Usmle Step 1 Review - Pharm One Liners

Front 1

Half-life (T1/2)

Back 1

Time it takes for amount of drug to fall to half of its value; this is a constant in first order kinetics (majority of drugs)

Front 2

Volume of distribution (VD)

Back 2

Relates the amount of drug in the body to the plasma concentration

Front 3

Cp

Back 3

Plasma concentration of a drug at a given time

Front 4

Clearance (CL)

Back 4

The ratio of the rate of elimination of a drug to its plasma concentration

Front 5

First pass effect

Back 5

The elimination of drug that occurs before it reaches the systemic circulation

Front 6

Bioavailability (F)

Back 6

The fraction of administered dose of a drug that reaches systemic circulation

Front 7

Steady state

Back 7

When the rate of drug input equals the rate of drug elimination

Front 8

Phase I

Back 8

This step of metabolism makes a drug more hydrophilic and hence augments elimination

Front 9

Oxidation, reduction, hydrolysis

Back 9

Different steps of Phase I

Front 10

Barbiturates, phenytoin, carbamazepine, and rifampin

Back 10

Inducers of Cytochrome P450 (CYP450)

Front 11

Cimetidine, ketoconazole, erythromycin, isoniazid and grapefruit

Back 11

Inhibitors of CYP450

Front 12

Glucuronate, acetic acid, and glutathione sulfate

Back 12

Products of Phase II conjugation

Front 13

First order kinetics

Back 13

Type of kinetics when a constant percentage of substrate is metabolized per unit time

Front 14

Zero order kinetics

Back 14

Drug elimination with a constant amount metabolized regardless of drug concentration

Front 15

Loading dose (Cp*(Vd/F))

Back 15

Target plasma concentration times (volume of distribution divided by bioavailability)

Front 16

Maintenance dose (Cp*(CL/F))

Back 16

Concentration in the plasma times (clearance divided by bioavailability)

Front 17

Affinity

Back 17

Strength of interaction between drug and its receptor

Front 18

Specificity

Back 18

Selectivity of a drug for its receptor

Front 19

Potency

Back 19

Amount of drug necessary to elicit a biologic effect; refers to the drug's strength

Front 20

Efficacy

Back 20

Maximum response achieveable from a drug

Front 21

Full agonist

Back 21

Ability of a drug to produce 100% of the maximum response regardless of the potency

Front 22

Partial agonist

Back 22

Ability to produce less than 100% of the response

Front 23

Competitive antagonist

Back 23

Ability to bind reversibly to the same site as the drug and without activating the effector system

Front 24

Noncompetitive antagonist

Back 24

Class of drugs with ability to decrease the maximal response to an agonist

Front 25

Thyroid and steroid hormones

Back 25

A hormone whose mechanism of action (MOA) utilizes intracellular receptors

Front 26

Insulin

Back 26

A hormone whose MOA utilizes transmembrane receptors

Front 27

Benzodiazepines and calcium channel blockers

Back 27

Class of drugs whose MOA utilizes ligand gated ion channels

Front 28

ED50

Back 28

Median effective dose required for an effect in 50% of the population

Front 29

TD50

Back 29

Median toxic dose required for a toxic effect in 50% of the population

Front 30

LD50

Back 30

Dose which is lethal to 50% of the population

Front 31

Therapeutic index

Back 31

Window between therapeutic effect and toxic effect

Front 32

High therapeutic index

Back 32

Term for a high margin of safety

Front 33

Low therapeutic index

Back 33

Term for a narrow margin of safety

Front 34

Dimercaprol, EDTA

Back 34

Antidote used for lead poisoning

Front 35

Nitrites

Back 35

Antidote used for cyanide poisoning

Front 36

Physostigmine

Back 36

Antidote used for anticholinergic poisoning

Front 37

Atropine, pralidoxime (2-PAM)

Back 37

Antidote used for organophosphate/anticholinesterase poisoning

Front 38

Deferoxamine

Back 38

Antidote used for iron salt toxicity

Front 39

N-acetylcysteine (Mucomyst)

Back 39

Antidote used for acetaminophen (APAP) toxicity

Front 40

Dimercaprol

Back 40

Antidote for arsenic, mercury, lead, and gold poisoning

Front 41

Penicillamine

Back 41

Antidote used in poisonings: copper (Wilson's disease), lead, mercury, and arsenic

Front 42

Protamine

Back 42

Antidote used for heparin overdose

Front 43

Vitamin K and Fresh frozen plasma (FFP)

Back 43

Antidote used for warfarin toxicity

Front 44

Aminocaproic acid

Back 44

Antidote for tissue plasminogen activator (t-PA), streptokinase

Front 45

Ethanol or fomepizole

Back 45

Antidote used for methanol and ethylene glycol

Front 46

Naloxone (IV), naltrexone (PO)

Back 46

Antidote used for opioid toxicity

Front 47

Flumazenil

Back 47

Antidote used for benzodiazepine toxicity

Front 48

Sodium bicarbonate

Back 48

Antidote used for tricyclic antidepressants (TCA)

Front 49

100% O2 and hyperbaric O2

Back 49

Antidote used for carbon monoxide poisoning

Front 50

Digibind (also need to d/c digoxin, normalize K+, and lidocaine if pt. Is arrhythmic)

Back 50

Antidote used for digitalis toxicity

Front 51

Esmolol

Back 51

Antidote used for beta agonist toxicity (eg. Metaproterenol)

Front 52

Leucovorin

Back 52

Antidote for methotrexate toxicity

Front 53

Glucagon

Back 53

Antidote for beta-blockers and hypoglycemia

Front 54

Magnesium sulfate

Back 54

Antidote useful for some drug induced Torsade de pointes

Front 55

sodium polystyrene sulfonate (Kayexalate)

Back 55

Antidote for hyperkalemia

Front 56

Alkalinize urine, dialysis

Back 56

Antidote for salicylate intoxication

Front 57

Log-kill hypothesis

Back 57

Constant proportion of cell population killed rather than a constant number

Front 58

Pulse therapy

Back 58

Treatment with cancer chemotherapy at high doses every 3-4 weeks, too toxic to be used continuously

Front 59

Rescue therapy

Back 59

Toxic effect of anticancer drug can be lessened by rescue agents

Front 60

Allopurinol

Back 60

Drug used concurrently with toxic anticancer agents to reduce renal precipitation of urates

Front 61

5-flouracil (5-FU)

Back 61

Pyrimidine analog that causes "Thymine-less death" given with leucovorin rescue

Front 62

Prednisone

Back 62

Drug used in cancer therapy causes Cushing-like symptoms

Front 63

SEVERE myelosuppression

Back 63

Side effect of Mitomycin

Front 64

Alkylating agent

Back 64

MOA of cisplatin

Front 65

Nephro and ototoxicity

Back 65

Common toxicities of cisplatin

Front 66

6-mercaptopurine (6-MP)

Back 66

Analog of hypoxanthine, needs HGPRTase for activation

Front 67

Allopurinol

Back 67

Interaction with this drug requires dose reduction of 6-MP

Front 68

Dexrazoxane

Back 68

May protect against doxorubicin toxicity by scavenging free radicals

Front 69

Bleomycin

Back 69

Blows DNA (breaks DNA strands), limiting SE is pulmonary fibrosis

Front 70

Testicular cancer

Back 70

Bleomycin+vinblastine+etoposide+cisplatin produce almost a 100% response when all agents are used for this neoplasm

Front 71

Adriamycin (doxorubicin) +bleomycin, vinblastine +dacarbazine

Back 71

ABVD regimen used for HD, but appears less likely to cause sterility and secondary malignancies than MOPP

Front 72

CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) plus rituximab

Back 72

Regimen used for non-Hodgkin's lymphoma

Front 73

CMF (cyclophosphamide, methotrexate, and fluorouracil) and tamoxifen if ER+

Back 73

Regimen used for breast cancer

Front 74

Mechlorethamine

Back 74

Alkylating agent, vesicant that causes tissue damage with extravasation

Front 75

Cyclophosphamide

Back 75

Anticancer drug also used in RA, produces acrolein in urine that leads to hemorrhagic cystitis

Front 76

Hydration and mercaptoethanesulfonate (MESNA)

Back 76

Prevention of cyclophosphamide induced hemorrhagic cystitis

Front 77

Vincristine

Back 77

Microtubule inhibitor that causes peripheral neuropathy, foot drop (eg. ataxia), and "pins and needles" sensation

Front 78

Paclitaxel (taxol)

Back 78

Interact with microtubules (but unlike vinca which prevent disassembly of tubules), it stabilizes tubulin and cells remain frozen in metaphase

Front 79

Cisplatin

Back 79

Toxicities include nephrotoxicity and ototoxicity, leading to a severe interaction with aminoglycosides

Front 80

Carboplatin

Back 80

Agent similar to cisplatin, less nephrotoxic, but greater myelosuppression

Front 81

L-asparaginase

Back 81

Converts asparagine to aspartate and ammonia, denies cancer cells of essential AA (asparagine)

Front 82

Interferon alpha

Back 82

Used for hairy cell leukemia; it stimulates NK cells

Front 83

Flutamide (Eulexin)

Back 83

Anti-androgen used for prostate cancer

Front 84

Tamoxifen

Back 84

Anti-estrogen used for estrogen receptor + breast cancer

Front 85

Letrozole, anastrozole

Back 85

Aromatase inhibitor used in breast cancer

Front 86

Toremifene (Fareston)

Back 86

Newer estrogen receptor antagonist used in advanced breast cancer

Front 87

Bleomycin, vinca alkaloids, antimetabolites (eg., 5-FU, 6-MP, methotrexate, etoposide)

Back 87

Some cell cycle specific anti-cancer drugs

Front 88

Alkylating agents (eg., mechlorethamine, cyclophosphamide), antibiotics (doxorubicin, daunorubicin), cisplatin, nitrosourea

Back 88

Some cell cycle non-specific drugs

Front 89

Odansetron, granisetron

Back 89

Anti-emetics used in association with anti-cancer drugs that are 5-HT3 (serotonin receptor subtype ) antagonists

Front 90

Carmustine (BCNU) and lomustine (CCNU)

Back 90

Nitrosoureas with high lipophilicity, used for brain tumors

Front 91

Procarbazine

Back 91

Produces disulfiram-like reaction with ethanol

Front 92

Octreotide

Back 92

Somatostatin (SRIF) analog used for acromegaly, carcinoid, glucagonoma and other GH producing pituitary tumors

