Pharmacology.block 3 Big Deals

Front 1

Nitrosureas such as _ are used to treat _

Back 1

Lomustine

Brain tumors (alkylating agent that can cross the BBB)

Front 2

alkylating agent that can cross the BBB

Back 2

Nitrosureas - Lomustine

Front 3

may lead to hemorrhagic cystitis.

used primarily to treat?

Back 3

Cyclophosphamide
(alkylating agent used to treat NHL)

Front 4

Busulfan is a _ thats used to treat _

Back 4

alkylating agent (chemo)

CML and polycythemia vera


Can cause pulmonary fibrosis

Front 5

Alkylating agents who's metabolite inhibits MAO, therefore pts should not ingest foods contains tyramine

Back 5

Procarbazine

Treats Hodgkins disease

Front 6

Platinum analogs such as _ are used to treat _ tumors.

Side effects?

Back 6

Cisplatin

Genitourinary

OTOTOXICITY CN VIII

Front 7

Methotrexate is considered (CCS/CCNS)

Back 7

CCS

Front 8

Cancer drug CI with allopurinol

Back 8

6 - Mercaptopurine

inhibits purine synthesis and is metabolized by xanthine oxidase

Front 9

Chemo drug to treat adenocarcinomas?

Back 9

5-FU, administered along with Leucovorin

Front 10

S phase specific, - limited to hematologic malignancies

Back 10

Cytarabine


(pyrimidine antagonist, inhibits DNA polymerase)

Front 11

activating enzyme found at higher concentrations in solid tumors

Back 11

Capecitabine

Front 12

1st line for metastatic adenocarcinoma of pancrease, NSCLC, Bladder, NHL

Back 12

Gemcitabine

(inhibits nucleotide reductase)

Front 13

halts division at metaphase by binding to tubulin and inhibiting microtubules. Cell cycle specific - during M phase

Back 13

Vinca (CCS)

Front 14

plant alkaloid that that causes neurotoxic side effects?

Back 14

Vincristine
treats hodgkins

Front 15

plant alkaloid that causes bone marrow suppression?

Back 15

vinBlastine

treats hodgkins

Front 16

promote stabilization of microtubules, halting mitosis, used after failure of combination therapy

Back 16

Paclitaxel

treats breast and ovarian

Front 17

Inhibits topoisomerase II, blocks division in late S - G2 phase

Back 17

Etoposide (VP-16)

Front 18

Plant alkaloid thats CCNS

Back 18

Topotecan

treats ovarian cancer, acts by inhibiting activity of topoisomerase I

Front 19

insert base pair of DNA and RNA, inhibit topoisomerase II. Cause the production of oxygen radicals

Back 19

Anthracyclines (CCNS)
--Doxorubicin
--Mitoxantrone

Front 20

Antibiotic that is CCS

Back 20

Bleomycin

Front 21

treats Pediatric tumors (Wilm's tumor)

Back 21

Dactinomycin

Front 22

metabolically activated into an alkylating agent that cross links DNA

Back 22

Mitomycin

Front 23

Anticancer antibiotic known to cause pulmonary fibrosis

Back 23

bleomycin

Front 24

GnRH agonist?

Back 24

Leuprolide

treats prostate ca

Front 25

Aromatase Inhibitors

Back 25

Anastrozole (letrozole, exemestane)

Front 26

mixed estrogen agonist and antagonist?

This drug is most effective in _

Back 26

Tamoxifen

postmenopausal women, used to treat breast cancer

Front 27

binds to circulating VEGF, inhibits angiogenesisi

Back 27

Bevacizumab

antibody, used to treat colon and lung ca

Front 28

inhibits platelet derived growth factor and intracellular kinase pathways. Competitive inhibitor of tyrosine kinase

Back 28

Imatinib

treats CML

Front 29

useful in patients with a hx of anaphylaxis by penicillin, only protects against gram negative aerobic organisms except acinetobacter

Back 29

Aztreonam

Front 30

First Gen Cephalosporins include _ and are used against _

Back 30

Cefadroxil (PO), Cefazolin* (IV), Cephalexin* (PO)

Gram positive cocci (pneumococci, streptococci, staphylococci). PEK: Proteus mirabilis, E coli, K. Pneumonia…treat resp, skin and UTIs

Front 31

used to treat PID, surgical prophylaxis. Offers anaerobic coverage

Back 31

Cefotetan (IV)*

2nd generation cephalosporin

Front 32

2nd gen cephalosporins include _,

they cover against _

Back 32

Loracarbef Cefotetan, Ceforanide, Cefprozil, Cefuroxime, Cefactor

1st generation + HNM : H influenza, N gonorrhea, M catarhalis,and some anaerobes. Less activity against staph

Front 33

only ceph that is excreted biliary (all others are renal). Treats gonorrhea and lyme disease

Back 33

Ceftriaxone IV

can cause precipitation in gall bladder

Front 34

3rd gen that also inhibits P aeruginosa

Back 34

Ceftazidime (IV)

(think of an old, rusty GREEN dime)

Front 35

Macrolides include _

MOA?

