• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/271

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

271 Cards in this Set

  • Front
  • Back
Treatment for Acute Mania
(Litium or Valproic acid or Carbamazepine) + Olazapine
Teratogenic effects of Valproic Acid
Neural Tube defects
- spina bifida
- meningocele
Why Valproic acid causes neural tube effect?
Because it inhibits intestinal folic acid absoption
Teratogenic effect of Litium
Cardiovascular
- Ebstein's anormaly
Basal Long acting insulin
1- NPH
Basal long acting insulin (2)
1- NPH
 twice daily
12-18 hr
2- Glargine
one daily
24 hr
Short acting insulin (3)
1- Regular
2-3 hr
 tx for: DKA
2-Lispro, Aspart
30-90 min
post-meal hyperglycemia
Most common side effect of BUPROPION
seizures
drugs that may cause seizures
1- Bupropion
2- Izoniazid (anti- tuberculosis)
3- Imiperen (antibiotic)
MOA of indinavir
Protease inhibitor
Side effects of indinavir
lypodystrophy
hyperglycemia
inhibition of CYT P450
Neprotoxicity
neprolithiasis
What is the use of TMP-SMX in a HIV pt?
Prevention and treatment of Pneumocystis carinii
Zolpedem
Short acting hypnotic medication chemically unrelated to benzodiazepines
Clinical use of Zolpedem?
short term treatment of insomnia
Tx of septic arthritis caused by Gonococcus?
Ceftriazone
Pioglitazone
what monitoring test you have to do?
Liver Function test
Side effect of Hydralazine, Procaimide
Systemic Lupus Like syndrome= slow acetylators
Statins
Side effects
hepatotoxicity
myopathy
You want to switch a Phenilzine treatment to Sertraline, how may weeks you must wait to begin Sertraline treatment?
2 weeks
why you have to wait 2 weeks to change treatment from MAO inhibitor to SSRI?
Phenelzine is a MAO inhibitor= Ser, NORE, DOPA
Sertraline is a SSRI= Ser
Co administration can cause Serotonin Syndrome
MAO of Verapamil
Blocks SA and AV node calcium channels
- slows phase 0 deporalization  decr rate of SA node firing  decr SA node conduction
Do not mix Diazepam with?
First generation Antihistaminines Ex: Diphenhydramine, Chlorpheniramine
Why you do not mix Diazepam with antihistaminine?
Sedation
Tx for Rheumatoid arthritis
Chronic: Glucocorticoids
- quick relief
- short term tx
Acute: NSAIDs
Tx for Giardia lamblia?
Metronidazole
Wilson's Disease tx?
Penincillamine- removes excess copper
Hemocromatosis tx?
Deferoxamine
Rituximab
monoclonal antibody used in lymphoma immunotherapy targets CD20
Cilostozol
inhibits platelet aggregation
vasodilatation
Effect of Beta blockers in renin
inhibits renin release
Hydroxyurea
Increases HbF synthesis= protection againts polymerization of sickle cells
Thyroid peroxidase
Catalizes iodine oxidation
Simvastatin
decrease LDL
decrease TGs
increase HDL
MOA of pioglitazone
Thiazolidinediones
↓ blood glucose levels by improving the target cell response to insulin
How pioglitazone works on target cell?
Transcription modulation
MAO of Aspirin
IRREVERSIBILY inhibits COX 1 and COX 2
Clinical use of Aspirin
↓ platelet aggregation (<300 mg/day)
antipyretic and analgesic(300-2400 mg/day)
anti-inflammatory (>2400 mg/day)
Cinical use of Reserpine
↓ BP
Side effects of Reserpine
Depression and suicidal ideation= due to NORE and SER depletion
PUD
MOA of Reserpine
Blocks the storage of adrenergic mediator in presynaptic neuron
Tx for Toxoplasmosis?
Pyrimethamine and sulfadiazine
Tx for CMV?
GANCICLOVIR
Tx for Listeria?
