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462 Cards in this Set
- Front
- Back
calcium channel blocker associated with accelerated progression of CHF?
|
verapamil
|
|
drug to slow ventricular response in Wolff-Parkinson White?
|
ibutilide
|
|
hypersensitivity angiitis or microscopic polyarteritis nodosa (can be caused by penicilin)
|
leukocytoclastic angiitis
|
|
in which part of the systemic circulation does the greatest decrease in blood pressure occur?
|
arterioles
|
|
vasodilator with lupus-like syndrome as side effect?
|
hydralazine
|
|
mechanism of hydralazine?
|
increases cGMP - smooth muscle relaxation; vasodilates arterioles > veins; reduces afterload
|
|
what calcium channel blocker is most selective for peripheral vasculature?
|
nifedipine
|
|
mechanism of calcium channel blockers?
|
block voltage-dependent L-type calcium channels of cardiac and SM and thereby reduce contractility
|
|
which calcium channel blocker is not used to treat arrhythmias?
|
nifedipine
|
|
what is the goal of antianginal therapy?
|
reduce myocardial O2 consumption by decreasing 1 or more of the determinants of MVO2: EDV, BP, HR, contractility, ejection time
|
|
what do nitrates affect in antianginal therapy?
|
preload
|
|
what happens to contractility and HR in nitrate therapy?
|
increase - reflex response
|
|
what do beta blockers affect in antianginal therapy?
|
afterload
|
|
how do nitrates affect ejection time and MVO2?
|
decrease
|
|
how do beta blockers affect ejection time?
|
increase it
|
|
what do beta blockers do to EDV?
|
increase it
|
|
what do beta blockers do to BP, contractility, and HR?
|
decrease them
|
|
what is digitoxin used for?
|
CHF (increases contractility) and atrial fibrillation (decreases conduciton at the AV node)
|
|
toxicities of digitoxin are increased by what?
|
renal failure, hpokalemia, and quinidine
|
|
blurry yellow vision is side effect of what?
|
digitoxin
|
|
what is the antidote for digitoxin?
|
slowly normalize K+, lidocaine, cardiac pacer, anti-dig Fab fragments
|
|
lupus-like syndrome is associated with what class IA antiarrythmic?
|
procainamide
|
|
what are the class IA antiarrythmics?
|
Na+ channel blockers: quinidine, amiodarone, procainamide, disopyramide (queen amy proclaims disco pyramids)
|
|
this class IA antiarrhythmic can cause cinchonism (headache, tinnitus, thrombocytopenia), torsades de pointes (due to increased QT interval)
|
quinidine
|
|
what class of antiarrhythmics are contraindicated post-MI
|
class IC - proarrhythmic
|
|
what beta blocker is very short acting?
|
esmolol
|
|
what is the antiarrhythmic action of beta blockers?
|
decrease cAMP and calcium currents; suppress abnormal pacemaker by decreasing slope of phase 4 - AV node particularly sensitive - increased PR interval
|
|
toxicity of amiodarone?
|
pulmonary fibrosis, hepatotoxicity, hypo/hyperthroidism;corneal deposits, skin deposits resulting in photodermatitis, neuro effects, constipation, bradycardia, heart block, CHF
|
|
K+ channel blockers that can cause torsades de pointes
|
soltalol, ibutilide
|
|
K+ channel blocker that can cause new arrhythmias and hypotension?
|
bretylium
|
|
wha type of cells do Ca2+ channel blockers primarily affect?
|
AV nodal cells
|
|
what type of antiarrhythmics are used for prevention of nodal arrhythmias?
|
class IV - Ca2+ channel blockers
|
|
what class IV antiarrhythmic can cause torsades de pointes?
|
bepridil
|
|
what is the drug of choice for diagnosing/abolishing AV nodal arrhythmias?
|
adenosine
|
|
what depresses ectopic pacemakers, especially in digitoxin toxicity?
|
K+
|
|
Mg+ is effective for treating what?
|
torsades de pointes and digitoxin toxicity
|
|
drug for hypertension in patient with PKD?
|
ACE inhibitor
|
|
anti-hypertesive for pregnant woman?
|
methyldopa
|
|
in patients with wolff parkinson white and atrial fibrillation, what can digitoxin do?
|
enhance transmission through accessory pathways that can predispose to v tac
|
|
when is mannitol contraindicated?
|
anuria, CHF
|
|
clinical use of mannitol?
|
shock, drug overdose, decrease intracranial/intraocular pressure
|
|
how does mannitol work?
|
increases tubular fluid osmolarity, producing increased urine flow
|
|
mechanism of acetazolamide?
|
carbonic anhydrase inhibitor - causes self-limited NaHCO3 diuresis and reduction in total body HCO3- stores
|
|
where does acetazolamide act?
|
proximal convoluted tubule
|
|
toxicity of acetazolamide?
|
hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy
|
|
clinical use of acetazolamide?
|
glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness
|
|
mechanism of furosemide?
|
sulfonamide loop diuretic - inhibits NKCC of thick ascending limb; abolishes hypertonicity of medulla, preventing concentration of urine
|
|
what effect does furosemide have on calcium excretion?
|
increases it - Loops Lose calcium
|
|
clinical use of furosemide?
|
edematous states (CHF, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, hypercalcemia
|
|
toxicity of furosimide?
|
OH DANG: ototoxicity, hypokalemia, dehydration, allergy (sulfa), nephritis (interstitial), gout
|
|
drug for diuresis in patients allergic to sulfa drugs?
|
ethacrynic acid
|
|
diuretic that can be used in hyperuricemia, acute gout?
|
ethacrynic acid
|
|
mechanism of hydrochlorothiazide?
|
inhibits NaCl reabsorption in distal convoluted tubule, reducing diluting capacity of the nephron, decreases calcium excretion
|
|
clinical use of hydrochlorothiazide?
|
hypertension, CHF, idiopathic hypercalciuiria, nephrogenic diabetes insipidus
|
|
diuretic used in nephrogenic diabetes insipidus?
|
hydrochlorothiazide
|
|
toxicity of hydrochlorothiazide?
|
hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, and hyperCalcemia (sulfa alergy)
|
|
what are the potassium sparing diuretics?
|
Spironolactone, Triamterene, Amiloride, eplercone (the K+ STAys)
|
|
mechanism of spironolactone?
|
competitive aldosterone receptor antagonist in cortical collecting tubule
|
|
how do triamterene and amiloride act?