Front 93

Somatrem

Back 93

Somatotropin (GH) analog used in GH deficiency (dwarfism)

Front 94

Sermorelin

Back 94

GHRH analog used as diagnostic agent

Front 95

Leuprolide

Back 95

GnRH agonist used for infertility or different types of CA depending on pulsatile or steady usage respectively

Front 96

Ganirelix

Back 96

GnRH antagonist with more immediate effects, used for infertility

Front 97

Bromocriptine

Back 97

Dopamine (DA) agonist (for Parkinson's disease), used also for hyperprolactinemia

Front 98

Dopamine

Back 98

Hormone inhibiting prolactin release

Front 99

Cosyntropin

Back 99

ACTH analog used for diagnosis of patients with corticosteroid abnormality

Front 100

Desmopressin (DDAVP)

Back 100

Synthetic analog of ADH hormone used for diabetes insipidus and nocturnal enuresis

Front 101

Increased thromboembolic events

Back 101

SE of OCs

Front 102

L-thyroxine (T4)

Back 102

Most widely used thyroid drugs such as Synthroid and Levoxyl contain

Front 103

Cytomel

Back 103

T3 compound less widely used

Front 104

Thioamides, iodides, radioactive iodine, and ipodate

Back 104

Anti-thyroid drugs

Front 105

Methimazole and propylthiouracil (PTU)

Back 105

Thioamide agents used in hyperthyroidism

Front 106

PTU

Back 106

Thioamide less likely to cross placenta, inhibits peripheral conversion of T4 to T3 in high doses, and should be used with extreme caution in pregnancy

Front 107

Inhibits thyroid hormone synthesis by blocking iodination of the tyrosine residues of thyroglobulin

Back 107

PTU (propylthiouracil) MOA

Front 108

Iodide salts

Back 108

Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism

Front 109

Thyroxine

Back 109

Dose may need to be increased during pregnancy or with Ocs due to increased TBG in plasma

Front 110

Radioactive iodine

Back 110

Permanently cures thyrotoxicosis, patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy

Front 111

Ipodate

Back 111

Radio contrast media that inhibits the conversion of T4 to T3

Front 112

Beta-blockers such as propranolol

Back 112

Block cardiac adverse effects of thyrotoxicosis such as tachycardia, inhibits the conversion of T4 to T3

Front 113

Iron deiodinates thyroxine

Back 113

Vitamins containing iron should NOT be taken simultaneously with levothyroxine because

Front 114

Estogens increase maternal TBG

Back 114

Thyroxine dose may need to be increased in hypothyroid patient during pregnancy because

Front 115

Glomerulosa (mineralocorticoids), fasciculata (glucocorticoid=GC), and reticularis (adrenal androgens)

Back 115

3 zones of adrenal cortex and their products

Front 116

GFR

Back 116

Pneumonic for 3 zones of adrenal cortex

Front 117

Glucocorticoids

Back 117

Used for Addison's disease, Congenital Adrenal Hyperplasia (CAH), inflammation, allergies, and asthma (as a local inhalation)

Front 118

Cortisone and hydrocortisone (equivalent to cortisol)

Back 118

Short acting glucocorticoids

Front 119

Prednisone, methylprednisolone, prednisolone, and triamcinolone

Back 119

Intermediate acting glucocorticoids

Front 120

Betamethasone and dexamethasone

Back 120

Long acting glucocorticoids

Front 121

Fludrocortisone and deoxycorticosterone

Back 121

Mineralocorticoids

Front 122

Osteopenia, impaired wound healing, inc. risk of infection, inc. appetite, HTN, edema, PUD, euphoria, psychosis, stria, thinning of skin

Back 122

Some side effects of corticosteroids

Front 123

5-7 days

Back 123

Period of time of therapy after which GC therapy will need to be tapered

Front 124

Dexamethasone suppression test

Back 124

Used for Cushing's syndrome (increased corticosteroid)

Front 125

Aminoglutethimide

Back 125

Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis

Front 126

Ketoconazole

Back 126

Antifungal agent used for inhibition of all gonadal and adrenal steroids

Front 127

Mifepristone

Back 127

Antiprogestin used as potent antagonist of GC receptor

Front 128

Spironolactone

Back 128

Diuretic used to antagonize aldosterone receptors

Front 129

Gynecomastia and hyperkalemia

Back 129

Common SE of spironolactone

Front 130

Estrogen

Back 130

Slightly increased risk of breast cancer, endometrial cancer, heart disease (questionable), has beneficial effects on bone loss

Front 131

Clomiphene and tamoxifen

Back 131

Antiestrogen drugs used for fertility and breast cancer respectively

Front 132

Hot flashes

Back 132

Common SE of tamoxifen and raloxifene

Front 133

Raloxifene

Back 133

Selective estrogen receptor modulator (SERM) used for prevention of osteoporosis and prophylaxis in women with risk factors for breast cancer

Front 134

Diethylstilbestrol (DES)

Back 134

Non-steroidal estrogen agonist causes clear cell adenocarcinoma of the vagina in daughters of women who used it during pregnancy

Front 135

Ethinyl estradiol and mestranol

Back 135

Estrogen mostly used in oral contraceptives (OC)

Front 136

Mifepristone (RU-486)

Back 136

Anti-progesterone used as abortifacient

Front 137

Combination oral contraceptives (OC)

Back 137

Constant low dose of estrogen and increasing dose of progestin for 21 days (last 5 days are sugar pills or iron prep)

Front 138

Ortho-Evra

Back 138

Oral contraceptive available in a transdermal patch

Front 139

Testosterone

Back 139

Converted to more active form DHT by 5 alpha-reductase

Front 140

Finasteride (Proscar and Propecia respectively)

Back 140

5 alpha-reductase inhibitor used for benign prostatic hyperplasia (BPH) and male pattern baldness

Front 141

Nandrolone, oxymetholone, and oxandrolone

Back 141

Anabolic steroid that has potential for abuse

Front 142

Cyproterone acetate

Back 142

Anti-androgen used for hirsutism in females

Front 143

Leuprolide

Back 143

Drug is used with testosterone for male fertility

Front 144

Glucagon

Back 144

What do alpha cells in the pancreas produce?

Front 145

Insulin

Back 145

What do beta cells in the pancreas produce?

Front 146

Islets of Langerhans

Back 146

Where are beta cells found in the pancreas?

Front 147

Somatostatin

Back 147

What do delta cells in the pancreas produce?

Front 148

C-peptide

Back 148

Product of proinsulin cleavage used to assess insulin abuse

Front 149

Little C-peptide

Back 149

Exogenous insulin contains

Front 150

Normal C-peptide

Back 150

Endogenous insulin contains

Front 151

Lispro (Humalog), aspart, glulisine

Back 151

Very rapid acting insulin, having fastest onset and shortest duration of action

Front 152

Regular (Humulin R)

Back 152

Rapid acting, crystalline zinc insulin used to reverse acute hyperglycemia

Front 153

Ultralente (humulin U)

Back 153

Long acting insulin

Front 154

Glargine (Lantus), detemir

Back 154

Ultra long acting insulin, has over a day duration of action

Front 155

Hypoglycemia

Back 155

Major SE of insulin

Front 156

GLUT 2

Back 156

Important in synthesis of glucose to glycogen in the liver

Front 157

GLUT 4

Back 157

Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation

Front 158

Acarbose, miglitol

Back 158

Examples of alpha-glucosidase inhibitors (AGI)

Front 159

Act on intestine, delay digestion and absorption of glucose formed from digestion of starch and disacchrides

Back 159

MOA of AGI's

Front 160

Flatulence (do not use beano to tx), diarrhea, abdominal cramps

Back 160

SE of AGI's

Front 161

Acarbose

Back 161

Alpha-glucosidase inhibitor associated with elevation of LFT's

Front 162

Nateglinide

Back 162

Amino acid derivative, active as an insulin secretagogue

Front 163

Insulin secretagogue - closes ATP-sensitive K+ channel

Back 163

MOA of nateglinide

Front 164

Metformin

Back 164

Biguanide

Front 165

Glyburide, glipizide, and rosiglitazone

Back 165

Drugs available in combination with metformin

Front 166

Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity

Back 166

MOA of metformin

Front 167

Decreased micro and macro vascular disease

Back 167

Vascular effects of metformin

Front 168

Lactic acidosis

Back 168

Most important potential SE of metformin

Front 169

None

Back 169

Incidence of hyoglycemia with metformin

Front 170

Repaglinide

Back 170

Meglitinide class of drugs

Front 171

Insulin release from pancreas; faster and shorter acting than sulfonylurea

Back 171

MOA of repaglinide

Front 172

Chlorpropamide, tolbutamide, tolazamide, etc.

Back 172

First generation sulfonylurea

Front 173

Glyburide, glipizide, glimepiride, etc.

Back 173

Second generation sulfonylurea

Front 174

Insulin release from pancreas by modifying K+ channels

Back 174

MOA of both generations

Front 175

Hypoglycemia

Back 175

Common SE of sulfonylureas, repaglinide, and nateglinide

Front 176

Chlorpropamide

Back 176

Sulfonylurea NOT recommended for elderly because of very long half life

Front 177

Pioglitazone, Rosiglitazone, Troglitazone (withdrawn/d from market)

Back 177

Thiazolidinediones

Front 178

Hepatic toxicity

Back 178

Reason troglitazone was withdrawn from market

Front 179

Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism

Back 179

MOA of thiazolindinediones

Front 180

Edema, mild anemia; interaction with drugs that undergo CytP450 3A4 metabolism

Back 180

SE of Thiazolindinediones

Front 181

Glucagon

Back 181

Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation

Front 182

Alendronate, etidronate, risedronate, pamidronate, tiludronate, and zoledronic acid

Back 182

Available bisphosphonates

Front 183

Inhibits osteoclast bone resorption

Back 183

MOA of Bisphosphonates

Front 184

Pamidronate, zoledronate, ibandronate

Back 184

Names of three bisphosphonates available IV

Front 185

Osteoporosis, Paget's disease, and osteolytic bone lesions, and hypercalcemia from malignancy

Back 185

Uses of bisphosphonates

Front 186

Chemical esophagitis

Back 186

Major SE of bisphosphonates

Front 187

Etidronate

Back 187

Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia

Front 188

Estrogen (HRT-Hormone replacement therapy)

