Usmle Step 1 First Aid Drugs Musculoskeletal And Heme/onc

Front 1

What enzyme(s) do NSAIDs, acetaminophen, aspirin block? Which are reversible and irreversible?

Back 1

COX-1, COX-2
Aspirin - irreversible
NSAIDs - reversible
Acetominophen - reversible

Front 2

Zafirlukast
Montelukast MOA?

Back 2

Blocks leukotrienes (LTC4, LTD4, LTE4)

Front 3

Aspirin: Adverse effects

Back 3

GI Upset and bleeding
Analgesic Nephropahy
Reye's syndrome

Front 4

Ketorolac: Drug Class and MOA

Back 4

NSAIDS - block COX-1 and COX-2

Front 5

Celecoxib: Class and MOA

Back 5

COX-2 inhibitor (reversible)

Front 6

Celecoxib: adverse effects

Back 6

increased risk of thrombosis

Front 7

Use this drug instead of aspirin to prevent Reye's syndrome

Back 7

Acetaminophen

Front 8

Etidronate: Class and MOA

Back 8

Bisphosphonate - inhibit osteoclastic activity

Front 9

Pamidronate: Class and MOA

Back 9

Bisphosphonate - inhibit osteoclastic activity

Front 10

ALendronate: Class and MOA

Back 10

Bisphosphonate - inhibit osteoclastic activity

Front 11

Colchicine: Class and MOA

Back 11

It's own class - depolymerzies microtubules, impairing leukocyte chemotaxis

Front 12

Colchicine: Use

Back 12

Chronic gout

Front 13

Probenecid: Class and MOA

Back 13

Inhibits reabsorption of uric acid in PCT

Front 14

Probenecid: Use

Back 14

Chronic Gout

Front 15

Allopurinol: Class and MOA

Back 15

Xanthine Oxidase inhibitor. Prevents the formation of plasma uric acid

Front 16

Allopurinol: Use

Back 16

Chronic Gout

Front 17

What should be used in an acute flare of gout?

Back 17

Indomethacin

Front 18

Allopurinol: Drug interactions

Back 18

Increases azathioprine and 6-MP (both normally metabolized by xanthine oxidase)

Front 19

Etanercept: Class and MOA

Back 19

Recombinant TNF receptor. binds TNF

Front 20

Etanercept: USes

Back 20

Rheumatoid arthritis, psoriasis, ankylosing spondylitis

Front 21

Infliximab: Class and MOA

Back 21

Monoclonal antibody that Binds TNF.

Front 22

Infliximab: Uses

Back 22

Crohn's disease, Rheumatoid arthritis, ankylosing spondylitis.

Front 23

Infliximab: Toxicity

Back 23

Infection predisposition (TB reactivation)

Front 24

Heparin: Class and MOA

Back 24

Anticoagulant. Catalyzes the activation of antithrombin III (decreases thrombin and Xa)

Front 25

Heparin: Use

Back 25

Immediate anticoagulation for PEs, strokes, MI, etc.

Front 26

How do you monitor Heparin use?

Back 26

Monitor PTT

Front 27

Heparin: Adverse effects

Back 27

Bleeding, Thrombocytopenia (via HIT), osteoporosis

Front 28

Reversal of Heparin OD?

Back 28

Protamine sulfate

Front 29

Lepirudin, bivalirudin: class and MOA

Back 29

Anticoagulants. Hirudin derivatives that directly inhibit thrombin.

Front 30

Lepirudin, bivalirudin: Use

Back 30

Replacement of heparin in HIT

Front 31

Warfarin: Class and MOA

Back 31

Anticoagulant. inhibits factor synthesis and γ-carboxylation of K-dependant factors (II, VII, IX, X and Proteins C and S)

Front 32

How do you monitor Warfarin use?

Back 32

PT

Front 33

Warfarin: Use

Back 33

Chronic anticoagulation

Front 34

What would you use in a pregnant woman, Warfarin or heparin?

Back 34

Heparin. Warfarin crosses the placenta

Front 35

Warfarin: adverse effects

Back 35

Bleeding, Warfarin-induced tissue necrosis, teratogen

Front 36

tPA: Class and MOA

Back 36

Thrombolytic. Activator of plasminogen -> breakdown of fibrin and fibrinogen

Front 37

tPA: Use

Back 37

Early MI, Ischemic Stroke

Front 38

tPA: Adverse Effects

Back 38

Bleeding, Contrai'ed in pts with bleeding.

Front 39

tPA: Toxicity Tx

Back 39

Aminocapric acid (inhibits plasminogen)

Front 40

Streptokinase, urokinase: Class and MOA

Back 40

Thrombolytic. Activate plasminogen

Front 41

Clopidogrel, ticlopidine: Class and MOA

Back 41

Anticoagulant. Inhibits platelet aggregation by blocking ADP receptors -> Inhibition of fibrinogen bdnding by prevention of gpIIb/IIIa

Front 42

Clopidogrel, ticlopidine: Use

Back 42

Acute coronary syndrome, coronary stenting

Front 43

ticlopidine: toxicity

Back 43

Neutropenia

Front 44

Abciximab: class and MOA

Back 44

Monoclonal antibody that binds the gpIIb/IIIa receptor on activated platelets, preventing aggregation

Front 45

Abciximab: Use

Back 45

Acute coronary syndromes, percutaneous transluminal coronary angioplasty

Front 46

Abciximab: adverse effects

Back 46

Bleeding, thrombocytopenia

Front 47

Methotrexate: Class and MOA

Back 47

DHF reductase inhibitor. No production of Thymidine.