Back 35

Erythromycin, Azithromycin, Clarithromycin, Dirithromycin

EACD - blocks aminoacyl tRNA complex translocation step ie Blocks Peptide Bond

Front 36

PO drug of choice when switching from IV vanvomycin

Back 36

Oxazolidinones - Linezolid

Front 37

Requires active transport across membrane. Causes misreading of codon (wrong AA added)

Back 37

Aminoglycosides (Gentamicin, Tobramycin, Amikacin)

Front 38

Regarding the aminoglycosides;

Gentamycin works best against _
Tobramycin : _
Amikacin : _

Back 38

Gentamycin - Serratia marcescens, Tobra- Pseudo and Acineto, Amika - for resistant strains of others

(require active transport to cross membrane - only works on aerobes. S/e: NOT. Measure peaks and trophs)

Front 39

DoC for Rickettsia?

Back 39

Doxycycline (tetracycline)

Front 40

30S inhibitor used in renal impairment patients

Back 40

doxycycline

Front 41

Linezolid (Zyvox®) is likely to cause what SE

Back 41

thrombocytopenia

Front 42

13) Who am I? I was once a promising new agent who had a dual mechanism of action on the ribosome that helped to overcome some of the resistance seen with my predecessors. I cover lesser gram negatives, basic gram positives, and even atypicals, so I was a great choice for treatment of respiratory tract infections. However, I am extensively hepatically metabolized, and have been shown to cause liver failure and death, so my use has been markedly decreased in the past few years. I am:

Back 42

d. Telithromycin (Ketek®)

Front 43

useful in patients with a hx of anaphylaxis by penicillin (or any other beta lactam)

Back 43

Aztreonam

Monobactam

Front 44

Only effective against gram negative aerobic organisms, and only administered IV or IM

Back 44

Aztreoname

Monobactam

Front 45

_ is resistant to all generations of cephalosporins

Back 45

Enterococcus

(gram +)

Front 46

First generation PO. DoC when switching from IV Cefazolin

Back 46

Cephalexin

Front 47

Anaerobic activity?

Back 47

Second Generation Cephalosporins - Cefotetan, Cefoxitin

Front 48

oral 3rd generation

Back 48

Cefpodoxime (PO) *

Front 49

Used to treat MRSA, and patients who anaphylaxis with penicillin and have a gram (+) infections

Back 49

Vancomycin

Front 50

Causes gram (+) cell death by directly binding to cell membrane and destroying it.

- This drug is destroyed by pulmonary surfactant and therefore not used against pneumonia

Back 50

Daptomycin

Used mostly for resistant staph, taking over for vanco. Never used for Pneumonia!

Front 51

blocks protein synthesis by blocking translocation, bind to the 50S subunit

Back 51

Macrolides

Azithromycin, Clarithromycin - these are often used to

Front 52

_ is DoC to treat chylamydia

Back 52

`Azithromycin

Front 53

Oral drug Used to treat CA-MRSA, BUT not HA-MRSA, (and covers anaerobes. )

Back 53

Clindamycin

Front 54

PO drug that treats all MRSA.

Back 54

Linezolid - Zybox

Preferably for HA-MRSA, because Clindamycin can be used for CA.
(interferes with initiation process)

Front 55

Treatment of MRSA is moving slighly away from Vancomycin. Daptomycin is one of these newer drugs, It is given (IV/PO) and is good for everything except _
The other new drug that is taking over for Vanco is _, which is given orally.

