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Q0001:Bioavailability


- Measure of absorption;- F = AUC oral/AUC injected x100;AUC = Area Under the Curve of;[Plasma] vs. Time


Q0002:Volume of Distribution


- Vd = D/C (mL);D = amount of drug in body;C = [plasma];-Low Vd -> drug in plasma;- Med Vd -> in p & interstitium;-

High Vd -> in p; i; & tissues/cells


Q0003:Drug Metabolism: Phase I v II


Phase I;-Converts lipophilic into slightly polar; water-solublemetabolites;- Cytochrome P-450;Phase II;-Yields very polar;

inactive metabolites that the kidneys can excrete;- Conjugationreactions


Q0004:Clearance (CL)


CL = rate of drug elimination/[plasma];= rate at which avolume of fluid is cleared of drug;= blood flow x extraction

rate;= Vd x Ke (L/hr)


Q0005:Elimination constant (Ke)


Ke gives information about the amount of time to reach asteady state or wash-out;Ke = CL/Vd (1/hr);*independent of

drug dose.


Q0006:Half-life (t1/2)


Time required to change amount of drug in body by 1/2;t1/2 =ln(0.5)/-Ke = 0.693Vd/CL;Infusion: 94%Css - 4 t1/2;87.5% -

3;75% - 2;50% - 1


Q0007:Stead State Plasma Concentration (Css)


elimination = rate of administration;Css = R/(Vd x Ke) =R/CL;R = infusion rate (amount/time)


Q0008:Loading & Maintenances doses


Loading dose = Vd x Cp/F;Maintenance = Cp x CL/F;Cp =target plasma Css


Q0009:Pharmacodynamics: Efficacy v. Potency


Efficacy = maximal response produced by a drug (~Vmax);Potency = amount required to elicit a response;

expressed as ED50=EC50= dose causing 50% max effect


Q0010:Pharmacodynamics: antagonists and partial agonists


Competitive ant: decreases potency;Noncompetitive ant:decreases efficacy;Partical ag: lower max. efficacy than full;

(potency is independent of efficacy)


Q0011:Urine pH - fx on drug elimination


Weak acids: pH = pKa + log(A-/HA);-Digested in acidicenvironments (<pKa);-Trapped in basic environment (A-);-

Treat overdose with bicarbonate;Weak bases: pH = pKa + log(B/BH+);-Digested in basic environments (>pKa);-Trapped inacidic environment (BH+);-Treat overdose with ammonium Cl


Q0012:Therapeutic index


TD50/ED50 = median toxic dose/median effectivedose;Measure of drug safety (higher # is more safe)


Q0013:Maximum dosing interval (tau-max)


Concentration constrained dosing;tau-max = ln(Cmax/Cmin)/k


Q0014:(amount of drug)/(fluid compartment concentration)


Vd


Q0015:protein bound drugs;liver and kidneydisease;pharmacodynamic variable altered?


Vd


Q0016:Vd eq


Vd = drug amount/drug concentration


Q0017:Cl eq


Cl = elimination rate/[drug]


Q0018:t1/2 eq


t1/2 = .7*Vd/Cl


Q0019:10% remaining concentration;# half lives?


3.3


Q0020:12.5% remaining concentration;# half lives?


3


Q0021:25% remaining concentration;# half lives?


2


Q0022:Loading dose eq


Loading dose = Cp*Vd/F


Q0023:Maintenance dose eq


Maintanence Dose = Cp*CL/F;Cp= target [drug];F =bioavailability


Q0024:change in loading dose with renal/hepatic disease


Unchanged


Q0025:change in maintanence dose with renal/hepatic disease


lower


Q0026:zero order elimination;constant __ of drug eliminatedper time


amount


Q0027:first order elimination;constant __ of drug eliminatedper time


fraction


Q0028:zero order elimitation;Cp decreaseslinearly/exponentially?


linearly


Q0029:first order elimination;Cp decreaseslinearly/exponentially?


exponentially


Q0030:Phase I metabolism;resulting metabolite characteritics


slightly polar;water soluble;often still active


Q0031:Phase I metabolism reactions


oxidation;reduction;hydrolysis


Q0032:oxidation;reduction;hydrolysis;Phase?


Phase I


Q0033:cytochrome P-450;phase?


Phase I


Q0034:Phase II metabolism;resulting metabolitecharacteristics


very polar;inactive;*renally excreted


Q0035:Phase II metabolism reactions


acetylation;glucuronidation;sulfanation


Q0036:acetylation;glucuronidation;sulfanation;Phase?


Phase II


Q0037:conjugation;Phase?


Phase II


Q0038:Phase metabolism lost in geriatrics


Phase I


Q0039:competitive antagonist effect on agonist dose curve


shift to right;**decreased potency


Q0040:noncompetitive antagonist effect on agonist dose curve


shifts downward;**decreased efficacy

Q0041:EC50 vs Kd in system w/ spare receptors

EC50 < Kd

Q0042:partial agonist vs full agonist

less efficacy

Q0043:phase 1 clinical trial questions

is it safe?;pharmacokinetics?

Q0044:Phase 2 clinical trial questions?

does it work in patients?


Does it work double blind?


Postmarketing is it safe?

Q0047:amount of drug in body/_______ = Vd

plasma drug concentration ;;(Vd is Volume of Distribution)

Q0048:rate of elimination of drug/[plasma drug] = ?

CL (Clearance)

Q0049:(.7)(Vd)/CL = ?

T 1/2

Q0050:A drug infused at a constant rate reaches about 94% ofsteady state after _______ t 1/2s.

4

Q0051:A loading dose is calculated using this formula.

Loading Dose = (Cp)(Vd)/F ;(Cp = target plasma conc; F =bioavailability)

Q0052:A maintenance dose is calculated using this formula.

(Cp)(CL)/F;(CL = Clearance)

Q0053:Rate of elimination is proportional to _______ ______in 1st order elimination.

drug concentration

Q0054:In the case of EtOH; which is elimated by _____ orderelimination; a constant amount of drug is eliminated per unit

time.

zero

Q0055:Phase ____ (I or II) reactions yield slightly polarmetabolites that are often _____ (active or inactive)

I; active

Q0056:Phase ____ (I or II) reactions yield very polarmetabolites that are often _____ (active or inactive) and are

excreted by the _______.

II; inactive; kidney

Q0057:Phase II reactions are often of this type.

conjugation

Q0058:Cytochrome P-450 is involved in _____ phase (I or II)reactions.

I

Q0059:A drug patent lasts for _____ years after filing forapplication.

20

Q0060:How many phases are there in drug development?

4

Q0061:Drugs are first tested in patients in phase _____ ofclinical testing; pharmacokinetic safety is determined in phase______ of clinical testing; double blind tests are done in phase

____ and post-market surveillance is done in phase _____.

2;1;3;4

Q0062:In a dose response curve; a competitive antagonistshifts the curve _____;a non-competitive antagonist shifts the

curve ______.

right;down

Q0063:What pharmacologic relationship would determine theexistence of spare receptors?

EC50 is lower then Kd (EC50 is more to the left)

Q0064:What does it mean if EC50 and Kd are equal?

The system does not have spare receptors

Q0065:A partial agonist acts on the same receptor system asa full agonist? T/F

TRUE

Q0066:What's the main difference between a partial agonistand a full agonist?

A partial agonist has a lower maximal efficacy.

Q0067:Is a partial agonist less potent than a full agonist?

Not necessarily. It can be less; more or equally potent as a fullagonist.

Q0068:Equation for Half Life

T 1/2 = (0.7 x Vd)/CL

Q0069:Percent of concentration in the following number ofhalf lives;1;2;3;3.3

1 = 50%;2 = 75%;3 = 87.5%;3.3 = 90%

Q0070:How do the Loading and Maintenance doses change ina patient w/ Renal or Hepatic dysfunction?

Loading - unchanged;;Maintenance - Decreased

Q0071:Equation for Theraputic Index

TI = Toxic dose/Effective dose

Q0072:Phase in clinical drug testing;safety; pharmacokinetics

1

Q0073:Phase in clinical drug testing;Protocol; dose level; workon patients

2

Q0074:Phase in clinical drug testing;double blind study;efficacy; adverse effects

3

Q0075:(3) drugs that use Zero-order elimination

Alcohol;;Aspirin;;Phenytoin

Q0076:What phase of a reaction uses cytP-450?;What is thepurpose of this phase?

Phase I;converts lipophilic to polar

Q0077:What is the main focus of Phase II reactions?

Conjugation

Q0078:When pH < pKa; what is more common?;(2);whichcan pass through the membrane?

HA and BH+;;HA passes thru the membrane (uncharged)

Q0079:Definition;Amount of the drug required for a givenresponse

Potency

Q0080:what is the first NT to everything?;the first receptor?

NT: ACh;Receptor: Nicotinic

Q0081:what system does not have a synapse from the spinalcord to the tissue?

Somatic NS;(skeletal muscle);ACh to Nicotinic receptor

Q0082:what is the only sympathetic ACh?;what is thereceptor?

Sweat gland;;receptor: Muscarinic

Q0083:what is the receptor for the Parasympathetic systemat the tissue?

Muscarinic

Q0084:what are the Adverse Effects of Acetylcholine?;whichis the only Nicotinic receptor response?

DUMBBELSS;Diarrhea; Urination;Miosis;Bradycardia;Bronchoconstriction;Excite skeletal muscle

(N);Lacrimation;Sweat; Salivation

Q0085:what receptors use Gq as their second messenger?;(5)

HAVe 1 M&M;H1;Alpha1;V1;M1;M3

Q0086:what G-protein uses Phospholipase C?

Gq

Q0087:what receptors use Gi as their secondmessenger?;action?

MAD 2s;M2;Alpha2;D2;inhibits Adenylyl Cyclase

Q0088:what receptor increases gastric acid secretion?

H2

Q0089:Inhibits choline re-entering the presynaptic terminal

Hemicholinium

Q0090:Inhibits ACh into vesicles

Vesamicol

Q0091:Inhibits NE into vesicles

Reserpine

Q0092:Inhibits release of ACh into synaptic membrane

Botulinum

Q0093:Inhibits release of NE into synaptic membrane

Guanethidine

Q0094:Promotes release of NE into synaptic membrane

Amphetamines

Q0095:Inhibits reuptake of NE into presynaptic nerve;(2)

Cocaine;TCA

Q0096:what receptor does NE act on in the presynapticneuron as neg feedback to inhibit its release?

alpha-2

Q0097:(3) Cholinomimetrics and use of each

Bethanechol - post-OP activates GI/GU;Carbachol -Glaucoma;Pilocarpine - Glaucoma

Q0098:Anticholinesterase used for post-OP activation ofGI/GU; myasthinia gravis;what is it an antidote for?

Neostigmine;;antidote: Curarae (NMJ block)

Q0099:Anticholinesterase used for glaucoma and crossesBBB;what is it an Antidote for?

Physostigmine;;antidote: Atropine overdose

Q0100:(3) ACh receptor blockers

Atropine;;Scopalamine;;Ipratropium

Q0101:ACh receptor blocker used for Motion Sickness

Scopolamine;(DOC)

Q0102:ACh receptor blocker used for Asthma/COPD

Ipratropium

Q0103:what drug slows the HR at 0.5mg and increases it at>1.0mg?

Atropine;(muscarinic antagonist)

Q0104:what are the AE of Atropine?

Opposite of DUMBBELSS;Hot as hare;Dry as bone;Red asbeet;Blind as Bat;Mad as hatter

Q0105:Insecticide antidote

Atropine

Q0106:Nicotinic ACh receptor antagonist;use?

Hexamethonium;use;prevents reflex bradycardia caused byNE

Q0107:drug used for intubation for its rapid onset and quickduration in causing flaccid paralysis

Succinylcholide

Q0108:which NMJ (nicotinic) blocker also releaseshistamine?

Tubocurarine

Q0109:Epinepherine effects on;1. BP;2. HR;3. TPR

Epinepherine;BP: Inc Systolic; Dec Diastolic;HR: Inc(tachycardia);TPR: Dec

Q0110:NE effects on;1. BP;2. HR;3. TPR

NE;BP: BIG INC in systolic and diastolic;HR:DECREASES;TPR: BIG INCREASE

Q0111:Isoproterenol effects on;1. BP;2. HR;3. TPR

Isproterenol;BP: Decrease in systolic and diastolic;HR: BIGINCREASE;TPR: BIG DECREASE

Q0112:DOC for Shock to increase renal perfusion and forCHF to increase CO

Dopamine

Q0113:DOC for CHF to increase CO w/o increasing oxygendemand

Dobutamine

Q0114:Alpha agonist that is used for HTN w/ renal Dz

Clonidine

Q0115:what occurs if atropine is given before NE?

Heart rate increases instead of decreases

Q0116:a1-blocker for urinary retention in BPH and HTN

Prazosin

Q0117:a2-blocker for depression

Mirtazapine

Q0118:what occurs w/ BP if a-blocker is given beforeIsoproterenol?

No change!

Q0119:what occurs w/ BP if a-blocker is given beforeEpinepherine?

Reverses the vasoconstriction effect of Epi and Decreases BP

Q0120:which beta-blockers are beta1 selective?

if they start w/ A-M in alphabet;(except Labetalol - partialagonist)

Q0121:what glaucoma drug should not be used in closed-angleglaucoma?

Epinepherine

Q0122:Antidote/Tx for;Salicylates

Alkalinize urine

Q0123:Antidote/Txfor;Anticholinesterases;Organophosphates;(2)

Atropine;;Pralidoxime

Q0124:Antidote/Tx for;Antimuscarinic;Anticholinergic agents

Physostigmine

Q0125:Antidote/Tx for;beta-blockers

Glucagon

Q0126:Antidote/Tx for;Digitalis;(4)

Stop Dig;;normalize K;;Lidocaine;;Magnesium

Q0127:Antidote/Tx for;Iron

Deferoxamine

Q0128:Antidote/Tx for;Lead;(3)

CaEDTA;;Dimercaprol;;Succimer (kids)

Q0129:Antidote/Tx for;Arsenic; gold; mercury;(2)

Dimercaprol;;Succimer (kids)

Q0130:Antidote/Tx for;Copper

Penicillamine

Q0131:Antidote/Tx for;Cyanide;(3)

Nitrite;;Hydrocobalamin;;Thiosulfate

Q0132:Antidote/Tx for;Methemoglobin

Methylene Blue

Q0133:Antidote/Tx for;Carbon Monoxide

100% O2;(or hyperbaric O2)

Q0134:Antidote/Tx for;Methanol;Ethylene glycol(antifreeze);(2)

Ethanol;;Fomepizole

Q0135:Antidote/Tx for;Opioids;(2)

Naloxone;;Naltrexone

Q0136:Antidote/Tx for;Benzodiazepines

Flumazenil

Q0137:Antidote/Tx for;TCAs

NaHCO3

Q0138:Antidote/Tx for;Heparin

Protamine

Q0139:Antidote/Tx for;Warfarin;(2)

Vitamin K;;FFP

Q0140:Antidote/Tx for;tPA; Streptokinase

Aminocaproic acid

Q0141:Urine pH and drug elimination for;Weak acids

alkalinize urine w/ Bicarb

Q0142:Urine pH and drug elimination for;Weak bases

Acidify urine w/ NH4Cl

Q0143:What is the reversible cholinesterase inhibitorindicated for the Tx of Alzheimer's Dz?

Tacrine

Q0144:what is the skeletal muscle relaxant that acts directlyon the contractile mechanism of the muscle fiber?

Dantrolene

Q0145:which Glaucoma agent acts by decreaseing productionof aqueous humor?

Timolol

Q0146:why is Epi mixed w/ anesthetics?

to retard the systemic absorption

Q0147:which muscles are most affected by tubocurarine?

fine movement muscles (head; neck; face)

Q0148:what is the alpha receptor-assoc eye muscle?

Radial muscle

Q0149:what agent for bronchial asthma causes tremor?

Salmeterol;(b-agonist)

Q0150:what ANS drug class masks hypoglycemia in treateddiabetics?;how?

b-blockers;;blocks catecholamines; which stimulateGlyconeogenesis

Q0151:(2) MAO inhibitors that are used for depression

Tranylclpromine;;Phenelzine sulfate

Q0152:DOC for thyroid storm

Propranolol

Q0153:Definition;two drugs act on the same tissue viaindependent receptors resulting in effects in the opposite

direction

Physiologic antagonist

Q0154:Definition;when two drugs combine and the activity ofone or both drugs is blocked

Chemical antagonist

Q0155:equation for the Elimination constant;(2)

Ke = 0.7/half-life = CL/Vd

Q0156:when calculating an IV dosage; what needs to beremembered?

multiply drug (mg/kg) by weight (kg)

Q0157:(2) equations for Extraction ratio

ER = (Ci-Co)/Ci = CL/Q

Q0158:Which is not absorbed well in the stomach;Aspirin(pKa = 3) or Propranolol (pka = 9.4)?

Propranolol

Q0159:the AE of convulsions are MC w/ what drug?

Strychnine

Q0160:what drug can cause Hypocalemic Tetany?

Edetate Disodium (Na-EDTA)

Q0161:what mineral toxicity can decrease Amylase secretion?

Zinc

Q0162:AE of drug is Congenital goiter; Hypothyroidism

Methimazole

Q0163:AE of drug is Agenesis of fetal kidneys

Chlorambucil

Q0164:Km: Definition

Km = Substrate at 0.5*Vmax;Km reflects the affinity of theenzyme for its substrate

Q0165:Vmax indicates what?

Vmax is directly proportional to the enzyme concentration.

Q0166:Relationship between Km and affinity

-The lower the Km; the higher the affinity;-Smaller Km meansenzyme is saturated earlier; which means that small amounts

of substrate are picked up by the enzyme.

Q0167:Reading an inverse curve: Y-intercept equals ?

1/Vmax;The higher the Y-intercept the lower the Vmax

Q0168:Reading an inverse curve: X-intercept equals ?

(1/-Km);The further to the right the x-intercept; the greaterthe Km

Q0169:Reading an inverse curve: Slope equals ?

Km/Vmax

Q0170:Reading an inverse curve: Effect of a competitiveinhibitor

X-intercept farther to the right; meaning Km is greater;because you need more substrate to get the same effect as thecompetitive inhibitor is hogging the enzyme;The y-interceptis the same; meaning Vmax hasn't changed; because there isn't

any more enzyme;;The slope is greater; because Km hasincreased while Vmax has stayed the same.

Q0171:Reading an inverse curve: Effect of a noncompetitiveinhibitor

The x-intercept is the same; meaning Km is the same; becausethe affinity for the enzyme hasn't changed; there's just less of

it;;The y intercept has increased; meaning Vmax hasdecreased; because enzyme has been inactivated by the

noncompetitive inhibitor;The slope is greater; because Vmaxhas decreased while Km has stayed the same.

Q0172:Competitive inhibitor: Resemble substrate

Yes

Q0173:Competitive inhibitor: Overcome by increasedsubstrate?

Yes

Q0174:Competitive inhibitor: Binds active site?

Yes

Q0175:Competitive inhibitor: Effect on Vmax

Unchanged. The amount of enzyme has not changed.

Q0176:Competitive inhibitor: Effect on Km

Increased. A lot more substrate needs to be available to seizethe active sites.

Q0177:Noncompetitive inhibitor: Resemble substrate?

No

Q0178:Noncompetitive inhibitor: Overcome by increasedsubstrate?

No

Q0179:Noncompetitive inhibitor: Binds active site?

No

Q0180:Noncompetitive inhibitor: Effect on Vmax

Decreased. Takes the enzyme out.

Q0181:Noncompetitive inhibitor: Effect on Km

Unchanged. Does not change the affinity for the enzyme.

Q0182:Volume of distribution: Abbreviation

Vd

Q0183:Vd: Stands for what?

Volume of distribution

Q0184:Volume of distribution: definition

Vd = (amount of drug in the body)/(plasma drugconcentration)

Q0185:Volume of distribution: What alters it?

Liver and kidney disease

Q0186:Where are drugs with a low Vd distributed?

plasma

Q0187:Where are drugs with a medium Vd distributed?

extracellular space

Q0188:Where are drugs with a high Vd distributed?

tissues

Q0189:Clearance: definition

=(rate of elimination of drug)/(plasma drugconcentration);=Vd x Ke where Ke=elimination constant

Q0190:Half life: definition

The time required to change the amount of drug in the bodyby 1/2 during elimination (or during a constant infusion).

Q0191:What percentage of steady state is a drug at after: 1half life

50%

Q0192:What percentage of steady state is a drug at after: 2half lives

75%


87.50%

Q0194:What percentage of steady state is a drug at after: 3.3half lives

90%


94%

Q0196:How many half lives does it take for a drug to reachthe following percentage of steady state: 50%

1 half life


2 half lives

Q0198:How many half lives does it take for a drug to reachthe following percentage of steady state: 87.5%

3 half lives


3.3 half lives


4 half lives

Q0201:Cp stands for what?

target plasma concentration

Q0202:What is the abbreviation for target plasmaconcentration?

Cp

Q0203:In pharmacology; what is F an abbreviation for?

Bioavailability

Q0204:What is the abbreviation in pharmacology forbioavailability?

F

Q0205:Loading dose: Definition

Loading dose = (Cp * Vd)/F (where Cp equals the targetplasma concentration; Vd equals volume of distribution; and F

equals bioavailability)

Q0206:Maintenance dose: Definition

Maintenance dose = (Cp * CL)/F (where Cp is the targetplasma concentration and CL is clearance and F is

bioavailability)

Q0207:Zero-order elimination: definition

Constant elimination over time regardless of drug.

Q0208:How does Cp vary with time during zero-orderelimination?

Cp decreases linearly with time.

Q0209:Zero-order elimination: Drug examples

-Ethanol;-Phenytoin;-Aspirin (at high concentrations)

Q0210:First-order elimination: definition

Rate of elimination is proportional to drug concentration

Q0211:Zero-order elimination vs First-order elimination:Comparison

Zero-order: Constant amount of drug eliminated per unittime;1st-order: Constant fraction of drug eliminated per unit

time

Q0212:How does Cp vary with time during first-orderelimination?

Cp decreases exponentially with time.

Q0213:Urine: Which species get trapped in urine?

Ionized species

Q0214:In what kind of environment is the following trapped?:Weak acids

Basic environments

Q0215:In what kind of environment is the following trapped?:Weak bases

Acidic environments

Q0216:In what kind of environment is the followingdigested?: Weak acids

Acidic environments (below pKa)

Q0217:In what kind of environment is the followingdigested?: Weak bases

Basic environments (above pKa)

Q0218:How do you treat an overdose of the following?: Weakacids

Bicarbonate

Q0219:How do you treat an overdose of the following?: Weakbases

Ammonium chloride

Q0220:Phase I metabolism: Processes

Cytochrome P450;-reduction;-oxidation;-hydrolysis

Q0221:Phase II metabolism: Processes

Conjugation;-acetylation;-glucuronidation;-sulfation

Q0222:Phase I metabolism: Metabolites

-slightly polar;-water-soluble;-often still active

Q0223:Phase II metabolism: Metabolites

-very polar;-renally excreted;-inactive

Q0224:What phase of metabolism do geriatric patients losefirst?

Phase I

Q0225:Effect on dose/effect curve of: competitive antagonist

Shifts curve to the right; decreasing potency and increasingEC50.

Q0226:Effect on dose/effect curve of: noncompetitiveantagonist

Shifts curve downward; decreasing efficacy

Q0227:What is EC50?

Dose causing 50% of maximal effect

Q0228:What is Kd?

Concentration of drug required to bind 50% of receptor sites


5 half lives


97%

Q0231:Effect on dose/effect curve: Spare receptors

The drug binding and drug effect are independent of each otherwith effect to the left of binding;This means that EC50 is

lower than Kd; so very little drug needs to bind to get 50% ofthe effect.

Q0232:Effect on dose/effect curve: Partial agonist

-Lower maximal efficacy;-Potency independent (amount ofdose to get to maximum effect)

Q0233:Therapeutic Index: Definition

=(TD50)/(ED50);where TD50 equals median toxic dose; andED50 equals median effective dose.

Q0234:blocks cell wall synthesis by inhibition ofpeptidoglycan cross-linking

penicillin;ampicillin;tiracillin;piperacillin;imipenem;aztrenam;cephalosporins

Q0235:block peptidoglycan synthesis

bacitracin; vancomycin; cycloserine

Q0236:disrupt bacterial/fungal cell membranes

polymyxins

Q0237:block nucleotide synthesis

sulfonamides; trimethoprim

Q0238:block fungal cell memebranes

amphotericin B;nystatin;fluconazole/azoles

Q0239:block nuecliotide synthesis

sulfonamides; trimethoprim

Q0240:block DNA topoisomerases

quinolones

Q0241:red orange body fluids

Rifampin

Q0242:Block Protein synthesis at 50S ribosomal subunit

chlorophenicol; erythromycin/macrolides; lincomycin;clindamycin; streptogramins (quinupristin; dalfopristin);

linezolid

Q0243:block protein synthesis at 30S ribosomal subunit

Aminoglycosides ; tetracylins

Q0244:bactericidal antibiotics

penicillin; cephalosporins; vancomycin; aminoglycosides;floroquines; metronidazole

Q0245:penicillin G

IV form of penicillin

Q0246:penicillin V

oral form of penicillin

Q0247:MOA of penicillin

1. bind penicillin binding protein (aka tranpepsidase);2. blocktranspepsidase cross-lining of cell wall;3. activate autolytic

enzymes;(works on dividing bacteria)

Q0248:clinical use of penicillin?

bactericidal ;for gram-positive cocci/rods;gram-negativecocci;spirochetes

Q0249:is penicillin penicillinase resistant?

no

Q0250:toxisity of penicillin

hypersensitivity reactions; drug-induced coombs positive-hemolytic anemia

Q0251:how do gram negative bacteria protect themselvesfrom penicillin?

1.prvent peniciiln from penetrating cell layers by alteringporins;2. beta-lactase enzyme;3.alter molecular structure of

transpepsidase so beta-lactam antibiotic (penicillin) no bind toit

Q0252:example of a bacteria that uses: altered molecularstructure of transpepsidase so beta-lactam antibiotic

(penicillin) no bind to it

MRSA

Q0253:how do gram positive bacteria protect themselvesfrom penicillin?

1. secrete beta-lactamase = penicillinase(S aureus) and try tointercept antibiotic outside the cell wall

Q0254:name the penicillinase resistant penicillin?

methicillin; nafcillin;dicloxacillin

Q0255:clinical use of penicillinase resistant penicillin?whysuch narrow spectrum?

s. Aureus - but not MRSA;B/C HAVE BULKIER r GROUP

Q0256:TOXICITY of penicillinase resistant penicillin

HYPERSENSITIVITY reactions

Q0257:which penicillinase resistant penicillin causesintersitial nephritis?

methicillin

Q0258:aminopenicillins - names?

ampicillin; amoxicillin

Q0259:MOA of aminopenicillins diff than penicillins?

wider specturm b/c better penitration through gram negativeouter membrane and better binding to transpepsidase

Q0260:are aminopenicillins penicillinase sensitive?

yes

Q0261:clinical use of aminopenicillins?

extended-spectrum penicillin;gram-poitive and gram negrods(H.influenza;E coli;listeria monocytes; proteus mirabilis;salmoella; enterococci;note: they are one of few drugs against

gram-positive enterococcus

Q0262:toxicity of aminopenicillins?

hypersensitivity reactions ;ampicillin rash;psuedomembranous colitis

Q0263:anti-pseudomonals?

ticarcillin; carbeicillin; pipercillin

Q0264:diff in MOA of anti-pseudomonals and penicillin?

nothing but extensed spectrum

Q0265:clinical use of anti-pseudomonals?

psudomonas spp. and gram negative rods ;anerobes(bacteroides fragalis)

Q0266:are anti-pseudomonals susceptible to penillinase?what can use to help with?

yes;give wiht clavulanic acid - which is a beta-lactamaseinhibitor

Q0267:toxicity of anti-pseudomonals?

hypersensitivity reactions

Q0268:B lactamdrugs that inhibit cel wall synthesis but areless susceptible to penicilinase. and a bactericidal

cephalosprins

Q0269:what are the first generation cephalosporins?

cefazolin; cephalexin;cef with lin xin

Q0270:clinical use of 1st generation cephalosporins?

gram positive cocci; proteus mirabilis; ecoil; klebsiellapneumoniae;pek

Q0271:what are the 2nd generation cephalosporins?

cefoxitin; cefaclor;cefuroxime;furry fox is fat

Q0272:clinical use of 2nd generation cephalosporins?

gram positive cocci;h. influenza; enterobacter aerogenes;neiseseria spp;proteus mirabilis; ecoil; klebsiella

pneumoniae;hen peks

Q0273:what are the 3rd generation cephalosporins?

cetriaxone; cefotaxime; ceftazidime

Q0274:clinical use of 3rd generation cephalosporins?

serious gram negative infections resistant to oteher Blactams;meningitis (most penetrate BBB)

Q0275:ceftazidime used for what?

pseudomonas

Q0276:ceftriaxone used for what?

gonorrhea

Q0277:what are 4th generation cephs?

cefepime and cefpiramide;pime mide

Q0278:clinical use of 4th generation cephalosporins?

increased activity against pseudomonas and gram positiveorganisms

Q0279:toxicities of all cephs?

hypersensitivity reactions;cross hypersensitivity wihtpenicillins;increased nephro tox of aminoglycosides;disuliram

like reaciton w/ ethanol

Q0280:what is aztreonam?

a monobactam resistan to Beta lactamase

Q0281:what is the mOA of aztreonam?

inhibits cell wall synthesis ( binds to PBP3) synergistic withaminoglycosides ;no cross-allergy with penicillin

Q0282:what is the clinical use of aztreonam?

gram negative rods;klebiella spp;pseudomonas spp; serratiaspp;NO activity against gram positive gram positives or

anerobes

Q0283:toxicity of aztreonam?

usually nontoxic; occasional GI upset

Q0284:what drugs avoid during preg?

SAFE Moms Take Really GoodCare;Sulfonamides;Aminoglycosides

;Fluoroquinolone;Erythromycin;Metronidazole;Tetracyclins;Ribavirin;Griseoulvin;Chloamphenicol

Q0285:what birth defect sulfonamides cause?

kernicterus

Q0286:what birth defect aminoglycosides cause?

ototoxicity

Q0287:what birth defect Fluoroquinolones cause?

Cartilage damage

Q0288:what birth defect erthyromycin cause?

acute cholestatic hepatitis in mom

Q0289:what birth defect clarithromycin cause?

embryotoxic

Q0290:what birth defect metronidazole cause?

mutagenesis

Q0291:what birth defect tetracylines cause?

discolored teeth; inhibition of bone growth

Q0292:what birth defect ribavirin cause?

teratogenic

Q0293:what birth defect griseofulvin cause?

teratogenic

Q0294:what birth defect choloramphenicol cause?

gray baby

Q0295:treat onchoceriasis

Ivermectin (rIVER blindness treated wiht IVERmectin)

Q0296:treat nemaode/ roundworm (pinworm;whipforminfections

mebendazole/thiabendazole

Q0297:used to treat;giant worm - ascaris;Hookworm-nectar/ancylostoma;pinworm-enterobius

pyrantel pamoate

Q0298:used to treat ;trematode/fluke-schistosomes;paragonimus;clonochis;and ;cyticercosis

praziquantel

Q0299:treat cestode/tapeworm-diphyllobothriumlatum;taenia;x-cept cysticercosis

Niclosamine

Q0300:RX leishmaniasis

pentavalent antimony

Q0301:Rx Malaria

Chloroquine;quinine;meloquine;atovaquone;proguanil

Q0302:Rx Latent hypnozoite(liver) forms of malaria(P.vivax;P.Ovale)

primaquine

Q0303:RX giardiasis ;amebic dysentry(e. histolytica);bacterial vaginitis (gardnerella vavginalis; Trichomonas

Metronidazole

Q0304:RX pneumocystis carnii pneumonia prophylaxis

TMP-SMX; pentamindine

Q0305:RX chagas disease; american typanosomiasis (T.cruzi)

Nifurtimox

Q0306:RX African trypanocomiasis (sleeping sickness)

Suramin

Q0307:what is imipenem/cilastratin. meropenem?

broad spectrum ; B lactamase resistant carbenem-alwaysadministered with cilastatin

Q0308:what is cilastatin and why is it administered withimipenem?

it is a renal dihydropeptidase inhibitor to decease theinactivation of renal tubules

Q0309:clinical use of imipenem/cilastatin; meropenem

gram poitive cocci; gram negative rods; and anerobes;enterobactor- drug of choice

Q0310:drug of choice for enteobacter ?

imipenem/cilastatin; meropenem

Q0311:what is tox of imipenem/cilastatin; meropenem?

GI distress ; skin rash; CNS tox(seizures)@ high plasmalevels

Q0312:what drung inhibits cell wall mucopeptide formationby binding D-ala D ala of cell wall precursors.

vancomycin

Q0313:how does vancomycin resistance occur?

D-ALA D-ALA TO D-ALA D-LAC

Q0314:is vacomycin bactericidal or static?

bactericidal

Q0315:what is the clinical use of vancomycin?

gram positive multidrug resistant organisms includ S. aureusand C. difficile

Q0316:what causes nephrotox; ototox; thrombophlebitis anddiffuse flusing

vancomycin

Q0317:what causes red man syndrome

vancomycin

Q0318:how prevent red man syndrom

pretraeat with antihistamines and slow inusion rate

Q0319:30 s inhibitors

AT 30 ;Aminoglycosides - bacteriocidal;Tetracyclines -bacteristatic

Q0320:50 s inhibitors

cell at50;Chloamphenicol;erythromycin;lincomycin;cLindamycin;all

bacterio static

Q0321:examples of aminoglycosides

streptomycin; gentamycin;tobramycin; amikacin

Q0322:they are bactericidal ;inhibit ormaltion of initiationcomplex and cause misrading of mrna ;require o2 for uptake

;therfore ineffective angainst anaerobes

aminoglycosides

Q0323:severe gram negative infections ;synergistic with B -lactam antibiotics

aminoglycosides

Q0324:used for bowel surgery

neomycin

Q0325:cause neph tox-es used wiht cephalosporins;ototox -espec with loop diuretics;teratogen

aminoglycosides

Q0326:B lactamase clevage of B lactam ring ;resistance againstwhat?

penicillins/cepalosporins

Q0327:Modification via acetylation; adenylation; orphosporylation;resistance against what

aminoglycosides

Q0328:terminal D alla of cell wall component with D LACdecreased affinity of drug;resistance against what

vancomcin

Q0329:mod via acetylaion;resistance against what

choloramphenicol;aminoglycosides

Q0330:methylation of rRNA near erythromycin's ribosome-binding site;resistance against what

macrolides

Q0331:increased transport out of cell;resistance against what

tetracyclin

Q0332:altered enzyme (bacterial dihydropteroate synthetase)or resistance against what

sulfonamides

Q0333:increased paba synthesis

sulfonamides

Q0334:decreased uptake

tetracyclin and sulfonamides

Q0335:antimirobial prophylaxis;meningococcal

riampin(drug o choice);minocyclin

Q0336:antimirobial prophylaxis;gonorrhea

ceftriaxone

Q0337:antimirobial prophylaxis;syphillis

Benzathine penicillin G

Q0338:antimirobial prophylaxis;history recurrent UTI's

TMP-SMX

Q0339:antimirobial prophylaxis;pneumocytis cariniipneumonia

TMP-SMX (drug of choice);aerosolized pentamidine

Q0340:antimirobial prophylaxis;endocarditis with surgical ordental procedures

penicillins

Q0341:inhibits cell wall synthesis ;used for fungus

caspofungin

Q0342:clinical use invasive aspergillos

caspofugin

Q0343:GI upset and flushing

caspofugin

Q0344:inhibits fungal enzyme squalene epoxidase

terbinafine

Q0345:used to treat dermatophytoses;esceciallyonychomycosis

terbinafine

Q0346:inhibits DNA synthesis by conversion to luorouracil;which completes wiht uracil

flucytosine

Q0347:used in systemic fungal infections (candida;cryptococcus)

flucytosine

Q0348:causes nausea; vomiting; diarrhea; bone marrowsuppression

flucytosine

Q0349:interferes wiht micotubule funtion; disrupts mitosis

griseofulvin

Q0350:deposits in keratin-containing tissues (nails)

griseofulvin

Q0351:used for oral treatmetn of superficial infections

griseofulvin

Q0352:inhibits growth of dermatophytes (tinea andringworm)

griseofulvin

Q0353:is a teratogenic; carcinogenic; causes confusion;headaches; increased p-450 and warfarin metabolism

griseofulvin

Q0354:binds to ergosterol ;disrupting ungal membranes ;tootoxic for systemic use

nystatin

Q0355:forms membrane pores that allow leakage ofelectrolyrtes and distrupts homeostatis;bind ergosterol

amphotericin B

Q0356:causes fever/chills (shake and bake) ; hypotention;neph tox; arrythmias; anemia; IV phlebiis (amphoterrible)

;hydration reduces nephrotox

amphotericin B

Q0357:used for wide specturm of systemic mycosis;cryptococcus; blastomyces; coccidiodies; aspergillus;

histoplasma; candida; mucor(systemic mycoses);intathecallyfor fungal memingitis; no cross BBB

amphotericin B

Q0358:swish and swallow or oral candidiasis(thrush);topicalor diaper rash or vaginal candidiasis

nystatin

Q0359:inhibit fungal steroid ergosterol synthesis

fluconazol; kepconazole; clotrimazole; itaconazole;voricconazole

Q0360:systemic mycosis


Q0361:used ofr cytptococcial meningitis in AIDS patinetsand candidal infections of all types -yeast infections

fluconazol

Q0362:blastomyces; coccidiodies; histoplasma; candidaalbicans ;

ketoconazole;

Q0363:hormone inhibition (gynecomastia); liver disfunciton(inhibit cytochrome p-450) fever and chills


Q0364:inhibits bacterial dihydrofolate reductase;bacteriostatic

trimethoprim

Q0365:causes megaloblastic anemia; leukopenia;granulocytopenia ;(may alleviate wiht supplimental folinic

acid)

trimethoprim

Q0366:used in combination wiht sulfonamides (TMP-SMX)causeing sequential block o folate sntheiss ;-combo used in for

what organisms?

trimethoprim;used or UTI'S shegella; salmoella; pneumocystiscarinii pneumonia

Q0367:What are the Macrolides:

Erythromycin; azithromycin; clarithromycin

Q0368:Inhibit protein synthesis by blocking translocation;bind to the 23S rRNA of the 50S ribosomal subunit;

bacteriostatic

Macrolides

Q0369:Clinical use of macrolides

URIs; pneumonias; STDs-- gram positive cocci (streptococcalinfections in patients allegic to penicillin); Mycoplasma;

Legionella; Chlamydia; Neisseria

Q0370:GI discomfort (most common cause ofnoncompliance); acute cholestatic hepatitis; eosinophilia; skin

rashes.

Macrolides toxicity

Q0371:Increases serum concentration of theophyllines; oralanticoagulants

Macrolides toxicity

Q0372:Chloamphenicol mechanism

Inhibits 50S peptidyltransferase; bacteriostatic

Q0373:Meningitis (Haemophilus influenzae;Neisseriameningitidis; Streptococcus pneumoniae

clinical use of chlorophenicol

Q0374:tox chloroamphenicol

anemia(doe dependent); aplastic anemia(does independnet);gray abby syndrome (in premature infants b/c they lack liver

udp-glycuronyl transferase

Q0375:clocks peptide bond formation at 50s ribosomalsubunit . bacteriostatic

clindamycin

Q0376:treats anaerobes above the diaphram

clindamycin

Q0377:treat anaerobic infections (Bacteroides fragalis;clostridium perfringens)

clindamycin

Q0378:pseudomembranous colitis (C. difficile overgrowth.fever ; diarrhea

clindamycin

Q0379:types of sulfonamides

sulfamethoxazole (SMX) sulfisoxazole; triple sulfas;sulfadiazine

Q0380:PABA antimetabolites inhibit dihydropteroatesynthase. bacteriostatic

sulfonamides MOA

Q0381:clinical use of sulfonamides

gram-positive; gram-negative; Nocaria; Chlamydia. Triplesulfas or SMX for simple UTI

Q0382:Hypersensitivity reactions; hemolysis if G6PDdeficient; nephrotoxicity (tubulointerstitial nephritis)

Sulfonamides

Q0383:kernicterus in infacnts

Sulfonamides

Q0384:displace other drugs from albumin (e.g. warfarin)

Sulfonamides

Q0385:What are the fluoroquinolones

ciprofloxacin; norfloxacin; ofloxacin; sparfloxacin;moxifloxacin; gatifloxacin; enoxacin; nalidixic acid (a

quinolone)

Q0386:inhibit DNA gyrase (topoisomerase II); bacericidal

fluoroquinolones' mechanism

Q0387:clinical use of fluoroquinolones

gram-negative rods or urinary and GI tracts (includingPesudonomas); Neisseria; some gram-positive organisms

Q0388:GI upset; superinfections; skin rashes; headache;dizziness.

fluoroquinolones tox

Q0389:Contradicted in pregnant women and children becauseanimal studies show damage to cartilage.


Q0390:Tendonitis and tendon rupture in adults; leg crampsand myalgias in kids.


Q0391:Metronidazole mechanism

forms metabolites in the bacterial cell; bactericidal

Q0392:Antiprotozoal

Metronidazole clinical use

Q0393:Giardia; Entamoeba; Trichomonas; Gardnerellavaginalis; anaerobes (bacteriodes; clostridium)


Q0394:used with bismuth and amoxicillim (or tetracycline) for"triple therapy" against H. pylori


Q0395:polymixin B and polymixin E are examples of what?

polymixins!duh

Q0396:bind to cell membranes of bacteria and distrupt theirosmotic properties ;care cationic;basic ;act like detergents

polymixins;-myxins mix up membranes

Q0397:resistant to grm negative infections

polymixins

Q0398:neurotox; acute renal tubular necrosis

polymixins

Q0399:streptomycin;pyrazinamide;isoniazid(INH);rifampin;ethambutol;cycloserin

e (2nd line therapy)

ANTI-TB DRUGS

Q0400:tb prophylazxis?

INH isoniazid

Q0401:deacerased synthesis of mycolic acid

isoniazid

Q0402:hemolysis if G6PD deficincy ; enurotox; hepatotox;SLE ;

INH

Q0403:what can prevent neurotox in INH

pyridoxine vit b6

Q0404:common tox to all anti-tb drugs

all hepatotoxic

Q0405:inhibits DNA- dependent RNA polymerase

Rifampin

Q0406:used against TB delays reasistance to dapsone whenused for leprosy ;used for meningococcal prophylaxis in

contacts of childeren with H. influenza type B

Rifampin

Q0407:causes minor heptotox and drug interaction (increasedP 450)

Rifampin

Q0408:inhibits influenza neuroaminidase. so release ofprogeny virus is decreased

Zanamivir; oseltamivir

Q0409:influeza A and B

Zanamivir; oseltamivir

Q0410:inhibits synthesos o guanine nucleotides bycompetivitly inhibiting IMP dehydrogenase

Ribavirin MOA

Q0411:RSV; chronic hepatitis C

Clinical use of ribavirin

Q0412:hemolytic anemia; sever teratogen

ribavirin

Q0413:preferentially inhibits viral DNA polymerase whenphosphorylates by viral thymidine kinase

acyclovir

Q0414:HSV;VZV;EBV;mucocutaneous and genital herpeslesions. prophylaxis in immunocompromised patients

acyclovir

Q0415:delirium; tremor; nephrotox

acyclovir

Q0416:lack of thymidine kinase

acyclovir

Q0417:phosphorylation by viral kinas preferentially inhibitsCMV DNA polymerase

Ganciclovir

Q0418:CMV ; esecially in immunocompromised patients

Ganciclovir

Q0419:leukopenia; neutropenia; thrombocytopenia; renal tox.MOre tox to host enzymes than acyclovir

Ganciclovir

Q0420:Mutated CMV DNA polymerase or lack of thymidinekinase

Ganciclovir

Q0421:blocks viral penetration/uncoating(M2 protein) maybuffer pH o endosome. also caus the release of dopamine rom

intact nerve terminals

Amantadine

Q0422:prophylaxis and treatmetn for influenza A;parkinson's disease

Clinical use of amantadine

Q0423:ataxia; dizziness; slurred speech

tox of amantadine

Q0424:Mutated M2 protein. In 2006 ; 90% of influenza Awere resistant to amantadine

amantadine

Q0425:is a derivative with fewer Cns side effects . does notcross the BBB

rimantidine

Q0426:Viral DNA polymerase inhibitor that binds to thepyroposphate binding site o the enzyme . does not require

activatiation by viral kinase

foscarnet

Q0427:nephrotox

foscarnet tox

Q0428:mutated DNA Polymerase

mechanism of resistance of foscarnet

Q0429:glycoproteins from human leukocytes that blockvarious various stages of RNA and DNA syntheiss. Induce

ribonuclease that degrades viral mRNA

Intererons

Q0430:pyrofosphate analog

foscarnet

Q0431:IFN alpha used for what

chronic hep B and C;KAPOSi's sarcoma

Q0432:IFN b

MS

Q0433:IFN gamma

NADPH; OXIDASE DEFICIENCY

Q0434:NEUTROPENIA

tox or interferone

Q0435:plioconanl

for poliovirus inhibits penetration of picornavirus into cell

Q0436:saquinavir ; ritonavir ; indinavir nelfinacir amprenavirused for what?are what>

HIV THERAPY ;are protease inhibitors;NAVIR tease a pro-tease inhibitor

Q0437:what inhibits assembly of new virus by blockingprotease in progency virons

protease inhibitors for HIV therapy;saquinavir ; ritonavir ;indinavir nelfinacir amprenavir

Q0438:cause GI intolerance (N; dia); hyperglycemia;lipodystrophy; thrombocytopenia(indinavir)

HIV therapy

Q0439:ZIDOVUDINE(AZT); didanosine (ddI);zalcitabine(ddC); stavudine(d4T); lamivudine(3TC);abacavir

nucleosides - reverse transcriptase inhibitores for HIV

Q0440:nin nucleoside reverse transcriptase inhibitors for HIV

Nevirapine; efavirenz;delavirdine

Q0441:prefeentially inhibit reverse transcriptase of HIV;incorporation of viral genome into ost DNA

reverse transcriptase inhibitors both types

Q0442:cause bone marrow suppression (neutropenia andanemia); peripheral neuropathy; lactic ascisoiss(neucleosides)

rash (non-nucleaosides); megaloblastic anemia(AZT)

TOX of reverse transcriptase inhibitors both types

Q0443:highly active antiretroviral therapy

HAART

Q0444:what is HAART

combo therapy o protease inhibitos reverse transcriptaseinhibitors

Q0445:at what cell count is HAART INDICATED

<500cells/mm3 of CD4; or high viral load

Q0446:is AZT USED during preg why?

yes - to reduce risk o etal transmission

Q0447:Clinical use of tetracyclines:

Vibrio cholerae; Acne; Chlamydia; Ureaplasma; Urealyticum;Mycoplasma pneumoniae; Tularemia; H. pylori; Borrelia

burgdorferi (Lyme Disease); Rickettsia;Vaccum the Bedroom

Q0448:GI distress; discoloration of teeth and inhibition ofbone growth in children; photosensitivity; contradiction in

pregnancy

Tetracycline toxicity

Q0449:Tetracyclines

Bacteriostatic; bind to 30S and prevent attachment ofaminoacyl-tRNA; limited to CNS penetration

Q0450:This is fecally eliminated and can be used in patientswith renal failure

Doxycycline ;(must not take with milk; antacids; or iron-containtaing preparations because divalent cations inhibit its

absorbtion in the gut)

Q0451:What are the tetracyclines?

Tetracyclines; doxycycline; demeclocycline; minocycline

Q0452:block mRNA synthesis

rifampin

Q0453:penicillin;blocks ___ (1.) cross-linking of cell wall bybinding PBP's;activates ___ (2.) enzymes;and is

bacteriCIDAL for ___(3; 4; 5; 6.)

1. transpeptidase;2. autolytic;3. gram pos cocci;4. gram posrods;5. gram neg cocci;6. spirochetes

Q0454:methicillin; nafcillin; dicoxacillin;are penicillinase __(1);have ___ (2) spectrum due to ___ (3);tx: (4)

1. resistant;2. narrow;3. bulkier R group;4. staph a

Q0455:ampicillin and amoxacillin;penicillinase __ (1);whichhas greater oral bioavailabiliity? (2);tx: (3-8)

1. sensitive;2. amOxacillin;3. Haemophilus;4. E. coli;5.listeria;6. proteus;7. salmonella;8. enterococci;(HELPS kill

Enterococci)

Q0456:carbenicillin; piperacillin; ticarcilin;penicillinase __(1);tx: (2; 3)

1. sensitive;2. pseudomonas;3. gram neg rods

Q0457:cephalosporins inhibit __ (1);1st gen tx (2-4);2nd gentx (5-10);3rd gen tx (11-12);(13) for pseduomonas;(14) for

gonorrhea;4th gen tx (15-16)

1. Proteus 2. E coli 3. Klebsiella (PEcK);4. Haemophilus 5.Enterobacter aerogenes 6. Neisseria 7. Proteus 8. E coli 9.

Klebsiella 10. Serratia (HEN PEcKS);11. serious gram neg and12. meningitis;13. ceftazidime;14. ceftriaxone;15.

pseudomonas and gram pos

Q0458:aztreonam;beta lactamase __(1);inhibits cell wallsynthesis by binding __(2);synergistic w/ __ (3);tx: (4-6);used

for patients;(7)

1. resistant;2. PBP3;3. aminoglycosides;4. Klebsiella;5.pseudomonas;6. serratia;7. with penicillin allergy and thosewith renal insufficiency who can't tolerate aminoglycosides

Q0459:impipenem;the kill is lastin w/ ; (1.)because (1)inhibits (2)to dec inactivation in renal tubules;beta lactamase

(3);tx (4-6);drug of choice for (7)

1. cilastatin;2. renal dihydropeptidase I;3. resistant;4. grampos cocci;5. gram neg rods;6. anaerobes;7. enterobacter

Q0460:vancomycin;inhibits cell wall mucopeptide formationby binding (1);tx: serious gram pos MDR organisms including;(2-3);it is generally well tolerated but side effects include (4-7)

1. D-ala-D-ala;2. staph a;3. C. difficille;4. Nephrotoxicity;5.Ototoxicity;6. Thrombophlebitis;7. red man syndrome

(minimized w/ HA)

Q0461:mnemonic for protein synthesis inhibitors;

buy AT 30; CELL at 50;Aminoglycosides -bacteriCIDAL;Tetracyclines;Chloramphenicol;Erythromycin;

Lincomycin;cLindamycin

Q0462:aminoglycosides;require _(1) for uptake;tx(2);synergistic w/ (3);use (4) for bowel surgery;toxicity (5; 6)

1. O2 (-> innefective against anaerobes);2. severe gram neg rodinf;3. beta lactams;4. neomycin;5. nephrotoxicity;6.

otoxicity;(amiNOglycosides)

Q0463:testracyclines;(1) is fecally eliminated -> can be usedw/ renal failure;must not take w/ (2) because divalent cations

inhibit absorption;tx (3-10)

1. doxycyclin;2. milk; anatids; Fe;3. vibrio 4. acne 5.chlamydia 6. ureaplasma urealyticum 7. mycoplasma

pneumonia 8. borellia 9. rickettsia 10. tularemia;(VACUUMyour Bed Room Tetracyclines)

Q0464:macrolides;tx generally (1-3);specifically- (4-8)

1. URI;2. pneumonia;3. STDs;4. gram pos cocci;5.mycoplasma;6. legionella;7. chlamydia;8. neisseria

Q0465:chloramphenicol;tx (1);limit use because of (2);causesGray baby syndrome because they lack (3)

1. meningitis;2. toxicities- dose dependent anemia; doseindependent aplastic anemia;3. UDP-glucuronyl transferase

Q0466:clindamycin;tx (1)

anaerobes above the diaphragm

Q0467:sulfonamides;inhibit (1);tx (2-5);toxicity (6-9)

dihydropteroate synthase;2. gram pos;3. gram neg;4.nocardia;5. chlamydia;6. hemolysis of G6pD;7.

nephrotoxicity;8. kernicterus in infants;9. displace drugs fromalbumin

Q0468:simple UTIs;recurrent UTIs

triple sulfas or SMX;TMP-SMX

Q0469:trimethoprim inhibits (1);toxicity (2);may alleviate w/supplemental (3)

1. DHF reductase;2. TMP- treats marrow badly(megaloblastic anemia; leukopenia; granulocytopenia);3.

folinic acid

Q0470:TMP/SMX combo used for;(1-4)

recurrent UTIs;salmonella;PCP;shigella;(USPS)

Q0471:fluoroquinolones;inhibit (1);tx: (2);toxicity (3)

1. DNA topoisomerase I (gyrase);2. gram neg rods of UTtract and GI tract;3. damage to cartilage; tendonitis; tendonrupture;(Fluoroquinolones hurt attachments to your bones)

Q0472:metronidazole tx (1-3);toxicity: (4)

1. giardia;2. entamoeba;3. trichomonas;(GET on the metro);4.disulfiram like effect w/ alcohol

Q0473:polymyxins are cationic basic proteins that act like(1);tx (2);toxicity (3-4)

1. detergents;2. res gram neg inf;3. neurotoxicity;4. acute renaltubular necrosis

Q0474:isoniazid;dec synthesis of;(1);only agent used as soloprophylaxis for (2);toxicity (3-6);different half-lives in (7)

1. mycolic acids;2. mycobacterium TB;3. hemolysis if G6PDdef;4. SLE-like syndrome;5. neurotoxicity (can prevent with

B6);6. hepatotoxicity;(INH Injures Neurons andHepatocytes);7. slow vs fast acetylators

Q0475:rifampin;inhibits (1);tx (2-5);6. Four R's of rifampin;

1. DNA dep RNA pol;2. TB;3. delays resistance to dapsonefor leprosy;4. meningococcal prophylaxis;5. H. influenze Bprphylaxis;6. RNA pol inhibitor;Revs up P450;Red/orange

body fluids;Rapid resistance if used alone

Q0476:1. name the five anti-TB drugs;2. which is used alonefor prophylaxis;3. all are ;

1. Rifampin; Ethambutol; Streptomycin; Pyrazinamide; INH(RESPIre);2. INH;3. hepatotoxic

Q0477:aminoglycoside resistance

modification via;acetylation;adenylation;phosphorylation

Q0478:vancomycin resistance

replace terminal D-Ala w/ D-lac to dec affinity

Q0479:macrolide resistance

methylation of rRNA near erythromycin's ribosome bindingsite

Q0480:tetracycline resistance

dec uptake or inc transport out of cell

Q0481:sulfonamide resistance

altered enzyme;dec uptake;inc PABA

Q0482:prophylaxis for;1. meningococcus;2. gonorrhea;3.syphilis;4. recurrent UTI;5. PCP

1. rifampin;2. ceftriaxone;3. benzathine penicillin G;4. TMP-SMX;5. TMP-SMX

Q0483:amphotericin;binds (1);tx (2);cross the bbb?(3);toxicity (4)

1. ergosterol - tears holes in wall;2. systemic mycoses;3.doesn't cross BBB- use intrathecaly for fungal meningitis;4.

"shake and bake" fevers and chills; arrhythmias(amphoterrible)

Q0484:nystatin;binds (1);tx (2)

1. ergosterol;2. swish and swallow for thrush

Q0485:azoles;inhibit (1);tx (2);(3) for cryptococcal meningitisand candida;(4) for blasto; coccidioides; histo; candida;also

used to tx (5);toxicity (6-7)

1. ergosterol synthesis;2. systemic mycoses;3. fluconazole;4.ketoconazole;5. hypercortisolism;6. gynecomastia;7. inh P450

Q0486:flucytosine;inhibits (1);tx (2)

1. DNA synthesis by conversion to FU which competes w/uracil;2. systemic fungal infections

Q0487:caspofungin ;inhibits (1);tx (2)

1. cell wall synthesis;2. invasive aspergillosis

Q0488:terbinafine;inhibits (1);tx (2)

1. squalene epoxidase which converts squalene to lanosterol;2.dermatoophytoses

Q0489:griseofulvin;inhibits (1);tx (2);toxicity (3)

1. microtubules fx;2. oral tx of superficial infections;3. incwarfarin metabolism

Q0490:amantadine;blocks (1);causes release of (2);tx (3-5);amantadine mnemonic (6)

1. uncoating;2. DA;3. influenza A;4. rubellA;5. Parkinson's;6.Amantadine blocks influenza A and rubellA and causes

problems with the cerebellA

Q0491:rimantadine has (1) CNS side effects than amantadine

fewer

Q0492:zanamivir inhibits (1);tx (2-3)

1. neuramidase;2. influenza A;3. influenza B

Q0493:ribavirin inhibits (1);tx (2);toxicities (3-4)

1. IMP dehydrogenase -> no guanine;2. CMV;3. hemolyticanemia;4. teratogenic!

Q0494:acyclovir;MOA (1)

inhibits DNA pol when phosphorylated by viral thymidinekinase

Q0495:DHPG (dihydroxy-2-propoxymethyl guanine);=(1);MOA (2);tx (3);toxicities (4-7)

1. ganciclovir;2. phosphorylation by viral kinase ->preferential inhibition of CMV DNA pol;3. CMV;4.

thrombocytopenia;5. leukopenia;6. neutropenia;7. renaltoxicity

Q0496:foscarnet;MOA (1);tx (2);toxicity (3)

1. binds to pyrophosphate binding site of DNA pol ->inhibition;(FOScarnet - pyroFOSphate analog);2. CMV

retinitis if ganciclovir fails;3. renal toxicity

Q0497:"-navir" drug;MOA

protease inhibitor

Q0498:Rerverse transcriptase inhibitors;(6)

abacavir;lamivudine;didanosine;stavudine;zidovudine(AZT);zalcitabine;(AL DiSsed ZZ and

NED);nevirapine;efavirenz;delavirdine;(NED is a non-nucleoside)

Q0499:interferons;tx (3);toxicity (4)

chronic HBV;HCV;kaposi sarcoma;neutropenia

Q0500:tx for onchocerciasis

ivermectin;(tx rIVER blindness with IVERmectin)

Q0501:taenia solium;transmission;tx

undercooked pork tapewom;praziquantel;albendazole forcysticercosis

Q0502:echinococcus granulosus;transmission;tx

dog feces -> cysts in liver;albendazole

Q0503:trematodes;tx

praziquantel

Q0504:schistosoma;transmission;tx

from snails -> granulomas and fibrosis of spleen andliver;praziquantel

Q0505:clonorchis sinensis;transmission;tx

undercooked fish -> biliary tract inflammation;praziquantel

Q0506:paragonimus westernami;transmission;tx

undercooked crab meat -> inflammation of lung;praziquantel

Q0507:ancylcostomal duodenale

hookworm;mebendazole

Q0508:ascaris lumbricoides

mebendazole

Q0509:enterobius vermicularis

pinworm;mebendazole

Q0510:strongyloids stercoralis

invermectin

Q0511:trichinella spiralis

thiabendazole

Q0512:dracuncullus medinensis

nitridazole;(Dracula comes out at Night)

Q0513:loa loa

transmitted by deer fly;can see worm crawling inconjunctiva;tx diethylcarbamazine

Q0514:toxocara canis

diethylcabamazine

Q0515:wucheria bancrofit

diethycarbamazine;(can cause elephantiasis)

Q0516:Imipenem/cilastatin What is imipenem?

broad spectrum beta-lactamase-resistant carbapenem

Q0517:Imipenem What do you always administer it with andwhy?

cilastatin -- it decreases inactivation of imipenem in renaltubules

Q0518:Imipenem/cilastatin What do you use it for?

Gram pos cocci; gram neg rods and anaerobes (broadspectrum); drug o' choice for Enterobacter;the girl from

Ipanema was a Broad; y era Enterita

Q0519:Imipenem/cilastatin What bug is it the drug of choicefor?

Enterobacter

Q0520:Imipenem/cilastatin What are its side-effects

GI distress; skin rash; seizures at high conc;kid with skinproblems getting nervous (upset stomach; shaking) when

talking to girl from Ipanema

Q0521:Vancomycin Is it bactericidal or bacteriastatic andwhy?

Bactericidal because it blocks cross linkage and elongation ofpeptidoglycan by binding D-ala D-ala protion of cell wall.

Q0522:Vancomycin How does resistance to Vanco occur?

D-ala D-ala is replaced with D-ala D-lactate which vanco doesnot block

Q0523:Vancomycin What is it used for?

Used for serious infection that is resistant to other drugs (e.g.gram pos multi-drug resistant organisms like S. aureus and C.

difficile; methicillin resistant staph (MRSA))

Q0524:Vancomycin What are the important toxicities ofvanco?

generally NOT many problems except; Nephrotoxicity;Ototoxicity and Thrombophlebitis;*also red man syndrome;

give with histamine to prevent

Q0525:Vancomycin What can happen with rapid infusion ofvanco?

Red man's syndrome. Diffuse flushing which can be controlledby pretreatment with anti-histamines and with slow infusion

rate

Q0526:Protein Synthesis Inhibitors Which drugs targetbacterial protein synthesis by blocking the 30S unit vs 50S

unit?

Buy AT 30; CELL at 50

Q0527:Protein Synthesis Inhibitors What does AT stand for?

A = Aminoglycosides (streptomycin; gentamicin; tobramycinan damikacin. And T = Tetracyclines

Q0528:Protein Synthesis Inhibitors What does CELL standfor?

C = Chloramphenicol; E= Erythromycin; L= Lincomycin andL= cLindamycin

Q0529:Which of the Protein Synthesis Inhibitors arebactericidal?

Only the aminoglycosides are; the rest are bacteriostatic

Q0530:Aminoglycosides Name some aminoglycosides?

Gentamicin; neomycin; amikacin; tobramycin andstreptomycin;mean GNATS

Q0531:Aminoglycosides How do these drugs work?

They inhibit formation of the initiation complex in mRNAtranslation

Q0532:Aminoglycosides Why are they ineffective againstanaerobes?

They require oxygen for uptake into bacteria

Q0533:Aminoglycosides When would you useaminoglycosides?

against severe gram-negative rod infections

Q0534:Aminoglycosides What drugs can you useaminoglycosides with for synergy?

the drugs that inhibit cell wall synthesis (e.g. penicillin andcephalosporins -- the beta-lactam antibiotics). Presumablythis allows the drug to get in with out reliance on oxygen

transport

Q0535:Aminoglycosides What drug in this class is commonlyused for bowel surgery?

Neomycin

Q0536:Aminoglycosides What are the major toxicities?

Nephrotoxicity (esp w/ cephalosporins); Ototoxicity (esp w/loop diuretics); Teratogen;mean GNATS canNOT kill

anaerobes

Q0537:Tetracyclines Name some tetracylcines

Tetracycline; doxycycline; demeclocycline; minocycline

Q0538:Tetracyclines How does it work?

Blocks t-RNA attachment to 30S subunit

Q0539:Tetracyclines Which tetracycline can you use inpatients with renal failure and why?

Can use doxycycline because its elimination is fecal

Q0540:Tetracyclines Should you take these drugs with a glassof milk?

NO; because it intereferes with absorption in the gut as doesantacids and iron-containing preparations; or any divalent

cations

Q0541:Tetracyclines What are tetracyclines used for?

