, Norfloxacin, Ofloxacin, Grepafloxacin, Enoxacin, Nalidixic acid

Front 76

Name the common Non-Nucleoside Reverse Transcriptase Inhibitors

Back 76

Nevirapine, Delavirdine

Front 77

Name the common Nucleoside Reverse Transcriptase Inhibitors

Back 77

Zidovudine (AZT), Didanosine (ddI), Zalcitabine (ddC), Stavudine (d4T), Lamivudine (3TC)

Front 78

Name the Protease Inhibitors (4)

Back 78

Saquinavir, Ritonavir, Indinavir, Nelfinavir

Front 79

Name two classes of drugs for HIV therapy

Back 79

Protease Inhibitors and Reverse Transcriptase Inhibitors

Front 80

Name two organisms Vancomycin is commonly used for?

Back 80

Staphlococcus aureus and Clostridium difficile (pseudomembranous colitis)

Front 81

Oral Penicillin

Back 81

Penicillin-V

Front 82

Resistance mechanisms for Aminoglycosides

Back 82

Modification via Acetylation, Adenylation, or Phosphorylation

Front 83

Resistance mechanisms for Cephalosporins/Penicillins

Back 83

Beta-lactamase cleavage of Beta-lactam ring

Front 84

Resistance mechanisms for Chloramphenicol

Back 84

Modification via Acetylation

Front 85

Resistance mechanisms for Macrolides

Back 85

Methylation of rRNA near Erythromycin's ribosome binding site

Front 86

Resistance mechanisms for Sulfonamides

Back 86

Altered bacterial Dihydropteroate Synthetase, Decreased uptake, or Increased PABA synthesis

Front 87

Resistance mechanisms for Tetracycline

Back 87

Decreased uptake or Increased transport out of cell

Front 88

Resistance mechanisms for Vancomycin

Back 88

Terminal D-ala of cell wall replaced with D-lac; Decreased affinity

Front 89

Side effects of Isoniazid (INH)?

Back 89

Hemolysis (if G6PD deficient), Neurotoxicity, Hepatotoxicity, SLE-like syndrome

Front 90

Specifically, how does Foscarnet inhibit viral DNA pol?

Back 90

Binds to the Pyrophosphate Binding Site of the enzyme

Front 91

The MOA for Chloramphenicol is?

Back 91

Inhibition of 50S peptidyl transferase, Bacteriostatic

Front 92

Toxic effects of TMP include?

Back 92

Megaloblastic anemia, Leukopenia, Granulocytopenia

Front 93

Toxic side effects of the Azoles?

Back 93

Hormone synthesis inhibition (Gynecomastia), Liver dysfunction (Inhibits CYP450), Fever, Chills

Front 94

Toxicities associated with Acyclovir?

Back 94

Delirium, Tremor, Nephrotoxicity

Front 95

What additional side effects exist for Ampicillin?

Back 95

Rash, Pseudomembranous colitis

Front 96

What antimicrobial class is Aztreonam syngergestic with?

Back 96

Aminoglycosides

Front 97

What are Amantadine-associated side effects?

Back 97

Ataxia, Dizziness, Slurred speech

Front 98

What are Aminoglycosides synergistic with?

Back 98

Beta-lactam antibiotics

Front 99

What are Aminoglycosides used for clinically?

Back 99

Severe Gram - rod infections.

Front 100

What are common serious side effects of Aminoglycosides and what are these associated with?

Back 100

Nephrotoxicity (esp. with Cephalosporins), Ototoxicity (esp. with Loop Diuretics)

Front 101

What are common side effects of Amphotericin B?

Back 101

Fever/Chills, Hypotension, Nephrotoxicity, Arrhythmias

Front 102

What are common side effects of Protease Inhibitors?

Back 102

GI intolerance (nausea, diarrhea), Hyperglycemia, Lipid abnormalities, Thrombocytopenia (Indinavir)

Front 103

What are common side effects of RT Inhibitors?

Back 103

BM suppression (neutropenia, anemia), Peripheral neuropathy

Front 104

What are common toxic side effects of Sulfonamides? (5)

Back 104

-Hypersensitivity reactions -Hemolysis -Nephrotoxicity (tubulointerstitial nephritis) -Kernicterus in infants Displace other drugs from albumin (e.g., warfarin)

Front 105

What are common toxicities associated with Macrolides? (4)

Back 105

GI discomfort, Acute cholestatic hepatitis, Eosinophilia, Skin rashes

Front 106

What are common toxicities associated with Tetracyclines?

Back 106

GI distress, Tooth discoloration and Inhibition of bone growth in children, Fanconi's syndrome, Photosensitivity

Front 107

What are common toxicities related to Vancomycin therapy?

Back 107

Well tolerated in general but occasionally, Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing='Red Man Syndrome'

Front 108

What are Fluoroquinolones indicated for? (3)

Back 108

1.Gram - rods of the Urinary and GI tracts (including Pseudomonas) 2.Neisseria 3. Some Gram + organisms

Front 109

What are major side effects of Methicillin, Nafcillin, and Dicloxacillin?

Back 109

Hypersensitivity reactions

Front 110

What are Methicillin, Nafcillin, and Dicloxacillin used for clinically?

Back 110

Staphlococcus aureus

Front 111

What are Polymyxins used for?

Back 111

Resistant Gram - infections

Front 112

What are the Anti-TB drugs?

Back 112

Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid (INH)

Front 113

What are the clinical indications for Azole therapy?

Back 113

Systemic mycoses

Front 114

What are the clinical uses for 1st Generation Cephalosporins?

Back 114

Gram + cocci, Proteus mirabilis, E. coli, Klebsiella pneumoniae (PEcK)

Front 115

What are the clinical uses for 2nd Generation Cephalosporins?

Back 115

Gram + cocci, Haemophilus influenza, Enterobacter aerogenes, Neisseria species, P. mirabilis, E. coli, K. pneumoniae, Serratia marcescens ( HEN PEcKS )

Front 116

What are the clinical uses for 3rd Generation Cephalosporins?

Back 116

1) Serious Gram - infections resistant to other Beta lactams 2) Meningitis (most penetrate the BBB)

Front 117

What are the clinical uses for Aztreonam?

Back 117

Gram - rods: Klebsiella species, Pseudomonas species, Serratia species

Front 118

What are the clinical uses for Imipenem/cilastatin?

Back 118

Gram + cocci, Gram - rods, and Anerobes

Front 119

What are the Macrolides used for clinically?

Back 119

-Upper respiratory tract infections -pneumonias -STDs: Gram+ cocci (streptococcal infect in pts allergic to penicillin) -Mycoplasma, Legionella,Chlamydia, Neisseria

Front 120

What are the major structural differences between Penicillin and Cephalosporin?

Back 120

Cephalosporin: 1) has a 6 member ring attached to the Beta lactam instead of a 5 member ring 2)has an extra functional group ( attached to the 6 member ring)

Front 121

What are the major toxic side effects of Imipenem/cilastatin?

Back 121

GI distress, Skin rash, and Seizures at high plasma levels

Front 122

What are the major toxic side effects of the Cephalosporins?

Back 122

1) Hypersensitivity reactions 2) Increased nephrotoxicity of Aminoglycosides 3) Disulfiram-like reaction with ethanol (those with a methylthiotetrazole group, e.g., cefamandole)

Front 123

What are the side effects of Polymyxins?

Back 123

Neurotoxicity, Acute renal tubular necrosis

Front 124

What are the side effects of Rifampin?

Back 124

Minor hepatotoxicity, Drug interactions (activates P450)

Front 125

What are toxic side effects for Metronidazole?

Back 125

Disulfiram-like reaction with EtOH, Headache

Front 126

What are toxicities associated with Chloramphenicol?

Back 126

Aplastic anemia (dose independent), Gray Baby Syndrome

Front 127

What conditions are treated with Metronidazole?

Back 127

Giardiasis, Amoebic dysentery (E. histolytica), Bacterial vaginitis (Gardnerella vaginalis), Trichomonas

Front 128

What do Aminoglycosides require for uptake?

Back 128

Oxygen

Front 129

What do you treat Nematode/roundworm (pinworm, whipworm) infections with?

Back 129

Mebendazole/Thiabendazole, Pyrantel Pamoate

Front 130

What drug is given for Pneumocystis carinii prophylaxis?

Back 130

Pentamidine

Front 131

What drug is used during the pregnancy of an HIV+ mother?, Why?

Back 131

AZT, to reduce risk of Fetal Transmission

Front 132

What drug is used to treat Trematode/fluke (e.g., Schistosomes, Paragonimus, Clonorchis) or Cysticercosis

Back 132

Praziquantel

Front 133

What is a common drug interaction associated with Griseofulvin?

Back 133

Increases coumadin metabolism

Front 134

What is a mnemonic to remember Amantadine's function?

Back 134

Blocks Influenza A and RubellA; causes problems with the cerebellA

Front 135

What is a prerequisite for Acyclovir activation?

Back 135

It must be Phosphorylated by Viral Thymidine Kinase

Front 136

What is a Ribavirin toxicity?

Back 136

Hemolytic anemia

Front 137

What is an acronym to remember Anti-TB drugs?

Back 137

RESPIre

Front 138

What is an additional side effect of Methicillin?

Back 138

Interstitial nephritis

Front 139

What is an occasional side effect of Aztreonam?

Back 139

GI upset

Front 140

What is Clindamycin used for clinically?

Back 140

Anaerobic infections (e.g., B. fragilis, C. perfringens)

Front 141

What is clinical use for Carbenicillin, Piperacillin, and Ticarcillin?

Back 141

Pseudomonas species and Gram - rods

Front 142

What is combination TMP-SMZ used to treat?

Back 142

Recurrent UTIs, Shigella, Salmonella, Pneumocystis carinii pneumonia

Front 143

What is combined with Ampicillin, Amoxicillin, Carbenicillin, Piperacillin, and Ticarcillin to enhance their spectrum?

Back 143

Clavulanic acid

Front 144

What is Fluconazole specifically used for?

Back 144

Cryptococcal meningitis in AIDS patients and Candidal infections of all types

Front 145

What is Imipenem always administered with?

Back 145

Cilastatin

Front 146

What is Ketoconazole specifically used for?

Back 146

Blastomyces, Coccidioides, Histoplasma, C. albicans; Hypercortisolism

Front 147

What is Metronidazole combined with for 'triple therapy'? Against what organism?

Back 147

Bismuth and Amoxicillin or Tetracycline; against Helobacter pylori

Front 148

What is Metronidazole used for clinically?

Back 148

Antiprotozoal: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis Anaerobes: Bacteroides, Clostridium

Front 149

What is Niclosamide used for?