Back 55

IV, except Respiratory Infections (surfact destroys it)

Linezolid Which is given PO, and is good for MRSA including respiratory infections

Front 56

_ is an example where the expiration date does matter! It decays into a toxic byproduct and can be dangerous

Back 56

Tetracyclines

Front 57

Clindamycin has _ activity but not _

Back 57

CA MRSA but not HA

Front 58

first line for latent therapy of TB, causes peripheral neuropathy

Back 58

Isoniazid

Front 59

Used together, aka Bacrim . Can cause rash (steven johnson syndrome)

Back 59

(SMX-TMP)
Sulfamethoxazole - Trimethoprim (TMP)
---Antifolates, nucleic acid synthesis

Front 60

Reduce ergosterol synthesis by inhibiting fungal cytochrome P450 enzymes

Back 60

Azoles (antifungals)

Front 61

Best azole for blasto and histo

Back 61

Itraconazole

Front 62

Azole that causes visual disturbances that are reversible with cessation of the drug

Back 62

Voriconazole

Front 63

DoC for prophylaxis of fungal infections in bone marrow transplant pts

Back 63

Posaconazole

(PO only) - inhibits the synthesis of ergosterol

Front 64

preferred azole if CNS involvement

Back 64

Voriconazole

Front 65

primarily used for onchyomycosis

Back 65

Terbinafine (Lamisil)

- also used topically for athletes foot (OTC)

Front 66

broadest spectrum of activity for antifungals (also covers bacterial and viral infections)

S/e of this drug?

Back 66

Amphotericin B

NEPHROTOXICITY and electrolyte imbalance (hypo K and Ma) --- not as bad in liposomal forms

Front 67

Antifungal that works on cell wall

Back 67

Echinocandins - Caspofungin

Front 68

MOA of Echinocandins?

Back 68

(ie CaspoFUNGIN)

target production of glucan in CELL WALL

Front 69

Whats different about Terbinafines MOA compared to Azoles?

Back 69

both reduce ergosterol synthesis, but terbinafine does so at an earlier step than azoles

Front 70

binds directly to ergosterol and causes the formation of holes in the fungal cell membrane

SE?

Back 70

Amphotericin B
(broadest spectrum of action)

Nephrotoxic, electrolyte disturbances

Front 71

Only antifungal that causes bone marrow suppression

Back 71

Flucytosine

(substitutes for uracil, inhibiting RNA synthesis)

Front 72

Only TB drug that doesn't cause hepatotoxicity

Back 72

Ethambutol

(does decrease visual ability)

Front 73

NNRTIs such as Efavirenz are known to cause what side effects?

MOA

Back 73

Vivid Dreams


This acts by directly binding to reverse transcriptase

Front 74

_ and _ are used in combo to inhibit conversion of ssHIV to dsHIV.

What are side effects?

Back 74

Emtricitabine & Tenofovir

Mitochondrial toxicity, lipoatrophy, lactic acidosis

Front 75

What HIV drug acts by binding GP41 and preventing the virus from entering?

Back 75

Enfuvirtide (T-20) - a fusion inhibitor

Front 76

Prevents perinatal transmission of HIV

Back 76

Zidovudine

Front 77

MOA of acyclovir, famciclovir, valacyclovir?

Back 77

These are nucleoside analogs - specifically, guanosine derivatives


-They need to be activated by viral enzymes, then human adds 3rd P, -->competes with GTP for base pairing.

Front 78

What antivirals are used to treat CMV?

MOA?

Back 78

Ganciclovir, Valgancyclovir

Get phosphorylated by UL97

Front 79

Zanamivir is a _, used to treat _ and is contraindicated in _

Back 79

neuramindase inhibitor (prevents budding of new virus)
Influenza A and B
Asthmatics


(note the other drug in this category is Oseltamavir(tamiflu) but is not CI in asthmatics)

Front 80

Drug used to treat Hep C?

Back 80

Ribavirin

Front 81

_ is used to treat ocular herpes and acts by irreversible inhibition of thymidylate synthetase, inhibiting thymidine

Back 81

Trifluride

--> Also inhibits Human DNA replication, that's why it's only used for eyedrops

Front 82

Drug used to treat resistant HSV?

Back 82

Foscavir

(and varicella)

Front 83

CCr5 antagonist?

Back 83

Maraviroc

Front 84

Integrase inhibitor

Back 84

Raltegravir

-recommend giving to HIV patients from the start

Front 85

M2 inhibitors such as _ and _ are used to treat _

Back 85

amantadine and rimantadine

Influenza A only

(think "a" without; ri - rid; "mantle" for cover or coat. M2 is required for the uncoating of Influenza A)

Front 86

Monoclonal antibody used for prevention of RSV?

Back 86

Palivizumab

Front 87

Used to treat Amebiasis?

Back 87

Metronidazole

Front 88

DoC when switching from IV Vanco? What is the MOA of this drug?