Toby; VACUUM THe Bed Room-- Vibrio cholerae; Acne;Chlamydia; Ureaplasma; Urealyticum; Mycoplasma

pneumoniae; Tularemia; H pylori; Borrelia burgdorferi;Rickettsia

Q0542:Tetracyclines What are the common toxicities

GI distress; teeth discoloration; inhibition of bone growth inchildren; Fanconi's syndrome and photosensitivity.

Contraindicated in pregnancy

Q0543:Macrolides Name some macrolides?

Erythromycin; azithromycin; Clarithromycin;EaZy was aCrip Mac

Q0544:Macrolides How do these drugs work?

bind to 23S rRNA of 50S and inhibit translocation;bacteriostatic

Q0545:Macrolides What are they used for?

URIs; pneumonias; STDs -- streptococcal in patients that areallergic to PNC --- Mycoplasm; Legionella; Chlamydia;

Neisseria;Eryc's Nipple's at the Mid Clavicular Line

Q0546:Macrolides Pneumonic for macrolide use?

Eryc's Nipple is at his Mid Clavicular Line (Eryc is brandname for erythromycin; and eazy e's real name). Neisseria;

Mycoplasm; Chlamydia; Legionella.

Q0547:Macrolides What are the major toxicities?

GI discomfort; acute Cholestatic hepatitis; Eosinophilia; skinrashes;increases serum theophylines and oral

anticoagulants;the Mac eazy E was a Gangsta Crip with badSkin

Q0548:Macrolides What is the most common cause for non-compliance to macrolides?

GI discomfort

Q0549:Chloramphenicol How does this drug work?

inhibits 50S peptidyltransferase

Q0550:Chloramphenicol Main use?

Meningitis (H. influenzae; N. meningitides; S. pneumo). Usedconservatively b/c of toxicity

Q0551:Chloramphenicol What are the main toxicities?

Anemia and aplastic anemia (both dose dependent); gray babysyndrome (in premes b/c they lack UDP-glucoronyl

transferase)

Q0552:Clindamycin How does it work?

blocks peptide bond formation at 50S;with CLINdamycin; theamino acids don't CLINk together

Q0553:Clindamycin When do you use it?

Anaerobic infections (e.g. Bacteroides fragilis andC.perfringens)

Q0554:Clindamycin Toxicities?

Pseudomembranous colitis; fever; diarrhea

Q0555:Sulfonamides Name some sulfonamides

Sulfamethoxazole (SMX); sulfisoxazole; triple sulfa andsulfadiazine

Q0556:Sulfonamides How does it work?

Inhibits bacterial folic acid synthesis from PABA by blockingdihydropteroate synthase.

Q0557:Sulfonamides What are its uses?

Gram-positive; gram-negative; Nocardia; Chlamydia. Triplesulfas and SMX for simple UTIs

Q0558:Sulfonamides Toxicities?

hypersensitivity rxn; hemolysis if G6PD deficient;nephorotoxicity (tubulointerstitial nephritis); kernicterus in

infants; displace other drugs from albumin (e.g. warfarin)

Q0559:Trimethoprim How does it work?

inhibits folic acid pathway by blocking dihydrofolatereductase which humans have as well

Q0560:Trimethoprim What are its uses?

used in combo with Sulfamethoxazole (TMP-SMX) causing asequential block of folate synthesis. Used for recurrent UTIs;

Shigella; Salmonella; and prophylaxis for PCP in AIDSpatients

Q0561:Trimethoprim Toxicities?

Megaloblastic anemia; pancytopenia (may be alleviated withsupplemental folinic acid)

Q0562:Fluoroquinolones What the most famousfloroquinolone?

Ciprofloxacin (treatment for Anthrax)

Q0563:Fluoroquinolones How does it work?

inhibits DNA gyrase (topoisomerase II)

Q0564:Fluoroquinolones What are its uses?

Gram neg rods or urinary and GI tract (incl. pseudomonas);Neisseria; some gram pos spp

Q0565:Fluoroquinolones What population is contraindicatedfor use?

pregnancy and children

Q0566:Fluoroquinolones What are its toxicities?

GI upset; superinfection; skin rashes; headache; dizziness andtendonitis and tendon rupture in adults. FluoroquinoLONES

hurt attachment to BONES.

Q0567:Metronidazole How does it work?

forms toxic metabolites in the bacteria. Bactericidal.

Q0568:Metronidazole What are its uses?

antiprotazoal;Giardia; Entamoeba; Trichomonas;GET on theMetro;anaerobes;gardnerella vaginalis; Bacteroides;clostridium;Used with bismuth and amoxicillin (or

tetracycline) for triple therapy against H pylori;BAM!

Q0569:What is the role of Metronidazole in H. pyloriinfection?

Used as part of triple therapy: bismuth; amoxicillin andmetronidazole;BAM!

Q0570:Metronidazole Main toxicity?

disulfiram-like (antabuse) reaction to alcohol and headache

Q0571:Which drug do you use to treat anaerobic infectionsabove the diaphram and which for below the diaphram

anaerobes above diaphram: Clindamycin; and anaerobes belowdiaphram: metronidazole

Q0572:Polymyxins How does it work?

disrupts osmotic properties of bacteria; acts like a detergent

Q0573:Polymyxins What is it used for?

resistant gram negative infections

Q0574:Polymyxins Toxicities?

neurotoxicity; acute renal tubular necrosis

Q0575:Isoniazid How does it work?

decreases synthesis of mycolic acid

Q0576:Isoniazid What is it used for?

MTB (mycobacterium tuberculosis). The only agent used assolo prophylaxis against TB

Q0577:Isoniazid Toxicities?

Hemolysis if G6PD deficient; neurotoxicity; hepatotoxicitiy;drug induced SLE. INH; Injures Neurons and Hepatocytes

Q0578:Isoniazid What vitamin prevents neurotoxicity

Vitamin B6 (pyridoxine)

Q0579:Isoniazid Why are toxicities particularly important tomonitor in patients taking INH?

INH half-lives are different in fast versus slow acetylators!

Q0580:Rifampin How does it work?

inhibits DNA-dependent RNA polymerase

Q0581:Rifampin What is it used for?

Mycobacterium tuberculosis; delays resistance to dapsonewhen used for leprosy; meningococcal prophylaxis

Q0582:Rifampin Toxicities?

Minor hepatotoxicity and increases P-450

Q0583:Rifampin How can it be used for leprosy?

rifampin delays resistance to dapsone when used for leprosy

Q0584:Rifampin What would happen if you used rifampinalone?

get rapid resistance

Q0585:Rifampin What does it do to bodily fluids?

makes them red/orange in color

Q0586:Rifampin What are the 4 R's of Rifampin

RNA polymerase inhibitor; Revs up microsomal p-450;Red/Orange body fluids; Resistance is rapid if used alone

Q0587:Anti-TB Drugs What are the anti-TB drugs?

Rifampin; Ethambutol; Streptomycin; Pyrazinamide;Isoniazid (INH) -- RESPIre

Q0588:Anti-TB Drugs What do you use for TB prophylaxis?

INH

Q0589:Anti-TB Drugs What toxicity is common to all?

hepatotoxicity

Q0590:Most common resistance mechanism for penicillins /cephalosporins.

Beta-lactamase cleavage of beta-lactam ring.

Q0591:Most common resistance mechanism foraminoglycosides.

Modification via acetylation; adenylation; orphosphorylation.

Q0592:Most common resistance mechanism for vancomycin.

Terminal D-ala of cell wall component replaced with D-lac;decrease affinity.

Q0593:Most common resistance mechanism forChlorampenicol.

Modification via acetylation.

Q0594:Most common resistance mechanism for macrolides.

Methylation of rRNA near erythromycin's ribosome-bindingsite.

Q0595:Most common resistance mechanism for tetracycline.

Decrease uptake or increase transport out of cell.

Q0596:Most common resistance mechanism for sulfonamides.

Altered enzyme (bacterial dihydropteroate synthetase);decrease uptake; or increase PABA synthesis.

Q0597:drug of choice for prophylaxis of meningococcalinfection.

Rifampin (drug of choice)

Q0598:Drug of choice for gonorrhea.

Ceftriaxone. 3rd generation cephalosporin.

Q0599:Drug of choice for syphilis.

Benzathine penicillin G.

Q0600:Drug of choice for meningococcal infection. Drug ofchoice for history of recurrent UTIs.

TMP-SMX.

Q0601:Drug of choice for Pneumocystis carinii pneumonia.

TMP-SMX (drug of choice); aerosolized pentamindine

Q0602:Viral adsorption and penetration into the cell isblocked by ---------.

Gama-globulins (non-specific).

Q0603:Uncoating of the virus after its penetration into thecell is blocked by --------.

Amantadine (influenza A).

Q0604:Antiviral chemotherapy: Early viral protein synthesisis blocked by --------.

Fomivirsen (CMV).

Q0605:Antiviral chemotherapy: Viral nuclei acid synthesis isblocked by --------.

Purine; pyrimidine analogs; reverse transcriptase inhibitors.

Q0606:Late viral protein synthesis and processing is blockedby --------.

Methimazole (variola); protease inhibitors.

Q0607:Antiviral chemotherapy: Packaging and assembly ofnew viron is blocked by --------.

Rifampin (vaccinia).

Q0608:Mechanism of action of Amantadine.

Blocks viral penetration/uncoating; may buffer pH ofendosome. Also causes the release of dopamine from intact

nerve terminals. "Amantadine blocks influenza A and rubellAand causes problems with the cerebellA."

Q0609:Clinical uses of Amantadine.

Prophylaxis for influenza A; Parkinson's disease.

Q0610:Symptoms of Amantadine toxicity.

Ataxia; dizziness; slurred speech. (Rimantidine is a derivativewith fewer CNS side effects.) "Amantadine blocks influenza

A and rubellA and causes problems with the cerebellA."

Q0611:Mechanism of action of Zanamivir.

Inhibits influenza neuraminidase.

Q0612:Clinical use of Zanamivir.

Both influenza A and B.

Q0613:Mechanism of action of Ribavirin.

Inhibits synthesis of guanine nucleotides by competitivelyinhibiting IMP dehydrogenase.

Q0614:Clinical use of Ribavirin.

RSV (respiratory syncytial virus).

Q0615:Symptoms of Ribavirin toxicity.

Hemolytic anemia. Severe teratogen.

Q0616:Mechanism of aciton of Acyclovir.

Perferentially inhibits viral DNA polymerase whenphosphorylated by viral thymidine kinase.

Q0617:Clinical use of Acyclovir.

HSV; VZV; EBV. Mucocutaneous and genital herpes lesions.Prophylaxis in immunocompromised patients.

Q0618:Symptoms of Acyclovir toxicity.

Delirium; tremor; nephrotoxicity.

Q0619:Mechanism of action of Ganciclovir.

Phosphorlation by viral kinase; perferentially inhibits CMVDNA polymerase.

Q0620:Clinical use of Ganciclovir.

CMV; especially in immunocompromised patients.

Q0621:Symptoms of Ganciclovir toxicity.

Leukopenia; neutropenia; thrombocytopenia; renal toxicity.More toxic to host enzymes than acyclovir.

Q0622:Mechanism of action of Foscarnet.

Viral DNA polymerase inhibitor that binds to thepyrophophate binding site of the enzyme. Does not require

activation by viral kinase. "FOScarnet = pyroFOSphateanalog."

Q0623:Clinical use of Foscarnet.

CMV retinitis in immunocompromised patients whenganciclovir fails.

Q0624:Foscarnet toxicity.

Nephrotoxicity.

Q0625:Saquinavir; ritonavir; indinavir; nelfinavir; amprenavirare example of this type of anti-HIV drug.

Protease inhibitor.

Q0626:Mechanism of action of protease inhibitors.

Inhibit assembly of new virus by blocking protease enzyme.

Q0627:Symptoms of protease inhibitor toxicity.

GI intolerance (nausea; diarrhea); hyperglycemia; lipidabnormalities; thrombocytopenia (indinavir).

Q0628:Zidovudine (AZT); didanosine (ddI); zalcitabine(ddC); stavudine (d4T); lamivudine (3TC); and abacavir are

examples of --------- reverse transcriptase inhibitors.

Nucleoside.

Q0629:Nevirapine; delavirdine; and efavirenz are examples of--------- reverse transcriptase inhibitors.

Non-nucleoside.

Q0630:Mechanism of action of reverse transcriptaseinhibitors.

Preferentially inhibit reverse transcriptase of HIV; preventincorporation of viral genome into host DNA.

Q0631:Symptoms of reverse transcriptase inhibitor toxicity.

Bone marrow supression (neutropenia; anemia); periphralneuropathy; lactic acidosis (nucleosides); rash (non-

nucleosides); megaloblastic anemia (AZT).

Q0632:Highly active antiretroviral therapy (HAART)generally entails combination therapy with ---------- and -------

----.

Protease inhibitors; reverse transcriptase inhibitors.

Q0633:When should HIV therapy be initiated?

When patients have low CD4 counts (<500 cells/mm3) orhigh viral load.

Q0634:Mechanism of action of Interferons.

Glycoproteins from human leukocytes that block variousstages of viral RNA and DNA synthesis.

Q0635:Clinical use of Interferons.

Chronic hepatitis B and C; Kaposi's sarcoma.

Q0636:Symptoms of Interferon toxicity.

Neutropenia.

Q0637:protease inhibitors name them

never (NAVIR) tease a pro-tease inhibitor. All end in "navir"

Q0638:protease inhibitor MOA

inhibits assembly of new virus by inhibiting protease inprogeny virus

Q0639:protease inhibitor toxicity

GI intolerance (nausea; diarhea); hyperglycemia;lipodystrophy; thrombocytopenia (indinavir)… metabolic

syndrome

Q0640:reverse transcriptase inhibitors

nucleoside: zidoVUDINE (AZT); staVUDINE (d4T);lamiVUDINE; abacavir; zalcitabine (ddC); didanosine (3TC).

Non-nucleosides: Never deliver nucleosides. Nevirapine;efavirenz; delavirdine

Q0641:reverse transcriptase inhibitors MOA

preferentially inhibits HIV reverse transcriptase. Preventsincorporation of viral genome into host DNA

Q0642:reverse transcriptase toxicity

BM supression (neutropenia; anemia); peripheral neuropathy;LACTIC ACIDOSIS (nucleosides); rash (non nucleosides);

megaloblastic anemia (didovudine

Q0643:reverse transcriptase inhib clinical use

HAART. Combination tx w/ protease inhibitors and reversetranscriptase inhibitors. Started when pts have CD4<500 orhigh viral load. AZT used in preg to reduce transmission risk

Q0644:interferons mechanism

block various stages of viral RNA and DNA syn. Inducesribonuclease that degrades viral mRNA.

Q0645:interferon clinical use

IFN alpha. Chronic hepatitis B and C; Kaposi sarcoma. IFNbeta - MS. IFN gamma - NADPH oxiodase deficiency

Q0646:interferon toxicity

neutropenia; depression

Q0647:pleconaril MOA

prevents attachment of poliovirus to cell

Q0648:Sulfamethoxazole (SMX);sulfisoxizole;triplesulfas;sulfadiazine

MECH: bacteriostatic; inhibits dihydropterate synthasewhich bac need to make folate;USE: Gm+; Gm-; Nocardia;

Chlamydia; PCP; UTIs;TOX;Cystalluria (tubulo-interstitialnephritis);hypersensitivity;hemolytic anemia (G6PD

deficiency);Kernicterus;drug potentiation (warfarin; displacesother drugs from albumin)

Q0649:Trimethoprim (TMP)

MECH: bacteriostatic; inhibits bac dihydrofolate reductaseinterfering with folate production. Folate is needed for nucleicacids; cell growth;USE: With sulfas; Gm-s are resistant;TOX:

folate deficiency → megaloblastic anemia; leukopenia;granulocytopenia (reversed with folinic acid - bac can't use)

Q0650:Co-Trimoxazole;Bactrim

MECH: inhibits two sequential steps of folate production inbac;USE: UTI (recurrent/chronic); PCP; Shigella; Salmonella;gonococcal urethritis; oropharyngeal gonorrhea;TOX: derm;

GI; heme (megaloblastic anemia; leukopenia;thrombocytopenia - reversed by folinic acid); HIV drug-

induced fever; drug interactions (warfarin)

Q0651:Penicillin G

IV form;MECH;1. Bind penicillin-binding proteins;2. Blocktranspeptidase cross-linking of cell wall;3. Activate autolytic

enzymes;USE: bateriocidal for gm+ cocci (esp.pneumococcus); gm+ rods (listeria); gm- cocci (gonococcus);

spirochetes (syphillis);TOX: Hypersensitivity rxn(sometimes causing hemolytic anemia via haptens associated

with RBC); diarrhea (imbalance of gut flora)

Q0652:Penicillin V

Oral form;MECH;1. Bind penicillin-binding proteins;2. Blocktranspeptidase cross-linking of cell wall;3. Activate autolytic

enzymes;USE: bateriocidal for gm+ cocci (esp.pneumococcus); gm+ rods (listeria); gm- cocci (gonococcus);

spirochetes (syphillis);TOX: Hypersensitivity rxn(sometimes causing hemolytic anemia via haptens associated

with RBC); diarrhea (imbalance of gut flora)

Q0653:Methicillin

Penicillinase-resistant penicillin;MECH;1. Bind penicillin-binding proteins;2. Block transpeptidase cross-linking of cellwall;3. Activate autolytic enzymes;USE: S. aureus (except

MRSA);TOX: Hypersensitivity rxn; *interstitial nephritis*

Q0654:Nafcillin


MRSA);TOX: Hypersensitivity rxn

Q0655:Oxacillin



Q0656:Cloxacillin; dicloxacillin



Q0657:Ampicillin

Aminopenicillin;MECH;1. Bind penicillin-binding proteins;2.Block transpeptidase cross-linking of cell wall;3. Activate

autolytic enzymes;USE: penicillin + more gm- enterobac;H.flu;E. coli;Listeria;Proteus;Salmonella;*combine with beta -

lactamase inhibitors (clavulanic acid) to extend;TOX:Hypersensitivity rxn; rash; pseudomembranous colitis

Q0658:Amoxicillin

Aminopenicillin (more orally bioavailable thanAmp);MECH;1. Bind penicillin-binding proteins;2. Block

transpeptidase cross-linking of cell wall;3. Activate autolyticenzymes;USE: penicillin + more gm- enterobac;H. flu;E.

coli;Listeria;Proteus;Salmonella;*combine with beta -lactamase inhibitors (clavulanic acid) to extend;TOX:Hypersensitivity rxn; rash; pseudomembranous colitis

Q0659:Clavulanic acid;Sulbactam;Tazobactam

beta -lactamase inhibitors;-Competitive inhibitor;-Combinewith penicillinase-sensitive penicillins

Q0660:Ticarcillin

Anti-pseudomonal;MECH;1. Bind penicillin-bindingproteins;2. Block transpeptidase cross-linking of cell wall;3.

Activate autolytic enzymes;USE: Pseudomonas aeruginosa &gm- rods (H. flu; enterobactor; E. coli; Proteus);*combine

with beta -lactamase inhibitors (clavulanic acid) to extend toKlebsiella;TOX: Hypersensitivity rxn

Q0661:Carbenicillin




Q0662:Piperacillin




Q0663:Cefazolin

1st Gen Cephalosporin w/ bone penetration;MECH: beta -lactam; inhibits cell wall synthesis (like penicillins);USE: gm+

cocci &;Proteus;E. coli;Klebsiella;TOX: Hypersensitivityreactions; disulfiram-like rxn

Q0664:Cephalexin

1st Gen Cephalosporin w/oral admin;MECH: beta -lactam;inhibits cell wall synthesis (like penicillins);USE: gm+ cocci

&;Proteus;E. coli;Klebsiella;TOX: Hypersensitivity reactions;disulfiram-like rxn

Q0665:Cefotoxitin

2nd Gen Cephalosporin ;MECH: beta -lactam; inhibits cellwall synthesis (like penicillins);USE: gm+ cocci & Bacteroides

fragilis;H. flu;Enterobactor;Neisseria;Proteus;E.coli;Klebsiella;Serratia;TOX: Hypersensitivity reactions;

disulfiram-like rxn

Q0666:Cefaclor

2nd Gen Cephalosporin (oral);MECH: beta -lactam; inhibitscell wall synthesis (like penicillins);USE: gm+ cocci &;H.

flu;Enterobactor;Neisseria;Proteus;E.coli;Klebsiella;Serratia;TOX: Hypersensitivity reactions;

disulfiram-like rxn; *serum sickness*

Q0667:Cefuroxime

2nd Gen Cephalosporin (oral);MECH: beta -lactam; inhibitscell wall synthesis (like penicillins);USE: gm+ cocci &;H.

flu;Enterobactor;Neisseria;Proteus;E.coli;Klebsiella;Serratia;TOX: Hypersensitivity reactions;

disulfiram-like rxn

Q0668:Ceftriaxone

3rd Gen Cephalosporin w/ long t1/2 and good CSFpenetration;MECH: beta -lactam; inhibits cell wall synthesis

(like penicillins);USE: gm- HEN PEcKS +; esp. Neisseriagonorrhea;TOX: Hypersensitivity reactions; disulfiram-like

rxn

Q0669:Cefotaxime

3rd Gen Cephalosporin w/ good CSF penetration;MECH:beta -lactam; inhibits cell wall synthesis (like penicillins);USE:

gm- HEN PEcKS +;TOX: Hypersensitivity reactions;disulfiram-like rxn

Q0670:Ceftazidime

3rd Gen Cephalosporin ;MECH: beta -lactam; inhibits cellwall synthesis (like penicillins);USE: gm- HEN PEcKS +; esp.

P. aeruginosa;TOX: Hypersensitivity reactions; disulfiram-like rxn

Q0671:Cefepime

4th Gen Cephalosporin w/ good CSF penetration;MECH:beta -lactam; inhibits cell wall synthesis (like penicillins);USE:

gm+ & P. aeruginosa; E. coli; Klebsiella; Proteus;TOX:Hypersensitivity reactions; disulfiram-like rxn

Q0672:Aztreonam

Monobactam;MECH: Inhibits cell wall synthesis; resistant tobeta -lactamase;USE: Gm- rods: Klebsiella; Pseudomonas;

Serratia;*No activity against gm+ or anaerobes;TOX: usuallynone

Q0673:Imipenam/cilastatin

Carbapenam;MECH: Inhibits cell wall synthesis; resistant tobeta -lactamase;*cilastatin protects imapenam from cleavage

which creates a nephrotoxic metabolite;USE: very broadspectrum: gm+ cocci; gm- rods; anaerobes; esp.

Enterobacter;TOX: GI; rash; seizures (at high plasma levels)

Q0674:Vancomycin

MECH: bactericidal; inhibits cell wall formation by bindin D-ala D-ala portion of cell wall precursors;USE: gm+ MDR

organisms - S. aureus; C. diff;TOX: Fever; chills; phlebitis;red man syndrome (fast infusion); nephrotox; ototox

Q0675:Tetracycline

MECH: Bacteriostatic; binds 30S and prevents aminoacyl-tRNA attachment to inhibit protein synthesis;USE: V.cholera; Acne; Chlamydia; Ureaplasma; Mycoplasma

pneumo; Tularemia; H. pylori; Borrelia burdorferi;Rickettsia;TOX: GI distress; binds calcifying tissue → teeth

discoloration & disrupted growth;photosensitivity;Contraindicated in preg and renal failure;

don't take with milk

Q0676:Doxycycline


pneumo; Tularemia; H. pylori; Borrelia burdorferi;Rickettsia;TOX: GI distress; binds calcifying tissue → teethdiscoloration & disrupted growth; photosensitivity;*Can be

used in pts with renal failure

Q0677:Demeclocycline

MECH: Bacteriostatic; binds 30S and prevents aminoacyl-tRNA attachment to inhibit protein synthesis; *antagonized

ADH;USE: SIADH; V. cholera; Acne; Chlamydia;Ureaplasma; Mycoplasma pneumo; Tularemia; H. pylori;

Borrelia burdorferi; Rickettsia;TOX: GI distress; bindscalcifying tissue → teeth discoloration & disrupted growth;photosensitivity;Contraindicated in preg and renal failure;

don't take with milk

Q0678:Minocycline


pneumo; Tularemia; H. pylori; Borrelia burdorferi; Rickettsia;*can cross BBB to eradicate carrier state;TOX: GI distress;binds calcifying tissue → teeth discoloration & disrupted

growth; photosensitivity; *vestibularproblems;Contraindicated in preg and renal failure; don't take

with milk

Q0679:Gentamicin

MECH: bactericidal; binds 30S inhibiting formation ofinitiation complex and causing mRNA misreading. Requires

O2 for uptake;USE: only aerobic; gm- rods;TOX: Nephrotox(dose-related); Ototox; teratogen

Q0680:Neomycin

Topical;MECH: bactericidal; binds 30S inhibiting formationof initiation complex and causing mRNA misreading. RequiresO2 for uptake;USE: only aerobic; gm- rods;TOX: Nephrotox

(dose-related); Ototox; teratogen

Q0681:Amikacin



Q0682:Tobramycin



Q0683:Streptomycin



Q0684:Erythromycin

MECH: binds 50S inhibiting translocation step;USE: same asPenG (good for pts with PEN allergies); URIs; pneumonias;STDs; Mycoplasma; Legionella; Chlamydia; Neisseria;TOX:

GI; acute cholestatic hepatitis; eosinophila; skin rash;metabolized in liver and interferes with warfarin; theophyline

leading to accumulation

Q0685:Clarithromycin

MECH: binds 50S inhibiting translocation step;USE: same asPenG (good for pts with PEN allergies); URIs; pneumonias;STDs; Mycoplasma; Legionella; Chlamydia; Neisseria;TOX:

GI; acute cholestatic hepatitis; eosinophila; skin rash;metabolized in liver and interferes with warfarin; theophyline

leading to accumulation

Q0686:Azithromycin

MECH: binds 50S inhibiting translocation step;USE: same asPenG (good for pts with PEN allergies); URIs; pneumonias;

STDs; Mycoplasma; Legionella; Chlamydia; Neisseria; H. flu;Moraxella; MAI;TOX: GI; acute cholestatic hepatitis;

eosinophila; skin rash; metabolized in liver and interferes withwarfarin; theophyline leading to accumulation

Q0687:Chloramphenicol

MECH: bacteriostatic; inhibits 50S peptidyltransferase;USE:Broad spectrum; but nasty toxicities limit use. Enters CNSreadily: H. flu; N. meningitidis; S. pneumo;TOX: hemolytic

anemis (G6PD deficiency); aplastic anemia; gray babysyndrome (UDP-glucuronyl transferase deficiency in

newborn)

Q0688:Clindamycin

MECH: blocks peptide bond formation at 50S;USE:Anaerobes above the diaphragm: B. frag; C. perf;TOX:

pseudomembranous colitis; diarrhea; fever

Q0689:-floxacin;Cipro-; moxi-; gati-; nor-; o-; spar-;

MECH: bactericidal; inhibit DNA gyrase → DNAcleavage;USE;- gm- rods of GI;Klebsiella;Enterobacter;E.

coli;Proteus;Serratia;Shigella;- gm- rods of urinarytract;KEEPSS + P. aeruginosa;- Resistant respiratory

infections: pneumococcus;- Neisseria;TOX: GI; CNS (HA;N/V; dizziness); skin

rash/photosensitivity;*Tendonitis/rupture in adults; crampsand myalgias in kids

Q0690:Isoniazid

MECH: inhibits synthesis of mycolic acids;USE:Mycobacterium Tuberculosis;TOX: Neurotox (peripheralneuritis; B6/pyridoxine can prevent); hepatotox; hemolysis

(G6PD deficient); SLE-like syndrome

Q0691:Rifampin

MECH: inhibits DNA dependent RNA polyerase;USE:Mycobacterium Tuberculosis; M. leprae; prophylaxis of

meningococcus and H. flu contacts;TOX: minor; druginteractions (increased P450); rapid resistance if used alone

Q0692:Pyrazinamide

USE: Mycobacterium Tuberculosis

Q0693:Ethambutol

USE: Mycobacterium Tuberculosis

Q0694:Dapsone

USE: M. leprae

Q0695:Amphotericin B

Polyene antifungal;MECH: binds ergosterol which disruptsfungal membrane → leakage;USE: wide spectrum for systemicinfections - Blasto; Histo; Cocci; Crypto; Aspergillus; Mucor;

Candida;*intrathecally for meningitis (doesn't crossBBB);TOX: highly toxic - fever/chills; hypotension;

nephrotox (hydration reduces); arrhythmias; anemia; phlebitis

Q0696:Nystatin

Polyene antifungal;MECH: binds ergosterol which disruptsfungal membrane → leakage;USE: Too toxic for systemic use -

oral thrush; diaper rash; vaginal candidiasis;TOX: same asamphotericin

Q0697:Azoles;Floconazole; ketoconazole; itraconazle;voriconazole

MECH: Inhibits ergosterol synthesis → disrupting membrane(don't use with ampho);USE: Systemic mycoses - ;Flucon forcrypto;Keto for blasto; cocci; histo; candida;TOX: Hormonesynthesis inhibition → endocrine abnormalities; liver dysfxn

(inhibits cytP-450); fever; chills

Q0698:Flucytosine

MECH: inhibits DNA synthesis;USE: systemic candida;crypto;*resistance develops - use with ampho;TOX: N/V;

dairrhea; bone marrow suppression; hepatotox

Q0699:Caspofungin

MECH: inhibits cell wall synthesis;USE: invasiveaspergilloss;TOX: GI; flushing

Q0700:Terbinafine

MECH: inhibits fungal enzyme squalene epoxidase;USE:dermatophytoses

Q0701:Griseofulvin

MECH: interferes with microtubules → disruptsmitosis;USE: dermatophytosis - oral treatment of superficialinfxns;TOX: teratogenic; carcinogenic; HA; increased P-450

and warfarin metabolism

Q0702:Metronidazole

MECH: nitro group serves as an electron-acceptor; formingreduced cytotoxic compounds that bind proteins and DNA →

cell death;USE;anaerobic protazoa: E. histolytica; Giardia;Trichomonas;anaerobic bac: Bacteroides; C. difficile;

Gardnerella;TOX: GI; metallic taste; oral yeast infection;disulfiram-like effect; neurotox (rarely)

Q0703:Primaquine

MECH: not understood - oxidants kill schizonts;USE: P.vivax and P. ovale (liver stage);TOX: Hemolytic anemia

(G6PD deficient)

Q0704:Chloraquine

MECH: inhibits schizont's ability to break down heme →build up; also kills RBC; alkalinization of food vacuole;

decreased DNA synthesis;USE: Plasmodium sporozites in theblood;TOX: GI; pruritis; HA

Q0705:Quinine

MECH: effects DNA synthesis;USE: chloraquine-resistantPlasmodium;TOX: cinchonism - N/V; tinnitus; vertigo;

hemolytic anemia

Q0706:Mefloquine

MECH: effects DNA synthesis;USE: choraquine-resistantPlasmodium;TOX: cinchonism - N/V; tinnitus; vertigo;

disorientaiton

Q0707:Pyrimethamine

MECH: inhibits plasmodial dihydrofolate reductase → blockof DNA synthesis;USE: sporonticide; P. falciparum; with

sulfonamide treats P. malariae and Toxoplasma gondii

Q0708:Melarsoprol

MECH: reacts with enzymes;USE: african sleeping sickness -trypanosoma brucei;TOX: CNS; hypersensitivity; GI

Q0709:Nifurtimox

MECH: oxygen radicals;USE: Trypanosoma cruzi(American);TOX: hypersensitivity; GI

Q0710:Stibugluconate

USE: Leishmania

Q0711:Albendazole; Mebendazole; Thiabendazole

MECH: inhibits microtubules → paralysis → passing ofworms in stool;USE: intestinal nematodes;Ancyclostoma

(hookworm);Ascaris(roundworm);Enterobius;Strongyloides;Trichinella;TOX: GI;

teratogenic

Q0712:Pyrantel pomoate

MECH: depolarizing neuromuscular blockingagent;USE;Ancyclostoma (hookworm);Ascaris(roundworm);Enterobius;TOX: N/V; HA; rash

Q0713:Diethylcarbamazine

MECH: increased phagocytosis of fillaria;USE;Wuchereriabancrofti (elephantitis);Loa loa (skin swelling);Onchocerca

volvulus (river blindness);TOX: reaction caused by death ofparasites

Q0714:Ivermectin

MECH: targets GABA → paralysis;USE: Onchocercavolvulus (river blindness);TOX: contraindicated with other

GABA agonists

Q0715:Praziquantel

MECH: increased calcium permeability →paralysis;USE;Trematodes - Schistosoma; Clonorchis;

Paragonimus westermani;Cestodes - Taenia; Echinococcus

Q0716:Niclosamide

MECH: inhibits ADP phosporylation → death of scolex(head);USE: Cestodes - Taenia; Echinococcus

Q0717:Amantadine

MECH: Blocks viral penetration/uncoating (M2); causesrelease of DA;USE: influenza A prophylaxis and treatment;Parkinson's dz;TOX: cerebellar (ataxia; dizziness; slurred

speech)

Q0718:Rimantidine

MECH: Blocks viral penetration/uncoating (M2);USE:influenza A prophylaxis and treatment;TOX: doesn't cross

BBB (fewer side fx than amantadine)

Q0719:Ribavarin

MECH: inhibits viral mRNA synthesis ;USE: RSV; HepC;Influenza A & B;TOX: hemolytic anemia; teratogen

Q0720:Acyclovir

MECH: preferentially inhibits viral DNA polymerase whenphosphorylated by viral thymidine kinase;USE: HSV

(mucocutaneous and genital lesions); VZV; EBV; prophylaxisin immunocompromised;TOX: delirium; tremor; nephrotox (in

dehydrated);RESISTANCE: lack of thymidine kinase

Q0721:Gancyclovir

MECH: preferentially inhibits CMV DNA polymerase whenphosphorylated by viral thymidine kinase;USE: CMV; esp. in

immunocompromised;TOX: leukopenia; neutropenia;thrombocytopenia; delirium; tremor; nephrotox

;RESISTANCE: lack of thymidine kinase or mutated DNApol

Q0722:Foscarnet

MECH: Binds pyrophosphate site of viral DNA polymerasecausing inhibition;USE: CMV retinitis in

immunocompromised after gancyclovir failure (IVonly);TOX: nephrotox;RESISTANCE: mutated DNA pol

(does not require kinase activation)

Q0723:Zidovudine (AZT);didanosine (ddI);zalcitabine(ddC);stavudne(d4T);lamivudine (3TC);abacavir

Reverse transcriptase inhibitors - nucleosides;MECH: inhibitRT; prevent viral incorporation;USE: HIV with HAART;reduce maternal-to-infant transmission;TOX: bone marrow

suppression; peripheral neuropathy; lactic acidosis;megaloblastic anemia(AZT)

Q0724:Nevirapine;efavirenz;delavirdine

Reverse transcriptase inhibitors - non-nucleosides;MECH:inhibit RT; prevent viral incorporation;USE: HIV with

HAART; reduce maternal-to-infant transmission;TOX: bonemarrow suppression; rash; elev liver enzymes

Q0725:Saquinavir;ritonavir;indinavir;nelfinavir

Protease inhibitors;MECH: block protease to inhibitassembly of new virions;USE: HIV with HAART;TOX:

dyslipidemia; insulin resistance/hyperglycemia;lipodystrophy

Q0726:Enfuviritide

MECH: binds gp41 preventing HIV fusion with targetcell;USE: salvage regimen

Q0727:Interferons (alpha; beta; gamma)

MECH: glycoproteins from human leukocytes that blockvarious stages of viral RNA and DNA synthesis; induce

ribunuclease to degrade viral mRNA;USE;IFNalpha - chronichepB and hepC; karposi's saroma;IFNbeta - MS;IFNγ -

NADPH oxidase deficiency;TOX: Neutropenia

Q0728:Mechanism of action of the anti-fungal therapypolyenes.

Form artificial pores in the cytoplasmic membrane.

Q0729:Mechanism of action of the anti-fungal therapiesterbinafine and azoles.

Terbinafine blocks the conversion of squalene to lanosterol.Azoles block the conversion of lanosterol to ergosterol.

Q0730:Mechanism of action of the anti-fungal therapyflucytosine.

Inhibits DNA synthesis by conversion to fluorouracil; whichcompetes with uracil.

Q0731:Mechanism of action of the anti-fungal therapygriseofulvin.

Disrupts microtubles. Deposits in keratin-containing tissues.

Q0732:Mechanism of action of Amphotericin B.

Binds ergosterol (unique to fungi); forms membrane pores thatallow leakage of electrolytes and disrupt homeostasis."Amphotericin 'tears' holes in the fungal membrane by

forming pores."

Q0733:Clinical uses of Amphotericin B.

Used for a wide spectrum of sytemic mycoses.Cryptococcus; Blastomyces; Coccidioides; Aspergillus;

Histoplasma; Candida; Mucor (systemic mycoses).Intrathecally for fungal meningitis; does not cross blood-brain

barrier.

Q0734:Symptoms of Amphotericin B toxicity.

Fever/chills ("shake and bake"); hypotension; nephrotoxicity;arrhythmias ("amphoterrible").

Q0735:Mechanism of action of Nystatin.

Binds to ergosterol; disrupting fungal membranes.

Q0736:Clinical use of Nystatin.

Swish and swallow for oral candidiasis (thrush). Topical fordiaper rash or vaginal candidiasis.

Q0737:Mechanism of action for fluconazole; ketoconazole;clotrimazole; miconazole; itraconazole; voriconazole.

Inhibits fungal steroid (ergosterol) synthesis. Blocks:lanosterol -> ergosterol

Q0738:Clinical uses of fluconazole; ketoconazole;clotrimazole; miconazole; itraconazole; voriconazole.

Systemic mycoses. Fluconazole for cryptococcal meningitis inAIDS patients and candidal infections of all types (i.e; yeast

infections). Ketoconazole for Blastomyces; coccidioides;Histoplasma; Candida albicans; hypercortisolism.

Q0739:Symptoms of fluconazole; ketoconazole; clotrimazole;miconazole; itraconazole; voriconazole toxicity.

Hormone synthesis inhibition (gynecomastia); liverdysfunction (inhibits cytochrome P-450); fever; chills.

Q0740:Mechanism of action of Flucytosine.

Inhibits DNA synthesis byconversion to fluorouracil; whichcompetes with uracil.

Q0741:Clinical uses of Flucytosine.

Used in sytemic fungal infections (e.g. Candida;Cryptococcus).

Q0742:Flucytosine toxicity.

Nausea; vomitting; diarrhea; bone marrow suppression.

Q0743:Mechanism of action for Caspofungin.

Inhibits cell wall synthesis.

Q0744:Clinical use of Caspofungin.

Invasive aepergillosis.

Q0745:Symptoms of Caspofungin toxicity.

GI upset; flushing.

Q0746:Mechanism of action of Terbinafine.

Inhibits the fungal enzyme squalene epoxidase. Inhibitssqualene -> lanosterol

Q0747:Clinical use of Terbinafine.

Used to treat dermatophytoses (especially onychomycosis).

Q0748:Mechanism of action of Griseofulvin.

Interfers with microtubule function; disrupts mitosis.Deposits in keratin-contianing tissues (e.g. nails).

Q0749:Clinical use of Griseofulvin.

Oral treatment of superficial infections; inhibits growth ofdermatophytes (tinea; ringworm).

Q0750:Symptoms of Griseofulvin toxicity.

Teratogenic; carcinogenic; confusion; headaches; increasewarfarin metabolism.

Q0751:opioid receptors that may be involved in alteringreactivity to pain are located in these regions of the brain?

basal ganglia; hypothalamus; limbic structures; and cerebralcortex

Q0752:what are the types of opioid receptors?

mu; delta; and kappa

Q0753:this opioid receptor plays a major role in therespiratory depressant actions of opioids?

Mu receptor

Q0754:activation of this receptor is involved in the sedativeactions of opioids?

Kappa receptor

Q0755:all 3 major opioid receptors are coupled to theireffector by these things?

G proteins and activate phospholipase C or inhibit adenylylcyclase

Q0756:at the postsynaptic level activation of the opioidreceptors causes this to occur?

opening of K+ channels to cause hyperpolarization (IPSP)

Q0757:at the presynaptic evel opioid receptor activation canclose these ion channels?

voltage gated Ca2+ channels to inhibit neurotransmitterrelease

Q0758:examples of strong opioids?

morphine; methadone; meperidine; fentanyl; levorphanol; andheroin

Q0759:these opioid are partial agonists and have mild tomoderate analgesic efficacy?

Codeine; hydrocodone and oxycodone

Q0760:this agent is a very weak opioid agonist?

Propoxyphene

Q0761:pupillary constriction is characteristic effect of allopioids except this one; which has a muscarinic blocking

action?

Meperidine

Q0762:this condition includes rhinorrhea; lacrimation chills;gooseflesh; muscle aches; diarrhea; yawning; anxiety and

hostility?

abstinenece syndrome

Q0763:which opioids are useful cough suppressants?

Codeine and detromethorphan

Q0764:opioids used to treat diarrhea?

loperamide and diphenoxylate

Q0765:this opioid may be useful in acute pulmonary edemabecause of its hemodynamic actions?

Morphine

Q0766:what is the triad of opioid overdose signs?

pupillary constriction; comatose state; and respiratorydepression

Q0767:diagnosis of opioid overdose is confirmed by thisaction?

IV injection of Naloxone (opioid antagonist)--->prompt signsof recovery

Q0768:concomitant use of certain opioid like meperidine withMAOIs can result in this condition?

hyperpyrexic coma

Q0769:meperidine has also been implicated in serotoninsyndrome when used with this antidepressant class?

SSRIs

Q0770:the prolonged activity of Buprenorphine is clinicallyuseful to suppress withdrawal signs in dependency

states;how does this property affect Naloxone reversalefforts?

Buprenorphine is resistant to naloxone reversal due to itsprolonged activity

Q0771:this drug decreases the craving for Alcohol and isapproved for adjunctive use in alcohol dependency programs?

Naltrexone

Q0772:Effects of H1 receptor activation

Increased capillary dilation and permeability (hypotension;edema); bronchoconstriction; activation of nociceptive

receptors (pain; pruritus)

Q0773:Effects of H2 receptor activation

Increased gastric acid secretion (ulcers); positive inotropism

Q0774:H1 antagonist drugs

Diphenhydramine; promethazine; chlorpheniramine;meclizine; hydroxyzine; loratadine; fexofenadine

Q0775:Uses of H1 antagonists

Hay fever; rhinitis; urticaria; motion sickness and vertigo(meclizine); nausea in pregnancy

Q0776:Adverse effects of H1 antagonists

M block and sedation; GI distress; allergic reactions.

Q0777:Substances that increase proton pump activity

ACh; gastrin; histamine (H2 receptors)

Q0778:H2 antagonist drugs

Cimetidine; ranitidine

Q0779:MOA of H2 antagonists

Indirectly decrease proton pump activity (histamine increasesproton pump activity)

Q0780:Uses of H2 antagonists

Peptic ulcer disease; GERD; Zollinger-Ellison

Q0781:Side effects of H2 antagonists

GI distress; dizziness; sommnolence; Cimetidine: inhibitsP450 --> increases effects of quinidine; phenytoin; TCAs;

warfarin; also decreases androgens --> gynecomastia

Q0782:Omeprazole

Direct; irreversible proton pump inhibitor. Uses: PUD;GERD; Zollinger-Ellison; H. pylori. Side effects: decreases

bioavailability of weak acids (fluoroquinolones;ketoconazole); inhibits P450

Q0783:Misoprostol

PGE1 analog; increases mucus and bicarbinote; decreases HCLsecretion. Use: NSAID-induced ulcers.

Q0784:Sulcralfate

Polymerizes in stomach to coat ulcers. Increases healing anddecreases ulcer recurrence.

Q0785:Drugs that require acid stomach pH to be absorbed

Azoles; fluoroquinolones; warfarin

Q0786:Drugs used as antiemetics

5HT3 antagonists (ondansetron); DA antagonists(metoclopramide); H1 blockers (diphenhydramine; meclizine);

muscarinic blockers (scopolamine)

Q0787:Metabolism of serotonin

5HT is metabolized by MAOa to 5-hydroxyinolacetic acid(marker for carcinoid)

Q0788:Buspirone

Partial 5HT1a agonist used for generalized anxiety disorder

Q0789:Sumatriptan

5HT1d agonist in cerebral vessels; used for migraine

Q0790:Olanzapine

Atypical antipsychotic; 5HT2a receptor antagonist; decreasespsychosis

Q0791:Cyproheptadine

5HT2 antagonist used in carcinoid

Q0792:Ondansetron

5HT3 antagonist; used as antiemetic in chemotherapy;radiation and post-op. 5HT3 receptors are found in area

postrema

Q0793:Ergonovine

Uterine muscle contraction after placental delivery

Q0794:Ergotamine

Partial 5HT2 and alpha agonist causes vasoconstriction todecrease pulsation in migraine acute attack. Side effect is

vasoconstriction (prinzmetal)

Q0795:Prophylaxis of migraine headaches

Propranolol; verapamil; amitriptyline; valproic acid

Q0796:PGE2

Vasodilation in kidneys; increases renal blood flow; increasesgastric mucosal blood flow (mucoprotection); activates

osteoclasts; fever; pain; maintains ductus arteriosus

Q0797:Prostacyclin (PGI2)

Vasodilation and inhibits platelet aggregation

Q0798:COX1

Constitutive enzyme synthesizes GI PGs and TxA2

Q0799:COX2

Inducible enzyme synthesizes PGs involved in inflammation;fever and pain.

Q0800:Zileuton

Lipoxygenase inhibtor used in asthma

Q0801:Zafirlukast and -lukasts

Leukotriene receptor antagonist used in asthma

Q0802:MOA of aspirin

Nonselective; irreversible COX inhibitor via acetylation ofserine near active site

Q0803:Actions of aspirin

Low dose: antiplatelet aggregation (post-MI); moderate dose:analgesia; antipyeresis; hyperuricemia; High dose:

antiinflammatory; uricosuria

Q0804:Effects of aspirin on acid-base and electrolytes

Antiinflammatory doses: uncoupling of ETC --> increasesrespiration --> decreased pCO2 --> resp. alkalosis --> renal

compensation via HCO3 excretion --> compensatedrespiratory alkalosis. Toxic doses: inhibits respiratory center -

-> decreases respiration --> resp. acidosis plus ETCuncoupling --> metabolic acidosis; decreases ATP;

hyperthermia; hypokalemia

Q0805:Side effects of aspirin

Gastritis; ulcers; bleeding; tinnitus; vertigo; decreased hearing;bronchoconstriction; hypersensitivity (asthma; nasal polyps;

rhinitis); Reye syndrome; increased bleeding time; renaldysfunction at high doses

Q0806:Aspirin overdose management

Gastric lavage; alkalinization of urine (zero-order kinetics attoxic doses)

Q0807:Celecoxib

Selective COX-2 inhibitor. Antiinflammatory. Increases PTwhen used with warfarin; prothrombotic. Cross

hypersensitivity with sulfonamides. Potential cardiotoxicityresulted in withdrawal of rofecoxib.

Q0808:Acetaminophen

Inhibits COX in CNS only. No antiplatelet activity; notimplicated in Reye syndrome; no effects on uric acid; no

bonchoconstriction. Metabolized via P450. Hepatotoxic dueto reactive metabolite N-acetylbenzoquinonemine; which is

inactivated by GSH. Upon GSH depletion; metabolitedamages hepatocytes; nausea; vomiting; abdominal pain;centrilobular necrosis. Inducers of P450 enhance toxicity.

Management of hepatotoxicity: N-acetylcysteine.

Q0809:Hydroxychloroquine

Used for rheumatoid arthritis. Stabilizes lysosomes anddecreases chemotaxis. Side effects: GI distress; visual

dysfunction; hemolysis in G6PDH deficiency

Q0810:Methotrexate

Used for rheumatoid arthritis. Cytotoxic to lymphocytes.Side effects: hematotoxicity; mucositis; crystalluria

Q0811:Sulfasalazine

Used for rheumatoid arthritis. Decreases B cell function;possibly inhibits COX. Side effects: GI distress; rash;hemolysis in G6PDH deficiency; drug-induced lupus

Q0812:Glucocorticoids

Used in rheumatoid arthritis. Decrease LTs and plateletactivating factor (PAF). Side effects: ACTH suppression;

Cushingoid state; osteoporosis; GI distress; glaucoma

Q0813:Gold salts

Used in rheumatoid arthritis. Decreases lysosomal andmacrophage functions. Side effects: dermatitis;

hematotoxicity; nephrotoxicity

Q0814:Penicillamine

Used in rheumatoid arthritis. Suppresses T cells andcirculating rheumatoid factor. Side effects: proteinuria;

hematotoxicity; autoimmune disease.

Q0815:Etanercept

Used in rheumatoid arthritis. Binds TNF. Side effects:hypersensitivity; injection site reactions; infections

Q0816:Infliximab

Used in rheumatoid arthritis. Monoclonal antibody to TNF.Side effects: infusion reactions; infections

Q0817:Anakinra

Used in rheumatoid arthritis. IL-1 receptor antagonist. Sideeffects: infections; injection site reactions

Q0818:Colchicine

Used in acute gout. Binds tubulin --> decreases microtubularpolymerization ; decreases LTB4 and leukocyte/granulocyte

migration. Side effects: diarrhea; GI pain; hematuria;myelosuppression; neuropathy

Q0819:Allopurinol

Prodrug converted by xanthine osidase into alloxanthine whichinhibits the enzyme --> decreases purine metabolism -->

decreases uric acid. Side effects: GI distress; neuropathy; rash;vasculitis; stones.

Q0820:Probenecid

Inhibits tubular reabsorption of urate. Interactions: inhibitssecretion of acidic drugs (cephalosporins; fluoroquinolones).

Side effects: GI distress; rash; nephrotic syndrome;crystallization

Q0821:Glucocorticoid drugs

Cortisol; prednisone; triamcinolone; betamethasone;dexamethasone

Q0822:MOA of glucocorticoids

Inhibits leukocyte migration; phagocytosis and capillarypermeability; decreases PGs; LTs; expression of COX2; PAF

and interleukins

Q0823:Uses of glucocorticoids

Antiinflammatory and immunosuppressive

Q0824:Side effects of glucocorticoids

Suppression of ACTH --> cortical atrophy; shock if abruptlywithdrawn; cushingoid syndrome; hyperglycemia (increased

gluconeogenesis); osteoporosis with vertebral fractures;gastric acid secretion (ulcers); Na+ and H2O retention with

edema and hypertension; hypokalemic alkalosis;hypocalcemia; inhibits bone growth in children; decreaseswound healing (infections); increased sorbitol (glaucoma;

cataracts); mental dysfunction.

Q0825:Role of beta agonists in asthma

Selective beta 2 agonists: Relief of acute bronchoconstriction(albuterol; metaproterenol; terbutaline) and prophylaxis ofnightime attacks (salmeterol). Side effects include anxiety;

tremors and CV toxicity

Q0826:Ipratropium

Muscarinic blocker causes bronchodilation in acute asthma.Safer than beta 2 agonists in patients with cardiovascular

disease. DOC in bronchospasm induced by beta -blockers.

Q0827:Theophylline

Inhibits phosphodiesterase --> increases cAMP -->bronchodilation. Also antagonizes adenosine

(broncoconstrictor). Narrow therapeutic index. Side effects:nausea; diarrhea; increases HR; arrhythmias. Increased

toxicity with erythromycin; cimetidine and fluoroquinolones.

Q0828:Role of glucocorticoids in asthma

Decreases reactivity by decreasing PGs; LTs and Ils; Maycause oropharyngeal candidiasis and retarded bon growth with

chronic use; low doses prevent desensitization of betareceptors.

Q0829:Zafirlukast; mentelukast

LTD4 antagonists with slow onset. Used prophylactically forantigen; exercise or drug-induced asthma.

Q0830:Zileuton

Selective inhibitor of lypoxygenases --> decreased Ils. Rapidonset; adjunct to steroids.

Q0831:MOA of NSAIDS

inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase(cox)

Q0832:Difference between aspirin and other NSAIDS

Aspirin irreversibly inhibits cyclooxygenase

Q0833:Four main actions of NSAIDS

Anti-inflammatory; analgesia; antipyretic and antiplateletactivity

Q0834:Agent used for closure of patent ductus arteriosus

Indomethacin

Q0835:Aspirin is contraindicated in children with viralinfection

Potential for development of Reye's syndrome

Q0836:SE of salicylates

Tinnitus; GI bleeding

Q0837:NSAID also available as an ophthalmic preparation

Diclofenac

Q0838:NSAID available orally; IM and ophthalmically

Ketoralac

Q0839:NSAID that is used for acute condition; such as pre-op anesthesia and has limited duration (<5 days) of use due to

nephrotoxicity

Ketoralac

Q0840:Newer NSAIDs that selectively inhibit COX-2

Celecoxib and rofecoxib

Q0841:COX 2 inhibitors may have reduced risk of

Gastric ulcers and GI Bleeding

Q0842:COX 2 inhibitors should be used cautiously in ptswith

Pre-existing cardiac or renal disease

Q0843:Acetaminophen only has

Antipyretic and analgesic activity

Q0844:SE of acetaminophen

Hepatotoxicity

Q0845:Antidote for acetaminophen toxicity

N-acetylcysteine

Q0846:DMARDs are slow acting drugs for

Rheumatic disease

Q0847:MOA of gold salts

Alter activity of macrophages and suppress phagocyticactivity of PMNs

Q0848:SE of gold salts

Dermatitis of the mouth aplastic anemia and agranulocytosis

Q0849:Causes bone marrow suppression

Methotrexate

Q0850:SE of penicillamine

Aplastic anemia and renal

Q0851:Interferes with activity of T-lymphocytes

Hydroxychloroquine

Q0852:Anti-malarial drug used in rheumatoid arthritis (RA)

Hydroxychloroquine

Q0853:SE of hydroxychloroquine

Retinal destruction and dermatitis

Q0854:MOA of Leflunomide (newer agent)

Inhibiting Dihydroorotate Dehydrogenase which leads todecreased pyrimidine synthesis

Q0855:Proteins that prevent action of tumor necrosis factoralpha (TNF-alpha)

Infliximab and etanercept

Q0856:Anti-rheumatic agent also used for ulcerative colitis

Sulfasalazine

Q0857:NSAIDS used in gout

Indomethacin and phenylbutazone

Q0858:NSAID contraindicated in gout

Aspirin

Q0859:SE of phenylbutazone

Aplastic anemia and agranulocytosis

Q0860:MOA of Colchicine (used in acute gout)

Selective inhibitor of microtubule assembly

Q0861:SE of colchicine

Kidney and liver toxicity

Q0862:Agent used to treat chronic gout by increasing uric acidsecretion

Probenecid and sulfinpyrazone

Q0863:Allopurinol treats chronic gout by inhibiting

Xanthine oxidase

Q0864:Disease caused by excess ergot alkaloids

St. Anthony's Fire

Q0865:Endogenous substances commonly interpreted ashistamine; serotonin; prostaglandins; and vasoactive peptides

Autocoids

Q0866:Syndrome of hypersecretion of gastric acid and pepsinusually caused by gastrinoma; it is associated with severe

peptic ulceration and diarrhea

Zollinger-Ellison Syndrome

Q0867:Drug that causes contraction of the uterus

Oxytocin

Q0868:Distribution of histamine receptors H1; H2; and H3

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

Q0869:Prototype antagonist of H1 and H2 receptors

Diphenhydramine and impromidine respectively

Q0870:1st generation antihistamine that is highly sedating

Diphendydramine

Q0871:1st generation antihistamine that is least sedating

Chlorpheniramine or cyclizine

Q0872:2nd generation antihistamines

Fexofenadine; loratadine; and cetirizine

Q0873:Generation of antihistamine that has the most CNSeffects

First generation due to being more lipid-soluble

Q0874:Major indication for H1 receptor antagonist

Use in IgE mediated allergic reaction

Q0875:Antihistamine that can be used for anxiety andinsomnia and is not addictive

hydroxyzine (Atarax)

Q0876:H1 antagonist used in motion sickness

Dimenhydrinate; meclizine; and other 1st generation

Q0877:Most common side effect of 1st generationantihistamines

Sedation

Q0878:Lethal arrhythmias resulting from concurrent therapywith azole fungals (metabolized by CYP 3A4) and these

antihistamines which inhibit the 3A4 iso-enzyme.

Terfenadine and astemizole (have been removed from themarket)

Q0879:H2 blocker that causes the most interactions withother drugs

Cimetidine

Q0880:Clinical use for H2 blockers

Acid reflux disease; duodenal ulcer and peptic ulcer disease

Q0881:Receptors for serotonin (5HT-1) are located

Mostly in the brain; and they mediate synaptic inhibition viaincreased K+ conductance

Q0882:5HT-1d agonist used for migraine headaches

Sumatriptan; naratriptan; and rizatriptan

Q0883:Triptan available in parenteral and nasal formulation

Sumatriptan

Q0884:H1 blocker that is also a serotonin antagonist

Cyproheptadine

Q0885:5HT2 antagonist mediate synaptic excitation in theCNS and smooth muscle contraction

Ketanserin; cyproheptadine; and ergot alkaloids (partialagonist of alpha and serotonin receptors)

Q0886:Agents for reduction of postpartum bleeding

Ergonovine and ergotamine

Q0887:Agents used in treatment of carcinoid tumor

Ketanserin cyproheptadine; and phenoxybenzamine

Q0888:5HT-3 antagonist used in chemotherapeutic inducedemesis

Ondansetron; granisetron; dolasetron and alosetron

Q0889:5ht-3 antagonist that has been associated with QRSand QTc prolongation and should not be used in patients with

heart disease

Dolasetron

Q0890:DOC of chemo induced nausea and vomiting

Odansetron

Q0891:Drug used in ergot alkaloids overdose; ischemia andgangrene

Nitroprusside

Q0892:Reason ergot alkaloids are contraindicated inpregnancy

Uterine contractions

Q0893:SE of ergot alkaloids

Hallucinations resembling psychosis

Q0894:Ergot alkaloid used as an illicit drug

LSD

Q0895:Dopamine agonist used in hyperprolactinemia

Bromocriptine

Q0896:Peptide causing increased capillary permeability andedema

Bradykinin and histamine

Q0897:Mediator of tissue pain; edema; inactivated by ACE;and may be a contributing factor to the development of

angioedema

Bradykinin

Q0898:Drug causing depletion of substance P (vasodilator)

Capsaicin

Q0899:Prostaglandins that cause abortions

Prostaglandin E1 (misoprostol) PGE2; and PGF2alpha

Q0900:Difference between COX 1 and COX 2

COX 1 is found throughout the body and COX 2 is only ininflammatory tissue

Q0901:Drug that selectively inhibits COX 2

Celecoxib; valdecoxib; and rofecoxib

Q0902:Inhibitor of lipoxygenase

Zileuton

Q0903:Major SE of zileuton

Liver toxicity

Q0904:Inhibitor of leukotrienes (LTD4) receptors and used inasthma

Zafirlukast and montelukast

Q0905:Used in pediatrics to maintain patency of ductusarteriosis

PGE1

Q0906:Approved for use in severe pulmonary HTN

PGI2 (epoprostenol)

Q0907:Prostaglandin used in the treatment impotence

Alprostadil

Q0908:Irreversible; nonselective COX inhibitor

Aspirin

Q0909:Class of drugs that reversibly inhibit COX

NSAIDS

Q0910:Primary endogenous substrate for Nitric OxidaseSynthase

Arginine

Q0911:MOA and effect of nitric oxide

Stimulates cGMP which leads to vascular smooth musclerelaxation

Q0912:Long acting beta 2 agonist used in asthma

Salmeterol

Q0913:Muscarinic antagonist used in asthma

Ipratropium

Q0914:MOA action of cromolyn

Mast cell stabilizer

Q0915:Enzyme which theophylline inhibits

Phosphodiesterase

Q0916:Methylxanthine derivative used as a remedy forintermittent claudication

Pentoxifylline

Q0917:Antidote for severe CV toxicity of theophylline

Beta blockers

Q0918:MOA of corticosteroids

inhibit phospholipase A2

Q0919:SE of long term (>5 days) corticosteroid therapy andremedy

Adrenal suppression and weaning slowly; respectively

Q0920:Parathyroid hormone (PTH) acts on these receptors toinc. cAMP in bone and renal tubular cells?

G-protein couples receptors

Q0921:Vit D is a derivative of this compound?

7-dehydrocholesterol

Q0922:the actions of Vit D are mediated through receptors inthis location?

nuclear receptors (which regulate gene expression)

Q0923:Bone formation may be increased by theadministration of this form of Vit D?

24;25-dihydroxyvitamin D (secalcifediol)

Q0924:Vit D supplements and synthetic derivatives are usedin these conditions?

deficiency states such as: chronic renal failure; intestinalosteodystrophy; & nutritional rickets

Q0925:this hormone has been used in conditions in which anacute reduction of serum calcium is needed (eg Paget's disease

and hypercalcemia)?

Cacitonin

Q0926:what is the benefit of using salmon calcitonin overhuman calcitonin?

Salmon Calcitonin has a longer half life and greater potency

Q0927:these drugs can prevent or delay bone loss inpostmenopausal women through inhibition of PTH-

stimulated bone resorption?

Estrogens and SERMS (tamoxifen and Raloxifen)

Q0928:chronic systemic use of these drugs is a common causeof osteoporosis in adults?

Glucocorticoids

Q0929:these hormone are useful in the intermediate termtreatment of Hypercalcemia?

Glucocorticoids

Q0930:examples of bisphosphonates?

alendronate; etidronate; pamidronate; and risedronate (ALLEND IN -DRONATE)

Q0931:actions of bisphosphonates?

reduce both resorption and formation of bone; affect Vit Dproduciton; calcium absorption from GI tract; and direct

effects of OsteoClasts

Q0932:chronic therapy with this class of drugs can slow theprogress of postemenopausal osteoporosis and REDUCES

FRACTURES?

Bisphosphonates

Q0933:what is the oral bioavailability of bisphosphonates?

LOW <10% (and food impairs absorption)

Q0934:side effect of bisphosphonates?

Esophageal ulceration (so pts shoudl take with lots of H2O)

Q0935:acute toxicity of this compound (as would occur w/ingestion of Rat poison) results in GI and Neurologic

symptoms?

Fluoride

Q0936:what is seen with CHRONIC Fluoride toxicity(fluorosis)?

Ectopic bone formation and Bony Bumps on Bones(exostoses)

Q0937:antibiotic used to reduce serum calcium and boneresorption in Paget's disease and hypercalcemia?

Plicamycin (mithramycin)

Q0938:what are the serious toxicities of Plicamycin?

thrombocytopenia; hemorrhage; hepatic and renal damage (sonot used commonly; mainly restricted to short term treatment

of serious hypercalcemia)

Q0939:diuretics that can affect serum calcium levels?

