Xxx - Drugs Bchm

Front 1

Hydroxyurea

- MOA

Back 1

Inhibits Ribonucleotide Reductase

( hyd R o xyu R ea )

Front 2

6-Mercaptopurine (6-MP)

- affects what biochem process & how?

Back 2

blocks DE NOVO Purine synthesis

Front 3

5-Fluorouracil (5-FU)

- MOA

Back 3

inhibits Thymidylate Synthase

(FU - Thy Sins)

Front 4

Methotrexate (MTX)

- MOA

Back 4

inhibits

Dihydrofolate Reductase

Front 5

Trimethoprim (TMP)

- MOA

Back 5

inhibits

BACTERIAL Dihydrofolate Reductase

Front 6

Drugs that DECREASE dTMP

- list 3 anti-neoplastics &/or antibiotics

Back 6

(decrease TMP = TMF)

- Trimethoprim (TMP)
- Methotrexate (MTX)
- Fluorouracil (5-FU)

Front 7

Treatment for:

- Orotic Aciduria

Back 7

PO Uridine

Front 8

What drug inhibits BACTERIAL Dihydrofolate Reductase?

What drug inhibits HUMAN DIhydrofolate Reductase?

Back 8

- Trimethoprim (TMP)

- Methotrexate (MTX)

Front 9

Fluoroquinolones (Cipro)

- MOA

Back 9

- inhibits DNA Gyrase

(specific prokaryote topoisomerase)

Front 10

PROTEIN SYNTHESIS INHIBITORS

- List the drugs that act on 30S ribosomal subunit

Back 10

- Aminoglycosides

- Tetracycline

Front 11

PROTEIN SYNTHESIS INHIBITORS

- List the drugs that act on 50S ribosomal subunit

Back 11

- Clindamycin
- Chloramphenicol
- Erythromycin
- Lincomycin
- Linezolid

Front 12

PROTEIN SYNTHESIS INHIBITORS

- Aminoglycosides MOA

Back 12

- binds to 30S ribosomal subunit and prevents the Formation of the Initiation complex

(also causes misreading of mRNA)

Front 13

PROTEIN SYNTHESIS INHIBITORS

- Tetracycline MOA

Back 13

- binds to 30S ribosomal subunit and prevents the Attachment of Aminoacyl-tRNA

Front 14

PROTEIN SYNTHESIS INHIBITORS

- List the Aminoglycosides

Back 14

- Gentamycin
- Neomycin
- Amikacin
- Tobramycin
- Streptomycin

Front 15

PROTEIN SYNTHESIS INHIBITORS

- which Aminoglycoside is used in Bowel Surgery

Back 15

- Neomycin

Front 16

PROTEIN SYNTHESIS INHIBITORS

- Aminoglycosides are INEFFECTIVE against what microbial organisms? (why?)

Back 16

- Anaerobes

(b/c aminoglycosides requires O2)

Front 17

PROTEIN SYNTHESIS INHIBITORS

- List the Tetracyclines

Back 17

- Tetracycline
- Doxycycline
- Demeclocycline
- Minocycline

Front 18

PROTEIN SYNTHESIS INHIBITORS

- which Tetracycline is Fecally eliminated?

- thus implies what clinically?

Back 18

- Doxycycline

- Contraindicated in Renal Failure patients

Front 19

PROTEIN SYNTHESIS INHIBITORS

- which Tetracycline is ADH antagonist?

- thus implies what clinically?

Back 19

- Demeclocycline

- SiADH Diuretic

Front 20

PROTEIN SYNTHESIS INHIBITORS

- Aminoglycoside toxicity?

Back 20

- Nephrotoxicity

- Ototoxicity

- Teratogen

Front 21

PROTEIN SYNTHESIS INHIBITORS

- Tetracycline toxicity?

Back 21

- Gray teeth

- Inhibits bone growth in kids

(Pregnancy contraindication)

Front 22

PROTEIN SYNTHESIS INHIBITORS

- Aminoglycosides are very effective against what microbial organisms?

Back 22

- Gram Negative Rods

Front 23

PROTEIN SYNTHESIS INHIBITORS

- Tetracycline is effective especially against what microbial organisms?

- why?