Back 88

Linezolid

interferes with Initiation Process

Front 89

Antitumor antibody that causes blue urine, sclera and skin?

Back 89

Mitoxantrone

Front 90

Cumulative neurotoxicity?

Back 90

Paclitaxel

works by binding to beta actin on tubulin and promoting stabilization of microtubules, halting mitosis

Front 91

Can cause excessive release of Antidiuretic hormone? (SIADH)

Back 91

Vincristine

Stops division during M phase, halts division at metaphase bu binding to tubulin and inhibiting microtubules.

Front 92

Patients who are taking methotexate must also be on what?

Back 92

folic acid supplements

(on a side note, remember that folic acid masks the symptoms of vit B12 deficiency)

Front 93

Tests for blood dopping?

Back 93

epoetin alfa

Front 94

Treats onchyomycosis and athletes foot

MOA

Back 94

Terbinafine
("athletes run terbo fast")


--> reduces ergosterol synthesis by inhibit squalene oxidase (earlier than azoles)

Front 95

Treats oral thrush

Back 95

Nistatin?

Not absorbed by GI

Front 96

approved for iron replacement during chronic hemodialysis

Back 96

Sodium Ferric Gluconate Complex – Ferrlecit

Front 97

How do you treat iron overdose?

Back 97

Deferoxamine and deferasirox

Front 98

Treats Megaloblastic anemia

Back 98

Vit B 12 - cyanocobalamic

Front 99

Monobactam?

Back 99

Aztreonam (IV or IM)

-->given for gram (-) coverage in patients with a hx of beta lactam anaphylaxis

Front 100

Coverage of 3rd gen cephalosporins?

Back 100

HNM-PEK + Salmonella, Shigella and Serratia. IV drugs also have enterobacter and citrobacter

Front 101

Vancomycin is used against _


To monitor toxicity, look at _

Back 101

(glycopeptid IV)

HA and CA MRSA
gram (+) infections in place of beta lactams ONLY when allergy is present

trophs

Front 102

Accumulates in renal cortex and ear hair cells

Back 102

Aminoglycosides
- inhibit protein synthesis at 30 s

Front 103

Can cause tendon rupture

Back 103

fluoroquinolones - inhibit topoisomerase II

(gemifloxacin, moxifloxacin)

Front 104

TB drug that acts by inhibiting DNA dependent RNA polymerase

Back 104

Rifampin
(very potent P450 inducer, orange discoloration of body fluids)

Front 105

1st line antifungal against Candida

Back 105

Fluconazole

(does not cover c. krusei)

Front 106

Directly binds ergosterol in fungal membrane.

SE?

Back 106

amphoteracin B (polyene)

electrolyte disturbances (prevent by fluid intake and sodium)

Front 107

Requires thymidine kinase to be activated

Back 107

Acyclovir, Famiciclovir, Valcyclovir

Front 108

Cidofovir and Foscarnet are used to treat

Back 108

CMV

Front 109

_ : IV only. Pyrophosphate analog, does not need to be phosphorylated, inhibits RNA/DNA polymerase

Back 109

Foscarnet

(Treats CMV)

Front 110

Interferons treat _

What are the main side effects of these agents?

Back 110

Hepatitic B and C

(ribavirin)

Flu like symptoms - resolve within 2-3 months, take at bedtime

Front 111

How to NRTIs work?

Back 111

Competively inhibit reverse transcriptase

(include emtricitabine, tenofovir, abacavir)

Front 112

How do NNRTIs work?

Back 112

bind directly to reverse transcriptase

(efavirenz)

Front 113

Side effects of Aminoglycosides

Back 113

Nephrotoxicity
Ototoxicity
Teratogenic

(also NMJ inhibition)

Front 114

TB drug that induces cytochrom P450?

Back 114

Rifampin

Front 115

Main side effect of Bacrim?

MOA?

Resistance?

Back 115

Rash (SJ syndrome); kernicterus in infants (CI)

anti-folates, target cofactor necessary to make base pairs

Over production of paba, altered target site

*this is the DoC for uncomplicated cystitis and recurrent UTIs

Front 116

MC cephalosporin used for surgical prophylaxis?

Back 116

Cefazolin
(1st gen)

Front 117

4th generation cephalosporin?

Back 117

Cefepime

Front 118

Causative agent of malaria?

Back 118

Plasmodium falciparum

Front 119

causative agent of cystericercosis?

Back 119

taenia solium

(pig?)