Back 149

Cestode/tapeworm (e.g., D. latum, Taenia species Except Cysticercosis

Front 150

What is Nifurtimox administered for?

Back 150

Chagas' disease, American Trypanosomiasis (Trypanosoma cruzi)

Front 151

What is the chemical name for Ganciclovir?

Back 151

DHPG (dihydroxy-2-propoxymethyl guanine)

Front 152

What is the clinical use for Ampicillin and Amoxicillin?

Back 152

Extended spectrum penicillin: certain Gram + bacteria and Gram - rods

Front 153

What is the clinical use for Nystatin?

Back 153

Topical and Oral, for Oral Candidiasis (Thrush)

Front 154

What is the clinical use for Penicillin?

Back 154

Bactericidal for: Gram + rod and cocci, Gram - cocci, and Spirochetes

Front 155

What is the major side effect for Ampicillin and Amoxicillin?

Back 155

Hypersensitivity reactions

Front 156

What is the major side effect for Carbenicillin, Piperacillin, and Ticarcillin?

Back 156

Hypersensitivity reactions

Front 157

What is the major toxic side effect of Penicillin?

Back 157

Hypersensitivity reactions

Front 158

What is the memory aid for subunit distribution of ribosomal inhibitors?

Back 158

Buy AT 30, CELL at 50'

Front 159

What is the memory key for Isoniazid (INH) toxicity?

Back 159

INH: Injures Neurons and Hepatocytes

Front 160

What is the memory key for Metronidazole's clinical uses?

Back 160

GET on the Metro

Front 161

What is the memory key for organisms treated with Tetracyclines?

Back 161

VACUUM your Bed Room'

Front 162

What is the memory key involving the '4 R's of Rifampin?'

Back 162

1. RNA pol inhibitor 2. Revs up P450 3. Red/orange body fluids 4. Rapid resistance if used alone

Front 163

What is the MOA for Acyclovir?

Back 163

Inhibit viral DNA polymerase

Front 164

What is the MOA for Amphotericin B?

Back 164

Binds Ergosterol, forms Membrane Pores that Disrupt Homeostatis

Front 165

What is the MOA for Ampicillin and Amoxicillin?

Back 165

Same as penicillin. Extended spectrum antibiotics

Front 166

What is the MOA for Carbenicillin, Piperacillin, and Ticarcillin?

Back 166

Same as penicillin. Extended spectrum antibiotics

Front 167

What is the MOA for Clindamycin?

Back 167

Blocks Peptide Bond formation at the 50S subunit, Bacteriostatic

Front 168

What is the MOA for Methicillin, Nafcillin, and Dicloxacillin?

Back 168

Same as penicillin. Act as narrow spectrum antibiotics

Front 169

What is the MOA for Metronidazole?

Back 169

Forms toxic metabolites in the bacterial cell, Bactericidal

Front 170

What is the MOA for Nystatin?

Back 170

Binds ergosterol, Disrupts fungal membranes

Front 171

What is the MOA for Rifampin?

Back 171

Inhibits DNA dependent RNA polymerase

Front 172

What is the MOA for the Aminoglycosides?

Back 172

Inhibits formation of Initiation Complex, causes misreading of mRNA, Bactericidal

Front 173

What is the MOA for the Azoles?

Back 173

Inhibit Ergosterol synthesis

Front 174

What is the MOA for the Cephalosporins?

Back 174

Beta lactams - inhibit cell wall synthesis, Bactericidal

Front 175

What is the MOA for the Fluoroquinolones?

Back 175

Inhibit DNA Gyrase (topoisomerase II), Bactericidal

Front 176

What is the MOA for the Macrolides?

Back 176

Blocks translocation, binds to the 23S rRNA of the 50S subunit, Bacteriostatic

Front 177

What is the MOA for the Tetracyclines?

Back 177

Binds 30S subunit and prevents attachment of aminoacyl-tRNA, Bacteriostatic

Front 178

What is the MOA for Trimethoprim (TMP)?

Back 178

Inhibits bacterial Dihydrofolate Reductase, Bacteriostatic

Front 179

What is the MOA for Vancomycin?

Back 179

Inhibits cell wall mucopeptide formation, Bactericidal

Front 180

What is the MOA of Amantadine?

Back 180

Blocks viral penetration/uncoating; may act to buffer the pH of the endosome

Front 181

What is the MOA of Aztreonam?

Back 181

Inhibits cell wall synthesis ( binds to PBP3). A monobactam

Front 182

What is the MOA of Foscarnet?

Back 182

Inhibits Viral DNA polymerase

Front 183

What is the MOA of Ganciclovir?

Back 183

Inhibits CMV DNA polymerase

Front 184

What is the MOA of Griseofulvin?

Back 184

Interferes with microtubule function, disrupts mitosis, inhibits growth

Front 185

What is the MOA of Imipenem?

Back 185

Acts as a wide spectrum carbapenem

Front 186

What is the MOA of Isoniazid (INH)?

Back 186

Decreases synthesis of Mycolic Acid

Front 187

What is the MOA of Polymyxins?

Back 187

Bind cell membrane, disrupt osmotic properties, Are Cationc, Basic and act as detergents

Front 188

What is the MOA of Ribavirin?

Back 188

Inhibits IMP Dehydrogenase (competitively), and therefore blocks Guanine Nucleotide synthesis

Front 189

What is the MOA of the RT Inhibitors?

Back 189

Inhibit RT of HIV and prevent the incorporation of viral genome into the host DNA

Front 190

What is the most common cause of Pt noncompliance with Macrolides?

Back 190

GI discomfort

Front 191

What is treated with Chloroquine, Quinine, Mefloquine?

Back 191

Malaria (P. falciparum)

Front 192

What microorganisms are Aminoglycosides ineffective against?

Back 192

Anaerobes

Front 193

What microorganisms are clinical indications for Tetracycline therapy?

Back 193

Vibrio cholerae Acne Chlamydia Ureaplasma Urealyticum Mycoplasma pneumoniae Borrelia burgdorferi (Lyme's) Rickettsia Tularemia

Front 194

What microorganisms is Aztreonam not effective against?

Back 194

Gram + and Anerobes

Front 195

What musculo-skeletal side effects in Adults are associated with Floroquinolones?

Back 195

Tendonitis and Tendon rupture

Front 196

What neurotransmitter does Amantadine affect? How does it influence this NT?

Back 196

Dopamine; causes its release from intact nerve terminals

Front 197

What organism is Imipenem/cilastatin the Drug of Choice for?

Back 197

Enterobacter

Front 198

What organisms does Griseofulvin target?

Back 198

Dermatophytes (tinea, ringworm)

Front 199

What parasites are treated with Pyrantel Pamoate (more specific)?

Back 199

Giant Roundworm (Ascaris), Hookworm (Necator/Ancylostoma), Pinworm (Enterobius)

Front 200

What parasitic condition is treated with Ivermectin?

Back 200

Onchocerciasis ('river blindness'--rIVER-mectin)

Front 201

What populations are Floroquinolones contraindicated in? Why?

Back 201

Pregnant women, Children; because animal studies show Damage to Cartilage

Front 202

What should not be taken with Tetracyclines? / Why?

Back 202

Milk or Antacids, because divalent cations inhibit Tetracycline absorption in the gut

Front 203

What Sulfonamides are used for simple UTIs?

Back 203

Triple sulfas or SMZ

Front 204

When is HIV therapy initiated?

Back 204

When pts have Low CD4+ (< 500 cells/cubic mm) or a High Viral Load

Front 205

When is Rifampin not used in combination with other drugs?

Back 205

1. Meningococcal carrier state 2. Chemoprophylaxis in contacts of children with H. influenzae type B

Front 206

Where does Griseofulvin deposit?

Back 206

Keratin containing tissues, e.g., nails

Front 207

Which Aminoglycoside is used for Bowel Surgery ?

Back 207

Neomycin

Front 208

Which antimicrobial classes inhibit protein synthesis at the 30S subunit? (2)

Back 208

1) Aminoglycosides = bactericidal 2) Tetracyclines = bacteriostatic

Front 209

Which antimicrobials inhibit protein synthesis at the 50S subunit? (4)

Back 209

1) Chloramphenical = bacteriostatic 2) Erythromycin = bacteriostatic 3) Lincomycin = bacteriostatic 4)cLindamycin = bacteriostatic

Front 210

Which individuals are predisposed to Sulfonamide-induced hemolysis?

Back 210

G6PD deficient individuals

Front 211

Which RT inhibitor causes Megaloblastic Anemia?

Back 211

AZT

Front 212

Which RT inhibitors cause a Rash?

Back 212

Non-Nucleosides

Front 213

Which RT inhibitors cause Lactic Acidosis?

Back 213

Nucleosides

Front 214

Which Tetracycline is used in patients with renal failure? / Why?

Back 214

Doxycycline, because it is fecally eliminated

Front 215

Why are Methicillin, Nafcillin, and Dicloxacillin penicillinase resistant?

Back 215

Due to the presence of a bulkier R group

Front 216

Why is Cilastatin administered with Imipenem?

Back 216

To inhibit renal Dihydropeptidase I and decrease Imipenem inactivation in the renal tubules

Front 217

List the mechanism, clinical use, & toxicity of 5 FU.

Back 217

-S-phase anti-metabolite Pyr analogue -Colon, solid tumors, & BCC/ -Irreversible myelosuppression

Front 218

List the mechanism, clinical use, & toxicity of 6 MP.

Back 218

-inhibits HGPRT (pur. Syn.) - Luk, Lymph,

Front 219

List the mechanism, clinical use, & toxicity of Bleomycin.

Back 219

-DNA intercalator -testicular & lymphomas -Pulmonary fibrosis mild myelosuppression.

Front 220

List the mechanism, clinical use, & toxicity of Busulfan.

Back 220

-Alkalates DNA -CML -Pulmonary fibrosis hyperpigmentation

Front 221

List the mechanism, clinical use, & toxicity of Cisplatin.

Back 221

-Alkalating agent -testicular,bladder,ovary,& lung -Nephrotoxicity & CN VIII damage.

Front 222

List the mechanism, clinical use, & toxicity of Cyclophosphamide.

Back 222

-Alkalating agent -NHL, Breast, ovary, & lung. - Myelosuppression, & hemorrhagic cystitis.

Front 223

List the mechanism, clinical use, & toxicity of Doxorubicin.

Back 223

-DNA intercalator -Hodgkin's, myeloma, sarcoma, and solid tumors -Cardiotoxicity & alopecia

Front 224

List the mechanism, clinical use, & toxicity of Etoposide.

Back 224

-Topo II inhibitor(GII specific) -Oat cell of Lung & prostate, & testicular -Myelosuppression & GI irritation.

Front 225

List the mechanism, clinical use, & toxicity of Methotrexate.