Back 188

Used for prevention of postmenopausal osteoporosis in women

Front 189

Raloxifene (SERM-selective estrogen receptor modulator)

Back 189

Increase bone density, also being tested for breast CA prophylaxis

Front 190

Calcitonin (salmon prep)

Back 190

Used intranasally and decreases bone resorption

Front 191

Calcium

Back 191

Used especially in postmenopausal women, dosage should be 1500 mg

Front 192

Vitamin D

Back 192

Vitamin given with calcium to ensure proper absorption

Front 193

St. Anthony's Fire

Back 193

Disease caused by excess ergot alkaloids

Front 194

Autocoids

Back 194

Endogenous substances commonly interpreted as histamine, serotonin, prostaglandins, and vasoactive peptides

Front 195

Zollinger-Ellison Syndrome

Back 195

Syndrome of hypersecretion of gastric acid and pepsin usually caused by gastrinoma; it is associated with severe peptic ulceration and diarrhea

Front 196

Oxytocin

Back 196

Drug that causes contraction of the uterus

Front 197

Smooth muscle; stomach, heart, and mast cells; nerve endings, CNS respectively

Back 197

Distribution of histamine receptors H1, H2, and H3

Front 198

Diphenhydramine and cimetridine, respectively

Back 198

Prototype antagonist of H1 and H2 receptors

Front 199

Diphendydramine

Back 199

1st generation antihistamine that is highly sedating

Front 200

Chlorpheniramine or cyclizine

Back 200

1st generation antihistamine that is least sedating

Front 201

Fexofenadine, loratadine, and cetirizine

Back 201

2nd generation antihistamines

Front 202

First generation due to being more lipid-soluble

Back 202

Generation of antihistamine that has the most CNS effects

Front 203

Use in IgE mediated allergic reaction

Back 203

Major indication for H1 receptor antagonist

Front 204

hydroxyzine (Atarax)

Back 204

Antihistamine that can be used for anxiety and insomnia and is not addictive

Front 205

Dimenhydrinate, meclizine, and other 1st generation

Back 205

H1 antagonist used in motion sickness

Front 206

Sedation

Back 206

Most common side effect of 1st generation antihistamines

Front 207

Terfenadine and astemizole (have been removed from the market)

Back 207

Lethal arrhythmias resulting from concurrent therapy with azole fungals (metabolized by CYP 3A4) and these antihistamines which inhibit the 3A4 iso-enzyme.

Front 208

Cimetidine

Back 208

H2 blocker that causes the most interactions with other drugs

Front 209

Acid reflux disease, duodenal ulcer and peptic ulcer disease

Back 209

Clinical use for H2 blockers

Front 210

Mostly in the brain, and they mediate synaptic inhibition via increased K+ conductance

Back 210

Receptors for serotonin (5HT-1) are located

Front 211

Sumatriptan, naratriptan, and rizatriptan

Back 211

"5HT-1d agonist used for migraine headaches "

Front 212

Sumatriptan

Back 212

Triptan available in parenteral and nasal formulation

Front 213

Cyproheptadine

Back 213

H1 blocker that is also a serotonin antagonist

Front 214

Oxytocin, ergonovine and ergotamine

Back 214

Agents for reduction of postpartum bleeding

Front 215

Ketanserin cyproheptadine, and phenoxybenzamine

Back 215

Agents used in treatment of carcinoid tumor

Front 216

Ondansetron, granisetron, dolasetron and alosetron

Back 216

5HT-3 antagonist used in chemotherapeutic induced emesis

Front 217

Dolasetron

Back 217

5HT-3 antagonist that has been associated with QRS and QTc prolongation and should not be used in patients with heart disease

Front 218

Odansetron

Back 218

DOC to treat chemo-induced nausea and vomiting

Front 219

Nitroprusside

Back 219

Drug used in ergot alkaloids overdose, ischemia and gangrene

Front 220

Uterine contractions

Back 220

Reason ergot alkaloids are contraindicated in pregnancy

Front 221

Hallucinations resembling psychosis

Back 221

SE of ergot alkaloids

Front 222

LSD

Back 222

Ergot alkaloid used as an illicit drug

Front 223

Bromocriptine

Back 223

Dopamine agonist used in hyperprolactinemia

Front 224

Bradykinin and histamine

Back 224

Peptide causing increased capillary permeability and edema

Front 225

Bradykinin

Back 225

Mediator of tissue pain, edema, inactivated by ACE, and may be a contributing factor to the development of angioedema

Front 226

Capsaicin

Back 226

Drug causing depletion of substance P (vasodilator)

Front 227

Prostaglandin E1 (misoprostol) PGE2, and PGF2alpha

Back 227

Prostaglandins that cause abortions

Front 228

COX 1 is found throughout the body and COX 2 is only in inflammatory tissue

Back 228

Difference between COX 1 and COX 2

Front 229

Celecoxib and rofecoxib

Back 229

Drug that selectively inhibits COX 2

Front 230

Zileuton

Back 230

Inhibitor of lipoxygenase

Front 231

Liver toxicity

Back 231

Major SE of zileuton

Front 232

Zafirlukast and montelukast

Back 232

Inhibitor of leukotrienes (LTD4) receptors and used in asthma

Front 233

PGE1

Back 233

Used in pediatrics to maintain patency of ductus arteriosis

Front 234

PGI2 (epoprostenol)

Back 234

Approved for use in severe pulmonary HTN

Front 235

Alprostadil

Back 235

Prostaglandin used in the treatment of impotence

Front 236

Aspirin

Back 236

Irreversible, nonselective COX inhibitor

Front 237

NSAIDS

Back 237

Class of drugs that reversibly inhibit COX

Front 238

Arginine

Back 238

Primary endogenous substrate for Nitric Oxidase Synthase

Front 239

Stimulates cGMP which leads to vascular smooth muscle relaxation

Back 239

MOA and effect of nitric oxide

Front 240

Salmeterol

Back 240

Long acting beta 2 agonist used in asthma

Front 241

Ipratropium

Back 241

Muscarinic antagonist used in asthma

Front 242

Mast cell stabilizer

Back 242

MOA action of cromolyn

Front 243

Pentoxifylline

Back 243

Methylxanthine derivative used as a remedy for intermittent claudication

Front 244

inhibit phospholipase A2

Back 244

MOA of corticosteroids

Front 245

Adrenal suppression and weaning slowly, respectively

Back 245

SE of long term (>5 days) corticosteroid therapy and remedy

Front 246

Inhibit DNA gyrase

Back 246

MOA of quinolones

Front 247

Block cell wall synthesis by inhibiting peptidoglycan cross-linkage

Back 247

MOA of penicillin

Front 248

Vancomycin

Back 248

Drug used for MRSA

Front 249

Blocks peptidoglycan synthesis

Back 249

Vancomycin MOA

Front 250

Point mutation

Back 250

Type of resistance found with vancomycin

Front 251

Rifampin

Back 251

Meningitis prophylaxis in exposed patients

Front 252

Scotch tape technique and mebendazole

Back 252

Technique used to diagnose perianal itching, and the drug used to treat it

Front 253

nephro and ototoxicity

Back 253

Two toxicities of aminoglycosides

Front 254

Erythromycin

Back 254

DOC for Legionnaires' disease

Front 255

Inhibit dihydropteroate synthase

Back 255

MOA of sulfonamides

Front 256

Methicillin, nafcillin, and dicloxacillin

Back 256

Penicillins active against penicillinase secreting bacteria

Front 257

Amoxicillin

Back 257

Cheap wide spectrum antibiotic DOC for otitis media

Front 258

Cephalosporins

Back 258

Class of antibiotics that have 10% cross sensitivity with penicillins

Front 259

Carbenicillin, piperacillin and ticarcillin

Back 259

PCN active against pseudomonas

Front 260

Vancomycin, infusion at a slow rate and antihistamines

Back 260

Antibiotic causing red-man syndrome, and prevention

Front 261

Tetracycline

Back 261

Drug causes teeth discoloration

Front 262

Decreases protein synthesis by inhibiting 30S ribosome

Back 262

MOA of tetracycline

Front 263

Chloramphenicol

Back 263

Drug that causes gray baby syndrome and aplastic anemia

Front 264

Clindamycin

Back 264

Drug notorious for causing pseudomembranous colitis

Front 265

Metronidazole

Back 265

DOC for tx of pseudomembranous colitis

Front 266

ORAL vancomycin

Back 266

Treatment of resistant pseudomembranous colitis

Front 267

Megaloblastic anemia

Back 267

Anemia caused by trimethoprim

Front 268

Cartilage damage

Back 268

Reason fluoroquinolones are contraindicated in children and pregnancy

Front 269

Metronidazole

Back 269

DOC for giardia, bacterial vaginosis, pseudomembranous colitis, and trichomonas

Front 270

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

Back 270

Treatment for TB patients (think RIPE)

Front 271

Disulfiram-like reaction

Back 271

Metronidazole SE if given with alcohol

Front 272

Red urine discoloration

Back 272

Common side effect of Rifampin

Front 273

Bind ergosterol in fungal cell membrane

Back 273

MOA of nystatin

Front 274

Administration of Vit. B6 (pyridoxine)

Back 274

Neurotoxicity with isoniazid (INH) prevented by

Front 275

Nephrotoxicity

Back 275

Toxicity of amphotericin

Front 276

Gynecomastia

Back 276

SE seen only in men with administration of ketoconazole

Front 277

Topical mupirocin (Bactroban)

Back 277

Topical DOC in impetigo

Front 278

Amantadine

Back 278

DOC for influenza A

Front 279

Ribavirin

Back 279

DOC for RSV

Front 280

Ganciclovir

Back 280

DOC for CMV retinitis

Front 281

Neutro, leuko and thrombocytopenia

Back 281

SE for ganciclovir

Front 282

Nevirapine, amprenavir

Back 282

Anti-viral agents associated with Stephen Johnson syndrome

Front 283

Protease inhibitors

Back 283

HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism

Front 284

Delavirdine, efavirenz, and ribavirin

Back 284

Antivirals that are teratogens

Front 285

Ganciclovir, zidovudine, saquinavir, and interferon

Back 285

Antivirals associated with neutropenia

Front 286

AZT (zidovudine)

