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159 Cards in this Set
- Front
- Back
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Erythromycin, azithromycin, clarithromycin side effects?
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Prolonged QT interval (especially erythromycin), GI discomfort (stimulates motilin receptors), acute cholestatic hepatitis, eosinophilia, skin rashes, deafness. Increases serum concentration of theophyllines, oral anticoagulants by inhibiting CYP-450s (exception: azithromycin.)
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Cidofovir side effects?
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Nephrotoxicity
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Pyrantel pamoate uses?
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Nematodes - Ascaris lumbricoides, Enterobius vermicularis, Ancylostoma duodenale, Necator americanus
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Cytarabine mechanism of action?
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Pyrimidine antagonist; inhibits DNA polymerase.
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Procarbazine side effects?
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Can cause secondary leukemias. Myelosupression. Avoid tyramine rich foods.
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Scopolamine use
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Motion sickness
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Glycopyrrolate MOA
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Muscarinic antagonist.
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Pirenzepine MOA
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Muscarinic antagonist.
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Propantheline MOA
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Muscarinic antagonist.
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Metaproterenol MOA
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Beta 2 adrenergic agonist.
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Guanethidine MOA
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Binds NE vesicles and blocks release. Effect blocked by TCAs because they require the same reuptake receptor.
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Trihexyphenidyl MOA
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Muscarinic antagonist.
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Mecamylamine MOA
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Nicotinic antagonist.
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Verapamil side effects?"
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Cardiac depression, AV block, peripheral edema, flushing, dizziness, heavy constipation. Gingival hyperplasia. Increases toxicity of digoxin by displacing from tissue-binding sites.
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Gemfibrozil mechanism of action?
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Induces LPL (via PPAR-alpha) leading to increased TG clearance).
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Hydrochlorothiazide, indapamide, metolazone side effects?
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Hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia (inhibits insulin release), hyperlipidemia (LDL, cholesterol), hyperuricemia, and hypercalcemia. Sulfa allergy.
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Cilostazol mechanism of action?
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Phosphodiesterase III inhibitor; increases cAMP in platelets thus inhibiting platelet aggregation. Vasodilator.
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Dipyridamole mechanism of action?
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Phosphodiesterase III inhibitor; increases cAMP in platelets thus inhibiting platelet aggregation. Vasodilator. Thromboxane synthase inhibitor.
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Argatroban, dabigatran mechanism of action?
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Direct thrombin inhibitor; (blocks factor IIa). Prevents fibrin formation.
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Pramlintide mechanism of action?
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Amylin analog; decreases glucagon levels,, satiety, slow gastric emptying
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Propylthiouracil side effects?
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Skin rash, agranulocytosis, aplastic anemia, hepatotoxicity.
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Misoprostol mechanism of action?
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"
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Magnesium citrate mechanism of action?"
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Provides osmotic load to draw water out.
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Polyethylene glycol mechanism of action?
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Provides osmotic load to draw water out.
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Cyclosporine side effects?
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Predisposes patients to viral infections and lymphoma; nephrotoxic (preventable with mannitol diuresis); gout.
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Tacrolimus (FK506) side effects?
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Significant nephrotoxicity, peripheral neuropathy, hypertension, pleural effusion, hyperglycemia.
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Oprelvekin mechanism of action?
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Recombinant IL-11.
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Mycophenolate mofetil mechanism of action?
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Inhibits inosine monophosphate dehydrogenase, which decreases de novo guanine synthesis and blocks lymphocyte production
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Valproic acid side effects?
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GI distress, rare but fatal hepatotoxicity (measure LFTs) , neural tube defects in fetus (spina bifida), tremor, weight gain. Contraindicated in pregnancy.
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Lamotrigine, felbamate mechanism of action?
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Blocks voltage-gated sodium channels and glutamate receptors.
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Toprimate mechanism of action?
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Blocks sodium channels and increases GABA action.