Back 225

-S-phase anti-metabolite folate analogue -Luk, Lymp, sarc, RA, & psoriasis / -Reversible myelosuppression

Front 226

List the mechanism, clinical use, & toxicity of Nitrosureas.

Back 226

-Alkalate DNA -Brain tumors -CNS toxicity

Front 227

List the mechanism, clinical use, & toxicity of Paclitaxel.

Back 227

-MT polymerization stabilizer -Ovarian & breast CA -Myelosupperession & hypersensitivity.

Front 228

List the mechanism, clinical use, & toxicity of Prednisone.

Back 228

-Triggers apoptosis -CLL, Hodgkin's in MOPP -Cushing-like syndrome

Front 229

List the mechanism, clinical use, & toxicity of Tamoxifen.

Back 229

-Estrogen receptor antagonist -Breast CA -increased endometrial CA risk

Front 230

List the mechanism, clinical use, & toxicity of Vincristine.

Back 230

-MT polymerization inhibitor(M phase) -MOPP, lymphoma, Willm's & choriocarcinoma -neurotoxicity and myelosuppression

Front 231

Which cancer drugs effect nuclear DNA (4)?

Back 231

-Alkalating agents+cisplatin -Doxorubicin+Dactinomycin -Bleomycin -Etoposide

Front 232

Which cancer drugs inhibit nucleotide synthesis(3)?

Back 232

- Methotrexate - 5 FU - 6 mercaptopurine

Front 233

Which cancer drugs work at the level of mRNA(2)?

Back 233

-Steroids -Tamoxifen

Front 234

Which cancer drugs work at the level of proteins(2)?

Back 234

-Vinca alkaloids(inhibit MT) -Paclitaxel

Front 235

ACE inhibitors- clinical use?

Back 235

hypertension, CHF, diabetic renal disease

Front 236

ACE inhibitors- mechanism?

Back 236

reduce levels of Angiotensin II, thereby preventing the inactivation of bradykinin (a potent vasodilator); renin level is increased

Front 237

ACE inhibitors- toxicity?

Back 237

fetal renal damage, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)

Front 238

Acetazolamide- clinical uses?

Back 238

glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness

Front 239

Acetazolamide- mechanism?

Back 239

acts at the proximal convoluted tubule to inhibit carbonic anhydrase. Causes self-limited sodium bicarb diuresis and reduction of total body bicarb stores.

Front 240

acetazolamide- site of action?

Back 240

proximal convoluted tubule

Front 241

Acetazolamide- toxicity?

Back 241

hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy

Front 242

Acetazolamide causes?

Back 242

ACIDazolamide' causes acidosis

Front 243

Adenosine- clinical use?

Back 243

DOC in diagnosing and abolishing AV nodal arrhythmias

Front 244

ADH antagonists- site of action?

Back 244

collecting ducts

Front 245

adverse effect of Nitroprusside?

Back 245

cyanide toxicity (releases CN)

Front 246

adverse effects of beta-blockers?

Back 246

impotence, asthma, CV effects (bradycardia, CHF, AV block), CNS effects (sedation, sleep alterations)

Front 247

adverse effects of Captopril?

Back 247

fetal renal toxicity, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)

Front 248

adverse effects of Clonidine?

Back 248

dry mouth, sedation, severe rebound hypertension

Front 249

adverse effects of ganglionic blockers?

Back 249

severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction

Front 250

adverse effects of Guanethidine?

Back 250

orthostatic and exercise hypotension, sexual dysfunction, diarrhea

Front 251

adverse effects of Hydralazine?

Back 251

nausea, headache, lupus-like syndrome, reflex tachycardia, angina, salt retention

Front 252

adverse effects of Hydrochlorothiazide?

Back 252

hypokalemia, slight hyperlipidemia, hyperuricemia, lassitude, hypercalcemia, hyperglycemia

Front 253

adverse effects of Loop Diuretics?

Back 253

K+ wasting, metabolic alkalosis, hypotension, ototoxicity

Front 254

adverse effects of Losartan?

Back 254

fetal renal toxicity, hyperkalemia

Front 255

adverse effects of Methyldopa?

Back 255

sedation, positive Coombs' test

Front 256

adverse effects of Minoxidil?

Back 256

hypertrichosis, pericardial effusion, reflex tachycardia, angina, salt retention

Front 257

adverse effects of Nifedipine, verapamil?

Back 257

dizziness, flushing, constipation (verapamil), nausea

Front 258

adverse effects of Prazosin?

Back 258

first dose orthostatic hypotension, dizziness, headache

Front 259

adverse effects of Reserpine?

Back 259

sedation, depression, nasal stuffiness, diarrhea

Front 260

Amiodarone- toxicity?

Back 260

pulmonary fibrosis, corneal deposits, hepatotoxicity, skin deposits resulting in photodermatitis, neurologic effects, consitpation, CV (bradycardia, heart block, CHF), and hypo- or hyperthyroidism.

Front 261

Beta Blockers- CNS toxicity?

Back 261

sedation, sleep alterations

Front 262

Beta Blockers- CV toxicity?

Back 262

bradycardia, AV block, CHF

Front 263

Beta Blockers- site of action?

Back 263

Beta adrenergic receptors and Ca2+ channels (stimulatory)

Front 264

Beta Blockers- BP?

Back 264

decrease

Front 265

Bretyllium- toxicity?

Back 265

new arrhythmias, hypotension

Front 266

Ca2+ channel blockers- clinical use?

Back 266

hypertension, angina, arrhythmias

Front 267

Ca2+ channel blockers- mechanism?

Back 267

block voltage dependent L-type Ca2+ channels of cardiac and smooth muscle- decreasing contractility

Front 268

Ca2+ channel blockers- site of action?

Back 268

Cell membrane Ca2+ channels of cardiac sarcomere

Front 269

Ca2+ channel blockers- toxicity?

Back 269

cardiac depression, peripheral edema, flushing, dizziness, constipation

Front 270

Ca2+ sensitizers'- site of action?

Back 270

troponin-tropomyosin system

Front 271

Cautions when using Amiodarone?

Back 271

check PFTs, LFTs, and TFTs

Front 272

Antiarrhythmic class IA effects?

Back 272

increased AP duration, increased ERP increased QT interval. Atrial and ventricular.

Front 273

Antiarrhythmic class IB- clinical uses?

Back 273

post MI and digitalis induced arrhythmias

Front 274

Antiarrhythmic class IB- effects?

Back 274

decrease AP duration, affects ischemic or depolarized Purkinje and ventricular system

Front 275

Antiarrhythmic class IB- toxicity?

Back 275

local anesthetic. CNS stimulation or depression. CV depression.

Front 276

Antiarrhythmic class IC- effects?

Back 276

NO AP duration effect. useful in V-tach that progresses to V-fib and in intractable SVT LAST RESORT

Front 277

Antiarrhythmic class IC- toxicity?

Back 277

proarrhythmic

Front 278

Antiarrhythmic class II- effects?

Back 278

decrease the slope of phase 4, increase PR interval (the AV node is particularly sensitive)

Front 279

Antiarrhythmic class II- mechanism?

Back 279

blocking the beta adrenergic receptor leads to decreased cAMP, and decreased Ca2+ flux

Front 280

Antiarrhythmic class II- toxicity?

Back 280

impotence, exacerbation of asthma, CV effects, CNS effects, may mask hypoclycemia

Front 281

Antiarrhythmic Class III- effects?

Back 281

increase AP duration, increase ERP, increase QT interval, for use when other arrhythmics fail

Front 282

Antiarrhythmic class IV- clinical use?

Back 282

prevention of nodal arrhythmias (SVT)

Front 283

Antiarrhythmic class IV- effects?

Back 283

decrease conduction velocity, increase ERP, increase PR interval

Front 284

Antiarrhythmic class IV- primary site of action?

Back 284

AV nodal cells

Front 285

Antiarrhythmic class IV- toxicity?

Back 285

constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression), and torsade de pointes (Bepridil)

Front 286

classes of antihypertensive drugs?

Back 286

diuretics, sympathoplegics, vasodilators, ACE inhibitors, Angiotensin II receptor inhibitors

Front 287

decrease Digitoxin dose in renal failure?

Back 287

NO

Front 288

decrease Digoxin dose in renal failure?

Back 288

YES

Front 289

Digitalis- site of action?

Back 289

Na/K ATPase

Front 290

Digoxin v. Digitoxin: bioavailability?

Back 290

Digitoxin>95% Digoxin 75%

Front 291

Digoxin v. Digitoxin: excretion?

Back 291

Digoxin=urinary Digitoxin=biliary

Front 292

Digoxin v. Digitoxin: half life?

Back 292

Digitoxin 168hrs Digoxin 40 hrs

Front 293

Digoxin v. Digitoxin: protein binding?

Back 293

Digitoxin 70% Digoxin 20-40%

Front 294

Esmolol- short or long acting?

Back 294

very short acting

Front 295

Ethacrynic Acid- clinical use?

Back 295

Diuresis in pateints with sulfa allergy

Front 296

Ethacrynic Acid- mechanism?

Back 296

not a sulfonamide, but action is the same as furosemide

Front 297

Ethacrynic Acid- toxicity?

Back 297

NO HYPERURICEMIA, NO SULFA ALLERGY; same as furosemide otherwise

Front 298

Furosemide- class and mechanism?

Back 298

Sulfonamide Loop Diuretic. Inhibits ion co-transport system of thick ascending loop. Abolishes hypertonicity of the medulla, thereby preventing concentration of the urine.

Front 299

Furosemide- clinical use?

Back 299

edematous states (CHF, cirrhosis, nephrotic syndrome, pulm edema), HTN, hypercalcemia

Front 300

Furosemide- toxicity? (OH DANG)

Back 300

Ototoxicity, Hypokalemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout

Front 301

Furosemide increases the excretion of what ion?

Back 301

Ca2+ (Loops Lose calcium)

Front 302

how do we stop angina?

Back 302

decrease myocardial O2 consumption by: 1-decreasing end diastolic volume 2- decreasing BP 3- decreasing HR 4-decreasing contractility 5-decreasing ejection time

Front 303

Hydralazine- class and mechanism?

Back 303

vasodilator- increases cGMP to induce smooth muscle relaxation (arterioles>veins; afterload reduction)

Front 304

Hydralazine- clinical use?

Back 304

severe hypertension, CHF

Front 305

Hydralazine- toxicity?

Back 305

compensatory tachycardia, fluid retention, lupus-like syndrome

Front 306

Hydrochlorothiazide- clinical use?

Back 306

HTN, CHF, calcium stone formation, nephrogenic DI.

Front 307

Hydrochlorothiazide- mechanism?

Back 307

Inhibits NaCl reabsorption in the early distal tubule. Decreases Ca2+ excretion.

