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395 Cards in this Set
- Front
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these drug can be used to treat both HTN and BPH
|
a1-blockers
*prazosin |
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this vinca alkaloid prevents the proper separation of chromosomes during M-phase of the cell cycle
|
vincristine
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in which patients are ACE inhibitors contraindicated in
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those with bilateral renal artery stenosis
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this high sedating anti-depressant is used to treat insonmia can cause priapism
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trazodone
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condition associated with fever, muscle rigidity, tachycardia, HTN, hyperkalmia, and myoglobinemia soon after surgery
|
malignant hyperthermia
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what causes malignant hyperthermia
|
hyerpsensitivity of skeletal muscles to anesthetics due to defect in ryanodine receptors of sarcoplasmic reticulum
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DOC in malignant hyperthermia
|
dantrolene - acts on ryanidine receptors and prevents further Ca release
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P450 inducers
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barbiturates
rifampin carbamazepine griseofulvin alcohol |
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P450 inhibitors
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isoniazid
cimetidine macrolides (azithromycin and erythromycin) azoles grapefruit juice ceprofloxacin ritonavir |
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first like treatment of acute gouty arthritis
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NSAIDs
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what are two way to reverse warfarin, which one is fastest
|
1. fresh frozen plasma (fastest)
2. vitamin K |
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understimulation of which receptor would lead to orthostatic hypotension and cerebral hypoperfusion (lightheadedness)
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a1-receptors
|
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dual mechanism of action of B-blockers during thryotoxicosis
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1. decreases sympathetic response
2. decreases T4 --> T3 |
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DOC in alcoholic with cough and foul smelling sputum
|
clindamycin - think aspiration pneumonia
|
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two side effects of lithium
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1. diabetes insipidus
2. hypothyroidism |
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Class IA antiarrhythmics
|
Disopyramide, Quinidine, Procainamide
*double quarter pounder |
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Class IB antiarrhythmics
|
Lidocaine, Tocainide, Mexiletine
*lettuce, tomato, mayo |
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Class IC antiarrhythmics
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Moricizine, Flecainide, Propafenone
*More fries please |
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this class of antiarrhytmics causes a prolonged action potential with some inhibition of phase 0
|
Class IA
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this class of antiarrhytmics causes shortened action potential with very weak inhibition of phase 0
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Class IB
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this class of antiarrhytmics has strong inhibition of phase 0 with no change of the action potential lenth
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Class IC
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5-HT 3 inhibitor used to treat nausea and vomiting following chemotherapy
|
ondansetron
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ideal treatment for patient in adrenal crisis - hypotension, hypoglycemia, generalized hyperpigmentation
|
corticosteroids
*hydrocortisone |
|
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what are dangerous to be taking with PDE inhibitors such as viagra
|
nitrates - this combination can lead to severe hypotension
|
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most common side effect of streptokinase
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hemorrhage
|
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mechanism of action of pramipexole and ropinerole
|
directly stimulate dopamine receptors - used for treatment of Parkinson's disease
|
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two classes of drugs that increase cholesterol hepatic synthesis and are associated with increased risk of gallstone formation
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1. fibrates
2. bile-acid binding agents (cholestyrmine, colestipol, colesevelam) |
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most effective prolonged treatment of duodenal ulcers
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eradication with antibiotics
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why must you wait 14 days before administration of SSRI after discontinuation of MAOI
|
monoamine oxidase re-synthesis so do not cause serotonin syndrome
|
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mechanism of action of heparin
|
increases effect of Antithrombin III (AT III)
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chemotherapeutic agent that inhibits sealing activity of topoisomerase II
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etoposide
|
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these analgesic drugs have decreased risk of bleeding and GI ulceration