|
cortical collecting tubule - block Na+ channels
|
|
clinical use of K+ sparing diuretics?
|
hyperaldosteronism, K+ depletion, CHF
|
|
toxicity of K+ sparing diuretics?
|
hyperkalemia, endocrine effects (e.g. spironolactone causes gynecomastia, antiandrogen effects)
|
|
diuretics causing acidosis?
|
carbonic anhydrase inhibitors, K+ sparing diuretics
|
|
diuretics causing alkalosis?
|
loop diuretics, thiazides
|
|
diuretic that increases urine calcium?
|
loop diuretics
|
|
diuretics that decrease urine calcium?
|
thiazides
|
|
name 3 ACE inhibitors
|
captopril, enlapril, lisinopril
|
|
mechanism of Losartan?
|
AT II receptor antagonist - not ACE inhibitor and so doesn't cause cough
|
|
toxicity of ACE inhibitors?
|
CATOPRIL: cough, angioedema, proteinuria, taste changes, hypOtension, pregnancy problems (fetal renal damage), rash, increased renin, lower angiotensin II; hyperkalemia
|
|
serious cardiac arrhythmias/torsades de pointes can occur with erythromycin and what?
|
cisapride
|
|
what type of drug are omeprazole, lansoprazole?
|
proton pump inhibitors
|
|
action of misoprostol?
|
PGE1 analog - increases production and secretion of gastric mucous barrier, decreases acid production
|
|
drug that can be used to prevent NSAID-induced peptic ulcers, maintain a PDA, and induce labor
|
misoprostol
|
|
action of pirenzepine, propantheline?
|
muscarinic antagonists - block M1 receptors on ECL cells (decrease histamine secretion) and M3 receptors on parietal cells (decrease H+ secretion) - used for peptic ulcer
|
|
monoclonal antibody to TNF-alpha
|
infliximab
|
|
sulfasalazine?
|
combination of sulfapyradine (antibacterial) and mesalamine (antinflammatory) activated by colonic bacteria; Rx for Crohn's and UC
|
|
mechanism of ondansetron?
|
5-HT3 antagonist - powerful central-acting antiemetic
|
|
overuse of aluminum hydroxide?
|
constipation and hypophosphatemia
|
|
overuse of magnesium hydroxide?
|
diarrhea
|
|
overuse of calcium carbonate?
|
hypercalcemia, rebound acid increase
|
|
all antacids can cause what metabolic disturbance?
|
hypokalemia
|
|
antiemetic that can cause Parkinsonian symptoms?
|
metoclopramide
|
|
how does cimetidine impact P-450 system?
|
potent inhibitor
|
|
H2 blocker with antiandrogenic effect that can decrease renal excretion of creatinine?
|
cimetidine
|
|
A patient presents with HA, tinnitis, vomiting,and confusion … you are concerned about and overdose of what common medication?
|
Aspirin
|
|
Aspirin overdose will manifest as a respiratory _____ and a metabolic ______?
|
Aspirin overdose will manifest as a respiratory alkalosis and metabolic acidosis
|
|
At a [CO] of 30% a patient will experience HA, and SOB because of hypoxia of what area of the brain?
|
gray matter
|
|
at a [co] of 50% there is hypoxia of the globus pallidus leading to what symptoms and signs?
|
loss of conciousness, convulsions, and coma
|
|
which mushroom is typically lethal, amanita muscaria or amanita phalloides?
|
phalloides - the toxin inhibits RNA polymerase and can lead to ab pain, vomiting, diarrhea, and fulminant hepatitis with extensive liver necrosis
|
|
"garlic scented breath"
|
arsenic poisioning
|
|
what are Mees lines?
|
transverse band on fingernails that may indicate chronic arsenic poisioning
|
|
what are the long term complications of chronic arsenic poisioning?
|
squamous cell carcinoma of lungs and skin
|
|
what is the most common chrnoic metal poisioining in the united states?
|
lead
|
|
lead poisionign ALWAYS involves
|
CNS toxicity
|
|
what is the mechanism of lead toxicity?
|
lead interferes with heme production by inhibiting d-aminolevulinic acid dehydratase and ferrochelatase
|
|
A patient presents with wrist and foot drop, microcytic anemia with basophillic stippling, and dark lines on their gums … you suspect …
|
lead poisioning
|
|
"bitter almond" scented breath
|
cyanide poisioing
|
|
what is the mechanism of cyanide poisioning
|
blocks cellular respiration by binding cytocrhome oxidase
|
|
what are the top 3 causes of death in smokers
|
1. heard disease, 2. lung cancer, 3. copd
|
|
T or F: stopping smoking for 15 years will reduce the risk of dying to almost the level of a non-smoker
|
TRUE
|
|
a patient presents with a perforation in the nasal septum and dilated cardiomyopathy … you suspect chronic use of what chemical?
|
cocain
|
|
what causes "track marks" of a IVDU
|
the healing of skin abscesses
|
|
mechanism of amantadine?
|
blocks viral penetration/uncoating; may buffer pH of endosome. also causes the release of dopamine from intact nerve terminals
|
|
clinical use of amantadine?
|
prophylaxis and treatment for influenza A; Parkinson's disease
|
|
toxicity of amantadine?
|
ataxia, dizziness, slurred speech
|
|
mehcanism of zanamivir, oseltamivir?
|
inhibit influenza neuraminidase
|
|
clinical use of zanamivir & oseltamivir?
|
both influenza A & B
|
|
mechanism of ribavirin?
|
inhibits synthesis of gruanine nucleotides by competitively inhibiting IMP dehydrogenase
|
|
clinical use of ribavirin?
|
RSV, chronic hepatitis C
|
|
toxicity of ribavirin?
|
hemolytic anemia, severe teratogen
|
|
mechanism of acyclovir?
|
preferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase; guanine analog
|
|
clinical use of acyclovir?
|
HSV, VZV, EBV; mucocutaneous and genital herpes lesions; prophylaxis in immunocompromised patients
|
|
toxicity of acyclovir?
|
delerium, tremor, nephrotoxicity
|
|
mechanism of ganciclovir?
|
phosphorylation by viral kinase; preferentially inhibits CMV DNA polymerase
|
|
clinical use of ganciclovir?
|
CMV, especially in immunocompromised patients
|
|
toxicity of ganciclovir?