Front 308

Hydrochlorothiazide- toxicity? (hyperGLUC, plus others)

Back 308

Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia, sulfa allergy.

Front 309

Ibutilide- toxicity?

Back 309

torsade de pointes

Front 310

K+- clinical use?

Back 310

depresses ectopic pacemakers, especially in digoxin toxicity

Front 311

K+ sparing diuretics- clinical use?

Back 311

hyperaldosteronism, K+ depletion, CHF

Front 312

K+ sparing diuretics- site of action?

Back 312

cortical collecting tubule

Front 313

K+ sparing diuretics- toxicity?

Back 313

hyperkalemia, endocrine effects (gynecomastia, anti-androgen)

Front 314

loop diuretics (furosemide)- site of action?

Back 314

thick ascending limb

Front 315

Mannitol- clinical use?

Back 315

ARF, shock, drug overdose, decrease intracranial/intraocular pressure

Front 316

Mannitol- contraindications?

Back 316

anuria, CHF

Front 317

Mannitol- mechanism?

Back 317

osmotic diuretic- increase tubular fluid osmolarity, thereby increasing urine flow

Front 318

mannitol- site of action?

Back 318

proximal convoluted tubule, thin descending limb, and collecting duct

Front 319

Mannitol- toxicity?

Back 319

pulmonary edema, dehydration

Front 320

Mg+- clinical use?

Back 320

effective in torsade de pointes and digoxin toxicity

Front 321

name five Antiarrhythmic drugs in class II?

Back 321

propanolol, esmolol, metoprolol, atenolol, timolol

Front 322

name four HMG-CoA reductase inhibitors.

Back 322

Lovastatin, Pravastatin, Simvastatin, Atorvastatin

Front 323

name four Antiarrhythmic drugs in class IA.

Back 323

Quinidine, Amiodarone, Procainamide, Disopyramide

Front 324

name four Antiarrhythmic drugs in class III.

Back 324

Sotalol, Ibutilide, Bretylium, Amiodarone

Front 325

name three ACE inhibitors?

Back 325

Captopril, Enalapril, Lisinopril

Front 326

name three calcium channel blockers?

Back 326

Nifedipine, Verapamil, Diltiazem

Front 327

name three Antiarrhythmic drugs in class IB.

Back 327

Lidocaine, Mexiletine, Tocainide

Front 328

name three Antiarrhythmic drugs in class IC.

Back 328

Flecainide, Encainide, Propafenone

Front 329

name three Antiarrhythmic drugs in class IV.

Back 329

Verapamil, Diltiazem, Bepridil

Front 330

name three K+ sparing diuretics?

Back 330

Spironolactone, Triamterene, Amiloride (the K+ STAys)

Front 331

name two bile acid resins.

Back 331

cholestyramine, colestipol

Front 332

name two LPL stimulators.

Back 332

Gemfibrozil, Clofibrate

Front 333

Nifedipine has similar action to?

Back 333

Nitrates

Front 334

preferential action of the Ca2+ channel blockers at cardiac muscle?

Back 334

cardiac muscle: Verapamil>Diltiazem>Nifedipine

Front 335

preferential action of the Ca2+ channel blockers at vascular smooth muscle?

Back 335

vascular sm. Mus.: Nifedipine>Diltiazem>Verapamil

Front 336

Procainamide- toxicity?

Back 336

reversible SLE-like syndrome

Front 337

Quinidine- toxicity?

Back 337

cinchonism: HA, tinnitus, thrombocytopenia, torsade de pointes due to increased QT interval

Front 338

Ryanodine- site of action?

Back 338

blocks SR Ca2+ channels

Front 339

Sotalol- toxicity?

Back 339

torsade de pointes, excessive Beta block

Front 340

Spironolactone- mechanism?

Back 340

competitive inhibirot of aldosterone in the cortical collecting tubule

Front 341

thiazides- site of action?

Back 341

distal convoluted tubule (early)

Front 342

Triamterene and amiloride- mechanism?

Back 342

block Na+ channels in the cortical collecting tubule

Front 343

Verapamil has similar action to?

Back 343

Beta Blockers

Front 344

what two vasodilators require simultaneous treatment with beta blockers to prevent reflex tachycardia and diuretics to prevent salt retention?

Back 344

Hydralazine and Minoxidil

Front 345

which diuretics cause acidosis?

Back 345

carbonic anhydrase inhibitors, K+ sparing diuretics

Front 346

which diuretics cause alkalosis?

Back 346

loop diuretics, thiazides

Front 347

which diuretics decrease urine Ca2+?

Back 347

thiazides, amiloride

Front 348

which diuretics increase urine Ca2+?

Back 348

loop diuretics, spironolactone

Front 349

which diuretics increase urine K+?

Back 349

all except the K+ sparing diuretics Spironolactone, Triamterene, Amiloride

Front 350

which diuretics increase urine NaCl?

Back 350

all of them

Front 351

Acetaminophen has what two clinical uses and lacks what one clinical use of the NSAIDs?

Back 351

Acetaminophen has antipyretic and analgesic properties, but lacks anti-inflammatory properties.

Front 352

Can Heparin be used during pregnancy?

Back 352

Yes, it does not cross the placenta.

Front 353

Can Warfarin be used during pregnancy?

Back 353

No, warfarin, unlike heparin, can cross the placenta.

Front 354

Does Heparin have a long, medium, or short half life?

Back 354

Short.

Front 355

Does Warfarin have a long, medium, or short half life?

Back 355

Long.

Front 356

For Heparin what is the Structure

Back 356

Large anionic polymer, acidic

Front 357

For Heparin what is the Route of administration

Back 357

Paranteral (IV, SC)

Front 358

For Heparin what is the Onset of action

Back 358

Rapid (seconds)

Front 359

For Heparin what is the Mechanism of action

Back 359

Activates antithrombin III

Front 360

For Heparin what is the Duration of action

Back 360

Acute (hours)

Front 361

For Heparin what is the Ability to inhibit coagulation in vitro

Back 361

Yes

Front 362

For Heparin what is the Treatment for overdose

Back 362

Protamine sulfate

Front 363

For Heparin what is the Lab value to monitor

Back 363

aPTT (intrinsic pathway)

Front 364

For Heparin what is the Site of action

Back 364

Blood

Front 365

For Warfarin what is the Structure

Back 365

Small lipid-soluble molecule

Front 366

For Warfarin what is the Route of administration

Back 366

Oral

Front 367

For Warfarin what is the Onset of action

Back 367

Slow, limited by half lives of clotting factors

Front 368

For Warfarin what is the Mechanism of action

Back 368

Impairs the synthesis of vitamin K-dependent clotting factors

Front 369

For Warfarin what is the Duration of action

Back 369

Chronic (weeks or months)

Front 370

For Warfarin what is the Ability to inhibit coagulation in vitro

Back 370

No

Front 371

For Warfarin what is the Treatment for overdose

Back 371

IV vitamin K and fresh frozen plasma

Front 372

For Warfarin what is the Lab value to monitor

Back 372

PT

Front 373

For Warfarin what is the Site of action

Back 373

Liver

Front 374

Is toxicity rare or common whith Cromolyn used in Asthma prevention?

Back 374

Rare.

Front 375

List five common glucocorticoids.

Back 375

1. Hydrocortisone 2. Predisone 3. Triamcinolone 4. Dexamethasone 5. Beclomethasone

Front 376

Secretion of what drug is inhibited by Probenacid used to treat chronic gout?

Back 376

Penicillin.

Front 377

The COX-2 inhibitors (celecoxib, rofecoxib) have similar side effects to the NSAIDs with what one exception?

Back 377

The COX-2 inhibitors should not have the corrosive effects of other NSAIDs on the gastrointestinal lining.

Front 378

What are are the Sulfonylureas (general description) and what is their use?

Back 378

Sulfonylureas are oral hypoglycemic agents, they are used to stimulate release of endogenous insulin in NIDDM (type-2).

Front 379

What are five advantages of Oral Contraceptives (synthetic progestins, estrogen)?

Back 379

1. Reliable (<1% failure) 2. Lowers risk of endometrial and ovarian cancer 3. Decreased incidence of ectopic pregnancy 4. Lower risk of pelvic infections 5. Regulation of menses

Front 380

What are five disadvantages of Oral Contraceptives (synthetic progestins, estrogen)?

Back 380

1. Taken daily 2. No protection against STDs 3. Raises triglycerides 4. Depression, weight gain, nausea, HTN 5. Hypercoagulable state

Front 381

What are five possible toxic effects of Aspirin therapy?

Back 381

1. Gastric ulceration 2. Bleeding 3. Hyperventilation 4. Reye's syndrome 5. Tinnitus (CN VIII)

Front 382

What are five toxicities associated with Tacrolimus (FK506)?

Back 382

1. Significant: nephrotoxicity 2. Peripheral neuropathy 3. Hypertension 4. Pleural effusion 5. Hyperglycemia.

Front 383

What are four advantages of newer low-molecular-weight heparins (Enoxaparin)?

Back 383

1. Better bioavailability 2. 2 to 4 times longer half life 3. Can be administered subcutaneously 4. Does not require laboratory monitoring

Front 384

What are four clinical activities of Aspirin?

Back 384

1. Antipyretic 2. Analgesic 3. Anti-inflammatory 4. Antiplatelet drug.

Front 385

What are four clinical uses of glucocorticoids?

Back 385

1. Addison's disease 2. Inflammation 3. Immune suppression 4. Asthma

Front 386

What are four conditions in which H2 Blockers are used clinically?

Back 386

1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger-Ellison syndrome

Front 387

What are four H2 Blockers?

Back 387

1. Cimetadine 2. Ranitidine 3. Famotidine 4. Nizatidine

Front 388

What are four Sulfonylureas?

Back 388

1. Tolbutamide 2. Chlorpropamide 3. Glyburide 4. Glipizide

Front 389

What are four thrombolytics?

Back 389

1. Streptokinase 2. Urokinase 3. tPA (alteplase), APSAC (anistreplase)

Front 390

What are four unwanted effects of Clomiphene use?

Back 390

1. Hot flashes 2. Ovarian enlargement 3. Multiple simultaneous pregnancies 4. Visual disturbances

Front 391

What are nine findings of Iatrogenic Cushing's syndrome caused by glucocorticoid therapy?

Back 391

1. Buffalo hump 2. Moon facies 3. Truncal obesity 4. Muscle wasting 5. Thin skin 6. Easy bruisability 7. Osteoporosis 8. Adrenocortical atrophy 9. Peptic ulcers

Front 392

What are signs of Sildenafil (Viagra) toxicity?

Back 392

Headache, flushing , dyspepsia, blue-green color vision.