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selective COX-2 inhibitors
*celecoxib, rofecoxib |
|
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this COX-2 inhibitor is associated with increased risk of heart attack, thrombosis, and stroke
|
rofecoxib
|
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why are EBV and CMV resistant to acyclovir
|
do not contain the same thymidine kinase needed to activate acyclovir
|
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most dangerous adverse effect of amphotericin B
|
nephrotoxicity
*decreased GFR, hypokalemia, and hypomegnesemia |
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treatment of hypoglycemia
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IM glucagon
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these two drugs decrease the activity of platelet PDE3 leading to increased cAMP and PKA
|
dipyridamole
cilostazol |
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this PDE3 inhibitor is also a direct vasodilator and is used in the treatment of peripheral arterial disease
|
cilostazol
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non-steroid anti-androgen drug that competes with testosterone and DHT for testosterone receptors used in the treatment of prostate cancer
|
flutamide
|
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anti-diabetic drug contraindicated in renal failure
|
metformin
|
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used for the treatment of urinary retention, paralytic ileus, and glaucoma
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cholinomimetics
|
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adverse effects of nicotinic acid
|
flushing (treated with aspirin)
hepatotoxicity |
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cholesterol drug that decreases hepatic synthesis of triglycerides and VLDL; also increases HDL
|
nicotinic acid
|
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two drugs that bind erogesterol in the fungal membrane and create pores
|
amphotericin B
nystatin |
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this class of drug inhibits ergosterol synthesis
|
azoles
|
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this drug inhibits glucan synthesis
|
caspofungin
|
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this drug interferes with fungal RNA and protein synthesis
|
5-fluorocytosine
|
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what type of drugs are preferentially processed by the liver
|
lipophilic - processed by liver into more polar compound to be excreted by kidney
|
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what reduces renin release
|
B-blockers
|
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preferred prophylaxis to inactivate N. meningitidis in exposed individual
|
rifampin
|
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two drugs that inhibit thyroid peroxidase
|
methimazole
propylthiouracil |
|
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DOC for simple partial seizure
*one body part with no loss of consciousness |
carbamazepine
|
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DOC for complex partial seizure
*loss of consciousness |
carbamazepine
|
|
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DOC for myoclonic sezirues
*brief jerky moves with no loss of consciouness |
Valproic acid
|
|
|
DOC for absence seizures
*starring spells |
1. ethosuzimide
2. valproate |
|
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diuretic associated with causing ototoxicity
|
loop diuretics
|
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common side effects of SSRIs in men
|
sexual dysfunction
|
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what happens to neutrophils, lymphocytes, monocytes, basophils, and eosinophils concentrations in corticosteroid use
|
increased neutrophil count
decreased everything else |
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DOC in patient with both absence and tonic-clonic seizures
|
valproate
|
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Ca channel blockers used in HTN that can lead to flushing and edema
|
amlodipine
nifedipine |
|
|
how do human tumor cells resist chemotherapy agents
|
human multidrug resistance gene (MDR1) - ATP-dependent efflux pump
|
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what increases the peripheral metabolism of levodopa decreasing it effectiveness
|
Vit. B6
|
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constant amount of drug being metabolized no matter the concentration of drug present
|
zero-order elimination
*first-order is dependent on drug concentration |
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what does organophosphate poisoning result in
|
AChE inhibition leading to increased amount of ACh available and overactivity of muscarinic and nicotinic receptors
|
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two drugs used in the reversal of symptoms in organophosphate poisoning
|
1. atropine - inhibits muscarinic receptors
2. pralidoxime - inhibits both muscarinic and nicotinic receptors |
|
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what can occur if only atropine is given to patient with organophosphate poisoning
|
muscle paralysis due to overstimulation of nicotinic receptors
|
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what activates both 6-mercaptopurine and 6-thioguanine
|
HGPRT
|
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what enzyme degrades 6-mercaptopurine
what drug would increase the concentration of 6-mercaptopurine |
xanthine oxidase degrades 6-mercaptopurine
allopurinol inhibits xanthine oxidase leading to increased concentration of 6-mercaptopurine |
|
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this class of drugs improves both positive and negative symptoms in schizophrenic
|
atypical antipsychotics
|