Thiazides and Furosemide (Loop)

Q0940:(5) Parkinsons drugs

BALSA;Bromocriptine;Amantadine;Levodopa;Selegiline;Antimuscarinics

Q0941:Parkinson drug;agonized dopamine receptors

Bromocriptine

Q0942:Parkinson drug;Increases Dopamine;(2)

Amantidine;;L-Dopa

Q0943:Parkinson drug;selectively inhibits MAO-B; therebyincreasing availability of DA

Selegiline

Q0944:Parkinson drug;improves cholinergic activity (tremorand rigidity)

Benztropine;(anti-muscarinic)

Q0945:what coverts L-dopa to dopamine in the brain?;AE toperiphreal L-dopa/carbidpoa

Carboxylase;;AE;Arrthymias

Q0946:serotonin agonist causing vasoconstriction for Tx ofmigraine or cluster HA;what specific receptor?;AE

Sumatriptan;receptor: 5HT-1D;AE: Coronary vasospasm

Q0947:AE of Benzodiazepines

Sedation

Q0948:(3) drugs that are first-line for Tonic-Clonic seizures

PVC;Phenytoin;;Valproic Acid;;Carbamazepine

Q0949:(2) drugs that are first-line for Absent seizures

Ethosuximide;;Valproic Acid

Q0950:MOA of Valproic Acid;(3) AE;Aside from Bipolard/o; what other psych Dx can it be used for?

MOA;Na-channel (and Ca-channel)blocker;AE;Hepatotoxicity;Neural tube defects infetus;Tremor;(also can be used for Schizophrenia)

Q0951:What are the (4) Tx for Status Epilepticus

Diazepam;;Lorazepam;;Phenytoin;;Phenobarbital

Q0952:DOC for seizures in pregnant women and children

Phenobarbital

Q0953:DOC for Trigeminal neuralgia; Tonic-Clonic seizures;schizophrenia and bipolar disorder;(2) AE;what monthly test

should be done to patient?

Carbamazepine;AE;Hepatotoxicity;Aplastic Anemia;monthlytest: LFTs

Q0954:(2) epilepsy drugs that can cause Stevens-Johnsonsyndrome

Ethosuximide;Lamotrigine

Q0955:MOA of Ethosuximide

Blocks T-type Ca-channels

Q0956:epileptic drug that blocks Na channels and inhibitsglutamate release from presynaptic neurons;AE (4)

Phenytoin;AE;Gingival hyperplasia;Hirsutism;SLE-likesyndrome;Nystagmus and ataxia

Q0957:drug class that facilitates GABA action by increasingthe duration of Cl- channel opening;contraindication?

Barbiturates;[barbiDURATes inc DURATion];CI: Porphyria

Q0958:Barbiturate that is used in ansthesia induction

Thiopental

Q0959:drug class that facilitates GABA action by increasingthe frequency of Cl- channel opening;use (4)*

Benzodiazepines;use (DumbASS);Detoxification;Anxiety;Status epilepticus;Sleep issues

(walking; terrors)

Q0960:(3) short-acting Benzos

short TOM thumb;Triazolam;Oxazepam;Midazolam

Q0961:DOC for Huntington's DZ;(3)*

Practice HuntingTrees;Phenothiazines;Haloperidol;Tetrabenazine

Q0962:DOC for Tourette's

Haloperidol

Q0963:beta-blocker used to Tx tremor

Propranolol

Q0964:DOC in Wilson's Dz

Penicillamine

Q0965:(3)* Neuroleptic Antipsychotics that block the D2receptors;main use?

THC;Thioridazine;;Haloperidol;;Chlorpromazine;use:Schizophrenia

Q0966:AE of Neuroleptics (antipsychotics);for each receptorblocked;1. DA;2. Muscarinic;3. Alpha;4. Histamine

DA: Hyperprolactinemia; gynecomastia;Muscarinic: drymouth; constipation;Alpha: Hypotension;;Histamine:

Sedation

Q0967:Dx;rigidity; myoglobinuria; autonomic instability;hyperpyrexia; recent Tx for schizophrenia;Tx?;(3 possible)

Neuroleptic Malignant syndrome;Tx;1. Bromocriptine;2.Amantidine;3. Dantrolene

Q0968:Dx;strange oral-facial movements; chorea; recentneuroleptic ingestion

Tardive Dyskinesia

Q0969:(3) Atypical Antipsychotics

OLanzapine; CLOZapine; RISPERidone;[its not ATYPICALfor OLd CLOZets to RISPER]

Q0970:MOA of Atypical antipsychotics;which is used to TxOCD?;which causes Agranulocytosis as an AE?

block Serotonin and Dopamine receptors;OLanzapine -OCD;CLOZapine - Agranulocytosis

Q0971:(4)* AE of Lithium;Use?

Lithium;LMNOP;Lithium AE =;Movement(tremor);Nephrogenic DI;hypOthyroidism;Pregnancy

problems;Use: Mood stabilizer for Bipolar disorder to blockmanic events

Q0972:(4)* SSRIs;;AE? (2)

"the CITy PAROt FLU downSERTRAIL";CITalopram;;PAROxetine;;FLUoxetine;;SERTR

ALine;AE: Sexual dysfunction and N/V

Q0973:(3) TCAs;MOA;Basic (not toxic) AE (2)

CIA;Clomipramine;Imipramine;Amitriptyline;MOA: blockreuptake of NE and Serotonin;AE;Sedation;anticholinergic

side effects

Q0974:TCA used for bedwetting

Imipramine

Q0975:TCA used for OCD

Clomipramine

Q0976:Toxicity of TCA;(3)

("Tri-C");Convulsions;;Coma;;Cardiotoxicity

Q0977:(5)* Heterocyclic Antidepressants

"you need BUtane in your VEINs to MURder for a MAP ofalcaTRAZ";BUproprion;VENlafaxine;MIRtazapine;MAProti

line;TRAZodone

Q0978:heterocyclic that also Tx smoking

Bupropion

Q0979:heterocyclic that inhibits Serotonin; NE and DAreuptake

Venlafaxine

Q0980:heterocyclic that is an alpha2-blocker

Mirtazapine

Q0981:what (3) drugs can MAO-inhibitors not combinewith?;why?

Tyramine - HTN crisis;SSRI - Serotonin syndrome;B-agonist- Serotonin syndrome

Q0982:what does it mean if an anesthetic has a high solubilityin blood?;(2)

slower induction and slower recovery time;(Low bloodsolubility = rapid induction and recovery time)

Q0983:what does it mean if an anesthetic has a high solubilityin lipids?

Increased Potency;High lipid solubility = 1/MAC

Q0984:AE of Halothane

Hepatotoxicity

Q0985:(5)* types of IV anesthetics

B.B.King on OPIATES PROPOsesFOOLishly;Barbs;Benzos;Ketamine;Opiates;Propofol

Q0986:common Benzo used for endoscopy

Midazolam

Q0987:how can you tell Amide local anesthetics versusesters?;MOA of locals

AmIdes have 2 "I's" in the name;ex: LIdocaIne;MOA: Na-channel blockers

Q0988:which local anesthetic has cardiovascular toxicity?

Bupivacaine

Q0989:used to Tx hyperthermia caused by inhalationanesthetics and neuroleptic malignant syndrome;MOA

Dantrolene;;MOA;prevents release of Ca from SR of skeletalmuscles

Q0990:what mixed agonist/antagonist of opioid receptors canplace a person on Methadone back into withdrawal?

Pentazocine

Q0991:what is the only opioid delivered parenterally?

Fentanyl

Q0992:what is the only local anesthetic used topically?

Benzocaine

Q0993:(2) MAO inhibitors

Phenelzine;;Tranylcypromine

Q0994:what NT does it block;Neuroleptics

Dompamine (D2)

Q0995:what NT does it block;Atypical antipsychotics

Serotonin;Dopamine

Q0996:what (2) NT does it block;TCAs

Serotonin;NE

Q0997:what NT does it block;Heterocyclics

Vary;

Q0998:which SSRI also inhibits NE?

Fluoxetine

Q0999:which opiate receptor has the majority of the AE andEuphoria?;which has Dysphoria?

U - Euphoria (and AE);;K - Dysphoria

Q1000:in addition to Tx schizo; what abdominal Sx doesChlorpromazine Tx?

Nausea and Vomiting

Q1001:what class of Antipsychotics have AE associated w/blocking Dopamine; Muscarinic; alpha and Histamine

receptors?

Neuroleptics;Chlorpromazine ("-AZINES") and Haloperidol

Q1002:Which Schizophrenic drug is also effective inminimizing the emotional bluntness and social withdrawal Sx?

Olanzapine

Q1003:what "NSAID" does not inhibit prostaglandinsynthesis?

Acetaminophen

Q1004:general anesthetic that causes AE of Hyperthermia;HTN; HyperK; tachycardia; muscle rigidity and Metabolic

Acidosis?

Halothane

Q1005:which Benzo is good for alcohol withdrawal?

Diazepam

Q1006:which anti-alcohol med causes nausea and vomiting w/alcohol consumption?

Disulfiram

Q1007:what Benzo is good versus Agoraphobia and Panicdisorders?

Alprazolam

Q1008:what anti-epileptic / anti-psychotic can induceseizures?

Clozapine

Q1009:AE of Propofol

Metabolic Acidosis

Q1010:list the progressive depression of the CNS;(5)

Sedation -> Hypnosis -> Anesthesia ->;Coma -> death

Q1011:what is the effect a local anesthetic has on nervefibers?

Pain -> Sensory -> Motor

Q1012:What is the underlying cause of Parkinson's?

loss of dopaminergic neurons and excess cholinergic activity

Q1013:Mneumonic for Parkinson's Disease drugs?

BALSA: Bromocriptine; Amantiadine; Levodopa(+carbidopa); Selegiline (+COMT inhibitors);

Antimuscarinics

Q1014:MOA of Bromocriptine?

agonize dopamine receptors (ergot alkaloid and partialdopamine agonist)

Q1015:Agents that increase dopamine?

Amantadine (increase dopamine release); L-dopa/carbidopa(converted to dopamine in CNS)

Q1016:MOA of Selegiline and entacapone/tolcapone?

Prevent dopamine breakdown (Selegiline=selective MAOtype B inhibitor)and (entacapone/tolcapone=COMT

inhibitors)

Q1017:MOA of Benztropine?

Curbs excess cholinergic activity (antimuscarinic)

Q1018:Antimuscarinic that improves tremor and rigidity buthas little effect on bradykinesia?

Benztropine

Q1019:Clinical use of L-dopa/carbidopa?

Parkinsonism

Q1020:MOA of L-dopa/carbidopa?

Increase dopamine levels in brain. Cross BBB and convertedby dopa decarboxylase in CNS to dopamine.

Q1021:Toxicity of L-dopa?

Arrhythmias from peripheral conversion to dopamine;dyskinesia after doses and akinesia between doses.

Q1022:How can you avoid L-dopa induced arrhythmias?

Give with carbidopa = a peripheral decarboxylase inhibitor

Q1023:Selegiline MOA?

Inhibits MAO-B; increase dopamine availability

Q1024:Selegiline toxicity?

enhance adverse effects of L-dopa

Q1025:Sumatriptin MOA?

5-HT1D agonist. Causes vasoconstriction.

Q1026:Clinical use of Sumatriptin?

acute migraine; cluster headaches

Q1027:Sumatriptin toxicity and contraindications?

coronary vasospasm; contraindicated in pts with CAD orangina

Q1028:Clinical use of phenytoin?

1st line for generalized tonic-clonic seizures and statusepilepticus prophylaxis. Also a class IB antiarrhythmic.

Q1029:MOA of phenytoin?

increase Na+ channel inactivation. Inhibits glutamate(excitatory) release.

Q1030:Clinical use of Carbamazepine?

1st line for generalized tonic-clonic seizures and trigeminalneuralgia. Also for simple and complex partial seizures.

Q1031:MOA of Carbamazepine?

increase Na+ channel inactivation

Q1032:Toxicity of Carbamazepine?

diplopia; atazia; agranulocytosis; aplastic anemia; livertoxicity; teratogenesis; induces cyto P-450

Q1033:Toxicity of phenytoin?

nystagmus; diplopia; ataxia; sedation; gingival hyperplasia;hirsutism; megaloblastic anemia; teratogenesis; malignanthyperthermia; SLE-like syndrome; induces cyto P-450

Q1034:Lamotrigine MOA?

blocks voltage-gaated Na+ channels

Q1035:Clinical use Gabapentin?

simple and complex partial seizures; generalized tonic-clonic.Also peripheral neuropathy.

Q1036:MOA of Gabapentin?

increase GABA release

Q1037:Topiramate MOA?

blocks Na+ channels; increase GABA action

Q1038:Gabapentin toxicity?

sedation; ataxia

Q1039:Lamotrigine toxicity?

Stevens-Johnson syndrome.

Q1040:Topiramete toxicity?

sedation; mental dulling; kidney stones; weight loss

Q1041:Phenobarbital clinical use?

1st line in preggers and kids. Generalized tonic-clonic andsimple and complex partial seizures.

Q1042:Barbituate toxicity?

sedation; tolerance; dependence; cyto P-450 induction;resp/CV depression; additive with alcohol

Q1043:Barbituate MOA?

increases GABA-A action by increase DURATION of Cl-channel opening; which decreases neuron firing.

[barbiDURATe=increased DURATion]

Q1044:Valproic acid clinical use?

1st line for generalized tonic-clonic seizures. Also formyoclonic and absence seizures.

Q1045:Valproic acid MOA?

increase Na+ channel inactivation. Increase GABAconcentration.

Q1046:Valproic acid toxicity?

GI distress; fatal hepatotoxicity; neural tube defects; tremor;weight gain

Q1047:Ethosuximide clinical use?

1st line for absence seizures.

Q1048:MOA ethosuximide?

blocks thalamice T-type Calcium channels

Q1049:Ethosuximide toxicity?

GI distress; lethargy; headache; urticaria; Stevens-Johnsonsyndrome

Q1050:Benzodiazepine clinical uses?

1st line for acute status epilepticus; also for seizures ofeclampsia

Q1051:Name 4 barbituates.

Phenobarbital; pentobarbital; thiopental; secobarbital

Q1052:Barbituate contraindication?

porphyria

Q1053:Name some Benzodiazepines. (8)

diazepam; lorazepam; triaxolam; temazepam; oxazepam;midazolam; chlordiazepoxide; alpraxolam

Q1054:MOA of Benzos?

Facilitate GABA-A action by increse FREQUENCY of Cl-channel opening

Q1055:What drug class do you use for alcohol withdrawal-DTs?

Benzos

Q1056:What are the 3 short-acting Benzos?

TOM thumb= Triazolam; Oxazepam; Midazolam

Q1057:Do benzos or barbituates have a higher risk of respdepression and coma?

Barbituates

Q1058:How do you treat a Benxo overdose?

Flumazenil (competitive antagonist at GABA receptor)

Q1059:Name 6 inhaled anesthetics

halothane; enflurane; isoflurane; sevoflurane; methoxyflurane;nitrous oxide

Q1060:Effects of inhaled anesthetics?

myocardial and resp depression; nausea/emesis; increasecerebral blood flow

Q1061:Toxicity of halothane; methoxyflurane; and enflurane?

hepatotoxicity (halothane); nephrotoxicity (methoxyflurane);proconvulsant (enflurane)

Q1062:Drug classes used as IV anesthetics? (5)

Barbiturates; Benzos; Ketamine; Opiates; Propofol

Q1063:Name the local anesthetics that are esters

procaine; cocaine; tetracaine; amides

Q1064:Name the local anesthetics that are amides

lidocaine; mepivacaine; bupivacaine

Q1065:barbiturate used as IV anesthetic?

thiopental - used for short surgical procedures and inductionof anesthesia

Q1066:drug used for endoscopy?

midazolam

Q1067:Arrylcyclohexamine (ketamine) effects?

CV stimulant; disorientation; hallucination; bad dreams;increase cerebral blood flow

Q1068:Opeates used during general anesthesia?

morphine; fentanyl

Q1069:MOA of local anesthetics?

block Na+ channels. Tertiary amines penetrate membrane inuncharged form; then bind to ion channels as charged form.

Q1070:Order of nerve block?

small diameter>large diameter. Myelinated>unmyelinated.Size predominates over myelination.

Q1071:order of loss during nerve block?

pain(1st)>temp>touch>pressure

Q1072:how do you enhance local action?

give with vasoconstrictors (EPI)

Q1073:What happens to local anesthetics in infected tissues?

tissue is acidic; anesthetics are charged and can't penetratemembrane. More anesthetic is needed.

Q1074:What receptor do neuromuscular blocking drugs targetand what are they used for clinically?

motor (vs. autonomic) nicotinic receptor. Used for muscleparalysis in surgery or mechanical ventilation.

Q1075:Depolarizing neuromuscular blocking drug?

succinylcholine

Q1076:nondepolarizing neuromuscular blocking drugs?

tubocurarine; atracurium; mivacurium; pancuronium;vecuronium; rapacuronium

Q1077:What is dantrolene used for?

treatment of malignant hyperthermia and neurolepticmalignant syndrome

Q1078:MOA of dantrolene?

prevents release of calcium from the SR of skeletal muscle

Q1079:How do you reverse blockade of nondepolarizingneuromuscular blocking drugs?

neostigmine; edrophonium; and other cholinesterase inhibitors

Q1080:Name 4 antipsychotics (neuroleptics).

thioridazine; haloperidol; fluphenazine; chlorpromazine

Q1081:What is the MOS of antipsychotics?

block dopamine D2 receptors

Q1082:Drug class used to treat excess dopamine connectedwith schizophrenia?

antipsychotics

Q1083:Adverse effects of antipsychotics?

extrapyramidal symptoms; gynacomastia; dry mouth;constipation; hypotension; sedation. Important: neuroleptic

malignant syndrome and tardive dyskinesia!

Q1084:Symptoms of neuroleptic malignant syndrome?

rigidity; myoglobinuria; autonomic instability; hyperpyrexia

Q1085:How do you treat neuroleptic malignant syndrom?

dantrolene and dopamine agonists

Q1086:What are EPS side effects?

acute dystonia; akinesia; akathisia; tardive dyskinesia (oftenirreversible)

Q1087:Name 3 atypical antipsychotics.

clozapine; olanzapine; riserperidone

Q1088:MOA of clozapine?

blocks 5-HT2 and dopamine receptors

Q1089:Clinical use of olanzapine?

schizo positive and neg. symptoms; OCD; anxiety disorder;depression; mania; tourettes

Q1090:Side effects of atypical antipsychotics?

fewer EPS and fewer anticholinergic side effects than typicalantipsychotics. Clozapine may cause agranulocytosis.

Q1091:Clinical use of lithium?

mood stabilizer for bipolar affective disorder; blocks relapseand acute mania events

Q1092:Side effects of lithium?

tremor; hypothyroidism; nephrogenic diabetes insipidus;teratogenesis. Narrow therapeautic window!!

Q1093:Buspirone MOA?

stimulates 5-HT1a receptors

Q1094:Buspirone clinical use?

generalized anxiety disorder

Q1095:Name the 4 main classes of antidepressants.

SSRIs; TCAs; Heterocyclic antidepressants; MAOIs

Q1096:Name 4 SSRIs.

fluoxetine; sertraline; paroxetine; citalopram

Q1097:Toxicity of SSRIs?

fewer side effects than TCAs. GI distress; sexual dysfunction;"serotonin syndrome" if used with MAOIs (= hyperthermia;

muscle rigidity; CV collapse)

Q1098:Do antidepressants work immediately?

No; usually takes 2-3 weeks

Q1099:What drug class do the following belong to:imipramine; amitriptyline; desipramine; nortriptyline;

clomipramine; doxepin?

TCAs

Q1100:How do TCAs work?

block reuptake of NE and serotonin

Q1101:Which TCAs have more anticholinergic side effects?

tertiary TCAs (amitriptyline) have more than secondaryTCAs (nortriptyline)

Q1102:What are the major toxixities associated with TCAs?

"Tri-C's" = Convulsions; Coma; Cardiotoxicity (arrhythmias).Also resp. depression and hyperpyrexia (extremely high

fever)

Q1103:Name the 5 heterocyclic antidepressants.

Bupropion; Venlafaxine; Mirtazapine; Maprotiline;Trazodone

Q1104:Which antidepressant is also used for smokingcessation?

Bupropion

Q1105:MOA of Venlafaxine?

inhibits serotonin; NE; and dopamine reuptake

Q1106:MOA of Mirtazapine?

alpha-2 antagonist (increases release of NE and serotonin); 5-HTs and 5-HT3 receptor antagonist

Q1107:MOA of Maprotiline?

blocks NE reuptake

Q1108:MOA of trazodone?

inhibits serotonin reuptake

Q1109:Name 2 MAOIs

phenelzine; tranylcypromine

Q1110:Clinical use of MAOIs?

atypical depression with psychotic or phobic features;anxiety; hypochondriasis

Q1111:Important toxicity of MAOIs?

Hypertensive crisis with tyramine ingestion (red wine; cheese;fava beans) and meperidine.

Q1112:define dopamine hypothesis (& the disorder itreferences)?

hypothesis of schizophrenia proposes that disorder is causedby relative excess of function activity of the neurotransmitter

dopamine in specific neuronal tracts in the brain

Q1113:what type of dopamine receptor is found on thecaudate putamen; nucleus accumbens; cerebral cortex; and

hypothalamus that is negatively coupled to adenylyl cyclase?

D2

Q1114:blockade of D2 receptors has this adverse effect?

extramyramidal dysfunction

Q1115:most of the newer atypical drugs (olanzapine;quetiapine; risperidone) have high affinity for this receptor?

5-HT 2A (although they may also interact with D2 and otherreceptors)

Q1116:with the exception of this drug all antipsychotic drugsblock H1 receptors to some degree?

Haloperidol

Q1117:what is the function of the dopaminergic mesocortical-mesolimbic pathways?

regulates mentation and mood

Q1118:what is the function of the dopaminergic nigrostriataltract?

extrapyramidal function

Q1119:what is teh function of the dopaminergictuberoinfundibular pathway?

control of prolactin release

Q1120:what are the positive symptoms of psychophrenia?

hyperactivity; bizarre ideation; hallucinations; and delusions

Q1121:newer atypical durgs are reported to improve some ofthe negative symptoms of schizophrenia including?

emotional blunting and social withdrawl

Q1122:this drug has been sued as the sole agent in the manicphase and acts as mood stabilizer in bipolar disorder?

Olanzapine

Q1123:this antipsychotic durg is used mainly in Tourette'ssyndrome?

Molindone

Q1124:with the exception of this drug most phenothiazinehave antiemetic actions?

thioridazine

Q1125:this phenothiazine is used soley for its antiemeticproperties?

Prochlorperazine

Q1126:extrapyramidal toxicity occurs most frequently withthis drug?

Haloperidol (and the more potent piperazine side chainphenothiazines (eg fluphenazine; trifluoperazine)

Q1127:this toxicity includes choreoathetoid movements of themuscles of the lips and buccal cavity and may be irreversible?

Tardive dyskinesias

Q1128:which drug has the strongest autonomic effects?

Thioridazine

Q1129:which drug has the weakest autonomic effects?

Haloperidol

Q1130:all of the atypicals can cause this side effect?

orthostatic hypotension

Q1131:failure ot ejaculate is common in men treated withthese drugs?

Phenothiazines

Q1132:endocrine and metabolic side effects ofantipyschotics?

hyperprolactinemia; gynecomastia; and amenorrhea-galactorrhea syndrome and infertility; significant also {weightgain and hyperglycemia (diabetogenic action) w/ olanzapine

and clozapine}

Q1133:pts particularly sensitive to the extrapyramidal effectsof antipsychotics may develop this syndrome?

malignant hyperthermic syndrome

Q1134:what is the treatment for malignant hyperthermia?

Dantrolene (and perhaps dopamine agonists)

Q1135:sedation is a marked side effect with phenothiazinesespecially this one?

Chlorpromazine

Q1136:what is the least sedating of the newer agents?

Aripiprazole

Q1137:visual impairment due to retinal deposits has occurredwith this drug

thioridazine

Q1138:at high doses this drug can cause severe conductiondefects in the heart resulting in fatal ventricular arrhythmias?

Thioridazine

Q1139:this drug prolongs the QT interval of the ECG?

Ziprasidone

Q1140:this drug causes a small but important (1-2%)incidence of agranulocytosis and at high doses has caused

seizures?

Clozapine

Q1141:plasma levels of this drug may be altered by changes inbody water?

Lithium

Q1142:dehydration of treatment with thiazide diuretics mayresult in an increase in levels of this drug that may reach toxic

levels?

Lithium

Q1143:this drug increases the renal clearance of Lithium?

Tehophylline

Q1144:MOA of lithium?

inhibits recycling of neuronal membrane phosphoinositidesinvolved in teh generation fo inositol triphosphate (IP3) and

DAG. these 2nd messengers are imp in amineneurotransmission

Q1145:what are the adverse neurologic symptoms ofLithium?

tremor; sedation; ataxia; & aphasia

Q1146:this renal condition occurs commonly at therapeuticdug levels of lithium?

Diabetes insipidus

Q1147:Edema is a frequent adverse effect of this drug?

Lithium

Q1148:acneiform skin eruptions occur and leukocytosis isalways present when on this drug?

Lithium

Q1149:the use of Lithium in prenancy may increase incidenceof this congenital defect?

Congentical Cardiac Anomalies (Ebstein's anomaly)

Q1150:Lithium is contraindicated in this group of people?

nursing mothers

Q1151:what is the amine hypothesis of mood?

postulates that brain amines; particularly NE and serotonin(5-HT) are neurotransmitters in pathways that function in the

expression of mood- a funcitonal decrease in the activity ofsuch amines -->depression and an increase --->mood elevation

Q1152:what is the acute effect of tricyclic drugs?

to inhibit the reuptake mechanisms (transporters) responsiblefor the termination of synaptic actions of both NE and

serotonin in the brain

Q1153:this drug has the unique action to increase aminerelease from nerve endings by antagonism of presynaptic

alpha2 adrenoceptors?

Mirtazapine (alpha2 receptors are involved in feedbackinhibition)

Q1154:this is a common CNS side effect of tricyclic drugs andsome heterocyclic agents?

Sedation

Q1155:MAOIs; SSRIs; and bupropion are more likely tocause this CNS effect?

CNS stimulation

Q1156:antagonism of these receptors occurs with alltricylcics?

antagonism of muscarinic receptors (marked withamitriptyline and doxepin)

Q1157:what are the cardiovascular effects that occur mostcommonly with tricyclics?

hypotension from alpha blockade and depression of cardiacconduction (may lead to arrhytmias)

Q1158:what happens to the convulsive threshold when onTCAs and MAOIs?

lowers seizure threshold so seizures may occur (esp withoverdoses)

Q1159:MAOIs are most useful in patients with theseadditional symptoms to depression?

anxiety; phobic features; and hypochondriasis

Q1160:this class of drugs can also be used in the treatment ofbipolar disorder; acute panic attacks; phobic disorders;

enuresis; ADHD and chronic pain states

TCAs

Q1161:high doses of this drug show efficacy in neuropathicpain?

Venlafaxine

Q1162:these drugs are effective in Obsessive compulsivedisorder?

Clomipramine and SSRIs

Q1163:this class of drugs is also approved for use in pts withgeneralized anxiety disorders; panic attacks; social phobias;

Bulemia; an dprementral dysphoric disorder and may beuseful in alcohol dependence treatment?

SSRIs

Q1164:this drug is used int eh management of patientsattemptins to withdraw from nicotine dependence?

Bupropion

Q1165:what are the 3 C's associated with TCA overdose?

coma; convulsions; and cardiotoxicity

Q1166:a withdrawal syndrome has been described for thisclass fo drugs that includes nausea; dizziness; anxiety; tremor

and palpitations?

SSRIs

Q1167:this class of drugs are inhibitors of P450 which leadsto increased activity of other drugs including TCAs and

Warfarin?

SSRIs

Q1168:this syndrome occurs with combo of fluoxetine andMAOI?

serotonin syndrome

Q1169:define serotonin syndrome?

life threatening syndrome includes severe muscle rigidity;myoclonus; hyperthermia; cardiovascualr instability; and

marked CNS stimulatory effects including seizures

Q1170:MAOIs administered with this class of drugs canresult in Serotonin syndrome?

SSRIs

Q1171:what are the low potency antipsychotics

chlorpromazine;thioridazine

Q1172:what are the side effects of thioridazine

most cardiotoxic in OD ;irreversible retinal pigmentation

Q1173:what are the side effects of chlorpromazine

hepatic toxicity ;derm problems (skin eruptions;discoloration);deposits in lens and cornea ;most sedating

Q1174:are low or high potency antipsychotics moreassociated with neurologic side effects?;non-neurologic?

high potency ;low potency

Q1175:examples of high potency antipsychotics

haloperidol;perphenazine ;fluphenazine

Q1176:what are EPS

pseudoparkinsonism ;akathisia ;acute dystonia

Q1177:aside from EPS what are other neurologic side effects

TD ;NMS ;decreased seizure threshold

Q1178:how to treat acute dystonia

anticholinergic ;antihistamine

Q1179:how to treat NMS

stop the offending drug immediately;give skeletal musclerelaxant;provide medical support;switch to low potency med

Q1180:how to treat TD

substitute low potency or atypical antipsychotic

Q1181:how to treat pseudoparkinsonism

anticholinergic (genztropine; ex) ;b/c DA normally suppressesACh activity; if you give anticholinergic it will cause increased

release of DA and relieve sx ;can also tx with antihistamine

Q1182:which neuro side effect takes >6mo to develop?

TD

Q1183:Side effects of amitryptiline

sedation ;anticholinergic

Q1184:which HCA is most serotonin specific

clomipramine

Q1185:which HCA is least sedating

desipramine

Q1186:which HCA has the least anticholinergic effects

desipramine

Q1187:which HCA stimulates appetite

desipramine

Q1188:what are the effects of desipramine

least sedating;stim appetite;least anticholinergic

Q1189:effets of doxepin

sedation ;antihistaminergic ;anticholinergic

Q1190:which HCA is likely to cause orthostatic hypotension

imipramine

Q1191:which HCA may cause seizures

maprotiline

Q1192:which HCA has low cardiotoxicity

maprotiline

Q1193:which HCA is LEAST likely to cause orthostatichypotension

nortriptyline

Q1194:other than depression; uses for amitryptiline

depresssion with insomnia ;chronic pain

Q1195:other than depression; uses for clomipramine

OCD

Q1196:other than depression; uses for desipramine

panic do ;depression in elderly ;eating DO ;(think of sideeffects)

Q1197:other than depression; uses for doxepine

GAD ;PUD

Q1198:other than depression; uses for maprtoiltine

anxiety with depressive features

Q1199:other than depression; uses for nortriptyline

depression in elderly ;pruritus ;pts with cardiac dz

Q1200:which HCAs are good for treating depression inelderly?

nortriptyline ;desipramine

Q1201:General side effects from SSRIs?

SIG HAS ;Sexual side effects;Insomnia;GIprobs;HA;Anorexia;Serotonin syndrome (if given w MAOIs)

Q1202:What are SSRIs used to treat?

OCD (fluvoxamine);Premature ejac ;Panic d/o;PMDD(fluoxetine) ;Social phobia (paroxetine)

;Hypochondriasis;Chronic pain ;PTSD;paraphilias

Q1203:which SSRI --> weight loss

fluoxetine

Q1204:which SSRI --> agitation and insomnia

fluoxetine;"one FLU over the cuckoo's nest"

Q1205:which SSRI is most sedating

paroxitine

Q1206:which SSRI is most anti-cholinergic

paroxitine

Q1207:which of sSRIs is most likely --> GI probs

sertraline

Q1208:which SSRI is most cardiotoxic

citalopram

Q1209:SNRI

Venlafaxine;duloxetine ;5HT and NorE reuptake inhib

Q1210:NDRI

buproprion ;norE/DA reuptake inhib

Q1211:SARI

Nefazodone ;Trazodone ;5HT antagonist and reuptake inhib

Q1212:NASA

Mirtazapine ;norE and 5HT antag

Q1213:advantage to SNRIs

rapid sx relief;few sexual side effects

Q1214:other than depression; uses of duloxetine

refractory depression ;urine stress incontinence

Q1215:other than depression; uses of venlafaxine

refractory depression ;GAD ;social phobia

Q1216:contradindications for buproprion

seizures ;eating d/o ;psychosis (at higher doses; high DAeffects) ;mania

Q1217:other than depression; uses of MAOIs

atypical depression;pain d/o ;eating d/o ;panic d/o ;socialphobia

Q1218:Pharmacological treatment for: Alcohol withdrawal

Benzodiazepines

Q1219:Pharmacological treatment for: Anorexia/bulimia

SSRIs

Q1220:Pharmacological treatment for: Anxiety

1. Barbiturates;2. Benzodiazepines;3. Buspirone (for GAD;does not cause sedation or addiction; and does not interactwith EtOH);4. MAO inhibitors;5. Venlafaxine (SNRI; for

GAD);6. Olanzapine (an atypical antipsychotic)

Q1221:Pharmacological treatment for: Atypical depression

MAO inhibitors

Q1222:Pharmacological treatment for: Bipolar disorder

Mood stabilizers (Lithium; Valproic acid; Carbamazepines)

Q1223:Pharmacological treatment for: Depression

1. SSRIs (endogenous depression);2. SNRIs (when SSRIs areineffective or neuropathic pain);3. TCAs/Maprotiline (severemajor depression);4. MAO inhibitors (atypical depression or

inability to use TCAs);5. Bupropion;6. Mirtazapine;7.Trazodone/Nefazodone;8. Olanzapine (an atypical

antipsychotic)

Q1224:Pharmacological treatment for: Depression withinsomnia

Trazodone and Mirtazapine

Q1225:Pharmacological treatment for: OCD

1. Fluvoxamine (an SSRI);2. Olanzapine (an atypicalantipsychotic);3. Clomipramine (a TCA)

Q1226:Pharmacological treatment for: Panic disorder

TCAs and Buspirone

Q1227:Pharmacological treatment for: Schizophrenia

1. Typical Neuroleptics;2. Atypical neuroleptics (for positiveand negative symptoms)

Q1228:Mechanism of neuroleptics

Most block dopamine D2 receptors (as excess dopamineeffects are connected with schizophrenia)

Q1229:Mechanism of Venlafaxine

Inhibits reuptake of serotonin (at all doses); norepinephrine(athigh doses); and dopamine (mild)

Q1230:Mechanism of lithium

Not established; possibly related to inhibition of PIPresynthesis leading to its relative depletion in neurons

Q1231:Mechanism of buspirone

Stimulates 5-HT1A receptors

Q1232:Mechanism of SSRIs

Selective serotonin reuptake inhibition; leading to downregulation of presynaptic inhibitory receptors; leading to

increased release of neurotransmitter; leading to therapeuticresponse.

Q1233:Mechanism of tricyclic antidepressants

1. Nonselectively inhibit reuptake of norepinephrine andserotonin (beneficial);2. Block serotonergic; alpha-adrenergic;

histaminic; and muscarinic receptors (not beneficial)

Q1234:Mechanism of clozapine

Blocks D2 like normal neuroleptic; but also blocks 5HT2 aswell as D1; D4; muscarinic; and alpha-adrenergic receptors.

Q1235:Mechanism of risperidone

Blocks 5HT2 receptors more than D2 receptors

Q1236:Mechanism of aripiprazole

Partial agonist of D2 and 5HT1A receptors; and blocks5HT2A receptors.

Q1237:Mechanism of bupropion

Unknown

Q1238:Mechanism of mirtazapine

Alpha2 antagonist (increasing release of NE and serotonin)and potent 5-HT2 and 5-HT3 receptor antagonist

Q1239:Mechanism of duloxetine

SNRI. Inhibits reuptake of serotonin and norepinephrine at alldose.

Q1240:Mechanism of nefazodone and trazodone

Block 5-HT1 presynaptic autoreceptors; thereby increasingserotonin release. Weak inhibitors of serotonin re-uptake.

Q1241:Mechanism of MAO inhibitors

Irreversibly inhibits monoamine oxidase which normallyinactivates monoamines such as NE; 5-HT; and DA that leak

out of presynaptic vesicles. MAO inhibitors allow theseleaky molecules to accumulate and activate post synaptic

response.

Q1242:Pharmacological treatment for: Psychosis

1. Typical neuroleptics

Q1243:Pharmacological treatment for: Acute mania

1. Typical neuroleptics;2. Olanzapine;3. Lithium (relapse andtreatment)

Q1244:Pharmacological treatment for: Tourette syndrome

1. Typical neuroleptics;2. Olanzapine

Q1245:Pharmacological treatment for: Bedwetting

1. Imipramine (a tricyclic antidepressant)

Q1246:Pharmacological treatment for: Hypochondriasis

1. MAO inhibitors

Q1247:Antidepressants which have adverse effect of GIdistress

SSRIs: all;SNRIs: all;Atypical: Nefazodone;Tricyclic:Clomipramine;MAO inhibitors: none

Q1248:Antidepressants which have adverse effect of sedation

Note: useful effect if agitated;SSRIs;1. Fluvoxamine;2.Paroxetine;SNRIs: none;Atypical: All except

bupropion;Tricyclic: All except desipramine andprotryptiline;MAO inhibitors: none

Q1249:Antidepressants which have high potential fororthostatic hypertension

SSRIs: none;SNRIs: none;Atypical: none;Tricyclic;1.Amitriptyline;2. doxepin;MAO inhibitors: All

Q1250:Antidepressants which have adverse effect of weightgain

SSRIs: none;SNRIs: none;Atypical: Mirtazapine;Tricyclic:(so big you need a DICTAphone to type);1. Doxepin;2.

Imipramine;3. Clomipramine;4. Trimipramine;5.Amitriptyline;MAO inhibitors: none

Q1251:Toxicities of typical neuroleptics

1. Extrapyramidal dopamine side effects;2. Endocrinedopamnine side effects (dopamine receptor antagonism

leading to hyperprolactinemia leading to gynecomastia);3.Blocking muscarinic receptors (dry mouth; constipation);4.

Blocking alpha-adrenergic receptors (hypotension);5.Blocking histamine receptors (sedation);6. Neuroleptic

malignant syndrome;7. Tardive dyskinesia

Q1252:Describe neuroleptic malignant syndrome.

Neuroleptic malignant syndrome can cause you HARM;1.Hyperpyrexia;2. Autonomic instability;3. Rigidity;4.

Myoglobinuria

Q1253:How is neuroleptic malignant syndrome treated?

Dantrolene or dopamine agonists (bromocriptine)

Q1254:Describe tardive dyskinesia and what causes it?

Long-term antipsychotic use leads to dopamine receptorsensitization which causes stereotypic oral-facial movements

Q1255:Mechanism and treatment for extrapyramidal sideeffects

Blocking of dopamine's inhibitory effects causes excessstimulation by acetylcholine. Treat wth anticholinergic drugs

like thioridazine.

Q1256:Toxicities of atypical neuroleptics

Weight gain. Clozapine may cause agranulocytosis. (Requiresweekly WBC monitoring.) Fewer extrapyramidal andanticholinergic side effects than typical neuroleptics.

Q1257:Which atypical neuroleptic can cause agranulocytosis?

Clozapine (requires weekly WBC monitoring)

Q1258:Toxicities of lithium

Mnemonic: LMNOPP (prounounced "pee-pee");Lithium sideeffects;1. Movement (Tremor);2. Narrow therapeuticwindow;3. hypOthyroidism;4. Pregnancy problems

(Teratogenesis);5. Polyuria as lithium is ADH antagonist;leading to nephrogenic diabetes insipidus

Q1259:Toxicities of SSRIs

1. GI distress;2. Sexual dysfunction (anorgasmia);3. Serotoninsyndrome (with MAO inhibitors)

Q1260:What is serotonin syndrome?

Excess serotonergic activity caused by use of both SSRIs andMAO inhibtiors;1. Hyperthermia;2. Muscle rigidity;3.

Cardiovascular collapse

Q1261:Side effects and toxicities of tricyclic antidepressants

TCAs mess you up. Make you a stuttering SHAARCCC;1.Sedation;2. Hyperpyrexia;3. alpha-blocking effects;4.

atropine-like (anticholinergic) effects (tachycardial; urinaryretention; confusion and hallucinations in elderly);5.

Respiratory depression;and the Tri-C's;6. Convulsions;7.Coma;8. Cardiotoxicity (arrhythmias)

Q1262:Treatment for confusion and hallucinations in elderlyon tricyclic antidepressants

Due to anticholinergic activity. Use nortriptyline instead.

Q1263:Toxicities of bupropion

1. Stimulant effects (tachycardia; insomnia);2. Headache;3.Seizure in bulimic patients

Q1264:Toxicities of venlafaxine

Things have trouble going down your SINCS (GI distress);1.Stimulant effects;2. Increased blood pressure;3. Nausea;4.

Constipation;5. Sedation

Q1265:Toxicities of mirtazapine

1. Sedation;2. Increased appetite;3. Weight gain;4. Dry mouth

Q1266:Toxicities of Maprotiline

1. Sedation;2. Orthostatic hypotension

Q1267:Toxicities of Trazodone

1. Sedation;2. Nausea;3. Priapism;4. Postural hypotension

Q1268:Toxicities of MAO inhibitors

1. Hypertensive crisis with tyramine ingestion andmeperidine;2. CNS stimulation;3. Serotonin syndrome (whencoadministered with SSRIs or beta-agonists);4. Increased risk

of orthostatic hypotension

Q1269:which lipid-lowering agent has best effect on HDL?

niacin (side effects: flushing which is dec'd by aspirin orlongterm use)

Q1270:which statin is NOT metabolized by P450 system?

pravastatin

Q1271:which lipid lowering agent causes a slight increase inTG?

bile acid resins (cholestyramine; colestipol)

Q1272:which lipid loweirng agents have biggest loweringeffect on TGs?

"fibrates"--gemfibrozil; clofibrate; bezafibrate; fenofibrate

Q1273:which lipid lowering agents work by decreasingproduction of VLDL?

niacin

Q1274:which lipid lowering agents work by stimulatingLPL/enhancing rate of catabolism of VLDL?

fibrates (gemfribrozil; clofibrate; bezafibrate; fenofibrate)

Q1275:which class of lipid lowering agents is safest and whatis the effect?

cholesterol absorption blockers (ezetimibe). only decreasesLDL. no effect on HDL or TGs

Q1276:which antihypertensive can cause a positive Coombstest?

methyldopa (cental acting alpha agonist; safe for preggers)

Q1277:which antiHTNives have sexual side effects?

hexamthonium (ganglionic blocker--sexual dysfxn);guanethidine (inhibits Mg-ATPase--sexual dysfxn); beta

blockers (impotence)

Q1278:which antiHTNive can cause hypertrichosis?

minodixil (a vasodilator; use with beta blocker to preventrelfex tachycardia and w/diuretic to block salt retention)

Q1279:which CCB should NOT be used for arrhythmias?

nifedipine

Q1280:MOA of nitroglycerin

vasodilate by releasing NO in smooth muscle--> increase incGMP and smooth muscle relaxation; dilates veins>> arteries

Q1281:which heart drug has "Monday dz" as a toxicity

(tolerance during the work week and loss of tolerance overweekend-> tachycardia; dizzinesss; headache); nitroglycerin

Q1282:half life of digoxin?

40hrs

Q1283:MOA of cardiac glycosides

directly inhibit Na/K ATPase--> indirect inhibition of Na/Caexchanger leads to increased intracellular calcium

Q1284:clinical use of cardiac glycosides

CHF (to increase contractility); afib (decreases conduxn at AVnode; depresses SA node)

Q1285:what diuretics should go with digoxin?

spironolactone/K+ sparers b/c hypokalemia potentiates digtoxicity

Q1286:what increases toxicities of digoxin

renal failure; hypokalemia; quinidine (dec'd clearance;displaces dig from tissue binding sites)

Q1287:antidote to digoxin toxicity

slowly normalize K+; lidocaine; cardiac pacer; anti-dig Fabfragments

Q1288:name 4 Class IA antiarr

quinidine; amiodarone; procainamide; disopyramide (queenamy proclaims diso's pyramid)

Q1289:name 3 Class IB antiarr

lidocaine; mexiletine; tocainide

Q1290:name 3 Class IC antiarr

flecainide; encainide; propafenone

Q1291:very short acting class II antiarr?

esmolol (beta blocker(

Q1292:name 4 class III antiarr

sotalol; ibutilide; bretylium; amiodarone

Q1293:name 2 class IV antiarr

verapamil; diltiazem

Q1294:compare the class I antiarr in terms of effect on APduration

IA (Na; intermediate acting)--increase duration; IB (Na; fastacting)--decrease duration; IC (Na; slow acting)--no change in

AP

Q1295:usefulness of IA antiarr?

(quinidine; amiodarone; procainamide; disopyramide) affectboth ATRIAL and VENTRICULAR s; esp reenrant and

ectopic tachycardias

Q1296:which antiarrhythmics useful in acute ventriculararrhytmias; esp post MI?

IB (lidocaine; mexiletine; tocainide)

Q1297:drug of choice in diagnosing/abolishing AV nodalarrhythmias

adenosine (maybe cause flushing)

Q1298:which antiarr contraindicated post-MI?

class IC (flecainide; encainide; propafenone)

Q1299:when use class IC antiarr?

usually only as last resort in refractory tachyarrhythmias

Q1300:which antiarr only work on AV and SA nodes?

class II (beta blockers)

Q1301:which antiarr can cause dyslipidemia?

metoprolol (class II)

Q1302:amiodarone toxicities

pulmonary fibrosis; hepatotoxicity; thyroidisms; cornealdeposits; photodermatitis; neurologic effects; constipation;

check PFTs; LFTs; TFTs!!!

Q1303:use of class IV antiarr?

(nondihydropyridine CCBs; verpamil; diltiazem); primarilyaffect AV nodal cells--> good for prevention of nodal

arrhythmias

Q1304:antiarrhythmic effect of K+?

depresses ectopic pacemakers; esp in digoxin toxicity

Q1305:botulinum toxin mechanism

blocks ACh release

Q1306:choline acetyltransferase action

synthesizes ACh

Q1307:acetylcholinesterase

breaksdown ACh

Q1308:rate-limiting step in NE synthesis

Tyrosine hydroxylase (tyrosine to dopa)

Q1309:metyrosine action

inhibits tyrosine hydroxylase

Q1310:uptake I

norepinephrine transporter into neuron

Q1311:uptake II

uptake by extraneuronal tissue

Q1312:Monoamine oxidase action

makes catecholamine aldehydes

Q1313:Catechol-o-methyltransferase (COMT) action

makes (nor)metanephrine

Q1314:physostigmine action

inhibits cholinesterase

Q1315:carbidopa action

dopa decarboxylase inhibition

Q1316:receptor type which stimulates adenylyl cyclase

Beta 1;2

Q1317:Gi receptor types

a2; M2

Q1318:receptor types stimulating PKC

a1

Q1319:phenylephrine mechanism

a1 agonist

Q1320:methoxamine mechanism

a1 agonist

Q1321:mydriasis

dilated pupil

Q1322:Phentolamine mechanism

competitive a1 antagonist;**short half life

Q1323:phentolamine uses

dx pheochromocytoma

Q1324:pphenoxybenzamine mechanism

noncompetitive a1 antagonist;*long acting

Q1325:phenoxybenzamine use

treat pheochromocytoma

Q1326:prazosin mechanism

alpha1 antagonist

Q1327:prazosin use

tx of hypertension and CHF

Q1328:prazosin risks

syncope after first oral dose;reduced efficacy with chronic use

Q1329:clonidine mechanism

a2 agonist--> reduced symp outflow

Q1330:clonidine use

tx of hypertension

Q1331:methyldopa mechanism

metabolite a-methyl*norepinephrine* is a2 agonist

Q1332:methyldopa use

tx of hypertension

Q1333:yohimbe mechanism

alpha 2 antagonist

Q1334:Isoproterenol mechanism

stimulates b1 and b2

Q1335:dobutamine mechanism

b1 agonist

Q1336:uses of dobutamine

tx of pulmonary edema; coronary bypass post op

Q1337:Propranolol mechanism

competitive inhibitor of b1 and b2

Q1338:uses of propranolol

tx of angina;ventricular arrhythmia;htn *dec renin*;postmyocardial infarction

Q1339:propranolol side efx

worse heart failure;reduced AVconduction;nightmares;fatigue;cold extremities

Q1340:Metoprolol mechanism

b1 blocker

Q1341:atenolol mechanism

b1 blocker; does not cross blood brain barrier.slow

Q1342:atenolol uses

htn (one a day);glaucoma

Q1343:bromocriptine mechanism

dopanergic agonist

Q1344:tyramine mechanism

displaces NE into synaptic cleft

Q1345:population vulnerable to tyramine relatedhypertension

pts on monoamine oxidase inhibitors

Q1346:Phenylpropanolamine mechanism

indirect sympathetic stim

Q1347:methacholine mechanism

cholinergic

Q1348:bethanachol mechanism

muscarinic agonist

Q1349:pilocarpine mechanism

muscarinic agonist

Q1350:bethanachol uses

improved gastric emptying;tx of urinary retension (if nophysical obstruction)

Q1351:pilocarpine uses

induce salivation;open angle glaucoma--constricts irissphincter (miosis)

Q1352:methacholine use

provoke bronchoconstriction for dx testing;(methacholinechallenge)

Q1353:atropine mechanism

muscarinic antagonist

Q1354:atropine use

raising heart rate when vagal activity is pronounced**vasovagal syncope;decreased respiratory secretions for

intubation

Q1355:Bezold-Jarisch reflex

bradyardia; hypotension; nausea from high nicotine dose

Q1356:ganglionic blocking agents mechanism

block Nn receptors

Q1357:insectiside mechanism

anticholinesterase

Q1358:physostigmine mechansim

"reversible" short acting cholinesterase inhibitor;enters CNS

Q1359:neostigmine mechanism

"reversible" short acting cholinesterase inhibitor;does notenter CNS

Q1360:physostigmine side effects

enters cns; restlessness; apprehension; hypertension;typicalmuscarinic/nicotinic efx

Q1361:why neostigmine no enter cns?

quaternary amine (charged)

Q1362:uses of neostigmine

myasthenia gravis;glaucoma

Q1363:propranolol "traditional" frequency of dosing

4 times a day

Q1364:atenolol mechanism

b1 selective blocker

Q1365:metroprolol mechanism

b1 blocker

Q1366:metabolism of propranolol

heavily liver metabolized;protein bound;interindividualvariability

Q1367:atenolol metabilism

reduced hepatic metabolization (vis a vis propranolol)

Q1368:metroprolol metabolism

less hepaticlly metabolized (vis a vis propranolol)

Q1369:esmolol clinical use

b blocker for critical care

Q1370:esmolol metabolism

short half life; IV use only

Q1371:labetolol mechanism

b blocker with a1 effect

Q1372:carvedilol clinical use

CHF

Q1373:carvedilol mechanism

beta blocker with a1 blocking

Q1374:type of b blocker for treatment of portal hypertensivebleeding

non selective (propranolol in US)

Q1375:betablocker type for essential tremor

non selective

Q1376:vascular headache prophylaxis betablocker type

propranolol (non selective and more lipophilic)

Q1377:methyldopa side effects

sedation; depression; dry mouth

Q1378:special situations in which methyldopa is particularlysafe

for htn in pts with ischemic heart disease (no efx on CO);doesnot block baroreceper rflx;--safe for anti-htn in elective

surgery

Q1379:dosing of methyldopa

delayed onset of effect (needs to be metabolized to methyel-NE);twice a day for maintanence

Q1380:drug of choice for hypertensive pregnant pts

methyldopa

Q1381:why clonidine is poor choice in pts with *severe*HTN?

clonidine rebound. withdrawal syndrome w/ massive sympdischarge

Q1382:pharmacokinetics of prazosin

hepatic metabolism

Q1383:pharmacokinetics of terazosin and doxazosin

longer lasting than prazosin

Q1384:labetolol R R stereoisomer mechanism

b1 antagonist and partial b2 agonist

Q1385:labetalol SR stereoisomer mechanism

a1 antagonist

Q1386:S isomer of Carvedilol

b blocker (both isomers a1 blockers)

Q1387:The critical factor affecting the therapeutic utility ofnitrates

tolerance

Q1388:what is given along with nitroprusside?

Na2S2O3 (Na thiosulfate);the antidote to CN

Q1389:pharmacokinetics of nitroprusside

infusion only--dissolved immediately prior to use inglucose/water;rapid/potent/fast half life

Q1390:nitroprusside clinical use

acute hypertensive crisis

Q1391:mechanism of hydralazine

who the fuck knows

Q1392:clinical utility of hydralazine

hypertension--use with beta blocker and diuretic;heart failure

Q1393:metabolism of hydralazine

acetylated (pt variability)

Q1394:hydralazine side effects

Na retention; coronary steal

Q1395:minoxidil mechanism

sulfate metabolite opens atp sensitive k channel;--hyperpolarizes cell;--arterial vasodilation

Q1396:chemical class: nifedipine

1;4 dihydropyridines

Q1397:chemical class: verapamil

phenylalkamines

Q1398:chemical class: diltiazem

benzothiazepines

Q1399:verapamil mechanism

L type calcium channel blocker;cardiac selective

Q1400:diltiazem mechanism

L type calcium channel blocker;intermediate cardiac/vascularselective

Q1401:nifedipine mechanism

L type calcium channel blocker;vascular selective

Q1402:diltiazem and verapamil tx for what arrythmia

supraventricular tachycardia

Q1403:CCB metabolism

protein bound and big first pass effect;low bioavailability

Q1404:CCBs inhibit what entity important for druginteractinos

CYP 3A4

Q1405:interaction of CCBs and beta blockers

profound conduction and contractile depression;decreasedliver flow (betas) less clearance of CCBs

Q1406:chemistry of captopril

contains a sulfhydryl group at zinc ligand site;--other ACEinhibs do not

Q1407:hyperkalemia in ace inhibitors???

decrease in aldosterone;**beware in pts with bad kidneys

Q1408:he "diluting segment" of the nephron.

thick ascending limb

Q1409:mannitol site of action

proximal tubule

Q1410:mannitol characteristics of diuresis

loss of H2O in excess of Na and Cl

Q1411:Acetazolamide site of action

proximal tubule; inhibits carbonic anhydrase

Q1412:acetazolamide characteristics of diuresis

loss of Na; HCO3; Cl; and K

Q1413:Furosemide site of action

thck ascending loop of henle

Q1414:furosemide characteristics of diuresis

loss of Na; Cl; K;Lose Mg and Ca;potentially loss of 50%filtered Na

Q1415:Thiazide like diuretics site of action

distal tubule +/- proximal tubule inner medullary collectingtubule

Q1416:thiazide like diuretics characteristics of diuresis

loss of Na; Cl and K;increase blood Ca and uricacid;**prevent kidney stones;**inhibit osteoporosis

Q1417:chemistry of carbonic anhydrase inhibitors

contain sulfamyl moiety;i.e. are sulfonamides

Q1418:acetazolamide mechanism

noncompetitive carbonic anhydrase inhibitor

Q1419:pharmacokinetics of acetazolamide

absorbed from GI;eliminated by kidney;actively secreted byorganic acid transport system

Q1420:clinical uses of carbonic anhydrase inhibitors

glaucoma

Q1421:toxicity of carbonic anhydrase inhibitors

metabolic acidosis;renal stone formation (renal stones fromalkaline pH);K+ wasting;decreased NH3 secretion

Q1422:furosemide mechanism

Na-K-Cl2 symport inhibitor

Q1423:ethacrynic acid mechanism

Na-K-Cl2 symport inhibitor

Q1424:ethacrynic acid chemistry

not a sulfonamide

Q1425:furosamide chemistry

contains sulfamyl moiety

Q1426:loop diuretics and mg++; ca++

substantial urinary loss of these divalent cations;**abolisheslumen positive potential

Q1427:pharmacokinetics of loop diuretics

absorved in GI;secretion via organic acid secretion;thresholdeffect--once at effective dosage; more wont help;**can

increase frequency for more urination

Q1428:toxicity of furosemide

K+ loss;ototoxicity;H loss with metabolic alkalosis

Q1429:hydrochlorothiazide chemistry

sulonamide (sulfamyl moiety)

Q1430:hydrochlorothiazide mechanism

inhibit Na trnasport in distal convoluted tubule

Q1431:pharmacokinetics of hydrochlorothiazide

rapidly absorbed from GI;filterd and secreted in proximaltubule;binds to plasma proteins

Q1432:thiazide diuretics and calcium

increase Ca++ reabsorption

Q1433:triamterene chemistry

organic base; not sulfonamide

Q1434:amiloride chemistry

organic base; not sulfonamide

Q1435:triamterene mechanism

inhibition of Na+ channel in collecting tubule;k sparing

Q1436:amiloride mechanism

inhibition of Na+ channel in collecting tubule;k sparing

Q1437:amiloride pharmacokinetics

partially absorbed from GI;completely eliminated in kidney

Q1438:triamterene pharmacokinetics

well absorbed from GI;elimenated by renal excretiona andmetabolism

Q1439:toxicity of amiloride and triamterene

do not combine with spironolactone;caution with aceinhibitors;do not combine with K+ supplements

Q1440:spironolactone mechanism

competitive aldosterone inhibitor

Q1441:Na+ channel blocking drugs terminate and preventarrhythmias by

· slowing conduction to interrupt a reentrant circuit;·increasing refractoriness to terminate functional reentry and so

that there is "less room" for premature beats (which causeslowed conduction ? reentry to occur)

Q1442:Tx of atrial flutter/fibrillation to slow ventricularresponse

AV nodal blockers;verapamil/diltiazem;beta blockers;digitalis

Q1443:tx of atrial flutter/fibrillation to maintain normal rythm

(increase refractoriness in fast respone tissue);class Ia;ClassIc;Class III

Q1444:tx of supraventricular reentrant tachycardias: Acute(IV);;***(Almost always; the reentrant loop involves the AV

node)

adenosine (drug of choice);verapamil or betablocker;digitalis;maneuvers to increase vagal tone: vasalva;

carotid massage

Q1445:txt of svt reentrant (assuming AV node) tachycardia:oral (chronic)

verapamil or diltiazem;beta blocker;digitalis;class Ic

Q1446:tx of svt using a bypass tract;(fast response tissue)

Class Ia;Class Ic;Class III;**avoid empiric tx with AV nodeblockers

Q1447:tx of ventricular arrhythmias: acute (IV);**(slowcondux; increase refractoriness in fast response tissue-

>ventricles)

lidocaine--Ib;procainamide--Ia;amiodarone--III

Q1448:tx of ventricular arrhythmia: chronic

class Ia;Class Ib;Class Ic;class III

Q1449:tx of undiagnosed wide complex tachycardia

could be PSVT or VT. "all bets are off";**avoid verapamil

Q1450:tx for narrow complex tachycardia

usually slow response=av node;adenosine;verapamil;esmolol

Q1451:tx of unstable rhythm causing hemodynamiccompromise

shock the muthafucka

Q1452:QUINIDINE class and mechanism

Ia;blocks Na+ and multiple K+ currents;a-receptor block andvagal inhibition

Q1453:Quinidine antiarrhythmic use

chronic therapy of atrial fib/flutter (and VT)

Q1454:Quinidine problems

diarrhea;more death in pts with a-fib?;torsade de pointes 2-5%

Q1455:procainamide class and mechanism

Ia;blocks Na and K+;metabolite N-acetylprocainamide blocksK+ channels

Q1456:procainamide use

IV for SVT adn ventricular arrhythmia

Q1457:procainamide things to look out for

dose adjustment in renal disease;lupus syndrome w/ chronictherapy

Q1458:LIDOCAINE class and use

Ib;decrease incidence of V fib;**mortality increase

Q1459:lidocaine dosage issues

rapid distribution half life;slow elimination half life;clearancereduced in CHF and liver disease

Q1460:Flecainide Class Ic use

effective at surpressing isolated PVC and reentrantSVT;*BUT INCREASED mortality in patients following

myocaridal infarction. wtf

Q1461:esmolol class and usage

Class II; beta blocker;short half life=9 min;useful for recklessbeta blockade

Q1462:why does bretylium (class III) suck?

due to hypotensive effect; bretylium can cause hemodynamiccollapse during previously well-tolerated VT (therefore use

lidocaine; procainamide first)

Q1463:amiodarone useage; but sucks b/c?;class?

Class I + II + III + IV action;· very effective for mostarrhythmias; but NOT first-line oral therapy because ;;·

multiple toxicities: eye; *lungs*; liver; skin; thyroid duringchronic treatment

Q1464:verapamil: NEVER USE WHEN

undiagnosed; wide complex tachycardia (? hemodynamiccollapse);· "preexcited" atrial fibrillation over an accessory

pathway in the Wolff-Parkinson-White syndrome (may cause? heart rate; VF);· heart failure;· sinus node dysfunction; AV

block (*caution: Class I + IV*)

Q1465:DILTIAZEM usefulness

· intravenous form: useful AV nodal blocker usually withouthypotension (especially for rate control of atrial fibrillation)

Q1466:ADENOSINE good for?

Acute therapy of choice for: supraventricular tachycardias;undiagnosed wide-complex tachycardia;**short acting--

seconds

Q1467:Quinidine; Verapamil; Amiodarone; (?Flecainide);interactinos with ;Digitalis

inc digitalis concentration and toxicity

Q1468:amiodarone interactions with ;warfarin; digoxin;procainamide; quinidine

decreased drug metabolism and excretion;increased drugeffects

Q1469:renal disease interaction wtih ;procainamide (Ia) anddofetilide (III)

decreased clearance

Q1470:liver disease interaction with lidocaine

decreased clearance

Q1471:heart failure interaction with lidocaine

decreased clearance;decreased central volume (lidocaine)whatever the fuck that means

Q1472:disopyramide; flecainide; beta blockers; verapamilinteraction with;heart failure

worsen heart failure

Q1473:dofetilide interaction with cimetidine and ketoconazole

increased dofetilide concentrations

Q1474:plasmin; enzyme type

serum protease

Q1475:enzyme that dissolves clots

plasmin

Q1476:what do kringle domains on plasminogen activatorsbind

fibrin

Q1477:Streptokinase mechanism

indirect activator of plasminogen;helps one plasminogenactivate another

Q1478:streptokinase problems

allergic rx's ;bleeding; hypotension

Q1479:urokinase mechanism

direct activator of plasminogen

Q1480:urokinase metabolism

liver; short half life 15 min

Q1481:urokinase inactivation

inactivated by PAI-1

Q1482:second generation thrombolytic with long half life

APSAC;60 mins. given by bolus

Q1483:APSAC; what is it?

complex of streptokinase and plasminogen

Q1484:t-PA mechanism

binds to fibrin and activates plasmin **clot specific**

Q1485:pharmacokinetics of t-PA

PAI-1 irreversibly inhibits;cleared in liver;short half life; 6mins

Q1486:Reteplase; what is it?

genetically engineered derivative of t-PA;just the kringle andprotease; not glycosylated

Q1487:TNK-t-PA (tenecteplase); wtf is it?

t-PA with no glycosylation site

Q1488:the two antifibrinolytics?