Front 393

What are the clinical uses for Ticlopidine, Clopidogrel?

Back 393

Acute coronary syndrome; coronary stenting. Decreases the incidence or recurrence of thrombotic stroke.

Front 394

What are the four conditions in which Omeprazole, Lansoprazole is used?

Back 394

1. Peptic ulcer 2. Gastritis 3. Esophageal reflux 4. Zollinger-Ellison syndrome

Front 395

What are three clinical uses of the Leuprolide?

Back 395

1. Infertility (pulsatile) 2. Prostate cancer (continuous: use with flutamide) 3. Uterine fibroids

Front 396

What are three clinical uses of the NSAIDs?

Back 396

1. Antipyretic 2. Analgesic 3. Anti-inflammatory

Front 397

What are three common NSAIDS other than Aspirin?

Back 397

Ibuprofen, Naproxen, and Indomethacin

Front 398

What are three complications of Warfarin usage?

Back 398

1. Bleeding 2. Teratogenicity 3. Drug-drug interactions

Front 399

What are three possible complications of Heparin therapy?

Back 399

1. Bleeding 2. Thrombocytopenia 3. Drug-drug interactions

Front 400

What are three possible toxicities of NSAID usage?

Back 400

1. Renal damage 2. Aplastic anemia 3. GI distress

Front 401

What are three toxicities of Leuprolied?

Back 401

1. Antiandrogen 2. Nausea 3. Vomiting

Front 402

What are three toxicities of Propylthiouracil?

Back 402

1. Skin rash 2. Agranulocytosis (rare) 3. Aplastic anemia

Front 403

What are three types of antacids and the problems that can result from their overuse?

Back 403

1. Aluminum hydroxide: constipation and hypophosphatemia 2. Magnesium hydroxide: diarrhea 3. Calcium carbonate: Hypercalcemia, rebound acid increase - All may cause hypokalemia

Front 404

What are three unwanted effects of Mifepristone?

Back 404

1. Heavy bleeding 2. GI effects (n/v, anorexia) 3. Abdominal pain

Front 405

What are two Alpha-glucosidase inhibitors?

Back 405

1. Acarbose 2. Miglitol

Front 406

What are two clinical uses of Azathioprine?

Back 406

1. Kidney transplantation 2. Autoimmune disorders (including glomerulonephritis and hemolytic anemia)

Front 407

What are two conditions in which COX-2 inhibitors might be used?

Back 407

Rheumatoid and osteoarthritis.

Front 408

What are two Glitazones?

Back 408

1. Pioglitazone 2. Rosiglitazone.

Front 409

What are two mechanisms of action of Propythiouracil?

Back 409

Inhibits organification and coupling of thyroid hormone synthesis. Also decreases peripheral conversion of T4 to T3.

Front 410

What are two processes Corticosteroids inhibit leading to decreased inflammation?

Back 410

1. Phospholipase A2 is prevented from releasing arachidonic acid 2. Decreases protein synthesis thus lowering amount of Cyclooxygenase enzymes

Front 411

What are two toxicities associated with Cyclosporine?

Back 411

1. Predisposes to viral infections and lymphoma 2. Nephrotoxic (preventable with mannitol diuresis)

Front 412

What are two toxicities of the Glitazones?

Back 412

1. Weight gain 2. Hepatotoxicity (troglitazone)

Front 413

What are two toxicities of the Sulfonylureas?

Back 413

1. Hypoglycemia (more common with 2nd-generation drugs: glyburide, glipizide) 2. Disulfiram-like effects (not seen with 2nd-generation drugs).

Front 414

What are two types of drugs that interfere with the action of Sucralfate and why?

Back 414

Sucralfate cannot work in the presence of antacids or H2 blockers because it requires an acidic environment to polymerize.

Front 415

What can result due to antacid overuse?

Back 415

Can affect absorption, bioavailability, or urinary excretion of other drugs by altering gastric and urinary pH or by delaying gastric emptying.

Front 416

What enzyme does Zileuton inhibit?

Back 416

Lipoxygenase

Front 417

What enzymes are inhibited by NSAIDs, acetaminophen and COX II inhibitors?

Back 417

Cyclooxygenases (COX I, COX II).

Front 418

What is a common side effect of Colchicine used to treat acute gout, especially when given orally?

Back 418

GI side effects. (Note: Indomethacin is less toxic, more commonly used.)

Front 419

What is a common side effect of Misoprostol?

Back 419

Diarrhea

Front 420

What is a possible result of overdose of Acetaminophen?

Back 420

Overdose produces hepatic necrosis; acetaminophen metablolite depletes glutathione and forms toxic tissue adducts in liver.

Front 421

What is a possible toxicity of Alpha-glucosidase inhibitors used in type-2 diabetes?

Back 421

GI disturbances.

Front 422

What is a possible toxicity of Ticlopidine, Clopidogrel usage?

Back 422

Neutropenia (ticlopidine); reserved for those who cannot tolerate aspirin.

Front 423

What is a sign of toxicity with the use of thrombolytics?

Back 423

Bleeding.

Front 424

What is action of insulin in the liver, in muscle, and in adipose tissue?

Back 424

1. In liver, increases storage of glucose as glycogen. 2. In muscle, stimulates glycogen and protein synthesis, and K+ uptake. 3. In adipose tissue, facilitates triglyceride storage.

Front 425

What is are two clinical uses of Cyclosporine?

Back 425

1. Suppresses organ rejection after transplantation 2. Selected autoimmune disorders.

Front 426

What is the category and mechanism of action of Zafirlukast in Asthma treatment?

Back 426

Antileukotriene; blocks leukotriene receptors.

Front 427

What is the category and mechanism of action of Zileuton in Asthma treatment?

Back 427

Antileukotriene; blocks synthesis by lipoxygenase.

Front 428

What is the category of drug names ending in -ane (e.g. Halothane)

Back 428

Inhalational general anesthetic.

Front 429

What is the category of drug names ending in -azepam (e.g. Diazepam)

Back 429

Benzodiazepine.

Front 430

What is the category of drug names ending in -azine (e.g. Chlorpromazine)

Back 430

Phenothiazine (neuroleptic, antiemetic).

Front 431

What is the category of drug names ending in -azol (e.g. Ketoconazole)

Back 431

Antifungal.

Front 432

What is the category of drug names ending in -barbital (e.g. Phenobarbital)

Back 432

Babiturate.

Front 433

What is the category of drug names ending in -caine (e.g. Lidocaine)

Back 433

Local anesthetic.

Front 434

What is the category of drug names ending in -cillin (e.g. Methicillin)

Back 434

Penicillin.

Front 435

What is the category of drug names ending in -cycline (e.g. Tetracycline)

Back 435

Antibiotic, protein synthesis inhibitor.

Front 436

What is the category of drug names ending in -ipramine (e.g. Imipramine)

Back 436

Tricyclic antidepressant.

Front 437

What is the category of drug names ending in -navir (e.g. Saquinavir)

Back 437

Protease inhibitor.

Front 438

What is the category of drug names ending in -olol (e.g. Propranolol)

Back 438

Beta antagonist.

Front 439

What is the category of drug names ending in -operidol (e.g. Haloperidol)

Back 439

Butyrophenone (neuroleptic).

Front 440

What is the category of drug names ending in -oxin (e.g. Digoxin)

Back 440

Cardiac glycoside (inotropic agent).

Front 441

What is the category of drug names ending in -phylline (e.g. Theophylline)

Back 441

Methylxanthine.

Front 442

What is the category of drug names ending in -pril (e.g. Captopril)

Back 442

ACE inhibitor.

Front 443

What is the category of drug names ending in -terol (e.g. Albuterol)

Back 443

Beta-2 agonist.

Front 444

What is the category of drug names ending in -tidine (e.g. Cimetidine)

Back 444

H2 antagonist

Front 445

What is the category of drug names ending in -triptyline (e.g. Amitriptyline)

Back 445

Tricyclic antidepressant.

Front 446

What is the category of drug names ending in -tropin (e.g. Somatotropin)

Back 446

Pituitary hormone.

Front 447

What is the category of drug names ending in -zosin (e.g. Prazosin)

Back 447

Alpha-1 antagonist

Front 448

What is the category, desired effect, and adverse effect of Isoproterenol in the treatment of Asthma?

Back 448

Nonspecific beta-agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Adverse effect is tachycardia (Beta 1).

Front 449

What is the category, desired effect, and period of use of albuterol in the treatment of Asthma?

Back 449

Beta 2 agonist; desired effect is the relaxation of bronchial smooth muscle (Beta 2). Use during acute exacerbation.

Front 450

What is the category, desired effect, and possible mechanism of Theophylline in treating Asthma?

Back 450

Methylzanthine; desired effect is bronchodilation, may cause bronchodilation by inhibiting phosphodiesterase, enzyme involved in degrading cAMP (controversial).

Front 451

What is the category, mechanism of action, and effect of Ipratroprium in Asthma treatment?

Back 451

Muscarinic antagonist; competatively blocks muscarinic receptors, preventing bronchoconstriction.

Front 452

What is the category, mechanism of action, and particular use of beclomethasone and prednisone in Asthma treatment?

Back 452

Corticosteroids; prevent production of leukotrienes from arachodonic acid by blocking phospholipase A2. Drugs of choice in a patient with status asthmaticus (in combination with albuterol.)

Front 453

What is the category, method of use, and adverse effects of Salmeterol in Asthma treatment?

Back 453

Beta 2 agonist; used as a long-acting agent for prophylaxis. Adverse effects are tremor and arrhythmia.

Front 454

What is the clincial use for Misoprostol?

Back 454

Prevention of NSAID-induced peptic ulcers, maintains a PDA.

Front 455

What is the clinical use for Clomiphene?

Back 455

Treatment of infertility.

Front 456

What is the clinical use for Heparin?

Back 456

Immediate anticoagulation for PE, stroke, angina, MI, DVT.

Front 457

What is the clinical use for Sildenafil (Viagra)?

Back 457

Erectile dysfunction.

Front 458

What is the clinical use for Sucralfate?

Back 458

Peptic ulcer disease.

Front 459

What is the clinical use for Warfarin?

Back 459

Chronic anticoagulation.

Front 460

What is the clinical use of Mifepristone (RU486)?

Back 460

Abortifacient.

Front 461

What is the clinical use of Tacrolimus (FK506)?

Back 461

Potent immunosuppressive used in organ transplant recipients.

Front 462

What is the effect of the Glitazones in diabetes treatment?

Back 462

Increase target cell response to insulin.

Front 463

What is the enzyme inhibited, the effect of this inhibition, and the clinical use of the antiandrogren Finasteride?

Back 463

Finasteride inhibits 5 Alpha-reductase, this decreases the conversion of testosterone to dihydrotestosterone, useful in BPH

Front 464

What is the lab value used to monitor the effectiveness of Heparin therapy?