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atypical antipsychotics
|
clozapine
resperidone olanzapine quetiapine |
|
|
high and low potency typical antipsychotics
|
high - haloperidol, fluphenazine, pimozide
low - chlorpromazine and thioridazine |
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which drug is metabolized into phenobartital and phenylethylmalonamide
|
primidone
|
|
|
antiplatelet agent that inhibits platelet surface ADP receptor
|
clopidrogrel
|
|
|
bind to PBP (transpeptidases) in bacterial peptidoglycan layer
|
penicillins
cephalosporins |
|
|
differentiate AV gradient, solubility, and onset of action in anesthetic agents
|
highly solubility - increased AV concnetration with slow onset of action
low solubility - decreased AV concentration with rapid onset of action |
|
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direct thrombin inhibitors used in the treatment of heparin-induced thryombocytopenia
|
argatroban
hirudin lepirudin |
|
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these drugs blocks GpIIb/IIIa receptor to prevent platelet aggregation
|
abciximab
eptifibatide tirofiban |
|
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two drugs that inhibit ADP mediated platelet aggregation
|
clopidogrel
ticlopidine |
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drug that can reverse methotrexate toxicity
|
folinic acid - doesn't need to be converted to THF by DHF reductase
|
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DHF reducatase inhibitor
|
methotrexate
|
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effects of a1-receptor stimulation
|
increased blood pressure
contraction of urethral sphincter mydriasis |
|
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effects of B2-receptor stimulation
|
decreased blood pressure
bronchodilation relaxation of uterus (tocolysis) |
|
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most potent class of diuretics, used for treating edema
|
loop diuretics
|
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these diuretics work at the descending limb of Henele and cause water to be drawn into the lumen
|
osmotic diuretics
|
|
|
DOC of anaphylactic shock
*vasodilation, bronchoconstriction, increased vessel permeability |
epinephrine - a1, B1, and B2 receptor agonist
|
|
|
PPAR-y agonists
|
thiazolinidiones
|
|
|
effects of PPAR-y
|
increased adiponectin
increased fatty acid transport protein increased insulin receptors increased GLUT-4 |
|
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this antifungal agent inhibits the synthesis of ergosterol by decreased the enzyme squaline epoxidase
|
terbinafine
|
|
|
this antifungal binds polymerized microtubules and disrupts fungal mitotic spindle formation (inhibits mitosis)
|
griseofulvin
|
|
|
B-lactamase inhibitors
|
clavulanic acid
sulbactam tazobactam |
|
|
depolarizing NMJ blocker that is not reversed by AChE agents
|
succinylcholine
|
|
|
what are non-polarizing NMJ blockers reversed
|
AChE agents such as neostigmine
|
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contraindicated in patients with asthma or COPD for treatment of heart failure
|
non-selective B blockers
|
|
|
COMT inhibitors used to increased availability of levodopa to the brain
|
entacapone
talcapone |
|
|
differentiate entacapone and talcapone
|
entacapone - inhibits peripheral methylation of levodopa
talcapone - inhibits both peripheral and central methylation of levodopa (associated with hepatotoxicity) |
|
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which COMT inhibitor is associated with hepatotoxicity
|
talcapone
|
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|
precursor amino acid of serotonine
|
tryptophan
|
|
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effects of serotonin syndrome
|
restlessness, tremor, tachycardia, HTN, clonus, hyperreflexia, diaphoresis
|
|
|
antihistamine with anti-serotonergic properties used for the treatment of serotonin syndrome
|
cyproheptadine
|
|
|
two organism that cause urethritis in men - dysuria and mucopurulent discharge
treatment for each |
N. gonorrhoeae - ceftriaxone
C. trachomatic - azithromycin |
|
|
DOC for oropharyngeal candidiasis
|
nystatin
|
|
|
DOC for essential tremor
|
propanol
|
|
|
DOC to slow progression and reduce all-cause mortality in patients with heart failure
|
carvedilol
|
|
|
PDE inhibitor that increases cardiac contractility and decreases both preload and afterload
|
milrinone
|
|
|
mechanism of action of digitalis
|
blocks Na/K ATPase and causes slowing of conduction through AV node - bradycardia
|
|
|
what increases susceptibility to digitalis
|
hypokalemia
|
|
|
adverse effects of digitalis toxicity
|
nausea, vomiting, abdominal pain, headache, dizziness, confusion, hyperkalemia
|
|
|
drugs used for treatment of atrial fibrillation with rapid ventricular response
|
Ca channel blockers - verapamil and diltiazem
B-blockers Digoxin |
|
|
DOC for HTN in patients with bradycardia
|
nifedipine
amlodipine |
|
|
two drugs that inhibit thymidylate formation
|
methotrexate - DHF reductase inhibitor
5-fluorouracil - inhibits thymidylate synthetase |
|
|
side effects of ACE inhibitor
|
1. decreased GFR (decreased ATN II)
2. hyperkalemia (decreased aldosterone) 3. cough (increased bradykinin) |
|
|
how is digoxin predominantly cleared, what must you do in elderly person
|
renal clearance
need to decrease dose due to decreased GFR in elderly individual |
|
|
adverse effects of antipsychotics
|
galactorrhea due to hyperprolactinemia
tradive dydkinesia |
|
|
associated with disulfiram-like effects
|
metronidazole
|
|
|
how many half life does it take to reach steady state concentration (~95%)
|
4 half lives
|
|
|
most effective treatment for TCA-associated cardiac abnormalities
|
sodium bicarb
|
|
|
antidepressant with quinidine-like effect on cardiac conduction system causing QRS and QR prolongation and cardiac dysrhythmias
|
TCAs
|
|
|