|
leukopenia, neutropenia, thrombocytopenia, renal toxicity; more toxic to host enzymes then acyclovir
|
|
mechanism of foscarnet?
|
viral DNA polymerase inhibitor that binds to the pyrophosphate binding site of the enzyme; does not require action by viral kinase
|
|
clinical use of foscarnet?
|
CMV retinitis in immunocompromised patients when ganciclovir fails; acyclovir-resistant HSV
|
|
toxicity of foscarnet?
|
nephrotoxicity, hypoglycemia, hypomagnesia
|
|
saquinavir, ritonavir, indinavir, nelfinavir, and amprenavir are what type of drugs?
|
protease inhibitors - used in HIV therapy
|
|
mechanism of protease inhibitors?
|
inhibit assembly of new virus by blocking protease enzyme
|
|
toxicity of protease inhibitors?
|
GI intolerance (nausea, diarrhea), hyperglycemia, lipid abnormalities
|
|
protease inhibitor that can cause thrombocytopenia?
|
indinavir
|
|
zidovudine, didanosine, zalcitabine, stavudine, lamivudine, and abacavir are what type of drug?
|
nucleoside RT inhibitors
|
|
nevirapine, delaviridine, and efavirenz are what type of drug?
|
non-nucleoside RT inhibitors
|
|
mechanism of reverse transcriptase inhibitors?
|
preferentially inhibit RT of HIV; prevent incorporation of viral genome into host DNA
|
|
toxicity of RT inhibitors?
|
bone marrow suppression (neutropenia, anemia), peripheral neuropathy
|
|
what type of reverse transcriptase inhibitors can cause lactic acidosis?
|
nucleosides - zidovudine, didanosine, zalcitabine, stavudine, lamivudine, and abacavir
|
|
what type of RT inhibitors can cause rash?
|
non-nucleosides -nevirapine, delaviridine, and efavirenz
|
|
nucleoside RT inhibitor that can cause megaloblastic anemia?
|
AZT (zidovudine)
|
|
what HIV drug is used during pregnancy to reduce the risk of fetal transmission?
|
AZT
|
|
interferon-alpha is used for what?
|
chronic hepatitis B andC, Kaposi's sarcoma
|
|
interferon beta is used in what disease?
|
MS
|
|
interferon gamma is used in what disease?
|
NADPH oxidase deficiency
|
|
toxicity of interferons?
|
neutropenia
|
|
these are glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis
|
interferons
|
|
drug used for giardiasis, amebic dysentery, bacterial vaginitis, trichomonas?
|
metronidazole
|
|
drug used for giant roundworm (asarcis), hookworm (necator/ancylostoma), and pinworm (enterobius)?
|
pyrantel pamoate
|
|
drug used for trematode/fluke (schistosomes, paragnimus, clornorchis), and cysticercosis?
|
praziquantel
|
|
drug used for cestode/tapeworm (e.g. diphyllobothrium latum, taenia species) infections except cysticercosis?
|
niclosamide
|
|
drug used for onchocerciasis?
|
ivermectin (rIVER blindness)
|
|
drug used for nematode/roundworm (e.g. pinworm, whipworm) infections?
|
mebendazole/thiabendazole
|
|
block cell wall synthesis by inhibition of peptidoglycan cross-linking
|
penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins
|
|
block peptidoglycan synthesis
|
bacitracin, vancomycin, cycloserine
|
|
disrupt bacterial/fungal cell membranes
|
polymyxins
|
|
disrupt fungal cell membranes
|
amphotericin B, nystatin, fluconazole/azoles
|
|
block nucleotide synthesis
|
sulfonamides, trimethoprim
|
|
block DNA topoisomerases
|
quinolones
|
|
block mRNA synthesis
|
rifampin
|
|
block protein synthesis at 50S ribosomal subunit
|
chloramphenicol, erythromycin/macrolides, lincomycin, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid
|
|
block protein synthesis at 30S ribosomal subunit
|
aminoglycosides, tetracyclines
|
|
bacteriacidal antibiotics (6)
|
penicilin, cephalosporins, vancomycin, aminoglycosides, fluoroquinolones, metronidazole
|
|
penicillin mechanism
|
bind PBPs, block transpeptidase cross-linking of cell wall; activate autolytic enzymes
|
|
penicillin toxicity
|
hypersensitivity reactions, hemolytic anemia
|
|
mechanism of methicillin, nafcillin, dicloxacillin
|
bind PBPs, block transpeptidase cross-linking of cell wall - penicillinase resistant because of bulkier R group
|
|
methicillin toxicity
|
interstitial nephritis
|
|
ampicillin, amoxicillin toxicity
|
hypersensitvity, ampicillin rash (esp. in pts. w/ mono), pseudomembranous colitis
|
|
ticarcillin, carbenicillin, piperacillin usage
|
pseudomonas (Takes Care of Pseudomonas)
|
|
mechanism of cephalosporins
|
beta-lactam drugs that inhibit cell wall synthesis - less susceptible to penicillinases
|
|
antibiotic for penicillin-allergic patients and patients w/ renal toxicity who can't tolerate aminoglycosides
|
aztreonam (synergistic w/ aminoglycosides)
|
|
drug of choice for enterobacter
|
imipenem/cilastin
|
|
antibiotic that can cause seizures at high plasma levels
|
imipenem/cilastin
|
|
mechanism of vancomycin
|
inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors
|
|
mechanism of resistance to vancomycin
|
amino acid change of D-ala D-ala to D-ala D-lac
|
|
vancomycin toxicity
|
well tolerated in general - does NOT have many problems: nephrotoxicity, ototoxicity, thrombophlebitis
|
|
aminoglycosides
|
streptomycin, gentamicin, tobramycin, amikacin - bacteriacidal
|
|
mechanism of action of aminoglycosides
|
inhibit 30S subunit - inhibit formation of initiation complex and cause misreading of mRNA
|
|
are aminoglycosides effective agains anaerobes?
|
no! require O2 or uptake
|
|
aminoglycosides cause nephrotoxicity especially when used in combination with _________
|
cephalosporins
|
|
aminoglycosides cause ototoxicity especially when used with_________
|
loop diuretics
|
|
are aminoglycosides safe to use in pregnancy?
|
no! teratogenic
|
|
which tetracycline can be used in patients with renal failure?
|
doxycycline because it is fecally eliminated
|
|
can you take tetracyclines with milk?