Ampicillin
Tx for Crytococcus neoformans?
Amphotericin
Which nitrates has 100% of bioavailability?
Isosorbide mononitrate
Risperidone
Atypical antipsycotic
Clinical use of Warfarin
Long term anticuagulation
1- prevent venous thrombosis
2- prevent resultant pulmonary embolism
MOA of Warfarin
inhibits vit K dependent carboxylation of glutamic acid residues of clotting factor 2, 7, 9, 10
Clinical use of Heparin
Acute management of venous thrombosis or thromboembolism
MOA of Acarbose
inhibitor of α- glucoside
↓activity of the membrane bound disaccharide on the intestine brush border
Side Effects of Acarbose
Flatulence
GI bleeding
Abdominal pain
Rash
MOA of Etoposide
inhibits Topoisomerase II→ chromosomal breaks to accumulate → cell death
Clinical uses of Etoposide
Testicular CA
Small cell lung CA
MOA of milrinone
inhibitor of phosphodiesterase → ↑CAMP
1- ↑Ca in cardiac myocytes
2- vasodilation in smooth muscle
What drug is resistant to degradation by adenosine deaminase?
Cladribine
DOC for hairy cell leukemia
Cladribine
Characteristic for High hepatic clerance
high lipophilicity= poorly eliminate through kidneys
Intracellular consequence of nitroglycerin
myosin dephosphorylation
Side effect of Propylthiouracil
Agranulocytosis
Side effect of methimazole
Teratogen
MOA of finastride
inhibits 5α- reductase
decreases peripheral androgen reduction
Prevention for the increase of myocardial O2 demand due to nitrates use
Metroprolol
Esmolol
Beta blocker
increases PR interval
which vessel is more succeptible to nitroglycerin?
Large veins
Cholestyramine
Bile acid resins= binds negative charged bile acids in the SI → insolubles complexes→feces
Side effect of bile acid resins
incr TGs
GI discomfort
Gritty taste
impide absorption of fat soluble vitamins
Warfarin overdose tx?
Fresh frozen plasma (rapid)
Vit K
Ciplastin toxicity?
Nephrotoxicity
Prevention of nephrotoxicity due to Ciplastin use
Amifostine
Metrotrexate overdose tx?
Leucovorin
Methanol or ethylene glycol poisoning
Fomepizole
Doxorubicin cardiotocity tx?
Dexrazoxane
Colecoxib
selective COX 2 inhibitor
Can Colecoxib impair platelet function?
NO
tPA
Stimulates plasminogen→ plasmin
At the begining of tPA tx, what side effect can be observed?
Reperfusion Arrhythmias on arterial re-opening
Agatroban
direct thrombin inhibitor
clinical uses of agatroban?
Heparin induced thrombocytopenia
Closes PDA
INDOMENTACIN
Keeps open PDA
PGE2
Tx for HTN that have minimal effect on AV conduction?
Nifedipine
Co administration of Erythromicin and statin cause...
Myopathy
Methilin resistant strains of Staphylococcus epidermis
Vancomycin + rifampin
Enoxapin
low molecular weight heparin
Clinical use of Enoxapin
↓ in death and recurrent MI
MOA of Heparin
Binds to antithrombin III
MOA of Etarnacept
TNF-α inhibitor
Clinical uses of Etarnacept
Rheumatic Arthritis that do not respond to methothrexate tx
Side effect of Etarnacept
Reactivation of latent tuberculosis
MOA of Ergonovine
Ergot alkaloid
=constricts vascular smooth muscle by stimulating α- adrenergic receptor and serotonergic receptors
Use of low doses of Ergonovine can cause...
Prizmental's angina
- chest pain at rest
- ST elevation
How benzodiazepines increases GABA action?
Binding to GABA receptor and stimulating the influx of Cl ions into neurons
Clinical use of Cilostozol?