mechanism of action of B-blocker (timolol) in glaucoma
|
decreases acqueous humor production by the ciliary epithelium
|
|
|
why is chlamydia trachomatis not effectively treated by ceftriaxone with young person presents with dysuria and discharge
|
lacks PG wall
*need azithromycin |
|
|
selective dopamin receptor agonist that causes arteriolar dilation and natruresis
|
fenoldapam
|
|
|
antihypertensive drug food for patients with renal insufficiency
|
fenoldapam
*selective dopamin agonist |
|
|
this asthma drug only reverses vagally-mediated bronchoconstriction
|
ipatropium
|
|
|
mechanism of vasodilatory effect of cholinergic agonists
|
binds to muscarinic recpetors on endothelial cells and promote release of NO
|
|
|
drugs most effective for motion sickness
|
scopolamine - antimuscarinic
meclizine - 1st generation antihistamine (has antimuscarinic properties) |
|
|
treatment for mycobacterium avium complex
|
azithromycin
|
|
|
treatment for focal numbness and tingling that fully resolves within minutes
|
aspirin
*most likely a TIA |
|
|
nitrate with 100% bioavailability
|
isosorbide mononitrate
|
|
|
best drug to stop cellular reaction and inflammation reaction in patient with asthma
|
corticosteroids
|
|
|
drugs used to control severe opthalmopathy in Grave's disease
|
corticosteroids
|
|
|
antihistamine with minimal sedative and antimuscarinic effects
|
2nd generation antihistamines
|
|
|
effects of 1st generation antihistamines
|
H1 blockers
antimuscarinic antiserotinergic a1-blocker cross blood brain barrier |
|
|
mycobacterial resistance to isoniazid
|
non-expression of catalase-peroxidase enzyme, needs this to become active and inhibit mycolic acid synthesis
|
|
|
dihydrofolate reductase inhibitors
|
trimethoprim (bacteria)
methotrexate (cancer) pyramethamine (protozoa) |
|
|
adverse effects associated with statins
|
hepatits
myopathy |
|
|
toxicities associated with niacin
|
cutaneous vasodilation
hyperuricemia (gout) hepatitis |
|
|
adverse effects associated with fibrates
|
gallstones
|
|
|
adverse effects associated with bile-acid resins
|
hypetriglyceridemia
|
|
|
two drugs associated with drug-induced lupus
|
procainamide
hydralazine |
|
|
treatment for postoperative urinary retention
|
bethanacol
|
|
|
adverse effects of INH
|
hepatotoxic
decrease B6 |
|
|
what diuretic is associated with elevations of LDL, calcium, uric acid, glucose
|
thiazide diuretics
|
|
|
drug toxicity associated with changes in color vision, anorexia, ventricular dysrhythmia, fatigue, confusion
|
digoxin toxicity
|
|
|
this neurotoxin blocks the presynpatic release of ACh
|
botulinum neurotoxin
|
|
|
adverse effect of osmotic diuresis (mannitol)
|
pulmonary edema
|
|
|
what can prevent tissue necrosis at the injection site of NE
|
a1 blocking drugs - phentolamine
|
|
|
differentiate amount of liter in plasma and interstitial space
how do drugs become trapped in plasma |
3-5 liters in plasma - drugs that are increased MW, plasma protein bound, increased charge, and hydrophilic are trapped in plasma
14-16 liters of plasma + interstitial space - opposite characteristics |
|
|
medication of choice for gestational diabetes
|
insulin
|
|
|
this first-line TB drug requires an acidic environment within the phagolysosome to exert antimicrobial effect
|
pyraziramide
|
|
|
nucleoside monophosphate that doesn't need conversion by herpesvirus kinase for conversion
|
cidofovir
|
|
|
what drug class if combined with benzodiazepines can cause significant sedation
|
1st generation antihistamines
|
|
|
properties of poorly soluble inhaled anesthetics
|
1. less amount to saturate blood
2. increased rise in tension of gas in blood 3. increased equilibration within the braine 4. increased onset of action |
|
|
primary effect of nitroglycerin
|
venodilator
|
|
|
three drugs that inhibit androgen receptor complex on target cells
|
flutamide
cyproterone acetate spironolactone |
|
|
structural analogues of pyrophosphate, an important component of hydroxyapatite
|
biphosphonates
|
|
|
nonselective (B1 and B2) antagonist
|
propanolol
|
|
|
nonselective (B1 and B2) agonist
|
isoproterenol
|
|
|
nonselective (a1 and a2) antagonist
|
phentolamine
|
|
|
nonbenzodiazepine drug that has benzodiazpine mechanism of action used for insomnia
|
zolpidem
|
|
|
two effects of digoxin
|
1. increased cardiac contractility by blocking Na/K ATPase
2. decreased AV nodal conduction by increased parasympathetic tone |
|
|
dobutamine
|
selective B1 agonsit
|
|
|
final common pathway of gastric acid secretion from parietal cell
|
proton pump
*inhibited by omeprazole, lanzoprazole |
|
|
aminoglycoside that inactivates 30S ribosomal unit in TB
|
streptomycin
|
|
|
all patients being treated with etanercept should be screened for what
|
latent TB
*TNF-a inhibitor |
|
|
TNF-a inhibitor
|
etanercept
|
|
|
TB drug associated with causing optic neuritis that results in color blindness and decreased visual acuity
|
ethambutol
|
|
|
two classes of drugs associated with medication-induced body fat redistribution
|
HIV-protease inhibitors
glucocorticoids |
|
|
selective inhibitors of aromatase
|
anastrozole
|
|
|
adverse effects associated with volatile anesthetics
|
increased cerebral blood flow
myocardial depression hypotension decreased renal function |
|
|
antidepressant that does not cause sexual dysfunction
|
buproprion
|
|
|
antidepressant associated with seizures
|
bupropion
|
|
|
how to prevent acyclovir crystalline nephropathy
|
adequate hydration
|
|
|
cholinesterase inhibitor used in the treatment of Alzheimers
|
donepezil
|
|
|
three drugs used in the treatment of Alzheimers
|
1. donepezil (cholinesterase inhibitor)
2. vitamin E 3. memantine (NMDA antagonist) |
|
|
NMDA antagonist used in the treatment of Alzheimers
|
memantine
|
|
|
inhibits tubulin polymerization and microtubule formation in leukocytes; used for treatment of acute gouty arthritis
|
colchicine
|
|
|
adverse effects associated with colchicine
|
N/V
diarrhea |