Back 286

HIV med used to reduce transmission during birth

Front 287

Suramin

Back 287

Drug used for African sleeping sickness

Front 288

Nifurtimox

Back 288

Drug used in Chagas disease

Front 289

Cefuroxime (2nd) generation, Ceftazidime, Ceftriaxone

Back 289

Cephalosporins able to cross the BBB

Front 290

Cefixime (3rd) generation

Back 290

Cephalosporins NOT able to cross the BBB

Front 291

Ceftriaxone

Back 291

Drug used for N. gonorrhea in females

Front 292

Ceftriaxone or cefuroxime

Back 292

Cephalosporin causes kernicterus in neonates

Front 293

Peripheral neuritis and hepatitis

Back 293

SE of INH

Front 294

Streptomycin

Back 294

Aminoglycoside that is least ototoxic

Front 295

Primaquine

Back 295

Drug used in exoerythrocytic cycle of malaria

Front 296

Minocycline

Back 296

Oral antibiotic of choice for moderate inflammatory acne

Front 297

Dapsone, rifampin and clofazimine combination

Back 297

Drug of choice for leprosy

Front 298

Acyclovir; incorporated into viral DNA and chain termination

Back 298

DOC for herpes and its MOA

Front 299

Sulfonamides

Back 299

Anti-microbials that cause hemolysis in G6PD-deficient patients

Front 300

Inhibition of protein synthesis at the 50s subunit of ribosome

Back 300

MOA of erythromycin

Front 301

sulfamethoxazole/ trimethoprim

Back 301

Anti-biotic frequently used for chronic UTI prophylaxis

Front 302

Aztreonam

Back 302

Lactam that can be used in PCN allergic patients

Front 303

Seizures

Back 303

SE of imipenem

Front 304

Didanosine

Back 304

Anti-viral with a dose limiting toxicity of pancreatitis

Front 305

Sedation

Back 305

Common side effect of hypnotic agents

Front 306

Tolerance

Back 306

Occurs when sedative hypnotics are used chronically or at high doses

Front 307

Additive CNS depression

Back 307

The most common type of drug interaction of sedative hypnotics with other depressant medications

Front 308

Temazpam, trizolam, flurazepam

Back 308

Benzodiazepines used to promote sleep

Front 309

Alprazolam

Back 309

Benzodiazepine used for anxiety

Front 310

Buspirone

Back 310

Non-benzodiazepine used as an anxiolytic

Front 311

Zolpidem

Back 311

Non-benzodiazepine used for sleep

Front 312

REM is decreased

Back 312

Major effect of benzodiazepines on sleep at high doses

Front 313

Anterograde amnesia

Back 313

Neurologic SE of benzodiazepines

Front 314

Ability to cross the placenta

Back 314

Reason benzos are used cautiously in pregnancy

Front 315

Hepatic

Back 315

Main route of metabolism for benzodiazepines

Front 316

Lorazepam, oxazepam, and temazepam

Back 316

Benzodiazepine that undergo extrahepatic conjugation (which are useful in older or hepatically impaired)

Front 317

increase the FREQUENCY of GABA-mediated chloride ion channel opening

Back 317

MOA for benzodiazepines

Front 318

Flumazenil

Back 318

Antidote to benzodiazepine overdose (antagonist that reverses the CNS effects)

Front 319

Diazepam

Back 319

Benzodiazepine with useful relaxant effects in skeletal muscle spasticity of central origin

Front 320

Clonazepam

Back 320

Benzodiazepine that has efficacy against absence seizures and in anxiety states, such as agoraphobia

Front 321

Alprazolam and Clonazepam

Back 321

Benzodiazepines that are the most effective in the treatment of panic disorder

Front 322

Midazolam

Back 322

Benzodiazepine that is used for anesthesia

Front 323

Diazepam

Back 323

DOC for status epilepticus

Front 324

Chlordiazepoxide and Diazepam

Back 324

Longer acting benzodiazepines used in the management of withdrawal states of alcohol and other drugs

Front 325

Diazepam, Flurazepam, chlordiazepoxide, and clorazepate

Back 325

Agents having active metabolites, long half lives, and a high incidence of adverse effects

Front 326

Acute intermittent porphyria

Back 326

Barbiturates may precipitate this hematologic condition

Front 327

Liver enzyme INDUCTION

Back 327

Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetics property

Front 328

Increase the DURATION of GABA-mediated chloride ion channels

Back 328

Barbiturates MOA

Front 329

Thiopental

Back 329

Barbiturate used for the induction of anesthesia

Front 330

Benzodiazepine receptor BZ1 (although do not have a benzodiazepine ring structure)

Back 330

Site of action for zaleplon and zolpidem

Front 331

Zolpidem, zaleplon

Back 331

Good hypnotic activity with less CNS SE than most benzodiazepines

Front 332

Buspirone

Back 332

Agent that is a partial agonist for the 5-HT1A receptor

Front 333

Buspirone

Back 333

Drug of choice for generalized anxiety disorder, NOT effective in acute anxiety

Front 334

Ethanol

Back 334

Agent that is metabolized to acetaldehyde by alcohol dehydrogenase and microsomal ethanol-oxidizing system (MEOS)

Front 335

Ethanol

Back 335

Agent with zero-order kinetics

Front 336

Aldehyde dehydrogenase

Back 336

Rate limiting step of alcohol metabolism

Front 337

MEOS

Back 337

System that increases in activity with chronic ethanol exposure and may contribute to tolerance

Front 338

Aldehyde dehydrogenase

Back 338

Enzyme that metabolizes acetaldehyde to acetate

Front 339

Disulfiram, metronidazole, certain sulfonylureas and cephalosporins

Back 339

Agents that inhibit acetaldehyde dehydrogenase

Front 340

FOMEPIZOLE - used to prevent formation of toxic metabolites from methanol and ethylene glycol ingestion

Back 340

Agent that inhibits alcohol dyhydrogenase and its clinical use

Front 341

Disulfiram

Back 341

Agent used in the treatment of alcoholism, if alcohol is consumed concurrently, acetaldehyde builds up and results in nausea, headache, flushing, and hypotension

Front 342

Peripheral neuropathy (also excessive alcohol use is associated with HTN, anemia, and MI)

Back 342

The most common neurologic abnormality in chronic alcoholics

Front 343

Ethanol

Back 343

Agent that is teratogen and causes a fetal syndrome

Front 344

Ethanol, fomepizole

Back 344

Agent that is the antidote for methanol overdose

Front 345

Fomepizole

Back 345

Drug that inhibits alcohol dehydrogenase and is used in ethylene glycol exposure

Front 346

Hepatic enzymes

Back 346

Most frequent route of metabolism

Front 347

Sodium channel blockade

Back 347

Mechanisms of action for Phenytoin, Carbamazepine, Lamotrigine

Front 348

GABA-related targets

Back 348

MOA for benzodiazepines and barbiturates

Front 349

Calcium channels

Back 349

MOA for Ethosuximide

Front 350

Affect calcium, potassium, and sodium channels

Back 350

MOA for Valproic acid at high doses

Front 351

Valproic acid and Phenytoin

Back 351

Drugs of choice for generalized tonic-clonic and partial seizures

Front 352

Phenobarbital

Back 352

DOC for febrile seizures

Front 353

Ethosuximide and valproic acid

Back 353

Drugs of choice for absence seizures

Front 354

Valproic acid

Back 354

Drug of choice for myoclonic seizures

Front 355

IV diazepam for short term (acute) treatment; phenytoin for prolonged therapy

Back 355

Drugs of choice for status epilepticus

Front 356

Corticosteroids

Back 356

Drugs that can be used for infantile spasms

Front 357

Valproic acid, carbamazepine, phenytoin and gabapentin

Back 357

Anti-seizure drugs used also for bipolar affective disorder (BAD)

Front 358

Carbamazepine

Back 358

Anti-seizure drugs used also for Trigeminal neuralgia

Front 359

Gabapentin

Back 359

Anti-seizure drugs used also for pain of neuropathic orgin

Front 360

Phenytoin

Back 360

Anti-seizure agent that exhibits non-linear metabolism, highly protein bound, causes fetal hydantoin syndrome, and stimulates hepatic metabolism

Front 361

Gingival hyperplasia, nystagmus, diplopia and ataxia

Back 361

SE of phenytoin

Front 362

Carbamazepine

Back 362

Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida

Front 363

Valproic acid

Back 363

Agent that inhibits hepatic metabolism, is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress

Front 364

Serum ammonia and LFT's

Back 364

Laboratory value required to be monitored for patients on valproic acid

Front 365

Stevens-Johnson syndrome

Back 365

SE for Lamotrigine

Front 366

Aplastic anemia and acute hepatic failure

Back 366

SE for Felbamate

Front 367

Valproic acid

Back 367

Anti-seizure medication also used in the prevention of migraines

Front 368

Agranulocytosis

Back 368

Carbamazepine may cause

Front 369

Carbamazepine, gabapentin, lamotrigine, and valproic acid

Back 369

Anti-seizure drugs used as alternative drugs for mood stabilization

Front 370

Most are thought to act at GABA-A receptor - chloride channel

Back 370

MOA of general anesthetics

Front 371

Nitrous oxide

Back 371

Inhaled anesthetic with a low blood/gas partition coefficient

Front 372

Minimum alveolar anesthetic concentration (MAC)

Back 372

Inversely related to potency of anesthetics

Front 373

Halothane and methoxyflurane

Back 373

Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents

Front 374

Decrease arterial blood pressure

Back 374

Most inhaled anesthetics SE

Front 375

Enflurane and halothane

Back 375

Inhaled anesthetics are myocardial depressants

Front 376

Isoflurane

Back 376

Inhaled anesthetic causes peripheral vasodilation

Front 377

Halothane

Back 377

Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis

Front 378

Nitrous oxide

Back 378

Inhaled anesthetic, less likely to lower blood pressure than other agents, and has the smallest effect on respiration

Front 379

Methoxyflurane

Back 379

Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency

Front 380

Nitrous oxide

Back 380

Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia

Front 381

Desflurane

Back 381

Pungent inhaled anesthetic which leads to high incidence of coughing and vasospasm

Front 382

Dantrolene

Back 382

DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics

Front 383

Thiopental

Back 383

IV barbiturate used as a pre-op anesthetic

Front 384

Midazolam

Back 384

Benzodiazepine used adjunctively in anesthesia

Front 385

Flumazenil

Back 385

Benzodiazepine receptor antagonist, it accelerates recovery from benzodiazepine overdose

Front 386

Ketamine

Back 386

This produces "dissociative anesthesia", is a cardiovascular stimulant which may increases intracranial pressure, and hallucinations occur during recovery