Amicar (e-aminocaproic acid) or tranexamic acid

Q1489:digoxin effects at AV node

increased ERP; and decreased conduction;slower ventricularrate during atrial flutter/fib

Q1490:Digoxin effects at His-Purkinje fibers

increased automaticity;premature ectopic beats

Q1491:digitalis effect on PR interval

increased

Q1492:digitalis effect on ST segment

depressed

Q1493:digitalis effect on amplituted of T waves

decreased;may invert

Q1494:digitalis effect on QT interval

decreased

Q1495:aspirin mechanism

blocks cyclooxegenase--> no thromboxane A2

Q1496:Dipyridamole action

Inhibits cyclic nucleotide phosphodiesterase to increaseintraplatelet accumulation of cAMP;¨ Blocks the uptake of

adenosine

Q1497:Ticlopidine and Clopidogrel mechanism

Metabolites Inhibit platelet activity via effects on;· Inhibitionof ADP induced platelet activation (primary);· Glycoprotein

IIb/IIIa receptor;· von Willebrand factor

Q1498:pharmacokinetics of ticlodipine and Clopidogrel

delay in onset;effects persist several days

Q1499:ticlodipine and Clopidogrel interactions

activated by CYP3A4;inhibitors of CYP3A4 may reduceactivation

Q1500:Adverse effects of Ticlodipine and Clopidogrel

neutropenia in 3% of pts. ticlodipine problem

Q1501:(Abciximab mechanism

antibody to the IIb/IIIa receptor;

Q1502:factors inactivated by heparin

thrombin (II);activated IX; X; XI; and XII;**inactivates freethrombin; thus best for preventing clots

Q1503:administration of heparin

IV; not absorbed thru GI

Q1504:never ever administer heparin this way

intra muscular

Q1505:Two forms of heparin-induced thrombocytopenia(HIT)

1 heparin induced platelet aggregation leading to decreasedplatelets;2 Rarer. b/t 7 and 11 days. immune response with

thrombotic complications

Q1506:what to do if in case of severe bleeding from heparinoverdose

discontinue infusion;protamine administration

Q1507:protamine mechanism

binds to and inactivates heparin;**possible allergic toxicity

Q1508:mechanism of low molecular weight heparin

bind antithrombin/factor Xa

Q1509:LMWH and PTT

b/c very little binds to AT-III/thrombin; little effect onPTT;NOT USED FOR MONITORING

Q1510:advantages of LMWH over regular heparin

less frequent administration;sub-q administration;morepredictable response to dose

Q1511:Direct Thrombin Inhibitors?

lepirudin; agatroban

Q1512:lepirudin; agatroban mechanism

directly inhibit binding of thrombin to fibrinogen

Q1513:warfarin action;which factors affected?

antagonist of vitamin K;affects synthesis of II; VII; IX; X;protein C; and protein S

Q1514:adverse effects of warfarin

bleeding; yo;paradoxical thrombis;--pretein C and S fucked upfirst

Q1515:beta blockers and hepatic metabolism

atenolol only beta blocker not metabolized in liver

Q1516:Bethanecol (class and application)

direct cholinomimetic; postop and neurogenic ileus andurinary retention;

Q1517:Bethanecol (class and action)

direct cholinomimetic; Activates Bowel and Bladder smoothmuscle; resistant to AChE

Q1518:Carbachol (class and application)

direct cholinomimetic; glaucoma;

Q1519:Carbachol (class and action)

direct cholinomimetic; activates ciliary muscle of the eye(open angle glaucoma); pupillary sphincter (narrow angle);

resistant to ACHE

Q1520:pilocarpine (class; application)

direct cholinomimetic; glaucoma;

Q1521:pilocarpine (class; action)

direct cholinomimetic; activates ciliary muscle of the eye(open angle glaucoma); pupillary sphincter (narrow angle);

resistant to ACHE

Q1522:Neostigmine (class; application)

indirect cholinomimetic (anticholinesterase); postop andnuerogenic ileus and urinary retention; myesthenia gravis;

reversal of neuromuscular junction blockade (postop)

Q1523:Neostigmine (class; action)

indirect cholinomimetic (anticholinesterase); increasedendogenous Ach

Q1524:Pyridostigmine (class; application)

indirect cholinomimetic (anticholinesterase); myestheniagravis

Q1525:Pyridostigmine (class; action)

indirect chlinomimetic (anticholinesterase); increasedendogenous Ach; increased strength

Q1526:Edrophonium (class; application)

indirect cholinomimetic (anticholinesterase); dx of myestheniagravis (very short acting)

Q1527:Edrophonium (class; action)


Q1528:Physostigmine (class; application)

indirect cholinomimetic (anticholinesterase); glaucoma(crosses BBB) and atropine overdose

Q1529:Physostigmine (class; action)

indirect cholinomimetic (anitcholinesterase); increasedendogenous Ach

Q1530:Echothiophate (class; application)

indirect cholinomimetic (anticholinesterase); glaucoma

Q1531:Echothiophate (class; action)


Q1532:Symptoms of Cholinesterase inhibitor poisoning

DUMB BELSS - Diarrhea; Urination; Miosis; Bronchospasm;Bradycardia; Excitation of skeletal muscle and CNS;Lacrimation; Sweating and Salivation (also abdominal

cramping)

Q1533:What are parathion and organophosphates?

cholinesterase inhibitors that are likely to poison you

Q1534:What is the antidote to cholinesterase inhibitorpoisoning?

atropine (muscarinic antag) plus pralidoxime (chem antagonistused to regenerate active cholinesterase)

Q1535:Atropine (class; site of action; application)

Cholinoreceptor blocker (muscarinic antag); Eye; producemydriasis and cycloplegia

Q1536:tropicamide (class; site of action; application)

Cholinoreceptor blocker; Eye; produce mydriasis andcycloplegia

Q1537:Benztropine (class; site of action; application)

cholinoreceptor blocker; CNS; Parkinson's

Q1538:Scopolamine (class; site of action; application)

Cholinoreceptor blocker; CNS; Motion Sickness

Q1539:Ipratropium (class; site of action; application)

Cholinoreceptor blocker; Respiratory; Asthma; COPD

Q1540:Methscopolamine (class; site of action; application)

Cholinoreceptor blocker; Genitourinary; Reduce urgency inmild cystitis and reduce bladder spasms

Q1541:oxbutin (class; site of action; application)


Q1542:Glycopyrrolate (class; site of action; application)


Q1543:Actions of Atropine

Blocks SLUD (Salivation; Lacrimation; Urination; Defecation)also pupil dilation and cycloplegia

Q1544:ADR of Atropine

hot as a hare; dry as a bone; red as a beet; blind as a bat; madas a hatter. Also rapid pulse; constipation. Can causeglaucoma in elderly; urinary retention in BPH pts; and

hyperthermia in infants

Q1545:Hexamethonium (MOA and application)

Nicotinic Ach receptor antagonist; ganglionic blocker;prevents vagal reflex responses to changes in BP (for

experimental models)

Q1546:Epinephrine (class; selectivity; applications)

catecholamine; direct general agonist (a1; a2; b1; b2);anaphylaxis; glaucoma (open angle); asthma; hypotension

Q1547:NE (class; selectivity; applications)

catecholamine; a1; a2; b1; hypotension (but decreased renalperfusion)

Q1548:Isoproterenol (class; selectivity; applications)

catecholamine; b1 = b2; AV block (rare)

Q1549:Dopamine (class; selectivity; applications)

catecholamine; D1 = D2 > b > a; shock (increased renalperfusion); heart failure

Q1550:Dobutamine (class; selectivity; applications)

catecholamine; b1 > b2; shock; heart failure

Q1551:Amphetamine (class; selectivity; applications)

sympathomimetic; indirect general agonist (releases storedcatecholamines); narcolepsy; obesity; ADD

Q1552:Ephedrine (class; selectivity; applications)

sympathomimetic; indirect general agonist (releases storedcatecholamines); nasal decongestion; urinary incontinence;

hypotension

Q1553:Phenylephrine (class; selectivity; applications)

sympathomimetic; a1 > a2; pupil dilator; vasoconstriction;nasal decongestion

Q1554:Albuterol (class; selectivity; applications)

sympathomimetic; b2 > b1; asthma

Q1555:Terbutaline (class; selectivity; applications)

sympathomimetic; b2 > b1; asthma

Q1556:Cocaine (class; selectivity; applications)

sympathomimetic; indirect general agonist (uptake inhibitor);causes vasoconstriction and local anesthesia

Q1557:Clonidine (class; selectivity; applications)

sympathomimetic; centrally acting a-agonist; decreased centraladrenergic outflow; hypertension; especially with renal dz (no

decreas in renal perfusion)

Q1558:a-methyldopa (class; selectivity; applications)

sympathomimetic; centrally acting a-agonist; decreased centraladrenergic outflow; hypertension; especially with renal dz (no

decreas in renal perfusion)

Q1559:Phenoxybenzamine (class; application; toxicity)

nonselective; irreversible a-blocker; pheochromocytoma; tox:orthostatic hypotension; reflex tachycardia

Q1560:Phentolamine (class; application; toxicity)

nonselective; reversible a-blocker; pheochromocytoma; tox:orthostatic hypotension; reflex tachycardia

Q1561:Prazosin (class; application; toxicity)

a1 blocker; HTN; urinary retention in BPH; tox: 1st doseorthostatic hypotension; dizziness; HA

Q1562:Terazosin (class; application; toxicity)


Q1563:Doxazosin (class; application; toxicity)


Q1564:Mirtazapine (class; application; toxicity)

a2 blocker; Depression; tox: sedation; increased serumcholesterol; increased appetite

Q1565:How do beta blockers work to treat HTN?

decreased cardiac output; decreased renin secretion

Q1566:5 major side effects for hydrochlorothiazide

hypokaleia; slight hyperlipidemia; hyperuricemia;hypercalcemia; hyperglycemia

Q1567:4 major side effects for loop diruetics

potassium wasting; metabolic alkalosis; ototoxicity;hypotension

Q1568:clonidine side effects (2)

dry mouth; severe rebound hypertension

Q1569:methyldopa side effects (2)

sedation; positive Coombs test

Q1570:hexamethonium side effects (4)

severe orthostatic hypotension; blurred vision; constipation;sexual dysfunction

Q1571:reserpine side effects (4)

sedation; depression; nasal stuffiness; diarrhea

Q1572:guanethidine side effects (4)

orstastic/exericse hypotension; sexual dysfunction; diarrhea

Q1573:prazosin side effects (3)

1st-dose orthostatic hypotensoin; dizziness; headache

Q1574:beta-blocker major side effects (6)

asthma; impotence; sleep problems; bradycardia; chf; av block

Q1575:hydralazine side effects (4)

lupus like snydrome; reflex tachycardia; angina; salt retention

Q1576:minoxidil side effets (5)

hair; pericardial effusion; reflex tachycardia; angina; saltretention

Q1577:vasodilator: calcium blocker side effects (3)

flushing; constipatipn; nausea

Q1578:nitroprusside major side efect

cyanodie toxicity

Q1579:captopril side effects (8)

hyperkalemia; cough; angioedema; proteinuria; taste changes;hypotension; pregnancy (fetal renal damage); rash

Q1580:ARB side effect (losartan)

fetal renal toxicity; hyperkalemia

Q1581:two drugs that cause hyperkalemia

losartan and captopril

Q1582:what do you have to do wit hhydralazine andminoxidil?

use beta blockers to treat reflex tachy; diuretic to block saltretention

Q1583:mechanism of hydralazine

increase cGMP; smooth muscle relaxation; vasodilatoin;afterload reduction

Q1584:what is dilation is hydralazine selective for

arerioles

Q1585:clinical use for hydralazine (2)

severe hypertension; CHF

Q1586:mechanism for clonidine

alpha2 agonist

Q1587:mechanism for methyldopa

alpha2 agonist

Q1588:mechanism for prazosin

alpha1 blocker

Q1589:mechanism for reserpine

decrease norepi

Q1590:mechanism for guanethidine

decrease norepi

Q1591:block ach receptor

hexamethonium

Q1592:name 3 calcium channel blockers

nifedipine; verapamil; diltiazem

Q1593:mechanism of calcium blockers

block voltage-dependent calcium channels on cardiac/smoothmuscle and reducing muscle contractility

Q1594:rank vascular smooth muscle block by calcium blocker

nifedipine>diltiazem>verapamil

Q1595:rank heart smooth muscle block by calcium blocker

verapamil>diltiazem>nifedipine

Q1596:use for calcium blockers

hypertension; angina; arryhtmia (not nifedipine)

Q1597:calcium blocker toxicity (3)

cardiac depression; peripheral edema; flushing;

Q1598:mechanism for nitro drugs

vasodilate by releasing nitric oxide; increase cGMP; smoothmuscle relaxation; decrease preload

Q1599:rank the preference for dilation in nitro drugs

veins > arterioles

Q1600:clinical use for nitro drugs (4)

angina; pulmonary edema; aphrodisiac; erection enhancer

Q1601:name side effects for nitro (4)

tachycardia; hypotension; headache; monday disease

Q1602:define monday disease

build tolerance to nitro during work; resensitize on weekendand get tachy and dizziness

Q1603:goal of antianginal therapy

reduce myocardial oxygen consumption

Q1604:name 5 determinants of antianginal therapy

end diastolic volume; blood presure; heart rate; contractility;and ejection time

Q1605:how does nitro effect end diastolic volume; bloodpressure; contractility; heart rate; and ejection time

decrease; decrease; increase (reflex); increase (reflex); decrease

Q1606:how does beta-blocker affect diastolic volume; bloodpressure; contractility; heart rate; ejection time

increase; decrease; decrease; decrease; increase

Q1607:name 3 factors that combo beta-blockers + nitrateswill decrease

blood pressure; heart rate; and overall myocardial oxygenconsumption

Q1608:for calcium channel blockers; what drug is similar tonitro

nifedipine

Q1609:for calcium channel blockers; what durg is similar tobeta-blockers

verapamil

Q1610:define bioavailability; protein bound percentage; whereecreted; and 1/2 life for digoxin

75%; 20-40%; kidney; 40 hours

Q1611:mechanism for digoxin

block na/k atpase; increase na; slow na/ca antiport; increaes ca;positive inotrope

Q1612:how does digoxin affect arryhtmia

vagal effects increase PR; decrease QT; T wave inversion onECG

Q1613:name 2 uses for digoxin

CHF (increase contractility) and a fib (decrease conduction atAV node)

Q1614:5 major general digoxin side efects

nausea; vomiting; diarrhea; blurry yellow vision; arryhtmia

Q1615:name 3 contraindications with digoxin

renal failure; quinidine (will displace dig on protein; potentiateeffect); hypokalemia (potentiate effect)

Q1616:what is the antidote for digoxin

slowly normalize K; lidocaine; cardiac pacer; anti-dig FABfragments

Q1617:describe function that all class I antiarryhtmics have

decrease slope of phase 4 depolarization

Q1618:define state dependency and state what drugs are statedependent

class I antiarryhtmics. selectively depress tissue what isdepolarized

Q1619:name 4 class Ia drugs

quinidine; amiodarone; procainamide; disopyramide

Q1620:name 3 mechanisms of class Ia

increase AP duratoin; increase ERP; increase QT interval

Q1621:what do you use class Ia for?

atrial and ventricular arryhtmias

Q1622:quinidine toxicities

cinchonism: headache; tinnitisum; thrombocytopenia plustorsades

Q1623:procainamide toxicity

reversible lupus like side effect

Q1624:name 3 class IB drugs

lidocaine; mexiletine; tocainide

Q1625:mechanism for class IB

decrease AP duration.

Q1626:where does class IB affect?

affect ischemic or depolarized purkinje ventricular tissue.

Q1627:what is class IB useful for?

acute ventricular arryhtmias (post-MI) and digitalis inducedarryhtmia

Q1628:name 4 side effects of class IB

local anesthetic; cns stimulation; cns depression;cardiovascular depression

Q1629:name 3 class IC drugs

flecainide; encainide; propafenone

Q1630:name mechanism of class IC

no effect on AP

Q1631:what is class IC sueful for?

v-tach that progress to V fib and also for SVT. usuaully onlygood for refractory tachyarryhtmias

Q1632:class IC toxicities

proarryhtmitic; especially post-mI (contraindiciated)

Q1633:name 5 class II antiarrythmiycs

propanolol; esmolol; metoprolol; atenolol; timolol

Q1634:mechanism of class II drugs

decrease camp; decrease CA; decrease slope phase 4; increasePR interval at AV node

Q1635:what is a short acting class II

esmolol

Q1636:name 5 side effects of class II drugs

mask hypoglycema; impotence; asthma; CV effects(bradycardia; av block; chf). sleep

Q1637:name 4 class III drugs

sotalol; ibutilide; bretylium; amiodarone

Q1638:mehcanism of class III

increase AP duration; incrase ERP; increase QT; used whenothers fail

Q1639:sotalol toxicity

torsades; excessive beta-block

Q1640:ibutilide toxicity

torsades

Q1641:bretylium toxicity

new arrhythmias; hypotension

Q1642:amiodorone toxicity

hypothyrodism/hyperthyrodism; pulmonary fibrosis; hepatictoxicity; corneal deposits; skin deposits (photodermatitis);

neurologic defects; constipation; bradycardia; heart block; chf

Q1643:what 3 tests to do before using amiodarone?

PFT; LFT; TFT

Q1644:name 2 class IV antiarrhytmics

verapamil; diltiazem

Q1645:mechanism for class IV

affect AV nodal cells; decrease conduction velocity; incraseERP; increase PR.

Q1646:what is class IV used for

prevent nodal arryhtmias (SVT)

Q1647:what are 4 general side effects for class IV

constipation; flushing; edema; cv (chf; av block; sinus nodedepression)

Q1648:bepridil toxicity

torsades

Q1649:adenosine function

drug of choice in diagnosisng/abolishing AV nodal arryhtmias

Q1650:potassium function

depress ectopic pacemaker; esp in dig toxicity

Q1651:magnesium function

torsades and dig toxicity use

Q1652:Parasympathetic preganglionic neurons release theneurotransmitter -------- which act on -------- receptors.

Ach; nicotinic.

Q1653:Parasympathetic postganglionic neurons release theneurotransmitter -------- which act on ------- receptors.

Ach; muscarinic.

Q1654:Sympathetic preganglionic neurons to sweat glandsrelease the neurotransmitter ------- which act on -------

receptors.

Ach; muscarinic.

Q1655:Sympathetic postganglionic neurons to sweat glandsrelease the neurotransmitter ------- which act on -------

receptors.

Ach; muscarinic.

Q1656:Sympathetic preganglionic neurons to glands; cardiacand smooth muscles release the neurotransmitter ------- which

act on ------- receptors.

Ach; nicotinic.

Q1657:Sympathetic postganglionic neurons to glands; cardiacand smooth muscles release the neurotransmitter ------- which

act on ------- receptors.

NE; alpha and beta

Q1658:Sympathetic preganglionic neurons to renal vascularsmooth muscle release the neurotransmitter ------- which act

on ------- receptors.

dopamine; D1

Q1659:Sympathetic postganglionic neurons to renal vascularsmooth muscle release the neurotransmitter ------- which act

on ------- receptors.

Dopamine; D1

Q1660:Sympathetic preganglionic neurons to the adrenalmedulla release the neurotransmitter ------- which act on -------

receptors.

Ach; nicotinic.

Q1661:Sympathetic preganglionic neurons to the adrenalmedulla synapse directly on ------- cells of the adrenal

medulla.

Chromaffin.

Q1662:Somatic neurons synapse directly on -------- muscleand release the neurotransmitter ------- which act on -------

receptors.

skeletal muscle; Ach; nicotinic.

Q1663:Ach is synthesized from acetyl-CoA and choline bythe enzyme ---------.

Choline acetyltransferase.

Q1664:The transport of choline into the nerve terminal can beinhibited by --------.

Hemicholinium.

Q1665:The release of transmitter from vesicles in the nerveending require the entry of ------ into the neuron.

Calcium.

Q1666:The action of Ach in the synapse is terminated by itsmetabolism to acetate and choline by the enzyme ---------.

Acetylcholinesterase.

Q1667:In the noradrenergic nerve terminal; tyrosine ishydroxylated to -------; which is decarboxylated to --------;

which is finally hydroxylated to NE.

DOPA; dopamine.

Q1668:Dopamine is transported into vesicles forhydroxylation to NE. This transport can be blocked by the

drug --------.

Reserpine.

Q1669:The action of NE and DA is terminated by ---------and ----------.

Reuptake; diffusion (different than for Ach).

Q1670:The --------- drugs promote catecholamine release.

Amphetamine.

Q1671:The drugs --------- and ---------- inhibit the reuptake ofNE.

Cocaine; TCA.

Q1672:The release of NE from a sympathetic nerve ending ismodulated by ---------; --------- and ---------.

NE; Ach; angiotensin II.

Q1673:NE inhibits its own release at the noradrenergic nerveterminal through --------- receptors.

Alpha 2.

Q1674:Angiotensin II --------- (inhibits / stimulates) therelease of NE from the noradrenergic nerve terminal.

Stimulates.

Q1675:Ach inhibits the release of NE from the noradrenergicnerve terminal by binding to --------- receptors.

M1.

Q1676:Clinical application and action of Bethanechol.

Postoperative and neurogenic ileus and urinary retention. /Activates bowel and bladder smooth muscle.

Q1677:Clinical application and action of Carbachol andPilocarpine.

Glaucoma. / Activates ciliary muscle of eye (open angle);pupillary sphincter (narrow angle).

Q1678:Clinical application / action of Neostigmine.

Postoperative and neurogenic ileus and urinary retention;myasthenia gravis; reversal of neuromuscular junctionblockade (postoperative). / Increase endogenous Ach.

Q1679:Clinical application / action of Pyridostigmine.

Myasthenia gravis. / Increase Ach; increase strength.

Q1680:Clinical application / action of Edrophonium.

Diagnosis of myasthenia gravis (extremely short acting). /Increase endogenous Ach.

Q1681:Clinical application / action of Physostigmine.

Glaucoma (crosses blood-brain barrier) and atropine overdose./ Increase endogenous Ach.

Q1682:Clinical application / action of Echothiophate.

Glaucoma. / Increase endogenous Ach.

Q1683:Symptoms of cholinesterase inhibitor poisoning.

Diarrhea; Urination; Miosis; Bronchospasm; Bradycardia;Excitation of skeletal muscle and CNS; Lacrimation; Sweating;

Salivation (also abdominal cramping). "DUMBBELSS".

Q1684:Cholinesterase inhibitor poisoning may be caused by ---------.

Parathion and other organophosphates.

Q1685:The cholinesterase regenerator ------- can be used as anantidote for cholinesterase inhibitor poisoning.

Pralidoxime.

Q1686:Mechanism of action of Pralidoxime.

Regenerates active cholinesterase; chemical antagonist; used totreat organophosphate exposure.

Q1687:Clinical uses of the muscarinic antagonist Atropine.

Dilate pupils; decrease acid secretion in peptic ulcer disease;decrease urgency in mild cystitis; decrease GI motility; reduce

airway secretions; and treat organophosphate poisoning."Blocks SLUD: Salivation; Lacrimation; Urination;

Defecation."

Q1688:Side effects of Atropine.

Increase body temp; rapid pulse; dry mouth; dry/flushed skin;disorientation; mydriasis with cycloplegia; and constipation."Atropine parasympathetic block side effects: Blind as bat;

Red as a beet; Mad as a hatter; Hot as a hare; Dry as a bone."

Q1689:Hexamethonium (ganglionic blocker) blocks --------receptors.

Nicotinic.

Q1690:tropi are anti-muscarinic; mneumonic?

while vacationing in the tropics you lie on a beach and yourmuscles waste away!

Q1691:benztropine is used to treat

Parkinson's disease

Q1692:scopolamine is used to treat

motion sickness

Q1693:name 2 antimuscarinic drugs that act on the CNS

benztropine; scopolamine

Q1694:name a muscarinic used to treat motion sickness

scopolamine

Q1695:name a muscarinic used to treat Parkinson's disease

benztropine

Q1696:mechanism of action of benztropine

antimuscarinic

Q1697:mechanism of action of scopolamine

antimuscarinic

Q1698:name three antimuscarinics that act on eye

atropine; homatropine; tropicamide

Q1699:the action of atropine is ______

produce mydriasis; cycloplegia

Q1700:mechanism of atropine is

antimuscarinic

Q1701:the action of homatropine is ______


Q1702:mechanism of homatropine is

antimuscarinic

Q1703:the action of tropicamide is


Q1704:mechanism of tropicamide is

antimuscarinic

Q1705:ipatropium is used to treat

asthma; COPD

Q1706:mechanism of ipatropium is

antimuscarinic

Q1707:name an antimuscarinic used to treat asthma andCOPD

ipatropium

Q1708:(2) diuretics used for HTN;;what do both lower as anAE?

Thiazides;Loops;;both lower K+

Q1709:Vasodilator used for severe HTN and CHF;AE?

Hydralazine;;AE: SLE-like effects

Q1710:Vasodilator used for emergency HTN situations;AE?

Nitroprusside;;AE: converts to cyanide

Q1711:Anti-HTN; anti-anginal and anti-arrhythmic class thatworks by reducing heart contractility;(2) AE

Calcium channel blockers;;AE: Cardiac depression; Edema

Q1712:which of the calcium channel blockers most specificfor;Vascular Smooth Muscle

Nifedipine

Q1713:which of the calcium channel blockers most specificfor;Heart muscle

Verapamil

Q1714:Drug for angina that also is effective againstpulmonary edema

Nitroglycerine

Q1715:what are the (5)* determinants of myocardial oxygenconsumption?

BEECH;BP;Ejection time;EDV;Contractility;HR

Q1716:Drug used for CHF and A-fib can causearrthymias;what are the ECG changes?;(3)

Digoxin;ECG;Inc PR;Dec QT;T-wave inversion

Q1717:MOA of digoxin;(2) AE?

Inhibit Na/K pump to indirectly inhibit Na/Ca antiport;causing Ca increase inside cell;AE;Yellow vision; Arrhythmias

Q1718:(4)* class IA antiarrhythmics

Queen Amy Proclaims Diso'sPYRAMID;Quinidine;Amiodarone;Procainamide;Disopyrami

de

Q1719:MOA of class IA Na-channel blockers;what type ofarrhythmias is it good for?

Inc action potential duration by Inc QRS (QT interval);Use:Ventricular Arrhythmia

Q1720:how do the Na-channel blockers affect HR; CO; BPand SV?

Dec HR -> Dec CO -> Dec BP -> Inc SV;(more time to fill)

Q1721:AE for Quinidine

Cinchonism;HA; Tinnitus; thrombocytopenia; Torsades dePointes

Q1722:why are Procainamide and Disopyamide successful atslowing the QT interval?

both are Amides; which are metabolized in the liver givingNH4 that can be converted to GLU -> GABA

Q1723:AE for Procainamide

SLE-like effects

Q1724:DOC for V-Tach

Lidocaine;(b/c it affects ischemic tissues and works quickly;IV only)

Q1725:what is the class and drug that is the last resort (V-fib)as a ;Na-channel blocker?;when is it contra-indicated?

Class IC: Flecainide;;CI;post-MI (leads to heart stopping)

Q1726:Na-channel blocker class/drug that decreases ActionPotential time

Class IB: Lidocaine

Q1727:(3) drugs that can block both Na and Ca channels;whatDx are they good for?

Procainamide;;Phenytoin;;Quinidine;use: Wolf ParkinsonWhite

Q1728:Class II antiarrhythmics class and MOA

Beta-blockers;MOA;Dec cAMP and Ca currents ->;Decslope of phase 4 and Inc PR interval

Q1729:(3) AE of Beta-blockers

blocking betas make me SICk;Sedation;;Impotence;;CV effects(bradycardia; CHF)

Q1730:B-blocker;Longest acting

Propranolol

Q1731:B-blocker;Shortest acting

Esmolol

Q1732:B-blocker;also blocks Alpha-receptors;(for Pheos andHTN crisis);(2)

Labetalol;;Carvedilol

Q1733:B-blocker;for Miosis

Timolol

Q1734:B-blocker;also blocks K+ channels

Sotalol

Q1735:B-blocker;good for patient w/ DM; asthmatics; MIand elderly

Atenolol

Q1736:(3)* drugs in Class III anti-arrhythmics

BiAS to K-channel blockers;Bretylium;;Amiodarone;;Sotalol

Q1737:MOA of K-channel blockers

Inc AP by Inc QT interval

Q1738:AE of Amiodarone;(4)

Amy aught to run PFTs; LFTs and TFTs or you'll beBLUE;Pulmonary

fibrosis;Hepatotoxicity;Hyper/Hypothyroidism (containsiodine);turns skin Blue

Q1739:Class of choice for Atrial arrhythmias;MOA

Ca-Channel blockers;;For AV nodal cells; Inc ST segment andInc PR interval

Q1740:DOC for Digitalis-induced arrthymias

Phenytoin

Q1741:drug that inhibits VLDL production; Dec TG and DecHDL breakdown;AE?

Niacin;;AE: Flushing

Q1742:class that increases the production of lipoproteinlipase to ;Inc breakdown of TG;(2) AE?

Fibrates;"-FIBR-" (Gemfibrozil; Fenofibrate);AE: GI upset;gall stones

Q1743:contraindication of Bile Acid Sequestrants?

High TG levels;BAS Increases TG

Q1744:DOC in AV nodal arrhythmias

Adenosine

Q1745:Antiarrhythmic that depresses ectopic pacemakers;(esp digoxin toxicity)

Potassium

Q1746:(3) First generation H1 blockers

Diphenhydramine (Benadryl);;Chlorpheniramine (Chlor-trimeton);;Promethazine (Phenergan)

Q1747:Clinical uses (3) and AE (3) of First generation H1blockers

Uses;Motion sickness;Allergy (hives; itching; nasal);Sleepaid;AE;Sedation;Antimuscarinic;Anti-alpha-adrenergic

Q1748:(3) Second generation H1 blockers;Use?

Loratadine (Claritin);;Fexofenadine (Allegra);;Centirazine(Zyrtec);Use: Non-drowsy Allergic rhinitis; Hay fever

Q1749:Name and MOA of a Nasal Decongestant

Pseudoepherine (Sudafed);Alpha-agonist leading tovasoconstriction

Q1750:(2) Cough suppressants

Codeine;;Dextromethophan (DM)

Q1751:Name and MOA of expectorant

Guaifenesin;(Robitussin);;Inc. respiratory secretions andviscosity

Q1752:Long acting B2-agonist for Asthma Prophylaxis

Salmeterol

Q1753:Methylxanthine used for Severe asthma;MOA?;(2)AE?

Theophylline;Bronchodilator by Inh Phosphodiesterase andDec cAMP hydrolysis;AE;Cardiotoxicity;Neurotoxicity

Q1754:Drug and MOA of Mast Cell Stabilizers;Use?

Cromolyn;causes Mast cells not to release histamine;use:Only for Prophylaxis

Q1755:what is the most potent anti-inflammatory agent thatis effective for mild; moderate and severe asthma ;(first line

for chronic asthma)?;MOA?

Glucocorticosteroids;;Inh NF-kB transcription factor thatinduces TNF-alpha; inhibiting formation of PGE and LTE

Q1756:(2) Adverse effects of Glucocorticoids?

Oral candidiasis;;bone demineralization

Q1757:Leukotriene effect modulator that inhibitslipoxygenase and leukotriene formation;AE?

Zileuton;;AE: Hepatotoxicity

Q1758:(2) Leukotriene effect Modulator that binds theleukotriene receptors;Use?

Zafirlukast;;Montelukast;;Use: Prophylaxis; mild/moderateasthma

Q1759:Muscarinic antagonist that preventsbronchoconstriction

Ipratropium

Q1760:non-specific Beta-agonist that relaxes bronchialsmooth muscle;AE?

Isoproterenol;;AE: tachycardia

Q1761:What asthma agents deal with an early response(bronchoconstriction)?;(4)

My BLT;Muscarinic antagonist;;Beta-agonist;;Leukotrieneantagonist;;Theophylline

Q1762:what asthma agents deal w/ mast cells releasingmediators?;(2)

Cromolyn;;Steroids

Q1763:Ganglionic blocker (rarely used) for the rapidreduction of HTN

Trimethaphan

Q1764:only drug that reduces morbidity and mortality inheart failure

Spironoloactone

Q1765:drug given IV for severe acute heart failure

Dobutamine

Q1766:what anti-HTN drug may ilicit a positive Coombs testand hemolytic anemia?

Methyldopa

Q1767:DOC for variant angina

Nifedipine

Q1768:what drug interaction w/ Digoxin increases its toxicity?

Thiazides;(Dec K+ -> Inc Dig toxicity)

Q1769:Anti-anginal Tx that has AE of severe constipation

Verapamil

Q1770:(2) AE of Adenosine

Burning sensation in chest;;SOB

Q1771:(2) AE of Dobutamine

Inc HR and BP

Q1772:HTN medication that has AE of "Loss of taste"

ACEi

Q1773:patient treated w/ anti-arrhythmic that causesrecurrent attacks of feeling faint and experiencing episodes of

loss of consciousness. what drug?

Quinidine

Q1774:Cardiac AP drug;affects Phase 4;(3)

Digoxin;;Verapamil ;(Ca-channel blockers);;Lidocaine

Q1775:Cardiac AP drug;affects Phase 0 to slow conductionand prolong repolarization

IA drugs;(All class I slow conduction; but only IA prolongsrepolarization)

Q1776:Cardiac AP drug;affects Phase 0 but causes no changein repolarization

Class IC - Flecainide

Q1777:Cardiac AP drug;blocks Na; Ca and K channels

Amiodarone

Q1778:Drug that lowers HTN by inhibiting PeptidylDipeptidase

ACEi;(at biochemical level)

Q1779:drug class for CHF that decreases Preload and BV

ACEi

Q1780:only Drug class that increases the survival rate in CHF

ACEi

Q1781:Diuretics

Bumetanide (Bumex);furosemide (Lasix);HCTZ-hydrochlorothiazide (Microzide; Esidrix);spironolactone(Aldactone);triamterene (Dyrenium/ Maxide w/ HCTZ)

Q1782:Beta-Blockers

Atenolol (Tenormin);Labetolol (Normodyne;Trandate);metoprolol (Lopressor);nadolol

(Corgard);propranolol (Inderal);timolol (Timoptic)

Q1783:ACE Inhibitors

Benazepril (Lotensin);captopril (Capoten);enalapril(Vasotec);fosinopril (Monopril);lisinopril (Zestril);moexipril(Univasc/ Uniretic w/HCTZ);quinapril (Accupril);ramipril

(Altace)

Q1784:Angiotensin II Antagonist

Losartan (Cozaar; Hyzaar w/ HCTZ);valsartan (Diovan)

Q1785:Calcium channel blockers

Amlodipine (Norvasc; Lotrel w/ Benazepril);Diltiazem(Cardizem; Tiazac);felodipine (Plendil);isradipine

(Dynacirc);nicardipine (Cardene);nifedipine (Procardia;Adalat);nisoldipine (Sular; Nisocor);verapamil (Calan; Covera;

Isoptin)

Q1786:Alpha Blockers

Doxazosin (Cardura);Prazosin (Minipress);Terazosin(Hytrin)

Q1787:Others

Clonidine (Catapres);diazoxide (HyperstatIV);hydralazine;alpha-methyldopa (Aldomet?);minoxidil

(Loniten);sodium nitroprusside (Nipride)

Q1788:Class I Na+ Channel Blockers?;(1A)

Disopyramide (Norpace);Procainamide (Procan);Quinidine(Quinidex)

Q1789:Class I Na+ Channel Blockers (1b)?

Lidocaine (Elamax/Lidoderm);Mexiletine (Mexitil);Tocainide(Tonocard)

Q1790:Class I Na+ Channel Blockers (1c)?

Flecainide (Tambocor);Propafenone(Rhythmol);Others;Adenosine;Digoxin

Q1791:Class II B-Blockers

Esmolol (Brevibloc);Metoprolol (Lopressor;Toprol);Pindolol(Visken);Propranolol (Inderal)

Q1792:Class III K+ Channel Blockers

Amiodarone (Cordarone);Bretylium (Bretylol);Sotalol(Betapace)

Q1793:Class IV Ca++ Channel Blockers

Diltiazem (Cardizem; Tiazac);Verapamil (Calan; Covera;Isoptin)

Q1794:Mechanism of action of Class IA antiarrhytmics?

Na+ Channel Blockers;class 1A slows phase 0 depolarization

Q1795:Mechanism of action of Class IB antiarrhytmics?

Na+ Channel Blockers;Class 1B shortens phase 3repolarization

Q1796:Mechanism of action of Class IC antiarrhytmics?

Na+ Channel Blockers;Class 1C markedly slows phase 0depolarization

Q1797:Mechanism of action of Class 2 antiarrhytmics?

Class II B-Blockers (supresses phase 4 depolarization)

Q1798:Mechanism of action of Class 3 antiarrhytmics?

Class III K+ Channel Blockers (prolongs phase 3repolarizaion)

Q1799:Mechanism of action of Class 4 antiarrhythmics?

Class IV Ca++ Channel Blockers (shortens action potential)

Q1800:What are the clinical uses of the H1 blockers?

allergy; motion sickness; sleep aid

Q1801:Name the H1 blockers. (3 1st generation and 3 2ndgeneration).

1st = diphenhydramine; dimenhydrinate; chlorpheniramine.2nd = loratadine; fexofenadine; desloratadine

Q1802:The side effects of H1 blockers?

sedation; animuscarinic; anti-alpha-adrenergic. 2nd gen far lesssedating.

Q1803:What classes of drugs are used to treat asthma?

B-agonists; B2-agonists; methylxanthines; muscarinicantagonists; cromolyn; corticosteroids; antileukotrienes

Q1804:Name the nonspecific B-agonist that causes bronchialsmooth muscle relaxation and tachycardia.

Isoproterenol

Q1805:Name the B2 agonist used during acute asthmaexacerbations.

Albuterol

Q1806:What is Salmeterol used for?

long-acting B2-agonist used for prophylaxis

Q1807:What is the MOA of Theophylline (amethylxanthine)?

causes bronchodilation by inhibiting phosphodiesterase anddecreasing cAMP hydrolysis.

Q1808:Adverse effects of Theophylline?

Narrow therapeautic index! Limited use! Cardiotoxicity andneurotoxicity

Q1809:Which class of drugs does Ipratropium belong to?

Muscarinic antagonists

Q1810:What is the MOA of Cromolyn and what is its clinicaluse?

prevents degranulation of mast cells; therefore only effectivefor prophylaxis and not during and asthma attack.

Q1811:What is 1st line therapy for chronic asthma?

corticosteroids (beclomethasone and prednisone)

Q1812:What is the MOA of beclomethasone?

inhibit cytokine synthesis. Inactivate NF-kappaB; the tf thatinduces TNF-alpha

Q1813:What is the MOA of Zileuton?

5-lipoxygenase pathway inhibitor that blocks conversion ofarachidonic acid to leukotrienes

Q1814:What are Zafirlukast and montelukast especially goodat treating? (MOA?)

aspirin-induced asthma; b/c they block leukotriene receptors

Q1815:Do expectorants (Guaifenesin) suppress the coughreflex?

No; they only remove excess sputum

Q1816:What is N-acetylcystine?

a mucolytic that can loosen mucus plugs in CF patients

Q1817:Epinephrine

Properties - stimulates both α (vasoconstriction - esp skin;mucosa and kidneys) and β (bronchodilatation) receptors. β2

stimulation may also decrease mast cell secretions. vitalcapacity increases due to relief of bronchial mucosal

congestion. not effective orally; rapidly absorded IM orSQ;Indications - acute asthmatic attacks; hypersensitivity

reactions; prolongation of infiltration anesthetic action; topicalhemostatic effect;SE; Tox - anxiety; termor; palpitations;

tachycardia; headache; diaphoresis; pallor;CI - HTN;hyperthroid; ischemic heart disease; cerebrovascular

insufficiency. don't use if older than 60 unless asthma isintractable.

Q1818:Ephedrine

Properties - stimulates both α and β receptors and increasesthe release of NE. vasoconstriction/cardiac stimulation -->increase pulse pressure. CNS stimulant. Rapidly absorbed

PO. Compared to epi - longer duration of action; more centraleffects; lower potency;Indications - chronic asthma (rarely

used now); mydratic (aqueously);SE; Tox - CNS stimulation;increased PVR.

Q1819:Isoproterenol

Properties - stimulates β receptors. all smooth muscle isrelaxed and PVR is lowered in skeltal; renal; and mesentericvascular beds. rapidly absorded after inhalation;Indications -relieves respiratory distress in severe asthmatic attacks butrarely used now that there's more selective agents;SE; Tox -

acute toxicity less than with epi. tachycardia; headache;flushing; nausea; dizziness; diaphoresis. anginal pain/cardiac

arrhythmias. tolerance can occur.

Q1820:Metaproterenol

Properites - β2 selective. relaxes smooth muscle of bronchi;uterus; skeletal muscle vasculature; decreases airway

resistance. resistant to COMT methylation. PO or inhaled;duration up to 4 hours;Indications - bronchodilator in

treatment of asthma; reversible bronchospasm;SE; Tox -tachycardia; hypertension; nervousness; termor; palpitations;n/v. caution in pts with severe HTN; coronary artery disease;

CHF; hyperthroid. tolerance less like compared to inhaledisoproterenol.

Q1821:Terbutaline

Properties - β2 selective when given orally but causes cardioeffects similar to isoproterenol when given SQ. resistant to

COMT methylation;Indications - only β2 agonist usedparenterally for tx of status asthmaticus;SE; Tox - oral causestremor. dizziness; nervousness; fatigue; tinnitus; palpitations

rare. SQ causes same effects as epi.

Q1822:Salmeterol

Properties - β2 selective. longer actinging;Indications - asthmaprophylaxis.

Q1823:Albuterol

Properties - similar to terbutaline. β2 selective. aviable as oraland aersol preparation. peak effect 30-40 min with 3-4 hour

duration;Indications - reversible obsructive airway disease;SE;Tox - nervousness; termor; headache; insomnia; weakness;

dizziness; tachycardia; palpitations. use in caution in pts wtihcoronary artery insufficiency; HTN; hyperthroid; DM and

pts recieving MAO-I or TCAs.

Q1824:Theophylline

Properties - inhibits phosphodiesterase --> increased cAMP.relaxes bronchial smooth muscles --> increased VC; potent

CNS stimulant; imporves diaphragmatic contractility. positiveinotropic action. increases water and electrolyte excretion.oral; rectal; or parental. distributed into all compartments;

60% pro bound;Met/Excr- liver met; t1/2 = 8 hrs;Indications -bronchodilator in asthma and COPD; improve diaphragmatic

function in COPD; reduceds prolonged apnea in preterminfants;SE; Tox - oral causes headache; nervousness;

dizziness; n/v; epigastric pain. iv causes cardiac arrhythmias(blocks adenosine receptors which then increases AV nodal

conduction); hypotension; cardiac arrest and seizures;inchildren; CNS stimulation; diuresis; fevers;monitor serumm

levels (tox at >20 mg/L; benefit at 7 10)

Q1825:Cromolyn Sodium/Nedocromil

Properties - inhibits the degranulation of mast cells preventingthe realse of histamine and other autacoids after immunologicand nonimmunologic stimulation. inhaled because of low oralabsorption;Met/Excr - excreted unchanged within a few days.

maximal levels reached within minutes with t1/2 = 1 hr.response observed within weeks;Indications - prevent asthma

attacks esp. in cold and exercise induced asthma. mostprotective n kids with chronic unstable asthma. can also be

used as a nasal spray for allergic rhinitis;SE; Tox - seen in lessthan 5% of pts. sore thraot; cough; dry mouth most common.

urticaria; maculopapular dermatitis; gastroenteritis.

Q1826:Prednisone/Prednisolone

Class - corticosteroids. reduce inflammation and edema andpotentiate the bronchodilating effects of adrenergic agonists.inactivate NF-kB the transcription factor that induces the

production of TNF-α;Indications - severe chronic and acutebronchospasm;SE; Tox - suppression of growth;

osteoporosis; aggravation of diabetes; aseptic bone necrosis;adrenocortical suppresions.

Q1827:Beclomethasone dipropionate

Class - corticosteroids. reduces inflammation and edema nadpotentiates the bronchodilating effects of adrenergic

agonists;Properties - inhaled in metered doses. highly potent.only minor systemic absorption and rapid metabolism so it

has no effect on the HPA axis;Indications - substiute for oralpreparations in selected individuals with severe steroid-dependent asthma;SE; Tox - oropharyngeal and laryngeal

candidal infection. hoarseness; sore throat; dry mouth.

Q1828:Atropine/Ipratropium Bromide

Properties - block muscarinic receptors thereby inhibitingaceycholine-induced bronchoconstriction;Indications - in

asthma pts unresponsive to adrenergic agents andmethylxantihines. bromidey is often used in COPD because italso reduced secretions;SE; Tox - drowsiness; sedation; drymouth; blurred vision; urinary retenion; constipation. not aspronounced with ipratropium because it does not cross the

BBB.

Q1829:Zileuton

Class - anitleukotriene;Properties - inhibits 5-lipoxygenasetherefore blocks synthesis of leukotrienes. use with

corticosteroids;Indications - prophylaxis of asthma;SE; Tox -diarrhea; headache; increased risk of infections.

Q1830:Zafirlukast

Blocks LTD4 leukotriene receptors. LTD4 is a receptorsfunction in bronchoconstriction; vasoconstriction; contraction

of smooth muscle and increased vascular permeability.

Q1831:First Generation H1 Blockers

Examples - Diphenhydramine; dimenhydrinate;chlorpheniramine;Indications - Allergy; motion sickness; sleep

aid;Toxicity - Sedation; antimuscarinic; anti-α-adrenergic.

Q1832:Second Generation Histamine Blockers

Examples - Loaratidine; fexofenadine;desloratadine;Indications - Allergy;Toxicity - far less sedating

than first generation.

Q1833:What are the short acting beta-2-adrenoreceptoragonists? What are they used to treat?

Albuterol; levalbuterol; metaproterenol; pirbuteol;These drugsare used for the treatment of the acute bronchoconstriction of

asthma by relaxing bronchial smooth muscle.

Q1834:What are the long acting beta-2-adrenoreceptoragonists? How are they chemically different than short acting

beta-2 adrenoreceptor agonists?

Salmeterol; formoterol;These drugs have lipophilic side chainsthat slow diffusion out of the airway.

Q1835:What is isoproterenol?

Nonselective beta-receptor agonists and a potentbronchodilator.

Q1836:What is the most common adverse effect of beta-2adrenoreceptor agonists?

Skeletal muscle tremor. Other: tachycardia; arrhythmias;exacerbation of angina.

Q1837:Theophylline; theobromine; and caffeine are part ofwhat drug family that is used to treat asthma? What are the

pharmacologic effects of theophylline?

Methylxanthines;Pharmacologic effects: relax bronchialsmooth muscle; decrease histamine release; stimulate ciliarytransport of mucus; stimulate medullary respiratory center.

Q1838:Name two anticholinergic drugs used to treat asthma.

Ipratropium bromide and atropine. They inhibit ACh-mediated constriction of bronchial airways and also decrease

vagal stimulated mucus secretion.

Q1839:How does cromolyn sodium treat asthma?

Cromolyn sodium inhibit the release of mediators from mastcells; suppress the activation of neutrophils; eosinophiles; and

monocytes and inhibit the cough reflex.

Q1840:How should cromolyn sodium be used in order toeffectively combat asthma?

Cromolyn sodium is used prophylactically. It does notreverse an established bronchospasm. It is also the only

antiasthmatic that inhibits both early and late phaseresponses.

Q1841:When is nedocromil sodium used in place of cromolynsodium?

Nedocromil is more effective in blocking bronchospasminduced by exercise or cold air.

Q1842:How does beclomethasone treat asthma?

It is a glucocorticoid that increases airway diameter byattenuating prostaglandin and leukotriene synthesis via

inhibition of phopholipase A2.

Q1843:What are the side effects of oral administration ofbudesoide and flunisolide?

These are glucocorticoids. Side effects include hoarseness andoral candidiasis. More serious adverse effects are adrenal

suppression and osteoporosis.

Q1844:The -lukast drugs are antagonists of the _______.

Montelukast and zafirlukast are antagonists of the leukotrienereceptor LT1. This blocks LTC; D; E4.

Q1845:Name the asthmatic drug that inhibits 5-lipoxygenase;the rate-limiting enzyme in leukotriene biosynthesis.

Zileuton.

Q1846:What is omalizumab?

Omalizumab is an anit-IgE antibody that binds to IgE's Fcreceptors; blocking the binding of IgE to mast cells and

basophils.

Q1847:Allergic rhinitis; but not rhinitis associated with colds;can be effectively treated with antihistamines (H1-receptor

antagonists). Name a few.

Diphenhydramine; brompheniramine; chlorpheniramine; andloratadine.

Q1848:What is clemastine used to treat?

Rhinorrhea. It is a second generation H1-receptor antagonist.

Q1849:What is an antitussive?

Medicine used to inhibit or suppress coughing.

Q1850:Name the mucolytic drug used to reduce the viscosityof mucus and treat COPD exacerbations.

Acetylcysteine: cleaves disulfide bonds.

Q1851:An asthmatic female who is recovering from an MI ison several medications. She complains about bruising easily.Blood panel reveals elevated ALT. What antiasthmatic is she

on?

Zilueton - inhibits metabolism of warfarin and increases liverenzymes.

Q1852:Why are opiods effective in the suppression ofcoughing?

They act centrally to decrease sensitivity of the cough centerto peripheral stimuli.

Q1853:What initiates coughing?

Cough receptors; specialized stretch receptors in the tracheaand bronchial tree; send vagal afferents to the cough center.

Q1854:Theophylline has several mechanims; many which areunknown. What are two known moa's of this drug?

Adenosine-receptor antagonist activity and the inhibition ofphosphodiesterase.

Q1855:What drug is used to counter opioid overdose?

Naltrexone.

Q1856:Which drug is most contraindicated in patients withCOPD: acebutolol; nadolol; atenolol; esmolol; metoprolol?

Nadolol because it is a non-selective beta antagonist.

Q1857:What asthma drug can cause U-waves on ECG? How?

Albuterol may cause potassium to shift into cells; resulting inhypokalemia.

Q1858:What drug can be used to stop the bronchoconstrictionresulting from an asthmatic allergic reaction?

Zileuton. Asprin diverts the arachidonic acid pathway to theleukotrienes. Zileuton blocks 5-lipoxygenase which is the

enzyme that forms the LTs.

Q1859:4 H2 blockers

cimetidine; ranitidine; famotidine; nizatidine

Q1860:MOA of H2 blockers

reversibly block H2 receptors which causes decreased H+secretion by gastric parietal cells

Q1861:cimetidine toxicities

P450 inhibitor; antiandrogenic; crosses BBB (confusion; HAs;dizziness) and placenta

Q1862:2 proton pump inhibitors

omeprazole; lansoprazole

Q1863:MOA of PPIs

irreversibly bind H+/K+ ATPase in gastric parietal cells

Q1864:MOA of bismuth; sucralfate

bind to ulcer base and provide physical protection; allowbicarb secretion to reestablish pH gradient in mucous layer

Q1865:triple tx of H. pylori?

metronidazole + bismuth + amoxicilin/tetracycline

Q1866:MOA of misoprostol

PGE1 analog; that increases production and secretion ofgastric mucous barrier and decreases acid production

Q1867:toxicity/contraindications for misoprostol

(PGE1 analog) diarrhea; not for women of childbearingpotential

Q1868:which 2 muscarinic antagonists used for treatment ofpeptic ulcer?

pirenzepine; propantheline

Q1869:toxicities of pirenzepine and propantheline?

tachycardia; dry mouth; difficulty focusing eyes

Q1870:overuse of aluminum hydroxide can cause whatproblems?

(antacid) constipation; hypophosphatemia; proximal mmweakness; osteodystrophy; seizures

Q1871:overuse of magnesium hydroxide can cause whatproblems?

(antacid) diarrhea; hyporeflexia; hypotension; cardiac arrest

Q1872:overuse of calcium carbonate can cause whatproblems?

(antacid)hypercalcemia; rebound acid increase

Q1873:MOA of infliximab

monoclonal TNF-alpha ab

Q1874:clinical use of infliximab

Crohn's dz; rheumatoid arthritis

Q1875:infliximab toxicity

respiratory infection; fever; hypotension

Q1876:MOA sulfasalazine

combo antibacterial (sulfapyridine) and anti-inflammatory(mesalamine); activated by colonic bacteria

Q1877:clinical use of sulfasalazine

UC; Crohn's disease

Q1878:toxicity of sulfasalazine (5)

malaise; nausea; sulfonamide toxicity; reversible oligospermia

Q1879:MOA of ondansetron

5-HT3 antagonist (powerful central acting anti emetic)

Q1880:clinical use of ondansetron

antiemetic; to control vomiting post-op and in pts undergoingchemotherapy

Q1881:toxicity of ondansetron

headache; constipation

Q1882:MOA of cisapride

acts thru serotoni R to increase Ach release at myentericplexus; increases esophageal tone; increases gastric and

duodenal contracitlity and improves transit time (prokinetic)

Q1883:Clinical use of cisapride

prokinetic (on GIT) but no longer used because of seriousinteractions with erythromycin; ketoconazole; nefazodone;

fluconazole (-->torsades de pointes!)

Q1884:MOA of metoclopramide

D2 R antagonist; increases resting tone; contractility; LEStone; motility but does not increase transit time thru colon.

(pro-kinetic)

Q1885:clinical use of metoclopramide

diabetic and post-surgery gastroparesis

Q1886:toxicity of metoclopramide

(D2 R antag). Increased Parkinsonian effects; restlessness;drowsiness; fatigue; depression; nausea; constipation.

Q1887:drug interactions of metoclopramide

digoxin and diabetic agents

Q1888:contraindications for metoclopramide?

(D2 R antag) pts with small bowel obstruction

Q1889:Calcium carbonate

Class - nonsystemic Antacid;Indication - PUD; refluxesophagitis;SE; Tox - hypercalcemia (esp. with dairy

products); renal stones; Ca stimulates secretion of gastrin andHCl --> acid rebound

Q1890:Aluminum hydroxide

Class - nonsystemic Antacid;Indications - PUD;SE; Tox -*constipation*; hypophosphatemia; proximal myopathy;

encephalopathy in pts on dialysis

Q1891:Magnesium salts

Class - nonsystemic Antacid;Indication - PUD;SE; Tox -*diarrhea*; milk-alkali syndrome with dairy products;

metabolic *alkalosis* esp. in renal insufficiency. exacerbationof CHF; edema because of sodium intake;CI - HTN

Q1892:Antacids

All can cause hypokalemia.

Q1893:Cimetidine

Class - H2 blockers (block parietal cell histaminereceptors);Indications - Tx/prevent PUD; ZE; gastritis; mildGERD;Properties - acid secretion inhibited for 4 hours;SE;Tox - only H2 blocker to inhibit P450 system --> increase

serum levels of EtOH; warfarin; digitoxin; TCA; phenytoin;carbamazepine; beta -blockers; benzos. antiadrogenic;

decreased renal excretion of creatinine.

Q1894:Ranitidine

Class - H2 blockers (block parietal cell histaminereceptors);Indications - Tx/prevent PUD; ZE; gastritis; mild

GERD;Properties - more potent than cimetidine. 1-2xdaily;SE; Tox - less than cimetidine; doesn't penetrate CNS as

much; no P450 effect.

Q1895:H2 Blockers

cimetidine; ranitidine; famotidine; nizatidine

Q1896:Omeprazole; Lansoprazole

Class - PPI;Indications - GERD; PUD; ZE; gastritis. esp.when refractory to H2 blockers;Properties - irreversible

inhibition; prodrug that diffuses into acid space of secretorycanaliculus where it is protonated to active form;SE; Tox -

overgrowth of bacteria

Q1897:Sucralfate

Indications - PUD;Properties - activated in acid environment.negative charges bind to positively-charged proteins inulcerated tissue. Provides physical protection;SE; Tox -

minor. mostly constipation. decrased absoprtion ofciproflaxin; norflaxin. because it needs acid to be activated; do

not give with antacids; H2 blockers; PPIs.

Q1898:Bismuth

Indications - PUD;Properties - binds to ulcerr providingphysical protection. possible antimicrobial activity against H.

pylori.

Q1899:Misoprostol

Class - PGE? analog;Indications - prevent gastric ulcerscaused by NSAIDS;SE; Tox - Diarrhea;CI - potentially

childbearing women (induces labor).

Q1900:Antibiotics for PUD

Tetracycline; Metronidazole; Clarithromycin; plus H2 blockerdrastically reduces recurrence compared to H2 blocker alone.

Q1901:Ipecac

Class - Emetic;Properties - irritates GI tract; stimulateschemoreceptor zone. Onset = 15-30 min.

Q1902:Prochlorperazine; chlorpromazine; metoclopramide

Class - Dopamine receptor antagonists;Properties - Act at D2receptors at chemoreceptor trigger zone --> antiemesis.

Q1903:Ondansetron

Class - Antiemetic;Properties - 5-HT3 antagonist;Indications- control vomiting postop and during chemotherapy;SE; Tox -

headache; constipation.

Q1904:Bulk-forming Laxatives

Examples - dietary fiber; semisyntheticpolysaccharides/cellulose (methylcellulose);Properties -osmotic effect --> fluid/electrolyte renetion in intestinal

lumen. increased fecal mass/softness --> accelerated transit.Works within 1-3 days after PO administration;Indications -

diverticular disease; IBS;SE; Tox - flatulance; electrolyteimbalances; esophogeal/intestinal obstruction therefore take

with fluids

Q1905:Castor Oil

Class - Stimulant laxative;Properties - hydrolyzed in smallintestine to active ingredient --> decreased reabsorption of

electrolytes/fluids and stimulates peristalsis. works within 1-3hours after PO administration;SE; Tox - chronic use impairsabsorption of essential nutrients; excacerbates dehydration

and electrolyte disturbances.

Q1906:Bisacodyl

Class - Stimulant laxative;Properties - onset of action (oral) =6-12h; (rectal) = 1h;SE; Tox - fluid/electrolyte deficiencies;

rash; rectal burning

Q1907:Anthroquinones

Class - Stimulant Laxative. (cascara and senna; eg);Properties -effect at large intestine. Increase peristalsis.

Q1908:Docusates

Class - Stimulant Laxative;Properties - anionic surfactant.Softens stool by emulsifying water; fat; and feces. Onset ofaction = 1-3d;Indications - used after abdominal surgery andpostMI;SE; Tox - nausea; cramping. Don't use with mineral

oil.

Q1909:Salt-containing Osmotic Laxatives

Properties - contain Mg; phosphate; sulfate salts. fluidretention --> increased motility. Onset of action = 2h;semifluid stools;Indications - bowel evacuation prior to

surgery/imaging;SE; Tox - Mg salts --> hypermagnesemia inpts with renal insufficiency. Na salts exacerbate CHF; cause

dehydration.

Q1910:Lactulose

Class - nonsalt Osmotic Laxative;Properties - semisyntheticdisaccharide. Traps ammonia as NH4+; enhances excretion ofnitrogenous wastes in hepatic insuffiency. Onset of action =1-3d;Indications - laxative and in hepatic encephalopathy;SE;Tox - N/V; flatulence; diarrhea; dehydration; hypokalemia.

Q1911:Mineral Oil

Class - Surfactant Laxative;Properties - softens stool;SE; Tox- limiting. pneumonitis after aspiration; imparied absorption

of fat-soluble nutrients; pruritus ani (ew.)

Q1912:Loperamide

Class - Opiate;Indications - Diarrhea;Properties - since itpoorly crosses BBB; it has few side effects and low potential

for abuse. decreases GI motility.

Q1913:Infliximab

Class - monoclonal Ab to TNF-alpha (a proinflammatorycytokine);Indications - Crohn's Disease; rheumatoid

arthritis;SE; Tox - respiratory infection; fever; hypotension

Q1914:Sulfasalazine

Class - combo of sulfapyridine (antibacterial) and mesalamine(anti-inflmmatory);Indications - Ulcerative colitis; Crohn's

disease;SE; Tox - Malaise; nausea; sulfonamide toxicity(hypersensitivity rxn; hemolysis in G6PD deficient pts;

nephrotoxicity; kernicterus; displacing drugs (warfarin) fromalbumin)

Q1915:examples of H2 blockers

cimitidine ;ranitidine;famotidine;nizatidine;(-tidine)

Q1916:mechanism of H2 blockers

reversibly bind to H2 recetors; blocking H2 activation anddecreased H+ release by parietal cells

Q1917:toxicity of H2 blockers

cimitidine has the most: anti-androgenic effects; p450interactions; crosses BBB (--> dizziness; confusion; HA); can

cross placenta;rantidine and cimetidine decrease renalexcretion of creatinine

Q1918:examples of PPI

omeprazole ;lansoprazole ;(-prazole)

Q1919:MOA of PPI

irreversibly binds to H-K-ATPase pump in parietal cells

Q1920:clinical use for H2 inhibitor

peptic ulcers;gastritis ;mild GERD

Q1921:clinical uses for PPI

peptic ulcers; gastritis; GERD; Zollinger-Ellison syndrome

Q1922:MOA of bismuth

binds at the base of the ucler; giving physical protection;allows HCO3- secretion to re-establish pH gradient in mucus

layer

Q1923:clinical use of bismuth

ucler healing;traveller's diarrhea

Q1924:MOA sucralfate

binds at base of ulcer; giving physical protection ;allowsHCO3- secretion to re-establish pH gradient in mucus layer

Q1925:clinical use of sucralfate

increase ulcer healing ;traveller's diarrhea

Q1926:MOA of misoprostol

agonizes PGE1; increases production of mucous barrier;decreases acid production

Q1927:what is the triple therapy against HP?

metronidazole ;bismuth;amoxy (or tetracycline)

Q1928:clinical uses for misoprostol

prevention of NSAID induced ulcers ;maintain patent PDA;induce labor

Q1929:toxicity of misoprostol

abortofacient

Q1930:examples of muscarinic antagonists

pirenzepine ;propantheline

Q1931:MOA of muscarinic antagonists

blocks M1 receptors on ECL cells and M3 receptors onparietal cells (vagal stimulation goes ot M3) ;blocking M1

receptor decreases H2 secretion and blocking M3 decreasesH+ secretion

Q1932:clinical uses for muscarinic antagonists

peptic ulcer

Q1933:toxicity of muscarinic antagonist

tachycardia;dry mouth;difficulty focusing eyes

Q1934:toxicity associated with Al(OH)3

constipation (minimum amt of feces);muscleweakness;osteodystrophy ;seizures;hypokalemia

Q1935:toxicity associated with Mg(OH)2

diarrhea ;hyporeflexia;hypotension;cardiac arrest;hypokalemia

Q1936:toxicity associated with calcium carbonate

hypercalcemia;rebound acid increase;hypokalemia

Q1937:MOA of infliximab

mAB against TNF-alpha

Q1938:clinical uses of infliximab

Crohn's disease;RA

Q1939:toxicity assicated with infliximab

respiratory infx;hypotension ;fever

Q1940:MOA sulfasalazine

combo of sulfapyridine and mesalamine (antibacterial andanti-inflammatory) ;activated by colonic bacteria

Q1941:clinical use of sulfasalazine

UC ;CD

Q1942:toxicity of sulfasalazine

malaise;nausea;sulfonamide toxicity ;reversible oligospermia

Q1943:MAO ondansetron

seratonin antagonist ;antiemetic

Q1944:clinical use for ondansetron

control vomiting post-op and in pts taking chemo

Q1945:toxicity associated with ondansetron

HA;constipation

Q1946:examples of pro-kinetic agents

cisapride ;metoclopramide

Q1947:MOA cisapride

increases ACh release at myenteric plexus ;increasesesophageal ton e;increases gastric and duo contractility

;improves transit time

Q1948:cisapride toxicity

NO LONGER USED b/c of interactions with erythromycin;ketoconazole; nefazodone; fluconazole

Q1949:MOA metoclopramide

D2 recepotr antagonist;increses resting tone; contractility;LES tone; motolity ;does not increase transit time through

colon

Q1950:which motility agent increases transit time throughcolon?

cisapride

Q1951:clinical use of metoclopramide

diabetic and post-surggery gastroparesis

Q1952:toxicity of metoclopramide

increased parkinsonian effects;restlessness;drowsiness;fatigue;depression;nausea;constipation

Q1953:drug interactions with metoclopramide

digoxin ;DM meds

Q1954:when is metoclopramide contraindicated

pts with small bowel obstruction

Q1955:Cimetidine

Reversible H2 Blocker;AE: P450 Inhibitor;Anti-androgenic;Cross BBB (confusion; etc);Decrease Creatinine

excretion.