|
|
three mood stabilizing drugs
|
lithium
valproic acid (anti-siezure) carbamazepime(anti-seizure) |
|
|
what class of drugs should not be used in patients with DM
|
nonselective B blockers
masks the symptoms of hypoglycemia |
|
|
what should be monitored in patients taking amiodarone
|
thyroid function
|
|
|
adverse effects of amiodarone
|
thyroid toxicosis
corneal micro-deposits pulmonary fibrosis drug-related hepatitis |
|
|
two drugs used for treatment of increased LDL
|
statins
ezetimibe |
|
|
two drugs used for treatment of increased triglycerides
|
fibrates
niacin |
|
|
selectively inhibits intestinal reabsorption of cholesterol
|
ezetimibe
|
|
|
this class of drugs activate PPAR -alpha
|
fibrates
|
|
|
mechanism of DDAVP (desmopressin analog) in patients with bleeding problem
|
induces endothelial release of vWF in deficient patients
|
|
|
adverse effect associated with thiazolidinediones
|
fluid retention with weight gain and edema
|
|
|
what three drugs can lead to increased lithium levels and toxicity
|
thiazide diuretics
NSAIDs ACE inhibitors |
|
|
lithium toxicity
|
NM excitability (tremors, fascicular twitching)
agitation ataxia delirium |
|
|
thiol-based cytoprotective free-radical scavanging agent used to decrease nephrotoxicty associated with platinum-containing agents (cisplatin)
|
amifostine
|
|
|
two way to decreased nephrotoxicity in patients with platinum-containing agents (cisplatin)
|
1. hydration with saline to increase choride diuresis
2. amifostine (free radical scavanger) |
|
|
decrease the progression of diabetic nephropathy
|
ACE inhibitors
ARBs |
|
|
what class of drugs can prevent MPTP-induced damage of dopaminergic neurons
|
MAO inhibitors
|
|
|
MAO inhibitors
|
selegiline
phenelzine tranylcypromine |
|
|
this antiarrhythmic has block B-blocking and K-blocking properties; associated with prolongation of PR and QT intervals
|
sotalol
|
|
|
class 3 antiarrhythmics
|
amiodarone
ibutilide dofetilide sotalol |
|
|
neuramidase inhibitors that impair release of newly formed virions
|
oseltamivir
zanamivir |
|
|
drug used for chelation therapy for Wilson's disease
|
penicillamine
|
|
|
what does para-aminobenzoid acid-containing sunscreens protect against
|
only UVB
|
|
|
side effects associated with nitrates
|
throbbing headache and facial flushing
|
|
|
best treatment to increase HDL concentration
|
niacin - better than diet and exercise
|
|
|
DOC in patient with HTN and chronic ischemia heart disease
|
ACE inhibitors
|
|
|
how do enterococci resist aminoglycosides
|
transfer chemical groups to the drug and impair the antibiotic binding ability
|
|
|
how do enterococci resist penicillins
|
beta-lactamases
have decreased affinity PBPs |
|
|
what have to the testosterone and DHT concentrations when leuprolide is given
|
GnRH agonist causes increased concentrations initially, then they decrease for the desired effect
|
|
|
what antilipid drugs can increased TGs
|
bile-acid binding resins
|
|
|
inhibit both the synthesis and release of thryoid hormones
|
iodide salts
|
|
|
competitive inhibitors of iodide uptake by thyroid gland
|
perchlorate
pertechnate |
|
|
mechanism of axn of class III antiarrhythmics
|
slow K efflux from ventricle myocyte and prolong repolarization and refractory period
*increased QT interval |
|
|
major cause of mordity and mortality in theophylline overdose
|
seizures
|
|
|
treatment for drug-induced parkinsonism caused by antipsychotics
|
centrally acting antimuscarinics
*trihyexyphenidyl, benztropine |
|
|
treatment for acetominophen toxicity
|
N-acetylcysteine (sulfhydryl donor)
*also acts as glutathione substitute |
|
|
why is active TB never treated with monotherapy
|
because selective survival of bacterial cells secondary to gene mutation can occur
|
|
|
mechanism of axn of nitroglycerin in patients with stable angina
|
venodilator causing decreased myocardial oxygen demand by decreased LV filling volume (preload) and cardiac work
|
|
|
drugs that can be used in Conn's syndrome
|
spironolactone
eplerenone |
|
|
two functions of carbonic anhydrase inhibitors
|
1. relieve intraocular pressure in glaucoma
2. acts of PCT as diuretic |
|
|
androgen receptor blocker associated with gynecomastia
|
spironolactone
|
|
|
antilipid drug associated with increased CK due to myopathy
|
statins
|
|
|
drug that irreversibly acetylates COX-1 and -2
|
aspirin
|
|
|
taking this anticoagulant can result in paradixical thrombus in patients with deficiency in protein C and S
|
warfarin
*inhibits protein C and S synthesis |
|
|
mechanism of axn of carbamazepine
|
blocks voltage-gated Na channels in neuronal membranes
*used for simple/complex partial seizures, and tonic-clonic seizures |
|
|
antiseizure drug associated with bone marrow suppression
|
carbamazepine
|
|
|
differentiate side effects associated with high vs. low potency antipsychotics
|
high - extrapyramidal
low - anti-cholinergic and anti-histamine effects |
|
|
given this opioid drug can cause withdrawal symptoms in patients who are dependent or tolerant to opioid use
|
pentazocine
|
|
|
this opioid drug is a partial k agonist and a weak u antagonist
|
pentazocine
|
|
|
what should be advised in patients taking inhaled corticosteroids for asthma
|
rinse mouth to prevent oropharyngeal candidiasis
|
|
|
enterococci resistance to vancomycin
|
D-lactate substitution for D-alanine
|
|
|
direct arteriolar vasodilators
|
hydralazine
minoxidil |
|
|
what should be given along with direct arteriolar vasodilators
|
B-blockers and diuretics due to tachycardia and edema reflex in this drug use
|
|
|
side effects of direct arteriole vasodilators
|
reflex tachycardia
edema |
|
|
antagonist of heparin
|
protamine sulfate
|
|
|
this class of antiarrhythmics are selective for rapidly and frequently depolarizing cells
|
Class 1B
|
|
|
this anticoagulant is able to bind both AT III and thrombin to allow AT III to inactivate thrombin
|
unfractionated heparin
|
|
|
Factor Xa inhibitor