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Tiagabine mechanism of action?
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Inhibits GABA reuptake.
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Vigabatrin mechanism of action?
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Irreversible inhibits GABA transaminase; increases GABA levels.
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Levetiracetam mechanism of action?
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Modulates GABA and glutamate release.
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Galantamine mechanism of action?
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Acetylcholinesterase inhibitor.
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Brimonidine mechanism of action?
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Alpha 2-agonist; decreases aqueous humor synthesis.
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Methysergide mechanism of action?
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Serotonin agonist.
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Methysergide uses?
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Used for migraine headaches
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Acamprosate mechanism of action?
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NMDA antagonists; GABA agaonists
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Doxepin mechanism of action?
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TCA; blocks reuptake of norepinephrine and serotonin.
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Amoxapine mechanism of action?
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TCA; blocks reuptake of norepinephrine and serotonin.
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Citalopram mechanism of action?
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Serotonin-specific reuptake inhibitors.
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Venlafaxine mechanism of action?
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SNRIs; inhibits serotonin and norepinephrine reuptake.
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Duloxetine mechanism of action?
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SNRIs; inhibits serotonin and norepinephrine reuptake. Stronger NE effect than venlafaxine.
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Isocarboxazid mechanism of action?
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Non-selective monoamine oxidase (MAO) inhibitors.
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Trazodone mechanism of action?
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Inhibits serotonin reputake.
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Doxepin mechanism of action?
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TCA; blocks reuptake of norepinephrine and serotonin.
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Amoxapine mechanism of action?
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TCA; blocks reuptake of norepinephrine and serotonin.
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Citalopram mechanism of action?
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Serotonin-specific reuptake inhibitors.
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Venlafaxine mechanism of action?
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SNRIs; inhibits serotonin and norepinephrine reuptake.
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Duloxetine mechanism of action?
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SNRIs; inhibits serotonin and norepinephrine reuptake. Stronger NE effect than venlafaxine.
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Isocarboxazid mechanism of action?
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Non-selective monoamine oxidase (MAO) inhibitors.
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Trazodone mechanism of action?
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Inhibits serotonin reputake.
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Oral contraceptives mechanism of action?
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Synthetic progestins, estrogen. Inhibit LH/FSH thus prevent estrogen surge. No estrogen surge means no Lh surge thus no ovulation.
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Carboprost mechanism of action?
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PGF-2 alpha agonist
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Dinoprostone mechanism of action?
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PGE2 agonist
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Meclizine mechanism of action?
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First generation H1 antagonist. Prevents G(q) activation.
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Dimenhydrinate mechanism of action?
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First generation H1 antagonist. Prevents G(q) activation.
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Chlorpheniramine mechanism of action?
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First generation H1 antagonist. Prevents G(q) activation.
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Guaifenesin mechanism of action?
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Expectorant.
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Epoprostenol mechanism of action?
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Prostacyclin analog (PGI2).
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Name three second generation H1 blockers?
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Cetirizine, loratadine, fexofenadine
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What is the suffix for H1 second generation vs H2 blockers?
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H1: tadine, H2: tidine
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What is amoxicillin? What is its specturm?
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Same as ampicillin; broad spectrum beta lactam sensitive penicillin
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What three antibiotic classes have phototoxicity?
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Sulfas, tetracyclines, fluoroquinolones
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What are the side effects of macrolides?
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Ototoxicity, stimulate GI motility, acute cholestatic hepatitis, prolonged QT interval
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What two antibiotics increase the QT interval?
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Fluoroquinolones and macrolides
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What is the MOA of aripiprazole?
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Partial dopamine agonist; partial serotonin agonist
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How do typical vs atypical antipsychotics differ in temrs of MOA?
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Atypicals tend to be partial agonists; typicals are competitive antagonists
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Do NNRTIs cause bone marrow suppression?
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NO
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How does GABA(B) work?