Q1956:Omeprazole

Irreversibly inhibts ACTIVE pumps;P450 clearance andINHIBITION;Prodrugs must be pronated in cells.

Q1957:Bismuth. Sucralafate.

Bind to ucler base; providing physical protrection. AllowHCO3 secretion to reestablish pH gradient in mucous;Also

anti-Diarrhea;Part of H. pylori triple therapy.

Q1958:Misoprostol

Prostaglandin analog;SE: Diarrhea;Contraindicated inchildbearing women.

Q1959:Pirenzepine; Propantheline.

Muscarinic antagonists (M1 on ECL cells and M3 on parietalcells);SE: Tachycardia; dry mouth; cycloplegia.

Q1960:Loperimide

Opioid anti-diarrheal;Excluded from CNS by mdrtransporter;SE: cIx in children.

Q1961:Sulfasalazine

Sulfapyridine (antibacterial) + Mesalanine (anti-inflammatory). Activated by colonic bacteria;SE: Malaise;

nausea; sulfonamide toxicity; oligospermia (reversible).

Q1962:Ondansetron

Antiemeic. 5HT3 antagonist;SE: Headache; Constiplation.

Q1963:Antacids in general

Can effect absorption; bioavailablity; urinary excretion ofother drugs by changing gastric pH or delaying gastric

emptying;Cause systemic alkalosis; hypokalemia.

Q1964:Aluminum Hydroxide

Antacid;SE: Constipation; hypophospahtemia; proximalmuscle weakness; osteodystrophy; seizures

Q1965:Magnesium Hydroxide

Antacid;SE: Diarrhea (osmotic); hyporeflexia; hypotension;cardiac arrest.

Q1966:Calcium Carbonate

Antacid;SE: Hypercalcemia; REBOUND ACIDINCREASE;Also; can chelate and decrease effectiveness of

other drugs (Tetracyclines).

Q1967:Cisapride

Prokinetic Agent;5HT receptors to increase ACh release atthe myenteric plexus. Increase esophageal tone; increasegastric/duodenal contractitlity;SE: NO LONGER USED.

TORSADES DES POINTES when given with erythromycin;ketoconazole; flucanazole; nefazodone.

Q1968:Metoclopramide

D2 receptor antagonist. Increases resting tone; contractility;LES tones; motility. DOES NOT influence colon transport

time;Used for gastroparesis (DM and post surgery);SE:Increases Parkinsonian effects. Interacts with digoxin and DM

agents. cIx if small bowel obstructed.

Q1969:Aspirin

Properties - inhibits COX therefore preventing TXA2synthesis (irreversible inhibition at platelets - life long = 7-10days) but endo can continue to produce anticoagulant PGI2.

Can prolong bleeding time after one dose;Indications - preventreinfarct; prevent MI; prevent occlusion in coronary artery

bypass grafts. pts with TIAs to prevent stroke.

Q1970:Why is there a yellow jacket in here?

Cuz mom left the door open for no reason. If I get stung whilestudying; I'm just not taking the boards.

Q1971:Clopidogrel

Properties - inhibits plately aggrecation by irreversiblymodifying the platelt ADP receptor;Indications - reduction of

atherosclorotic events in pts with known atherosclorosis.

Q1972:Ticlopidine

Properties - inhibits expression of glycoprotein IIb/IIIAreceptors on platelets. GPIIb/IIIA has fibrinogen bindingsites;Indications - pts with stroke precursors who can't

tolerate aspirin;SE; Tox - life-threatening blood dyscrasia.

Q1973:Heparin

Properties - accelarates antithrombin III (heparin cofactor)binding to thrombin which then inactivates thrombin; Xa; XIa;

XIIa; and kallikrein. Given IV/SQ. Prolongs PTT; thrombintime; whole blood clotting time. only anticoagulate that workswithin minutes;Met/Excr - liver met by heparinase;Indications- sq in low doses to prevent clot for pts at high risk; used tostop ongoing thrombosis; in the acute phase of MI; safe in

pregnant women because doesn't cross the placenta;SE; Tox -bleeding - monitor PTT! protamine sulfate reverses theanticoag effect of heparin but too much causes its ownanticoagulant effect. so that's helpful. transient and mild

thrombocytopenia. hypersensitivity. chonically;osteoporosis. elevation of LFTs.

Q1974:Low Molecular Weight Heparins

Properties - have more antifactor Xa activity; less inactivationof thrombin; less inhibition of platelets. longer half life than

heparin. don't need to be monitored but are not easilyreversible;Indications - hip replacements.

Q1975:Hirudin

Properties - a thrombin inhibitor - binds to the active site andfibrinogen recognition site of thrombing. little bleeding at

therapeutic doses. given IV or SQ.

Q1976:Streptokinase

Properties - produced by beta -hemolytic strep. formscomplexes with plasminogen which can then cleave free

plasminogen into plasmin. longest half life of the thrombolyticagents;Indications - AMI;SE; Tox - bleeding;

hypersensitivity-Ag reactions. rare anaphylaxis.

Q1977:Alteplase (tPA)

Properties - an endogenously produce serine protease. "fibrinselective" - activates only plasminogen bound to fibrin; so V;

VIII remain active. Half life of only 5 minutes;SE; Tox -Hemorrhage with no less incidence than streptokinase.

Q1978:E Aminocaproic Acid (anistreplase)

Properties - a lysine analog that binds to lysine-binding siteson plasminogen and plasmin to block plasmin's binding tofibrin; inhibiting fibrinolysis;Indications - Tx of systemichyperfibrinolysis with surgical commplications followingheart surgery and portocaval shunt. or cancer and blah. can

reverse the action of thrombolytic agents.

Q1979:Epoetin alpha

Properties - growth factor produced by the kidney thatstimulates RBC production. Given parenterally;Indications -

anemia secondary to renal failure and chemotherapy;secondary to AZT in AIDS pts. used prior to surgery to

alleviate potential surgical blood loss and to facilitateautologous blood donation.

Q1980:Sargramostim

Properties - recombinant granulocyte granulocyte-macrophagecolony-stimulating factor. Produced by T lymphocytes leadsto proliferation of granulocytes; monocytes; macrophages;

megakaryocytes;Indications - neutropenia;SE; Tox -induration; thrombophlebitis at site; bone pain; fever; rashes;myalgias. limit-dose if pleuritis; pleural effusions; pericarditis.

Q1981:Filgrastim

Properties - recombinant granulocyte colony-stimulatingfactor. produced by monocytes; fibroblasts; endothelial cells

and stimulates the production of neutrophils;Indications -chemotherapy-induced neutropenia and others;SE; Tox - less

severe than with GM-CSF. bone pain and vascultitis.

Q1982:Abciximab

Properties - binds to glycoprotein receptor IIb/IIIa onactivated platelets;Indications - acute coronary snydromes;

PTCA;SE; Tox - bleeding; thrombocytopenia.

Q1983:Name 4 antiplatelet drugs and their MOA

aspirin: inhibits CO dec. TXA2;clopidogrel: modifies ADPreceptor;Ticlopidine: inhibits GPIIb/IIIaexpression;Abciximab: binds GPIIb/IIIa

Q1984:Heparin MOA;lab?

activates antithrobin III;(thus decreases thrombin andinactivates IXa-XIIa);increase PTT

Q1985:Heparin use

immediate anticoag;(pulmonary embolism; stroke; angina; MI;DVT)

Q1986:What can you administer to reverse the heparineffects?

protamine sulfate;(binds neg. charged heparin)

Q1987:Low MX heparins;(enoxaprin);(used in hipreplacements);MOA;advantages

act more at Xa;;longer half-life;subQ administration;do nothave to monitor PTT

Q1988:Warfarin MOA (an oral agent);lab?

interferes w/ Vit K dep modification II; VII; IX; X; Protein Cand S;follow PT

Q1989:Warfarin use

chronic anticoag

Q1990:How do you treat warfarin overdose

IV of Vit K and fresh frozen plasma

Q1991:What drugs can increase the hepatic metab. of warfarin(3)

barbituates;glutethimide;rifampin

Q1992:what drugs can decrease the metabolism of warfarin(6);IMPORTANT

metronidazole;trimethoprim;disulfiram;cimetidine;phenylbutazone;sulfonamides;(influenza vaccine and acute alcohol intox)

Q1993:Heparin or warfarin; which crosses the placenta?

warfarin;(it is teratogenic)

Q1994:Name 4 thrombolytic agents and their use

streptokinase;anistrepelase (ASPAC);atelplase(tPA);urokinase;early MI

Q1995:Aminocaproic acid class;MOA

fibrinolytic inhibitor;blocks plasmin biding to fibrinogen andfibrin

Q1996:Name the follwing hematopoeitic growthfactors;RBC;GM-CSF;C-CSF;macrophage (2)

erythropoietin;Sargamostin (recombinant);Filgrastim(recombinant);Il-3 and M-CSF

Q1997:Heparin

Activates antithrombin III; decreases thrombin & factorXa;Intrinsic pathway inhibitor; increases PTT more thanPT;Short half-life. Does not cross placenta;Antidote =

protamine sulfate

Q1998:Warfarin

Inhibits synthesis & gamma-carboxylation of vit K dependentfactors (II; VII; IX; X; prot C; prot S);Crosses placenta

(teratogen);Inhibits extrinsic pathway; increases PT;Antidote= vitamin K; fresh frozen plasma

Q1999:Aspirin

Irreversibly inhibits COX-1 and COX-2;Increased bleedingtime. No change to PT; PTT;SE: ulcers; bleeding;

hyperventilation; Reye's syndrome; tinnitus (CN8)

Q2000:Clopidogrel; Ticlopidine

Inhibits platelet aggregation. Irreversibly blocks ADPreceptors; blocks GP IIb/IIIa expression;SE: ticlopidine =

neutropenia

Q2001:Abciximab

Inhibits platelet aggregation; antibody to GP IIb/IIIareceptors;SE: thrombocytopenia

Q2002:tPA; urokinase; streptokinase; anistreplase

Thrombolytics; aid conversion of plasminogen to plasmin andcleaves thrombin/fibrin clots;Antidote = aminocaproic acid

(fibrinolysis inhibitor)

Q2003:Heparin

Anticoagulant;MECH: increased activity of antithrombin(III) which inhibits thrombin (IIa); Xa; and IXa (given

parenterally; short t1/2; monitor PTT);USE: PE; MI; angina;stroke; DVT; can be used during preg (doesn't cross

placental);TOX: bleeding; thrombocytopenia; drug-druginteractions (very negative molecule); hypersensitivity; anti-

platelet antibodies

Q2004:Enoxaparin

LoAnticoagulant;MECH: increased activity of antithrombin(III) to inhibit Xa (can be given subcu; longer t1/2);USE: PE;MI; angina; stroke; DVT; can be used during preg (doesn't

cross placental);TOX: bleeding; thrombocytopenia; drug-druginteractions (very negative molecule); hypersensitivity; anti-

platelet antibodies

Q2005:Protamine sulfate

MECH: very positively charged molecule binds heparinwhich is negatively charged;USE: reversal of heparinization

Q2006:Warfarin/coumadin

Anticoagulant;MECH: interferes with normal synthesis andcarboxylation of vitamin-K dependent clotting factors - II;VII; IX; X; C; S (oral; long t1/2; several days to take effect;

monitor PT);USE: long term anticoagulation - DVT; PEprophylaxis;TOX: bleeding teratogenic; drug-drug interactions

(

Q2007:Alteplase / tPA (tissue plasminogen activator)

Thrombolytic;MECH: activates plasminogen bound to fibrinto plasmin which dissolves fibrin clots; recombinant humanprotein;USE: Acute MI and ischemic stroke (within 3-6 oursof the event); PE; DVT;TOX: bleeding (internal and external)

Q2008:Streptokinase

Thrombolytic;MECH: activates plasminogen (free and bound)to plasmin which dissolves fibrin clots; isolated from

streptococci;USE: Acute MI and ischemic stroke (within 3-6ours of the event); PE; DVT;TOX: bleeding (internal and

external); hypersensitivity rxn

Q2009:Urokinase

Thrombolytic;MECH: activates plasminogen (free and bound)to plasmin which dissolves fibrin clots; isolated from

streptococci;USE: PE;TOX: bleeding (internal and external);less antigenic than streptokinase

Q2010:APSAC (anistreplase)

Thrombolytic;MECH: lys-plasminogen/streptokinasecomplex which binds fibrin and becomes slowing

activated;TOX: non-selective; long lasting hypocoagulablestate

Q2011:Aminocaproic acid

Anti-thrombolytic;MECH: inhibits fibrinolysis;USE:thrombolytic toxicity

Q2012:Aspirin (ASA)

Antithrombotic;MECH: Acetylates and irreversibly inhibitscyclooxygenase (COX-1 and -2) to prevent conversion of

arachidonic acid to prostaglandins: (1) inhibition ofthromboxane (TxA2) → decreased activity and aggregation ofplatelets; (2) at high doses; it decreased synthesis of PGI2 byendothelial cells which reduces the antithrombotic action;USE:antipyretic; analgesic; anti-inflammatory; anti-platelet;TOX:

gastric ulceration; bleeding; hyperventilation; Reye'ssyndrome; tinnitus

Q2013:Dipyridamole

Antithrombotic;MECH: inhibits platelet uptake of adenosinewhich had vasodilatory and antiaggregating activity;USE:

prophylaxis in pts with prosthetic heart valves

Q2014:Clopidigrel (Plavix) & Ticlopidine

Antithrombotic;MECH: (1) irreversibly block ADP receptors→ decreased platelet aggregation; (2) prevent glycoprotein

IIb/IIIa expresion → decreased fibrinogen binding;USE: acutecoronary syndromes; percutaneous; transluminal coronary

angiography;TOX: bleeding; thrombocytopenia

Q2015:Abciximab; Eptifibatide & Tirofiban

Antithrombotic;MECH: chimeric monoclonal antibody;synthetic peptide; & peptide mimetic that bind IIb/IIIa →

decreased fibrinogen binding → decreased plateletaggregation;USE: MI; angina; percutaneous coronary

intervention;TOX: bleeding

Q2016:Mechlorethamine

Alkylating Agent;MECH: binds Ns and Os of purines andpyrimidines in DNA → abnl base pairing; depurination; ringcleavage and DNA strand crosslinks; acts in late G1 and S

phase;USE: IV route; MOPP regime for Hodgkins dz;TOX:leukopenia and thromboctyopenia

Q2017:Cyclophosphamide

Alkylating Agent;MECH: binds Ns and Os of purines andpyrimidines in DNA → abnl base pairing; depurination; ringcleavage and DNA strand crosslinks; acts in late G1 and Sphase; requires bioactivation by liver which also creates a

toxic metabolite (acrolein);USE: oral; IV; or IM; non-Hodgkin's lymphoma; breast & ovarian CA;

immunosuppressant;TOX: myelosuppression; hemorrhagiccystitis (Acrolein) can be prevented with MESNA

Q2018:Ifosfamide

Alkylating Agent;MECH: binds Ns and Os of purines andpyrimidines in DNA → abnl base pairing; depurination; ringcleavage and DNA strand crosslinks; acts in late G1 and Sphase; requires bioactivation by liver which also creates a

toxic metabolite (acrolein);USE: oral; IV; or IM; non-Hodgkin's lymphoma; breast & ovarian CA;

immunosuppressant;TOX: myelosuppression; hemorrhagiccystitis (less tox than cyclophosphamide)

Q2019:Chlorambucil


phase;USE: orally for CLL; some lymphomas; andHodgkins;TOX: less severe marrow suppression than other

nitrogen mustards

Q2020:Busulfan


phase;USE: orally for CML;TOX: pulmonary fibrosis;hyperpigmentation

Q2021:Carmustine; lomustine; semustine

Alkylating Agent;MECH: binds Ns and Os of purines andpyrimidines in DNA → abnl base pairing; depurination; ringcleavage and DNA strand crosslinks; acts in late G1 and Sphase;USE: highly lipophillic → cross BBB → treat brain

tumors (including GBM); Hodgkin's dz;TOX:myelosuppression; renal failure; CNS tox (dizziness; ataxia)

Q2022:Streptozocin


phase;USE: pancreatic islet cell CA and carcinoid;TOX: NOTmyelosuppressive; renal tox is dose-limiting

Q2023:Cisplatin

Platinum compound;MECH: complexes with DNA to formcross-links (like alkylating agents);USE: testicular; ovarian;

and bladder CAs;TOX: nephrotox; ototox; peripheralneuropathy

Q2024:Carboplatin

Platinum compound;MECH: complexes with DNA to formcross-links (like alkylating agents);USE: testicular; ovarian;

bladder; transitional; NSC lung CA;TOX: myelosuppression;nephrotox; ototox; peripheral neuropathy

Q2025:Methotrexate

Antimetabolite;MECH: S-phase specific folic acid analoguethat inhibits dihydrofolate reductase → decreased DNA andprotein synthesis;USE: ALL; choriocarcinoma; trophoblastic

tumors; Burkitt and other non-Hodgkin's lymphoma;osteogenic sarcoma; abortion; ectopic pregnancy; RA;

psoriasis;TOX: myelosuppressive (treat withleucovorin/folinic acid); Gi; nephrotox

Q2026:Cytarabine

Antimetabolite;MECH: S-phase specific pyrimidineantagonist - metabolites inhibit DNA polyermase;USE: Acuteleukemias (esp. AML) and non-Hodgkin's lymphoma;TOX:

leukopenia; thrombocytopenia; megaloblastic anemia

Q2027:Flourouracil (5-FU)

Antimetabolite;MECH: S-phase specific pyrimidineantagonist; activated form complexes folic acid that inhibits

thymidilate synthase → decreased DNA and proteinsynthesis;USE: parenterally colon CA and other solid cancers;topically basal cell CA;TOX: myelosuppression (rescue with

thymidine); photosensitivity

Q2028:Mercaptopurine & Thioguanine

Antimetabolite;MECH: analogues of purines; activated byHGPRTase; block de novo purine synthesis;USE: leukemias;

lymphomas (not CLL or Hodgkins);TOX: bone marrowsuppression

Q2029:Fludararbine

Antimetabolite;MECH: analogues of purines; interferes withDNA synthesis;USE: CLL;TOX: bone marrow suppression

Q2030:Vincristine

Vinca alkaloid;MECH: M-phase specific; binds tubulin toprevent microtubule polymerization → mitotic spindle can't

form;USE: lymphoma (MOPP); Wilm's tumor;choriocarcinoma;TOX: neurotox (areflexia; peripheral

neuritis); paralytic ileus

Q2031:Vinblastine

Vinca alkaloid;MECH: M-phase specific; binds tubulin toprevent microtubule polymerization → mitotic spindle can't

form;USE: lymphoma (MOPP); Wilm's tumor;choriocarcinoma;TOX: bone marrow suppression

Q2032:Paclitaxel

MECH: M-phase specific; stabilizes microtubles so that themitotic spindle cannot break down in anaphase;USE: ovarian

& breast CA;TOX: myelosuppression; hypersensitivity

Q2033:Etoposide

MECH: G2-phase specific; inhibits topoisomerase II → dsDNA breaks;USE: SCLC; prostate and testicular CA;TOX:

leukopenia

Q2034:Dactinomycin (actinomycin D)

Antibiotic;MECH: intercalates into DNA; phase non-specific;USE: Wilm's tumor; Ewing's sarcoma;rhabdomyosarcoma;TOX: myelosuppression

Q2035:Doxorubicin (adriamycin); daunorubicin

Antibiotic;MECH: intercalate into DNA; generate freeradicals → DNA strand breaks;USE: part of many regimens

(ABVD); Hodgkin's; myelomas; sarcomas; solid tumors;TOX:cardiotoxicity; alopecia

Q2036:Bleomycin

MECH: induces formation of free radicals → DNA strandbreaks (G2 phase specific);USE: testicular CA; lymphomas

(ABVD);TOX: pulmonary fibrosis; skin changes

Q2037:Imatinib (Gleevec)

MECH: bcr-abl tyrosine kinase inhibitor ;USE: CML(Philadelphia chrom); GI stromal tumors;TOX: fluid retention

Q2038:Trastumab (Herceptin)

MECH: IgG against HER2 protein (erb-B2); cell death byantibody dependent cytotoxicity;USE: Metastatic breast

cancer;TOX: cardiotoxicity

Q2039:Tamoxifen; raloxifene

MECH: competitive antagonist of estrogen receptor → blockestrogen-dependent growth;USE: breast cancer;

osteoporosis;TOX: hot flashes; increased risk of endometrialcancer (not raloxifene)

Q2040:Prednisone

MECH: may trigger apoptosis (glucocorticoid);USE: CLL;Hodgkin's; autoimmune dzs;TOX: Cushing-like symptoms

Q2041:Rituximab

MECH: binds CD20 antigen on B-cells → cell lysis;USE:non-hodgkin's lymphoma; thrombocytopenic purpura;TOX:

derm and GI

Q2042:which cancer drugs are cell cycle specific (5)

antimetabolites (MTX; 5-FU; 6-MP); etoposide; bleomycin;vinca alkaloids; paclitaxel

Q2043:which cancer drugs are cell cycle nonspeficic (2)

alkylating agents; antibiotics

Q2044:MOA of MTX

S-phase specific antimetabolite. Inhibits duhydrofolatereductase (b/c is folate acid analog)

Q2045:Clinical uses of MTX

leukemias; lymphomas; choriocarcinomas; sarcomas; abortion;ectopic preggers; RA; psoriasis

Q2046:toxicities of MTX

myelosuppression (use leucovorin for "rescue");macrovesicular fatty change in liver

Q2047:MOA 5-FU

S-phase specific antimetabolite. Bioactivated form (5F-dUMPcomplexes with folic acid and inhits thymidylate synthase

Q2048:Clinical use of 5-FU

colon cancer and other solid tumors; basal cell carcinoma(topical). Synergy with MTX

Q2049:toxicity of 5-FU

myelosuppression which is NOT reversible with leucovorin(vs MTX); photosensitivity

Q2050:MOA 6-MP

blocks de novo purine synthesis

Q2051:what activates 6-MP?

HGPRTase

Q2052:Toxicities of 6-MP

done marrow; GI; liver; metabolized by xanthine oxidase soincreased toxicity with allopurinol

Q2053:MOA cytarabine (ara-C)

inhibits DNA polymerase

Q2054:Clinical use of ara-C?

AML

Q2055:toxicities of ara-C

leukopenia; thrombocytopenia; megaloblastic anemia

Q2056:MOA of cyclophosphamide/ifosfamide

(alkylaying agts) covalently x-link DNA at guanine N-7;require bioactivation by liver

Q2057:Clinical use of cyclophosphamide/ifosfamide

non-Hodgkin's lymphoma; breast and ovarian carcinomas

Q2058:toxicities of cyclophosphamide

myelosuppressin; hemorrhagic cystitis (use mesna!!)

Q2059:4 nitrosoureas

carmustine; lomustine; semustine; streptozocin

Q2060:MOA of nitrosoureas

(e.g. carmustine; steptozocin). Alkylate DNA; requirebioactivation; CROSS BBB!!

Q2061:toxicities of nitrosoureas

CNS (dizziness; ataxia)

Q2062:MOA of cisplatin; carboplatin

act like alkylating agents

Q2063:clinical uses of cisplatin?

testicular; bladder; ovary; and lung carcinomas

Q2064:toxicity of cisplatin?

nephrotoxicity and acoustic nerve damage

Q2065:MOA of busulfan

alkylates DNA

Q2066:clinical use of busulfan

CML

Q2067:toxicities of busulfan

pulmonary fibrosis; hyperpigmentation

Q2068:MOA of doxorubucin; daunurubicin

generate free radicals and noncovalently intercalate into DNA

Q2069:Clinical uses of doxorubucin; daunorubicin

part of ABVD treatment for Hodgkin's; also for myelomas;sarcomas; solid tumors

Q2070:toxicities of doxorubicin; daunorubicin

cardiotoxic; myelosuppression; marked alopecia; toxicextravasation

Q2071:MOA dactinomycin

DNA intercalater

Q2072:clinical uses of dactinomycin

Wilm's tumor; Ewing's sarcoma; rhabdomyosarcoma (forchildhood tumors!)

Q2073:toxicity of dactinomycin

myelosuppression

Q2074:MOA of bleomycin

induces formation of free radicals-->DNA strand breaks

Q2075:Clinical uses of bleomycin

testicular cancer; part of ABVD for Hodgkin's (along withdoxorubicin/daunorubicin)

Q2076:toxicities of bleomycin

PULMONARY FIBROSIS; skin changes; MINIMALmyelosuppression

Q2077:MOA of etoposide

G2 phase specific agt; inhibits topoisomerase II

Q2078:Clinical uses of etoposide

small cell carcinoma of lung and prostate; testicular carcinoma

Q2079:Toxicities of etoposide

myelosuppression; GI irritation; alopecia

Q2080:MOA of prednisone

steroid; may trigger apoptosis?

Q2081:Clinical uses of prednisone

lots but spefically part of MOPP regimen for Hodgkin's ;CLL

Q2082:Toxicities of prednisone

Cushing-like sxs; immunosuppression; CATARACTS; acne;OSTEOPOROSIS; HTN; peptic ulcers; hyperglycemia;

psychosis

Q2083:MOA of tamoxifen; raloxifene

estrogen R antagonits in breasts; agonists in bone

Q2084:tamoxifen vs raloxifene

tamoxifen may increase risk of endometrial cancer butraloxifene is an endometrial ANTAGonist

Q2085:MOA of trastuzumab (herceptin)

monoclonal Ab against HER-2; helps kill breast cancer cellsthat overexpress HER-2

Q2086:Clinical use of trastuzumab

(herceptin) metastatic breast cancer

Q2087:toxicity of trastuzumab

cardiotoxicity

Q2088:MOA of imatinib?

(Gleevec) Phl chromosome bcr-abl tyrosine kinase inhibitor

Q2089:Clinical uses of imatinib

(gleevec) CML; GI stromal tumors

Q2090:toxicity of imatinib

(gleevec) fluid retention

Q2091:MOA of vincristine; vinblastine

(vinca alkaloids) M phase specifics; bind tubulin and blockpolymerization of microtubules

Q2092:Clinical uses of vincristine; vinblastine

part of MOPP regimen (as is prednisone) for lymphoma;Wilms' tumor; choriocarcinoma

Q2093:toxicity of vincristine

neurotoxicity; paralytic ileus

Q2094:toxicity of vinblastine

myelosuppression (vinBLASTine BLASTS bone marrow)

Q2095:MOA of taxols

(e.g. paclitaxel) M phase specific agents to bind tubulin anddisallow microtubule breakdown

Q2096:clinical uses of taxols

ovarian and breast carcinomas

Q2097:toxicities of taxols

myelosuppression and hypersensitivity

Q2098:Which cancer drugs are M-phase specific?

taxols and vinca alkaloids

Q2099:protects against rejection from organ transplants. doesnot induce bone marrow depression.

Cyclosporine

Q2100:alkylating agent of both purine and pyrimidine basesof DNA. treatment for CLL.

Cyclophosphamide

Q2101:causes nepho and ototoxicity

Cisplatin

Q2102:anti-metabolite of folic acid: inhibits dihydrofolatereductase

Methotrexate

Q2103:this drug can block or reduce the host toxicity ofMethotrexate by providing a reduced folate to increase folic

acid

Leucovorin Rescue

Q2104:toxicity profile includes pneumonitis and pulmonaryfibrosis

Bleomycin

Q2105:drug used in organ transplantation = kidney allografts.Allopurinol can inc. the activity by inhibiting its

biotransformation by xanthine oxidase

Azathiorine

Q2106:chemotherapy regimen used in hodgkin's disease

MOPP = Mechlorethamine (nitrogen mustard); Oncovorin(aka Vincristine blocks microtubule assembly); Procarbazine;

Prednisone (glucocorticoid that induces apoptosis)

Q2107:estrogen receptor blocker used to treat breat tumors;can potentially result in endometrial cancer.

Tamoxifen

Q2108:antiandrogenic. used w/ Leuprolide (LHRH analog) totreat prostate cancer

Flutamide

Q2109:progesterone receptor inhibitor used to treatEndometrial cancer

Megestrol

Q2110:androgenic steroid used to treat mammary cancer inpostmenopausal women

Fluoxymesterone

Q2111:folic acid analog that inhibits tetrahydrofolatesynthesis by inhibiting dihydrofolate reductase. used to treat

ALL and Psoriasis

Methotrexate

Q2112:treatment for Brain tumor

Lomustine and Carmustine

Q2113:side effect of carmustine

pulmonary fibrosis

Q2114:drug that attaches to beta cells and is used to treatpancreatic insulinomas

Streptozocin

Q2115:pyrimidine analog that is DOC for AML

Cytarabine (AraC)

Q2116:used for Wilms tumor and rhabdomyosarcoma

Dactinomycin

Q2117:used for oat cell carcinoma

Etoposide

Q2118:used for Ovarian Cancer

Paclitaxel

Q2119:can decrease nephrotoxicity caused by chronic use ofCisplatin

Amifostine

Q2120:Catalyzes the activation of antithrombin III todecrease thrombin and Xa;Uses (2);site of action?

Heparin;;Uses;Immediate anticoagulation;(PE; MI; stroke;DVT);Used during pregnancy (does not cross);site: Blood

Q2121:Interferes w/ factors II; VII; IX and X and protein Cand S;Use;site of action?

Warfarin;use;Chronic coagulation;[the EX-PaTriot went toWAR];EXtrinsic-PT pathway;site: Liver

Q2122:drug class that aids in conversion of plasminogen toplasmin (which cleaves thrombin and fibrin clots);name (4)

Thrombolytics;Streptokinase;Urokinase;tPA(alteplase);Antistreplase

Q2123:what inhibits plasminogen to plasmin?

Aminocaproic acid

Q2124:what glycoprotein in platelet binds to exposedcollagen?;which bind together to aggregate?

to collagen: GP-1a;;together: GP-IIb/IIIa

Q2125:The only irreversible binder in the group to inhibitCOX-1 and COX-2

Aspirin

Q2126:drug inhibits platelet binding by irreversibly blockingADP receptors; thereby inhibiting fibrinogen binding by

preventing GP-IIb/IIIa expression;(2) uses;AE?

Clopidogrel;use;Acute Coronary syndrome;Coronarystenting;AE;Neutropenia;(tiCLOPidine)

Q2127:drug that binds directly to GP-IIb/IIIa on activatedplatelets; preventing aggregation;use?

Abciximab;;use;Angioplasty

Q2128:S-phase specific anti-cancer drugs;(5)

Methotrexate;5-FU;Cytarabine;6-MP;Hydroxyurea

Q2129:S-phase antimetabolite that inhibits DHF reductaseresulting in low dTMP;(2) AE?

Methotrexate;;AE;Myelosuppression;Macrovesicular fattyliver

Q2130:what reduces the myelosuppression toxicity inMethotrexate?

Leucovorin

Q2131:S-phase pyrimidine analog that inhibits thymidylatesynthase; resulting in low dTMP;(3) uses;(2) AE

5-Fluorouricil (5-FU);uses;Colon CA;solid tumors;Basal cellCA;AE;Myelosuppression;photosensitivity

Q2132:S-phase that blocks Purine synthesis and is activatedby HGPRTase;(2) uses?;what can increase toxicity?

6-Mercaptopurine (6-MP);use;Leukemias (notCLL);Lymphomas (not Hodgkin);inc Toxicity:Allopurinol;(metabolized by Xanthine Oxidase)

Q2133:S-phase tha inhibits DNA polymerase to compete w/dCTP;use?;(3) AE

Cytarabine (ARA-C);use:AML;AE;Leukopenia;Thrombocytopenia;Megaloblastic

anemia

Q2134:Alkylating agent covalently x-link DNA at guanine N-7;use (3);AE

Cyclophosphamide;use;Non-Hodgkins lymphomas;BreastCA;Ovarian CA;AE;hemorrhagic CYSTITIS

Q2135:Alkylating agent class that crosses BBB;name drugs(2);AE

Nitrosoureas;drugs;"-MUSTINE";Streptozocin;AE;CNStoxicity (dizzy; ataxia)

Q2136:(2) anti-cancer drugs that act like Alkylating agentsand form free radicals; they cause AE of Ototoxicity and

Nephrotoxicity;use (4)

Cisplatin; Carboplatin;use (BOLT);Bladder CA;OvarianCA;Lung CA;Testicular CA;;[BOLT ON the PLAnTation]

Q2137:Alkalaying agent of DNA used as DOC for CML;(2)AE

Busulfan;AE;Pulmonary fibrosis;hyperpigmentation

Q2138:(2) anti-cancers that generates free radicals andnoncovalently intercalate in DNA (breaking strands); AE

include cardiotoxicity;(2) uses;another AE

Doxorubicin (Adriamycin);Danorubicin;use;Hodgkins (A inABVD combo);solid tumors;AE;Alopecia

Q2139:another name for;Doxorubicin

Adriamycin

Q2140:what anti-cancer drug that intercalates in DNA; is usedfor childhood tumors?

ACTinomycin-D;[children ACT out]

Q2141:drug that induces formation of free radicals to causebreaks in DNA; AE is pulmonary fibrosis;(2) uses

Bleomycin;use;Testicular CA;Hodgkins (B in ABVD combo)

Q2142:G2-specific agent that inhibits Topoisomerase-II;(3)uses

EToPoSide (VP-16);uses;T: Testicular CA;P: Prostate CA;S:Small cell CA of lung

Q2143:MC glucocorticoid in cancer therapy;(2) uses;asidefrom usual corticoid AE (cushings; osteoporosis) what other

AE?

Prednisone;use;Hodgkins (P in MOPPcombo);CLL;AE;cataracts

Q2144:monoclonal Ab against HER-2 (erb-B2)--BreastCA;AE

Trastuzumab (HERceptin);AE;Cardiotoxicity

Q2145:monoclonal Ab against the Philadelphia chromosomebrc-abl tyrosine kinase

Gleecec (Imatinib)

Q2146:M-phase specific alkaloids that bind to tubulin andblock polymerization of microtubules so that spindle fibers

cannot form;use (3);AE (2)

Vincristine ("Oncovin"); Vinblastine;use;Hodgkins (O inMOPP combo);Wilm's

Tumor;Choriocarcinoma;AE;Vincristine -Neurotoxicity;Vinblastine - BLASTs bone marrow

Q2147:M-phase specific that bind to tubulin andhyperstabilize polymerized microtubules so that spindle

fibers cannot breakdown (anaphase cant occur);use (2);AE (2)

Taxols (Paclitaxel);use;Ovarian CA;BreastCA;AE;myelosuppression;Hypersensitivity

Q2148:what are the drugs in the ABVD Hodgkins combo?

Adriamycin(doxorubicin);Bleomycin;Vinblastine;Dacarabazine

Q2149:what are the drugs in the MOPP Hodgkins combo?

Mechlorethamine;Oncovoin(Vincristine);Prednisone;Procarbazine

Q2150:DOC for CLL

Prednisone

Q2151:DOC in CML;(2)

Gleevac;;Busulfan

Q2152:DOC in AML

Cytarabine

Q2153:anti-cancer drug that causes Pancreatitis

Asparaginase

Q2154:anti-cancer drug that causes oral and GI ulcers

5-FU

Q2155:which ant-cancer drugs are clasified as Alkylatingagents?;(4)*

"at NITe the CYCLOne picked-up the BUS andCAR";NITrosureas;CYCLOphosphamide;BUSulfan;CARbop

latin; cisplatin

Q2156:what anti-cancer drug works in the G-0 phase?

Busulfan

Q2157:which anti-cancer drugs generate free radicals?;(3)*

BAD radicals;Bleomycin;Actinomycin-D;Doxorubicin;Daunorubicin

Q2158:(2) drugs that work in the G-2 phase

Bleomycin;;Etoposide (VP-16)

Q2159:Inhibit IL-2 production/secretion

Cyclosporine (calceneurin); Tacrolimus (FK506)

Q2160:IL-2 Inhibitors (downstream)

Sirolimus (mTOR inhibitor); Daclizumab (mAb against IL-2receptor)

Q2161:Antimetabolites

Azathioprine (6MP precursor; lymphtoxic); Mycophenolatemofetil (Inhibits de novo Guanine synethesis)

Q2162:Other Action

Muronomab-CD3 (OKT3)--mAb binds to CD-3 on T-cells

Q2163:activated T helper cells secrete this cytokine whichcauses proliferation and activation of two subsets of T helper

cells; TH1 & TH2

IL-2

Q2164:function of TH1 cells?

cell mediated immunity and delayed hypersensitivityreactions

Q2165:what do TH1 cells produce?

IFN-gamma; IL-2 and TNF-B (which activate macrophages;CTLs; & NK cells.

Q2166:what do TH2 secrete when activated?

IL-4; IL-5; IL-6 (which promote B cell proliferation anddifferentiation)

Q2167:what is the action of IL-10?

down regulate the action of TH1 cells

Q2168:what is action of IFN-gamma on helper T cells?

down regulates TH2 response

Q2169:name an agent that acts at the step of antigenrecognition in the immune response?

antibodies including Rho(D) immune globulin;antilymphocyte globulin; and muromonab CD3.

Q2170:name an agent that acts at the step of differentiationand synthesis in the immune response?

cyclosporine; tacrolimus; dactinomycin; and antilymphocyticglobulin and monoclonal anti-T cell antibodies

Q2171:MOA of glucocorticoids?

decrease the synthesis of Prostaglandins; leukotrienes;cytokines; and other signaling molecules that participate inimmune responses (eg Platelet activating factor). They alsoinhibit proliferation of T cells and to a lesser degree dampenhumoral immunity. continuous therapy lowers IgG levels

through inc. catabolism

Q2172:what is the toxicity of corticosteroids?

adrenal suppression; growth inhibition; muscle wasting;osteoporosis; salt retention; diabetogenesis and possible

psychosis

Q2173:MOA of cyclosporine?

binds to cyclophilin to inhibit Calcineurin; a cytoplasmicphosphatase. which prevents T cell production of cytokines

that would be produced w/ TCR activation

Q2174:MOA of tacrolimus?

binds to FK-binding protein and inhibits calcineurin; aphosphatase that regulates the ability of activated T cells toproduce cytokines; thus inhibiting this cytokine production

(same action as cyclosporine but diff binding site)

Q2175:MOA of Sirolimus?

ALSO binds to FKBP however it inhibits T cell RESPONSEto Cytokines w/o affecting cytokine production (and potentinhibitor of B cell prolif. antibody product. and mononuclear

cell responses to colony stimulating factors as well)

Q2176:most frequent toxicities of Cyclosporine andTacrolimus?

renal dysfunction; hypertension and neurotoxicity

Q2177:sirolimus is more likely than cyclospoine or tacrolimusto induce this side effect?

HyperTriglyceridemia; hepatotoxicity; diarrhea andmyelosuppression

Q2178:MOA of Mycophenolate Mofetil?

rapidly converted to mycophenolic acid; which inhibitsinosine monophosphate dehydrogenase; an enzyme in the de

novo pathway of purine synthesis. SO this suppressesBOTH B & T cell ACTIVATION

Q2179:toxicity of Mycophenolate mofetil?

neutropenia

Q2180:MOA of Azathioprine?

prodrug transformed to antimetabolie mercaptopurine; whichinhibits enzymes in purine metabolism. It is cytotoxic to early

phase of lymphoid cell proliferation w/ greater effect onTcells than B cells

Q2181:toxicity of azathioprine?

associated with inc incidence of cancer. toxic effects inc byconcomitant use of allopurinol b/c azathio is metabolized by

xanthine oxidase

Q2182:MOA of cyclophosphamide?

transformed by liver enzymes to an alkylating agent that iscytotoxic to proliferating lymphoid cells. greater effect on BCELLS than T cells and will inhibit an estrablished immune

response

Q2183:MOA of etanercept?

recombinant form of TNF receptor that binds TNF-a; aproinflamm cytokine; thereby decreasing formation of IL and

adhesion molecules (used in RA)

Q2184:name two monoclonal antibodies that block the actionsof TNF-alpha?

Infliximab and adalimumab

Q2185:MOA of the RA drug Leflunomide?

arrests lymphocytes in the G1 phase of cell cycle

Q2186:what is thalidomide used for?

Leprosy; SLE; and as an anti-Cancer drug also aphthousulcers and the wasting syndrome in AIDS is treated with the

Rx

Q2187:MOA of thalidomide?

sedative drug notorious for teratogenic effects; ALSOsuppresses TNF production

Q2188:MOA Antilymphocyte globulin and AntithymocyteGlobulin?

selectively block cellular immunity rather than Antibodyformation; which account for their ability to suppress organ

graft rejection; a cell mediated process

Q2189:MOA of RhoD immune globulin?

feedback immunosuppression

Q2190:MOA Muromonab-CD3?

MAb binds to the CD3 antigen on surface of thymocytes andmature T cells and blocks the killing action of CTLs and other

T cell functions

Q2191:MOA of daclizumab?

highly specific MAb that binds to the alpha subunit of the IL-2 receptor expressed on T cells and prevents activation by IL-

2

Q2192:what is the drug that induces remission in treatment-resistant Crohn's disease?

Infliximab (targeted against TNF-alpha)

Q2193:MOA of Aldeslekin?

recombinant IL-2; that promotes production of cytoxic T cellsand activates NK cells - indicated for adjunctive trx of renal

cell carcinoma and malignant melanoma

Q2194:IFN-beta-1b has some beneficial effects in thisrelapsing disorder?

MS

Q2195:what disease is IFN-alpha-2a used for?

hairy cell leukemia; chronic myelogenous leukemia; malignantmealnoma; Kaposi's sarcoma and hep B and C

Q2196:this drug is used for immunization against TB?

BCG (Bacille Calmette-Guerin) (it activates macrophages andresults in enhancement of immune responses)

Q2197:MOA thymosin?

stimulates maturation of pre-T cells in thymusand promotesformation of T cells from lymphoid stem cells (Used in

DiGeorge's syndrome; thymic aplasia)

Q2198:define mechanism of Type 2 hypersensitivity drugallergy?

involves IgG or IgM antibodies that are bound to circulatingblood cells.

Q2199:give examples of type 3 hypersensitivity reactions?

Drug induced serum sickness and vasculitis; stevens johnsonfrom sulfonamide therapy is another

Q2200:examples of type 4 hypersensitivity?

contact dermatitis (cell mediated injury)

Q2201:examples of drugs that commonly cause a type 1hypersens. rxn?

penicillins and sulfonamides

Q2202:DOC for long-term obesity management;MOA;(2) AE

Orlistat;(Inhibits pancreatic lipases);AE;Steatorrhea;GI pain

Q2203:Drug that acts as a short and long-term obesitymanagement;MOA;(2) AE

Sibutramine;(Serotonin and NE reuptakeinhibitor);AE;Tachycardia;HTN

Q2204:Inhibits thyroid hormone synthesis and decreasesperipheral conversion of T4 -> T3;(3) AE

Propylthiouracil (PTU);AE;Aplastic anemia;skinrash;Agranulocytosis (rare)

Q2205:DOC for Turner's syndrome

Somatostatin;(also GH deficiency)

Q2206:What (4) disorders does Octreotide (somatostatinanalog) treat?

"C 8 (Oct)GAG";Carcinoid;;Gastrinoma;;Acromegaly;;Glucagonoma

Q2207:Tx for Central DI

Desmopressin

Q2208:Tx for Hypothyroidism;(3) AE

Levothyroxine; Triiodothyronine;AE;Tachycardia;Heatintolerance;Tremors

Q2209:(4) Dx that use Glucocorticoids as Tx;AE?

Addisons Dz;;Inflammation;;Immunesupression;;Asthma;AE: Iatrogenic Cushing's syndrome

Q2210:A 5-alpha-reductase inhibitor used to Tx BPH andpromote hair growth*

Finasteride

Q2211:a Non-steroidal competitive inhibitor of androgens atthe testosterone receptor to Tx prostate CA

Flutamide

Q2212:Tx PCOS

Oral birth control

Q2213:(2) drugs that inhibit steroids and are used in PCOS totreat hirsutism

Ketoconazole;;Spironolactone

Q2214:Inhibits cGMP phosphodiesterase causing Inc cGMPand smooth muscle relaxation in corpus cavernosum;(2) AE?

Sildenafil (or Vardenafil);AE;headache;blue-green vision;(headthrobs w/ blue balls)

Q2215:what drug is both an agonist and antagonist toGnRH?;(explain);Use for each?

Leuprolide;Pulsitile fashion: Agonist;(Infertility);Continuous:Antagonist;(prostate cancer)

Q2216:Partial agonist at estrogen receptors in pituitarygland;Use?;AE?

Clomiphene;(prevents Neg feedback to increase LH andFSH);Use;Stimulate Ovulation (infertility Tx);AE;Ovarian

enlargement; multiple preg

Q2217:Competitive inhibitor of Progestins at progesteronereceptor;Use?;(2) AE?

Mifepristone (RU-486);Abortifacient (preventsimplantation);AE;Heavy bleeding;GI upset

Q2218:greatest AE of oral contraception

Hypercoagulable state

Q2219:Tx for hormone replacement therapy andOsteoporosis;(2)

Raloxifene;(SERM);;Estrogen/Progesterone therapy

Q2220:for contraception; what is in Oral; Depo and animplant?

Oral: E2/P4 combo;Depo: Medroxyprogesterone;Implant:Norgestrel

Q2221:DOC for Breast CA w/ estrogen receptors;AE?

Tamoxifen;(SERM);AE: Endometrial hyperplasia

Q2222:what drug class has AE of Acne; decreased HDL;depression; hirsutism; weight gain

Progestins

Q2223:Drug that activates E2 receptors in Endometrium andblocks them in Breast

Tamoxifen

Q2224:Drug that activates E2 receptors in bone and blocksthem in Breast and Endometirum

Raloxifene

Q2225:DOC for reduction of bone resorption and increasingnew bone formation

Alendronate;(bisphosphonate)

Q2226:MOA of Etidronate

Inhibition of the formation of Hydroxyapatite crystals

Q2227:DOC for Padget's Dz

Calcitonin

Q2228:what is the treatment for Tetany following athyroidectomy?

Calcium gluconate

Q2229:What drug is useful in testing endocrinefunction?;How?;MOA

Metyrapone;Tests Pituitary-adrenal axis;Inhibits 11b-OH

Q2230:how do glucocorticoids work as anti-inflammatory andimmunosupressive drugs?

Reduce capillary permeability and edema at the inflam siteand prevent PMNs from entering interstitial space

Q2231:DOC to inhibit Prolactin release

Bromocriptine

Q2232:Rapid onset insulin form

Lispro

Q2233:(2) Maintenance forms of insulin (peak 4 - 12 hrs)

NPH;;Lente

Q2234:Longest acting insulin

Glargine

Q2235:MOA of Sulfonylureas

blocks K+ channels in Beta cell causing opening of Cachannels; releasing insulin from storage vesicles

Q2236:DOC for Rickets or any Vit-D deficiency;MOA

Calcitrol;(enhances intestinal absorption of calcium)

Q2237:DOC androgen derivative for Endometriosis

Danazol;(monitor LFTs)

Q2238:Dx;postmenopausal female develops weakness;polyuria and polydipsia; also mild acidosis and

nephrocalcinosis

Hypervitaminosis D;(too much Vit-D)

Q2239:MOA of PTU

Inhibition of Thyroidal Peroxidase

Q2240:what drug inhibits; by acting as a competitor; theaccumulation of Iodide in thyroid follicular cells?

Potassium Perchlorate

Q2241:what is the Tx for Graves Dz in pregnent woman?

PTU

Q2242:Steroid derivative that promotes the synthesis offactors II; VII; IX and X and may interfere w/ effects of

Warfarin or result in thromboemboli?

Ethinyl Estradiol

Q2243:steroid to help promote lung maturity

Betamethasone

Q2244:Drug that lowers serum calcium from cancers

Plicamycin

Q2245:Octreotide

Properties - Synthetic somatostatin analog givenSQ;Indications - acromegaly; glucagonoma; insulinoma; GI

bleeding; intractable diarrhea

Q2246:Leuprolide

Properties - GnRH analog that inhibits gonadotropin releasewhen given in continuous doses. Given SQ or IM;Indications

- Prostate cancer; PCOS; uterine fibroids; endometriosis.

Q2247:Bromocriptine

Properties - Dopamine receptor agonist. Givenorally;Indications - hyperprolactinemia and associated

infertility and breast ingorgement; inhibit lacation postpartum.Can also be used with octreotide in acromegaly;SE; Tox - N/V;

arrhythmias; hypotension; paranoia/psychosis.

Q2248:Oxytocin

Properties - posterior pituitary hormone. Given IV toinduce/maintain labor; IM to control postpartum bleeding; as

a nasal spray to cause milk secretion.

Q2249:DDAVP (desmopressin)

Properties - analog of ADH with no V1 effects (so no smoothmuscle contraction --> HTN);Indications - central diabetes

insipidus

Q2250:Menotropins

Properties - partially degraded FSH and LH;Indications -induces ovulation in infertile women when followed by HCG.

induces spermatogenesis in infertile men when followingHCG;SE; Tox - overstimulation of ovaries --> multiple

pregnancies; ovarian cysts.

Q2251:Cosyntropin

Properties - a sythetic ACTH analog which is lessantigenic;Indications - Used in the diagnosis of adrenalfunction (failure to respond indicates primary adrenal

disorder).

Q2252:Levothroxine sodium

Properties - levo isomer of T4 given orally or IV. T4 hashalflife of 6-7 days;Indications - hypothyroidism. preferreddrug because cheaper; easier to monitor; and has longer half

life than synthetic T3 drug.

Q2253:Iodine

Properties - 50+mg/d will lead to autoinhibition of thyroidhormone production. Blocks uptake of iodide by the glandand diminishes vascularity. Given as Lugol solution (iodineand potassium iodide). Works within 24 hours;Indications -given preop to shrink the gland before surgical removal; as tx

for thyroid storm. NOT long term;SE; Tox - dose-related.hypersensitivity; head cold symptoms; gastric irritation;parotitis. long-term use --> sudden disinhibition --> acute

hyperparathyroidism.

Q2254:Propylthiouricil (PTU) and methimazole

Class - Thioamides;Properties - inhibit the peroxidaseenyzmes (oxidation of iodide and coupling of iodinatedtyrosyl groups) --> decreased hormone synthesis. Also

inhibits peripheral T4 --> T3. Onset of action after performedhormones have been metabolized;Indications - control of

hyperthyroidism until surgery; until the effect of radioactiveiodide begins; and long-term therapy for mild-moderate cases.

PO;SE; Tox - maculopapular rash; joint pain; headache;nausea; hair loss. Rare; serious agranulocytosis. Can crossplacenta and enter breast milk; PTU is more protein-bound

therefore less likely to do so.

Q2255:Radioactive Iodine

Properties - Either PO or IV; it is taken up rapidly by thethyroid --> thyroglobulin. Causes destruciton of the gland byemission of beta particles with minimal damage to surroundingtissue;Indications - hyperthyroidism;SE; Tox - overdosage -->

delayed hypothyroidism;CI - pregnancy.

Q2256:Calcitonin

Properties - lowers serum calcium; inhibits bone resorption;blocks Ca; phosphate release from bone;Indications -

hypercalcemia; hyperPTH; vitamin D toxicity; Paget disease;bone tumors; osteoporosis;SE; Tox - hypersensitivity rxns;

hypocalcemia

Q2257:Vitamin D

Indications - hypocalcemia due to rickets; hypoPTH;osteomalacia;SE; Tox - hypercalcemia

Q2258:Diphosphonates

Properties - analogs of pyrophosphate bind tohydroxyapatite crystals and reduce their formation; growth;

and dissolution --> less bone turnover;Indications -hypercalcemia of malignancy; Page disease; osteoporosis;

hyperPTH

Q2259:Sulfonylureas

Examples - Tolbutamide; chlorpropamide; glyburide;glipizide;Properties - stimulates insulin release by closing Kchannels in beta cell membrane --> depol --> Ca influx and

insulin release;Indications - NIDDM;SE; Tox - hypoglycemiaesp. with long-acting chlorpropamide and high-potency

glyburide and glipizide; skin rashes; GI upset;hypothyroidism; disulfiram-like reaction; esp with

chlorpropamide

Q2260:Metformin

Properties - mechanism unknown; possibly inhibitsgluconeoneogenesis; increases glycolysis --> decreased serum

glucose levels;Indications - NIDDM; don't need isletfunction;SE; Tox - NO hypoglycemia; can result in lactic

acidosis

Q2261:Glitazones or Thiazolidinediones (the longest nameEVER)

Examples - Pioglitazone; risiglitazone;Properties - increasetarget cell response to insulin. can be used alone or with other

agents;SE; Tox - weight gain; troglitazone is hepatotoxic

Q2262:Repaglinide

Properties - sulfonylurea-like; stimulates insulin release

Q2263:Acorbose

Properties - inhibits alpha -glucosidase of brush border andprevents asorption of glucose;SE; Tox - GI discomfort

Q2264:Short acting insulins?

insulin; lispro

Q2265:intermediate insulins?

NPH

Q2266:long acting insulins?

lente; ultralente

Q2267:MOA of insulin?

liver (increased glucose stored as glycogen) Muscle (increasedglycogen and protein synth; K uptake) Fat (aids TG storage)

Q2268:Uses of insulin other than DM1?

life threatening hyperkalemia and stress inducedhyperglycemia

Q2269:Insulin toxicity?

hypoglycemi; hypersensitivity rxn (very rare)

Q2270:Name the first generation sulfonylureas.

tolbutamide; chlorpropamide

Q2271:name the second generation sulfonylureas.

glyburide; glimeperide; glipizide

Q2272:MOA of sulfonylureas.

close K channel in beta cell membrane so cell depolarizes…triggers insulin release via increased Ca influx

Q2273:Are sulfonylureas good for DM1; DM2 or both?

DM2. (useless in DM1 b/c needs some islet fxn)

Q2274:First generation sulfonylureas toxicities?

disulfiram-like effects

Q2275:Second generation sulfonylurea toxicity?

hypoglycemia

Q2276:What class of drugs is metformin?

biguanide

Q2277:Probable MOA of metformin?

decreased GNG; increased glycolysis; decreased serumglucose

Q2278:Metformin for DM1; DM2 or both?

both

Q2279:Metformin toxicity?

lactic acidosis (contraindicated in renal insufficiency; CHF;elderly)

Q2280:MOA of glitazones?

increased target cell response to insulin

Q2281:Glitazones; DM1; DM2 or both?

DM2

Q2282:Glitazone toxicities/

weight gain; CHF (fluid retention); (troglitazone ishepatotoxic)

Q2283:name two alpha glucosidase inhibitors.

acarbose; miglitol

Q2284:alpha glucosidase inhibitor MOA?

inhibit intestinal brush border alpha glucosidases (delayedsugar hydrolysis and glucose absorption lead to decreased

postpradial hyperglycemia)

Q2285:alpha glucosidase inhibitor toxicity?

flatulence

Q2286:Orlistat MOA?

alters fat metabolism by inhibiting pancreatic lipases

Q2287:Indications for orlistat?

long term obesity management

Q2288:Orlistat toxicities?

steatorrhea; GI discomfort; reduced absorption of fat solublevitamins; HA

Q2289:Sibutramine MOA?

sympathomimetic SNRI

Q2290:Indication for sibutramine?

short-term and long term obesity management

Q2291:Sibutramine toxicity?

HTN; tachycardia

Q2292:Propylthiouracil; methimazole MOA?

inhibit organification and coupling of thyroid hormonesynthesis. Propylthiouracil also decreases peripheral

conversion of T4 to T3

Q2293:Indications for propylthiouracil or methimazole?

hyperthyroidism

Q2294:Toxicities of propylthiouracil and methimazole?

skin rash; agranulocytosis (rare); aplastic anemia

Q2295:Indication for somatostatin?

GH deficiency; turner's syndrome

Q2296:Indication for octreotide?

acromegaly; carcinoid; gastrinoma; glucagonoma

Q2297:Indication for oxytocin?

stimulates labor; uterine contractions; milk let-down; controlsuterine hemorrhage

Q2298:Indication for desmopressin?

Central (not nephrogenic) DI

Q2299:Uses of levothyroxine; triiodothyroxine?

hypothyroidism; myxedema

Q2300:Levothyroxine; triiodothyroxine toxicity?

tachycardia; heat intolerance; tremors

Q2301:What kind of drug is triamcinolone?

glucocorticoid

Q2302:MOA of glucocorticoids?

decreased production of leukotrienes/prostaglandins byinhibiting PLA2 and COX-2 expression

Q2303:Uses of glucocorticoids?

addison's; inflammation; immune suppression; asthma

Q2304:Glucocorticoid toxicity?

iatrogenic cushings (buff hump; moon facies; truncal obesity;muscle wasting; thin skin; easy bruisability; osteoporosis;

adrenocortical atrophy; peptic ulcers)

Q2305:Action and use of Finasteride?

5alpha-reductase inhibitor (decreased conversion oftestosterone to dihydrotestosterone). Used for BPH and

baldness

Q2306:Action and use of Flutamide?

nonsteroidal competitive inhibitor of androgens at thetestosterone receptor. Used in prostate ca

Q2307:Action and use of ketoconazole?

inhibit steroid synth; used in polycystic ovarian syndrome toprevent hirsutism

Q2308:Action and use of spironolactone?

inhibit steroid synth; used in polycystic ovarian syndrome toprevent hirsutism

Q2309:MOA of sildenafil/vardenafil?

inhibit cGMP phosphodiesterase causing increased cGMP;smooth musc relax in corpus cavernosum; increased blood

flow and erection

Q2310:Use of sildenafil/vardenafil?

treatment of erectile dysfxn

Q2311:Toxicity of sildenafil/vardenafil?

HA; flushing; dyspepsia; blue-green color vision. Risk of life-threatening hypotension in pts taking nitrates

Q2312:MOA of leuprolide?

GnRH analog w/agonist properties when used in pulsatilefashion; antagonist properties when used in continuous

fashion (continous causes transient initial burst of LH andFSH)

Q2313:Use of leuprolide?

infertility (pulsatile); prostate ca (continuous w/flutamide);unterine fibroids

Q2314:Toxicity of leuprolide?

antiandrogen; N/V

Q2315:MOA of clomiphene?

partial agonist at estrogen receptors in pituitary gland.Prevents nrm feedback inhibition and increases release of LH

and FSH from pituitary…stimulates ovulation

Q2316:Use of clomiphene?

tx of infertility

Q2317:Toxicity of clomiphene?

hot flashes; ovarian enlargement; multiple simultaneouspregnancies; visual disturbances

Q2318:MOA of mifepristone (ru-486)?

competitive inhibitor of progestins at progesterone receptors

Q2319:Use of mifepristone?

abortifactant (prevents implantation)

Q2320:Toxicity of mifepristone (ru-486)?

heavy bleeding; GI effects (N/V; anorexia); ab pain

Q2321:Advantages of oral contraceptives (5)?

reliable; decreased risk of endometrial/ovarian ca; decreasedrisk ectopic preg; decreased pelvic infxn; regulation of menses

Q2322:Disadvantages of oral contraception (5)?

taken daily; no STD protection; increased triglycerides;depression/wt gain/nausea/HTN; hypercoaguable state

Q2323:Which drugs cause gynecomastia as a side effect?

Some Drugs Create Awesome Knockers! - Spironolactone;Digitalis; Cimetidine; Alcohol; Ketoconazole

Q2324:Finasteride use and mechanism

used for BPH and male-pattern baldness; blocks 5-alpha-reductase to prevent conversion of T to DHT

Q2325:Flutamide use and mechanism

nonsteroidal competitive inhibitor of androgens. blocks Treceptor. Used in prostate carcinoma

Q2326:Kotoconazole use and mechanism

inhibits steroid synthesis; used in treatment of polycysticovarian syndrome to prevent hirsutism

Q2327:Spironolactone use and mechanism

inhibits steroid binding; used in Polycystic ovarian syndrometo prevent hirsutism

Q2328:Mechanism of Leuprolide?

GnRH analog with agonist properties when used in pulsatilefashion. Antagonist when used continuously.

Q2329:Uses of Leuprolide?

Infertility (pulsatile); prostate cancer (continuous use withflutamide); uterine fibroids

Q2330:Toxicity of Leuprolide?

antiandrogen; nausea; vomiting

Q2331:Sildenafil; Vardenafil mechanism

Inhibits cGMP phosphodiesterase --> increased cGMP -->smooth muscle relaxation in corpus cavernosum --> increased

blood flow --> PENILE ERECTION!

Q2332:Toxicity of Sildenafil and Vardenafil?

HA; flushing; dyspepsia; impaired blue-green color vision.DO NOT USE WITH NITRATES!!! causes hypotension

Q2333:mechanism of Mifepristone (RU-486)?

competitive inhibitor of progestins at progesterone receptors

Q2334:clinical use of mifepristone

termination of pregnancy. used with misoprostol (PGE1)

Q2335:toxicity of mifepristone

heavy bleeding; GI effects (nausea; vomiting; anorerxia);abdominal pain

Q2336:advantages of OCPs?

decreased risk of endometrial and ovarian cancer; decreasedincidence of ectopic pregnancy; decreased pelvic infections;

regulation of menses

Q2337:disadvantages of OCPs?

no protection against STDs; increased triglycerides;depression; weight gain; nausea; hypertension;

hypercoagulable state

Q2338:What is Dinoprostone?

PGE2 analog causing cervical dilation and uterine contraction;inducing labor

Q2339:Ritodrine/Terbutaline are what?

B2 agonists that relax the uterus

Q2340:What is anastrozole?

aromatase inhibitor used in postmenopausal women withbreast cancer.

Q2341:What are the toxicities of estrogens (ethinyl estradiol;DES; mestranol)

increased risk of endometrial cancer; bleeding inpostmenopausal women; clear cell adenocarcinoma of vaginain females exposed to DES in utero; increased risk of thrombi

Q2342:What is the toxicity of testosterone?

masculinization in females; reduces intratesticular testosteronein males by inhibiting Leydig cells; leads to gonadal atrophy.

premature closure of epiphyseal plates. increased LDL;decreased HDL

Q2343:Mechanism of Clomiphene?

partial agonist at estrogen receptors in pituitary gland.prevents normal feedback inhibition and increased release of

LH and FSH from pituitary; which stimulates ovulation

Q2344:Uses of Clomiphene?

treat infertility and PCOS.