Back 464

The PTT.

Front 465

What is the lab value used to monitor the effectiveness of Warfarin therapy?

Back 465

The PT.

Front 466

What is the main clinical use for the thrombolytics?

Back 466

Early myocardial infarction.

Front 467

What is the mecanism of action of Sucralfate?

Back 467

Aluminum sucrose sulfate polymerizes in the acid environment of the stomach and selectively binds necrotic peptic ulcer tissue. Acts as a barrier to acid, pepsin, and bile.

Front 468

What is the mecanism of action of the COX-2 inhibitors (celecoxib, rofecoxib)?

Back 468

Selectively inhibit cyclooxygenase (COX) isoform 2, which is found in inflammatory cells nad mediates inflammation and pain; spares COX-1 which helps maintain the gastric mucosa.

Front 469

What is the mecanism of action, effective period, and ineffective period of use for Cromolyn in treating Asthma?

Back 469

Prevents release of mediators from mast cells. Effective only for the prophylaxis of asthma. Not effective during an acute attack.

Front 470

What is the mechanism of action and clinical use of the antiandrogen Flutamide?

Back 470

Flutamide is a nonsteroidal competitive inhibitor of androgens at the testosterone receptor, used in prostate carcinoma.

Front 471

What is the mechanism of action and clinical use of the antiandrogens Ketoconazole and Spironolactone?

Back 471

Inhibit steroid synthesis, used in the treatment of polycystic ovarian syndrome to prevent hirsutism.

Front 472

What is the mechanism of action of Acetaminophen?

Back 472

Reversibly inhibits cyclooxygenase, mostly in CNS. Inactivated peripherally.

Front 473

What is the mechanism of action of Allopurinol used to treat chronic gout?

Back 473

Inhibits xanthine oxidase, decresing conversion of xanthine to uric acid.

Front 474

What is the mechanism of action of Aspirin?

Back 474

Acetylates and irreversibly inhibits cyclooxygenase (COX I and COX II) to prevent the conversion of arachidonic acid to prostaglandins.

Front 475

What is the mechanism of action of Clomiphene?

Back 475

Clomiphene is a partial agonist at estrogen receptors in the pituitary gland. Prevents normal feedback inhibition and increses release of LH and FSHfrom the pituitary, which stimulates ovulation.

Front 476

What is the mechanism of action of Colchicine used to treat acute gout?

Back 476

Depolymerizes microtubules, impairing leukocyte chemotaxis and degranulation.

Front 477

What is the mechanism of action of Cyclosporine?

Back 477

Binds to cyclophilins (peptidyl proline cis-trans isomerase), blocking the differentiation and activation of T cells mainly by inhibiting the production of IL-2 and its receptor.

Front 478

What is the mechanism of action of Heparin?

Back 478

Heparin catalyzes the activation of antithrombin III.

Front 479

What is the mechanism of action of Mifepristone (RU486)?

Back 479

Competitive inibitor of progestins at progesterone receptors.

Front 480

What is the mechanism of action of Misoprostol?

Back 480

Misoprostol is a PGE1 analog that increases the production and secretion of the gastic mucous barrier.

Front 481

What is the mechanism of action of NSAIDs other than Aspirin?

Back 481

Reversibly inhibit cyclooxygenase (COX I and COX II). Block prostaglandin synthesis.

Front 482

What is the mechanism of action of Omeprazole, Lansoprazole?

Back 482

Irreversibly inhibits H+/K+ ATPase in stomach parietal cells.

Front 483

What is the mechanism of action of Probenacid used to treat chronic gout?

Back 483

Inhibits reabsorption of uric acid.

Front 484

What is the mechanism of action of Sildenafil (Viagra)?

Back 484

Inhibits cGMP phosphodiesterase, casuing increased cGMP, smooth muscle relaxation in the corpus cavernosum, increased blood flow, and penile erection.

Front 485

What is the mechanism of action of the Alpha-glucosidase inhibitors?

Back 485

Inhibit intestinal bursh border Alpha-glucosidases; delayed hydrolysis of sugars and absorption of sugars leading to decresed postprandial hyperglycemia.

Front 486

What is the mechanism of action of the glucocorticoids?

Back 486

Decrease the production of leukotrienes and protaglandins by inhibiting phospholipase A2 and expression of COX-2.

Front 487

What is the mechanism of action of the H2 Blockers?

Back 487

Reversible block of histamine H2 receptors

Front 488

What is the mechanism of action of the Sulfonylureas?

Back 488

Close K+ channels in Beta-cell membrane leading to cell depolarization causing insulin release triggered by increase in Calcium ion influx.

Front 489

What is the mechanism of action of the thrombolytics?

Back 489

Directly of indirectly aid conversion of plasminogen to plasmin which cleaves thrombin and fibrin clots. (It is claimed that tPA specifically converts fibrin-bound plasminogen to plasmin.)

Front 490

What is the mechanism of action of Ticlopidine, Clopidogrel

Back 490

Inhibits platelet aggregation by irreversibly inhibiting the ADP pathway involved in the binding of fibrinogen.

Front 491

What is the mechanism of action of Warfarin (Coumadin)?

Back 491

Warfarin interferes with the normal synthesis and gamma-carboxylation of vitamin K-dependent clotting factors II, VII, IX, and X, Protein C and S via vitamin K antagonism.

Front 492

What is the mechanism of Azathioprine?

Back 492

Antimetabolite derivative of 6-mercaptopurine that interferes with the metablolism and synthesis of nucleic acid.

Front 493

What is the mechanism of Leuprolide?

Back 493

GnRH analog with agonist properties when used in pulsatile fashion and antagonist properties when used in continuous fashion, causing a transient initial burst of LH and FSH

Front 494

What is the mechanism of Tacrolimus (FK506)?

Back 494

Similar to cyclosporine; binds to FK-binding protein, inhibiting secretion of IL-2 and other cytokines.

Front 495

What is the memory key for the action of Sildenafil (Viagra)?

Back 495

Sildenafil fills the penis

Front 496

What is the memory key for the effect of aluminum hydroxide overuse?

Back 496

AluMINIMUM amount of feces.

Front 497

What is the memory key for the effect of magnesium hydroxide overuse?

Back 497

Mg = Must go to the bathroom.

Front 498

What is the memory key to remember which pathway (extrinsic vs. intrinsic) and which lab value Warfarin affects?

Back 498

WEPT: Warfarin affects the Extrinsic pathway and prolongs the PT.

Front 499

What is the possible mechanism and effect of Metformin in treating diabetes?

Back 499

Mechanism unknown; possibly inhibits gluconeogenesis and increases glycolysis; effect is to decrease serum glucose levels

Front 500

What is the specific clinical use of Indomethacin in neonates?

Back 500

Indomethacin is used to close a patent ductus arteriosus.

Front 501

What is used to reverse the action of Heparin?

Back 501

Protamine Sulfate is used for rapid reversal of heparinization (positively charged molecule that binds to negatively charged heparin).

Front 502

What patients are at risk for life threatening hypotension when taking Sildenafil (Viagra)?

Back 502

Those patients who are taking nitrates.

Front 503

What process does Zafirlukast interfere with?

Back 503

Leukotrienes increasing bronchial tone.

Front 504

What type of gout is treated with Allopurinol?

Back 504

Chronic gout.

Front 505

What type of gout is treated with Colchicine?

Back 505

Acute gout.

Front 506

What type of gout is treated with Probenacid?

Back 506

Chronic gout.

Front 507

What type of patient should not take Misoprostol and why?

Back 507

Misoprostol is contraindicated in women of childbearing potential because it is an abortifacient.

Front 508

Which H2 Blocker has the most toxic effects and what are they?

Back 508

Cimetidine is a potent inhibitor of P450; it also has an antiandrogenic effect and decreases renal excretion of creatinine. Other H2 blockers are relatively free of these effects.

Front 509

Why are the Sulfonylureas inactive in IDDM (type-1)?

Back 509

Because they require some residual islet function.

Front 510

Acetaldehyde is metabolized by Acetaldehyde dehydrogenase, which drug inhibs this enzyme?

Back 510

-Disulfram & also sulfonylureas, metronidazole

Front 511

Explain pH dependent urinary drug elimination?

Back 511

-Weak Acids>Alkinalize urine(CO3) to remove more -Weak bases>acidify urine to remove more

Front 512

How do you treat coma in the ER (4)?

Back 512

-Airway -Breathing -Circulation -Dextrose (thiamine & narcan) -ABCD

Front 513

In coma situations you rule out what (7)?

Back 513

-Infections -Trauma -Seizures -CO -Overdose -Metabolic -Alcohol (IT'S COMA)

Front 514

List some specifics of lead poisoning(4)?

Back 514

-A57Blue lines in gingiva & long bones -Encephalopathy & Foot drop -Abdominal colic / -Sideroblastic anemia

Front 515

List the specific antidote for this toxin: Acetaminophen

Back 515

-N-acetylcystine

Front 516

List the specific antidote for this toxin: Amphetamine

Back 516

-Ammonium Chloride

Front 517

List the specific antidote for this toxin: Anticholinesterases (organophosphate.)

Back 517

-Atropine & pralidoxime

Front 518

List the specific antidote for this toxin: Antimuscarinic (anticholinergic)

Back 518

-Physostigmine salicylate

Front 519

List the specific antidote for this toxin: Arsenic (all heavy metals)

Back 519

-Dimercaprol, succimer

Front 520

List the specific antidote for this toxin: Benzodiazepines

Back 520

-Flumazenil

Front 521

List the specific antidote for this toxin: Beta Blockers

Back 521

-Glucagon

Front 522

List the specific antidote for this toxin: Carbon monoxide

Back 522

-100% oxygen, hyperbaric

Front 523

List the specific antidote for this toxin: Copper

Back 523

-Penicillamine

Front 524

List the specific antidote for this toxin: Cyanide

Back 524

-Nitrate, hydroxocobalamin thiosulfate

Front 525

List the specific antidote for this toxin: Digitalis

Back 525

-Normalize K+, Lidocaine, & Anti-dig Mab

Front 526

List the specific antidote for this toxin: Heparin

Back 526

-Protamine

Front 527

List the specific antidote for this toxin: Iron

Back 527

-Deferoxamine

Front 528

List the specific antidote for this toxin: Lead

Back 528

-EDTA, dimercaprol, succimer, & penicillamine

Front 529

List the specific antidote for this toxin: Methanol & Ethylene glycol

Back 529

-Ethanol, dialysis, & fomepizole

Front 530

List the specific antidote for this toxin: Methemoglobin

Back 530

-Methylene blue

Front 531

List the specific antidote for this toxin: Opioids

Back 531

-B51Naloxone / naltrexone (Narcan)

Front 532

List the specific antidote for this toxin: Salicylates

Back 532

-Alkalinize urine & dialysis

Front 533

List the specific antidote for this toxin: TPA & Streptokinase

Back 533

-Aminocaproic acid

Front 534

List the specific antidote for this toxin: Tricyclic antidepressants

Back 534

-NaHCO3

Front 535

List the specific antidote for this toxin: Warfarin

Back 535

-Vitamin K & fresh frozen plasma

Front 536

What are the products and their toxicities of the metabolism of ethanol by / alcohol dehydrogenase?