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G-protein coupled receptor; K+ efflux
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What is the MOA of buspirone?
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5-HT1A partial agonist
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What inhaled anesthetic sensitizes to catecholamines? What is the effect?
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Halothane; causes arrhythmias
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Why is atracurium special? What is its major side effect?
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Safe in hepatic or renal imapirment; breaks down to laudanosine which causes seizures
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Why does mivacurium have such a short half life? What is the major contraindication?
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Esterase; if patient is a slow metabolizer you must contraindicate
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What is naltrexone used for?
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Reduces craving in opiate and alcohol addiction
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What kind of cardiotoxicity is caused by antimuscarinics?
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Long QT
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How do you treat bipolar disorder in a pregnant woman?
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Gabapentin
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Bisacodyl MOA and use
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Contact laxative; promotes evacuation of colon and increases secretion;
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Docusate MOA and use
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Laxative; surfcatant that isn't bulk forming and doesn't affect transit time
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What is the role of the endosome?
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Sorting center for materials brought from outside the cell or from the golgi; sends back to the membrane or golgi for furhter use
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What is the regulation of HMG-CoA reductase?
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Induced by insulin, inhibited by cholesterol, glucagon, and statins
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What is the direct source for Acetyl-CoA to make fatty acids?
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Citrate via ATP citrate lyase
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What are the symptoms of abetalipoproteinemia? What is defective?
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Failure to thrive, steatorrhea, acanthyocytosis (thorny RBC projections), ataxia, night blindness; defect in apoB-100 and apoB-48 (microsomal transfer protein)
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Is alcohol dehydrogenase or acetylaldehyde dehydrogenase deficient in Asians?
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Acetylaldehyde dehydrogenase
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What are the three major symptoms of Lesch-Nyhan syndrome?
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Hyperuricemia/gout, mental retardation, self mutilation
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What is the reaction undertaken by fatty acid synthase?
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Converts malonyl CoA + NADPH => CO2 + growing fatty acid (palmitate, 16 carbon)
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What is the role of the clathrin coated vesicle?
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Transports vesicle from trans golgi to cell membrane / lysosome
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What two amino acids are ONLY ketogenic? What does that mean?
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Lysine and leucine; the other 18 are gluconeogenic
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What enzyme in FA synthesis generates NADPH besides the HMP shunt?
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Malic enzyme (malate + NADP => pyruvate + NADPH)
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What is the regulation of acetyl CoA carboxylase?
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Induced by citrate, insulin; inhibited by glucagon
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What is the function of CETP?
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Cholesterol ester transfer protein; gives cholesterol esters to VLDL, IDL, and LDL from HDL
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What compounds inhibit and stimulate pyruvate kinase?
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Inhibit: ATP, alanine; stimulate: fructose-1,6-BP
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What are the symptoms of MCAD deficiency?
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HYPERAMMONEMIA, hypoketotic hypoglycemia, weakness, hypotonia, elevated dicarboxylic acids in blood
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How are elastin molecules crosslinked?
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Lysine
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What are the two purely ketogeneic amino acids?
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Lysine and leucine
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What is the rate limiting enzyme of fatty acid oxidation?
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Carnitine acyltransferase I
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What four amino acids are glucogenic?
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Met, Val, Arg, His
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What is the regulation for PFK-1?
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Induced by 2,6-FBP [liver only], AMP; inhibited by ATP, citrate
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What is the regulation of fructose-6-bisphosphatase?
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Induced by ATP (from beta oxidation), inhibited by F-2,6-BP
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Why does exercise exacerbate gout?
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Lactic acid competes with uric acid for excretion at the proximal tubule organic anion transporter
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What type of brain lesion is linked to perseveration? What is perseveration?
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Frontal lobe; unable to stop drawing a line once you start
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What type of brain lesion is linked to constructional apraxia (unable to reproduce two overlapping squares)?
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Nondominant parietal lobe (right)
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How would a lesion of the dominant temporal lobe (left) present?