|
no! nor atacids or iron-containing preparations because divalent cations inhibit its absorption in the gut
|
|
tetracycline toxicity
|
discoloration of teeth and inhibition of bone growth in children, photosensitivity
|
|
mechanism of action of macrolides
|
inhibit protein synthesis by blocking translocation - bind to 23S rRNA of the 50S subunit
|
|
name 3 macrolides
|
erythromycin, azithromycin, clarithromycin
|
|
when can sulfonamides cause hemolysis?
|
G6PD deficiency
|
|
most common cause of noncompliance with macrolides
|
GI discomfort
|
|
macrolides increase the serum concentration of what drugs?
|
theophyllines, oral anticoagulants
|
|
acute cholestatic hepatitis & eosinophilia are toxicities of which class of antibiotics?
|
macrolides
|
|
clinical use of chloramphenicol
|
meningitis - H. flu, neisseria, strep pneumo
|
|
why does chloramphenicol cause gray baby syndrome?
|
because infants lack liver UDP-glucoronyl transferase
|
|
is the aplastic anemia seen with chloramphenicol dose dependent?
|
no! the anemia is, however
|
|
mechanism of action of chloramphenicol
|
inhibits 50S peptidyltransferase
|
|
what is the clinical use of clindamycin?
|
treatment of anaerobic infections - B. frag, C. perfringfens
|
|
clindamycin toxicity
|
pseudomembranous colitis - destroys normal GI flora
|
|
mechanism of action of sulfonamides (sulfamethoxazole, sulfisoxazole, triple sulfas, etc.)
|
PABA antimetabolites inhibit dihydropteroate synthase
|
|
what side effect can sulfonamides cause in infants?
|
kernicterus
|
|
mechanism of action of trimethoprim
|
inhibits bacterial dihydrofolate reductase
|
|
trimethoprim toxicity
|
megaloblastic anemia, leukopenia, granulocytopenia (may alleviate with supplemental folinic acid)
|
|
mechanism of action of fluoroquinolones
|
inhibit DNA gyrase (topoisomerase II)
|
|
what class of antibiotics can cause cartilage damage in kids?
|
fluoroquinolones
|
|
what drug is associated with a disulfiram-like reaction with alcohol and a metallic taste
|
metronidazole
|
|
what can prevent the neurotoxicity associated with INH?
|
pyridoxine (vitamin B6)
|
|
INH toxicity
|
hemolysis if G6PD deficient, neurotoxicity, hepatotoxicity, SLE-like syndrome
|
|
mechanism of action of rifampin
|
inhibits DNA-dependent RNA polymerase
|
|
what drug delays resistance to dapsone when used for leprosy?
|
rifampin
|
|
resistance mechanism for penicillins/cephalosporins
|
beta-lactamase cleavage of beta lactam ring
|
|
resistance mechanism for aminoglycosides
|
modification via acetylation, adenylation, or phosphorylation
|
|
resistance mechanism for chloramphenicol
|
modification via acetylation
|
|
resistance mechanism for macrolides
|
methylation of rRNA near erythromycin's ribosome binding site
|
|
resistance mechanism for tetracycline
|
decreased uptake or increased transport out of cell
|
|
resistance mechanism for sulfonamides
|
altered enzyme (bacterial dihydropteroate synthetase), decreased uptake, or increased PABA synthesis
|
|
mechanism of action of amphotericin B
|
binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes and disrupt homeostasis
|
|
drug of choice for systemic mycoses
|
amphotericin B
|
|
amphotericin B toxicity
|
fever/chills, hypotension, nephrotoxicity, arrhythmias, hypochromic normocytic anemia
|
|
do ketoconazole and ampho B act synergistically?
|
no - they antagonize each other's actions, so should never be used together
|
|
which has greater oral availability - amoxicillin or ampicillin?
|
amOxicillin
|
|
spectrum of ampicillin, amoxicillin
|
HELPS kill enterococci: h. flu, e. coli, listeria, proteus, salmonella, enterococci
|
|
cefazolin and cephalexin are what generation cephalosporins?
|
first
|
|
coverage of cefazolin and cephalexin?
|
proteus, e. coli, klebsiella and gram +
|
|
cefoxitin, cefaclor, cefuroxamine are what generation?
|
second
|
|
coverage of cefoxitin, cefaclor, cefuroxamine?
|
h. flu, enterobacter, neisseria, proteus, e. coli, klebsiella
|
|
ceftriaxone, cefotaxime, and ceftazidime are what generation?
|
third
|
|
use of ceftriaxone, cefotaxime, and ceftazidime?
|
serious gram-negative infections resistant to other beta lactams; meningitis; ex. ceftazidime for pseudomonas, ceftriaxone for gonorrhea
|
|
cefepime, cefpiramide belong to what generation?
|
fourth
|
|
use of cefepime, cefpiramide?
|
increased activity against pseudomonas and gram-positive organisms
|
|
serum-like sickness in infants and kids can be seen with what cephalosporin?
|
ceflacor (2nd generation)
|
|
this is an inhibitor of renal dihydropeptidase I
|
cilastin - decreases inactivation of imipenem in renal tubules
|
|
why are aminoglycosides ineffective against anaerobes?
|
require O2 for uptake
|
|
drug used for bowel surgery?
|
neomycin
|
|
this tetracycline is an ADH antagonist - acts as a diuretic in SIADH
|
demeclocylcine
|
|
clinical use of tetracyclines?
|
VACUUM THe BedRoom: vibrio cholerae, acne, chlamydia, ureaplasma urealyticum, mycoplasma, tularemia, h. pylori, borrelia burgdorferi, rickettsia
|
|
this drug treats anaerobes above the diaphragm
|
clindamycin
|
|
these drugs can cause leg cramps and myalgias in kids
|
fluoroquinolones
|
|
used for anaerobes below the diaphragm
|
metronidazole
|
|
how does nystatin work?
|
binds to ergosterol, disrupting fungal membranes (too toxic for systemic use)
|
|
mechanism of the -azoles?
|
inhibit fungal steriod (ergosterol) synthesis
|
|
toxicities of -azoles?
|
hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibition of P450), fever, chills
|
|
this antifungal inhibits DNA synthesis by conversion to fluorouracil, which competes with uracil
|
flucytosine
|
|
toxicity of flucytosine
|
nausea, vomiting, diarrhea, bone marrow suppression
|
|
mechanism of caspofungin?