Back 23

- Rickettsia
- Chlamydia

- b/c Tetracycline can accumulate intracellularly

Front 24

PROTEIN SYNTHESIS INHIBITORS

- which is BacterioCIDAL?

Back 24

- only Aminoglycosides

Front 25

PROTEIN SYNTHESIS INHIBITORS

- which has limited CNS penetration?

Back 25

- Tetracycline

Front 26

PROTEIN SYNTHESIS INHIBITORS

- which can NOT be taken with Divalent Cation?

- what does Divalent Cation cause?

- list some things with Divalent Cations.

Back 26

- Tetracycline

- Divalent cations prevent gut absorption

- Antacids
- Milk
- Iron containing solutions

Front 27

List the drugs that act on Microtubules

(also list their clinical uses)

Back 27

(microtubes Make Good PVC tubes)
- Mebendazole/Thiabendazole (antihelminthic)
- Griseofulvin (antifungal)
- Paclitaxel (anti-breast cancer)
- Vincristine/Vinblastine (anti-cancer)
- Cochicine (anti-gout)

Front 28

List 2 drugs that inhibit the Sodium Pump (Na+/K+ ATPase)

Back 28

- Oubain

- Cardiac glycosides
(digoxin/digitoxin)

Front 29

Which sodium pump inhibitor DIRECTLY inhibits it?

Back 29

- Cardiac glycosides
(digoxin/digitoxin)

Front 30

Which sodium pump inhibitor INDIRECTLY inhibits it?

How so?

Back 30

- Oubain

- binds to K+ binding site

Front 31

CARDIAC GLYCOSIDES

- upon Directly inhibiting the sodium pump, it will then lead to the Indirect inhibition of?

- causes what change in plasma levels?

- plasma level changes causes what physiological effect?

Back 31

- Na+/Ca2+ exchange pump

- increases [Ca2+]

- increases Cardiac Contractility

Front 32

FAMILIAL ADENEMATOUS POLYPOSIS

- treatment

Back 32

Colon resection

Front 33

HEREDITARY SPHEROCYTOSIS

- treatment

Back 33

Splenectomy (curative)

Front 34

CYSTIC FIBROSIS

- Treatment?
- Tx for what purpose?
- Tx MOA on molecular level?

Back 34

N-Acetylcysteine

Loosen up mucous plugs

Cleaves Disulfide Bonds
(within mucous glycoproteins)

Front 35

What drug can cause Pellegra?

Explain why or how.

Back 35

Isoniazid (INH)

INH induces B6 deficiency.
B6 is a necessary cofactor for the conversion of Trp to Niacin (B3)

Front 36

Isoniazid (INH)

- associated with what vitamin deficiencies?

Back 36

- B3 (indirectly)

- B6 (directly)

Front 37

Niacin

- comes from what vitamin?
- used as treatment in what dz?
- side effects?

Back 37

- B3

- Hyperlipidemia

- Facial Flushing

Front 38

FOLIC ACID

- comes from what vitamin?
- Folic acid deficiency can be caused by what medications?

Back 38

- B9

(PMS)
- Phenytoin
- MTX
- Sulfonamides

Front 39

METHOTREXATE

- MOA
- generally used to treat what?

Back 39

- (human) DHF Reductase inhibitor

- Cancer

Front 40

METHOTREXATE

- what does MTX do to Cancer cells?
- how do you "RESCUE" the non-cancer cells?

Back 40

- Takes Folate away from CA cells

- Give Leukovorin

Front 41

Alcoholic patient with macrocytic, megaloblastic anemia. Next step in management?

Why?

Back 41

- Treat the B12 deficiency

- Prolonged B12 deficiency leads to Irreversible neuropathy

Front 42

Excessive Antibiotic usage & raw egg ingestion will lead to what vitamin deficiency?

Back 42

- Biotin deficiency

Front 43

CARBOXYLATION Enzymes (especially those that add 1C groups) require what cofactor vitamin?

Back 43

- Biotin

Front 44

VITAMIN C

- Antioxidant for what system?

Back 44

- GI

Front 45

VITAMIN C

- required for what enzymes?

Back 45

- Hydroxylation enzymes

(hydroxylases)

Front 46

VITAMIN C

- is a necessary cofactor in what part of the collagen synthesis pathway?