Q2345:toxicity of clomiphene?

hot flashes; ovarian enlargement; multiple pregnancies; visualdisturbances

Q2346:mechanism of Tamoxifen?

estrogen antagonist on breast tissue. used to preventrecurrence of ER-positive breast cancer

Q2347:mechanism and use of Raloxifene?

estrogen agonist on bone; reduces reabsorption of bone; usedto treat osteoporosis

Q2348:MOA of mannitol

(osmotic diuretic); increases tubular fluid osmolarity; therebyincreasing urine flow

Q2349:Clinical uses of mannitol

shock; drug OD; to decrease intracranial/intraocular P

Q2350:MOA acetazolamide

carbonic anhydrase inhibitor; causes self-limited NaHCO3diuresis and reduction in total-body bicarb stores

Q2351:Clinical uses of acetazolamide

glaucoma; urinary alkalinization; metabolis alkalosis; altitutesickness

Q2352:toxicities of acetazolamide

hyperchloremic metabolic acidosis; neuropathy; NH3toxicity; sulfa allergy

Q2353:MOA of ethacrynic acid

(diuretic); phenoxyacetic acid derivative--NOT sulfonamide--that works like furosemide (loop diuretic)

Q2354:Clinical use of ethacrynic acid

diuresis in pts with sulfa allergy (b/c NOT a sulfonamide)

Q2355:toxicity of ethacrynic acid

similar to furosemide (OH DANG) but can be used inhyperuricemia and no sulfa allergy

Q2356:MOA of furosemide

sulfonamide loop diuretic; inhibits Na-K-2Cl contransporterof thick ascending limb; abolishes hypertonicity of medulla

which prevents concentration of urine; increases Ca excretion

Q2357:toxicity of furosemide

OH DANG! Ototoxicty; Hypokalemia; Dehydration;Allergy; Nephritis (interstitial); Gout

Q2358:MOA hydrochlorothiazide

thiazide loop diuretic. Inhibits NaCl reabsorption in earlydistal tubule which reduces diluting capacity of nephron.

Q2359:thiazide diuretics vs. loop diuretics with respect tocalcium?

loop diuretics (furosemide; ethacrynic acid)--increase Caexcretion; thiazides DECREASE Ca excretion.

Q2360:4 K+ sparing diuretics

spironolactone; triamterene; amiloride; eplereone

Q2361:MOA of spironolactone

competitive aldosterone R antagonist in cortical collectingtubule

Q2362:MOA of triamterene

(K+sparer) block Na channels in CCT (same as amiloride)

Q2363:MOA of amiloride

(K+sparer) blocks Na channels in CCT (same as triameterene)

Q2364:Clinical use of K+ sparing diuretics

hyperaldosteronism; K+ depletion; CHF

Q2365:toxicity of K+ sparing diuretics

hyperkalemia; endocrine effects (eg. Spironolactone--gynecomastia; antiandrogenics)

Q2366:which diuretics decrease the blood pH (more acidic)

carbonic anhydrase inhibitors (acetazolamide); K+ sparers(spironolactone; triamterene; amiloride; eplererone)

Q2367:which diuretics increase blood pH (make more basic)

loop diuretics (furosemide; ethacrynic acid); thiazides

Q2368:3 AcE inhibitors

captopril; enalapril; lisinopril

Q2369:MOA of ACE inhibitors

inhibit angiotensin converting enzyme which reduces levels ofangiotensin II and prevents inacitvation of bradykinin (potent

vasodilator); renin release increased b/c of lack of feedbackinhibition

Q2370:effect of ACE inhibitors on renin release?

renin release increased due to loss of feedback inhibition

Q2371:Clinical uses of ACE inhibitors

HTN; CHF; diabetic renal disease

Q2372:toxicities of ACE inhibitors

CAPTOPRIL: cough; angioedema; proteinuria; taste changes;hypOtension; preggers problems; rash; increased renin; lower

angiotension II. Also hyperkalemia.

Q2373:can ACE inhibitors be used in bilateral renal arterystenosis?

no

Q2374:Why am I so frightened right now?

Cuz the man who lives in our fridge is making really angrynoises and there's a moth that keeps flying into my head.

Q2375:Democlocycline

Properties - antagonizes ADH ;Indications - SIADH.

Q2376:Drugs that cause SIADH

carbamazepine (seizures; manic) TCAs; thiazides;phenothiazines (neuroleptics?); chlorpropamide (sulfonylura

for DM); cisplatin (anti-neoplastic)

Q2377:Pulmonary infiltrations inducing drugs

"Go BAN Me!";Gold;Bleomycin/ Busulphan/BCNU;Amiodarone/ Acyclovir/

Azathioprine;Nitrofurantoin;Melphalan/ Methotrexate/Methysergide

Q2378:Respiratory depression inducing drugs

"STOP breathing";Sedatives andhypnotics;Trimethoprim;Opiates;Polymyxins

Q2379:Monoamine oxidase inhibitors: members

"PIT of despair";Phenelzine;Isocarboxazid;Tranylcypromine;·A pit of despair; since MAOs treat depression.

Q2380:Gynaecomastia-causing drugs

DISCOS;Digoxin;Isoniazid;Spironolactone;Cimetidine;Oestrogens;Stilboestrol

Q2381:Sulfonamides: common characteristics

SULFA;Steven-Johnson syndrome/ Skin rash / Solubilitylow;Urine precipitation/ Useful for UTI;Large spectrum (grampositives and negatives);Folic acids synthesis blocker (as well

as synthesis of nucleic acids);Analog of PABA

Q2382:Muscarinic effects

SLUG BAM;Salivation/ Secretions/Sweating;Lacrimation;Urination;Gastrointestinalupset;Bradycardia/ Bronchoconstriction/ Bowelmovement;Abdominal cramps/ Anorexia;Miosis

Q2383:Clopidogrel: use

CLOPIdogrel is a drug that prevents ;CLots; an Oral PlateletInhibitor (OPI).

Q2384:Morphine: side-effects

MORPHINE;Myosis;Out of it (sedation);Respiratorydepression;Pneumonia (aspiration);Hypotension;Infrequency

(constipation; urinary retention);Nausea;Emesis

Q2385:Methyldopa: side effects

METHYLDOPA;Mental retardation;Electrolyteimbalance;Tolerance;Headache/ Hepatotoxicity;psYcological

upset;Lactation in female;Drymouth;Oedema;Parkinsonism;Anaemia (haemolytic)

Q2386:4-Aminopyradine (4-AP) use

4-AP is For AP";For AP (action potential) propagation inMultiple Sclerosis

Q2387:LITHIUM

L- lithium intox;M-metallic taste; movement disorders;N-nephrogenic diabetes insipidus;O - hypothyroidism;P - contra

in pregnancy

Q2388:Calcium chelator

Tetracycline

Q2389:Brown teeth

Tetracycline

Q2390:Gray-baby syndrome

Chloramphenicol

Q2391:Oto- and nephrotoxicity

Vancomycin; aminoglycosides

Q2392:Optic neuritis

Ethambutol

Q2393:Polyarthralgia

Pyrazinamide

Q2394:Induces cytochrome P450

Rifampin

Q2395:Red-man syndrome

Vancomycin

Q2396:Pseudomembranous colitis

Clindamycin

Q2397:Kernicterus

Sulfonamides

Q2398:Megaloblastic anemia (supplement with vitamin B6)

Trimethoprim-sulfamethoxazole

Q2399:Cartilage damage; tendonitis

Fluoroquinolones

Q2400:Orange bodily fluids

Rifampin

Q2401:Fast vs. slow acetylators

Isoniazid

Q2402:Infusion-related toxicity

Amphotericin B

Q2403:D-Ala-D-Ala

Vancomycin

Q2404:PBP3

Aztreonam

Q2405:Blocks peptidyltransferase

Chloramphenicol

Q2406:Blocks peptide bond formation

Clindamycin

Q2407:Blocks ribosomal translocation by preventing exit oftRNA

Macrolides

Q2408:Inhibits initiation complex; causes mRNA misreading;blocks translocation

Aminoglycosides

Q2409:Blocks tRNA binding to ribosome

Tetracycline

Q2410:Bactericidal for H. flu; S. pneumo; N. meningitidis

Chloramphenicol

Q2411:Blocks initiation step of protein synthesis

Linezolid

Q2412:PABA analogue

Sulfonamides

Q2413:Prevents synthesis of dihydrofolic acid

Sulfonamides

Q2414:Inhibits dihydropteroate synthetase

Sulfonamides

Q2415:Prevents synthesis of tetrahydrofolic acid

Trimethoprim

Q2416:Inhibits dihydrofolate reductase

Trimethoprim

Q2417:Resistance is due to rRNA methylation

Clindamycin; macrolides

Q2418:DNA gyrase; topoisomerase IV

Fluoroquinolones

Q2419:RNA polymerase

Rifampin

Q2420:Inhibits mycolic acid synthesis

Isoniazid

Q2421:Inhibits arabinogalactan synthesis

Ethambutol

Q2422:Inhibits microtubule function

Griseofulvin

Q2423:Inhibits beta(1;3)D-glucan synthetase

Caspofungin

Q2424:Binds ergosterol

Amphotericin B; nystatin

Q2425:Inhibits lanosterol demethylation by cytochrome P450

Azoles

Q2426:Inhibits thymidylate synthase

Flucytosine

Q2427:Used to treat cryptococcal meningitis

Flucytosine

Q2428:Used for meningococcal prophylaxis

Rifampin

Q2429:Used to treat Pseudomonas infection in CF patients

Fluoroquinolones

Q2430:Used to treat nocardiosis

Sulfonamides

Q2431:Used to treat VRE; MRSA; PRSP

Linezolid

Q2432:Used to treat C. perfringens and B. fragilis

Clindamycin

Q2433:Used to treat Mycoplasma pneumoniae

Tetracycline

Q2434:Used to treat chlamydia

Tetracycline

Q2435:Used to treat Legionella

Macrolides

Q2436:Used to treat gonorrhea

Ceftriaxone

Q2437:Used to treat H. flu meningitis

Chloramphenicol

Q2438:Agranulocytosis;(2)*

Clozapine;Carbamazepine;[AGRANny parked her CAR-BAM in the CLOZet]

Q2439:Aplastic Anemia;(3)

Chloramphenicol;NSAIDs;Benzene

Q2440:Atropine-like Side Effects;(sedation; seizures; coma;anticholinergic effects; arrhythmias)

TCAs

Q2441:Cardiotoxicity;(2)

Doxorubicin;Daunorubicin;[double D "Rubis" are a "sin" forthe chest]

Q2442:Cartilage Damage in children

Fluoroquinolones (Ciprofloxacin)

Q2443:Cinchonism (HA; tinnitus);and;Torsades de pointes

Quinidine

Q2444:Cough

ACE Inhibitors

Q2445:Diabetes Insipidus

Lithium

Q2446:Disulfiram-like effect;and;Metallic taste

Metronidazole

Q2447:Extrapyramidal Side Effects

Antipsychotics;Typical > Atypical;(Thioridazine;Haloperidol; Chlorpromazine)

Q2448:Fanconi’s Syndrome;(growth failure; rickets;dehydration)

Tetracycline

Q2449:Gingival Hyperplasia

Phenytoin;;[PHEN he's TOYIN' w/ GINGer]

Q2450:Gray Baby Syndrome

Chloramphenicol

Q2451:Gynecomastia;(6)*

Some Excellent Drugs Create AwesomeKnockers;Spirolactone;Estrogens;Digitalis;Cimetidine;Alcohol

(chronic);Ketoconazole

Q2452:Hemolytic Anemia in G6PD-deficiency;(5)*

C'PISA;Chloramphenicol;Primaquine;Isoniazid;Sulfonamides;Aspirin;[AN ENEMIA (enemy) and 6 PDs knocked down

C'PISA]

Q2453:Hepatitis

Isoniazid

Q2454:Hot Flashes; Flushing;(3)*

No Cold Temp;Niacin;Calcium Channel Blockers;Tamoxifen

Q2455:Induce CP450;(6)*

Queen Barb takes Phen-phen & Refuses Greasy Carbs;-Quinidine;- Barbiturates;- Phenytoin;- Rifampin;-

Griseofulvin;- Carbamazepine

Q2456:Inhibit CP450;(8)*

Inhibitors Stop Cyber Kids From Eating Grapefruit Salad;-Isoniazid;- Sulfonimides;- Cimetidine;- Ketoconazole;- FQ

(Ciprofloxacin);- Erythromycin;- Grapefruits/St. Johns Wort

Q2457:Interstitial Nephritis

Methicillin

Q2458:What is Monday Disease?;Cause?

- Nitroglycerin Industrial exposure -> tolerance during week -> loss of tolerance during weekend -> headache; tach;

dizziness upon re-exposure

Q2459:Orange Body Fluids

Rifampin

Q2460:Osteoporosis;(2)

Heparin;Corticosteroids

Q2461:Positive Coombs’ Test

Methyldopa

Q2462:Pulmonary Fibrosis;(2)*

Amiodarone;Bleomycin;[AMY cant BLEOw anymore]

Q2463:Red Man Syndrome;(histamine release)*

Vancomycin;[red mAN vAN]

Q2464:Severe HTN with Tyramine;and;Serotonin syndrome(w/ meperidine)

MAOIs

Q2465:SLE-like Syndrome / Drug-induced Lupus;(7)*

Lupus Quickly Moaned In Pain - His Penis Cracked;-Quinidine;- Methyldopa;- INH;- Procainamide;-Hydralazine;- Penicillamine;- Chlorpromazine

Q2466:Tardive Dyskinesia

- Antipsychotics ;(Thioridazine; Haloperidol;Chlorpromazine)

Q2467:Tinnitus;(2)*

Aspirin;Quinidine;[ApirIN for QuIN-tIN Tinnitus]

Q2468:Torsades de pointes;(2 classes)

Class III;Class IA antiarrhythmics

Q2469:fetal Spina Bifida

Valproic Acid;[no folIC ACID or valproIC ACID]

Q2470:fetal Renal Dysgenesis -> death;(2)

ACE inhibitors;ARB

Q2471:Arrhythmias and Yellow visual changes

Digoxin

Q2472:Acute cholestatic Hepatitis

Macrolides

Q2473:Massive Hepatic Necrosis;(4)*

A Hepatic Ending Varies;- Acetaminophen;- Halothane;-Ethanol;- Valproic acid

Q2474:Livedo Reticularis;(patchy swollen blood vessels onlegs with cold)

Amantidine

Q2475:Thyroid toxicity;(2)

Lithium;Amiodarone

Q2476:Severe rebound HA and HTN;dry mouth

Clonidine

Q2477:Hemorrhagic Cystitis;Myelosuppression

Cyclophosphamide

Q2478:Photosensitivity;(3)*

SAT for a photo;- Sulfonamides;- Amiodarone;- Tetracycline

Q2479:Stevens-Johnson syndrome;(2)

Sulfonamides;Ethosuximide

Q2480:Seziures;(3)*

Impending Big Chills;- Imipenem;- Bupropion;- Cilastatin

Q2481:Retinal Toxicity

- Chloroquine;[CHLORine in pools hurts eyes]

Q2482:both Nephrotoxicity & Ototoxicity;(3)

Aminoglycosides;Loop diuretics;Cisplatin;[an ALCoholiccant hear well and urinates a lot]

Q2483:Priapism ;(prolonged erection w/o sexual stimulation)

Trazodone;(anti-depressant)

Q2484:Erectile dysfunction;(3 classes)*

No Tone Bone;- Neuroleptics;- TCAs;- Beta-blockers

Q2485:Malignant Hyperthermia

Succinylcholide

Q2486:Enhances erections

- Dopamine agonist;[it's DOPE AGain to get a big erection]

Q2487:atropine-like side effects

tricyclics

Q2488:cardiac toxicity

doxorubicin; daunorubicin

Q2489:coronary vasospasm

cocaine

Q2490:cutaneous flushing

niacin (lipid lowerer; increases HDL); CCB; adenosine;vancomycin (red man syndrome!)

Q2491:torsades de pointes

class III antiarrythm (sotalol); class IA antiarrhythm.(quinidine); cisapride

Q2492:agranulocytosis (3)

clozapine (atypical antipsych; least EPS); carbamazepine(AED; mood stabilizer; P450 inducer); colchicine

Q2493:aplastic anemia

chloramphenicol; benzene; NSAIDs; also: propylthioracil;methimazole (inhibit organificatin and coupling of thyroid

hormone synth)

Q2494:gray baby syndrome

(ab distention; progressive pallid cyanosis; vasomotorcollapse) chloramphenicol (binds 50s; inhibits

peptidlytransferase)

Q2495:hemolysis in G6PD deficient pts

sulfonamides; INH; aspirin; ibuprofen; primaquine;nitrofurantoin (abx)

Q2496:thrombotic complications

OCPs

Q2497:cough

ace inhibitors (bradykinin!)

Q2498:pulmonary fibrosis

bleomycin (induces free radical formation; for testicularcacner; lymphomas--ABVD regimen); amiodarone (class IAantiarrhthm); busulfan (alkylates DNA; CML; also causes

hyperpigmentation)

Q2499:acute cholestatic hepatitis

macrolides (dont give to preggers!)

Q2500:focal to massive hepatic necrosis

halothane (inhaled anesthetic); valproic acid; acetaminophen;Amanita phalloides (mushroom poison alpha amanitin--

>inhibits euk RNA pol)

Q2501:gynecomastia

Some Drugs Create AwesomE Knockers--Spironolactone;Digitalis; Cimetidine; Alcohol chronique; Estrogens;

Ketoconazole

Q2502:gingival hyperplasia

phenytoin

Q2503:osteoporosis

corticosteroids; heparin

Q2504:photosensitivity

sulfonamides; amiodarone; tetracycline; also 5-FU

Q2505:SLE-like syndrome

hydralazine (antiHTN for preggers; stim cGMP); INH;procainamide (Class IA antiarrh.); phenytoin

Q2506:Fanconi's syndrome

expired tetracycline

Q2507:interstitial nephritis

methicillin; also acute interstitial nephritis: NSAIDs; betalactams; sulfa diuretics; phenytoin; cimetidine; methyldopa

Q2508:hemorrhagic cystitis

cyclophosphamide; ifosfamide

Q2509:diabetes insipidus

lithium; demeclocycline

Q2510:seizures

bupropion (heterocyclic antidepressant; no sexual sideeffects); imipenem/cilastin

Q2511:disulfiram-like reaction

metronidazole; some cephalosporins; procarbazine(antineoplastic alkylator); sulfonylureas

Q2512:nephrotoxicity/neurotoxicity

polymyxins

Q2513:nephrotoxicity/ototoxicty

aminoglycosides; loop diuretics; cisplatin

Q2514:Acetaminophen: Antidote

N-acetylcysteine

Q2515:Salicylates: Antidote

Alkalnize urine; dialysis

Q2516:Anticholinesterases; organophosphates: Antidote

Atropine; Pralidoxime

Q2517:Antimuscarinic (Atropine); anticholinergics: Antidote

Physostigmine (AChE inhibitors)

Q2518:B-blockers: Antidote

Glucagon

Q2519:Digitalis: Antidote

1. Stop digitalis;2. Normalize K+;3. Lidocaine;4. Mg2+;5.anti-dig Fab fragments

Q2520:Iron: Antidote

Deferoxamine

Q2521:Lead: Antidote

- CaEDTA; Dimercaprol (1st line for adults);- Succimer (kids- "sucks" to be a kid with lead poisoning);- Penicillamine

Q2522:Arsenic: Antidote

Dimercaprol; Succimer;Penicillamine

Q2523:Mercury: Antidote

Dimercaprol; Succimer

Q2524:Gold: Antidote

Dimercaprol; Succimer;Penicillamine

Q2525:Copper: Antidote

Penicillamine

Q2526:Cyanide: Antidote

1. Nitrite - (oxidizes Hemoglobin to methemoglobin [Fe3+];which has high afinity for CN- but low affinity for O2);2.

Hydroxocobalamin;3. Thiosulfate

Q2527:Methanol; Ethylene glycol: Antidote

Ethanol; dialysis;- Fomepizole

Q2528:Methemoglobin: Antidote

Methylene blue

Q2529:Carbon monoxide: Antidote

100% 02; hyperbaric O2

Q2530:Opioids: Antidote

Naloxone/Naltrexone

Q2531:Benzodiazepines: Antidote

Flumazenil

Q2532:TCA's: Antidote

NaHCO3 (nonspecific) ??

Q2533:Heparin: Antidote

Protamine

Q2534:Warfarin: Antidote

Vit K (hours); Fresh Frozen Plasma (instant)

Q2535:tPA; streptokinase: Antidote

Aminocaproic acid

Q2536:Lead poisoning: LLEEAADD

- Lead Lines on gingivae and long bone epiphyses (on xray);-Encephalopathy; Erythrocyte basophilic stippling;-

Abdominal colic; Anemia (sideroblastic);- Drops-wrist andfoot drop; Dimercaprol as antidote (Succimer for kids)

Q2537:Inducers of CYP450

Quinidine;Barbiturates(phenobarbitol);Phenytoin;Rifampin;Griseofulvin;Carbemaze

pine;St. Johns Wort

Q2538:Inhibitors of CYP450

Isoniazid(INH);Sulfonylureas;Cimetidine;Ketoconazole;Erythromycin;

Grapefruit Juice

Q2539:tx benzodiazepam overdose

flumazenil

Q2540:go from phospholipids in the cell membrane tolukotrienes and other products of arachidonic acid metabolism

1. phospholipid in cell membrane -> phospholipase A2 (+ bybradykinin and angiotensin; - by corticosteroids);2.

phospholipase A2 -> arachidonic acid;3a. arachidonic acidbecomes PGG2 via cyclooxygenase (- by NSAIDS) -> PGG2

broken down by hydroperoxidase to PGH2 -> PGH2becomes thromboxane A2 (inhibited by dipyridamole); PGE2;

PGF2; and PGI2 (aka prostacyclin);3b. arachidonic acidbecomes 5-HPETE via 5-lipoxygenase -> 5-HPETE becomes

leukotrienes

Q2541:what causes the cough and angioedema in patient on anACEI

bradykinin

Q2542:how much epinephrine do you use in shock

1:1000 dilution subcutaneously

Q2543:what is dantrolene used for

treatment of malignant hyperthermia after halothane

Q2544:treat acetaminophen overdose

acetylcysteine to replace used of GSH (neutralizesacetaminophen free readicals formed in the liver cytochrome

system)

Q2545:mechanism of a loop diuretic

blocks Na-K-2Cl cotransport in the thick ascending limb inthe renal medulla; also blocks Ca reabsorption

Q2546:treat cyanide poisoning (useful to know that takingnitropusside orally instead of IV gives cyanide poisoning)

infusion of sodium thiosulfate -> produce thiocyanate;alsouse amyl nitrite

Q2547:complication of corticosteroid inhaler

thrush

Q2548:isotretinoin given to a young woman requires;

pregnancy test; then put them on OCs

Q2549:mechanism of propylthiouracil

blocks iodinqation of the tyrosine residues of thyroglobulin;also blocks coupling of DIT an MIT; only drug that can be

used in pregnancy but may produce goiter in the newborn andnail defects

Q2550:what does the P450 in the liver do

makes drugs water soluble

Q2551:what do angioedema and renal failure have to do withone another

ACEI

Q2552:MOA of retinoic acid

behaves like a steroid in that it binds to receptors in thenucleus w/ subsequent transcription of genes; proteins

produced by the action ar eimportant in growth;differentiation; reproduction; and embryonic development;

also used in treatment of acute progranuloctyic leukemia

Q2553:allopurinol MOA in purine synthesis

blocks xanthine oxidase (takes hypoxanthine to xanthine andxanthine to uric acid); mercaptopurine degradation is inhibited

also

Q2554:most common antibiotic used to prevent endocarditisin patients w/ valvular disease

amoxicillin (all vavlular diseases except asymptomatic MVPand all congential heart disease except asymptomatic ASD)

Q2555:drug that may cause yellow coloration of skin that canbe mistaken for jaundice

quinacrine;(chlorpromazine and arsenic produce blue-greycolor to the skin)

Q2556:diffuse erythema followed by separation of the skin(scalded skin syndrome or toxic epidermal necrolysis)- drug?

barbituates; sulfonamides; phenytoin; NSAIDS

Q2557:hair loss in a woman- drug?

oral contraceptives (predictable side effect- estrogen causeshair to be at same stage of development; may also occur after

delivery)

Q2558:erythematous; hyperpigmented plaque-like lesion thatrecurs at the same site every time?

fixed drug eruption (phenolphthalein; NSAIDS; tetracycline;Bactrim; and barbituates are the most common)

Q2559:group of drugs that has the highest association w.urticarial and maculopapular lesions

amoxicillin; TMP/SMX; ampicillin/penicllin (rashes are theMOST COMMON adverse reaction to drugs; with

maculopapular rashes leading the list; most drug reactionsinvolving the skin are NOT type I hypersensitivity related)

Q2560:elderly woman on thiazides is most at risk fordeveloping;

gout

Q2561:tardive dyskinesia; malignant syndrome (sweating;hyperpyrexia; autonomic instability)

neuroleptics

Q2562:antipsychotic drug requiring visual exam

thioridazine (also produces heart conduction defects)

Q2563:nephrogenic diabetes insipidus- drug?

lithium for bipolar disturbances

Q2564:drug contraindicated w/ MAOI

epinephrine

Q2565:use of phentolamine

non-selective alpha blocker that lowers blood pressure duringsurgery for a pheochromocytoma

Q2566:mechanism of AZT

inhibits reverse transcriptase; produces a macrocytic anemiaunrelated to folate/B12

Q2567:treatment of Pb poisoning

BAL and EDTA

Q2568:drugs involved in folate metabolism

phenytoin blocks intestinal conjugase (polyglutamate tomonoglutamate); BCP blocks uptake of monoglutamate;methotrexate/TMP-SMX block dihydrofloate reductase

Q2569:MOA of cromolyn sodium

stabilizes mast cell membrane preventing release of preformedmediators and release of prostaglandins/leukotrienes after the

release reaction

Q2570:methotrexate MOA

blocks dihydrofolate reductase and the conversion ofdihydrofolate to tetrahydrofolate

Q2571:glucoronyl transferase in liver renders compounds;

water soluble

Q2572:COX inhibitors

aspirin inhibits irreversible;NSAIDS reversible

Q2573:thromboxane A2

synthesized in platelet; vasoconstrictor and increases plateletaggregation; also a bronchoconstrictor

Q2574:effect of proton blockers

blocks H-K-ATPase proton pump in parietal cell; not areceptor mediated event

Q2575:H2 blockers

blocks H2 receptor; which normally activates adenylatecyclase producing cAMP which stimulates protein kinase

Q2576:misoprostol

blocks the prostaglandin receptor; which normally inhibitsadenylate cyclase and cAMP production

Q2577:treatment of schistosomiasis and clonorchiasis

praziquantel

Q2578:7-fold membrane spanning protein- drug?

propranolol

Q2579:phase 3 clinical trials

double blind

Q2580:ticlopidine

substitute for aspirin in preventing strokes; CAD if thepatient is allergic to aspirin; causes neutropenia

Q2581:drug induced SLE

hydralazine;INh;procainamide;phenytoin

Q2582:overdose of succinylcholine

acetylcholine blocker

Q2583:finasteride

blocks 5-a-reductase which converts testosterone inodihydrotestosterone; hence testosterone would increase

proximal to the block and dihydrotestosterone would decrase-> increases hair growth

Q2584:flutamide; cyproterone and spironolactone

block androgen receptors; hencetestosterone/dihydrotestosterone increase byt have no

physiologic effect

Q2585:ketoconazole

inhibits testosterone synthesis (suppresses adrenal steroidsynthesis)

Q2586:leuprolide

GnRH analogue; which when given in sustained fashioninhibits FSH and LH; hence lowering testosterone and

estrogen levels

Q2587:ACEI

increase in renin and ATI; but a decrease in ATII andaldosterone; aldosterone eventually increases; hence the

addition of spironoladctone to keep aldosterone suppressed;increases longevity in CHF

Q2588:arsenic poisoning

dimercaprol

Q2589:chloroquine in treatmento f malaria- malaria recurred;why?

exoerythrocytic/hepatic stage (P. vivax and P. ovale); drugkills active disease but does not eradicate hepatic stage

Q2590:primaquine in treatment of malaria

not good in active stage byt does kill the hepatic stage of p.vivax and p. ovale

Q2591:dantrolene MOA

reduces the release of Ca from the sarcoplasmic reticulum ofskeletal muscle; antispasmodic drug also used in treating

malignant hyperthermia

Q2592:methanol

increased anion gap metabolic acidosis due to conversion ofmethanol into formic acid; optic nerve degeneration and

blindness; treat w/ alcohol infusion to block metabolism ofmethanol by alcohol dehydrogenase

Q2593:botulsim toxin

blocks the release of acetylcholine; used to treat LES spasm inachalasia

Q2594:ribavirin

used in severe RSV infection in kids

Q2595:asthma

albuterol (b2 selective agonist); may cause hypokalemia-drives K into cells

Q2596:acetylcholine breakdown

occurs in the synapse into choline and acetate byacetylcholinesterase in the cleft; products are recycled and not

excreted

Q2597:know the graph of norepi/epi and isoproterenol andtheir effects on blood pressure and heart rate

plus the effect of alpha -1 blockers

Q2598:amphotericin

disrupts cell membrane permeability; binds to ergosterol inthe membrane

Q2599:ketoconazole

inhibits the metabolism of nosedating antihistamines likeSeldane leading to cardiac arrhytmias

Q2600:be very familiar w/ secondary messengers

IP3 DAG and on and on

Q2601:opiod toxicity tx

naloxone (opiod receptor antagonist)

Q2602:codeine

metabolized into morphine in amall amounts owing tosignificant first pass metabolism of morphine in liver

Q2603:delirium trements tx

benzodiazepines

Q2604:lovastatine

HMG CoA reductase inhibitors

Q2605:patent ductus arteriosus- keep open w/ ?

PGE

Q2606:penicillin

beta lactam antibiotic that inhibits cell wall synthesis; binds tospecific receptors in cytoplasmic membrane; inhibits

transpeptidase enzymes that cross-link linear peptidoglycoanchains that form part of the cell wall; activate autolytic

enzymes in the cell wall

Q2607:cephalosporins + aminoglycosides

synergistic effect of enhancing nephrotoxicity

Q2608:erythromycin

interacts w/ 50S subunit of bacterial ribosomes leading toinhibition of protein synthesis;inhibits the formation of the

initiation complex and interferes w/ translocationreactions;resistance develops secondary to plasmid mediated

formation of enzymes that methylate reactions;resistancedevelops secondary to plasmid mediated formation of

enzymes that methylate the receptor that erythromycin bindswith;coliforms produce an transmissible plasmid that

produces an esterase that hydrolyzes the lactone ring oferythromycin

Q2609:chloramphenicol

gray baby syndrome (dose related aplastic anemia)

Q2610:sulfonamides; dapsone

may precipiate hemolysis in G6P deficiency

Q2611:TMP

inhibits dihydrofolate reductase; plasmid mediated resistance;TMP + SMX has a synergistic effect from the sequential

blockade of folate synthesis; since SMX blocksdihydropterate synthase; which is an enzyme that converts

PABA into DHF

Q2612:metronidzole

produces a disulfiram like reaction

Q2613:fluconazole

tx of esophageal candidiasis

Q2614:ganciclovir

first drug used in treating CMV retinitis; the most commoncause of blindness in AIDS; foscarbet is used if ganciclovir

doesn't work

Q2615:clolinomimetic used in treating open angle glaucoma

pilocarpine;physostigmine

Q2616:dobutamine

inotropic (increase contractility) vasodilator (decreasesafterload) that activates alpha 1 and beta 1 > beta 2 activitywithout much chronotropic effect; used in the treatment ofshock (cardiogenic) associated w/ hypotension; hyptension

associated w/ renal failure of CHF

Q2617:dopamine

stimulates cardiac beta 1 receptors; peripheral alphareceptors; and dopaminergic receptors in vessels in the renaland splanchnic bed; at low doses it is primarily a vasodilator

that increases renal and splanchnic blood flow; at high doses itincreases cardiac contractility and cardiac output via its

activation of cardiac beta 1 receptors

Q2618:benzodiazepine MOA

via its own receptors in the thalamus; limbic structures; andcerebral cortex which are part of the GABA freceptgor-chloride ion channel macromolecular complex; benzo'dfacilitate the inhibitor action of GABA via increased

conductgance in the chloride ion channels (flumazenil blocksthis effect by blocking the receptor for benzos and is the

treatment of choice for benzo overdose)

Q2619:a child who ingests 30 adult aspirin is most likely todevelop;

increased anion gap metabolic acidosis ;(adults get mixedmetabolic acidosis and respiratory alkalosis);tx is to performgastric lavage and add activated charcoal and to produce an

alkalone urine for increased excretion

Q2620:open angle gaucoma is best treated w/

a beta blocker (timolol is good; pilocarpine may als be used;most common type of glaucoma; produces gradual loss of

peripheral vission (tunnel vision) and optic atrophy)

Q2621:trazodone

second degneration anti-depressant; inhibition of serotoninreuptake; sedation; may cause priapism

Q2622:thioridazine complication

retinitis pigmentosum

Q2623:tamoxifen

anti-estrogen; estrogen receptor partial agonist that blocks thebinding of estrogen to their redceptors in ERA-[os breast

cancer cells; also protects against osteoporosis and CAD; riskfactor for endometrial cancer; can be used in treating progestin

resistant endometrial cancer

Q2624:acetaminophen

analgesic and antipyrietic but not an anti-inflammatory agent;inhibiots prostaglandin synthesis in the CNS; very weak

COX inhibitor; most common drug causing acute fulminanthepatitis; converted into free readicals in the liver; glutathione

inactivates the FRs

Q2625:digitalis toxicity

tx w/ digoxin FAB antibodies

Q2626:cephalosporins

first generation: drug of choice for surgical prophylaxis inmany cases;second: sinusitis (cefuroxime); mixed anaerobic

infection;third: minigitis; GC (ceftriaxone)

Q2627:cromolyn sodium in asthma

only for prophylaxis; blocks early and late asthmaticresponses to allergens

Q2628:omeprazole

inhibits the proton pump located on the luminal membrane ofthe parietal cell; useful in the treatment of ZE syndrome;

GERD; and h. pylori infection

Q2629:clozapine

blocks D4 and 5-HT receptors more so than D2 receptors

Q2630:fever in a patient on a loop diuretic

do not use any type of NSAID (including aspirin) since itblocks renal synthesis of prostaglandin; which it does not

interfere with prostaglandin synthesis. Loop diuretics lead tovolume depletion; hence angiotensin II will be elevated

(vasoconstricts efferent arteriole);loss of prostaglandin effectpredisposes the patent to renal failure

Q2631:pathogenesis of cough and angioedema in ACEI

increase in bradykinin

Q2632:red man syndrome

iv vancomycin

Q2633:drug for bacterial carrier states (s. aureus; N.meningitidis; h. influenza)

rifampin

Q2634:single dose drug for GC and chlamydia

azithromycin

Q2635:Rx of malignant hypertension

nitroprusside

Q2636:patient on Lasix who develops fever and needsantipyrietic

use acetaminophen; do not use NSAIDs since they blockprostaglandin production in the kidneys

Q2637:antihypertensive and antiarrhtymic drug that lowersblood pressure and increases heart rate

Ca channel blocker (nifedipine)

Q2638:What drugs are Ototoxic; Auditory?

Loops (Ethacrynic Acid >Furosemide);VANCOMYCIN;Macrolides;Cisplatin

Q2639:What drugs are Ototoxic; Vestibular?

Minocycline

Q2640:What drugs are Ototoxic Auditory and Vestibular?

Aminoglycosides

Q2641:What drugs are Ototoxic causing Tinnitus?

Quinidine/Quinine (cinchonism);ASA (salicylism)

Q2642:What drugs are nephrotoxic?

Vancomycin;Aminoglycosides;Amphothericin B;Foscarnet(hypercalcemia);Cisplatin (minimized w/

Amifestine);Cyclosporine

Q2643:What drug causes causes SIADH?

Carbamazepine;Chlorpropamide

Q2644:What drug causes Nephrogenic DI?

Lithium;Demeclocycline

Q2645:What drug causes hemorrhagic cystitis?

Cylcophosphamide

Q2646:How do you prevent hemorrhagic cystitis w/cyclophosphamide?

MESNA

Q2647:How do you minimize nephrotoxicity from Cisplatin?

Amifostine

Q2648:What are the hepatotoxic drugs?

AMIODARONE;STATINS;VALPROIC ACID(hepatitis);Felbamate;Tolcapone;TETRACYCLINE (in

pregnancy);RIPE TB therapy (Rifampin; Isoniazid;Pyrazinamide);ACETAMINOPHEN

Q2649:What do you give to OD w/ ACETAMINOPHEN?

Acetylcysteine

Q2650:What drugs cause Blood dyscrasias?

Carbamazepine

Q2651:What drug causes Aplastic Anemia?

Felbamate

Q2652:What drug causes agranulocytosis?

Clozapine

Q2653:What drug causes aplastic anemia and is dosedependent and dose independent?

Chloramphenicol

Q2654:What HIV medication causes Blood dyscrasias(anemia/bone marrow suppresion)?

Zidovudine

Q2655:What anticoagulant produces thrombocytopenia?

Heparin

Q2656:What drug causes thrombotic thromocytopenia;purpura or TPP?

Ticlopidine

Q2657:Most Cancer chemotherapeutic drugs cause?

Blood Dyscrasias

Q2658:What drugs cause pancreatitis?

Valproic Acid;Didanosine/Zalcitabine;Sulindac;Asparaginase

Q2659:What drug used for seizures causes pancreatitis?

Valproic Acid

Q2660:What drug used for HIV cause pancreatitis?

Didanosine;Zalcitabine

Q2661:What NSAID causes pancreatitis?

Sulindac

Q2662:What drug used for ALL causes pancreatitis?

Asparaginase

Q2663:What drugs produce gingival hyperplasia?

Phenytoin;Nifedipine;Cyclosporine

Q2664:What drugs cause SLE in SLOW acetylators?

Hydralazine;Isoniazid;Procainamide

Q2665:Drugs w/ problems with AtypicalPseudocholinesterase?

Succinylcholine (prolongs the activity)

Q2666:What drug causes malignant hyperthermia?

Halothane/SUX

Q2667:What drug causes Hemolytic Anemia in G6PDdeficiency?

Sulfonamide;Primaquine;Quinidine

Q2668:What drugs cause disulfiram like reaction?

Metronidazole;Chlorpropamide;Griseofulvin;Cefamandole;Cefotetan;Cefoperazone

Q2669:What drug (combination) causes Serotonin Sx?

MAOIs; TCAs; SSRIs; Meperidine

Q2670:What drug causes acute hypertensive crisis?

Non-Selective MAOIs + Tyramine

Q2671:What are the non-selective MAOIs?

Phenelzine;Trancylpromine

Q2672:What contains Tyramine?

Aged Cheese;Red Wine

Q2673:What DDI (drug-drug interaction) causes decrease inB.P. and possible death?

Sildenafil + Nitroglycerin

Q2674:What two drugs in anti-cancer therapy you shouldnever mix?

6-MP (Azathioprine) + Allopurinol;precipitate gout

Q2675:DOC for Borrelia?

Doxycicline

Q2676:DOC for Ricketssia?

Doxycycline

Q2677:DOC for T. pallidum?

Penicillin G

Q2678:DOC for gonorrhea?

Ceftriaxone;"Floxacins"

Q2679:DOC for Atypicals (Chlamydia; Mycoplasma)?

Doxycicline or ;Macrolide

Q2680:DOC listeria?

Ampicillin

Q2681:DOC Legionella?

Macrolide

Q2682:DOC Step (Group A)?

Pen G [V]

Q2683:DOC C. difficile?

Metronidazole;or Vancomycin

Q2684:DOC enterococcus?

Penicillin + AG (Aminoglucoside)

Q2685:DOC P. areuginosa?

Ticarcillin + AG

Q2686:DOC for T. pallidum but penicillin allergy?

Doxycicline

Q2687:DOC N. gonorreah but Penicillin Allergy?

Floxacin

Q2688:DOC for Listeria but penicillin allergy?

TMP-SMX

Q2689:DOC Strep (Group A) but penicillin allergy?

Macrolide

Q2690:DOC enterococcus but penicillin allergy?

Vacomycin + AG

Q2691:DOC P. areuginosa but penicillin allergy?

Aztreonam

Q2692:DOC Borrelia in Pregnancy or Child?

Amoxicillin

Q2693:DOC Ricketssia in Pregnancy or Child?

Chloramphenicol

Q2694:DOC N. gonorrhea in Pregnancy or Child?

Ceftriaxone

Q2695:DOC atypicals [chlamydia; Mycoplasma] inPregnancy or Child?

Macrolide

Q2696:DOC P. areuginosa w penicillin allergy?

Aztreonam; AG; Floxacin

Q2697:DOC for Borelia for a prenant woman?

Amoxicillin

Q2698:DOC N. gonorrhea for a prenant woman?

Ceftriaxone

Q2699:DOC Atypicals [Chlamydia; Mycoplasma] for aprenant woman?

Macrolide

Q2700:DOC for Borrelia in Children?

Amoxicillin

Q2701:DOC N. gonorrhea in Children?

Ceftriaxone

Q2702:DOC Atypicals in Children?

Macrolides

Q2703:What is the Serotonin Sx?

Hyperthermia;Rigidity;AutonomicInstability;Myoclonus;Kind of like when having sex!!!

Q2704:What causes Serotonin Sx in w/ Meperidine?

Combination w/ MAOIs; TCAs;but it is a metabolite callednormeperidine that acts like SSRI

Q2705:How do protease inhibitors work?

Inhibit Aspartate Protease

Q2706:Name two protein inhibitors?

Indinavir;RitonAVIR;gp120;gp41

Q2707:What happens to Uric Acid at high does Aspirin?

UA stays in the lumen and is peed out = uricosuric

Q2708:What happens to Uric acid w/ low dose Aspirin?

Transport of UA (Uric Acid) is blocked from the blood to thelumen so it causes hyperuricemia;Aspirin (low dose) blocks

secretion of Uric Acid

Q2709:What drug protects patient from nephrotoxicity takingcisplatin?

Amifostine

Q2710:What drug prevents cardiotoxicity w/ Doxorubicin?

Dexrazoxane

Q2711:What drug prevents toxicity to epithelial; GI and bonemarrow in Methotrexate high dose anti-cancer tx?

Leucovorin;restores purines

Q2712:Where does Aspirin work?

COX-1;Cycloxygenase 1

Q2713:Where does abcximab work?

GP IIB/IIIA receptor on platelets. Can't join together

Q2714:Where does ticlopidine work? (Clopidrogel)

Blocks ADP release

Q2715:Where does propilthioracil and Methimazole work?

Peroxidase in thyroid synthessis

Q2716:Where does Iodide (high dose) work?

blocks release of proteolytic T3 ---> T4

Q2717:Where does Propilthioracil and Propanolol work?

inhibit deiodinase (liver) conversion of T4 to T3

Q2718:28 year old chemist presents with MPTPexposure;What NT is depleted?

Dopamine

Q2719:Woman taking tetracycline exhibitsphotosensitivity;What are the clinical manifestations?

Rash on sun-exposed regions of body

Q2720:Nondiabetic patient presents with hypoglycemia butlow levels of C peptide;What is the diagnosis

Surreptitious insulin injection

Q2721:African American male who goes to Africa developshemolytic anemia after taking malaria prophylaxis;What is the

enzyme defficiency

Glucose 6 phosphate dehydrogenase

Q2722:27 year old female with history of psychiatric illnessnow has urinary retention due to neuroleptic;What do you

treat it with?

Bethanechol

Q2723:Farmer presents with dyspnea; salivation; miosis;diarrhea; cramping and blurry vision;What caused this and

what is the mechanism

Insecticide poisoning; inhibition of acetylcholinesterase

Q2724:Patient with recent kidney transplant is oncyclosporine for immunosuppresion; he requires antifungalagent for candidiasis;What antifungal drug would result in

cyclosporine toxicity?

Ketoconazole

Q2725:Man on several medications including antidepressantsand antihypertensives; has mydriasis and becomes

constipated;What is the cause of symptoms?

TCA

Q2726:55 year old postmenopausal woman on tamoxifentherapy;What is she at increased risk of acquiring?

Endometrial carcinoma

Q2727:Woman on MAO inhibitor has hypertensive crisisafter meal;What did she ingest?

Tyramine (wine or cheese)

Q2728:After taking clindamycin; patient develops toxicmegacolon and diarrhea;What is the mechanism of diarrhea?

Clostridium difficile overgrowth

Q2729:Man starts a medication for hyperlipidemia. He thendevelops rash; pruritus and GI upset;What drug was it?

Niacin

Q2730:Patient is on carbamazepine;What routine workupshould be done?

LFT's

Q2731:23 year old female who is on rifampin for TBprophylaxis and on birth control (estrogen) gets

pregnant;Why?

Rifampin augments estrogen metabolism in liver rendering itless effective

Q2732:Patient develops cough and must discontinuecaptopril;WHat is a good replacement drug and why doesnt it

have the same side effects?

Losartan - an angiotensin II receptor antagonist; does notincrease bradykinin as captopril does

Q2733:Relates the amount of drug in the body to plasmaconcentration

Vd - volume of distribution

Q2734:Formule for volume of distribution

Vd = amount of drug in the body/plasma drug concentration

Q2735:Vd of plasma protein-bound drugs can be altered bywhat disease?

Liver and kidney

Q2736:Relates the rate of elimination to plasma concentration

CLEARANCE

Q2737:Formula for clearance

Cl = rate of elimination of drug/plasma drug concentration

Q2738:The time required to change the amount of drug in thebody by 1/2 during elimination (or during constant infusion) is

called _

Half life T1/2

Q2739:After 1 half life concentration of drug equals _ %

50%

Q2740:After 2 half lifes concentration of drug equals_

75%

Q2741:A drug infused at constant rate reaches about _ % ofsteady state after 4 T1/2

94

Q2742:Formula for T1/2

T1/2 = 0.7 * Vd/CL

Q2743:Loading dose formula

Loading dose = Cp * Vd/F;Cp= target plasma concentration;F= bioavailibility

Q2744:Formula for maintenance dose

Cp * CL / F;Cp = target plasma concentration;F =bioavailibility

Q2745:In patients with impaired renal or hepatic function; theloading dose decreases; increases or remains unchanged?

;Maintenance dose?

Loading dose remains unchanged;Maintenance dose decreases

Q2746:Rate of elimination is constant (constant amount ofdrug is eliminated per unit time) - what order

elimination?;What happens to target plasma concentration?

Zero order elimination;Target plasma concentration decreaseslinearly with time

Q2747:Rate of elimination is proportional to drugconcentration (constant fraction of drug eliminated per unit

time) - what order elimination? ;What happens to targetplasma concentration?

First order elimination;Cp decreases exponentially with time

Q2748:Give examples of drugs with zero order elimination

Ethanol;Phenytoin;Aspirin (at high or toxic concentration)

Q2749:Phase I metabolism (reduction; oxidation; hydrolysis)yields _ metabolites (often still active)

Slightly polar; water soluble

Q2750:What phase of metabolism associated withcytochrome P450

Phase I

Q2751:What phase of metabolism associated with conjugation

Phase iI

Q2752:Phase II metabolism (acetylation; glucoronidation;sulfation) yields _ metanolites (renally excreted)

Very polar; inactive

Q2753:Geriatric patients lose which phase of metabolismfirst?

Phase I

Q2754:Is it safe? Pharmacokinetics? - which phase of clinicaltesting of the drug

Phase I

Q2755:Does it work in patients?- which phase of clinicaltesting of the drug

Phase II

Q2756:Does it work? Double blind - which phase of clinicaltesting of the drug

Phase III

Q2757:What happens in phase IV of clinical testing of thedrug

Postmarketing surveillance

Q2758:A competitive antagonist shifts agonist curve where?

To the right

Q2759:A noncompetitive antagonist (irreversible) shiftsagonist curve where?

Downward

Q2760:Name antibiotics that block cell wall synthesis byinhibition of peptidoglycan cross linking

Penicillin;Ampicillin;Ticarcillin;Pipercarcillin;Imipenem;Aztreonam;Cephalosporins

Q2761:Name antibiotics that block peptidoglycan synthesis

Bacitracin;Vancomycin;Cycloserine

Q2762:Name antibiotics that block protein synthesis at 50Sribosomal unit

Chloramphenicol;Erythromycin/macrolides;Lincomycin;Clindamycin;Streptogramins (quinupristin; dalfopristin);Linezolid

Q2763:Name antibiotics that block protein synthesis at 30Sribosomal unit

Aminoglycosides;Tetracyclines

Q2764:Name antibiotics that block nucleotide synthesis

Sulfonamides;Trimethoprim

Q2765:Name antibiotics that block DNA topoisomerase

Quinolones

Q2766:Name antibiotic that blocks mRNA synthesis

Rifampin

Q2767:Name bactericidal antibiotics

Penicillin;Cephalosporins;Vancomycin;Aminoglycosides;Fluoroquinolones;Metronidazole

Q2768:Name drugs that disrupt bacterial/fungal cell membrane

Polymyxins

Q2769:Name drugs that disrupt fungal cell membranes

Amphotericin B;Nystatin;Flucoconazole/azoles

Q2770:Oral form of penicillin is called _ ;IV form?

Penicillin V;Penicillin G

Q2771:Mechanism of penicillin

- Binds penicillin binding proteins;- Blocks transpeptidasecross linking of cell walls;- Activates autolytic enzymes

Q2772:This antibiotic is bactericidal for gram positive cocci;gram positive rods; gram negative cocci and spirochetes. Not

penicillinase resistant

PENICILLIN

Q2773:Toxicity of penicillin

Hypersensitivity reactions;Hemolytic anemia

Q2774:Methicillin; nafcillin; dicloxacillin - mechanism ofaction? ;Narrow or broad action? ;Penicillinase resistant or

not?

Same as penicillin;Narrow action;Penicillinase resistantbecause of bulkier R groups

Q2775:Methcillin; nafcillin and dicloxacillin are clinically usedfor treatment of what bug?

S. aureus

Q2776:Methicillin toxicity

Interstitial nephritis

Q2777:Methcillin; nafcillin; dicloxacillin toxicity

Hypersensitivity reactions

Q2778:Ampicillin; Amoxicillin- mechanism ofaction;Penicillinase sensitive or resistant? ;Spectrum narrow

or wide?

SAME AS PENICILLIN;Wide spectrum;Penicillinasesensitive

Q2779:Ampicillin; amoxicillin can be combined with _ toenhance spectrum

Clavulinic acid

Q2780:Which has greater oral bioavailibility - amoxicillin orampicillin

AmOxicillin has greater Oral bioavailibility

Q2781:Name antibiotics that are extended-spectrumpenicillins - against certain gram positive and gram negative

rods ;Name rods

HELPS kill enterococci - H influenzae; E.coli; Listeriamonocytogenes; Proteus mirabilis; Salmonella;

enterococci;Ampicillin; amoxicillin

Q2782:Toxicity for ampicillin and amoxicillin

Hypersensitivity reactions; ampicillin rash;pseudomembranous colitis

Q2783:Mechanism for carbenicillin; pipercillin;ticarcillin;Spectrum?

Same as penicillin; extended spectrum

Q2784:Name penicillins used for treatment of Pseudomonas;and gram negative rods;Is it penicillinase resistant or

sensitive;Can it be used with clavulinic acid

Carbencillin; Piperacillin; Ticarcillin;Penicillinasesensitive;Use with clavulinic acid

Q2785:Toxicity for carbencillin; piperacillin; ticarcillin

Hypersensitivity reactions

Q2786:Beta lactam drugs that inhibit cell wall synthesis butare less susceptible to penicillinases; bactericidal

CEPHALOSPORINS

Q2787:Which cephalosporins target gram positive cocci +Proteus ; E. coli;Klebsiella

1st generation

Q2788:Which cephalosporins target gram positive cocci + H.flu; Enterobacter; Neisseria; Proteus; E coli Klebsiella; Serratia

2nd generation

Q2789:Which cephalosporins target serious gram negativeinfections resitant to other beta lactams; meningitis (most

penetrate BBB) - give examples

3d generation - ceftazidime; ceftriaxone

Q2790:3d generation cephalosporin used for treatment ofPseudomonas

Ceftazidime

Q2791:3d generation cephalosporin used for treatment ofgonorrhea

Ceftriaxone

Q2792:Which cephalosporins have increased activity againsPsedudomonas and gram positive organisms

4th generation

Q2793:Is there cross hypersensitivity betweencephalosporins and penicillin

Yes; 5-10%

Q2794:Toxicity for cephalosporins

Hypersensitivity reactions;Increase nephrotoxicity ofaminoglycosides;Disulfiram like reaction with ethanol (in

cephalosporins with methylthiotetrazole group) -cefamandole

Q2795:A monobactam resistant to beta lactamases. Inhibitscell wall synthesis (binds to PBP3); synergistic with

aminoglycosides; no cross allerginicity with penicillins

AZTREONAM

Q2796:This antibiotic is used for Gram negative rods(Klebsiella; Pseudomonas; Serratia); no activity agains gram

positives or anaerobes; for penicillin allergic patients andthose with renal insufficiency who cannot tolerate

aminoglycosides

AZTREONAM

Q2797:Is there any toxicity associated with AZTREONAM

Usually nontoxic; occasional GI upset

Q2798:Broad spectrum beta lactamase resistant carbapenem

Imipenem

Q2799:Imipenem is ALWAYS administered with _ ;WHY?

CILASTATIN;Inhibitor of renal dihydropeptidase I - todecrease inactivation of the drug in renal tubules

Q2800:Drug of choice for Enterobacter; also active againstgram positive cocci; gram negative rods and anaerobes

Imipenem + cilastatin

Q2801:Toxicity associated with Imipenem/cilastatin

GI distress; skin rash; CNS toxicity (seizures) at high plasmalevels

Q2802:Inhibits cell wall mucopeptide formation by binding Dala D ala portion of cell wall precursors. Resistance occurs

with amino acid change of D ala D ala to D ala D lac

VANCOMYCIN

Q2803:This antibiotic is used for serious gram positive multidrug resistant organisms; including S aureus; and Clostridium

difficile (pseudomembranous colitis)

VANCOMYCIN

Q2804:Diffuse flushing ("red man syndrome") associatedwith vancomycin can be largely prevented by?

Pretreatment with antihistamines and slow infusion rate

Q2805:Toxicity for Vancomycin

Nephrotoxicity;Ototoxicity;Thrombophlebitis;Well toleratedin general - does NOT have many problems

Q2806:Gentamicin; neomycin; amikacin; tobramycin;streptomycin - what class of antibiotics?

Aminoglycosides

Q2807:Bactericidal; inhibit formation of initiation complexand cause misreading of mRNA. Require O2 for uptake;

therefore ineffective against anaerobes

AMINOGLYCOSIDES

Q2808:Which aminoglycoside is used for bowel surgery

Neomycin

Q2809:Aminoglycosides are _ with beta lactams

Synergistic

Q2810:Aminoglycosides are clinically used for treatment of _

Severe gram negative rod infections

Q2811:Toxicity of aminoglycosides

Nephrotoxicity (especially with cephalosporins);Ototoxicity(especially with loop diuretics)

Q2812:Doxycycline; demeclocycline; minocycline - nameclass of antibiotics

Tetracyclines

Q2813:Bacteriostatic; bind to 30S and prevent attachment ofaminoacyl-tRNA; limited CNS penetration

Tetracyclines

Q2814:Which tetracycline is fecally eliminated and can beused in patients with renal failure

Doxycycline

Q2815:Must NOT take tetracyclines with _ ;Why?

Milk;Antacids;Iron containing preparations;Divalent cationsinhibit its absorption in gut

Q2816:Clinical use of tetracyclines

Vibriocholerae;Acne;Chlamydia;Ureaplasma;Urealyticum;Mycoplas

ma pneumonia;Boreliaburgdorferi;Riccketsia;Tularemia;VACUUM your BedRoom

Tonight

Q2817:Toxicity of tetracyclines

GI distress; discoloration of teeth and inhibition of bonegrowh in children; photosensitivity

Q2818:Erythromycin; azithromycin; clarithromycin- nameclass of antibiotics

Macrolides

Q2819:Inhibit protein synthesis by blocking translocation -bind to 23S rRNA of 50S ribosomall subunit; bacteriostatic

Macrolides

Q2820:Clinical use macrolides

URI;Pneumonia;STD;gram positive cocci (streptococcalinfections in patients allergic to penicillin); Mycoplasma;

Legionella; Chlamydia; Neisseria

Q2821:Toxicity macrolids

GI discomfort; acute cholestatic hepatitis; eosinophilia; skinrashes

Q2822:Patient on antibiotic therapy develops acutecholestatic hepatitis - which clas of drug?

Macrolides

Q2823:Most common cause of non compliance withmacrolides

GI discomfort

Q2824:Inhibits 50S peptidyltransferase; bacteriostatic

Chloramphenicol

Q2825:This drug is used for treatment of meningitis (H flu; Nmeningitidis; Strep pneumoniae) but conservatively used due

to toxicities

Chloramphenicol

Q2826:Toxicities with chloramphenicol

Anemia (dose dependent);Aplastic anemia (doseindependent);Gray baby syndrome

Q2827:Which drug causes gray baby syndrome and why

Chloramphenicol - premature infants because they lack liverUDP-glucuronyl transferase)

Q2828:Blocks peptide bond formation at 50S ribosomalsubunit; bacteriostatic

Clindamycin

Q2829:Which antibiotic is used to treat anaerobic infections(Bacteroides fragilis; Clostridium perfringens)

CLindamycin

Q2830:Toxicity associated with clindamycin

Pseudomembranous colitis (C. difficile overgrowth); fever;diarrhea

Q2831:PABA antimetabolites inhibit dehydropteoratesynthase; bacteriostatic

Sulfonamides

Q2832:Which sulfonamides are used for treatment of simpleUTI

Triple sulfas or SMX

Q2833:Clinical use of sulfonamides

Gram positive;Gram negative;Nocardia;Chlamydia

Q2834:Toxicity with sulfonamides

Hypersensitivity reactions;Hemolysis if G6PDdeficient;Nephrotoxicity (tubulointerstitial

nephritis);Kernicterus in infants;Displace other drugs fromalbumin (warfarin)

Q2835:Antibiotic inhibits dihydropteorate synthase

Sulfonamides

Q2836:Antibiotic inhibits dihydrofolate reductase

Trimethoprim; pyrimethamine

Q2837:Inhibits bacterial dihydrofolate reductse; bacteriostatic

Trimethoprim

Q2838:This drug is used in combination with sulfonamidescausing sequential block of folate synthesis

Trimethoprim

Q2839:This drug is used for recurrent UTI's; Shigella;Salmonella; Pneumocystis carinii pneumonia

TMP-SMX

Q2840:Toxicity of trimethoprim

Megaloblastic anemia;Leukopenia;Granulocytopenia;TMP -Treats Marrow Poorly

Q2841:Toxicity connected with trimethoprim can bealleviated by _

Supplemental folinic acid

Q2842:Ciprofloxacin; norfloxacin; ofloxacin; sparfloxacin;moxifloxacin; gatifloxacin; enoxacin - name class

Fluoroquinolones

Q2843:Antibiotics inhibit DNA gyrase (topoisomerase II);bactericidal

Fluoroquinolones

Q2844:Used clinically for treatment of gram negative rods ofurinary and GI tracts (including Pseudomonas); Neisseria;

some gram positive organisms

Fluoroquinolones

Q2845:Are fluoroquinolones safe in pregnant women

Contraindicated in pregnant women and in children becauseanimal studies show damage to cartilage.

Q2846:Fluoroquinolones toxicity

Tendonitis and tendon rupture in adults;GIupset;Superinfections;Skin

rashes;Headache;Dizziness;FluoroquinoLONES hurtattachments to your BONES

Q2847:Forms toxic metabolites in bacterial cells; bactericidal

Metronidazole

Q2848:Antiprotozoal; Giardia; Entamoeba; Trichomonas;Gardenrella vaginalis; anearobes (bacteroides; clostridium) -

name drug

Metronidazole

Q2849:This drug is used with bismuth and amoxicillin (ortetracycline) for "triple therapy" against H pylori

Metronidazole

Q2850:Anaerobic infections above diaphragm - ?;Anaerobicinfections below diaphragm?

Above - clindamycin;Below - metronidazole

Q2851:Toxicity of metronidazole

Disulfiram like reaction with alcohol; headache

Q2852:Bind to cell membranes of bacteria and disrupt theirosmotic properties; cationic; basic proteins that act like

detergents - treat resistant gram negativ infections

Polymyxins

Q2853:Toxicity for polymyxins

Neurotoxicity;Acute renal tubular necrosis

Q2854:Name anti TB drugs

RESPIre;Rifampin;Ethambutol;Streptomycin;Pyrazinamide;Isoniazid

Q2855:2nd line therapy for TB

Cycloserine

Q2856:All anti TB drugs have same toxicity - name it

liver toxicity

Q2857:Anti TB drug - decreases synthesis of mycolic acids

Isoniazid

Q2858:The only agent used as solo prophylaxis against TB

Isoniazid

Q2859:Toxicity for INH (Isoniazid)

Hemolysis if G6PDdefficient;Neurotoxicity;Hepatoxocitiy;SLE like

syndrome;INH - Injures Neurons and Hepatocytes

Q2860:_ can prevent neurotoxicity caused by isoniazid

Pyridoxine (B6)

Q2861:Which anti TB drug has different half lifes in fast vsslow acetylators

Isoniazid

Q2862:Anti TB drug - inhibits DNA dependent RNApolymerase

Rifampin

Q2863:Delays resistance to dapsone when used for leprosy

Rifampin

Q2864:Used for meningococcal prophylaxis andchemoprophylaxis in contacts of children with H influenzae

type B

Rifampin

Q2865:Rifampin toxicity

Minor hepatoxicity and drug interactions (increases P450)

Q2866:Rifampin 4 R's

RNA polymerase inhibitos;Revs up P450;Red/orange bodyfluids;Rapid resistance if used alone

Q2867:Beta lactamase cleavage of beta lactam drug is aresistance mechanism against which drugs

Penicillins and cephalosporins

Q2868:Modification via acetylation; adenylation; orphosphorylation is resistance mechanism against which drugs

Aminoglycosides

Q2869:Terminal D ala component of cell wall replaced with Dlac; decreases affinity - resistance mechanism against which

drug

Vancomycin

Q2870:Modification via acetylation - resistance mechanismagainst which drug

Chloramphenicol

Q2871:Decreased uptake or increased transport out of cell isresistance mechanism against which drugs

Tetracyclines

Q2872:Altered enzyme (bacterial dihdropteorate synthetase);decreased uptake or increased PABA synthesis is resistance

against which drugs

Sulfonamides

Q2873:Drug of choice for prophylaxis of meningococcalinfections;Alternative?