|
inhibits cell wall syntehsis
|
|
use of caspofungin?
|
invasive aspergillosis
|
|
toxicity of caspofungin?
|
GI upset, flushing
|
|
this antifungal inhibits the fungal enzyme squalene epoxidase
|
terbinafine
|
|
use of terbinafene?
|
used to treat dermatophytoses (especially onychomycosis)
|
|
mechanism of griseofulvin?
|
interferes with microtubule function; disrupts mitosis; depostis in keratin-containing tissues (e.g. nails)
|
|
clinical use of griseofulvin?
|
oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)
|
|
toxicity of griseofulvin?
|
teratogenic, carcinogenic, confusion, headaches, increases warfarin metabolism
|
|
actions of insulin/insulin-like drugs?
|
TK activity: liver (increase glucose stored as glycogen), muscle (increase glycogen and protein synthesis, K+ uptake), fat (aids TG storage)
|
|
what type of drug: tolbutamide & chlorpropamide?
|
first generation sulfonylureas
|
|
what type of drug: glyburide, glimepiride, glipizide?
|
second generation sulfonylureas
|
|
mechanism of action of sulfonylureas?
|
close K+ channel in beta cell membrane so cell depolarizes, triggering of insulin release via Ca2+ influx
|
|
what are sulfonylureas used for?
|
stimulate release of endogenous insulin in type 2 DM; require some islet function so useless in type 1
|
|
side effects of first generation sulfonylureas?
|
disulfiram-like reactions
|
|
side effect of second generation sulfonylureas?
|
hypoglycemia
|
|
what is the most grave side effect of metformin?
|
lacti acidosis
|
|
can metformin be used in patients without islet function?
|
yes
|
|
action of pioglitazone and rosiglitazone?
|
increase target cell response to insulin
|
|
action of acarbose and miglitol?
|
alpha glucosidase inhibitors - inhibit intestinal brush border alpha glucosidases; delayed sugar hydrolysis and glucose and glucose absorption lead to decreased postprandial hyperglycemia
|
|
mechanism of propylthiouracil, methimazaole?
|
inhibit organification and coupling of thyroid hormone synthesis - used for hyperthyroidism
|
|
toxicity of propylthiouracil, methimazole?
|
skin rash, agranulocytosis (rare), aplastic anemia
|
|
what are orlistat and dsibutramine used for?
|
obesity management (orlistat is long-term)
|
|
use of glucocorticoids?
|
Addison's disease, inflammation, immune suppression, asthma
|
|
mechanism of finasteride?
|
5 alpha reductase inhibitor
|
|
mechanism of flutamide?
|
nonsteroidal competitive inhibitor of androgens at the testosterone receptor
|
|
mechanism of leuprolide?
|
GnRH analog with agonist properties when used in pulsatile fashion and antagonist properties when used in continuous fashion
|
|
mechanism of clomephine?
|
partial agonist at estrogen receptors in hte pituitary - prevents normal feedback inhibition and increases release of LH and FSH from the pituitary, which stimulates ovulation
|
|
drug of choice for women with estrogen receptor + breast cancer?
|
tamoxifen - competitively inhibits estradiol at estrogen receptors
|
|
treatment for polycystic ovarian syndrome?
|
ketoconazole, spironolactone
|
|
drugs with what type of solubility in blood have rapid induction and recovery times?
|
decreased solubility
|
|
drugs with what solubility in lipids have increased potency?
|
increased solubility
|
|
the greater the MAC, the what?
|
greater the concentration needed to produce anesthesia
|
|
what inhaled anesthetic is associated with hepatotoxicity?
|
halothane
|
|
what inhaled anesthetic is associated with nephrotoxicity?
|
methoxyflurane
|
|
what inhaled anesthetic is a proconvulsant?
|
enflurane
|
|
what is the Rx for malignant hyperthermia?
|
dantrolene
|
|
this class of intravenous anesthetics causes decreased cerebral blood flow and is therefore desirable for patients with cerebral edema
|
barbiturates
|
|
this IV anesthetic class can cause exacerbation of intermittent porphyria
|
barbiturates
|
|
what is the most common anesthetic used for endoscopy?
|
midazolam
|
|
this class of IV anesthetics can cause severe post-op respiratory depression, decreased BP, and amnesia? what do you treat this with?
|
benzodiazepenes; flumazenil
|
|
this class of anesthetics are PCP analogs that act as dissociative anesthetics
|
arylcyclohexamines, e.g. ketamine
|
|
these anesthetics can cause disorientation, hallucination, and bad dreams
|
arylcyclohexamines (ketamine) - also increase cerebral blood flow
|
|
what reverses the CNS and respiratory effects of opiods?
|
naloxone
|
|
this IV anesthetic has less post-op nausea than thiopental
|
propofol
|
|
this IV anesthetic is used for rapid anesthesia induction and short procedures
|
propofol
|
|
procaine, cocaine, tetracaine belong to what class of local anesthetic?
|
esters
|
|
lidocaine, mepivacaine, bupivacaine belong to what class of local anesthetic
|
amides - amides have 2 i's in name
|
|
how do local anesthetics work?
|
block Na+ channels by binding to specific receptors on inner portion of cannel; tertiarty amines penetrate membranes in uncharged form, then bind to ion channels in charged form
|
|
why do you need more local anesthetic in infected tissues?
|
infected tissues is acidic, so anesthetics are charged and cannot penetrate membrane effectively
|
|
what is the order of loss with local anesthetics?
|
pain > temperature > touch > pressure
|
|
what local anesthetic has severe CV toxitcity?
|
bupivacaine
|
|
what local anesthetic is associated with hypertension, hypotension, and arrhythmias?
|
cocaine
|
|
what is the mechanism of action of dantrolene?
|
prevents the release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle
|
|
what kind of drug is succinylcholine?
|
depolarizing NM blocker
|
|
what is the antidote for phase I NM block?
|
none - block is potentiated by cholinesterase inhibitors
|
|
what is the antidote for phase II NM block?
|
cholinesterase inhibitors, e.g. neostigmine
|
|
how do you reverse nondepolarizing NM blockade?
|
neostigmine, edrophonium, and other cholinesterase inhibitors
|
|
what class of drugs do tubocurarine, atracurium, mivacurium, pancuronium, vercuronium, rapacuroniumm belong to?
|
nondepolarizing NM blockers
|
|
what type of NM blockers compete with ACh for receptors?