Front 387

Fentanyl

Back 387

Opioid associated with respiratory depression, but is used in high risk patients who may not survive full general anesthetia

Front 388

Neuroleptanesthesia

Back 388

State of analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide

Front 389

Propofol

Back 389

Produces both rapid anesthesia and recovery, has antiemetic activity and commonly used for outpatient surgery, may cause marked hypotension

Front 390

Block voltage-dependent sodium channels

Back 390

MOA of local anesthetics (LA's)

Front 391

Hyperkalemia

Back 391

This may enhance activity of local anesthetics

Front 392

Hypercalcemia

Back 392

This may antagonize activity of local anesthetics

Front 393

Vasodilation

Back 393

Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity

Front 394

Cocaine

Back 394

Local anesthetic with vasoconstrictive property, favored for head, neck, and pharyngeal surgery

Front 395

Tetracaine and bupivacaine

Back 395

Longer acting local anesthetics which are less dependent on vasoconstrictors

Front 396

Cocaine and benzocaine

Back 396

These LA's have surface activity

Front 397

CNS toxicity

Back 397

Most important toxic effects of most local anesthetics

Front 398

Cocaine

Back 398

Commonly abused LA which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage, cardiac arrhythmias, and myocardial infarction

Front 399

Prilocaine

Back 399

LA causing methemoglobinemia

Front 400

Neuromuscular blocking drugs

Back 400

Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation

Front 401

Inhaled anesthetics, especially isoflurane, aminoglycosides, and antiarrhythmic

Back 401

These drugs strongly potentiate and prolong effect of neuromuscular blockade (NMB)

Front 402

Nondepolarizing type antagonists

Back 402

These prevent the action of Ach at the skeletal muscle endplate to produce a "surmountable blockade," effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine)

Front 403

Tubocurarine

Back 403

Agent with long duration of action and is most likely to cause histamine release

Front 404

Mivacurium

Back 404

Non-depolarizing skeletal muscle antagonist that has short duration

Front 405

Pancuronium

Back 405

Skeletal muscle agent that can block muscarinic receptors

Front 406

Atracurium

Back 406

Skeletal muscle agent that undergoes Hofmann elimination (breaks down spontaneously)

Front 407

Succinylcholine

Back 407

One depolarizing blocker that causes continuous depolarization and results in muscle relaxation and paralysis, causes muscle pain postoperatively and myoglobinuria may occur

Front 408

Cholinesterase inhibitors

Back 408

During Phase I these agents worsen muscle paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine

Front 409

Spasmolytic drugs

Back 409

Agents acting in the CNS or in the skeletal muscle, used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease

Front 410

Diazepam

Back 410

Facilitates GABA presynaptic inhibition

Front 411

Baclofen

Back 411

GABA agonist in the spinal cord

Front 412

Tizanidine

Back 412

Similar to clonidine and may cause hypotension

Front 413

Dantrolene

Back 413

DOC for malignant hyperthermia by acting on the sacroplasmic reticulum or skeletal muscle

Front 414

Cyclobenzaprine

Back 414

Agent used for acute muscle spasm

Front 415

Drug induced Parkinsonism

Back 415

Irreversible condition resulting from the use of antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog)

Front 416

L-dopa

Back 416

Agent used in drug therapy of Parkinson's instead of Dopamine which has low bioavailability and does not cross the BBB

Front 417

Carbidopa

Back 417

This is combined with L-dopa, inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE's (GI distress, postural hypotension, and dyskinesias)

Front 418

"On-off-phenomenon"

Back 418

Clinical response that may fluctuate in tx of Parkinson's dx

Front 419

Levodopa

Back 419

Anti-Parkinson's drug which increases intraocular pressure and is contraindicated in closed angle glaucoma

Front 420

Bromocriptine

Back 420

Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia

Front 421

Pramipexole and ropinirole

Back 421

Non ergot agents used as first-line therapy in the initial management of Parkinson's

Front 422

Amantadine

Back 422

Enhances dopaminergic neurotransmission SE's include CNS excitation, acute toxic psychosis and livedo reticularis

Front 423

Selegiline

Back 423

Inhibitor of MAO type B which metabolizes dopamine, used adjunct to levodopa or as sole agent in newly diagnosed patients

Front 424

Entacapone and Tolcapone

Back 424

Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson's dx and cause acute hepatic failure (monitor LFT's)

Front 425

Benztropine

Back 425

Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects

Front 426

Propranolol

Back 426

Agent effective in physiologic and essential tremor

Front 427

Tetrabenazine (amine depleting drug), Haloperidol (antipsychotic)

Back 427

Agents used in Huntington's Disease

Front 428

Haloperidol or pimozide

Back 428

Agents used in Tourette's dx

Front 429

Penicillamine

Back 429

Chelating agent used in Wilson's disease

Front 430

Older antipsychotic agents, D2 receptors

Back 430

Extrapyramidal dysfunction is more common with these agents, which block this subtype of dopamine receptor

Front 431

Dopamine blockade

Back 431

MOA of neuroleptics

Front 432

Hyperprolactinemia, menorrhea, galactorrhea, confusion, mood changes, decreased sexual interest, and weight gain

Back 432

Side effects occuring in antipsychotics that block dopamine

Front 433

Older antipsychotics

Back 433

Antipsychotics that reduce positive symptoms only

Front 434

Olanzapine, aripiprazole, and sertindole

Back 434

Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation

Front 435

Risperidone

Back 435

Antipsychotic used in the treatment of psychiatric symptoms in patients with dementia

Front 436

Risperidone

Back 436

Atypical antipsychotic causing high prolactin levels

Front 437

Olanzapine

Back 437

Newer atypical antipsychotic used for bipolar disorder, known to cause weight gain, and adversely affect diabetes

Front 438

Haloperidol

Back 438

Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker

Front 439

Dantrolene

Back 439

Drug used in neuroleptic malignant syndrome

Front 440

Muscarinic blockers

Back 440

Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)

Front 441

Thioridazine

Back 441

Antipsychotic having the strongest autonomic effects

Front 442

Haloperidol

Back 442

Antipsychotic having the weakest autonomic effects

Front 443

Thioridazine

Back 443

Only phenothiazine not exerting antiemetic effects, can cause visual impairment due to retinal deposits, and high doses have been associated with ventricular arrhythmias

Front 444

Clozapine

Back 444

Agent having no effect on D2 receptors, blocks D4, reserved for resistant schizophrenia, and can cause fatal agranulocytosis

Front 445

Clozapine

Back 445

Anti-psychotic not shown to cause tardive dyskinesia

Front 446

Fluphenazine and haloperidol

Back 446

Anti-psychotics available in depot preparation

Front 447

Low-potency typical antipsychotics and clozapine

Back 447

Reduced seizure threshold

Front 448

Low potency phenothiazines and ziprasidone

Back 448

Orthostatic hypotension and QT prolongation

Front 449

Quetiapine

Back 449

Increased risk of developing cataracts

Front 450

Kidneys

Back 450

Major route of elimination for Lithium

Front 451

Lithium toxicity

Back 451

Patients being treated with lithium, who are dehydrated, or taking diuretics concurrently, could develop

Front 452

Theophylline

Back 452

Drug increases the renal clearance hence decreases levels of lithium

Front 453

Cardiac anomalies and is contraindicated in pregnancy or lactation

Back 453

Lithium is associated with this congenital defect

Front 454

Lithium

Back 454

DOC for bipolar affective disorder

Front 455

Low therapeutic index

Back 455

Concern using lithium

Front 456

Tremor, sedation, ataxia, aphasia, thyroid enlargement, and reversible diabetes insipidus

Back 456

SE of lithium

Front 457

Clomipramine, fluoxetine and fluvoxamine

Back 457

Example of three antidepressants that are indicated for obsessive compulsive disorder

Front 458

Norepinephrine and serotonin

Back 458

Neurotransmitters affected by the action of antidepressants

Front 459

2 to 3 weeks

Back 459

Usual time needed for full effect of antidepressant therapy

Front 460

Elderly patients

Back 460

Population group especially sensitive to side effects of antidepressants

Front 461

Side-effect profile and prior pt response

Back 461

All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion

Front 462

SSRI's, bupropion, and venlafaxine

Back 462

Well-tolerated and are first-line antidepressants

Front 463

Monamine oxidase inhibitors

Back 463

Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression

Front 464

Hypertensive crisis

Back 464

Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)

Front 465

Serotonin syndrome

Back 465

MAOI should not be administered with SSRI's or potent TCA's due to development of this condition

Front 466

Tricyclic antidepressants (TCA)

Back 466

Sedation is a common side effect of these drugs, they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis, and chronic pain and their overdose can be deadly

Front 467

Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)

Back 467

Three C's associated with TCA toxicity

Front 468

Tertiary amines

Back 468

Agents having higher sedation and antimuscarinic effects than other TCA's

Front 469

Amitriptyline

Back 469

TCA used in chronic pain, a hypnotic, and has marked antimuscarinic effects

Front 470

Imipramine

Back 470

TCA used in chronic pain, enuresis, and ADD

Front 471

Doxepin

Back 471

TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep

Front 472

Clomipramine

Back 472

TCA used in obsessive compulsive disorder (OCD), most significant of TCA's for risk of seizure, weight gain, and neuropsychiatric signs and symptoms

Front 473

Nortriptyline, Desipramine

Back 473

Secondary amines that have less sedation and more excitation effect

Front 474

Muscarinic blockade (dry mouth, constipation); weak alpha-1 block (orthostatic hypotension); weak hisamine block (sedation)

Back 474

Side effects seen with tricyclic antidepressants

Front 475

Amoxapine

Back 475

Antidepressant associated with neuroleptic malignant syndrome

Front 476

Maprotiline

Back 476

Antidepressant associated with seizures and cardiotoxicity

Front 477

Venlafaxine

Back 477

Antidepressant having stimulant effects similar to SSRI's and can increase blood pressure

Front 478

Venlafaxine

Back 478

Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake

Front 479

Trazodone

Back 479

Antidepressant also used for sleep that causes priapism

Front 480

Nefazodone

Back 480

Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure

Front 481

Bupropion

Back 481

Heterocyclic antidepressants least likely to affect sexual performance, used for management of nicotine withdrawal, SE's include dizziness, dry mouth, aggravation of psychosis, and seizures