Rifampin;Minocyclin

Q2874:Prophylaxis of gonorrhea

Ceftriaxone

Q2875:Prophylaxis of syphillis

Benzathine penicillin G

Q2876:Prophylaxis in patients with history of recurrent UTI

TMP-SMX

Q2877:Drug of choice for prophylaxis for pneumocysticcarinii pneumonia;Alternative

TMP-SMX;Aerosolized pentamidine

Q2878:Binds ergosterol (unique to fungi); forms membranepores that allow leakage of electrolytes and disrupt

homeostasis

Amphotericin B

Q2879:Used for wide spectrum of systemic mycoses(Cryptococcus; Blastomyces; Coccidioides; Aspergillus;Histoplasma; Candida; Mucor). Intrathecally for fungal

meningitis; does NOT cross BBB

Amphotericin B

Q2880:Toxicity of Amphotericin B

NEPHROTOXICITY;Arrhythmias(amphoterrible);Fever/chills (shake and bake);Hypotension

Q2881:Binds to ergosterol; disrupting fungal membranes; usedas "swish and swallow" for oral candidiasis (thrush)

NYSTATIN

Q2882:Inhibit fungal steroid (ergosterol) synthesis

AZOLES

Q2883:Drug of choice for cryptococcal meningitis in AIDSpatients and candidal infections of all types (i.e yeast

infections)

FLuconazole

Q2884:Drug of choice for Blastomyces; Coccidioides;Histoplasma; Candida albicans; hypercortisolism

Ketoconazole

Q2885:Toxicity of azoles

Hormone synthesis inhibition (gynecomastia);Liverdysfuntion (inhibits cytochrome P450);Fever; chills

Q2886:Inhibits DNA synthesis by conversion to fluorouracilwhich competes with uracil; used in systemic fungal

infections (Candida; Cryptococcus); causes bone marrowsuppression; n/v/d

FLUCYTOSINE

Q2887:Antifungal medication; inhibits cell wall synthesis;clinically used for invasive aspergillosis; can cause GI upset

and flushing

CASPOFUNGIN

Q2888:Antifungal; inhibits fungal enzyme squalene epoxidase;used to treat dermatophytoses (especially onychomycosis)

TERBINAFINE

Q2889:Anti fungal; interferes with microtubule function;disrupts mitosis; deposits in keratin containing tissues (nails)- oral treatment of superficial infections; inhibits growth of

dermatophytes (tinea; ringworm)

GRISEOFULVIN

Q2890:Toxicity Griseofulvin

Teratogenic;Carcinogenic;Confusion';Headache;Increasedwarfarin metabolism

Q2891:Antiviral drug used for prophylaxis for influenza Aand treatment of Parkinsons

Amantadine

Q2892:Derivative of Amantadine with fewer CNS side effects

Rimantidine

Q2893:Anti viral medication; blocks biralpenetration/uncoating; may buffer pH of endosome; alsocauses release of dopamine from intact nerve terminals

Amantadien

Q2894:Toxicity of amantadine

Ataxia + dizziness+ slurred speech;Amantadine causesproblems with cerebellA

Q2895:Two antiviral medications that inhibits influenzaneuraminidase; both used for influenza A and B

Zanamivir;Oseltamivir

Q2896:Antiviral - inhibits synthesis of guanine nucleotides bycompetitively inhibiting IMP dehydrogenase; used for

treatment of RSV and chronic hep C

Ribavirin

Q2897:Toxicity for Ribavirin

Severe teratogen;Hemolytic anemia

Q2898:THis antiviral medication preferentially inhibits viralDNA polymerase when phosphorylated by viral thymidine

kinase

Acyclovir

Q2899:Antiviral medication used for treatment of VZV; HSV;EBV; mucocutaneous and genital herpes lesions; prophylaxis

in immunocompromised patients

Acyclovir

Q2900:Toxicity for acyclovir

Delirium;Tremor;Nephrotoxicity

Q2901:Antiviral drug - works by phosphorylation viralkinase; preferentially inhibits CMV DNA polymerase; drugof choice for CMV especialy in immunocopromised patients

Ganciclovir

Q2902:Which drug is more toxic - acyclovir or ganciclovir tohost enzymes

Ganciclovir

Q2903:Ganciclovir toxicity

Leukopenia;Neutropenia;Thrombocytopenia;Renal toxicity

Q2904:Viral DNA polymerase inhibitor that binds to thepyrophosphate binding site of the enzyme. Does not require

activation by viral kinase

FOSCARNET = pyroFOSphate analog

Q2905:Antiviral drug used for treatment of CMV retinitis inimmunocompromised patients when ganciclovir fails

FOSCARNET

Q2906:Patient is on foscarnet for CMV retinitis; whichtoxicity could be suspected?

Nephrotoxicity

Q2907:Saquinavir; ritonavir; indinavir; nelfinavir; aprenavir -class of drugs

HIV therapy; protease inhibitors - inhibit assembly of newvirus by blocking protease enzyme

Q2908:HIV patient is taking anti HIV drugs; develops GIintolerance - nausea; diarrhea; hyperglycemia; lipid

abnormalities; thrombocytopenia - which drugs was he taking

PROTEASE INHIBITORS

Q2909:Zidovudine (AZT); didanosine; zalcitobine; stavudine;lamivudine; abacavir - what class of drugs

Reverse transcriptase inhibitors; nucleosides

Q2910:Name non-nucleosides reverse transcriptase inhibitors

Nevirapine;Delavirdine;Efavirenz

Q2911:Toxicity associated with reverse transcriptaseinhibitors

Bone marrow suppression (neutropenia; anemia);Peripheralneuropathy;Lactic acidosis (nucleosides);Megaloblastic

anemia;Rash (non-nucleosides)

Q2912:Highly active antiretroviral therapy (HAART)generally entails combination of?

Protease inhibitors + reverse transcriptase inhibitors

Q2913:Which antiretroviral drug is used during pregnancy toreduce risk of fetal transmission

AZT

Q2914:Patient on anti HIV therapy develops megaloblasticanemia - which drug most likely caused it

AZT

Q2915:When is HAART initiated?

When patients have low CD4 counts (<500 cell/mm3) or highviral load

Q2916:Glycoproteins from human leukocytes that blockvarious stages of viral RNA and DNA synthesis; used fortreatment of chronic hep B and C; Kaposis sarcoma;Name

drug and what toxicity associated with it

Interferons;Neutropenia

Q2917:Antiparasitic drug from onchocerciasis

Ivermectin (rIVER blindness treated with IVERmectin)

Q2918:Antiparasitic drug used to treat nematode/roundworm(pinworm; whipworm) infections

Mebendazole/thiabendazole

Q2919:Antiparasitic drugs used to treat gian roundowrm(ascaris); hookworm (Necator/Ancylostoma) and pinworm

(Enterobius)

Pyrantel pamoate

Q2920:Antiparasitic used to treat trematode/fluke(shistosomes; Paragonimus; Clonorchis) and cysticercosis

Praziquantel

Q2921:Niclosamide is used to treat?

Cestode/tapeworm infections except cysticercosis

Q2922:Drug of choice for leishmaniasis

Pentavalent antimony

Q2923:Name anti malaria drugs

Chloroquine;Quinine;Mefloquine;Atovaquone;Proguanil

Q2924:Name drug used for treatment of latent hypnozoite(liver) forms of malaria (Plasmodium vivax; P.ovale)

Primaquine

Q2925:Drug of choice agains giardiasis; amebic dysentery;bacteria vaginitis; Trichomonas

Metronidazole

Q2926:Drug of choice for Chagas disease; Americantrypanosomiasis (trypanosoma cruzi)

Nifurtimox

Q2927:Drug of choice for African trypanosomiasis (sleepingsickness)

Suramin

Q2928:Cholinomimetic used for postoperative and neurogenicileus and urinary retention - activates bowel and bladder

smooth muscle

BETHANECHOL

Q2929:Direct agonist; cholinomimetic used for treatment ofglaucoma; activates ciliary muscle of eye (open angle);

pupillary sphincter (narrow angle)

Carbachol; pilocarpine

Q2930:Anticholinesterase; used in treatment of postoperativeand neurogenic ileus and urinary retention; myasthenia gravis;reversal of neuromuscular junction blockade (postoperative);

increases endogenous Ach

Neostigmine

Q2931:Anticholinesterase used in treatment of myastheniagravis - increases endogenous Ach; increases strength

Pyridostigmine

Q2932:This anticholinesterase is used for diagnosis ofmyasthenia gravis (extremely short acting); increases

endogenous Ach

Edrophonium

Q2933:Anticholinesterase; used in treatment of glaucoma(crosses BBB to CNS) and atropine overdose; increases

endogenous Ach

Physostigmine

Q2934:Anticholinergic; used for treatment of glaucoma;increases endogenous Ach

Echothiophate

Q2935:Name symptoms of cholinesterase inhibitor poisoning

DUMBBELSS;Diarrhea;Urination;Miosis;Bronchospasm;Bradycardia;Excitation of skeletal muscle;Lacrimation;Sweating

;Salivation (also abdominal cramping)

Q2936:Name substances that can lead to cholinesteraseinhibitor poisoning

Parathion and other organophosphates

Q2937:Antidote used in treatment of organophosphatepoisoning

Atropine (muscarinic antagonist) plus pralidoxime (chemicalantagonist used to regenerate active cholinesterase)

Q2938:What do you develop w/ benzodiazepines use? Whatreceptors?

Tolerance;down-regulation of B2 receptors

Q2939:Initial Tx for Status Epilepticus?

1) Diazepam;2) Lorazepam

Q2940:What drug causes sedation; ataxia and diplopia?

Phenytoin;SAD Sx.

Q2941:What is SAD Sx and who produces it?

sedation; ataxia and diplopia;Phenytoin

Q2942:What drugs causes gingival hyperplasia?

1) Phenytoin;2) Nifedipine;3) Cyclosporin

Q2943:CNS drugs

CNS drugs;

Q2944:Name the anticonvulsant that is degraded in zero-order?

Phenytoin

Q2945:What drug is used for tx of abscence seizure?

Ethosuximide

Q2946:What is the mechanism of action of ethosuximide?

blocks Ca+ in thalamic neurons

Q2947:What drug do you use for preop sedation i.v.? Itcauses amnesia;

Midazolam

Q2948:Name the drug that causes megaloblastic anemia anddecreases folic acid?

Phenytoin

Q2949:What anticovulsant causes SIADH?

Carbamazepine

Q2950:What effect does carbamazepine have on the liver?

it induces cyt P450 (+)

Q2951:What is the formula for minimal alveolar anestheticconcentration?

MAC= 1/(potency[lipid solubility]);Lipid = potency =1/MAC

Q2952:What anticonvulsant causes drug induced Ricketts orostemalacia?

Phenytoin

Q2953:DOC for trigeminal neuralgia?

Carbamazepine

Q2954:What are 3 Side/Effects (S/E)of Carbamazepine?

1) Cyt. P450 inducer (+);2) Hematotoxicity;3) increase ADH(retains water)

Q2955:What is the effect of carbamazepine and OralContraceptives?

inactivates sex steroids and O.C;lowers estriol

Q2956:What is carbamazepine the DOC for?

Trigeminal Neuralgia

Q2957:What effect does carbamazepine have on P450?

induces it

Q2958:Name two important Side/Effects (S/E) ofCarbamazepine?

1) hematotoxicity;2) SIADH

Q2959:Drug used for Anxiety/Panic?

A/P AlPrazolam

Q2960:Patien w/ depression needs to be treated but has liverfailure? Tx pt. w/ which benzos;

1) Oxazepam;2) Temazepam;3) Lorazepam;Out The Liver

Q2961:What are the three OUT THE LIVERBenzodiazepines?

Oxazepam;Temazepam;Lorazepam

Q2962:Tx for Status Epilepticus (I.V.)?

Lorazepam

Q2963:What drug is used for relaxation and detoxification forwithdrawal states?

diazepam

Q2964:Antidote for Zolpidem overdose?

Flumazenil

Q2965:Where do benzodiazepines work?

GABAa receptor;gama binding site;BZ1 hypnotic(sleep);increases frecuency of Cl- channel

Q2966:What site do benzodiazepines act in?

gama binding site;BZ 1

Q2967:What drug is antagonist at the BZ receptor?

flumazenil

Q2968:What drug acts in the BZ1 receptor but it's not abenzodiazepine?

Zolpidem

Q2969:What is the action of barbiturates [high dose]?

increase duration Cl-;opens Cl- channels;blocks Na+channels;barbiDURATES;increases duration of Cl- open

Q2970:What is the mechanism of Buspirone?

- no gaba;- partial agonist at 5HT1a;-nonsedating

Q2971:What is the action of disulfiram? Whic cellcompartment does it work on?;Increase what?

inhibits acetaldehyde dehydrogenase;- mitochondria;-increases NADH

Q2972:What is Methanol used for? (Tx)

- Ehtanol intoxication;- fomepizole

Q2973:What is the definite Tx for ethanol/fomepizoleintoxication?

Dialysis

Q2974:What is methanol degraded to?;Enzyme?

formaldehyde;- alcohol dehydrogenase

Q2975:What is the lethal dose of methanol?

5 ounces

Q2976:What is the toxic retinal dose of methanol?

5cc

Q2977:What does the Disulfiram Reaction consists of?

1) Nausea;2) Vomiting;3) Vertigo;4) Hypotension/Shock

Q2978:What causes a 3/sec spike pattern on EEG?

Abscence seizure ;Petite Mal

Q2979:What is indicated in neuropathic pain?

1) Felbamate;2) Lamotrigine;3) Gabapentin

Q2980:What are the S/E of Felbamate?

Aplastic Anemia;Acute Liver Failure

Q2981:What are the S/E of Lamotrigine?

Steven-Jonhson Sx;Rash

Q2982:What are felbamate; lamotrigine and gabapentin usedfor?

Neuropathic pain

Q2983:Name the 3 new Anticovulsants?

Felbamate;Lamotrigine;Gabapentin

Q2984:Name 3 drugs used in complex seizure tx?

Valproic Acid;Phenytoin;Carbamazepine

Q2985:Tx for Generalized Anxiety States (GAS)?

Buspirone

Q2986:How long do you wait for buspirone to take effect?

1-2 weeks

Q2987:What is divalproex used for?

Bipolar Disorder (backup)

Q2988:What is the mech. of action (M/A) for Divalproex?

Ca+ block;inhibits GABA transaminase;axonal Na+ block

Q2989:What are the A/E of Valproic Acid?

1) hePAtotoxicity;2) PAncreatitis;3) aloPEcia;4) sPIna Bifida(Teratogenic);PA PE PI;VALPA PE PI

Q2990:What combination w/ anticonvulsants have additiveCNS depression?

1) antihistamines;2) ethanol;3) sedative-hypnotics;4) opioids

Q2991:What happens if you withdrawal anticonvulsantsabruptly?

Seizure might be precipitated

Q2992:What is the Tx for Tonic-clonic seizure?

- Valproic Acid;- Phenytoin;- Carbamazepine

Q2993:This is unique to collagen?

hydroxyproline

Q2994:What is the defect in Ehlers-Danlos? name the gene

mutation of collagen gene;- lysine hydroxylase gene

Q2995:What are the symptoms of Ehlers-Danlos

hyperextensible; hypermobile joints; dislocations

Q2996:What is the defect in Menkes Dz?

inhibition of lysyl oxidase;Copper (Cu+) deficiency

Q2997:What are the symptoms in Menkes Dz?

depigmented steely hair;decrease urinary Cu+

Q2998:What disease has mutation in collagen I?

Osteogenesis Imperfecta

Q2999:What are the symptoms for Osteogenesis Imperfecta?

Pathologic Fractures;blue sclera;collagen problems

Q3000:Patient with coarse facial features; gingival hyperplasiaand macroglosia? Dx?

I-Cell Dz

Q3001:What enzyme is deficient in I-Cell Dz?

phosphotransferase

Q3002:Where in the cell is the problem in I-Cell Dz?

Golgi apparatus;Manose-6 Residues

Q3003:What are the symptoms of I-cell Dz?

coarse facial features;gingival hyperplasia;macroglosia

Q3004:Patient with deficiency in Leu; Ile and Val aminoacids?

Maple Syrup Dz

Q3005:What type of amino acids are Leu; Ile and Val?

Branched Amino Acids

Q3006:What drug inhibits activation? binds to t-RNA withribosome?

blocks initiation;Aminoglycosdies;A first letter of thealphabet

Q3007:What drug has the mechanism of inhibiting peptidyltransferase?

Chloramphenicol

Q3008:What drug inhibits aminoacyl-tRNA binding to Asite?;Elongation

Tetracycline;t is for tRNA

Q3009:What drug inhibits the translocation of tRNA?;E.F.3

Macr(ol)ides

Q3010:What bacteria have the same mechanism of action asmacrolides?

diphtheria toxin;pseduomonas toxin

Q3011:What drug is an Angiotensin II blocker?

SARTANS

Q3012:What are the effects of Sartans on aldosterone;bradykinin; AT-1

decrease aldosterone;decrease bradykinin;increase AT-1

Q3013:What is the DOC (drug of choice) for CHF (CardiacHeart Failure)?

ACE inhibitor

Q3014:What effect does ACE have on ATII; bradykinin;aldosterone; fluid; preload; afterload?

decrease ATII;increase bradykinin;decreasealdosterone;decrease fluid;increase vasodilation;decrease

preload;decrease afterload

Q3015:What it the drug used for HTN causes dry cough andangioedema?

PRILS [Ace(-)]

Q3016:Why do ACE(-) cause cough?

increases bradykinin and causes edema in the pharynx

Q3017:What drug causes disorientation; visual effects (halos);hallucinations; SVTs; AV block?

Digitalis Toxicity

Q3018:What enzymes increase cAMP in cardiac cells?

(+) adenylyl cyclase;(-) phosphodiesterase III

Q3019:What is the mechanism of action of sildenafil?

blocks PDE V;(-) phosphodiesterase V;increases cGMP

Q3020:What drug interacts with sildenafil?

Nitrous Oxide;since NO also increases cGMP

Q3021:What is the mechanism of phosphodiesterase III?What cells are involved?

inhibits conversion of cAMP to AMP ;so increase incAMP;Cardiac Cell

Q3022:What two drugs inhibit PDE III?

theophylline;inamirone

Q3023:What is the mechanism of action of inamirone?

blocks cAMP to AMP;incrases cAMP inside cardiaccell;increases force of contractilily

Q3024:What enzymes are deficient in vitamin C def?

(-) prolyl and lysyl hydroxylase

Q3025:What part of the cell are prolyl and lysylhydroxylase?

inside the R.E.R.

Q3026:What is the mechanism of action of dobutamine anddopamine?

B1 receptor;increase adenylyl cyclase (+);ATP----> increasescAMP;cAMP---> Protein Kinase;Protein Kinase opens Ca2+

channels;increase in Ca2+

Q3027:What is the mechanism of action of digoxin?

inhibits Na+/K+ ATPase;decreases sodium/Ca+ exchange;Ca+stays inside the cell;to increase contraction force;inhibited by

K+ increase

Q3028:What 5 drugs/states cause digitalis toxicity?

1) quinidine;2) NSAIDS;3) Amiodarone;4) Verapamil;5)hypokalemia

Q3029:What is the mechanism of phosphodiesterase V?

increases cGMP;blocks breakdown of cGMP--> GMP

Q3030:What drugs/compounds stimulate Gq to IP3?

Acetylcholine (Ach);Bradykinin;5HT

Q3031:What happens to Gq after it is converted to IP3?

releases Calcium

Q3032:What is Calciums effect on Nitrous Oxide?

it stimulates the conversion of L-arg to NO

Q3033:What amino acid does Nitrous Oxide derive from?

L-Arginine

Q3034:Where is does the reaction L-Arg to NO take place?

endothelium

Q3035:What does NO do inside the smooth muscle?

stimulates guanylate cyclase

Q3036:What does guanulate cyclase stimulate?

Conversion of GTP to cGMP;so increase cGMP

Q3037:What other amino acid is involved in making NO?

cysteine

Q3038:What does NO stimulate?

guanylate cyclase;and conversion of GTP to cGMP;increasescGMP

Q3039:Where in the nephron does acetazolamide act?

proximal convoluted tube

Q3040:What are the effects of acetazolamide?

decreases HCO3-

Q3041:What are the toxic effects of acetazolamide?

metabollic acidosis;neuropathy; sulfa allergy

Q3042:What happens to the urine with acetazolamide?

increase Na+ excresion;increases HCO3- excresion

Q3043:What diuretic works in the collecting ducts?

Potassium Sparing (K+) diuretics

Q3044:What are the K+ sparing diuretics?

Spirinolactone;Amiloride;Triamterene

Q3045:How is Spirinolactone different from Amiloride andtriamterene?

Spirinolactone is an Aldosterone receptor inhibitor;the othertwo are Na+ Channel blockers

Q3046:What drug blocks Na+/Cl- symport in the renalsystem?

Thiazides

Q3047:What part of the nephron do thiazides act in?

Distal Convoluted Tube;DCT

Q3048:What is used in HTN and Heart Failure (CHF)?

Thiazides

Q3049:What happens to ions in blood after thiazideadministration?

Hypokalemia;Alkalosis;HyperCAlcemia

Q3050:What are thiazides used for?

HTN and CHF

Q3051:What are the toxicities of hydrochorothiazides?

hyperGLUC;sulfa allergies

Q3052:What does hyperGLUC stand for?

hyperGlycemia;hyperLipidemia;hyperUricemia;hyperCalcemia;Sulfa Allergies

Q3053:What is the potential toxicity of K+-SparingDiuretics?

Hyperkalemia;endocrine effects likeGYNECOMASTIA!;Anti-Androgen

Q3054:Diuretic that causes hyperglycemia?

Thiazide

Q3055:What is the mechanism for thiazide acting ashyperglycemia?

blocks insulin release;opens K+ Channels;keeps insulin insideb-cells

Q3056:What diurectic causes alkalosis and hypoCalcemia?

Loop diuretics

Q3057:What diuretic causes alkalosis and hyperCalcemia?

Thiazide

Q3058:What diuretic causes acidosis and hyperKalemia?

K+ sparing

Q3059:What diuretic causes acidosis and hypoKalemia?

Carbonic Anahydrase inhibitors

Q3060:All diuretics cause what?

hypokalemia to a degree;except K+ sparing

Q3061:What is the mechanism of CA(-) Carbonic anahydraseinhibitors?

NaHCO3 diuresis;HCO3- decreases in blood so causes H+ tobe unbalanced;Acidosis

Q3062:What is the only lipid friendly thiazide?

Indapamide

Q3063:What diuretics are in the sulfa family?

CA(-);Loops

Q3064:What diuretic works on ATII? Aldosterone receptorblocker?

Spironolactone

Q3065:What mechanism does Spirinolactone use? (protein)

acts via Zinc Finger Protein;increases geneexpression;increases Na+ Channels to open

Q3066:What diuretic causes ginecomastia?

Spirinolactone

Q3067:Diuretic that causes hypoCAlcemia?

Loops;Loops Loose Calcium;Tx malignancies with it!

Q3068:Diuretic that causes hyperCalcemia?

Thiazides!

Q3069:Question

Answer

Q3070:Pharmacology Kaplan

Pharm

Q3071:What drug do Loop diuretics interfere with?

Lithium decreases clearance and increases lithium in serum

Q3072:What drug potentiates OTOtoxicity w/ Loopdiuretics?

Aminoglycosides

Q3073:What drug interacts w/ Gemfibrozil?

HMG-coA reductase inhibitors (statin drugs)

Q3074:What is the result of the DDI (drug drug interaction)of Gemfibrozil and Statin drugs?

Rhabdomyolisis increases

Q3075:What drug potentiates Gemfibrozil?

Warfarin and Sulfonylurea

Q3076:What drugs inhibit HMG-coA reductase?

Statin drugs

Q3077:What effect do statin drugs have on cytochrome p450?

increases p450 activity p450(+) inducer

Q3078:What is the effect of stain drugs on HDL and TGs?

HDL increase and decrease in TGs (triclyerides)

Q3079:What are the A/E (adverse/effects) of statin drugs?

myalgia/myopathy; rhabdomyolysis; p450(+) renal failure;death

Q3080:What antilipid drug causes flushing and pruritus(hepatotoxicity)?

Nicotinic Acid

Q3081:What is the mechanism of action of Cholestipol andCholestyramine?

they are bile acid sequestrants that prevent reabsorption ofbile salts in the GI tract

Q3082:What is the effect of decrease in bile acid?

increase synthesis of new bile salts; decrease liver cholesterol;increase LDL receptors; decrease plasma LDL

Q3083:What is contraindicated w/ bile acid sequestrants?

concomitant use with hypertriglyceridemias because theyincrease VLDL and TGs

Q3084:What do bile acid sequestrants DDI with?

DDI digoxin and warfarin; decrease their absorption

Q3085:Does HMG-coA reductase cause SLE Sx?

yes

Q3086:What ist the mechanism of action of nicotinic acid?

inhibits VLDL synthesis and apoprotein synthesis

Q3087:What is good about nicotinic acid?

increase HDL

Q3088:How do you treat the flushing and pruritus w/nicotinic acid?

ASA (aspirin)

Q3089:What is another adverse effect of nicotinic acid?

hepatotoxicity

Q3090:What drug causes flushing; sedation; dyspnea and onlyacts for t1/2 30 sec?

adenosine

Q3091:Adenosine is antagonized by?

theophilline and caffeine

Q3092:Pharmacologist refer to adenosine as?

Reset Button Dead for 30 seconds and then heart starts again

Q3093:DOC for PSVTs?

adenosine

Q3094:What are the effects of adenosine on SA and AV?

decrease SA and AV; increases AV refractory period

Q3095:What drug is an M blocker and is used for asthma andCOPD? It has no CNS entry

Ipratropium

Q3096:It's a cholinomimetic; AchE inhibitor; contracts ciliarym; increases outflow?

Pilocarpine and ECHOthiopate

Q3097:What are Pilocarpine and Echothiopate used for?

Glaucoma

Q3098:What are the three K+ channel blockers?

Amiodarone; Bretylium and Sotalol ABS system

Q3099:What do K+ channel blockers do?

slow phase 3; increase APD

Q3100:What is the mechanism of action of Quinidine?

blocks Na+ channels (decrease I Na); increase APD and ERP;M blocker; alpha block

Q3101:DOC for arrythmias following cardioversion? I.V. use

Lidocaine

Q3102:What is amiodarone used for?

Atrial and Ventricular Arrythmias

Q3103:What are the S/E of Amiodarone?

hepatic necrosis; PULMONARY FIBROSIS; CornealDeposits; BLUE Pigmentation (SMURF) Skin; Photoxocity;

Thyroid Dysfunction

Q3104:What is the t1/2 life of Amiodarone?

40 days; Largest Vd

Q3105:What is Manitol used for?

1) maintain renal function; 2) close angle glaucoma; 3) decreaseintracraneal pressure (tumor; hematoma)

Q3106:Newborn w/ strabysmus; decrease growth; midfacilhypoplasia; microcephaly; CNS Dysfunction; Thin Upperlip

(Phyltrum)

Fetal Alcohol Syndrome

Q3107:What is Benztropine and Trihexyphenidyl used for?

Parkinson's; Drug-Induced Extrapyramidal Dysfunction

Q3108:Mechanism of action of Benztropine andTrixehyphenidyl?

M Blocker

Q3109:Drug used in organophosphate poisoning?

Pralidoxime

Q3110:What does Pralidoxime do w/ symptoms?

corrects patients labored breathing and decreases muscleweakness

Q3111:What is pralidoxime used for?

Organophosphate Poisoning

Q3112:What drug is used for Parkinson and Drug-InducedExtrapyramidal Dysfunction?

Benztropine and Trihexyphnidyl

Q3113:How does alcohol produce gout?

Alcohol decreases NADH and increases NAD; increasesconversion of reversible reaction pyr ---> Lactate; Lactateincreases and competes w/ uric acid excrecion causing gout

Q3114:What biochemical compound is increased inalcoholism?

NAD+

Q3115:What 2 drugs interact with digoxin (DDI)?

Quinidine and Verapamil (the queen and the rapper alwaysinterfere)

Q3116:Drug that causes phototoxicity?

Amiodarone

Q3117:Name 3 drugs used in AchE inhibitor poisoning?

Malathion; Parathion and Sarin (nerve gas)

Q3118:What is the MOA of Hydralazine?

increase NO;increase Guanylate Cyclase;increasecGMP;relaxes vascular musculature

Q3119:What is the effect of Hydralazine on TPR?

decreases TPR;involves NO/EDRF pathway;decreasesresistnace in coronary; renal and cerebral beds

Q3120:What is hydralazine used for?

Tx for moderate to severe HTN

Q3121:What is Hydralazine metabolized by?

N-acetyltransferase

Q3122:What are A/E of hydralazine?

headache; flushing; sweating and fluid retention;part of HIP;soSLE-like symptoms

Q3123:What is used in HT emergency?

Nitroprusside

Q3124:What is the effect of nitroprusside on TPR?

decrease TRP via dilation of arterioles and venules

Q3125:What happens when there is venule dilation afternitroprusside use?

Orthostatic Hypotension

Q3126:What are by-products of nitroprusside?

thiocyanate and cyanide ions

Q3127:What part of the mitochrondria is damaged withcyanide compounds?

Comple IV (looks like N);cyt. a/a3

Q3128:What is ethylene glycol?

Anti-freeze

Q3129:What happens to ethylene glycol once ingested?

it is degraded to gycoaldehyde;- Alcohol Dehydrogenase is theenzyme

Q3130:What comes after degradation of glycoaldehyde?

glycolic acid and oxalic acid;latter is nephrotoxic

Q3131:What causes drug induced SIADH?

1) Carbamazepine;2) Chlorpropamide

Q3132:What are the symptoms in Phenytoin Intoxication?

SAD Sx;;Sedation;Ataxia;Diplopia

Q3133:Name an anticonvulsant that is Zero-Order?

Phenytoin

Q3134:What condition has an EEG with 3/sec spike pattern?

Generalized Abscence Seizure

Q3135:What is the Tx for Generalized Abscence Seizure?

Ethosuximide

Q3136:Name 4 drugs that block voltage gated axonal Na+influx of fast channels?

1) Carbamazepine;2) Phenytoin;high dose;3) Barbiturates;4)Valproic Acid

Q3137:What drug decreases Ca2+ influx through T channelsin thalamic neurons?

Ethosuximide;Valproic Acid

Q3138:What is the action on alpha 2 receptors?;1) NE;2)trasmitter release;3) platelets;4) Pancreas

1) decrease NE synthesis;2) decrease transmitter release atprejunctional nerve terminals;3) increase aggregation of

platelets;4) decrease insulin secretion;catabolism

Q3139:Effect of B1 receptors on renin?

increase renin release

Q3140:What adrenoreceptor increases insulin secretion?

beta 2 receptor stimulation

Q3141:What adrenoreceptor induces glycogenolysis?

B2 stimulation

Q3142:What adrenoreceptor causes uterine relaxation?

B2 stimulation

Q3143:amount of drug in body/_______ = Vd

plasma drug concentration (note: Vd is Volume ofDistribution)

Q3144:rate of elimination of drug/[plasma drug] = ?

CL (Clearance)

Q3145:(.7)(Vd)/CL = ?

T 1/2

Q3146:A drug infused at a constant rate reaches about 94% ofsteady state after _______ t 1/2s.

4

Q3147:A loading dose is calculated using this formula.

(Cp)(Vd)/F (note: Cp = target plasma concentration; and F =bioavailability)

Q3148:A maintenance dose is calculated using this formula.

(Cp)(CL)/F

Q3149:Rate of elimination is proportional to _______ ______in 1st order elimination.

drug concentration

Q3150:In the case of EtOH; which is elimated by _____ orderelimination; a constant amount of drug is eliminated per unit

time.

zero

Q3151:Phase ____ (I or II) reactions yield slightly polarmetabolites that are often _____ (active or inactive)

I; active

Q3152:Phase ____ (I or II) reactions yield very polarmetabolites that are often _____ (active or inactive) and are

excreted by the _______.

II; inactive; kidney

Q3153:Phase II reactions are often of this type.

conjugation

Q3154:Cytochrome P-450 is involved in _____ phase (I or II)reactions.

I

Q3155:A patent lasts for _____ years after filing forapplication.

20

Q3156:How many phases are there in drug development?

4

Q3157:Drugs are first tested in patients in phase _____ ofclinical testing; pharmacokinetic safety is determined in phase______ of clinical testing; double blind tests are done in phase

____ and post-market surveillance is done in phase _____.

2;1;3;4

Q3158:In a dose response curve; a competitive antagonistshifts the curve _____; while a non-competitive antagonist

shifts the curve ______.

right; down

Q3159:What pharmacologic relationship would determine theexistence of spare receptors?

EC50 < Kd

Q3160:What does it mean if EC50 and Kd are equal?

The system does not have spare receptors

Q3161:A partial agonist acts on the same receptor system asa full agonist? T/F

TRUE

Q3162:What's the main difference between a partial agonistand a full agonist?

A partial agonist has a lower maximal efficacy.

Q3163:Is a partial agonist less potent than a full agonist?

Not necessarily. It can be less; more or equally potent as a fullagonist.

Q3164:The penicillin type drugs work by blocking ------synthesis; specifically by inhibiting this molecule from cross-

linking?

blocks bacterial cell wall synthesis by inhibition ofpeptidoglycan synthesis.

Q3165:Which other drugs (aside from penicillin) have thissame mechanism of action?

Imipenem; aztreonam and cephalosporins

Q3166:Bacitracin; vancomycin and cycloserine block thesynthesis of this molecule; preventing cell wall synthesis

peptidoglycans

Q3167:These drugs block the 50s ribosomal subunit

clindamycin; chloramphenicol; erythromycin; lincomycin;linezolid; streptogramins "Buy AT 30; CELL at

50"

Q3168:These drugs block the 30s ribosomal subunit

Aminoglycosides and tetracyclines "Buy AT 30; CELLat 50"

Q3169:These drugs block nucleotide synthesis by interferingwith the folate pathway

Sulfonamides (e.g. Bactrim); trimethoprim

Q3170:These drugs block DNA topoisomerases

Quinolones (e.g. Cipro)

Q3171:Which drug blocks mRNA synthesis

rifampin

Q3172:Which are the bacteriacidal Abx

Penicillin; cephalosporin; vancomycin; aminoglycosides;fluoroquinolones; metronidazole

Q3173:These drugs disrupt the bacterial/fungal cellmembranes

polymyxins

Q3174:These specific disrupt fungal cell membranes

amphotericin B; nystatin; fluconazole/azoles (FAN the fungalcell membranes)

Q3175:What is the mechanism of action of Pentamidine

Unknown

Q3176:Which is the IV form and which is the oral form

G = IV; V=oral

Q3177:Which of these is not a mechanism of penicillin action:(1) binds penicillin-binding protein; (2) blocks peptidoglycansynthesis; (3) blocks transpeptidase catalyzed cross-linking

of cell wall and (4) activates autolytic enzymes

Penicillin does not block peptioglycan synthesis; bacitracin;vancomycin and cycloserine do that

Q3178:T or F: penicillin is effective against gram pos andgram neg rods

False: penicillin is used to treat common streptococci (but notstaph); meningococci; gram pos bacilli and spirochetes (i.e.

syphilis; treponema). Not used to treat gram neg rods.

Q3179:What should you watch out for when giving penicillin?

Hypersensitivity rxn (urticaria;severe pruritus) and hemolyticanemia

Q3180:These drugs are used mainly for what type ofinfection

Staphlococcal infection (hence very narrow spectrum)

Q3181:T or F: these drugs have the same mechanism of actionas penicillin

TRUE

Q3182:Are these drugs penicillinase resistant? If so why?

Bulkier R group makes these drugs resistant to penicillinase

Q3183:What should you watch out for when giving thesedrugs?

Hypersensitivity rxn (urticaria;severe pruritus); methicillincan cuase interstitial nephritis

Q3184:T or F: these drugs have the same mechanism of actionas penicillin

TRUE

Q3185:Which has greater oral bioavailability?

amOxicillin (O for Oral)

Q3186:What do you use these for?

Ampicillin/amoxicillin HELPS to kill enterococci (H.influenzae; E. coli; Listeria monocytogenes; Proteus mirabilis;

Salmonella)

Q3187:Can penicillinase effect these drugs efficacy?

Yes; they are penicillinase sensitive

Q3188:Why not give these drugs with a penicillinaseinhibitor. Name one.

clavulanic acid


Hypersensitivity rxn (ampicillin rash); pseudomembranouscolitis

Q3190:Why are these Carbenicillin; piperacillin; ticarcillinconsidered to have an extended spectrum?

Because they are effective against pseudomonas and othergram neg rods (enterobacter and some species of klebsiella)


Hypersensitivity rxn

Q3192:Why does concomitant administration with clavulanicacid increase the efficacy of these drugs?

Because they are penicillinase sensitive. (only piperacillin andticarcillin)

Q3193:What is the mechanism of action of Cephalosporins?

inhibit cell wall synthesis

Q3194:How are they similar/different from penicillin?

both have a beta-lactam ring structure but cephalosporins areless susceptible to penicillinases

Q3195:What are the main similarities/difference between 1stand 2nd generation cephalosporins?

2nd gen has extensive gram neg coverage but weaker gram poscoverage

Q3196:1st gen covers what bugs?

gram positives (staph and strep); Proteus mirabilis; E. coli;Klebsiella (PEcK)

Q3197:2nd gen covers what bugs?

gram positives (staph and strep) though less so; H.influenzae; Enterobacter aerogenes; Neisseria; Proteus

mirabilis; E. coli; Klebsiella (HEN PEcK)

Q3198:What can 3rd generation drugs do that 1st and 2ndgeneration can't?

Cross the blood brain barrier

Q3199:What are some other benefits of 3rd gen?

better activity against gram neg bugs resistant to beta-lactamdrugs. Ceftazidime for Pseudomonas and ceftriaxone for N.

gonorrhea

Q3200:What are the benefits of 4th gen (e.g. Cefipime)?

increased activity against Pseudomonas; gram pos organismsand more beta-lactamase resistant (i.e. 4th gen combines 1st

gen and 3rd gen characteristics into super drug)

Q3201:What drugs should you avoid taking withcephalosporins?

Aminoglycosides (increases nephrotoxicity) and ethanol(causes a disulfiram-like rxn -- headache; nausea; flushing;

hypotension)

Q3202:When would you use aztreonam?

Only to treat Klebsiella; Pseudomonas and Serratia spp.

Q3203:Is it beta-lactamase resistant?

Yes; this is one of the huge benefits of the drug; and it is notcross-reactive with PCN!

Q3204:Which population of pt. is this drug good for?

The PCN-allergic patient that can't take aminoglycosides b/cof renal insufficiency

Q3205:Are there any toxicity issues with this drug?

Not really. Generally well tolerated with occasional GI upset.Vertigo; Headache and rare hepatotoxicity have been reported.

Q3206:What is imipenem?

broad spectrum beta-lactamase-resistant abx

Q3207:What do you always administer it with and why?

cilastatin -- it decreases inactivation of imipenem in renaltubules

Q3208:What do you use it for?

Gram pos cocci; gram neg rods and anaerobes (broadspectrum)

Q3209:What bug is it the drug of choice for?

Enterobacter

Q3210:What are its side-effects

GI distress; skin rash; seizures at high conc.

Q3211:Is Vancomycin bactericidal or bacteriastatic and why?

Bactericidal because it blocks cross linkage and elongation ofpeptidoglycan by binding D-ala D-ala protion of cell wall.

Q3212:How does resistance to Vanco occur?

D-ala D-ala is replaced with D-ala D-lactate which vanco doesnot block

Q3213:What is it used for?

Used for serious infection that is resistant to other drugs (e.g.gram pos multi-drug resistant organisms like S. aureus and C.

difficile; methicillin resistant staph (MRSA))

Q3214:What are the important toxicities of vanco?

generally NOT many problems except; Nephrotoxicity;Ototoxicity and Thrombophlebitis

Q3215:What can happen with rapid infusion of vanco?

"Red man's" syndrome. Diffuse flushing whichcan be controlled by pretreatment with anti-histamines and

with slow infusion rate

Q3216:Which drugs target bacterial protein synthesis byblocking the 30S unit vs 50S unit?

Buy AT 30; CELL at 50

Q3217:What does AT stand for?

A = Aminoglycosides (streptomycin; gentamicin; tobramycinan damikacin. And T = Tetracyclines

Q3218:What does CELL stand for?

C = Chloramphenicol; E= Erythromycin; L= Lincomycin andL= cLindamycin

Q3219:Which of the above are bactericidal?

Only the aminoglycosides are; the rest are bacteriostatic

Q3220:Name some aminoglycosides?

Gentamicin; neomycin; amikacin; tobramycin andstreptomycin

Q3221:How do these drugs work?

They inhibit formation of the initiation complex in mRNAtranslation

Q3222:Why are they ineffective against anaerobes?

They require oxygen for uptake into bacteria

Q3223:When would you use aminoglycosides?

against severe gram-negative rod infections

Q3224:What drugs can you use aminoglycosides with forsynergy?

the drugs that inhibit cell wall synthesis (e.g. penicillin andcephalosporins -- the beta-lactam antibiotics). Presumablythis allows the drug to get in with out reliance on oxygen

transport

Q3225:What drug in this class is commonly used for bowelsurgery?

Neomycin

Q3226:What are the two major toxicities?

Nephrotoxicity (esp. when used with cephalosporins) andOtotoxicity (esp. when used with loop diuretics).

amiNOglycosides

Q3227:Name some tetracylcines

Tetracycline; doxycycline; demeclocycline; minocycline

Q3228:How does it work?

Blocks t-RNA attachment to 30S subunit

Q3229:Which tetracycline can you use in patients with renalfailure and why?

Can use doxycycline because its elimination is fecal

Q3230:Should you take these drugs with a glass of milk?

NO; because it intereferes with absorption in the gut as doesantacids and iron-containing preparations

Q3231:What are tetracyclines used for?

VACUUM your Bed Room -- Vibrio cholerae; Acne;Chlamydia; Ureaplasma; Urealyticum; Mycoplasma

pneumoniae; Borrelia burgdorferi; Rickettsia; tularemia

Q3232:What are the common toxicities

GI distress; teeth discoloration; inhibition of bone growth inchildren; Fanconi's syndrome and photosensitivity

Q3233:Name some macrolides?

Erythromycin; azithromycin; clarithromycin

Q3234:How do these drugs work?

inhibit protein synthesis

Q3235:What are they used for?

URIs; pneumonias; STDs -- gram pos cocci in patients thatare allergic to PNC --- Mycoplasm; Legionella; Chlamydia;

Neisseria.

Q3236:Pneumonic for macrolide use?

Eryc's Nipple is at his Mid Clavicular Line (Eryc is brandname for erythromycin). Mycoplasm; Legionella; Chlamydia;

Neisseria.

Q3237:What are the major toxicities?

GI discomfort; acute cholestatic hepatitis; eosinophilia; skinrashes

Q3238:What is the most common cause for non-complianceto macrolides?

GI discomfort

Q3239:How does Chloramphenicol work?

inhibits 50S peptidyltransferase

Q3240:Main use?

Meningitis (H. influenzae; N. meningitides; S. pneumo). Usedconservatively b/c of toxicity

Q3241:What are the main toxicities?

Anemia and aplastic anemia (both dose dependent); gray babysyndrome (in premes b/c they lack UDP-glucoronyl

transferase)

Q3242:How does Clindamycin work?

blocks peptide bond formation at 50S

Q3243:When do you use it?

Anaerobic infections (e.g. Bacteroides fragilis andC.perfringens)

Q3244:Toxicities?

Pseudomembranous colitis; fever; diarrhea

Q3245:Name some sulfonamides

Sulfamethoxazole (SMX); sulfisoxazole; triple sulfa andsulfadiazine


Inhibits bacterial folic acid synthesis from PABA by blockingdihydropteroate synthase.

Q3247:What are its uses?

Gram-positive; gram-negative; Nocardia; Chlamydia. Triplesulfas and SMX for simple UTIs

Q3248:Toxicities?

hypersensitivity rxn; hemolysis if G6PD deficient;nephorotoxicity (tubulointerstitial nephritis); kernicterus in

infants; displace other drugs from albumin (e.g. warfarin)

Q3249:How does Trimethoprim work?

inhibits folic acid pathway by blocking dihydrofolatereductase which humans have as well


used in combo with Sulfamethoxazole (TMP-SMX) causing asequential block of folate synthesis. Used for recurrent UTIs;

Shigella; Salmonella; and prophylaxis for PCP in AIDSpatients

Q3251:Toxicities?

Megaloblastic anemia; pancytopenia (may be alleviated withsupplemental folinic acid)

Q3252:What the most famous floroquinolone?

Ciprfloxacin (treatment for Anthrax)


inhibits DNA gyrase (topoisomerase II)


Gram neg rods or urinary and GI tract (incl. pseudomonas);Neisseria; some gram pos spp

Q3255:What population is contraindicated for use?

pregnancy and children

Q3256:What are its toxicities?

GI upset; superinfection; skin rashes; headache; dizziness andtendonitis and tendon rupture in adults. FluoroquinoLONES

hurt attachment to BONES.

Q3257:How does Metronidazole work?

forms toxic metabolites in the bacteria. Bactericidal.


anti-protozoal: Giardia; Entamoeba; Trichomonas; Gardnerellavaginalis; anaerobes (bacteroides; clostridium)

Q3259:What is the role of Metronidazole in H. pyloriinfection?

Used as part of triple therapy: bismuth; amoxicillin andmetronidazole

Q3260:Main toxicity?

disulfiram-like (antabuse) reaction to alcohol and headache

Q3261:Which drug do you use to treat anaerobic infectionsabove the diaphram and below the diaphram

anaerobes above diaphram: Clindamycin; and anaerobes belowdiaphram: metronidazole

Q3262:How does polymyxin work?

disrupts osmotic properties of bacteria; acts like a detergent


resistant gram negative infections

Q3264:Toxicities?

neurotoxicity; ATN

Q3265:How does INH work?

decreases synthesis of mycolic acid


MTB (mycobacterium tuberculosis). The only agent used assolo prophylaxis against TB

Q3267:Toxicities?

Hemolysis if G6PD deficient; neurotoxicity; hepatotoxicitiy;drug induced SLE. INH; Injures Neurons and Hepatocytes

Q3268:What vitamin prevents neurotoxicity

Vitamin B6 (pyridoxine)

Q3269:Why are toxicities particularly important to monitor inpatients taking INH?

INH half-lives are different in fast versus slow acetylators!


inhibits DNA-dependent RNA polymerase


MTB; meningococcal prophylaxis

Q3272:Toxicities?

Minor hepatotoxicity and increases P-450

Q3273:How can it be used for leprosy?

rifampin delays resistance to dapsone when used for leprosy

Q3274:What would happen if you used rifampin alone?

get rapid resistance

Q3275:What does it do to bodily fluids?

makes them red/orange in color

Q3276:What are the 4 R's of Rifampin

RNA polymerase inhibitor; Revs up microsomal p-450;Red/Orange body fluids; Resistance is rapid

Q3277:What are the anti-TB drugs?

Rifampin; Ethambutol; Streptomycin; Pyrazinamide;Isoniazid (INH) -- RESPIre

Q3278:What do you use for TB prophylaxis?

INH

Q3279:What toxicity is common to all?

hepatotoxicity

Q3280:name the enzyme that liberates AA from the cellmembrane

phospholipase A2

Q3281:what does the lipoxygenase pathway yield

leukotrienes (L for Lipoxygenase and Leukotrienes)

Q3282:LTB4 is a____

neutrophil chemotactic agent

Q3283:which leukotrienes are involved inbronchoconstriction; vasoconstriction; smooth muscle

contraction; and increased vascular permeability

LT C4; D4; E4 (SRS-A)

Q3284:what are the 3 products of the cyclooxygenasepathway?

thromboxane; prostacyclin; prostaglandin

Q3285:what are the 2 functions of TxA2

platelet aggregation; vasoconstricion

Q3286:what are the 2 functions of PGI2

inhibition of platelet aggregation; vasodilation (PlateletGathering Inhibitor)

Q3287:what are the shape and dimensions of a microtubule?

cylindrical; 24 nm in diameter; variable length.

Q3288:what are the components of a microtubule

polymerized dimers of alpha and beta tubulin (+2 GTPs perdimer)

Q3289:where are microtubules found

cilia; flagella; mitotic spindles; neuronal axons (slowaxoplasmic transport)

Q3290:antihelminthic drug that acts on microtubules

mebendazole/thiabendazole

Q3291:anti breast cancer drug that acts on microtubules(prevent disassembly)

taxol

Q3292:antifungal drug that acts on microtubules

griseofluvin

Q3293:anti cancer drug that acts on microtubules (preventassembly)

vincristine/vinblastine

Q3294:anti gout drug that acts on microtubules

cholchicine

Q3295:Most common resistance mechanism for penicillins /cephalosporins.

Beta-lactamase cleavage of beta-lactam ring.

Q3296:Most common resistance mechanism foraminoglycosides.

Modification via acetylation; adenylation; orphosphorylation.

Q3297:Most common resistance mechanism for vancomycin.

Terminal D-ala of cell wall component replaced with D-lac;decrease affinity.

Q3298:Most common resistance mechanism forChlorampenicol.

Modification via acetylation.

Q3299:Most common resistance mechanism for macrolides.

Methylation of rRNA near erythromycin's ribosome-bindingsite.

Q3300:Most common resistance mechanism for tetracycline.

Decrease uptake or increase transport out of cell.

Q3301:Most common resistance mechanism for sulfonamides.

Altered enzyme (bacterial dihydropteroate synthetase);decrease uptake; or increase PABA synthesis.

Q3302:Drug of choice for meningococcal infection.

Rifampin (drug of choice); minocycline.

Q3303:Drug of choice for gonorrhea.

Cefriaxone.

Q3304:Drug of choice for syphilis.

Benzathine penicillin G.

Q3305:Drug of choice for history of recurrent UTIs.

TMP-SMX.

Q3306:Drug of choice for Pneumocystis carinii pneumonia.

TMP-SMX (drug of choice); aerosolized pentamindine.

Q3307:Mechanism of action of the anti-fungal therapypolyenes.

Form artificial pores in the cytoplasmic membrane.

Q3308:Mechanism of action of the anti-fungal therapiesterbinafine and azoles.

Terbinafine blocks the conversion of squalene to lanosterol.Azoles block the conversion of lanosterol to ergosterol.

Q3309:Mechanism of action of the anti-fungal therapyflucytosine.

Blocks the production of purines from the precurors.

Q3310:Mechanism of action of the anti-fungal therapygriseofulvin.

Disrupts microtubles.

Q3311:Mechanism of action of Amphotericin B.

Binds ergosterol (unique to fungi); forms membrane pores thatallow leakage of electrolytes and disrupt homeostasis.

"Amphotericin 'tears' holes in the fungal membrane byforming pores."

Q3312:Clinical uses of Amphotericin B.

Used for a wide spectrum of sytemic mycoses.Cryptococcus; Blastomyces; Coccidioides; Aspergillus;

Histoplasma; Candida; Mucor (systemic mycoses).Intrathecally for fungal meningitis; does not cross blood-brain

barrier.

Q3313:Symptoms of Amphotericin B toxicity.

Fever/chills ("shake and bake"); hypotension;nephrotoxicity; arrhythmias ("amphoterrible").

Q3314:Mechanism of action of Nystatin.

Binds to ergosterol; disrupting fungal membranes.

Q3315:Clinical use of Nystatin.

"Swish and swallow" for oral candidiasis (thrush).

Q3316:Mechanism of action for fluconazole; ketoconazole;clotrimazole; miconazole; itraconazole; voriconazole.

Inhibits fungal steroid (ergosterol) synthesis.

Q3317:Clinical uses of fluconazole; ketoconazole;clotrimazole; miconazole; itraconazole; voriconazole.

Systemic mycoses. Fluconazole for cryptococcal meningitis inAIDS patients and candidal infections of all types (i.e; yeast

infections). Ketoconazole for Blastomyces; coccidioides;Histoplasma; Candida albicans; hypercortisolism.

Q3318:Symptoms of fluconazole; ketoconazole; clotrimazole;miconazole; itraconazole; voriconazole toxicity.

Hormone synthesis inhibition (gynecomastia); liverdysfunction (inhibits cytochrome P-450); fever; chills.

Q3319:Mechanism of action of Flucytosine.

Inhibits DNA synthesis byconversion to fluorouracil; whichcompetes with uracil.

Q3320:Clinical uses of Flucytosine.

Used in sytemic fungal infections (e.g. Candida;Cryptococcus).

Q3321:Symptoms of Flucytosine toxicity.

Nausea; vomitting; diarrhea; bone marrow suppression.

Q3322:Mechanism of action for Caspofungin.

Inhibits cell wall synthesis.

Q3323:Clinical use of Caspofungin.

Invasive aepergillosis.

Q3324:Symptoms of Caspofungin toxicity.

GI upset; flushing.

Q3325:Mechanism of action of Terbinafine.

Inhibits the fungal enzyme squalene epoxidase.

Q3326:Clinical use of Terbinafinel.

Used to treat dermatophytoses (especially onychomycosis).

Q3327:Mechanism of action of Griseofulvin.

Interfers with microtubule function; disrupts mitosis.Deposits in keratin-contianing tissues (e.g. nails).

Q3328:Clinical use of Griseofulvin.

Oral treatment of superficial infections; inhibits growth ofdermatophytes (tinea; ringworm).

Q3329:Symptoms of Griseofulvin toxicity.

Teratogenic; carcinogenic; confusion; headaches; increasewarfarin metabolism.

Q3330:Viral adsorption and penetration into the cell isblocked by ---------.

Gama-globulins (non-specific).

Q3331:Uncoating of the virus after its penetration into thecell is blocked by --------.

Amantadine (influenza A).

Q3332:Early viral protein synthesis is blocked by --------.

Fomivirsen (CMV).

Q3333:Viral nuclei acid synthesis is blocked by --------.

Purine; pyrimidine analogs; reverse transcriptase inhibitors.

Q3334:Late viral protein synthesis and processing is blockedby --------.

Methimazole (variola); protease inhibitors.

Q3335:Packaging and assembly of new viron is blocked by --------.

Rifampin (vaccinia).

Q3336:Mechanism of action of Amantadine.

Blocks viral penetration/uncoating; may buffer pH ofendosome. Also causes the release of dopamine from intactnerve terminals. "Amantadine blocks influenza A and

rubellA and causes problems with the cerebellA."

Q3337:Clinical uses of Amantadine.

Prophylaxis for influenza A; Parkinson's disease.

Q3338:Symptoms of Amantadine toxicity.

Ataxia; dizziness; slurred speech. (Rimantidine is a derivativewith fewer CNS side effects.)

Q3339:Zanamivir

p299

Q3340:Mechanism of action of Zanamivir.

Inhibits influenza neuraminidase.

Q3341:Clinical use of Zanamivir.

Both influenza A and B.

Q3342:Mechanism of action of Ribavirin.

Inhibits synthesis of guanine nucleotides by competitivelyinhibiting IMP dehydrogenase.

Q3343:Clinical use of Ribavirin.

RSV (respiratory syncytial virus).

Q3344:Symptoms of Ribavirin toxicity.

Hemolytic anemia. Severe teratogen.

Q3345:Mechanism of aciton of Acyclovir.

Perferentially inhibits viral DNA polymerase whenphosphorylated by viral thymidine kinase.

Q3346:Clinical use of Acyclovir.

HSV; VZV; EBV. Mucocutaneous and genital herpes lesions.Prophylaxis in immunocompromised patients.

Q3347:Symptoms of Acyclovir toxicity.

Delirium; tremor; nephrotoxicity.

Q3348:Mechanism of action of Ganciclovir.

Phosphorlation by viral kinase; perferentially inhibits CMVDNA polymerase.

Q3349:Clinical use of Ganciclovir.

CMV; especially in immunocompromised patients.

Q3350:Symptoms of Ganciclovir toxicity.

Leukopenia; neutropenia; thrombocytopenia; renal toxicity.More toxic to host enzymes than acyclovir.

Q3351:Mechanism of action of Foscarnet.

Viral DNA polymerase inhibitor that binds to thepyrophophate binding site of the enzyme. Does not require

activation by viral kinase. "FOScarnet = pyroFOSphateanalog."

Q3352:Clinical use of Foscarnet.

CMV retinitis in immunocompromised patients whenganciclovir fails.

Q3353:Symptoms of Foscarnet toxicity.

Nephrotoxicity.

Q3354:Saquinavir; ritonavir; indinavir; nelfinavir; amprenavirare example of this type of anti-HIV drug.

Protease inhibitor.

Q3355:Mechanism of action of protease inhibitors.

Inhibit assembly of new virus by blocking protease enzyme.

Q3356:Symptoms of protease inhibitor toxicity.

GI intolerance (nausea; diarrhea); hyperglycemia; lipidabnormalities; thrombocytopenia (indinavir).

Q3357:Zidovudine (AZT); didanosine (ddI); zalcitabine(ddC); stavudine (d4T); lamivudine (3TC); and abacavir are

examples of --------- reverse transcriptase inhibitors.

Nucleoside.

Q3358:Nevirapine; delavirdine; and efavirenz are examples of--------- reverse transcriptase inhibitors.

Non-nucleoside.

Q3359:Mechanism of action of reverse transcriptaseinhibitors.

Preferentially inhibit reverse transcriptase of HIV; preventincorporation of viral genome into host DNA.

Q3360:Symptoms of reverse transcriptase inhibitor toxicity.

Bone marrow supression (neutropenia; anemia); periphralneuropathy; lactic acidosis (nucleosides); rash (non-

nucleosides); megaloblastic anemia (AZT).

Q3361:Highly active antiretroviral therapy (HAART)generally entails combination therapy with ---------- and -------

----.

Protease inhibitors; reverse transcriptase inhibitors.

Q3362:When should HIV therapy be initiated?

When patients have low CD4 counts (<500 cells/mm3) orhigh viral load.

#NAME?

AZT.

Q3364:Mechanism of action of Interferons.

Glycoproteins from human leukocytes that block variousstages of viral RNA and DNA synthesis.

Q3365:Clinical use of Interferons.

Chronic hepatitis B and C; Kaposi's sarcoma.

Q3366:Symptoms of Interferon toxicity.

Neutropenia.

Q3367:Clinical uses of Ivermectin.

Onchocerciasis "rIVER blindness treated withIVERmectin"

Q3368:Clinical uses of Mebendazole / thiabendazole.

Nematode/roundworm (e.g; pinworm; whipworm) infections.

Q3369:Clinical uses of Pyrantel pamoate.

Giant roundworm (Ascaris); hookworm(Necator/Ancylostoma); pinworm (Enterobius).

Q3370:Clinical uses of Praziquantel.

Trematode/fluke (e.g; schistosomes; Paragonimus; Clonorchis)and cysticercosis.

Q3371:Clinical uss of Niclosamide

Cestode/tapeworm (e.g; Diphyllobothrium latum; Taeniaspecies) infections except cysticercosis.

Q3372:Clinical uses of Pentavalent antimony.

Leishmaniasis.

Q3373:Clinical uses of Chloroquine; quinine; mefloquine;atovaquone; proguanil.

Malaria.

Q3374:Clinical uses of Primaquine.

Latent hypnozoite (liver) forms of malaria (Plasmodiumvivax; P.ovale).

Q3375:Clinical uses of Metronidazole.

Giardiasis; amebic dysentery (Entamoeba histolytica);bacterial vaginitis (Gardnerella vaginalis); Trichomonas.

Q3376:Clinical uses of Pentamidine.

Pneumocystis carinii pneumonia prophylaxis.

Q3377:Clinical uses of Nifurtimox.

Chagas' disease; American trypanosomiasis (Trypanosomacruzi).

Q3378:Clinical uses of Suramin.

African trypanosomiasis (sleeping sickness).

Q3379:Parasympathetic preganglionic neurons release theneurotransmitter -------- which act on -------- receptors.

Ach; nicotinic.

Q3380:Sympathetic preganglionic neurons to sweat glandsrelease the neurotransmitter ------- which act on -------

receptors.

Ach; nicotinic.

Q3381:Ach is synthesized from acetyl-CoA and choline bythe enzyme ---------.

Choline acetyltransferase.

Q3382:In the noradrenergic nerve terminal; tyrosine ishydroxylated to -------; which is decarboxylated to --------;

which is finally hydroxylated to NE.

DOPA; dopamine.

Q3383:The action of NE and DA is terminated by ---------and ----------.

Reuptake; diffusion (different than for Ach).

Q3384:The drugs --------- and ---------- inhibit the reuptake ofNE.

Cocaine; TCA.

Q3385:Ach inhibits the release of NE from the noradrenergicnerve terminal by binding to --------- receptors.

M1.

Q3386:Clinical application and action of Carbachol andPilocarpine.

Glaucoma. / Activates ciliary muscle of eye (open angle);pupillary sphincter (narrow angle).

Q3387:Clinical application / action of Neostigmine.

Postoperative and neurogenic ileus and urinary retention;myasthenia gravis; reversal of neuromuscular junctionblockade (postoperative). / Increase endogenous Ach.

Q3388:Clinical application / action of Pyridostigmine.

Myasthenia gravis. / Increase Ach; increase strength.

Q3389:Clinical application / action of Physostigmine.

Glaucoma (crosses blood-brain barrier) and atropine overdose./ Increase endogenous Ach.

Q3390:Clinical application / action of Echothiophate.

Glaucoma. / Increase endogenous Ach.

Q3391:Symptoms of cholinesterase inhibitor poisoning.

Diarrhea; Urination; Miosis; Bronchospasm; Bradycardia;Excitation of skeletal muscle and CNS; Lacrimation; Sweating;

Salivation (also abdominal cramping)."DUMBBELSS"

Q3392:Cholinesterase inhibitor poisoning may be caused by ---------.

Parathion and other organophosphates.

Q3393:The cholinesterase regenerator ------- can be used as anantidote for cholinesterase inhibitor poisoning.

Pralidoxime.

Q3394:Mechanism of action of Pralidoxime.

Regenerates active cholinesterase; chemical antagonist; used totreat organophosphate exposure.

Q3395:Clinical uses of the muscarinic antagonist Atropine.

Dilate pupils; decrease acid secretion in peptic ulcer disease;decrease urgency in mild cystitis; decrease GI motility; reduce

airway secretions; and treat organophosphate poisoning."Blocks SLUD: Salivation; Lacrimation; Urination;

Defecation."

Q3396:Side effects of Atropine.

Increase body temp; rapid pulse; dry mouth; dry/flushed skin;disorientation; mydriasis with cycloplegia; and constipation."Atropine parasympathetic block side effects: Blind asbat; Red as a beet; Mad as a hatter; Hot as a hare; Dry as a

bone."

Q3397:Hexamethonium (ganglionic blocker) blocks --------receptors.

Nicotinic.

Q3398:"tropi" are anti-muscarinic

while vacationing in the tropics you lie on a beach and yourmuscles waste away!