Interminet Claudication
Nitroglycerin
↓ cardiac preload= ↓ Left ventricular diastolic volumen
↓ cardiac work
↓ myocardial O2 demand
Side effects of Thiazides
HyperGLUC= hyperglycemia, hyperlypidemia, hyperuremia, hypercalcemia
Hyponatremia= hypotention
HypoKalemia
Common side effect of Metformin
LACTIC ACIDOSIS
Phentolamine
α- receptor blocker= vasodilation
prevents local tissue necrosis produced by NORE leak
Drugs that ↓LDL
1- STATINS
2- Ezetimibe
drugs that ↓ TGs
1- Fibrate
2- Niacin
drug that has the most ↑ HDL
NIACIN
Side effects of Ace inhibitors
CAPTOPRIL
cough
angioedema
protenuria
taste changes
hypO tention
pregnancy problems
rash
increases renin
low angiotensin II
Side effect of Spinolactone
Gynecomastia
hypekalemia
Side effect of Niacins
Flushing
Carvediol
Beta blocker= ↓ CHF mortality
Amiloride can not be mix with?
ACE inhibitors= cause hyperkalemia
Adrenal crisis tx?
Corticosteroids
Propanolol and hypoglycemia?
mask adrenergic symptoms of hypoglycemia
Proptosis tx?
Glucocorticoids
What can cause a co admistration of ACE inhibitors and thiazide or loops diuretics?
First dose hypotension
2dary hyponatremia due to diuretics tx
Can ACE inhibitor be use in renal artey stenosis?
NO
Co administration of Verapamil with Beta adrenergic can cause..(2 SE)
Sinus Bradycardia
Hypotension
What are the 2 metabolites formed from Primidone's metabolization?
Phenobarbital + PEMA
Muscarinic agonist
Bind to endothelial surface--> release of NO + Endothelial derivated relaxing factor→ ↑GC→ ↑cGMP→ smooth muscle relaxation
Molecular weight of COX 2
72 kD
Cystitis tx?
Fluoroquinole or TMP-SMX
A 37 weeks pregnant woman is positive for GBS, what is the treatment?
Intapartum Prophylaxis
- Penincillin or ampicillin
Hartnup Disease tx?
Niacin (B3)
Effects of glucocorticoids in white blood cells differential
Increases: neutrophil
Decreases: basophil, eosiniphils, monocytes, lymphocytes
Lansoprazole
inhibits H/K ATPase pump at parietal cells
= block final common pathway of gastric acid secretion, which is stimulated by Ach, hist, gastrin
DOC of heroin addition and abuse
Methadone
what is the principal characteristic of Methadone that justifies its substitution for heroin?
Long half life
MOA of sulfonylureas
stimulates insulin release in type II DM→ increases C peptide
MOA of Flucytosine
inhibits DNA + RNA synthesis
MOA of Caspofungin
inhibits fungi cell wall
MOA of Amphotericin B
binds to ergosol → inhibits cell membrane
MOA of Azoles
inhibits ergosterol synthesis
Cyt P 450 inducers (8)
Queen Barb Steels Phen-phen and refuses greasy carbs chronically
Q- Quinidine
B- Barbituates
S- St. John's warts
P- Phenytoin
R- Rifampin
G- Griseofulvin
C- Carbamazepine
Chronic alcohol use
Cyt P 450 inhibitors (7)
KEG is Acutely SICk
K- Ketoconazole
E- Erythromycin
G- Grapefruit

Acute alcohol use

S- Sulfonamides
I- INH
C- Cimetidine
At what ph Pyrazinamide work best?
Acidic
MOA of Abciximab
Blocker of GP IIb/IIa
Clinical use of Abciximab
Glanzmann thrombocytopenia
Effect of Timolol in aqueous humor
↓secretion of aqueous humor by ciliary epithelium
Side effect of gancyclovir
Neutropenia
Side effect of Forscarnet
Hypomagnesemia
↓PTH
Lime disease tx?