|
nondepolarizing
|
|
antiarrhythmic causing hemolytic anemia?
|
quinidine
|
|
antineoplastic agent causing hemorrhagic cystitis?
|
cyclophosphamide
|
|
notable toxicity of cisplatin?
|
nephrotoxicity, ototoxicity
|
|
toxicity of vincristine?
|
dose-limited neurotoxicity
|
|
treatment of choice for legionella?
|
erythromycin
|
|
what type of drug is hexamethonium?
|
ganglionic blocker
|
|
neuromuscular blocker that initially causes fasciculations?
|
succinylcholine
|
|
what enzyme does warfarin inhibit?
|
epoxide reductase - converts vitamin K into its active quinone form
|
|
what does zileuton inhibit?
|
5-lipoxygenase
|
|
what is the active ingredient in rat poisoning?
|
warfarin
|
|
diuretic that can increase blood glucose in diabetics?
|
hydrochlorothiazide
|
|
what is the mechanism of dantrolene?
|
prevents the release of calcium from the sarcoplasmic reticulum, thereby reducing skeletal muscle contractions (Rx for malignant hyperthermia)
|
|
what is pralidoxime?
|
an AChE reactivating agent
|
|
what is tyramine?
|
an indirect-acting sympathomimetic
|
|
what is the mechanism of opiod analgesics?
|
act as agonists at opiod receptors to modulate synaptic transmission
|
|
what opiod works at the mu receptor?
|
morphine
|
|
what opiod works at the delta receptor?
|
enkaphalin
|
|
what opoid workds at the kappa receptor?
|
dynorphin
|
|
how do you treat opiod toxicity?
|
naloxone or naltrexone (opiod receptor antagonists)
|
|
what is contraindicated in morphine overdose?
|
O2 - might contribute to respiratory failure
|
|
toxicity of opiods?
|
respiratory depression, miosis (pinpoint pupils), additive CNS depression with other drugs, constipation, addiction
|
|
how do NSAIDs work?
|
reversibly inhibit COX-1 and COX-2; block prostaglandin synthesis
|
|
what is used to close a PDA?
|
indomethacin
|
|
toxicity of NSAIDs?
|
renal damage, aplastic anemia, GI distress, ulcers
|
|
how do celecoxib, valdecoxib work?
|
selectively inhibit COX-2, which is found in inflammatory cells and mediates inflammation and pain
|
|
why should COX 2 inhibitors not have the corrosive effects of other NSAIDs on the GI lining?
|
spares COX-1, which helps maintain the gastric mucosa
|
|
what are COX 2 inhibitors used for?
|
rheumatoid and osteoarthritis
|
|
what is the mechanism of acetominaphen?
|
reversibly inhibits cyclooxygenase, mostly in CNS; inactivated peripherally
|
|
what is the antidote for acetominaphen toxicity?
|
N-acetylcysteine
|
|
what drug is used for acute gout?
|
colchicine
|
|
this gout drug depolymerizes microtubules, impairing leukocyte chemotaxis and degranulation
|
colchicine
|
|
what acute gout drug is less toxic than colchicine and therefore is used more frequently?
|
indomethacin
|
|
this drug is used for chronic gout - it inhibits resorption of uric acid
|
probenecid
|
|
what gout drug inhibits secretion of penicillin?
|
probenecid
|
|
what is the mechanism of allopurinol? what is it used for?
|
inhibits xanthine oxidase, decreasing conversion of xanthine to uric acid; used for chronic gout (when under control)
|
|
what gout drug is also used in lymphoma and leukemia to revent tumor lysis-associated nephropathy?
|
allopurinol
|
|
what is etanercept?
|
recombinant form of human TNF receptor that binds TNF-alpha
|
|
what is etanercept used for?
|
RA, psoriasis, ankylosing spondylitis
|
|
what is infliximab?
|
TNF-alpha antibody
|
|
what is infliximab used for?
|
Crohn's disease, RA, ankylosing spondylitis
|
|
this drug binds to cyclophilins, and the complex blocks the differentiation and activation of T cells by inhibiting calcineurin, thus preventing production of IL-2 and its receptor
|
cyclosporine
|
|
when is cyclosporine used?
|
suppresses organ rejection after transplantation; selected AI disorders
|
|
the nephrotoxicity associated with cyclosporine is preventable with what?
|
mannitol diuresis
|
|
what toxicity is associated with cyclosporine?
|
predisposes to viral infections and lymphoma
|
|
what is the mechanism of action of tacrolimus (FK-506)? what drug is it similar to?
|
binds to FK-binding protein, inhibiting secretion of IL-2 and other cytokines; similar in action to cyclosporine
|
|
what is tacrolimus used for?
|
potent immunosuppressive used in organ transplant recipients
|
|
what toxicities are associated with tacrolimus?
|
significant nephrotoxicity, peripheral neuropathy, hypertension, pleural effusion, hyperglycemia
|
|
this drug is an antimetabolite derivative of 6-mercaptopurine that interferes with the metabolism and synthesis of nucleic acids; it is toxic to proliferating lymphocytes
|
azathioprine
|
|
when is azathioprine used?
|
kidney transplants; AI disorders including glomerulonephritis and hemolytic anemia
|
|
toxic effects of this drug may be increased by allopurinol
|
azathioprine - active metabolite mercaptopurine is metabolized by xanthine oxidase
|
|
what is the major toxicity associated with azathioprine?
|
bone marrow suppression
|
|
acetomeniphen metabolite depletes what in the liver?
|
glutahione and forms toxic tissue adducts
|
|
low doses of uricosuric agents and salicylates do what to the serum uric acid concentration?
|
increase it
|
|
action of carbachol, pilocarpine
|
glaucoma drugs - activates ciliary muscle of eye (open angle), pupillary sphincter (narrow angle); resistant to AChE
|
|
neostigmine, pyridostigmine, edrophonium, physostigmine, and echothiophate all do what?
|
increase endogenous ACh
|
|
this extremely short acting anticholinesterase is used for hte diagnos of myasthenia gravis
|
edrophonium
|
|
this anticholinesterase is used for post-op and neurogenc ileus and urinary retention, MG, and postop reversal of NM blockade
|
neostigmine
|
|
this anticholinesterase is used for glaucoma and atropine OD
|
phsostigmine
|
|
symptoms of cholinesterase inhibitor poisoning
|
diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating, and salivation
|
|
antidote for parathion/cholinesterase inhibitor poisoning?