Front 482

Mirtazapine

Back 482

Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating

Front 483

Liver toxicity, increased serum cholesterol

Back 483

SE of mirtazapine

Front 484

Citalopram and its metabolite escitalopram

Back 484

Except for these agents all SSRI have significant inhibition of CytP450 enzymes

Front 485

CNS stimulation; GI upset

Back 485

Side effects frequently seen with SSRIs

Front 486

SSRIs

Back 486

Antidepressants with no effect on BP, no sedation

Front 487

Fluoxetine

Back 487

SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx

Front 488

Fluoxetine (Sarafem)

Back 488

SSRI indicated for premenstrual dysphoric disorder

Front 489

Panic attacks, social phobias, bulimia nervosa, and PMDD (premenstrual dysphoric disorder), OCD

Back 489

Some of SSRIs' therapeutic effects beside depression

Front 490

Fluoxetine

Back 490

SSRI less likely to cause a withdrawal syndrome

Front 491

Ascending pathways

Back 491

Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons

Front 492

Presynaptic mu, delta, and kappa receptors

Back 492

Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release

Front 493

Postsynaptic Mu receptors

Back 493

Activation of these receptors open K+ ion channels to cause membrane hyperpolarization

Front 494

Miosis and constipation

Back 494

Tolerance to all effects of opioid agonists can develop except

Front 495

Meperidine

Back 495

All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction

Front 496

Opioid Analgesics

Back 496

SE of these drugs include dependence, withdrawal syndrome, sedation, euphoria, respiratory depression nausea and vomiting, constipation, biliary spasm, increased ureteral and bladder tone, and reduction in uterine tone

Front 497

Morphine, methadone, meperidine, and fentanyl

Back 497

Strong opioid agonists

Front 498

Morphine and fentanyl

Back 498

Opioids used in anesthesia

Front 499

Methadone

Back 499

Opioid used in the management of withdrawal states

Front 500

Fentanyl

Back 500

Opioid available trans-dermally

Front 501

Morphine

Back 501

Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema

Front 502

Meperidine

Back 502

Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI's can lead to serotonin syndrome

Front 503

Codeine, hydrocodone, and oxycodone

Back 503

Moderate opioid agonists

Front 504

Propoxyphene

Back 504

Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures

Front 505

Buprenorphine

Back 505

Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal

Front 506

Naloxone

Back 506

Opioid antagonist that is given IV and had short DOA

Front 507

Naltrexone

Back 507

Opioid antagonist that is given orally in alcohol dependency programs

Front 508

Dextromethorphan, Codeine

Back 508

These agents are used as antitussive

Front 509

Diphenoxylate, Loperamide

Back 509

These agents are used as antidiarrheal

Front 510

NO, chloroform, and diethyl ether

Back 510

Inhalant anesthetics

Front 511

Fluorocarbons and Industrial solvents

Back 511

Toxic to the liver, kidney, lungs, bone marrow, peripheral nerves, and cause brain damage in animals, sudden death has occurred following inhalation

Front 512

Organic nitrites

Back 512

Cause dizziness, tachycardia, hypotension, and flushing

Front 513

Steroids

Back 513

Causes acne, premature closure of epiphyses, masculinization in females, hepatic dysfunction, MI, and increases in libido and aggression

Front 514

Changes in heart rate, blood pressure, respiration, body temperature, sweating, bowel signs, and pupillary responses

Back 514

Readily detected markers that may assist in diagnosis of the cause of a drug overdose include

Front 515

Heroin, morphine, oxycodone, meperidine and fentanyl

Back 515

Most commonly abused in health care professionals

Front 516

IV administration

Back 516

This route is associated with rapid tolerance and psychologic dependence

Front 517

Overdose of opioids

Back 517

Leads to respiratory depression progressing to coma and death

Front 518

Abstinence syndrome

Back 518

Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome

Front 519

Methadone, followed by slow dose reduction

Back 519

Treatment for opioid addiction

Front 520

Naloxone

Back 520

This agent may cause more severe, rapid and intense symptoms to a recovering addict

Front 521

Reduce inhibition, suppress anxiety, and produce relaxation

Back 521

Sedative-Hypnotics action

Front 522

CNS depressants

Back 522

Additive effects when Sedative-Hypnotics used in combination with these agents

Front 523

Depression of medullary and cardiovascular centers

Back 523

Common mechanism by which overdose result in death

Front 524

Flunitrazepam (rohypnol)

Back 524

"Date rape drug"

Front 525

Excessive CNS stimulation (seizures)

Back 525

The most important sign of withdrawal syndrome

Front 526

Long-acting sedative-hypnotic or a gradual reduction of dose, clonidine or propranolol

Back 526

Treatment of withdrawal syndrome involves

Front 527

Ethanol, Barbiturates, and Benzodiazepines

Back 527

These agents are CNS depressants

Front 528

Caffeine

Back 528

Withdrawal from this drug causes lethargy, irritability, and headache

Front 529

Nicotine

Back 529

W/D from this drug causes anxiety and mental discomfort

Front 530

Patches, gum, nasal spray, psychotherapy, and bupropion

Back 530

Treatments available for nicotine addiction

Front 531

Psychotic state, overdose causes agitation, restlessness, tachycardia, hyperthermia, hyperreflexia, and seizures

Back 531

Chronic high dose abuse of nicotine leads to

Front 532

Amphetamines

Back 532

Tolerance is marked and abstinence syndrome occurs

Front 533

Dextroamphetamines and methamphetamine

Back 533

Amphetamine agents

Front 534

DOM, STP, MDA, and MDMA "ecstasy"

Back 534

These agents are congeners of Amphetamine

Front 535

Cocaine "super-speed"

Back 535

Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias, seizures, respiratory depression, or severe HTN (MI and stroke)

Front 536

PCP

Back 536

Most dangerous of the currently popular hallucinogenic drugs, OD leads to nystagmus, marked hypertension, and seizures, presence of both horizontal and vertical nystagmus is pathognomonic

Front 537

Urinary acidification and activated charcoal or continual nasogastric suction

Back 537

Removal of PCP may be aided

Front 538

Marijuana

Back 538

THC is active ingredient, SE's include impairment of judgment, and reflexes, decreases in blood pressure and psychomotor performance occur

Front 539

Bethanechol

Back 539

This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention

Front 540

Pilocarpine

Back 540

Only direct acting agent that is very lipid soluble and used in glaucoma

Front 541

Cevimeline

Back 541

This agent used to treat dry mouth in Sjögren's syndrome

Front 542

Edrophonium

Back 542

Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis

Front 543

Neostigmine

Back 543

Carbamate with intermediate action, used for+A1170 postoperative and neurogenic ileus and urinary retention

Front 544

Physostigmine

Back 544

Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions

Front 545

Pyridostigmine

Back 545

Treatment of myasthenia gravis

Front 546

Echothiophate

Back 546

Antiglaucoma organophosphate

Front 547

Long acting cholinesterase inhibitors

Back 547

Associated with an increased incidence of cataracts in patients treated for glaucoma

Front 548

Malathion

Back 548

Scabicide organophosphate

Front 549

Metrifonate

Back 549

Organophosphate anthelmintic agent with long DOA

Front 550

DUMBELSS (diarrhea, urination, miosis, bronchoconstriction, excitation of skeletal muscle and CNS, lacrimation, salivation, and sweating)

Back 550

Toxicity of organophosphate:

Front 551

Respiratory failure

Back 551

The most frequent cause of acute deaths in cholinesterase inhibitor toxicity

Front 552

Parathion

Back 552

The most toxic organophosphate

Front 553

Atropine

Back 553

Treatment of choice for organophosphate overdose

Front 554

Pralidoxime

Back 554

This agent regenerates active cholinesterase and is a chemical antagonist used to treat organophosphate exposure

Front 555

Nonselective Muscarinic Antagonists

Back 555

Prototypical drug is atropine

Front 556

Benztropine, trihexyphenidyl

Back 556

Treat manifestations of Parkinson's disease and EPS

Front 557

Scopolamine, meclizine

Back 557

Treatment of motion sickness

Front 558

Atropine, homatropine,C1208 tropicamide

Back 558

Produce mydriasis and cycloplegia

Front 559

Ipratropium

Back 559

Bronchodilation in asthma and COPD

Front 560

Dicyclomine, methscopolamine

Back 560

Reduce transient hyper GI motility

Front 561

Oxybutynin, dicyclomine

Back 561

Cystitis, postoperative bladder spasms, or incontinence

Front 562

block SLUD (salivation, lacrimation, urination, defecation

Back 562

Toxicity of anticholinergics

Front 563

"dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat"

Back 563

Another pneumonic for anticholinergic toxicity

Front 564

Infants

Back 564

Atropine fever is the most dangerous effect and can be lethal in this population group

Front 565

Infants, closed angle glaucoma, prostatic hypertrophy

Back 565

Contraindications to use of atropine

Front 566

Severe hypertension

Back 566

Limiting adverse effect of ganglion blockade that patients usually are unable to tolerate

Front 567

Cholinesterase inhibitors

Back 567

Reversal of blockade by neuromuscular blockers

Front 568

Nondepolarizing Neuromuscular Blockers

Back 568

Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis

Front 569

Succinylcholine

Back 569

Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use; has short duration of action

Front 570

Cholinesterase regenerators, pralidoxime

Back 570

Chemical antagonists that bind to the inhibitor of ACh Estrace and displace the enzyme (if aging has not occurred)

Front 571

Pralidoxime, atropine

Back 571

Used to treat patients exposed to insecticides such as parathion

Front 572

You have 1 heart (Beta 1) and 2 lungs (Beta 2)

Back 572

Pneumonic for beta receptors

Front 573

Epinephrine

Back 573

This is the drug of choice for anaphylactic shock

Front 574

Amphetamines

Back 574

Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction

Front 575

Phenylephrine

Back 575

Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia

Front 576

Reduce aqueous secretion

Back 576

Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma by acting to

Front 577

Albuterol

Back 577

Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis

Front 578

Salmeterol

Back 578

Longer acting Beta 2 agonist is recommended for prophylaxis of asthma

Front 579

Beta1 agonists

Back 579

These agents increase cardiac output and may be beneficial in treatment of acute heart failure and some types of shock

Front 580

Alpha1 agonists

Back 580

These agents decrease blood flow or increase blood pressure, are local decongestants, and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion