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Euphoria, audiotry hallucinations, deulsions, thought disorders, Wernicke's
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How would a lesion of the non-dominant temporal lobe (right) present?
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Dysphoria, irritability, decreased visual and musical ability
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We spend the most time in what stage of sleep? What are two characeristics of its EEG graph?
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II; K-complexes and spindles
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What is the function of serotonin, Ach, NE, and DA in sleep?
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Serotonin: initates sleep; ACH: increases in REM sleep; NE: decreases in REM sleep; dopamine: arousal and wakefulness
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Low birth weight definition; aossicated with what problems?
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< 2500 g; hgreater incidence of physical and emotional problems, infections, respiratory diress syndrome, necrotizing enterocolitis, germinal matriax hemorrhages, persistant fetal circulation (PDA).
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Fixation - definition and example
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Partially remaining at a more childish level of development (vs. regression); eg. men fixating on sports games.
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What is the ONLY peptide hormone that isn't water soluble (is bound to a carrier)?
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IGF
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What hormone is cortisol permessive on?
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Glucagon
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What is the effect of organ transplant on resistance and cardiac outout/heart rate?
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Increase resistance, therefore causes a NORMAL bradycardia
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What is the main determinant of diastolic and systolic pressure?
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Diastolic = TPR, systolic = SV
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If a normal person is given 100% O2, what happens to their ventilation rate? What is the controlling chemoreceptor?
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No change in ventilation rate; still under central respiratory drive
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What kind of breathing is caused by mid brain lesions or increased ICP?
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Biot's breathing (irregular periods of apnea, then several breaths of identical death)
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Effect of histamine on bronchioles?
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Bronchoconstriction.
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Physiological dead space (Vd) formula
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(Vd)=(Vt)*(PaCO2-PeCO2)/(PaCO2) PaCO2 = arterial PCO2, PeCO2 = expired air PCO2
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Resistance formula
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8*(blood viscosity)*(vessel length)/(pi*radius^4)
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Where is ventilation greatest in the lungs? Where is perfusion greatest in the lungs?
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Both are greatest at the base.
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Haldane effect
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As hemoglobin is oxygenated in the lungs, it loses affinity to H+ and favors CO2 formation.
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Effect of PTH and AT-II on the PCT
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PTH inhibits sodium/hosphate cotransport, increasing phosphate exretion. AT-II stimulates sodium/hydrogen exchanger, increasing sodium/water reabsorption (contraction alkalosis).
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Tubular fluid to plasma concentration ratio TF/P >1
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When solute is reabsorbed less quickly than water (urea, chloride), when solute is not absorbed at all (inulin, mannitol, creatinine) or there is a net secretion (PAH)
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Tubular fluid to plasma concentration ratio TF/P =1
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When solute and water are reabsorbed at the same rate (potassium, sodium).
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What two aminoacids are potent stimulators of gastrin?
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Phenylalanine and tryptophan
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What is the role of the fetal adrenal gland?
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Fetal lung maturation and surfactant production
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What three factors increase insulin release?
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Hyperglycemia, GH, coritsol
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Which endocrine hormones use the cAMP signaling pathway?
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FSH, LH, ATH, TSH, CRH, hCG, ADH (V2), MSH, PTH, calcitonin, GHRH, glucagon, histamine (H2) (FLAT CHAMP)
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Which endocrine hormones use the cGMP signaling pathway?
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ANP, nitric oxide
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Which endocrine hormones use the IP3 signaling pathway?
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GnRH, oxytocin, ADH (V1), TRH, histamine (H1), angiotensin II, gastrin (GOAT)
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What is the effect of elevated SHBG in men?
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Lowers free testosterone resulting in gynectomastia
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What is the effect of lowered SHBG in women?
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Raises free testosterone resulting in hirsutism
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JVP components; what are the a, c, v, x, and y waves?