|
fondaparinux
|
|
|
use of what other medication should be questioned when thinking of prescribing ACE inhibitors to avoid first-dose hypotension
|
diuretic use
|
|
|
treatment for patients experiencing: AV block, Bell's palsy, asymmetric large joing arthritis
|
lyme disease - doxycycline or penicillin-type
|
|
|
class of drugs used to diagnose and treat myasthenia gravis
|
AChE inhibitors
*physostigmine, edrophonium |
|
|
newer anticonvulsant that may cause hypersensitivity skin rash; should discontinue immediately
|
lamotrigine
|
|
|
treatment to prevent hemorrhagic cystitis in patients taking cyclophosphamide
|
mesna
*sulfhydryl compound |
|
|
this blocks the storage of adrenergic mediators in presynpatic vesicles and predisposes patients to depression
|
reserpine
|
|
|
DOC for hypertensive emergency
|
nitroprusside
|
|
|
toxicity that can result from nitroprusside use
|
cyanide toxicity
|
|
|
treatment for cyanide toxicity seen in patients taking nitroprusside
|
sodium thiosulfate
|
|
|
receptor that increased both systolic and diastolic BP, cause vagal-mediated decreased in HR, contractility, and conductance
|
a1-agonists
|
|
|
what should be recommended to patients taking nitrates
|
have nitrate-free period everyday to avoid tolerance
|
|
|
what does inhibition of fatty acid oxidation do in myocardial cells
|
shift energy production to glucose oxidation and decreases amount of O2 needed to support cardiac function
|
|
|
akathisia
|
movement disorder characterized by restlessness caused by antipsychotic therapy
|
|
|
what is rat poison analogous go
|
warfarin
|
|
|
a-glucosidase inhibitors
|
acarbose
miglitol |
|
|
mechanism of axn of a-glucosidase inhibitors
|
decreased activity of membrane-bound disaccharidases on brush border
|
|
|
drugs used to treat baldness in men
|
finasteride
*5-a-reductase inhibitor |
|
|
severe adverse effect in thioamides (antithyroid) drugs
|
agrnulocytosis, need WBC count with differential in patients receiving this medication
|
|
|
thioamides
|
methimazole
proprylthiouracil |
|
|
how can hypokalemia secondary to ACE inhibitors happen
|
in patients with renal insufficiency or taking K-sparing diuretics (amiloride, triamterene, spironolactone)
|
|
|
K-sparing diuretics
|
amiloride
triamterene spironolactone eplerenone |
|
|
mechanism of action of benzodiazepines, barbiturates, alcohol
|
bind to GABAa receptors and facilitate their inhibitory action
|
|
|
selective 5-HT1A agonist that is used for generalized anxiety disorder with reduced abuse potential
|
buspirone
|
|
|
treatment of bradycardia in patients with inferior MI
|
atropine
*inferior MI from RCA block causes bradycardia due to involvement in SA/AV nodes |
|
|
patient being treated for their bradycardia post-inferior MI develops eye pain, what medication are they on
|
atropine - increased intraocular pressure leads can precipitate glaucoma
|
|
|
adverse effect associated with chloramphenicol
|
aplastic anemia
|
|
|
anti-progestin that can be used to terminate early pregnancy
|
mifepristone
|
|
|
purine analog resistant to adenosine deaminase, DOC for hairy cell leukemia
|
cladribine
|
|
|
class of drugs to reverse atropine poisoning
|
cholinesterase inhibitors
|
|
|
what is Jimson weed analogous to
|
atropine
|
|
|
drugs that can provide quick relief of symptoms in rheumatoid arthritis, only used for short-term therapy
|
glucocorticoids
|
|
|
what mediates the cutaneous vasodilation seen in niacin therapy
|
prostaglandins
|
|
|
neurotransmitter and receptor type involved in the different target cells of sympathetic chain ganglia
|
sweat glands - ACh (muscarainic)
visceral organs and glands - NE renal vasculature - D1 |
|
|
what neurotransmitter and receptor type activates sympathetic chain ganglia from spinal column
|
ACh (nicotinic)
|
|
|
what neurotransmitter and receptor type activates adrenal medulla from spinal column
|
ACh (nicotinic)
|
|
|
parasympathetic activation of target cells from spinal columna
|
spinal column --> ACh(N) --> ACh (M) on target cell
|
|
|
drug combination that increases risk for myopathy in dyslipidemia
|
statins plus fibrates
|
|
|
durg combination that increases risk for cholesterol gallstones in dyslipidemia
|
fibrates plus bile-acid resins
|
|
|
fibrates
|
gemfibrozil
fenofibrate |
|
|
equation for bioavailability using area under the curve
|
F = AUC oral drug/AUC IV drug
*if same dosage of each is taken **if not same dosage, multiply the top by IV dose and bottom by oral dose |
|
|
DOC to prevent cerebral vascular spasm following subarachnoic hemorrhage
|
nimodipine
*calcium channel blocker |
|
|
what two side effects are not subject to tolerance in opioid use
|
miosis
constipation |
|
|
spironolactone has been shown to reduce morbidity and mortality in heart failure
|
**
|
|
|
mechanism of action of phenytoin and carbamazepine
|
decrease ability of Na channel to recover from inactivation
|
|
|
mechanism of action of ethosuximide
|
blocks T-type Ca channels in thalamic neurons causing hyperpolarization
|
|
|
blocks NMDA, K, Na, and GABA
|
valproic acid
|
|
|
competitive antagonist of endothelial receptors for treatment of idiopathic pulmonary HTN
|
bosentan
|
|
|
preferred treatment for DKA
|
regular insulin
|
|
|
administration of what may prevent thyroid absorption of radioactive iodine isotopes by competitive inhibition
|
potassium iodide
|
|
|
mechanism of action of nitrates
|
increase cGMP leading to decreased intracellular calcium and myosin dephosphorylation
|
|
|
GP IIb/IIIa receptor blocker
|
abciximab
|
|
|
commonly used in treatment of agitated patient
|
haloperidol
|
|
|
drug most commonly associated with neuroleptic malignant syndrome (hyperthermia, rigidity, autonomic instability, altered mental status)
|
haloperidol
|
|
|
drug chemically similar to vitamin B6
|
INH
|
|
|
antilipid drug that can potentiate effects of antihypertensive drugs due to vasodilatory effects and may cause insulin resistance
|
niacin
|
|
|