Doxycycline or penincillin derivates (Ex. Ceftriazone)
MOA of Nystatin
Binds ergosterol in the fungal cell membrane
Clinical use of Nystatin
Candidiasis
Rifampin is used as chemoprophyliaxis for?
N. meningitidis
Common side effect of Rifampin
Orange discoloration of secretions
Tx for Trigeminal neuralgia?
Carbamazepine
Carbamazepine side effects
aplastic anemia
P 450 inducer
what drug can be use against gram (-), gram (+), and bacteriodes?
Piperacillin- Tazabatam
MOA of Isoniazid
inhibition of mycolic acid synthesis

mycolic acid= make mycobacterium acid fast
t 1/2 Formula
t 1/2= (Vd x 0.7)/CL
Clinical uses of Valproate
Absence and tonic-clonic seizures
Clinical use of Ethosuximade
Absence seizures
MOA of pentazocine
partial agonist activity and weak antagonist activity at mu receptor
Pentazocine and morphine can cause...
Precipitate opiod withdrawal
Ceftriazone does not work in C. Trachomatic and U. Urealyticum. Why?
Because they lack of peptidoglycan cell wall
C. Trachomatic and U. Urealyticum tx?
Macrolides
tetracyclines
Anesthesics
↓MAC, ↑potency
↑solubility, ↑anesthetic is needed to saturate the blood
↑solubility, slow onset of action
↑[Arteriovenous] gradient, slow onset of action
Cyproheptadine
Serotonin receptor antagonist
MOA of Colchicine
Binds to IC protein tubulin→ inhibits polymerization into microtubules
SE of Colchicine
Nausea
Abdominal pain
diarrhea
Clinical use of Fenoldopam
Emergency hypertension
improves RPF→ ↓BP
Izoniazid Resistance
non-expression of the catalase peroxidase enzyme
Arsenic poisoning tx?
Dimercaprol
Cyanide poisoning tx?
Amyl nitrate
Acute lead and mercury poisoning?
CaNa2EDTA
Essential tremor tx?
Propanolol
Enfuvirtide
inhibits viral penetration into target cells
Initial tx for hypoglycemia
- no- medical setting
- medical setting
- no- medical setting= IM glucagon
- medical setting= IV Dextrose
MOA of Rifampin
inhibits DNA dependent RNA synthesis
benzodiazepines that causes day time drowsiness
Long term
FLUROZEPAM
DIAZEPAM
CLORAZEPAK
CHORDAZIPOSIDE
How can be prevented the hemorragic cystitis caused by Cyclophosphamide?
MESNA
Clinical use of Ribavirin
Infants w confirmed RSV broncholitis
HCV
MOA of Ribavirin
inhibits synthesis of guanine nucleotides
Amantadine
impairs uncoating of Influenzae A
BNP
vasodilatation
diuresis/natiuresis
↓BP
Is Nafcillin resistant to degradation by bacterial B- lactamase?
yes
Clinical use of naftcillin
Skin infections of S. aureus
Quetiapine
Atypical antipsycotic that treat negative and positive symptoms
Which vitamin has Izoniazid chemical similitud?
Vit B6
Side effect of atropine
MYDRIASIS --> ↑IOP--> GLAUCOMA
principally in African americans
Resistance to streptomycin
altered structure of bacterial ribosomes proteins
Most specific effect of Dobutamine
↑ cardiac conduction velocity
MOA of digoxin
slow conduction through AV node
↑parasympathetic tone --> ↓AV conduct
S. epidermidis tx?
Vancomycin
Dose dependant characteristics of Isoproterenol
↑cardiac contractility
↓vascular resistance
Clavulinic acid
B- lactamase inhibitor
Why amoxillin is co-administrated with clavulinic acid?
Clavulinic acid ↓amoxillin cleavege by bacterial cells
Tx of opioid withdrawal in neonates?