Front 581

Increasing afterload and tissue perfusion declines

Back 581

Shock due to septicemia or myocardial infarction is made worse by

Front 582

Reduce the loss from area of injection

Back 582

Epinephrine is often mixed with a local anesthetic to

Front 583

Midodrine

Back 583

Chronic orthostatic hypotension can be treated with

Front 584

Terbutaline

Back 584

Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus

Front 585

Epinephrine

Back 585

Sympathetic agent which stimulates heart rate and can dilate vessels in skeletal muscle at low doses

Front 586

Epinephrine

Back 586

Mast cells to reduce release of hisamine and inflammatory mediators

Front 587

Dopamine

Back 587

Agent used in shock because it dilates coronary arteries and increases renal blood flow

Front 588

Dobutamine

Back 588

Agent which stimulates cardiac contractile force more than rate with little effect on total peripheral resistance

Front 589

Ephedrine

Back 589

Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis

Front 590

Hypertension

Back 590

Alpha 1 agonist toxicity

Front 591

Sinus tachycardia and serious arrhythmias

Back 591

Beta 1 agonist toxicity

Front 592

Skeletal muscle tremor, tachycardia

Back 592

Beta 2 agonist toxicity

Front 593

high doses

Back 593

The selective agents loose their selectivity at

Front 594

Phenoxybenzamine

Back 594

Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis

Front 595

Phentolamine

Back 595

Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud's phenomena

Front 596

Prazosin, terazosin, doxazosin

Back 596

Selective Alpha 1 blocker used for hypertension, BPH, may cause first dose orthostatic hypotension

Front 597

Tamsulosin

Back 597

Selective Alpha-1A blocker, used for BPH, but with little effect on HTN

Front 598

Yohimbine

Back 598

Selective Alpha 2 blocker used for impotence (controversial effectiveness)

Front 599

Acebutolol, atenolol, esmolol, metoprolol

Back 599

SelectiveB1 Receptor blockers that may be useful in treating patients even though they have asthma

Front 600

Labetalol and carvedilol

Back 600

Combined alpha and beta blocking agents that may have application in treatment of CHF

Front 601

Pindolol and acebutolol

Back 601

Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma

Front 602

Timolol

Back 602

This beta blocker lacks local anesthetic activity (a property which decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma

Front 603

Esmolol

Back 603

This parenteral beta blocker is a short acting (minutes)

Front 604

Nadolol

Back 604

This beta blocker is the longest acting

Front 605

Acebutolol and atenolol

Back 605

These beta blockers are less lipid soluble

Front 606

Propranolol

Back 606

This beta blocker is highly lipid soluble and may account for side effects such as nightmares

Front 607

Beta blockers

Back 607

Clinical uses of these agents include treatment of HTN, angina, arrhythmias, chronic CHF, and selected post MI patients

Front 608

Beta blockers

Back 608

Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF; signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)

Front 609

Pilocarpine, carbachol, physostigmine

Back 609

Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction

Front 610

Epinephrine, dipivefrin

Back 610

Nonselective alpha agonists that increases outflow, probably via the uveoscleral veins

Front 611

Apraclonidine, brimonidine

Back 611

Selective alpha agonists that decreases aqueous secretion

Front 612

Timolol (nonselective), betaxolol (selective)

Back 612

These Beta blockers decrease aqueous secretion

Front 613

Acetazolamide

Back 613

This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis

Front 614

Prostaglandin PGF2a

Back 614

This agent cause increased aqueous outflow

Front 615

ACE inhibitors

Back 615

Inhibit angiotensin-converting enzyme (ACE)

Front 616

ACE inhibitors

Back 616

Captopril and enalapril (-OPRIL ending) are

Front 617

Dry cough, hyperkalemia

Back 617

SE of ACE inhibitors

Front 618

pregnancy and with K+

Back 618

ACE inhibitors are contraindicated in

Front 619

Angiotensin receptor

Back 619

Losartan and valsartan block

Front 620

Dry cough

Back 620

Angiotensin receptor blockers do NOT cause

Front 621

Calcium channel blockers

Back 621

Agents that block L-type calcium channel

Front 622

Verapamil

Back 622

CCB contraindicated in CHF

Front 623

Nifedipine

Back 623

CCB with predominate effect on arteriole dilation

Front 624

Constipation, edema, and headache

Back 624

SE of CCB

Front 625

Beta-blockers

Back 625

Agents that reduce heart rate, contractility, and O2 demand

Front 626

Beta-1 selective blockers

Back 626

B-blockers that are more cardioselective

Front 627

Atenolol, acebutolol, and metoprolol

Back 627

Cardioselective Beta 1-blockers

Front 628

Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease

Back 628

Beta-blockers should be used cautiously in

Front 629

Propranolol

Back 629

Non-selective Beta-blocker also used for migraine prophylaxis

Front 630

Bradycardia, SEXUAL DYSFUNCTION, decrease in HDL, and increase in Triglycerols (TG)

Back 630

SE of beta blockers

Front 631

Prazosin, terazosin and doxazosin (-AZOSIN ending)

Back 631

Alpha 1selective blockers

Front 632

Phenoxybenzamine

Back 632

Non-selective Alpha1blockers use to treat pheochromocytoma

Front 633

Phentolamine

Back 633

For rebound HTN from rapid clonidine withdrawal

Front 634

Tamsulosin (Flomax)

Back 634

A1a-selective blocker with no effects on HTN used for BPH

Front 635

Orthostatic hypotension (especially with first dose) and reflex tachycardia

Back 635

SE of alpha blockers

Front 636

Clonidine, and methyldopa

Back 636

Presynaptic Alpha 2 agonist used in HTN, and acts centrally

Front 637

Positive Comb's test, depression

Back 637

SE of methyldopa

Front 638

Geriatrics due to its CNS (depression) effects

Back 638

Methyldopa is contraindicated in

Front 639

Rebound HTN, sedation, dry mouth

Back 639

SE of clonidine

Front 640

Hydralazine

Back 640

Direct vasodilator of arteriolar smooth muscle

Front 641

Lupus-like syndrome

Back 641

SE of hydralazine

Front 642

Minoxidil

Back 642

Arterial vasodilator that works by opening K+ channels

Front 643

Hypertrichosis

Back 643

SE of minoxidil

Front 644

Nitroprusside

Back 644

IV Drug used Hypertensive Crisis

Front 645

Arteries and veins

Back 645

Nitroprusside vasodilates

Front 646

Cyanide toxicity treated with sodium thiosulfate

Back 646

Toxicity caused by nitroprusside and treatment

Front 647

Acetazolamide

Back 647

Carbonic anhydrase inhibitor

Front 648

Acetazolamide

Back 648

Diuretic used for mountain sickness and glaucoma

Front 649

Paresthesias, alkalization of the urine (which may ppt. Ca salts), hypokalemia, acidosis, and encephalopathy in patients with hepatic impairment

Back 649

SE of acetazolamide

Front 650

inhibits Na+/K+/2Cl- cotransport

Back 650

MOA of loop diuretics

Front 651

Thick ascending limb

Back 651

Site of action of loop diuretics

Front 652

Hyperuricemia, hypokalemia and ototoxicity

Back 652

SE of loop (furosemide) diuretics

Front 653

Ototoxicity

Back 653

Aminoglycosides used with loop diuretics potentiate adverse effect

Front 654

Calcium

Back 654

Loops lose and thiazide diuretics retain

Front 655

Inhibit Na+/Cl- cotransport

Back 655

MOA of thiazide diuretics

Front 656

Work at early distal convoluted tubule

Back 656

Site of action of thiazide diuretics

Front 657

Sulfonamides

Back 657

Class of drugs that may cause cross-sensitivity with thiazide diuretics

Front 658

Hyperuricemia, hypokalemia and hyperglycemia

Back 658

SE of thiazide (HCTZ) diuretics

Front 659

Na+/K+ exchange

Back 659

Potassium sparing diuretics inhibit

Front 660

Spironolactone

Back 660

Diuretic used to treat primary aldosteronism

Front 661

Gynecomastia hyperkalemia, and impotence

Back 661

SE of spironolactone

Front 662

Mannitol

Back 662

Osmotic diuretic used to treat increased intracranial pressure

Front 663

Desmopressin (DDAVP)

Back 663

ADH agonist used for pituitary diabetes insipidus

Front 664

Demeclocycline

Back 664

Used for SIADH

Front 665

Bone marrow and teeth discoloration for children under 8 years of age

Back 665

SE of demeclocycline

Front 666

Sodium channel blockers

Back 666

MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics

Front 667

Lupus-like syndrome

Back 667

SE of procainamide

Front 668

Prolongs QT interval

Back 668

Limiting side effect of Quinidine

Front 669

Thrombocytopenic purpura, and CINCHONISM

Back 669

Other side effects of Quinidine

Front 670

Increases concentration of Digoxin

Back 670

Major drug interaction with Quinidine

Front 671

Amiodarone

Back 671

DOC for management of acute ventricular arrhythmias

Front 672

Phenytoin

Back 672

DOC for digoxin induced arrhythmias

Front 673

Gingival hyperplasia

Back 673

SE of phenytoin

Front 674

Class IC (flecainide, propafenone, moricizine)

Back 674

Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents

Front 675

B-blockers

Back 675

Class II antiarrhythmics are

Front 676

Sotalol

Back 676

Antiarrhythmic that exhibits Class II and III properties

Front 677

prolongs QT and PR interval

Back 677

Side effect of sotalol

Front 678

Esmolol

Back 678

Used intravenously for acute arrhythmias during surgery

Front 679

B-blockers

Back 679

Anti-arrhythmics that decrease mortality

Front 680

Potassium channel blockers

Back 680

MOA of class III antiarrhythmics

Front 681

Amiodarone

Back 681

Class III antiarrhythmic that exhibits properties of all 4 classes

Front 682

Prolonged half-life, up to six weeks

Back 682

Specific pharmacokinetic characteristic of amiodarone

Front 683

Amiodarone

Back 683

Antiarrhythmic effective in most types of arrhythmia

Front 684

Cardiac dysfunction, photosensitivity, skin (blue smurf syndrome), Pulmonary fibrosis, thyroid and corneal deposits

Back 684

SE of Amiodarone

Front 685

Calcium channel blockers

Back 685

MOA of class IV antiarrhythmics

Front 686

Torsades de pointes

Back 686

Life threatening cardiac event that prolong QT leads to

Front 687

Magnesium sulfate

Back 687

Agent to treat torsades de pointes

Front 688

Digoxin

Back 688

Drug used supraventricular arrhythmias

Front 689

Adenosine

Back 689

DOC for paroxysmal supraventricular tachycardia (PSVT)