chelating agent used in the treatment of arsenic poisoning
|
dimercaprol
|
|
|
blockage of what results in flushed skin and mydriasis
|
muscarinic receptor blockade
|
|
|
classes of drugs that also have anticholinergic properties
|
TCAs
1st generation antihistamines low potency antipsychotics parkinson drugs |
|
|
treatment of hirsutism in women
|
spironolactone
|
|
|
this opioid antagonist has the greatest affinity for which receptor
|
u-receptor more than k and d
|
|
|
atypical antipsychotic D4 receptor antagonist that is associated with agranulocytosis
|
clozapine
|
|
|
HIV drug class associated with hyperglycemia, lipodystrophy, and inhibition of P450
|
protease inhibitors
|
|
|
what is the effect of low dose dopamine administration
|
increased contractility via B1 receptors
increased renal blood flow *epinephrine causes increased contractility with decreased renal blood flow |
|
|
best drug for long-term treatment for chronic gout
|
allopurinol
|
|
|
this can cross the BBB and reverse both CNS and peripheral symptoms of atropine toxicity, DOC
|
physostigmine
|
|
|
cleaves the disulfide bonds within mucous glycoproteins and loosens thick sputum in CF
|
N-acetylcysteine
|
|
|
leads to endometrial hyperplasia and thromboembolism because is both estrogen agonist and antagonist
|
tamoxifen
|
|
|
drug used in patients with hypercalcuria
|
hydrochlorothiazide
|
|
|
what do class III and class IA antiarrhythmics have in common
|
both prolong QT interval due to slowing of phase 3 repolarization
*amiodarone does not predispose to torsades de pointes like others |
|
|
patients presents with constipation after treatment of atrial fibrillation with ventricular tachyarrhythmias, drug that was given
|
verapamil
*calcium channel blocker |
|
|
depletion of what electrolyte leads to muscle weakness and cramping
|
potassium
|
|
|
this class of drugs does not require activation via intracellular phosphorylation in the treatment of HIV
|
non nucleoside reverse transcriptase inhibitors
|
|
|
NNRTIs
|
nevirapine
efavirenz delaviridine |
|
|
NtRTIs
|
tenofovir
adefovir |
|
|
NRTIs
|
zidovudine
didanosine stavudine lamivudine abacavir |
|
|
this class of NSAIDs will not impair platelet function
|
selective COX-2 inhibitor
|
|
|
drug that mother was taking in child born with apical displacement of TV, decreased RV volume, and atrialization of RV
|
lithium
|
|
|
inhibit the synthesis of ergosterol by inhibiting P450 enzymes
|
azoles
|
|
|
inhibit carbohydrate polymerization and therefore prevents PG cell wall synthesis in TB
|
emthambutol
|
|
|
how is INH metabolized
|
acetylation - different people are fast or slow acetylators
*slow acetylators are at risk of adverse effects (peripheral neuropathy, hepatotoxicity) |
|
|
mechanism for ACE inhibitor causing increased creatinine and BUN
|
decreased filtration fraction due to decreased ATN II not being able to constrict the efferent arteriole
|
|
|
what kind of drug metabolism do drug-induced lupus associated drugs undergo
|
metabolized by N-acetylation in the liver
*procainamide and hydralazine |
|
|
what is the essential protein in activation of IL-2
|
calcineurin
|
|
|
what two drugs inhibit calcineurin and therefore IL-2
|
cyclosporine
tacrolimus |
|
|
what are 3Hz spikes of EEG associated with
|
absence seizures
|
|
|
what side effects of levodopa can actually worsen with administration with carbidopa
|
behavioral changes such as anxiety and agitation, more levodopa is available to the brain
|
|
|
best treatment for chronic cough caused by ACE inhibitor
|
change to ARB
|
|
|
what happens to: renin, ATN I and II, Aldosterone, and bradykinin with administration of ACE inhibitor
|
increased renin, ATN I, and bradykinin
decreased ATN II and Aldosterone |
|
|
what class of antibiotics are structurally similar to D-ala-D-ala
|
penicillins
|
|
|
what do statins do to LDL receptor density on the liver
|
increased LDL receptor density to uptake more LDL
|
|
|
what does decreased minimal alveolar concentration signify
|
increased potency because less drug is needed to saturate the blood
|
|
|
what do class III antiarrhythmics (B-blockers) do to AV conduction and the PR interval
|
decrease AV conduction leading to increased PR interval
|
|
|
what class of drugs are associated with causing dilated cardiomyopathy
|
anthracyclines (doxorubicin and daunorubicin)
|
|
|
mechanism how TCAs cause arrhythmias
|
inhibit fast Na channels in conduction system (bundle of His)
|
|
|
what are the actions of TCAs
|
1. inhibit reuptake of NE and 5-HT
2. antimuscarinic 3.. a1-agonist 4.. inhibit fast Na channels |
|
|
most common cause of death in TCA overdose
|
arrhythmia
|
|
|
what drug is associated with neutropenia and presents with fever and mouth ulcers
|
ticlodipine (ADP receptor inhibitor that decreases platelet aggregation)
|
|
|
toxicity associated with vincristine
|
peripheral neuropathy
|
|
|
what is used to monitor warfarin and heparin respectively
|
warfarin - PT
heparin - aPTT |
|
|
what would drugs target against gp41 and gp120 do to HIV virions
|
gp41 inhibition would prevent viral membrane fusion with target cell
gp120 inhibition would prevent virion attachment to target cell |
|
|
DOC for RSV infection in young child presenting with bronchiolitis
|
ribaviron
|
|
|
drug associated with gingival hyperplasia
|
phenytoin
*due to increased PDGF |
|
|
mechanism of action of nucleoside reverse transcriptase inhibitors (NRTIs)
|
do not contain 3'-OH group making 5'-3' phosphodiester linkage formation impossible
|
|
|
mechanism of action of hydroxyurea
|
increases HbF synthesis
|
|
|
mechanism of action of oral contraceptives
|
inhibit ovulation by decreases release of FSH and LH via decreased GnRH
|
|
|
major polysaccharide component of fungal cell wall
what drug inhibits this production |
glucan
caspofungin |
|
|
what is unique about Foscarnet
|
pyrophosphate analog that does not require intracellular activation by viral or cellular kinases