Opioid solution= tincture of opium
MOA of Ethosusimide
↓ Ca current in thalamic neurons
Blocks T- type Ca
Phenytoin
↓Na in cortical neurons
Long term tx for duodenal ulcers
Antibiotics
Prevention of crystalline neupropathy due to Acyclovir
Acute Hydratation
Dobutamine
B1>B2
↑HR, CONDUCTION, CONTRACTILITY, myocardial O2 consumption
Thiopental redistribution?
Muscle and fat tissue
Tx for idiopathic parkinson disease?
trihexyphenidyl
benztropine
Disopyrimide
slows phase 0 depolarization
prolonged phase 3 reporalization of ventricular myocyte
What vitamin can not be mixed with Levodopa?
VIT B6
incr levodopa peripheral metabolism--> decr enter to CNS
2 types of exacerbation of Mysthenia Gravis
1- myathetic gravis= subterapeutic , there is low Ach to compite with AB
2- Cholinergic crisis= inapropiated high doses
Prevention of thrombotic events in homocystenuria
Vit B6
Anticonvulsant and mood stabilizer
Valproid acid
ARBs
decr aldosterone
no change bradykin
incr AT I, AT II, renin
tx for malaria- chloride resistant
mefloquine
tx for acute gouty arthritis
NSAIDs
Side effect of Amitryline in BPH pts
urinary retention
Steps for status epilepticus tx
1- IV lorazepam
2- Phenytoin (simultaneously)
3- continues seizures= Give phenobarbital
4- if seizures persists= intubation and anesthesics
Menotropin and hCG
menotropin= human menopausal gonadotropin. Acts lik FSH--> ovarian follicle

hCG--> LH surge--> ovulation
Dofetlilde
Class III antiarrhrytmic
affects phase 3
Cefuroxime
inhibits cell wall synthesis
2 nd gen of cephalosporins
MOA of desmopressin (DDAVP) in edothelial cells
stimulates the release of factor VIII and von Willebrand factor
what type of antiarrhytmic is Dofetilide?
CLASS III
MOA of N- acetylcysteine
Mucolytic agent that loosens the thick sputum by cleaving disulfide bonds
Tx for motion sickness?
Most common side effect
Antihistaminics
Scopolamine
SE: dry mouth
Prophylaxis for MAC infection in HIV patient
Azithromycin
Side effect of B- blockers
Bronchoconstriction
Asthma exacerbation
Medication- induced body fat redistribution syndrome is caused by (2)
Glucocorticoids
HIV-1 protease inhibitors
Competitive inhibitor of integrin
Glycoprotein IIB/IIIA
Crytococus neoformans tx?
Amphotericin B or Nystatin or azoles
MOA of isotretinoin
Retinoid
binds eukaryotic nuclear receptors
MOA of paclitaxel
inhibitor of intimal hyperplasia
↓ stent trombosis
Psoriasis tx?
Acitretin
Calciprotrine
synthetic vit D3 analog that binds DNA and acts as a transcription factor --> stimulates cell proliferation and induce normal cell diferentiation
is Acitretin teratogenic?
yes
CNS abn
cardiac abn
thymic abn
craniofacial abn
MOA od Cyclosporine
inhibitor of IL-2 transcription

binds to cyclophilin--> forms comples--> inhibits calcineurin--> ↓IL-2
Antibiotics that act on 50S
chloramphenicol
clindamycin
linezoid
erythromicin
Resistance to antibiotic that acts on 50 S
bacterial acquisition of genetic material encoding methylation of 23S rRNA
Tx of vomiting or gastric stasis?
Metoclopramide
side effect of Metoclopramide
exarcebate or cause Parkinsoniam symptoms
Phenylephrine
alpha 1 agonist
↑vascular resistance--> ↑BP--> activates baroreceptors-->↓SV, ↓ HR
Atropine overdose tx?