|
atropine (muscarinic antagonist) plus pralidoxime (chemical antagonist used to regenerate active cholinesterase)
|
|
how do atropine, homatropine, and tropicamide affect the eye?
|
produce mydriasis and cycloplegia (cholinoreceptor blockers)
|
|
actions of atropine?
|
muscarinic antagonist - blocks SLUD
|
|
toxicity of atropine?
|
inccreased body temp, rapid pulse, dry mouth, dry, flushed skin, cycloplegia, constipation, disorientation
|
|
mechanism/selectivity of epinephrine?
|
direct general agonist (alpha 1/2, beta 1/2)
|
|
mechanism/selectivity of NE?
|
alpha 1/2, beta 1
|
|
mechanism/selectivity of isoproterenol?
|
beta 1 = beta 2
|
|
mechanism/selectivity of dopamine?
|
D1=D2 > B > a
|
|
mechanism/selectivity of dobutamine?
|
B1 > B2
|
|
mechanism of amphetamines?
|
indirect general agonist, rerleases stored catecholamines
|
|
mechanism of ephedrine?
|
indirect general agonist, rerleases stored catecholamines
|
|
mechanism/selectivity of phelylephrine?
|
a1 > a2
|
|
mechanism/selectivity of albuterol?
|
B2 > B1
|
|
mechanism of cocaine?
|
indirect general agonist, uptake inhibitor
|
|
mechanism of clonidine, alpha-methyldopa?
|
centrally acting alpha agonist, decreases central adrenergic outflow
|
|
name three a1 selective blockers
|
prazosin, terazosin, doxazosin
|
|
what kind of drug is mirtazapine?
|
alpha 2 selective blocker, used for depression
|
|
what are alpha 1 blockers used for?
|
hypertension, urinary retention in BPH
|
|
which is reversible: phenoxybenzamine or phentolamine?
|
phentolamine
|
|
wwhat are phenoxybenzamine and phentolamine used for?
|
nonselective alpha blockers used for pheochromocytoma
|
|
what are the B1 selective blockers?
|
A BEAM: acebutolol (partial agonist), betaxolol, esmolol, atenolol, metoprolol
|
|
what is a short-acting B1 blocker?
|
esmolol
|
|
what two nonselective beta blockers are partial agonists?
|
pindolol, labetalol
|
|
how does timolol work in glaucoma?
|
decreases secretion of aqueous humor
|
|
what is the only irreversible alpha blocker?
|
phenoxybenzamine
|
|
P450 inducers?
|
Queen Barb takes Phenphen and Refuses Greasy Carbs: quinidine, barbiturates, phenytoin, rifampin, griseofulvin, carbamazepine
|
|
P450 inhibitors?
|
inhibitors stop cyber kinds from eating grapefruit: isoniazid, sulfonamides, cimetidine, ketoconazole, erythromycin, grapefruit juice, st. john's wort
|
|
what is inhibited by disulfiram?
|
acetaldehyde dehydrogenase
|
|
antibiotic causing ototoxicity in pregnancy?
|
aminoglycosides
|
|
antibiotic that can cause acute cholestatic hepatitis in mom?
|
erythromycin
|
|
antibiotic that can cause mutagenesis?
|
metronidazole
|
|
loading dose?
|
Cp x Vd/F
|
|
|
(Cp = target plasma concentration)
|
|
maintenance dose?
|
Cp x CL/F
|
|
half life?
|
(0.7 x Vd)/CL
|
|
volume of distribution?
|
amount of drug in body/plasma drug concentration
|
|
clearance?
|
rate of elimination of drug/plasma concentration of drug
|
|
Parkinson's drug that selectively inhibits MAO-B
|
selegiline
|
|
epilepsy drug that can cause agranulocytosis
|
carbamazepine
|
|
what do you use to treat benzodiazepine overdose?
|
flumazenil (competitive antagonist at GABA receptor)
|
|
seizure drug that can cause SLE-like syndrome
|
phenytoin
|
|
what is the mechanism of dilantin/phenytoin?
|
use-dependent blockade of Na+ channels
|
|
chronic use of this anti-epileptic can cause gingival hyperplasia in kids, peripheral neuropathy, hirsutism, megaloblastic anemia, and malignant hyperthermia
|
phenytoin
|
|
mechanism of action of barbiturates?
|
facilitate GABA action by increasing duration of Cl- channel opening, thus decreasing neuron firing
|
|
what seizure drug is contraindicated in porphyria?
|
barbiturates
|
|
barbiturates do what to the P-450 system?
|
induce it
|
|
what epilepsy drug is associated with hepatotoxicity and neural tube defects?
|
valproic acid
|
|
what drug is used to treat neuroleptic malignant syndrome (rigidity, myoglobinuria, autonomic instability, hyperprexia)
|
dantrolene and dopamine agonists
|
|
tardive dyskinesia can result from long-term use of what class of drugs?
|
neuroleptics (antipsychotics) - thioridazine, haloperidol, fluphenazine, chlorpromazine
|
|
schizophrenia drug that can cause agranulocytosis
|
clozapine
|
|
side effects of lithium?
|
polyuria (ADH antagonist causeing nephrogenic diabetes insipidus), hypothyrodism
|
|
what is the mechanism of action of atypical antipsychotics (clozapine, olanzapine, risperidone)
|
block 5-HT2 and dopamine receptors
|
|
what is 'serotonin syndrome'?
|
can occur when SSRIs are given with MAOI's - hperthermia, muscle rigidity, CV collapse
|
|
fluoxetine, sertaline, paroxetine, and citalopram are what type of drugs?
|
SSRIs
|
|
how do TCAs work?
|
block reuptake of NE and serotonin - imipramine, amitrptyline, desipramine, nortriptyline, clomipramine, doxepin
|
|
what TCA can be used for bedwetting?
|
imipramine
|
|
which TCA is the least sedating?
|
desipramine
|
|
which class of antidepressants has convulsions, coma, arrythmias, respiratory depression as potential toxicities?
|
tricyclics
|
|
tricyclics can cause confusion and hallucinations in elderly due to anticholinergic side effects - what do you use?
|
nortriptyline
|
|
which of the SSRIs inhibits the P-450 system?
|
fluvoxamine
|
|
which atypical antipsychotic can also be used to treat OCD, GAD, depression, mania?
|
olanzapine
|
|
what is the mechanism of antipsychotic drugs?