|
|
|
what is Foscarnet used for
|
gangciclovir-resistant CMV
acyclovir-resistant HSV |
|
|
what symptom of Grave's disease is not improved with prapanolol administration
|
expothalmos
|
|
|
what happens to: renin, ATN I and II, Aldosterone, and bradykinin in ARB administration
|
increased renin, ATN I and II
decreased aldosterone no change to bradykinin |
|
|
what happens to: renin, ATN I and II, Aldosterone, and bradykinin with administration of B-blocker
|
decreased renin, ATN I and II, Aldosterone
no change to bradykinin |
|
|
two effects of PDE3 inhibitors
|
1. increased contractility via increased cAMP
2. vasodilation via increased cAMP |
|
|
DOC for treating patient with opioid addiction
|
methodone due to very long half-life
|
|
|
DOC for non MRSA S. aureus infection
|
nafcillin
|
|
|
DOC for pregnant patient with DVT
|
heparin
|
|
|
involuntary perioral movements caused by antipsychotics
|
tardive dyskinesia
|
|
|
mechanism of action of polyethylene glycol
|
osmotic laxative
|
|
|
this estrogen binding drug inhibits osteoporosis
|
raloxifene
|
|
|
DOC for trigeminal neuralgia
|
carbamazepine
|
|
|
DOC for B-blocker overdose
|
glucagon
*increases HR and contractility independently of adrenergic receptors |
|
|
mechanis of action for glucagon causing increased HR and contracility
|
activates G-protein receptors on cardiac myocytes causing increased cAMP; independent of adrenergic receptors
|
|
|
two drugs that bind ergosterol; they can also bind cholesterol in human cell membranes leading to nephrotoxicity and hepatotoxicity
|
amphotericin B
nystatin |
|
|
mechanism of macular degeneration
|
increased VEGF causing angiogenesis
|
|
|
what class of drugs can lead to reactivation of latent TB
|
TNF-a inhibitors
*influximab, etanercept, adalimumab |
|
|
TNF-a inhibitors
|
influximab
etanercept adalimumab |
|
|
opiate antidiarrheal drugs
|
diphenoxylate
loperamide |
|
|
what can TCAs do in patients with BPH
|
cause urinary retention due to antimuscarinic effects
|
|
|
TCAs
|
clomipramine
amitryptiline nortryptiline doxepine imipramine |
|
|
antipsychotic associated with retinal deposits that resemble retinitis pigmentosa
|
thioridazine
|
|
|
antipsychotic associated with corneal deposits
|
chlorpromazine
|
|
|
adverse effect of olazipine (antipsychotic)
|
weight gain
|
|
|
what class of drugs can preceipitate mania in patients with bipolar disorder
|
antidepressants
|
|
|
binding of which type of receptor is associated with Na and Ca influx with K efflux without use of cAMP or IP3
|
nicotinic
|
|
|
preferred treatment for patients with moderate RA, may cause stomatitis and liver function abnormalities
|
methotrexate
|
|
|
what drug is associated with precipitating angioedema due to bradykinin accumulation
|
ACE inhibitors
|
|
|
antimycobacterial drug that blocks the action of DNA-dependent RNA polymerase inhibiting transcription
|
rifampin
|
|
|
equation for calculating half life
|
t1/2 = Vd x 0.7 / Cl
|
|
|
what is the cause of rapid plasma decay of barbiturate anesthetic
|
rapid redistribution of the drug to other tissues
|
|
|
first-line DOC for management of status epilepticus
what is administered simultaneously to prevent recurrence |
benzodiazepines
phenytoin |
|
|
two drugs that inhibit neurotransmitter reuptake in adrenergic synapses
|
coccaine
TCAs |
|
|
what drug is used in long-term prevention of recurrent venous thromboembolisms
|
warfarin
|
|
|
mechanism of action of warfarin
|
inhibits K-dependent glutamic acid residues (II, VII, IX, X, protein C and S)
|
|
|
what type of benzodiazepines are associated with increased risk of falling in elderly
|
long-acting cause most drowsiness, but are least addicting
*diazepam and flurazepam |
|
|
what does activation of alpha and Beta receptors do to insulin secretion
|
a-receptors stimulation inhibits insulin secretion
B-receptors stimulation stimulates insulin secretion |
|
|
Normally, administration of epinephrine inhibits insulin secretion. what would pretreatment with a-blocker then do to insulin secretion
|
cause epinephrine to secrete insulin via B-receptor
|
|
|
what does INH do to vitamin B6
|
causes increased urinary excretion due to similar properties with itself, leads to defective synthesis of neurotransmitters and peripheral neuropathies
|
|
|
what drug can cause generalized lymphadenopathy
|
phenytoin
|
|
|
DOC for quick action in people with paroxysmal supraventricular tachycardia
|
adenosine
|
|
|
adverse effects of adenosine administration
|
bronchospasm
flushing high grade heart block |
|
|
adverse effect of Foscarnet
|
chelates Ca and promotes renal wasting of Mg leading to hypocalcemia and hypomagnesmia
|
|
|
mechanism of action for thiazolidinidiones
|
decreases insulin resistance by binding PPAR-y, a transcription regulator of genes involved in glucose and lipid metabolism
*also increases adiponectin |
|
|
DOC for listeria monocytogenes infection
|
ampicillin
|
|
|
do benzodiazepines increase the frequency or duration of GABAa receptors when they activate them
|
frequency of them opening
|
|
|
inhibits leukocyte migration and phagocytosis by blocking tubulin polymerization
|
colchicine
|
|
|
nonselective irreversible a-adrenergic antagonist that decreases number of receptors available for NE binding
|
phenoxybenzamine
|
|
|
inhibits mast cell degranulation
|
cromalyn
|
|
|
short-acting barbiturate used for anesthesia
|
sodium thiopental
|
|
|
what two drugs when combined can have additive negative chronotropic effects yielding bradycardia and hypotension
|
B-blockers and verapamil/diltiazem
|
|
|
adverse effect associated with gangciclovir; precipitated even more with co-administration with zidovudine
|
neutropenia
|
|
|
used for prophylaxis for post-infected individual with N. meningitidis
|
rifampin
|
|
|
what is contraindicated in patients taking oral contraceptives
|
smoking
|
|
|
most common cause of retinitis in HIV positive patient
|
CMV retinitis
*treat with gangciclovir |