Front 690

Activattion on an inward K+ current and inhibition of Ca++ current resulting in marked hyperpolarization

Back 690

Adenosine's MOA

Front 691

Adenosine

Back 691

Anti-arrhythmic with 15 second duration of action

Front 692

Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP

Back 692

MOA of sildenafil (Viagra)

Front 693

Aspirin, Nitrates, CCB, and Beta blockers

Back 693

Drugs used in the management of angina

Front 694

Platelet aggregation inhibition

Back 694

Aspirin reduces mortality in unstable angina by

Front 695

Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles

Back 695

MOA of nitrates

Front 696

Nitroglycerin sublingual tablets

Back 696

Nitrate used for acute anginal attacks

Front 697

Oral and transdermal forms of nitroglycerin

Back 697

Nitrate used to prevent further attacks

Front 698

Tolerance

Back 698

Nitrate free intervals are needed due to

Front 699

Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation

Back 699

SE of nitrates

Front 700

Prinzmetal's angina

Back 700

CCB are DOC for

Front 701

Classic

Back 701

Beta blockers are used for which type of anginal attack

Front 702

Indirectly increase intracellular calcium and cardiac contractility by inhibiting Na+/K+ ATPase

Back 702

MOA of Cardiac glycosides (eg. digoxin)

Front 703

Atrial fibrillation and CHF

Back 703

Digoxin is used in

Front 704

Hypokalemia

Back 704

Digoxin toxicity can be precipitated by

Front 705

Digibind

Back 705

Antidote for digoxin toxicity

Front 706

Amrinone and milrinone

Back 706

Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects

Front 707

Thrombocytopenia

Back 707

SE of amrinone

Front 708

Dobutamine and dopamine

Back 708

Beta 1 agonists used in acute CHF

Front 709

Reducing preload

Back 709

Diuretics work in CHF by

Front 710

Reducing progression of heart failure (never use in acute heart failure)

Back 710

Beta blockers work in CHF by

Front 711

Nesiritide (BNP)

Back 711

Peptide drug used to treat CHF

Front 712

Increasing sodium excretion and decreases arterial and venous tone

Back 712

MOA of nesiritide

Front 713

Excessive hypotension and kidney failure

Back 713

SE of nesiritide

Front 714

Carvedilol

Back 714

Agent used in CHF that is a selective alpha and nonselective beta blocker

Front 715

Nesiritide (Natrecor)

Back 715

Agent used in acutely decompensated CHF resembling natriuretic peptide

Front 716

Warfarin (PT)

Back 716

Vitamin K dependent anticoagulant

Front 717

Pregnancy

Back 717

Warfarin is contraindicated in

Front 718

Heparin

Back 718

Anticoagulant of choice in pregnancy

Front 719

Antithrombin 3

Back 719

Heparin (PTT) increases activity of

Front 720

Oral

Back 720

Route of administration of warfarin

Front 721

IV and IM (only LMW)

Back 721

Routes of administration of heparin

Front 722

Bleeding

Back 722

SE of both warfarin and heparin

Front 723

Heparin induced thrombocytopenia (HIT)

Back 723

SE of heparin

Front 724

Lepirudin

Back 724

Alternative anticoagulant used if HIT develops

Front 725

Vitamin K or fresh frozen plasma

Back 725

Antidote to reverse actions of warfarin

Front 726

Protamine sulfate

Back 726

Antidote to reverse actions of heparin

Front 727

Irreversibly blocking cyclooxygenase

Back 727

MOA of aspirin

Front 728

Aspirin, metoprolol

Back 728

Agent used to treat MI and to reduce incidence of subsequent MI

Front 729

GI bleeding

Back 729

SE of Aspirin

Front 730

Ticlopidine

Back 730

Antiplatelet drug reserved for patients allergic to aspirin

Front 731

Neutropenia and agranulocytosis

Back 731

SE for ticlopidine

Front 732

Clopidogrel and ticlopidine

Back 732

Effective in preventing TIA's

Front 733

Dipyridamole

Back 733

Prevents thrombosis in patients with artificial heart valve

Front 734

Abciximab, tirofiban and eptifibatide

Back 734

Block glycoprotein IIb/IIIa involved in platelet cross-linking

Front 735

Degradation of fibrin clots and are administered IV

Back 735

MOA of thrombolytics

Front 736

Pulmonary embolism and DVT

Back 736

Thrombolytics are used for

Front 737

Streptokinase

Back 737

Thrombolytic that can cause allergic reaction

Front 738

Tissue plasmin activator

Back 738

Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA

Front 739

Cerebral hemorrhage

Back 739

SE of tPA

Front 740

Aminocaproic acid

Back 740

Antidote for thrombolytics

Front 741

Ferrous sulfate

Back 741

Agent to treat hypochromic microcytic anemias

Front 742

Deferoxamine

Back 742

Chelating agent used in acute iron toxicity

Front 743

Cyanocobalamin (Vit B12)

Back 743

Agent for pernicious anemia

Front 744

Vitamin B12

Back 744

Agent used for neurological deficits in megaloblastic anemia

Front 745

Folic acid

Back 745

Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy

Front 746

Erythropoietin

Back 746

Agent used for anemias associated with renal failure

Front 747

G-CSF (filgrastim) and GM-CSF (sargramostim)

Back 747

Agent used neutropenia especially after chemotherapy

Front 748

Interleukin 11 (oprelvekin)

Back 748

Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy

Front 749

Bile acid-binding resins

Back 749

Drugs decrease intestinal absorption of cholesterol

Front 750

Bile acid-binding resins

Back 750

Cholestyramine and colestipol are

Front 751

Impair absorption of fat soluble vitamin absorption (A,D,E,K)

Back 751

Major nutritional side effect of bile acid-binding resins

Front 752

inhibits HMG COA reductase

Back 752

MOA of lovastatin (STATIN)

Front 753

Pregnancy

Back 753

HMG CoA reductase inhibitors are contraindicated in

Front 754

Inhibit Cytochrome P450 3A4

Back 754

MOA of drug or foods (grapefruit juice) that increase statin effect

Front 755

Rhabdomyolysis and Hepatotoxicity

Back 755

SE of HMG COA reductase inhibitors

Front 756

LFT's

Back 756

Monitoring parameter to obtain before initiation of STATINS

Front 757

Niacin

Back 757

Decreases liver triglycerol synthesis

Front 758

Cutaneous flush

Back 758

SE of niacin

Front 759

Aspirin

Back 759

Cutaneous flush and be reduced by pretreatment with

Front 760

Lipoprotein lipase

Back 760

Fibrates (gemfibrozil) increase activity of

Front 761

Nausea

Back 761

Most common SE of fibrates

Front 762

Pregnancy

Back 762

Fibrates are contraindicated in

Front 763

Rhabdomyolysis

Back 763

Concurrent use of fibrates and statins increases risk of

Front 764

Ezetimibe (Zetia)

Back 764

New class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins

Front 765

inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)

Back 765

MOA of NSAIDS

Front 766

Aspirin irreversibly inhibits cyclooxygenase

Back 766

Difference between aspirin and other NSAIDS

Front 767

Anti-inflammatory, analgesia, antipyretic and antiplatelet activity

Back 767

Four main actions of NSAIDS

Front 768

Indomethacin

Back 768

Agent used for closure of patent ductus arteriosus

Front 769

Potential for development of Reye's syndrome

Back 769

Aspirin is contraindicated in children with viral infection

Front 770

Tinnitus, GI bleeding

Back 770

SE of salicylates

Front 771

Diclofenac, ketoralac

Back 771

NSAID also available as an ophthalmic preparation

Front 772

Ketoralac

Back 772

NSAID available orally, IM and ophthalmically

Front 773

Ketoralac

Back 773

NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity

Front 774

Celecoxib

Back 774

Newer NSAID that selectively inhibits COX-2

Front 775

Gastric ulcers and GI Bleeding

Back 775

COX 2 inhibitors may have reduced risk of

Front 776

Pre-existing cardiac or renal disease

Back 776

COX 2 inhibitors should be used cautiously in pts with

Front 777

Antipyretic and analgesic activity

Back 777

Acetaminophen only has

Front 778

Hepatotoxicity

Back 778

SE of acetaminophen

Front 779

N-acetylcysteine

Back 779

Antidote for acetaminophen toxicity

Front 780

Rheumatic disease

Back 780

DMARDs are slow acting drugs for

Front 781

Methotrexate

Back 781

Initial DMARD of choice for patients with RA

Front 782

Methotrexate

Back 782

Drug ofter used in combination with TNF - alpha inhitors for RA

Front 783

Methotrexate

Back 783

Causes bone marrow suppression

Front 784

Aplastic anemia and renal toxicity

Back 784

SE of penicillamine

Front 785

Hydroxychloroquine

Back 785

Interferes with activity of T-lymphocytes

Front 786

Hydroxychloroquine

Back 786

Anti-malarial drug used in rheumatoid arthritis (RA)

Front 787

Retinal destruction and dermatitis

Back 787

SE of hydroxychloroquine

Front 788

Inhibiting dihydroorotate dehydrogenase which leads to decreased pyrimidine synthesis, decreased T cell proliferation and decreased antibody production by B cells

Back 788

MOA of Leflunomide (newer agent)

Front 789

Adalimumab, infliximab and etanercept

Back 789

Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)

Front 790

Sulfasalazine

Back 790

Anti-rheumatic agent also used for ulcerative colitis

Front 791

Infliximab

Back 791

Anti-rheumatic agent also used for Chron's disease

Front 792

Indomethacin

Back 792

NSAID used in gout

Front 793

Aspirin

Back 793

NSAID contraindicated in gout

Front 794

Selective inhibitor of microtubule assembly

Back 794

MOA of colchicine (used in acute gout)

Front 795

Kidney and liver toxicity, diarrhea

Back 795

SE of colchicine

Front 796

Probenecid and sulfinpyrazone

Back 796

Agent used to treat chronic gout by increasing uric acid secretion and excretion

Front 797

Xanthine oxidase

Back 797

Allopurinol treats chronic gout by decreasing uric acid production by inhibiting

Front 798

lispro insulin, aspart insulin, glulisine insulin

Back 798

Rapid acting insulins that do not self-aggregate

Front 799

Insulin glargine

Back 799

Peakless ling acting insulin

Front 800

Adenosine

Back 800

DOC for paroxysmal supraventricular tachycardia; has high efficacy and short duration of action