Back 536

-Acetaldehyde -Nausea, vomiting, headache, & hypotension

Front 537

What are the products and their toxicities of the metabolism of Ethylene Glycol by / alcohol dehydrogenase?

Back 537

-Oxalic acid -Acidosis & nephrotoxicity

Front 538

What are the products and their toxicities of the metabolism of Methanol by / alcohol dehydrogenase?

Back 538

-Formaldehyde & formic acid -severe acidosis & retinal damage

Front 539

Which drug(s) cause this reaction: Adrenocortical Insufficiency

Back 539

-Glucocorticoid withdrawal

Front 540

Which drug(s) cause this reaction: Agranulocytosis (3)?

Back 540

-Cloazapine -carbamazapine -colchicine -PTU

Front 541

Which drug(s) cause this reaction: Anaphylaxis?

Back 541

-Penicillin

Front 542

Which drug(s) cause this reaction: Aplastic anemia (5)?

Back 542

-Chloramphenicol -benzene -NSAIDS -PTU -phenytoin

Front 543

Which drug(s) cause this reaction: Atropine-like side effects?

Back 543

-Tricyclic antidepressants

Front 544

Which drug(s) cause this reaction: Cardiac toxicity?

Back 544

-Daunorubicin & Doxorubicin

Front 545

Which drug(s) cause this reaction: Cinchonism (2)?

Back 545

-Quinidine -quinine

Front 546

Which drug(s) cause this reaction: Cough?

Back 546

-ACE inhibitors (Losartan>no cough)

Front 547

Which drug(s) cause this reaction: Cutaneous flushing (4)?

Back 547

-Niacin -Ca++ channel blockers -adenosine -vancomycin

Front 548

Which drug(s) cause this reaction: Diabetes insipidus?

Back 548

-Lithium

Front 549

Which drug(s) cause this reaction: Disulfram-like reaction (4) ?

Back 549

-Metronidazole -certain cephalosporins -procarbazine -sulfonylureas

Front 550

Which drug(s) cause this reaction: Drug induced Parkinson's (4) ?

Back 550

-Haloperidol -chlorpromazine -reserpine -MPTP

Front 551

Which drug(s) cause this reaction: Extrapyramidal side effects (3)?

Back 551

-Chlorpromazine -thioridazine -haloperidol

Front 552

Which drug(s) cause this reaction: Fanconi's syndrome?

Back 552

-Tetracycline

Front 553

Which drug(s) cause this reaction: Focal to massive hepatic necrosis (4)?

Back 553

-Halothane -Valproic acid -acetaminophen -Amantia phalloides

Front 554

Which drug(s) cause this reaction: G6PD hemolysis(8)?

Back 554

-Sulfonamides -INH -ASA -Ibuprofen -primaquine -nitrofurantoin /-pyrimethamine -chloramphenicol

Front 555

Which drug(s) cause this reaction: Gingival hyperplasia?

Back 555

-Phenytoin

Front 556

Which drug(s) cause this reaction: Gray baby syndrome?

Back 556

-Chloramphenicol

Front 557

Which drug(s) cause this reaction: Gynecomastia (6)?

Back 557

-Cimetidine -ketoconazole -spironolactone -digitalis -EtOH -estrogens

Front 558

Which drug(s) cause this reaction: Hepatitis?

Back 558

-Isoniazid

Front 559

Which drug(s) cause this reaction: Hot flashes?

Back 559

-Tamoxifen

Front 560

Which drug(s) cause this reaction: Neuro and Nephrotoxic?

Back 560

-polymyxins

Front 561

Which drug(s) cause this reaction: Osteoporosis (2)?

Back 561

-Corticosteroids -heparin

Front 562

Which drug(s) cause this reaction: Oto and Nephrotoxicity (3)?

Back 562

-aminoglycosides -loop diuretics -cisplatin

Front 563

Which drug(s) cause this reaction: P450 induction(6)?

Back 563

-Barbiturates -phenytoin -carbamazipine -rifampin -griseofulvin -quinidine

Front 564

Which drug(s) cause this reaction: P450 inhibition(6)?

Back 564

-Cimetidine -ketoconazole -grapefruit juice -erythromycin -INH -sulfonamides

Front 565

Which drug(s) cause this reaction: Photosensitivity(3)?

Back 565

-Tetracycline -amiodarone -sulfonamides

Front 566

Which drug(s) cause this reaction: Pseudomembranous colitis?

Back 566

-Clindamycin

Front 567

Which drug(s) cause this reaction: Pulmonary fibrosis(3)?

Back 567

-Bleomycin -amiodarone -busulfan

Front 568

Which drug(s) cause this reaction: SLE-like syndrome?

Back 568

-Hydralazine -Procainamide -INH -phenytoin

Front 569

Which drug(s) cause this reaction: Stevens-Johnson syn. (3)?

Back 569

-Ethosuxamide -sulfonamides -lamotrigine

Front 570

Which drug(s) cause this reaction: Tardive dyskinesia?

Back 570

-Antipsychotics

Front 571

Which drug(s) cause this reaction: Tendonitis and rupture?

Back 571

-Fluoroquinolones

Front 572

Which drug(s) cause this reaction: Thrombotic complications?

Back 572

-Oral Contraceptives

Front 573

Which drug(s) cause this reaction: Torsade de pointes (2)?

Back 573

-Class III antiarrhythmics (sotalol) -class IA (quinidine)

Front 574

Which drug(s) cause this reaction: Tubulointerstitial Nephritis (5)?

Back 574

-Sulfonamides -furosemide -methicillin -rifampin -NSAIDS (ex. ASA)

Front 575

Describe first-order kinetics?

Back 575

Constant FRACTION eliminated per unit time.(exponential)

Front 576

Describe Phase I metabolism in liver(3)?

Back 576

-reduction, oxy, & hydrolysis -H2O sol. Polar product -P450

Front 577

Describe Phase II metabolism in liver(3)?

Back 577

-acetylation, glucuron., & sulfation -Conjugation -Polar product

Front 578

Explain differences between full and partial agonists(2).

Back 578

- Act on same receptor - Full has greater efficacy

Front 579

Explain potency in relation to full and partial agonists(2).

Back 579

- partial agonist can have increased, decreased, /A21or equal potency as full agonist. - Potency is an independent factor.

Front 580

How do spare receptors effect the Km?

Back 580

- ED 50 is less than the Km (less than 50% of receptors)

Front 581

How do you calculate maintenance dose?

Back 581

Md= (CpxCL)/F Cp= plas. Conc. CL=clear. F=bioaval.

Front 582

How does a competitive antagonist effect an agonist?

Back 582

-Shifts the curve to the right -increases Km

Front 583

How does a noncompetitive antagonist effect an agonist?

Back 583

- Shifts the curve down -reduces Vmax

Front 584

Name the steps in drug approval(4)?

Back 584

-Phase I (clinical tests) -Phase II -Phase III -PhaseIV (surveillance)

Front 585

Steady state concentration is reached in __ number of half-lifes

Back 585

In 4 half-lifes= (94%) T1/2 = (0.7x Vd)/CL

Front 586

What is the definition of zero-order kinetics? Example?

Back 586

-Constant AMOUNT eliminated per unit time. -Etoh & ASA

Front 587

What is the formula for Clearance (CL)

Back 587

CL= (rate of elimination of drug/ Plasma drug conc.)

Front 588

What is the formula for Volume of distribution (Vd)

Back 588

Vd= (Amt. of drug in body/ Plasma drug conc.)

Front 589

What is the loading dose formula?

Back 589

Ld= (CpxVd)/F Cp=plasma conc. F= Bioaval.

Front 590

A 12yo patient was treated for a reaction to a bee sting, what drug provides the best coverage of sympathomimetic receptors?

Back 590

Epinephirine(Alpha1,2 and Beta 1,2)

Front 591

A 57 yo heart failure pt develops cardiac decompensation, what drug will give you adequate perfusion of his kidneys as well as tx for his Hypotension

Back 591

Dopamine

Front 592

A fellow passenger on a Carnival cruise ship looks pale and diaphoretic, what antimuscarinic agent would you give them?

Back 592

scopolamine

Front 593

A group of pts are rushed into the ER complaining of excessive sweating, tearing, salivation, HA, N and V, muscle twitching, difficulty breathing and diarrhea. What drug would be the most effective immediate tx

Back 593

Atropine pts are suffering from Cholinestrase inhibitor poisining (Nerve gas/Organophosphate poisining)

Front 594

As an Anes you want to use a depolarizing neuromuscular blocking drug on your pt, what do you use

Back 594

Succinylcholine

Front 595

MOA of Succinylcholine

Back 595

Prevents the release of Ca from SR of skeletal muscle

Front 596

Clonidine is the preferred sym pathomimetic tx of HTN in pts with renal disease, why??

Back 596

Centrally acting alpha agonist, thus causing a decrease in central adrenergic outflow, spairing renal blood flow

Front 597

Cocaine casues vasoconstriction and local anesthesia by what mechanism

Back 597

Indirect agonist, uptake inhibitor

Front 598

Cocaine shares is mechanism of action with what antidepressant

Back 598

TCA

Front 599

Dobutamine used for the tx of shock acts on which receptors

Back 599

Beta1 more than B2

Front 600

Guanethidine enhances the release of Norepi?

Back 600

No, it inhibits the release of Nor Epi

Front 601

How does angiotensin II affect NE release?

Back 601

It acts presynaptically to increase NE release.

Front 602

How does botulinum toxin result in respiratory arrest?

Back 602

Prevents the release of ACh, which results in muscle paralysis.

Front 603

How does dantrolene work?

Back 603

Prevents the release of calcium from the sarcoplasmic reticulum of skeletal muscle.

Front 604

How does NE modulate its own release? What other neurotransmitter has this same effect?

Back 604

NE acts presynaptically on alpha-2 receptors to inhibit its own release. ACh also acts presynaptically through M1 receptors to inhibit NE release.

Front 605

How would hemicholinium treatment affect cholinergic neurons?

Back 605

Hemicholinium inhibits the transport of choline into the nerve, thus inhibiting formation of ACh.