Front 48

Methotrexate: Use

Back 48

Cancer, Rheumatoid Arthritis, Psoriasis

Front 49

Methotrexate: Adverse effects (and how to reverse)

Back 49

Myelosuppression, reverisble with leucovorin (folinic acid) rescue

Front 50

5-fluorouracil: Class and MOA

Back 50

Thymidylate synthase inhibitor (no production of dTMP)

Front 51

5-fluorouracil: Use

Back 51

Cancer. Synergistic with MTX

Front 52

5-fluorouracil: Adverse effects (and how to reverse)

Back 52

Myelosuppression. Thymidine rescue

Front 53

6-mercaptopurine: class and MOA

Back 53

Block of de novo purine synthesis. Needs activated by HGPRTase.

Front 54

6-mercaptopurine:Use

Back 54

Cancer

Front 55

6-mercaptopurine: Adverse Effects

Back 55

Bone marrow, GI, Liver. Metabolized with xanthine oxidase...toxicity with allopurinol

Front 56

Cytarabine (ara-c): Class and MOA

Back 56

Inhibits DNA polymerase

Front 57

Cytarabine (ara-c): Use

Back 57

Cancer (A__Ls and non-hodgkin's)

Front 58

Cytarabine (ara-c): Adverse Effects

Back 58

Leukopenia, thrombocytopenia, Megaloblastic anemia

Front 59

Cyclophosphamide, Ifosfamide: Class and MOA

Back 59

Alkylating agents. Colvalently link DNA at guanine. Both require activation by liver

Front 60

Cyclophosphamide, Ifosfamide: USe

Back 60

Cancer and immunosuppression

Front 61

Cyclophosphamide, Ifosfamide: Adverse effects (and reversibility)

Back 61

Myelosuppression, HEMORRHAGIC CYSTITIS (reversible with mesna)

Front 62

Nitrosureas: Names

Back 62

Carumustine, lomustine, semustine, streptozocin

Front 63

Nitrosureas: Class and mOA

Back 63

DNA Alkylating agents. Require activation. Cross BBB.

Front 64

Nitrosureas: Use

Back 64

Brain tumors

Front 65

Nitrosureas: Adverse effects

Back 65

CNS toxicity

Front 66

Cisplatin, carboplatin: Class and MOA

Back 66

Crosslink DNA

Front 67

Cisplatin, carboplatin: Use

Back 67

Cancer

Front 68

Cisplatin, carboplatin: Adverse effects

Back 68

NEPHROTOXIC and acoustic nerve damage

Front 69

Busulfan: Class and MOA

Back 69

Alkylates DNA

Front 70

Busulfan: Use

Back 70

Cancer and Bone marrow ablation

Front 71

Busulfan: Adverse effects

Back 71

Pulmonary Fibrosis, hyperpigmentation

Front 72

Doxorubicin: Class and MOA

Back 72

Generates free radicals

Front 73

Doxorubicin: Adverse Effects

Back 73

Cardiotoxic

Front 74

Dactinomycin: Class and MOA

Back 74

Intercalates DNA

Front 75

Dactinomycin: Use

Back 75

Childhood cancers

Front 76

Dactinomycin: Adverse Effects

Back 76

Myelosuppression

Front 77

Bleomycin: Class and MOA

Back 77

Free radical induction

Front 78

Bleomycin: Use

Back 78

Cancer (testicular), ABVD Hadgkin's regimen

Front 79

Bleomycin: Adverse Effects

Back 79

Pulmonary fibrosis, skin changes

Front 80

Hydroxyurea: Class and MOA

Back 80

Inhibits Ribonucleotide Reductase, decreased DNA synthesis

Front 81

Hydroxyurea: Use

Back 81

Cancer

Front 82

Hydroxyurea: Adverse Effects

Back 82

BM Suppresion, GI upset

Front 83

Etoposide (VP-16): Class and MOA

Back 83

G2 specific agent taht inhibits topo II and enhances DNA degradation

Front 84

Etoposide (VP-16): USe

Back 84

cancer

Front 85

Etoposide (VP-16): Adverse effects

Back 85

Myelosuppression, GI irritation, alopecia

Front 86

Prednisone: Class and MOA

Back 86

Apoptosis trigger.

Front 87

Prednisone: Use

Back 87

Most common glucocorticoid in cancer, CLL, Lymphomas (MOPP), immunosuppressant

Front 88

Prednisone: Adverse Effects

Back 88

Cushing-like, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis

Front 89

Tamoxifen, reloxifene: Class and MOA

Back 89

SERMs. Estrogen receptor agonsits in estrogen sensitive cancers

Front 90

Tamoxifen, reloxifene: Uses

Back 90

Breast cancer. Osteoporosis prevention

Front 91

Tamoxifen, reloxifene: adverse effects

Back 91

tamoxifen may increase risk of endometrial carcinoma.

Front 92

Trastuzumab: Class and MOA

Back 92

monoclonal Ab to HER-2 in breast cancer cells that overexpress this molecule.

Front 93

Trastuzumab: Use

Back 93

Breast Cancer

Front 94

Trastuzumab: Toxicity

Back 94

Cardiotoxic

Front 95

Imatinab (Gleevec): Class and MOA

Back 95

Philadelphia chromosome bcr-abl tyrosine kinase inhibitor

Front 96

Imatinab (Gleevec): USE

Back 96

CML, GI stromal tumors

Front 97

Vincristine, vinblastine: Class and MOA

Back 97

Microtubule polymerization blockers. M-phase-specific

Front 98

Vincristine, vinblastine: Use

Back 98

Hodgkin's (MOPP), other cancers

Front 99

Paclitaxel: Class and MOA

Back 99

Binds tubulin, preventing microtubule formation. (no anaphase). M-phase-specific

Front 100

Paclitaxel: Use

Back 100

Ovarian and breast carcinomas

Front 101

Paclitaxel: Adverse Effects

Back 101

Myelosuppression and hypersensitivity