|
block dopamine D2 receptors
|
|
this parkinson's drug agonizes dopamine receptors
|
bromocriptine
|
|
mechanism of action of amantadine? what is it used for?
|
increased dopamine - parkinson's
|
|
entacapone and tolcapone are parkinson's drugs that inhibit what?
|
COMT - prevent dopamine breakdown
|
|
this parkinson's drug curbs excess cholinergic activity
|
benztropine - antimuscarinic, improves tremor and rigidity but has littel effect on bradykinesia
|
|
mechanism of l-dopa
|
increased level of dopamine in brain
|
|
what is l-dopa administered with and why?
|
carbidopa - a peripheral decarboxylase inhibitor - increases the bioavailability of l-dopa in the brain and to limit peripheral side effects
|
|
what is sumatriptan and what is it used for?
|
5-HT1D agonist - causes vasoconstriction; used for acute migraine & cluster headache attacks
|
|
sumatriptan is contraindicated in patients with what? why?
|
can cause coronary vasospasm, so contraindiicated in pts. with CAD or prinzmental's angina
|
|
which 2 epilepsy drugs can cause stevens-johnson syndrome?
|
lamotrigine, ethosuximide
|
|
what is the first line drug for absence seizures?
|
ethosuximide
|
|
what is the first line drug for acute status epilepticus?
|
benzodiazepines (diazepam or lorazepam)
|
|
what is the first line drug for prophylaxis of status epilepticus?
|
phenytoin
|
|
what is the first-line seizure drug for pregnant women, children?
|
phenobarbital
|
|
this drug is a first-line treatment for tonic-clonic seizures and trigeminal neuralgia
|
carbamazepine
|
|
what is the mechanism of action of benzodiazepines?
|
facilitate GABAa action by increasing frequency of Cl- channel opening
|
|
this class of antidepressants can cause sedation, alpha-blocking effects, atropine-like effects (tachycardia, urinary retention)
|
TCAs
|
|
what is the mechanism of action of venlafaxine?
|
heterocyclic antidepressant - inhibits serotonin, NE, and dopamine reuptake
|
|
mechanism of action of mirtazapine?
|
alpha2 agonist - increases release of NE and serotonin, and potent 5-HT2 and 5-HT3 receptor antagonist
|
|
this heterocyclic antidepressant blocks NE reuptake
|
maprotiline
|
|
what is the clinical use of MAOIs?
|
atypical depression (i.e. with psychotic or phobic features(, anxiety, hypochondriasis
|
|
MAOIs are contraindicated with what two classes of drugs?
|
SSRIs and beta blockers (prevent serotonin syndrome)
|
|
what is a sensitive indicator of alcohol use?
|
serum gamma-glutamyltransferase
|
|
disinhibition, emotional lability, slurred speech, ataxia, coma, and blackout are signs of what type of intoxication?
|
alcohol
|
|
tremor, tachycrdia, hypertension, malaise, nausea, seizures, agitation, hallucinations are signs of withdrawal from what?
|
alcohol
|
|
CNS depression, nausea and vomiting, constipation, pinpoint pupils, and seizures may be signs of what type of intoxication?
|
opiods
|
|
anxiety, insomnia, anorexia, sweating, dilated pupils, fever, rhinorrhea, piloerection, nausea, cramps, diarrhea, yawning are signs of withdrawal from what type of drug?
|
opiods
|
|
psychomotor agitation, impaired judgement, pupillary dilation, hypertension, tachycardia, euphoria, prolonged wakefulness and attention, cardiac arrythmias, delusions, hallucinations, and fever may be signs of what type of intoxication?
|
amphetamines
|
|
post use crash, including depression, lethargy, headache, stomach cramps, hunger, and hypersomnolence are characteristic of withdrawal from what?
|
amphetamines
|
|
euphoria, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, hypertension, hallucinations (including tactile), paranoid ideations, angina, and sudden cardiac death may be signs of intoxication with what drug?
|
cocaine
|
|
post use crash, including severe depression and suicidality, hpersomnolence, fatigue, malaise, severe psychologial craving are characteristic of withdrawal from what?
|
cocaine
|
|
belligerence, impulsiveness, fever, pschomotor agitation, vertical and horizontal nystagmus, tachycardia, ataxia, homicidality, psychosis, and delerium are indicative of intoxication with what drug?
|
PCP
|
|
recurrence of intoxication symptoms due to reabsorption in GI tract, sudden onset of severe, random, homicidal violence may occur with withdrawal from what substance?
|
PCP
|
|
what 2 drugs are not typically associated with withdrawal symptoms?
|
marijuana, LSD
|
|
marked anxiety or depression, delusions, visual hallucinations, flashbacks, and pupil dilation are characteristic of intoxication with what substance?
|
LSD
|
|
euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social withdrawal, increased appetite, dry mouth, and hallucinations are characteristics of what type of substance use?
|
marijuana
|
|
which has a higher safety margin: barbiturates or benzodiazepines?
|
benzodiazepines
|
|
anxiety, seizures, delerium, life-threatening CV collapse are potential side effects of withdrawal from what?
|
barbiturates
|
|
what drug inhibits opiods?
|
naltrexone
|
|
this drug of abuse causes pupillary constriction/pinpoint pupils
|
opiods
|
|
these 3 drugs of abuse can cause pupillary dilation
|
amphetamines, cocaine, LSD
|
|
this drug of abuse can cause vertical and horizontal nystagmus
|
PCP
|
|
this drug of abuse can cause angina and sudden cardiac death
|
cocaine
|
|
which drug of abuse is associated wtih homicidality?
|
PCP
|
|
which epilepsy drug can cause kidney stones?
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topiramate
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name two MAOIs
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phenelzine, tranylcypormine
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what class of benzodiazepines are the most appropriate for acute insomnia and jet lag?
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short-acting, e.g. triazolam
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alpazolam is what type of benzodiazepine and what is it most often used for?
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intermediate-acting; panic attacks
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is secobarbital short- or long-acting?
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short
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what is xerostomia?
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dry mouth
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what type of drug is benztropine?
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anticholinergic - leads to anti-SLUDG side effects
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how do methamphetamine/amphetamine work?
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gain entrance to dopamine and NE nerve terminals, causing the release of these NTs via the uptake carriers; DA is a significant factor in the reinforcing effects of stimulants
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how does supatriptan work?
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serotonin1D agonist
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