Front 606

How would you reverse the effect of a neuromuscular blocking agent?

Back 606

Give an antichloinesterase - neostigmine, edrophonium, etc

Front 607

If a patient is given hexamethonium, what would happen to his/her heart rate?

Back 607

It would increase to ~ 100 beats/min. Both sympathetic and vagal stimulation would be knocked out, but the SA node has an intrinsic pace of 100 beats/min, which is normally checked by vagal stimulation.

Front 608

Isopoterenol was given to a patient with a developing AV block, why?

Back 608

Stimulates beta adrenergic receptors

Front 609

Norepi feedbacks and inhibits the presynaptic receptor by what mechanism

Back 609

Binding to the presynaptic alpha 2 release modulating receptors

Front 610

Reserpine will block the syntheis of this drug and but not its precursor.

Back 610

Blocks Norepi, but not Dopamine

Front 611

These drugs acts indirectly by releasing strored catecholamines in the presynaptic terminal

Back 611

Amphetamine and Ephedrine

Front 612

What anticholinesterase crosses the blood-brain-barrier?

Back 612

physostigmine

Front 613

What antimuscarinic agent is used in asthma and COPD?

Back 613

Ipratropium

Front 614

What antimuscarinic drug is useful for the tx of asthma

Back 614

Ipratropium

Front 615

What are the classic symptoms of cholinesterase inhibitor poisoning (parathion or other organophosphates)?

Back 615

Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation = DUMBBELS; also abdominal cramping

Front 616

What are the clinical indications for bethanechol?

Back 616

Activates cholinergic receptors on bladder and bowel smooth muscle, alleviating post-op and neurogenic ileus and urinary retention.

Front 617

What are the clinical indications for neostigmine?

Back 617

Post-op and neurogenic ileus and urinary retention, myasthenia gravis, and reversal of neuromuscular junction blockade (post-op) through anticholinesterase activity.

Front 618

What are the indications for using amphetamine?

Back 618

narcolepsy, obesity, and attention deficit disorder (I wouldn't recommend this)

Front 619

What are the nondepolarizing neuromuscular blocking drugs?

Back 619

Tubocurarine, atracurium, mivacurium, pancuronium, vecuronium, rapacuronium

Front 620

What are the phases of succinylcholine neuromuscular blockade?

Back 620

Phase 1 = prolonged depolarization, no antidote, effect potentiated by anticholinesterase; Phase 2 = repolarized but blocked, an anticholinesterase is the antidote for this phase.

Front 621

What are two indirect acting adrenergic agonists?

Back 621

amphetamine and ephedrine

Front 622

What beta 2 agonist will help your 21yo Astma pt?

Back 622

Albuterol, tertbutaline

Front 623

What cholinergic inhibitor acts by directly inhibiting Ach release at the presynaptic terminal

Back 623

Botulinum

Front 624

What cholinomimetic is useful in the diagnosis of Myasthenia Gravis

Back 624

Edrophonium

Front 625

What cholinomimetics might your pt be taking for his glaucoma

Back 625

Carbachol, pilocarpine, physostigmine, echothiophate

Front 626

What class of drug is echothiophate? What is its indication?

Back 626

anticholinesterase glaucoma

Front 627

What conditions would you use dantrolene?

Back 627

In treatment of malignant hyperthermia, due to concomitant use of halothane and succinylcholine. Also in neuroleptic malignant syndrome, a toxicity of antipsychotic drugs.

Front 628

What drug is used to diagnose myasthenia gravis?

Back 628

edrophonium (extremely short acting anticholinesterase)

Front 629

What drugs target anticholinesterase

Back 629

Neostigmine, pyridostigmine edrophonium, physostigmine echothiophate

Front 630

What effect would atropine have on a patient with peptic ulcer disease?

Back 630

Theoretically it could be used to block the cephalic phase of acid secretion (vagal stimulation).

Front 631

What effect would atropine have on the preganglionic sympathetic activation of sweat glands? Would this person sweat?

Back 631

None. No, because atropine would block the postganglionic muscarinic receptors involved in sweat gland stimulation.

Front 632

What enzyme is responsible for the breakdown of ACh in the synaptic cleft?

Back 632

Acetylcholinesterase; ACh is broken down into choline and acetate.

Front 633

What enzyme is responsible for the degredation of Ach

Back 633

Acetylcholine esterase

Front 634

What enzyme is responsible for the production of Ach from Acetyl CoA and Choline

Back 634

Choline acetyltransferase

Front 635

What is the clinical utility of clonidine?

Back 635

Treatment of hypertension, especially with renal disease (lowers bp centrally, so flow is maintained to kidney).

Front 636

What is the clinical utility of cocaine?

Back 636

The only local anesthetic with vasoconstrictive properties.

Front 637

What is the difference between the affinity for beta receptors between albuterol/terbutaline and dantroline?

Back 637

Dobutamine has more of an affintiy for beta-1 than beta-2, and is used for treating heart failure and shock. Albuterol and terbutaline is the reverse, and is used in treatment of acute asthma.

Front 638

What is the difference in receptor affinity of epinephrine at low doses? High doses?

Back 638

Prefers beta's at low doses, but at higher doses alpha agonist effects are predominantly seen.

Front 639

What is the effect of epinephrine infusion on bp and pulse pressure?

Back 639

Increased systolic and pulse pressure, decreased diastolic pressure, and little change in mean pressure.

Front 640

What is the effect of guanethidine on adrenergic NE release?

Back 640

It inhibits release of NE.

Front 641

What is the effect of norepinephrine on bp and pulse pressure?

Back 641

Increases mean, systolic, and diastolic bp, while there is little change in pulse pressure.

Front 642

What is the effect of TCA's on the adrenergic nerve?

Back 642

They inhibit reuptake of NE at the nerve terminal (as does cocaine).

Front 643

What is the only depolarizing neuromuscular blocking agent?

Back 643

Succinylcholine

Front 644

What is the receptor affinity and clinical use of isoproterenol?

Back 644

It affects beta receptors equally and is used in AV heart block (rare).

Front 645

What physiological effects was the Anes using Atropine to tx

Back 645

SLUD (salivation, Lacrimation, urination, Defecation)as well as airway secretion, GI motility, acid secretions

Front 646

What reversal agent could a Anes give to reverse the effects of Atropine

Back 646

Bethanechol, Neostigmine, physostigmine

Front 647

What side effect of using atropine to induce pupillary dilation would you expect?

Back 647

Atropine would also block the receptors in the ciliary muscle, causing an impairment in accommodation (cycloplegia).

Front 648

What sympathomimetic would you not prescribe for hypotension in a pt with renal artery sclerosis.

Back 648

Norepinephrine (Alpha1,2 and beta 1)

Front 649

What type of neurological blockade would hexamethonium create?

Back 649

Hexamethonium is a nicotinic antagonist, and thus is a ganglionic blocker.

Front 650

What would be the effect on blood pressure with infusion of the alpha -2 agonist clonidine?

Back 650

Initially vasoconstriction would increase bp, but then it acts on central alpha-2 receptors to decrease adrenergic outflow resulting in decreased bp.

Front 651

Which antimuscarinic agents are used in producing mydriasis and cycloplegia?

Back 651

atropine, homatropine, tropicamide

Front 652

Which drug increases Sys BP w/o affecting Pulse Pressure

Back 652

Epinephrine

Front 653

Which of epi, norepi, or isoproterenol results in bradycardia?

Back 653

Norepinephrine

Front 654

Which of the following would atropine administration cause? Hypothermia, bradycardia, excess salivation, dry flushed skin, or diarrhea

Back 654

Dry flushed skin, due to inhibition of sympathetic post-ganglionic blockade on muscarinic receptors of sweat glands. All others are opposite of what would be expected.

Front 655

Which of these three drugs will cause a reflex bradycardia in your pt (Norepi, Epi, or Isoporterenol)

Back 655

Norepinephrine

Front 656

Which receptors does phenylephrine act upon?

Back 656

alpha-1 > alpha-2; used as a pupil dilator, vasoconstrictor, and for nasal decongestion

Front 657

While at a tail gait party, you bite into a sandwich that a yellow jacket is also enjoying. Knowing your allergy to this creature, what should you do?

Back 657

Epinephrine to treat anaphylaxis. Also useful if you have open angle glaucoma, asthma, or hypotension.

Front 658

Why are albuterol and terbutaline effective in tx of acute asthmatic attacks?

Back 658

These B-2 agonists cause respiratory smooth muscle to relax.

Front 659

Why does atropine dilate the pupil?

Back 659

Blocking muscarinic receptors in the circular fibers of the eye, results in unopposed action of radial muscles to dilate.

Front 660

Why does NE result in bradycardia?

Back 660

NE increases bp, which stimulates baroreceptors in the carotid sinus and the aorta. The CNS signals through vagal stimulation to decrease heart rate.

Front 661

Why is carbachol and pilocarpine useful in treatment of glaucoma?

Back 661

They activate the ciliary muscle of the eye (open angle) and pupillary sphincter (narrow angle).

Front 662

Why is pyridostigmine effective in the treatment of myasthenia gravis?

Back 662

As an anticholinesterase it increases endogenous ACh and thus increases strength.

Front 663

Why is reserpine effective in treating HTN?

Back 663

Reserpine inhibits dopamine transport into vesicles, attenuating its conversion to NE by dopamine beta-hydroxylase.

Front 664

Why is there a drop in systolic, mean, and diastolic bp with infusion of isoproterenol?

Back 664

Stimulating beta receptors stimulates heart rate, but beta receptor induced vasodilation reduces peripheral resistance.

Front 665

Why would a patient with cog-wheel rigidity and a shuffling gait be given benztropine?

Back 665

Parkinson patients benefit from antimuscarinic agents through its inhibitory action within the indirect pathway.

Front 666

Why would dopamine be useful in treating shock?

Back 666

Receptors = D1=D2>beta>alpha, thus increasing heart rate (beta) and blood pressure (alpha vasoconstriction) while maintaining kidney perfusion (dopamine receptors)

Front 667

Why would you give a drug like pancuronium or succinylcholine?

Back 667

Useful in muscle paralysis during surgery or mechanical ventilation.

Front 668

Why would you use pralidoxime after exposure to an organophosphate?

Back 668

Pralidoxime regenerates active cholinesterase.

Front 669

Will Hemicholinum affect the release of stored Ach during Cholinergic Stimulation

Back 669

No, hemicholinum block the uptake of Choline and thus Ach synthesis

Front 670

Would blockade of muscarininc receptors in the bladder be useful in treating urinary retention?

Back 670

No. Atropine is used to reduce urgency in mild cystitis. So it would aggravate the urinary retention.

Front 671

Your patient wants an effective drug to treat his motion sickness, what would you prescribe

Back 671

Scopolamine