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a: atrial contraction, c: RV contraction, v: increase RA pressure due to filling agianst closed tricuspid; x descent: artrial relaxation and downward movement of tricuspid; y descent: blood flow from RA to RV
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What two conditions can cause paradoxial splitting?
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LBBB, aortic stenosis (P2 > A2)
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What is the T wave?
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Ventricular repolarization
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What is the Cushing reaction?
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Increase ICP => constricts arterioles => cerebral ischemia => hypertension => reflex bradhycardia ( triad: hypertnesion, bradycardia, respiratory depression)
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What is the presentation of a transplacental listeria infection?
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Disseminated granulomas with central necrosis; high fatality rate
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What test do you do for the diptheria toxin? How do you culture diptheria?
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Elek test; tellurite agar
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What virus type is a flavivirus?
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+ssRNA, enveloped
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What are examples of flaviviruses? How can you generalize them in terms of transmissioN?
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Arbovriuses; west nile, saint louis encephalitis, dengue, yellow fever, Hep C
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What are examples of togaviruses?
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Western/Eastern equine ecephalitis; rubella
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What does Tat gene do?
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Transactivator of transcription (upregulation)
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What does Rev gene do?
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Upregulated transport of unlsplice dand spliced transcripts to cell cytoplasm
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What type of viruses are bunyaviruses? What are the examples?
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Segmented -ssRNA enveloped; California and LaCrosse encephalitis; hantavirus
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Listeria monocytogenes treatment?
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Ampicillin/amoxicillin
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Mycobacterium leprae treatment?
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Dapsone, clofazimine, and rifampin
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Borrelia burgdorferi treatment?
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Doxycycline
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Dracunculus medinensis treatment?
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Niridazole. Cheese cloth filtration of water.
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Ochocerca volvulus treatment?
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Ivermectin.
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Wuchereia bancrofti, Brugia malayi treatment?
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Diethylcarbamazine
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Toxocara canis treatment?
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Diethylcarbamazine
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What two RNA viruses replicate in the nucleus?
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Rotavirus and influenza
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Rickettsiae typi symptoms, lab values/clinical findings?
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1. Endemic typhus. Headache, fever, rash (vasiculitis). Flea vector. Rash starts centrally and spreads outward, no palm or sole involvement.| 2. Positive Weil-Felix test
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Rickettsiae prowazekii symptoms, lab values/clinical findings?
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1. Epidemic typhus. Headache, fever, rash (vasiculitis). Human body louse vector. Rash starts centrally and spreads outward, no palm or sole involvement.| 2. Positive Weil-Felix test.
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Coxiella burnetii symptoms, lab values/clinical findings?
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1. Headache, fever, but no rash (Q fever). Aerosol vector. Can survive extracellularly. Atypical pneumonia.| 2. Negative Weil-Felix test.
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Klebsiella granulomatis (formerly Calymmatobacterium granulomatis) symptoms, lab values/clinical findings?
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1. Granuloma inguinale (donovanosis); ulcerating sclerotic granulomas of the penis. "Beefy-red."| 2.
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Candida albicans symptoms, lab values/clinical findings?
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1. Superifical or systemic fungal infection. Oral or esophageal trush (AIDS, diabetics, neonates, steroids). Endocarditis (IV drug user). Vaginal candidiasis (at normal pH ~4.0)| 2. Yeasts with pseudohyphae, germ tubes
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Trichomonas vaginalis symptoms, lab values/clinical findings?
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1. Vaginitis: foul-smelling, greenishing discharge, itching and burning. Strawberry-colored mucosa.| 2. Vaginitis at a pH of 8.0.
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Dracunculus medinensis symptoms, lab values/clinical findings?
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1. In drinking water; skin inflammation nad ulceration| 2. Nematode.
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Ochocerca volvulus symptoms, lab values/clinical findings?
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1. Transmitted by blackflies; hyperpigmented skin and river blindness| 2. Nematode.
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