Back 46

(SHaG - PC)

Hydroxylation of Proline & Lysine

Front 47

VITAMIN C

- is a necessary cofactor in what neurotransmitter pathway?

- what is the enzyme involved?

Back 47

Conversion of Dopamine to NE

Dopamine-Beta-Hydroxylase

Front 48

VITAMIN C

- Vitamin C deficiency causes what Dz?

- List some symptoms x4

Back 48

- Scurvy

- Bleeding from Gums
- Bleeding from Hair Follicles
- Easy Bruising
- Poor Wound Healing

Front 49

What vitamin can be used to treat measles?

Back 49

- Vitamin A

Front 50

Severe Acne

- Treatment?
- Tx is based on what vitamin?
- What must be done prior to Tx?
- Why?

Back 50

- Isotretinoin

- Vitamin A

- Pregnancy test

- Excess Vitamin A is teratogenic

Front 51

Neonates are given what vitamin injection at birth?

To Prevent what?

Back 51

- Vitamin K

- Neonatal Hemorrhage

Front 52

Warfarin

- MOA
- administered how?

Back 52

- Vitamin K antagonist
(competitive inhibition)

- PO

Front 53

WARFARIN

- what is its electrical charge?
- why important & clinical correlation

Back 53

- neutral

- crosses placenta
- thus Teratogenic

Front 54

WARFARIN

- follow what lab values?
- why?

Back 54

- PT
(also INR increases 2-3 times normal)

- b/c Warfarin inhibits Extrinsic Pathway

Front 55

HEPARIN

- follow what lab values?
- why?

Back 55

- aPTT

- b/c Heparin inhibits the Intrinsic clotting pathway

Front 56

How do you use Anticoagulation drugs in treatment?

(regarding Heparin & Warfarin)

Back 56

- Always give Heparin first (x2 days)

- Then give Warfarin

Front 57

ANTICOAGULATION DRUGS

- why can you NOT give Warfarin first?

Back 57

Protein C is a thrombolytic with shortest half life.
If you give Warfarin first, it will eliminate Protein C first, thus it will INCREASE CLOTTING.

Front 58

ANTICOAGULATION DRUGS

- if you give Warfarin prior to giving Heparin, then what is the 1st sign that is seen?

Back 58

- Skin necrosis

Front 59

ANTICOAGULATION DRUGS

- Tx to reverse Warfarin

Back 59

- Vitamin K infusion

Front 60

ANTICOAGULATION DRUGS

- Tx to reverse Heparin

Back 60

- Protamine Sulfate

Front 61

ANTICOAGULATION DRUGS

- if acute bleed with INR > 3, then what Tx is administered?

Back 61

- Fresh Frozen Plasma

Front 62

ANTICOAGULATION DRUGS

- MC side effect of Heparin?
- 2nd MC side effect of Heparin?
- 3rd MC side effect of Heparin?

Back 62

- Bleeding

- Hyperlipidemia

- Heparin-Induced-Thrombocytopenia

Front 63

ANTICOAGULATION DRUGS

- Heparin can cause Hyperlipidemia by activating what?

- What else can activate the same thing?

Back 63

- Hormone Sensitive Lipase

- Glucagon

Front 64

ANTICOAGULATION DRUGS

- How does Heparin cause HIT (Heparin Induced Thrombocytopenia)?

Back 64

- Heparin sits on top of platelets, making it look foreign, thus triggering autoimmune response.

Front 65

HEPARIN

- acts as a cofactor for?
- thus causes what effect (MOA) on which clotting factors?

Back 65

- Antithrombin III

Blocks
- Thrombin
- Clotting factors 9, 10, 11, 12

Front 66

HEPARIN

- why is Heparin not a teratogenic like Warfarin?

Back 66

- electrically charged

(so it won't cross placenta)

Front 67

If a patient on Heparin suffers a Pulmonary Embolism, what is the next step in treatment?

Back 67

- IVC Filter

Front 68

HEPARIN

- in order to reduce side effects of Heparin (aka - unfractionated heparin), what is the next step in Tx?