Physostigmine
opioid effect resistance to tolerance
Constipation
miosis
MOA of Pramipexole
stimulates DOPA receptors
Side effect of Vincristine
Neurotoxicity
MOA OF Osteltamir
Impair viron particle release
tx for the recurrence of genital herpes
daily oral acyclovir, valacyclovir, or fanciclovir after the first episode
How spironolactone benefit overall survival in CHF?
↓ALDOSTERONE
B/C CHF stimulates RAA system
Protect against UVB
PABA esters
Protect against UVB and UVA
Zinc-oxide containing suncrens
most common side effect of aspirin
fecal blood loss
which reverse trancriptase do not need IC phosphorylation?
Nevirapine
Side effect of Ticlopidine
neutropenia
fever
mouth ulcers
MOA of methothrexate
inhibits enzyme dihydrofolate reductase to block folic acid syntheis
Side effect of methothrexate
stomatitis= painful mouth ulcers
hepatitis, fibrosis, cirrhosis
Xanthine oxidase inactivates?
6- mercaptopurine
Zidovutine
nucleoside reverse transcriptase inhibitor
No 3'- OH group, making 5-3 phosphodisterase linkage imposible
effect of diphenoxylate in motility
slows it
Why thiazides increase lithium toxicity?
Lithim is excreted by kidneys
thiazides cause volume depletion bc kidneys try to retain Na + H2O, lithium reabsorption follows Na reabsorption
Gout long term tx?
Allopurinol= xanthine oxidase inhibitor
monitoring test for warfarin
PT/INR
monitoring test for heparin
PTT
Foscarnet
pyrophosphate analog that does not require IC activation
tx for herpes and HIV
Side effect of Thioridazine
Retinal deposits
Side effect of Chlorpromazine
Corneal deposists
Side effect of Ziprasidone
prolonged QT
Effect of Pilocarpine in pupils
cause pupullary constriction
Direct muscarinic cholinergic agents
Tetracyclines are bacteriostatic for?
Mycoplasma
Ricketsia
Chlamydia
Hepatic encephalopathy tx?
Lactulose--> degraded by colonic bacteria--> lactic acid + acetic acid
Red man syndrome
Vancomycin
↑ blood [histamine]
Bacterial Rsistance MOA
↓ IC accumulation of drug
1- ↓permeability
2- Pump drug ou= saturates w protein--> eliminates the ion [] gradient
What part of the ear cytoplastin damages?
the apical sterocilia on hair cells causing hearing loss
Side effects of atropine
fever
dry skin and mucous membrane
flushing
mydriasis and cycloplegia
altered mental status
Effects the diazepam in elderly
↓TBM
↓TBW
↓HEPATIC SIZE and BF
↑body fat--> ↑volumen of distribution

SE: confusion
MOA of cocaine
inhibits presynaptic reuptake of NORE, DOPA, SER
Side effects of cocaine
incr BP
vasocontricction--> chest pain
agitation
mydriasis
which diuretic causes brisk diuresis?
LOOP
Bile acid resins increases risk for?
Gallbladder stones
Quinidine- like effects (QT & QRS prolongation)
TCA
Tx for TCA overdose?
NaHCO3
RESISTANCE TO CEPHALOSPORINS
change in protein synthesis
Drug with Vd= 3-5 L
inc MW--> binded to plasma protein
---> hydrophilic
Drug with Vd= 41 L
decr MW
uncharged
so drug can cross cell membrane and goes to IC compartment
Streptokinase side effect
intracerrebral hemorrhage
TX of acute C. diphteriae
1- diphteria toxin= rapid administration good prognosis
2- penincillin or erythromycin
3- DPT vaccine
Nimodipine
CA channel blocker
Nimodopine tx for?
prevention of cerebral vascular spam following SAH
what u have to monitored in ethambutol tx?
Visual acuity
- color blindness
- central scotoma
what u have to monitored in amynoglycoside or vancomicin tx?
Hearing and vestibular function
Tx for myoclonic seizures?
Valproid acid
MOA of entarcapone?
COMT inhibitor
- incr bioavaliability of levodopa