Back 68

- switch to Low Molecular Weight Heparin

Front 69

B3 Deficiency causing drugs

B6 Deficiency causing drugs

B9 Deficiency causing drugs

Back 69

- INH (indirectly from B6 def.)
- OC (indirectly from B6 def.)

- INH
- OC

- Phenytoin
- MTX
- Sulfonamides

Front 70

List 2 drugs that are involved with ethanol metabolism

Back 70

- Fomepizole

- Disulfiram (Antabuse)

Front 71

Fomepizole

- MOA

Back 71

- inhibits Alcohol DHase

Front 72

Disulfiram

- MOA

Back 72

- inhibits Acetaldehyde DHase

Front 73

If a patient taking Disulfiram drinks alcohol, what symptoms would be experienced? Why?

Back 73

- Hangover

- Due to Acetaldehyde accumulation
(acetaldehyde causes hangover Sx)

Front 74

Methanol poisoning antidote?

Back 74

Fomepizole

Front 75

Ethylene glycol poisoning antidote?

Back 75

Fomepizole

Front 76

What 2 vitamin deficiencies can occur with prolonged use of broad spectrum antibiotics?

Back 76

(Broad speKtrum antibiotics)

- Biotin

- Vitamin K

Front 77

PYRUVATE DHase DEFICIENCY

- Treatment?
- give examples of treatment?

Back 77

- Increase intake of Ketogenic nutrients
(so you have less glucogenic AA)

- High Fat content diet
- Diet high in Leucine & Lycine

Front 78

Electron Transport Inhibitors

- list them

Back 78

(ARCC)

- Antimycin A
- Rotenone
- Carbon Monoxide
- Cyanide

Front 79

Electron Transport Inhibitors

- MOA
- effects on Proton Gradient
- effects on ETC

Back 79

- Direct inhibition of the ETC

- Decreases proton gradient

- Stops ETC (stops ATP synthesis)

Front 80

ATPase Inhibitors

- list them

Back 80

- Oligomycin

Front 81

ATPase Inhibitors

- MOA
- effects on Proton Gradient
- effects on ETC

Back 81

- Directly inhibits mitochondrial ATPase

- INCREASES proton gradient

- Stops ETC (stops ATP synthesis)

Front 82

Uncoupling Agents

- list them

Back 82

(DAT)

- 2,4 DNP
- ASA
- Termogenin

Front 83

Uncoupling Agents

- MOA
- effects on Proton Gradient
- effects on ETC

Back 83

- Increases Proton PERMEABILITY

- Decreases proton gradient

- ETC will CONTINUE

Front 84

Which ETC/Ox Phos poison also increases HEAT production?

What else does it increase?

Back 84

- Uncoupling Agents (DAT)

- O2 consumption

Front 85

Fructose Intolerance

- Tx?

Back 85

Decrease intake of:
- Fructose
- Sucrose

(note Sucrose = Glucose + Fructose)

Front 86

Classic Galactosemia

- Tx

Back 86

EXCLUDE

- Galactose
- Lactose

Note: Lactose = Galactose + Glucose

Front 87

Lactase Deficiency

- Tx

Back 87

- avoid dairy foods

or add lactase pills to diet

Front 88

HYPERAMMONEMIA

- First Tx option?
- What medications can be given to decrease ammonia levels?

Back 88

- Limit Protein in Diet

- Benzoic acid
- Phenylbutyrate

Front 89

CARBIDOPA

- blocks what enzyme?
- blocks what reaction?

Back 89

- Dopamine Beta-Hydroxlase

- Dopamine ===> Norepinephrine

Front 90

PHENYLKETONURIA (PKU)

- Tx?

Back 90

- Increase Tyrosine in diet

- Decrease Phenylalanine in diet
(contained in aspartame, i.e. - nutrasweet)

Front 91

HOMOCYTEINURIA

- if due to Cystathionine Synthase defciency, then what is the Tx?

Back 91

Dietary Increase of:
- Cysteine
- B9 (Folic acid)
- B12

Dietary decrease of:
- Methionine

Front 92

HOMOCYTEINURIA

- if due to Cystathionine Synthase defciency, then what is the Tx?

Back 92

- Dietary increase in B6

Front 93

CYSTINURIA

- Tx?
- reasoning behind Tx?

Back 93

- Acetazolamide

- in order to ALKALANIZE the urine