Q3399:benztropine is used to treat

Parkinson's disease

Q3400:scopolamine is used to treat

motion sickness

Q3401:name 2 antimuscarinic drugs that act on the CNS

benztropine; scopolamine

Q3402:name a muscarinic used to treat motion sickness

scopolamine

Q3403:name a muscarinic used to treat Parkinson's disease

benztropine

Q3404:mechanism of action of benztropine

antimuscarinic

Q3405:mechanism of action of scopolamine

antimuscarinic

Q3406:name three antimuscarinics that act on eye

atropine; homatropine; tropicamide

Q3407:the action of atropine is ______


Q3408:mechanism of atropine is

antimuscarinic

Q3409:the action of homatropine is ______


Q3410:mechanism of homatropine is

antimuscarinic

Q3411:the action of tropicamide is


Q3412:mechanism of tropicamide is

antimuscarinic

Q3413:ipatropium is used to treat

asthma; COPD

Q3414:mechanism of ipatropium is

antimuscarinic

Q3415:name an antimuscarinic used to treat asthma andCOPD

ipatropium

Q3416:neuromuscular blocking drugs are used for

muscle paralysis in surgery or mechanical ventilation

Q3417:name a depolarising neurmuscular blocking drug

succinylcholine

Q3418:name 6 nondepolarizing neuromuscular blocking drugs

tubocurarine

Q3419:*mnemonic -- the "cur" drugs arenondepolarizing neuromuscular blocking agents

Atracurium; mivacurium; pancuronium; vecuronium;rapacuronium

Q3420:is succinylcholine depolarizing or nondepolarizing?

depolarizing

Q3421:is tubocurarine depolarizing or nondepolarizing?

nondepolarizing

Q3422:is atracurium depolarizing or nondepolarizing?

nondepolarizing

Q3423:is mivacurium depolarizing or nondepolarizing?

nondepolarizing

Q3424:is pancuronium depolarizing or nondepolarizing?

nondepolarizing

Q3425:is vacuronium depolarizing or nondepolarizing?

nondepolarizing

Q3426:is rapacuronium depolarizing or nondepolarizing?

nondepolarizing

Q3427:what is tubocurarine used for

nondepolarizing neuromuscular blockade

Q3428:what agents are used to reverse neuromuscularblockade by succinylcholine?

cholinesterase inhibitors in phase II (ex -- neostigmine)

Q3429:what phase of succinylcholine neuomuscularbloackade is reversible?

phase II (repolarized but blocked)

Q3430:what agents are used to reverse pahse I neuromuscularblockade by succinylcholine?

phase I Succinylcholine neuromuscular blockade cannot bereversed

Q3431:what phase of succinylcholine neuomuscularbloackade is irreversible?

phase I Succinylcholine neuromuscular blockade cannot bereversed

Q3432:what is atracurium used for


Q3433:what is the effect of cholinesterase inhibitors onsuccinylcholine neuromuscular blockade?

phase I: cholinesterase inhibitors potentiates the blockadephase II: cholinesterase inhibitors reverse the blockade

Q3434:what cholinesterase inhibitor is used to reverse phaseII of succinylcholine neuromuscular blockade?

neostigmine

Q3435:what is mivacurium used for



treat malignant hyperthermia

Q3437:what causes malignant hyperthermia

use inhalation anesthetics and succinylcholine together

Q3438:what inhalation anesthetic DOES NOT causemalignanat hyperthermia?

N2O


neuroleptic malignant syndrome

Q3440:what is neuroleptic malignant syndrome

a toxicity of antipsychotic drugs

Q3441:what drug is used to treat malignant hyperthermia

dantrolene

Q3442:what is the mechanism of dantrolene

prevents release of Ca++ from saarcoplasmic reticulum ofskeletal muscle

Q3443:epinephrine; NE; isoproterenol; dopamine; anddobutamine are all________________

catecholamines

Q3444:catecholamines are_____________________

sympathomimetics

Q3445:name 5 catecholamines

EPI; NE; Isoproterenol; dopamine; dobutamine

Q3446:what receptors does epinephrine act on?

alpha-1; alpha-2; beta-1; beta-2 adrenergics

Q3447:what receptors does NE work on?

alpha-1; alpha-2; beta-1 adrenergics

Q3448:what receptors does isoproterenol work on?

beta-1 = beta-2 adrenergics

Q3449:what receptors does dopamine work on?

D1 = D2; D1 and D2 more than beta; beta more than alpha

Q3450:what receptors does dobutamine work on?

beta-1 > beta-2

Q3451:which catecholamines are agonists to alpha-adrenergicreceptors

EPI; NE > dopamine

Q3452:which catecholamines are agonists to beta-1 adrenergicreceptors

EPI; NE; Isoproterenol; dopamine; dobutamine

Q3453:which catecholamines are agonists to beta-2 adrenergicreceptors

EPI; isoproterenol; dopamine and dobutamine (less)

Q3454:what is epinephrine used to treat?

anaphylaxis; open-angle glaucoma; asthma; hypotension

Q3455:what is norepinephrine used to treat?

hypotension (but decreases renal perfusion)

Q3456:what is isoproterenol used to treat?

AV block

Q3457:what is dopamine used to treat

shock with renal failure; heart failure

Q3458:what is dobutamine used to treat

shock; heart failure

Q3459:what catecholamine is used to treat anaphylaxis

epinephrine ("EPI-pen")

Q3460:what catecholamines are used to treat hypotension

EPI; NE

Q3461:what catecholamine is used to treat asthma

epinephrine

Q3462:what catecholamine is used to treat AV block

isoproterenol

Q3463:what catecholamines are used to treat shock

doapmine; dobutamine

Q3464:what is the action of amphetamine

indirect general adrenergic agonist; releases storedcatecholamines

Q3465:what is the action of ephedrine

indirect general adrenergic agonist; releases storedcatecholamines

Q3466:what is amphetamine used to treat

narcolepsy; obesity; attention deficit disorder

Q3467:what is ephedrine used to treat

nasal decongestion; urinary incontinence; hypotension

Q3468:name three sympathomimetic drugs used to treathypotension

epinephrine; norepinephrin; ephedrine

Q3469:what is the action of phenylephrine

adrenergic agonist; alpha-1 > alpha-2

Q3470:what is the action of albuterol

adrenergic agonist; beta-2 >beta-1

Q3471:what is the action of terbutaline

adrenergic agonist; beta-2 >beta-2

Q3472:what is phenylephrine used for?

pupil dilator; vasoconstriction; nasal decongestion

Q3473:what sympathomimetics are used to treat nasalcongestion

ephedrine; phenylephrine

Q3474:what is the mechanism of cocaine

indirect general adrenergic agonist; catecholamine uptakeinhibitor

Q3475:what is the action of cocaine

vasoconstriction; local anesthesia

Q3476:what is the mechanism of clonidine

centrally acting alpha-adrenergic agonist; decreases centraladrenergic outflow

Q3477:what drug has the same mechanism as amphetamine

ephedrine

Q3478:what is the mechanism of alpha-methyldopa

centrally acting alpha-adrenergic agonist; decreases centraladrenergic outflow

Q3479:what drug has the same mechanism as clonidine

alpha-methyldopa

Q3480:what are clonidine and alpha-methyldopa used to treat

hypertension; especially in renal disease because they do notdecreased blood flow to the kidney

Q3481:what sympathomimetic is used to treat urinaryincontinence

ephedrine

Q3482:what sympathomimetic is used to treat attentiondeficit disorder

amphetamine

Q3483:what sympathomimetic is used to treat narcolepsy

amphetamine

Q3484:name a nonselective irreversible alpha blocker

phenoxybenzamine

Q3485:name a nonselective reversible alpha blocker

phentolamine

Q3486:what is the mechanism of phenoxybenzamine

nonselective irreversible alpha blocker

Q3487:what is the mechanism of phentolamine

nonselective reversible alpha blocker

Q3488:what are phenoxybenzamine and phentolamine usedfor

pheochromocytoma

Q3489:what are the side effects of nonselective alpha blockers

orthostatic hypotension; reflex tachycardia

Q3490:name 3 alpha-1 selective adrenergic blockers

prazosin; terazosin; doxazosin

Q3491:what is the mechanism of prazosin

alpha-1 selective adrenergic blocker

Q3492:what is the mechanism of terazosin


Q3493:what is the mechanism of doxazosin


Q3494:what are alpha-1 selective adrenergic alpha blockersused for

hypertension; urinary retention in BPH

Q3495:what are the side effects of alpha-1 blockers

orthostatic hypotension; dizziness; headache

Q3496:what is prazosin used for?

hypertension; urinary retention in BPH

Q3497:what drugs have the same action as prazosin

terazosin; doxazosin

Q3498:what are the side effects of terazosin?

orthostatic hypotension; dizziness; headache

Q3499:what selective alpha blockers cause orthostatichypotension

phenoxybenzamine; phentolamine; terazosin; prazosin;doxazosin

Q3500:name an alpha-2 selective adrenergic blocker

yohimbine

Q3501:what is yohimbine used for

impotence (effectiveness controversial)

Q3502:what alpha blockers are used to treatpheochromocytoma

phenoxybenzamine; phentolamine

Q3503:name some beta-blockers

propranolol; metoprolol; atenolol; nadolol; timolol; pindolol;esmolol; labetalol

Q3504:what is the mechanism of propanolol

selective beta-adrenergic blocker

Q3505:what is the mechanism of metoprolol


Q3506:what is the mechanism of esmolol


Q3507:what is the mechanism of pindolol


Q3508:what are beta-blockers used to treat

hypertension; angina; MI; SVT; CHF; glaucoma

Q3509:how do beta blockers treat hypertension

decrease cardiac output; decrease renin secretion

Q3510:how do beta blockers treat angina

decrease heart rate; decrease cardiac contractility; decreasedO2 consumption

Q3511:why are beta blockers used to treat MI

decrease MI mortality

Q3512:which beta blockers are used to treat SVT

propanolol; esmolol

Q3513:how do propanolol and esmolol treat SVT

decrease AV conduction velocity

Q3514:how do beta blockers treat CHF

slow progression of chronic failure

Q3515:which beta blocker is used to treat glaucoma

timolol

Q3516:what is timolol used to treat glaucoma

decrease secretion of aqueous humor

Q3517:what are the toxic effects of beta blockers

impotence; exacerbation of asthma; caution in diabetes

Q3518:what are the cardiovascular toxic effects of betablockers

bradychardia; AV block; CHF

Q3519:what are the CNS adverse effects of beta blockers

sedation; sleep alterations

Q3520:which beta blockers are beta-1 selective

acebutolol; betaxolol; esmolol; atenolol; metaprolol (A BEAMof beta-1 blockers)

Q3521:which beta-1 blocker is short-acting

esmolol

Q3522:which beta blockers are non-selective

propanolol; timolol; pindolol; nadolol; labetalol

Q3523:which beta blocker also blocks alpha receptors

labetalol (all others are spelled "olol")

Q3524:which alpha agonists are used to treat glaucoma

epinephrine; brimonidine

Q3525:which beta blockers are used to treat glaucoma

timolol; betxolol; carteolol

Q3526:which cholinomimetics are used to treat glaucoma

pilocarpine; carbachol; physostigmine; echothiophate

Q3527:which diuretics are used to treat glaucoma

acetazolamide; dorzolamide; brinzolamide

Q3528:which prostaglandin is used to treat glaucoma

latanoprost

Q3529:what classes of drugs are used to treat glaucoma

alpha agonists; beta blockers; cholinomimetics; diuretics;prostaglandins (*mnemonic -- treating glaucoma is easy as

ABCD)

Q3530:what is the effect of epinephrine in glaucoma

increase outflow of aqueous humor

Q3531:what are the side effects of epinephrine treatment inglaucoma

mydriasis; stinging

Q3532:what glaucoma should epinephrine NOT be used for

closed-angle glaucoma

Q3533:what is the effect of brimonidine in glaucoma

decreased aqueous humor synthesis

Q3534:what are the side effects of brimonidine treatment inglaucoma

no pupillary or vision changes

Q3535:what is the effect of beta-blocker treatment inglaucoma

decrease aqueous humor secretion

Q3536:what are the side effects of beta blocker treatment inglauzoma


Q3537:what is the effect of cholinomimetics in glaucoma

ciliary muscle contraction; opening of trabecular meshwork;increase outflow of aqueous humor

Q3538:what are the side effects of cholinomimetics inglaucoma

miosis; cyclospasm

Q3539:what is the effect of diuretic treatment in glaucoma

inhibition of carbonic anhydrase --> decrease HCO3secretion --> decrease aqueous humor secretion

Q3540:what are the side effects of diuretics in glaucoma


Q3541:what is the effect of prostaglandin (latanoprost)treatment in glaucoma

increase outflow of aqueous humor

Q3542:what is the side effect of prostaglandin treatment inglaucoma

darkens color of iris (browning)

Q3543:which drugs used to treat glaucoma increase outflow ofaqueous humor

cholinomimetics; prostaglandin; epinephrine

Q3544:can you use epinephrine in closed-angle glaucoma

NO

Q3545:brimonidine is used to treat what eye disease

glaucoma

Q3546:what kind of drug is latanoprost

prostaglandin

Q3547:latanoprost is used to treat what eye disease

glaucoma

Q3548:which glaucoma drugs decrease aqueous secretion

beta blockers; diuretics

Q3549:what does L-dopa stand for

levodopa

Q3550:what is the mechanism of action of L-dopa/carbidopa

increase dopamine level in brain

Q3551:what is L-dopa/carbidopa used to treat

Parkinson's disease

Q3552:how is L-dopa different from dopamine

L-dopa can cross the blood-brain barrier; dopamine cannot

Q3553:what happens to L-dopa after it crosses the BBB

converted to dopamine by dopa decarboxylase

Q3554:what enzyme convertes L-dopa to dopamine

dopa decarboxylase

Q3555:what is the function of carbidopa

peripheral decarboxylase inhibitor

Q3556:why is carbidopa given with L-dopa

increase L-dopa availability in CNS by inhibitingdecarboxylase in periphery; also limits peripheral side effects

Q3557:what are the side effects of L-dopa.carbidopatreatment

arrhythmias; dyskinesias

Q3558:why do patients taking L-dopa get arrhythmias

peripheral effects of dopamine

Q3559:why do patients taking L-dopa get dyskinesias

excess dopamine stimulation in CNS

Q3560:what drugs are used to treat Parkinson's disease

dopamine agonists; MAO inhibitors; antimuscarinics

Q3561:specifically; which drugs are used to treat Parkinson's

Bromocriptine; Amantadine; Levodopa; Selegiline;Antimuscarinics (BALSA)

Q3562:which dopamine agosts are used to treat Parkinson's

L-dopa/carbidopa; bromocriptine; pramipexole; ropinirole;amantadine

Q3563:what is the action of bromocriptine in Parkinson's

ergot alkaloid; partial dopamine agonist

Q3564:what is the action of amantadine in Parkinson's

enhances dopamine release

Q3565:what MAOI is used to treat Parkinson's

selegiline

Q3566:what is the mechanism of selegiline

selective MAO type B inhibitor

Q3567:what antimuscarinic is used to treat Parkinson's

benztropine

Q3568:what is the effect of benztropine in Parkinson's

improves tremor; rigidity; little effect on bradykinesia

Q3569:what is sumatriptan used for

acute migraine; cluster headache attacks

Q3570:what is the mechanism of sumatriptan

5-HT1D agonist

Q3571:what is the half life of sumatriptan

less than 2 hours

Q3572:what are the side effects of sumatriptan

chest discomfort; mild tingling

Q3573:what are the contraindications for sumatriptan

patients with CAD or Prinzmetal's angina

Q3574:which drugs are used for simple and complex partialseizures

phenytoin; carbamazapine; lamotrigine; gabapentin;topiramate; phenobarbital

Q3575:what types of seizures is phenytoin indicated for

simple and complex partial; tonic-clonic; status epilepticus

Q3576:what types of seizures is carbamazepine indicated for

simple and complex partial; tonic-clonic

Q3577:what types of seizures is lamotrigine indicated for


Q3578:what types of seizures is gabapentin indicated for


Q3579:what types of seizures is topiramate indicated for

simple and complex partial

Q3580:what types of seizures is phenobarbital indicated for


Q3581:what drugs can be used for tonic-clonic seizures

phenytoin; carbamazapine; lamotrigine; gabapentin;phenobarbital; valproate

Q3582:what drugs can be used for absence seizures

valproate; ethosuximide

Q3583:what drugs can be used for status epilepticus

phenytoin; benzodiazapines (diazepam; lorazepam)

Q3584:what types of seizure is valproate indicated for

tonic-clonic; absence

Q3585:what types of seizure is ethosuximide inidcated for

absence

Q3586:what type of seizure are benzodiazepines indicated for

status epilepticus

Q3587:other than anti-seizure; what else is phenytoin usedfor

class 1B anti-arrhythmic

Q3588:how should a patient taking carbamazepine befollowed

monitor LFT's weekly

Q3589:which seizure drugs have adjunct use

gabapentin; topiramate

Q3590:which seizure drug is safest in pregnant women

phenobarbital

Q3591:which seizure drug is used in Crigler-Najjar II

phenobarbital

Q3592:what are the advantages of phenobarbital

can be used in pregnant women; Crigler Najjar II

Q3593:what are the side effects of benzodiazepines

sedation; tolerance; dependence

Q3594:what are the side effects of carbamazepine

diplopia; ataxia; CYP induction; blood dyscrasias; livertoxicity

Q3595:what are the side effects of ethosuximide

GI distress; lethargy; headache; urticaria; Stevens-Johnsonsyndrome

Q3596:what are the side effects of phenobarbital

sedation; CYP induction; tolerance; dependence

Q3597:what are the side effects of phenytoin

nystagmus; diplopia; ataxia; sedation; ginigival hyperplasia;hirsutism; anemias; teratogenic

Q3598:what are the side effects of valproate

GI distress; rare by fatal hepatotoxicity; neural tube defects(spina bifida)

Q3599:what are the side effects of lamotrigine

life-threatening rash; Stevens-Johnson syndrome

Q3600:what are the side effects of gabapentin

sedation; movement disorders

Q3601:what are the side effects of topiramate

sedation; mental dulling; kidney stones; weight loss

Q3602:which anti-epileptic drug is teratogenic

phenytoin

Q3603:which anti-epileptic drug can cause dependence

benzodiazepines; phenobarbital

Q3604:which anti-epileptic drug can cause neural tube defects

valproate

Q3605:which anti-epileptic drugs can cause GI distress

valproate; ethosuximide

Q3606:it is necessary to check LFT's with which anti-epileptic drugs

carbamazepine; valproate

Q3607:which anti-epileptic drugs cause CYP induction

phenobarbital; carbamazepine

Q3608:which anti-epileptic drugs can cause blood problems

carbamazepine; phenytoin

Q3609:which anti-epileptic drugs can cause Stevens-Johnsonsyndrome

lamotrigine; ethosuximide

Q3610:which anti-epileptic drugs can cause diplopia

carbamazepine; phenytoin

Q3611:what is the mechanism of phenytoin action

use-dependent blockade of Na+ channels

Q3612:what is the clinical application of phenytoin

grand mal seizures

Q3613:what are the toxicities of phenytoin

nystagmus; ataxia; diplopia; lethargy

Q3614:what are the chronic toxicities of phenytoin

gingival hyperplasia in children; peripheral neuropathy;hirsutism; megaloblastic anemia; malignant hyperthermia

(rare)

Q3615:should pregnant women take phenytoin

NO -- teratogenic

Q3616:why does phenytoin cause megaloblastic anemia

causes decreased vitamin B-12

Q3617:name 4 barbiturates

phenobarbital; pentobarbital; thiopental; secobarbital

Q3618:what is the mechanism of barbiturate action

increase duration of Cl channel opening --> decreasedneuron firing --> facilitate GABA-A action

Q3619:how do barbiturates facilitate GABA-A action

increase duration of Cl channel opening which decreasesneuron firing (Barbidurate increases duration

Q3620:is barbiturate action on the CNS stimulatory orinhibitory

inhibitory

Q3621:what is the clinical application of barbiturates

sedative for anxiety; seizures; insomnia; anesthesia induction(thiopental)

Q3622:which barbiturate is used for anesthesia induction

thiopental

Q3623:what are the side effects of barbiturates

dependence; additive CNS depression effects with alcohol;respiratory or CV depression (death); drug interactions due to

CYP induction

Q3624:what should you find out before giving a patientbarbiturates

what other medications they take; because of CYP inductionand many drug interactions

Q3625:what happens if you give barbiturates to a patient inalcohol-induced coma or DT's

they might DIE!! Because of additive effect of barbituratesand alcohol --> respiratory depression

Q3626:when are barbiturates contra-indicated

porphyria

Q3627:can barbiturates cause dependence

YES

Q3628:My friend Barb was very anxious so her doctor gaveher barbiturates to increase the duration of the time she couldspeak in public without freaking out and having a seizure. She

became so dependent on it that she recommended it to herfriend Portia who couldn't take it because of porphyria. Oneday Barb drank too much alcohol and took her barbiturates

and never woke up! THE END

clinical pharmacology made ridiculous. Period

Q3629:name a bunch of benzodiazepines

diazepam; lorazepam; triazolam; temazepam; oxazepam;midazolam; chlordiazepoxide (all have ZZZ in them)

Q3630:what is the mechanism of benzodiazepines

increase frequency of Cl channel opening --> facilitateGABA-A action (Frenzodiazepines increase frequency)

Q3631:which GABA receptors are facilitated by barbituratesand bezodiazepines

GABA-A

Q3632:what are the clinical applications of benzodiazepines

anxiety; spasticity; status epilepticus (diazepam);detoxification (alcohol withdrawal; DT's)

Q3633:which benzodiazepine can be used for statusepilepticus

diazepam

Q3634:what drugs can be used to treat alcohol withdrawal

benzodiazepines

Q3635:which benzodiazepines are short-acting

TOM thumb: Triazolam; Oxazepam; Midazolam

Q3636:what are the toxic effects of benzos

dependence; additive CNS depression effects with alcohol

Q3637:how are benzos better than barbiturates

less respiratory depression and coma risk

Q3638:how do you treat benzo overdose

flumazenil

Q3639:what is flumzenil used for

benzo overdose

Q3640:how does flumazenil work

competitive antagonist at GABA receptor

Q3641:can a patient become benzodiazepine dependent

YES

Q3642:are barbiturates or benzodiazepines used for alcoholwithdrawal

benzodiazepines

Q3643:what is another name for antipsychotics

neuroleptics

Q3644:name 4 antipsychotic drugs

thioridazine; haloperidol; fluphenazine; chlorpromazine

Q3645:how do you keep benzos straight from antipsychotics

Benzos help 3rd year Jon Kazam be less anxious aroundpatients: Shazam Kazam! Without antipsychotics patients

talk like a crazy 'zine (well; not perfect; but I'm working on it)

Q3646:what is the mechanism of most antipsychotics

block dopamine D2 receptors

Q3647:what is the clinical application of antipsychotics

schizophrenia; psychosis

Q3648:what are the side effects of antipsychotics

extrapyramidal side effects (EPS); sedation; endocrine;muscarinic blockade; alpha blockade; histamine blockade

Q3649:what is a long-term effect of antipsychotic use

tardive dyskinesia

Q3650:what is neuroleptic malignant syndrome

a side effect of antipsychotics; rigidity; autonomic instability;hyperpyrexia

Q3651:how do you treat neuroleptic malignant syndrome

dantrolene; dopamine agonists

Q3652:what is tardive dyskinesia

side effect of neuroleptics; stereotypic oral-facial movements;may be due to dopamine receptor sensitization

Q3653:what is the "rule of 4" with EPS sideeffects from antipsychotic drugs

evolution of EPS side effects: 4 hours -- acite dystonia; 4 days-- akinesia; 4 weeks -- akasthesia; 4 months -- tardvie

dyskinesia

Q3654:is tardvie dyskinesia reversible

often irreversible

Q3655:what is fluphenazine used for

schizophrenia; psychosis

Q3656:name 3 atypical antipsychotics

clozapine; olanzapine; risperidone

Q3657:what type of antipsychotic is clozapine

atypical

Q3658:what type of antipsychotic is olanzapine

atypical

Q3659:what type of antipsychotic is risperidone

atypical

Q3660:what is the mechanism of atypical antipsychotics

block 5-HT2 and dopamine receptors

Q3661:what is the mechanism of clozapine


Q3662:what is the mechanism of olanzapine


Q3663:what is the mechanism of risperidone


Q3664:what is the clinical application of clozapine

schizophrenia positive and negative symptoms

Q3665:what is the clinical application of olanzapine

schizophrenia positive and negative symptoms; OCD; anxietydisorder; depression

Q3666:what is the clinical application of risperidone

schizophrenia positive and negative symptoms

Q3667:how are atypical antipsychotics different from classicones

atypicals treat positive and negative symptoms ofschizophrenia; fewer extrapyramidal and anticholinergic side

effects than classic antipsychotics

Q3668:which antipsychotics should be used to treat positiveand negative symptoms of schizophrenia

atypical ones -- clozapine; olanzapine; risperidone

Q3669:which antipsychotics should be used for fewer sideeffects

atypical ones -- clozapine; olanzapine; risperidone

Q3670:what is a potential toxicity of clozapine

agranulocytosis

Q3671:which antipsychotic drug can cause agranulocytosis

clozapine

Q3672:what test must be done weekly on patients takingclozapine

WBC count because of potential agranulocytosis

Q3673:what is the mechanism of action of lithium

unknown; may be related to inhibition of phosphoinositolcascade

Q3674:what is the clinical application of lithium

mood stabilizer for bipolar disorder

Q3675:how does lithium help people with bipolar disorder

prevents relapse and acute manic episodes

Q3676:what are the side effects of lithium

tremor; hypothyroidism; polyuria; teratogenic

Q3677:is it OK for women taking lithium to get pregnant

NO -- teratogenic

Q3678:what does lithium cause polyuria

ADH antagonist --> nephrogenic diabetes insipidus

Q3679:What do the following drugs inhibit: 1. MAOinhibitors; 2. Desipramine/maprotilline; 3. Mirtazapine and 4.

Fluoxetine/trazodone?

1. MAO 2. NE reuptake 3. Alpha 2-R 4. 5HT reuptake

Q3680:All of the above actions are ------synaptic

PRE

Q3681:List the Tricyclic Antidepressants

pg 311 Imipramine; amitriptyline; desipramine; nortriptyline;clomipramine; doxepin

Q3682:What are the three C's of their toxicity?

Convulsions; Coma; Cardiotoxicity (arrythmias). Alsorespiratory depression; hypyrexia.

Q3683:How about toxicity in the eldery?

confusion and hallucinations due to anticholinergic SE

Q3684:What is the mechanism of TCA?

block reuptake of NE and 5HT

Q3685:What is the clinical uses of TCAs?

Endogenous depresion. Bed wetting - imipramine. OCD-clomipramine.

Q3686:How are tertiary TCA's different than secondary interms of side effects?

Amitriptyline (tertiary) has more anti-cholinergic effects thando secondary (nortriptyline). Desipramine is the least

sedating.

Q3687:what are the SE of TCAs?

sedation; alpha blocking effects; atropine-like anti cholinergicside effects (tachycardia; urinary retention)

Q3688:Fluoxetine; sertraline; paroxetine; citalopram are whatclass of drugs?

pg 311 SSRI's for endogenous depression

Q3689:How long does it take an anti-depressant to have aneffect?

2-3weeks

Q3690:How does the toxicity differ fromTCA's and what arethey?

Fewer than TCA's. CNS stimulation - anxiety; insomnia;tremor; anorexia; nausea; and vomiting.

Q3691:What toxicity happens with SSRI's and MAOinhibitors given together?

Seratonin Syndrome! Hyperthermia; muscle rigidity;cardiovascular collapse

Q3692:What are heterocyclics?

pg 312 2nd and 3rd generation antidepressants with variedand mixed mechanisms of action. Used major depression.

Q3693:Examples of heterocyclics?

trazodone; buproprion; venlafaxine; mirtazapine; maprotiline

Q3694:Which one is used for smoking cessation?

Buproprion. Mechanism not known. Toxicity - stimulanteffects; dry mouth; aggrevation of pyschosis

Q3695:Which one used in GAD?

Venlafaxine - inhibits 5HT and DA reuptake. Toxicity -stimulant effects

Q3696:which one blocks NE reuptake

maprotiline

Q3697:Which one increases release of NE and 5HT via alpha2 antagonism?

mirtazapine. Also potent 5HT Rantagonist. Toxicity -sedation; increase serum cholesterol; increase appetite

Q3698:What is trazodone and it' SE?

primarily inhibits seratonin reuptake. Toxicity - sedation;nausea; priapism; postural hypotension

Q3699:Give 2 examples of MAO

pg 312 phenelzine. Tranylcypromine

Q3700:Mechanism and Clinical Uses?

non selevtive MAO inhibition. Atypical antidepressant;anxiety; hypochondriasis

Q3701:What is the toxicity with tyramine ingestion (in foods)and meperidine?

Hypertensive crisis

Q3702:Other toxicities?

CNS stimulation; contraindicated with SSRI's or B-agonists

Q3703:What is the mechanims of selgiline (deprenyl)?

pg 312 Selectively inhibits MAO-B; increasing DA

Q3704:what is the clinical use and toxicity?

adjunctive agent to L-dopa for Parkinsons. May enhanceadverse effects of L-dopa

Q3705:What is the significance of drugs with decreasedsolubility in blood?

rapid induction and recovery times . Ie. N20

Q3706:What is the significance of drugs with increasedsolubility in blood?

increased potency = I/ MAC. Ie. Halothane

Q3707:list Inhaled Anesthetics

halothane; enflurane; isoflurane; sevoflurane; methoxyflurane;nitrous oxide

Q3708:What is good about lower solubility?

the quicker the anesthetic response; and the quicker therecovery

Q3709:What are these drug's effects?

myocardial depression; respiratory depression; nausea/emesis;increase cerebral blood flow

Q3710:What toxicity mactches the following drugs 1.Halothane 2. Methoxyflurane 3. Enflurane 4. Rare

1. Hepatotoxcity 2. Nephrotoxicty 3. Proconvulsant 4.Malignant hyperthermia

Q3711:What do barbituates; benzodiazepines;arylcyclohexylamines and narcotic analgesics have in

common?

they are IV anesthetics

Q3712:What the pharmacokinetics and uses of thiopental?

high lipid solubility; rapid entry into brain. Used for inductionof anesthesia for short surgical procedures. Terminated byredistribution from brain. Decreased cerebral blood flow

Q3713:Give an example of a benzo and what is this class'sshortcoming?

midazolam used for endoscopy. Used with gaseousanesthetics and narcotics. May cause severe post-op

respiratory depressio and amnesia

Q3714:What does Ketamine (PCP analog and anarylcyclohexylamine) do?

dissociative anesthetic. Cardiovascular stimulant. Causesdisorientation; hallucination; bad dreams. Increases cerebral

blood flow.

Q3715:How are narcotic analgesics used? Examples?

Morphone and fentanyl are used with CNS depressant duringgeneral anesthesia.

Q3716:What is the advantage of propofol

used for rapid anesthesia induction and short procedures. Lesspost-op nausea than thiopental

Q3717:Name some Local ester anesthetics?

procaine; cocaine; tetracaine;

Q3718:Name some amides?

lidocaine; bupivacaine; (amides have two I's in name!)

Q3719:What is the mechanism and clinical use?

bind receptor and block Na channels. Tertiary amine localanesthetics penetrate membrane in uncharge form; then bind

charged form. Use for minor surgical procedures; spinalanesthesia.

Q3720:How do you decide to use ester or amides?

if allergic to esters; give amides

Q3721:what is the toxicity

CNS excitation; severe cardiovascular toxicity (bupivacaine);hypertension; arrhythmias (cocaine)

Q3722:In infected ________ tissue; anesthetics are chargedand cannot penetrate membrane. Therefore; ______

anesthetics are needed.

acidic; more

Q3723:What is the order of nerve blockade for size andmyelination? Which factor predominates?

small diameter> large diameter. Myelinated fibers>unmyelinated fibers. Size factor predominates

Q3724:what is the order of loss of sensation?

pain first; then temp; then touch; then pressure

Q3725:Why would you give these drugs withvasoconstrictors?

to enhance local action

Q3726:List as many Opiod analgesics as you can.

morphine; fentanyl; codeine; heroin; methadone; meperidine;dextromethorphan

Q3727:Mechanism: They act as _____ for opiod receptors tomodulate synaptic transmission

agonists

Q3728:which drugs act at the mu; delta; kappa receptors?

morphine enkephalin; dynorphin

Q3729:Clinical use?

pain; cough supression (dex); diarrhea (loperamide); acutepulmonary edema; methadone maintenance programs

Q3730:What are the major toxicities?

addiction; respiratory depression; constipation; miosis;additive CNS depression wth other drugs

Q3731:Tolerance does not develop to __________and______

miosis and constipation

Q3732:How would you treat toxicity?

naloxone; naltrexone (opiod R antagonist)

Q3733:List three NSAIDS?

ibuprofen; naproxen; indomethacin

Q3734:What is their mechanism?

reversibly inhibit COX 1 and 2. Blocks PG synthesis

Q3735:What is their clinical use (3As)?

Antipyretic; analgesic; anti-inflammatory. Indomethacin isused to close a PDA.

Q3736:What are common toxicities?

renal damage; aplastic anemia; GI distress; ulcers

Q3737:Where is cox2 found?

in inflammatory cells and mediates inflammation and pain

Q3738:Why is cox2 inhibition better than cox1?

cox1 helps to maintain gastric mucosa; thus; should not havethe corrosive effects of other NSAIDs on the GI lining (less

incidence of ulcers and bleeding)

Q3739:Clinical Use?

RA and osteoarthritis

Q3740:What is Acetaminophen mechanism and where does itwork?

reversibly inhibits cox; mostly in CNS. Inactivatedperipherally.

Q3741:What are its 2 As?

antipyretic; analgesic but NOT anti-inflammatory.

Q3742:Overdose effects?

hepatic necrosis; acetaminophen metabolites depletesglutathine and forms toxic tissue adducts in the liver

Q3743:Changes in CO affect two major cardiovascularpathways?

1. Carotid sinus firing; sympa discharge 2. Renal blood flow;renin-ang pathway

Q3744:What is the effect of the following drugs: 1. Positiveinotropic drugs 2. Beta blockers 3. Ace inhibitors 4. AII

antagonists 5. Vasodilators and 6. Diuretics

1. Increases cardiac output. 2. Inhibit renin release. 3. InhibitACE 4. Inhibits effects of AngII including increasing the

preload; increasing the afterload and remodelling. 5. Decreasethe preload and afterload. 6. Decrease the preload and

afterload

Q3745:What are the adverse effects of these two diueretics:hydrochlorothiazide; loop diuretics

1. Hypokalemia; hyperlipidemia; hyperuricemia; lassitude;hypercalcemia; hyperglycemia 2. Hypokalemia; met alk;

hypotension; ototoxicity

Q3746:These are what class of drugs: clonidine; methyldopa;ganglionic blockers; reserpine; guanethidine; prazosin; beta

blockers?

sympathoplegics

Q3747:Adverse effects of clonidine?

dry mouth; sedation; severe rebound HTN

Q3748:Adverse effects of methyldopa?

sedation; positive coombs test

Q3749:Adverse effects of ganglionic blockers?

orthostatic HTN; blurred vision; constitpation; sexualdysfuncction

Q3750:Adverse effects of reserpine?

sedation; depression; nasal stuffiness; diarrhea

Q3751:adverse effects of beta blockers?

impotence; asthma; cardiovascular; cns

Q3752:Adverse effects of guanethidine?

orthostatic and exercise Hypotension; sex dysfxn; diarrhea

Q3753:Adverse effects of prazosin?

1st dose orthostatic hypotension; dizzy; headache

Q3754:The following are what class: hydralazine; minoxidil;nifedipine; verapamil; nitroprusside

vasodilators

Q3755:which one causes lupus like syndrome? Othertoxicities?

hydralazine; nausea; headache; reflex tachycardia; angina; saltretention

Q3756:adverse effets of minoxidil?

hypertrichosis (hair growth - think Rogaine with minoxidil!);pericardial effusion; reflex tachycardia; angina; salt retention

Q3757:Side effects of nifedipine; verapamil?

dizziness; flushing; constipation; nausea

Q3758:which one causes cynide toxicity?

nitroprusside

Q3759:Adverse effects of ACE-I Captorpil? ThinkCAPTOPRIL

C: cough; A: angioedema; P: proteinuria; T: taste changes; O:hypOtension; P: pregnancy problems like fetal renal damage;

R: rash; I: increased renin; L: lower angiotensin. Alsohyperkalemia.

Q3760:Losartan is a ----------- R-Inhibitor? With ____-toxicity and ____kalemia

angiotensin II; fetal renal; hyper

Q3761:Which two anti-HTN drugs do you use with Bblockers to prevent reflex tachycardia; diuretic to block salt

retention?

hydralizine; minoxidil

Q3762:What is hydralizine's mechanims and clinical use?

increase cGMP --> smooth muscle relaxation. Vasodilatesarteries > veins. Reduces afterload. Used for severe HTN

or CHF

Q3763:Calcium channel blockers; name three

pg. 315 - nifedipine; verapamil; diltiazem

Q3764:Mechanism: block _____ chanels of cardiac andsmooth muscles to reduce contractility

voltage dependednt L type Ca

Q3765:Rank their effects on vascular smooth muscle ad onthe heart.

smooth muscle nifed> diltia > verapamil heart: vera>diltia> nifedepine

Q3766:What is the calcium channel blockers use?

HTN; angina; arrythmias (not nifedipine)

Q3767:ACE -I; name three

pg 316 - captopril; enalapril; lisinopril

Q3768:Mechanim considering bradykinin and renin release?

reduce lvels of ang II; prevent inactivation of bradykinin; reninrelease is increased to to loss of feedback inhibition

Q3769:what is the clinical use of these?

HTN; CHF; diabetic renal disease

Q3770:What is the site of action of 1. Acetazolamide; 2.Osmotic agents; 3. Loop agents; 4. Thiazides; 5. Potassium

sparing; 6. ADH antagonists

1. PCT 2. PCT; thin desc limb; CD 3. Thick ascending limb 4.Distal conv tubule 5. DCT a bit later 6. CD in inner medulla

Q3771:How does mannitol an osmotic diuretic work?

increase tubular fluid osmolarity; producing increased urineflow

Q3772:what is the use and toxicity?

Use: shock; drug overdose; decrease intracranial pressure.Toxicity - pulmonary edema; dehydration. Contraindicated in

anuria; CHF

Q3773:Acetazolamide Is a ______inhibitor. Causes______diuresis and _____ in total body HC03 stores.

Carbonic anhydrase; self-limited NaHCO3; reduction.

Q3774:What electrolye disturbace does it treat? Does itcause?

treats met alk; causes in toxicity hyperchloremic met acidosis.ACIDazolamide caues ACIDosis.

Q3775:Other toxicity?

neuropathy; NH3 toxicity; sulfa allergy

Q3776:uses?

glaucoma; urinary alk; met alk; altitude sickeness

Q3777:This sulfonamide loop diuretic Furosemide inhibits_______cotransport

NA; K; 2CL

Q3778:Furosemide also works by?

abolishes hypertonicit y of medulla; prevent concentration ofurine. Increase Caexcertion. Loops Lose calcium

Q3779:The three uses for this loop diuretic?

edematous states; htn; hypercalcemia

Q3780:Toxicity using the OH DANG?

ototoxicity; hypokalemia; dehydration; allergy; nephritisinterstitial; gout

Q3781:How is Ethacrynic Acid different from furosemide?And how does that affect its use?

Although both have the same action; ethacrynic is aphenoxyacetic acid derivative not a sulfonamide. Therefore

use this drug when you are allergic to sulfa.

Q3782:What drug can be used to treat acute gout?

ethacrynic acid

Q3783:Hydrochlorothiazide is a thiazide diuretic that inhibitsthe reabsorption of ----- in the ---- tubule

NaCl; early distal tubule

Q3784:Does hydrochlorothiazide increase or decrease theexcretion of calcium ion?

decrease

Q3785:A toxic dose of hydrochlorathiazide will do what tothe blood levels of these electrolites: potassium; sodium;

glucose; lipid; uric acid; calcium

hypokalemic metabolic alkalosis; hyponatremia;hyperGlycemia; hyperLipidemia; hyperUricemia;

hyperCalcemia (hyperGLUC)

Q3786:Spironolactone is a competitive antagonist to the ---receptor in the ---- tubule

aldosterone; cortical collecting tubule

Q3787:Name two K+-sparing diuretics that block Na+channels in the cortical collecting duct

Triamterine and amiloride

Q3788:Besides causing hyperkalemia; a toxic dose ofspironolactone will cause this endocrine effect

Gynecomastia (antiandrogen effect)

Q3789:Name three K+-sparing diuretics

Spironolactone; Triamterene; Amiloride (The K+ STAys.)

Q3790:Diuretics are classified as carbonic anhydraseinhibitors; loop diuretics; thiazides; and K+-sparing diuretics.

Which of these causes in increase in urine NaCl?

All of them!

Q3791:Which types of diuretucs increase urine K+?

All except K+-sparing diuretics. Carbonic anhydraseinhibitors; loop diuretics; thiazides.

Q3792:Do carbonic anhydrase inhibitors increase or decreaseblood pH?

Decrease; cause acidosis

Q3793:Do K+-sparing diuretics cause acidosis or alkalosis?

Acidosis; decreases pH

Q3794:Do loop diuretics cause acidosis or alkalosis?

Alkalosis; increases pH

Q3795:Do thiazide diuretics cause an increase or decrease inblood pH?

Increase; cause alkalosis

Q3796:Do loop diuretics increase or decrease levels of urinecalcium ion?

Increase

Q3797:Do thiazide diuretics increase or decrease levels ofurine calcium ion?

Decrease

Q3798:Name four determinants of the level of myocardialoxygen consumption

There are five: end diastolic volume; blood pressure; heartrate; contractility; ejection time

Q3799:Do nitrates affect preload or afterload?

preload

Q3800:Do Beta-blockers affect preload or afterload?

afterload

Q3801:What is the effect of nitrates on: diastolic volume;blood pressure; contractility; heart rate; ejection time?

decrease EDV; decrease BP; increase contractility (reflexresponse); increase HR (reflex response); decrease ejection

time

Q3802:What is the effect of Beta-blockers on: diastolicvolume; blood pressure; contractility; heart rate; ejection

time?

increase EDV; decrease BP; decrease contractility; decreasedHR; increase ejection time

Q3803:The effects of using nitrates and Beta-blockerstogether will: a) decrease myocardial oxygen demands by the

same amount as using either alone; b) decrease myocardialoxygen demands by an amount greater than if each were used

alone; or c) have no effect on myocardial oxygen demand

b) Decrease myocardial oxygen demands by an amount greaterthat if each were used alone

Q3804:Nifedipine blocks -- channels

calcium

Q3805:In its effects on myocardial oxygen consumption; isNifedipine similar to Nitrates or B-blockers?

Nitrates (Nifedipine is similar to Nitrates)

Q3806:In its effects on myocardial oxygen consumption; isVerapamil similar to Nitrates or B-blockers?

B-blockers

Q3807:Dose nitroglycerin dilate arteries or veins more?

Veins>>arteries

Q3808:Does nitroglycerin increase or decrease cGMP insmooth muscle?

Increase

Q3809:In industrial exposure to nitroglycerine; weekendwithdrawal is characterized by which three symptoms?

Tachycardia; dizziness ; and headache ("Mondaydisease")

Q3810:Toxic dosage of nitroglycerine causes which threesymptoms?

Tachycardia; hypotension; headache

Q3811:Digitalis has its action on which cell membranetransporter?

Na/K ATPase

Q3812:Ryanodine has its action on which channel?

Calcium release channel in the sarcoplasmic receptor

Q3813:Calcium enters cardiac cells through which channel?

Voltage-gated calcium channel

Q3814:Cytoplasmic calcium concentrations in cardiac cellscan be decreased by sequestering calcium in the sarcoplasmicreticulum. Calcium enters the SR through which transporter?

Calcium pump in the wall of the SR

Q3815:Calcium channel blockers have their effect on whichcalcium transporters?

Voltage-gated calcium channel

Q3816:What is digoxin's effect on the intracellular Na+ level?

Increase

Q3817:What is digoxin's effect on the intracellular calciumlevel?

Increase

Q3818:Name two ECG changes ellicited by digoxinadministration

There are 4: increase PR; decrease QT; scooping of STsegment; T-wave inversion

Q3819:Name three symptoms of digoxin toxicity

Nausea; vomiting; diarrhea; blurry vision; arrhythmia

Q3820:Which potentiates the effects of digoxin- hypo- orhyperkalemia?

hypokalemia

Q3821:Which phase of the cardiac action potential doantiarrhythmics decrease the slope of?

Phase 4 depolarization

Q3822:What type of antiarrhythmic is Amiodarone?

Class 1A (Class 1A includes Quinidine; Amiodarone;Procainamide; Disopyramide; "Queen Amy Proclaims

Diso's pyramid."

Q3823:Do class 1A antiarrhythmics increase or decrease theeffective refractory period; AP duration; and QT interval?

Increase ERP; increase AP duration; increase QT interval

Q3824:What do class 1B antiarrhythmics do to the APduration?

Decrease AP duration

Q3825:What type of antiarrhythmic is mexiletine?

Class 1B (includes Lidocaine; mexiletine; tocainide)

Q3826:What type of antiarrhythmic is encainide?

Class IC (includes flecainide; encainide; propafenone)

Q3827:What effect do class 1C antiarrhythmics have on theAP duration?

No effect!

Q3828:What does esmolol do to the cAMP in cardiac cells?

decreases cAMP (a beta-blocker)

Q3829:What does atenolol do the calcium currents in cardiaccells?

decreases calcium current (beta-blocker)

Q3830:Timolol decreases the slope of which phase of thecardiac AP cycle?

Phase 4 (a beta-blocker)

Q3831:What does propanolol do the the PR interval?

Increases interval (beta-blocker)

Q3832:Is esmolol a short- or long-acting beta blocker?

short-acting

Q3833:Does amiodarone increase or decrease AP duration?

Increase (K+ channel blocker)

Q3834:Does sotalol increase or decrease the effectiverefractory period?


Q3835:Does bretylium increase or decrease the QT interval?


Q3836:Name a symptom of sotalol toxicity.

Torsades de pointes (K+ channel blocker)

Q3837:Name three of the symptoms of amiodarone toxicity.

Pulmonary fibrosis; corneal deposits; hepatoxicity; skindeposits resulting in photodermatitis; neurologic effects;

constipation; bradychardia; heart block; CHF;hypothyroidism/hyperthyroidism. (Therefore; should check

PFTs; LFTs; and TFTs)

Q3838:Does verapamil increase or decrease the conductionvelocity of the AV nodal cells?

Decrease (calcium channel blocker)

Q3839:How does diltiazem affect the effective refractoryperiod and the PR interval?

Increases ERP; increases PR (calcium channel blocker)

Q3840:Name a potential use of Mg+ to treat arrhythmias.

To treat torsades de pointes and digoxin toxicity

Q3841:Name a potential use of K+ to treat arrhythmias.

Depress ectopic pacemakers; especially in digoxin toxicity

Q3842:Name a use of adenosine in treating arrhythmias.

To diagnose and abolish AV nodal arrhythmias.

Q3843:What is the effect of cholestyramine on the serumtriglyceride level?

Slight increase (cholestyramine is a bile acid resin)

Q3844:What is the effect of colestipol on HDL?

No effect! (colestipol is a bile acid resin)

Q3845:What is the effect of lovastatin on HDL?

Increase (lovastatin is an HMG-CoA reductase inhibitor)

Q3846:Name 2 side effects of pravastatin.

Increase LFTs and cause myositis (prevastatin is an HMG-CoA reductase inhibitor)

Q3847:What is the effect of Niacin on HDL?

Increase

Q3848:What are the side effects of clofibrate?

Incease LFTs and cause myositis (Clofibrate is a"Fibrate")

Q3849:Which increases HDL most: simvastatin; niacin; orgemfibrozil?

Niacin

Q3850:Which decreases triglyceride level most: colestipol;Atorvastatin; niacin; or bezafibrate?

Bezafibrate

Q3851:What is the main effect of ezetimibe?

decrease serum LDL (a cholesterol absorption inhibitor)

Q3852:Gemfibrozil increases the activity of which enzyme?

Lipoprotein lipase (which converts VLDL to IDL)

Q3853:What enzyme breaks down membrane lipid intoarachidonic acid?

Phospholipase A2

Q3854:What two enzymes are responsible for the productionof Hydroperoxides (HPETEs) and Endoperoxidases;

respectively from arachidonate?

Lipoxygenase= HPETE; Cyclooxygenases=endoperoxidases

Q3855:What major class of products do HPETEs give rise to?

Leukotrienes

Q3856:What are the 3 major products of Endoperoxidases?

Prostacyclin (PGI); Prostaglandins (PGE; PGF);Thromboxane (TXA)

Q3857:In general what effect do leukotrienes have onbronchial tone?

Leukotrienes in general increase bronchial tone

Q3858:In the arachodonic acid pathway; what two enzymesdo corticosteroids block?

Phospholipase A2; COX-2

Q3859:NSAIDs; Acetaminophen and COX-2 inhibitors blockwhich arachadonic acid pathway enzymes

NSAIDs-non-selectively block COX-1 and COX-2;acetaminophen doesn't block COX-1 or COX-2; but instead it

may block COX-3 in found in the brain; COX-2 inhibitorsblock COX-2

Q3860:What are the 4 major effects of Prostacyclin

decrease platelet aggregation; decrease vascular tone; decreasebronchial tone; decrease uterine tone

Q3861:What are the 3 major effects of Prostaglandins

increased uterine tone; decrease vascular tone; decreasebronchial tone

Q3862:What are the 3 major effects of Thromboxane

increase platelet aggregation; increase vascular tone; increasebronchial tone

Q3863:Zileuton is a ________ pathway inhibitor?

Lipoxygenase

Q3864:Zariflukast is associated with what enzymes?

Lekukotrienes

Q3865:Bronchodilation is mediated by what molecule

cAMP

Q3866:Bronchoconstriction is mediated by _________ and___________

Ach and adenosine

Q3867:How many asthma drug categories are there?

7- (1) nonspecific B-agonists; (2) B2 agonists; (3)Methylxanthines; (4) muscarinic antagonist; (5) cromolyn; (6)

corticosteroids; (7) Antileukotrienes

Q3868:What is the only nonspecific B-agonist drug and whatare its effects?

Isoprotenerol-relaxes bronchial smooth muscle (B2) andtachycardia (B1) (adverse effect).

Q3869:What are the two B2 selective agonist asthma drugs?

Albuterol- relaxes bronchial smooth muscle (B2); Salmetrol

Q3870:What are the indications for Albuterol and Salmetrol;respectively?

Albuterol- use during acute exarcebation; Salmetrol- long-acting agent for prophylaxis

Q3871:what are the notable adverse effects of B2 agonist?

arythmias and tremor

Q3872:B2-agonists activate this enzyme in bronchial smoothmuscle that leads to an increase in ________ =

bronchodilation

B2 agonists activate adenylate cyclase and increase conversionof ATP to cAMP

Q3873:What are the likely mechanism of action theophylline?

bronchodialation by inhibition phosphodiesterase (PDE);decreasing cAMP hydrolysis and antagnonizing adenosine

action

Q3874:Why is usage of theophylline limited?

limited b/c narrow therapeutic index (cardiotoxicity;neurotxicity)

Q3875:What kind of drug is Ipratropium?

muscarinic antagonist

Q3876:How does mechanism of action of Ipratropium?

competitive block of muscarinic receptors= prevention ofbronchoconstriction

Q3877:cromolyn works by inhibiting the release of _______from ______ cell?

prevents release of medicators from mast cells

Q3878:Cromolyn is mainly used for the ______ of athsmaand it is not indicated for _______ treatment of athsma?

Used only for prophylaxis; not effective during acute episode.Also; toxicity rare

Q3879:__________and ________ are two majorcorticosteroids used for treatment of what kind of asthma?

Beclomethasone and prednisone are 1st line therapy forchronic asthma

Q3880:What is the mechanism of action of corticosteroids?

inhibits the synthesis of virtually of cytokines-->inactivates NF-KB; the transcription factor that inducesthe production of TNF-a; amonth other inflammatory agents.

Q3881:Zileuton blocks the conversion of _______ to________.

zileuton is a 5-lipoxygenase pathway inhibitior. Blocks theconversion of arachidonic acti to leukotrienes

Q3882:Zafirlukast works by_______ ________ ________

bloking leukotriene receptors

Q3883:What the most basic asthma treatment strategy?

avoidance of exposure to antingen (dust; pollen; etc)

Q3884:After exposure to antigen crosslinks IgE on mast cells.This is prevented by the following drugs: _________ and

________

cromolyn and steroids

Q3885:Following allergen exposure mediators are released (ex._______ and _________). This triggers an ______ asthmaticresponse characterized by ________ and may be treated with

the following 3 asthmatic drug categories to treat thesymptoms.

examples of mediators are leukotrienes and histamine.Following allergen exposure an early asthmatic response

characterized by bronchoconstriction that can be treated withB-agonsists; methylxanthines; and muscarinic antagonists.

Q3886:Also; mediators elicit a ________ response is whichleads to bronchial __________ and is treated with

__________.

mediators elicit a late response and this leads to bronchialhyperactivity. This is best treated with steroids.

Q3887:the following questions are from the diagram at the topof the page

Q3888:_____ cells are predominatly found in the antrum and_________ cells are predominatly found in the fundus.

Gastrin cells are predominant in the antrum and parietal cellsare predominant in the fundus.

Q3889:What are the 3 main stimuli of acid secretion?

Ach; histamine; gastrin

Q3890:Gastrin stimulates the ECL cells to secrete histaminethat stimulates ______ cells. Gastrin also activate the ______

cells to increase expression of _______ that increases______secretion.

Gastrin stimulates the ECL cells to secrese histamine thatstimulates parietal cells. Parietal cells are also activated bygastrin to increase the expression of the H;K ATPase that

increases acid secretion.

Q3891:This type of drug acts by inhibiting M1 and M3receptors on ECL cells and Parietal cells; respectively.

muscarinic antagonists block M1 receptors in ECL cells andM3 receptors in parietal cells.

Q3892:This type of drug inhibits the ability of the ECL cellto stimulate acid secretion by interfering with the _____

receptor.

H2 blocker inhibits the ability of the ECL cell to stimulateacid secretion by interfering with the parietal H2 receptor.

Q3893:The most direct way of inhibiting acid secretion is byusing this type of drug which acts on this enzyme.

the most direct way of inhibiting acid secretion is by usingproton pump blockers which inhibit the H;K ATPase on

parietal cells.

Q3894:____________ acts by binding to the ulcer andincreasing its healing. It may interfere with drug absorption in

the stomach.

sucralfate binds to the ulcer base and provides physicalprotection. It allows HCO3- secretion to reestablish pH

gradient in the mucus layer.

Q3895:What hormone binds ECL cells and decreases acidsecretion?

somatostatin

Q3896:These type of drugs used to decrease pH in thestomach.

antacids….duh….jk. (I was instructed to make a question ofevery word)

Q3897:____________; ___________; ___________; and___________ are examples of H2 blockers and they act by

(reversibly/irreversibly)

cimetedine; ranitidine; famotidine; nizatidine reversilbly blockH2 receptors.

Q3898:This H2 blocker is the only one that has many sideeffects which include potent inhibition of ______; _____

effects; and _____ renal excretion of creatinine.

cimetedine is a potent inhibitor of P450; it has antiandrogeniceffect and decrease renal excretion of creatinine. Other H2

blockers are relatively free of these effects.

Q3899:_________ and _________ (reversibly/irreversibly)inhibit the H/K ATPase in the stomach _______cells.

Omeprazole and Iansoprazole irreversibly inhibit the H/KATPase in stomach parietal cells

Q3900:Proton pump inhibitors are indicated for peptic ulcer;________; _______; and _________ syndrome

peptic ulcer; gastritis; esophageal reflux; and Zollinger-Ellisonsyndrome

Q3901:T/F: Bismuth and sucralfate allow HCO3- secretion.

True: bismuth and sucralfate bind to ulcer base and providephysical protection; and allow HCO3- secretion to reestablish

pH gradient in the mucus layer=increased ulcer healing

Q3902:T/F: misoprostol is a PGE2 analog and increases theproduction and secretion of gastric mucous barrier.

False: misoprostol is a PGE1 analog and it increases theproduction and secretion of gastric mucous barrier.

Q3903:What are the 3 indications for misoprosol?

prevention of NSAID-induced peptic ulcers; maintains a PDAand used to induce labor

Q3904:In what population is misoprostol contraindicated?

women of childbearing potential (abortifacient). It also casuesdiarrhea

Q3905:Infliximab is ___________ against ______.

monoclonal antibody to TNFa

Q3906:The clinical indication for Infliximab is:

Crohn's; along with fistula healing

Q3907:T/F: Infliximab can cause respiratory infection; fever;hypotension

TRUE

Q3908:This drug offers both anitbacterial action and anti-inflamatory effects. It is used for 2 inflammatory GI diseases

______ and _______.

sulfasalazine: combination of sulfapyridine (antibacterial) andmesalamine (anti-inflammatory effects). It is used for

Ulcerative colitis and remission of Crohn's.

Q3909:T/F: Side effects of the above include: malaise;sulfonamide toxicity; neutropenia

false: side effects: malaise; nausea; sulfonamide toxicity

Q3910:___________ is a powerful central-acting antiemetic.It acts by antagonizing the______ receptor.

Ondansetron: is a powerful antiemetic. Think: you will notvomit with ondansetron; so you can go on dancing.

Q3911:T/F used to treat vomiting preoperatively and forcancer chemo therapy pts.

False: it is used to treat vomiting postoperatively.

Q3912:Headache and __________ are side effects

constipation (can't vomit or poop)

Q3913:Antacid overuse can affect:_________; __________;or ______ excretion of other drugs by altering ______ and

______ pH or by delaying gastric _________.

Antacid overuse can affect absorption; bioavailability; orurinary excretion of other drugs by altering gastric and urinary

pH or by delaying gastric emptying.

Q3914:Constipation and (hypo/hyper) phosphatemia is seenwith overuse of ________________

aluminum hydroxide - Aluminimum amt. of feces

Q3915:Magnesium hydroxide overuse = ___________

diarhea; Mg = Must go to the bathroom

Q3916:Calicium carbonate= hypercalcemia and(increase/decreased) acid

causes hypercalcemia and increased acid.

Q3917:T/F: hyperkalemia can be seen with AlOH; MgOH;CaCO2

False! hypokalemia

Q3918:heparin Catalyzes activation of ____________;decreases ________ and __________. It has a ____t1/2. check

PTT

catalyzes the activation of antithrombin III; decreasesthrombin and Xa. It has a short t1/2

Q3919:It is used for immediated anticoagulation forpulmonary embolism;_______; _______; MI; and ________.

Follow PTT

used for pulmonary embolism; stroke; angina; MI; and DVT.

Q3920:T/F: Is used during pregnancy

true: it is used during pregnancy because it does not cross theplacenta.

Q3921:It can cause bleeding;___________; and drug-druginteractions.

thrombocytopenia

Q3922:___________ is used for rapid reversal of heparization(it is a _______ charged molecule that binds the ________

charged heparin)

protamine sulfate is used for rapid reversal of heparinization(it is a positively charged molecule that binds the negatively

charged heparin).

Q3923:Newer________________ (enoxaparin) act more on_____; have better bioavailability and 2-4 times longer t1/2.

Can be administered subcut and (with/without) labmonitoring.

lower-molecular-weight heparins (enoxaparin) act more on Xa;have better bioavailabitlity and 2-4 times longer half-life. Can

be adm. Subcut and without lab monitoring.

Q3924:warfirin (coumandin) Interferes with normal synthesisand gamma-carboxylation of vitamin K-dependent factors

___; ___; ___; and ___; also; ___ and ___ via ______antagonism.

Interferes with normal synthesis and gamma-carboxylation ofvitamin K-dependent clotting factors II; VII; IX; and X;

protein C and S via vitamin K antagonism.

Q3925:t1/2 (short/long)

long

Q3926:Used for _______ anticoagulation. Follow PT

WEPT - Warfirin affects the Extrinsic pathway and prolongsPT

Q3927:T/F: is used during pregnacy

False! (warfarin; unlike heparin; can cross the placenta).

Q3928:Toxicity: bleeding; _________; drug-drug interactions

teratogenic

Q3929:Heparin is a (large/small) _____charged acicid polymerwhile Warfarin is (large/small) (charged/neutral) molecule

Heparin is a large negatively charged acidic polymer whileWarfarin is a small neutral charged lipid-soluble molecule

Q3930:T/F: Heparin is given orally while warfarin is givenSC/IV

False! Heparin is given IV/SC and warfarin is give oral

Q3931:Site of action: heparin _________; warfarin ______

heparin's site of action is the blood; warfarin's site of action isthe liver (synthesises clotting factors)

Q3932:Onset of action of _________ is slow; the onset ofaction of ______ is rapid

onset of action of heparin is rapid (secs) and the onset ofaction of warfarin is slow; limitd by t1/2 of normal clotting

factors.

Q3933:Warfarin works by imparing the synthesis of _______dependent factors __; ___; ___; and ___ also _____; and

____; heparin activates _____; ____ and ___

Warfarin works by imparing the synthesis of vitamin Kdependent factors II; VII; IX; and X also protein S and

protein C; heparin activates ATIII; Iia (thrombin) and Xa.

Q3934:Heparin 's duration of action is (acute/chronic);warfarin's duration of action is (actue/chronic)

Heparin's duration of action is actute and warfarin's durationof action is chronic.

Q3935:Tx of acute OD: Heparin = _________;warfarin=______

Tx of heparin OD is protamine sulfate; Tx of warfarin= IVvit. K and fresh frozen plasma.

Q3936:Warfarin is monitored by _________ while Heparin ismonitored by ___________.

Warfrin is monitored by PT (extrinsic pathway) (WEPT) andheparin is monitored by PTT (intrinsic pathway)

Q3937:plasmin is the major ___________ enzyme. It breaksdown both _______ and _______

fibrinolytic enzyme. It accelerates breaks down of both fribinand fibrinogen yielding fibrin splip products and degradation

products; respectively.

Q3938:Fibrinogen is converted to fibrin by _________

thrombin

Q3939:tPA and urokinase promote the converson of ______to ________ thereby increasing fibrinolysis.

plasminogen to plasmin

Q3940:Various stimuli activate a blood proactivator to ablood activator that promotes conversion of _________ to

blank thereby increasing fibrinolysis

plasminogen to plasmin

Q3941:Aminocaproic acid:____________ fibrinolysis.

inhibits fibrinolysis by inhibition of plasminogen conversionto plasmin.

Q3942:4 examples of thrombolytics include: ________;_________; _____________; and ___________

Streptokinase; urokinase; tPA(altepalse); APSAC(anistreplase)

Q3943:work by directly or indirectly aiding the conversion of___________ to __________; which cleaves ______ and

________ clots. tPA specifically coverts _______________to plasmin

Directly or indirectly aid conversion of plaminogen toplasmin; which cleaves thrombin and fribrin clots. It is

claimed that tPA specifically coverts fribrin-boundplasminogen to plasmin.

Q3944:T/F: clinical use is for DVTs

False: used for early MI

Q3945:pts. receiving this medication are at most risk for:______

bleeding

Q3946:When a break in the endothelium occurs _________and _________ are exposed.

collagen and vWF

Q3947:Platelets are activated by binding to the abovemacromolecules. The two structures expressed by theplatelets involved in this process are __________ and

_________ and they bind to _________ and __________;repectively

Platelets bind to collagen and vWF. The two structuresexpressed by platelets that are involved in this process are GP

1a and GP 1b. GP 1a and GP 1b bind to collagen and vWF;respectively.

Q3948:After platelet activation _________ is expressed ontheir surface. What is the role of this structure?

after platelets are activated they express GP IIb/IIIa. Thismolecule is important in platlelet-platelet aggregation.

Q3949:_________ and _________ interaction is needed inorder for platelet aggregation to occur.

GP IIb/IIIa and fribinogen

Q3950:5-HT; _______; and ________ are molecules that playa role in the glycoprotein expression of activated platelets.

5-HT; ADP; and TxA2 are molecules that play a role in theglycoprotein expression of activated platelets.

Q3951:Aspirin acts by inhibiting production of ________that in turn inhibits glycoprotein expression in activated

platelets.

TxA2

Q3952:ADP production is inhibited by the drug _________.

ticlopidine

Q3953:This antibody drug targets the _______ on platelets.

Abciximab

Q3954:Copidogrel; ticlopidine T/F: inhibits plateleaggregation by irreversibly inhibiting the ADP pathway

involved in the binding of fibrinogen

TRUE

Q3955:It is used for ______ ________ syndrome; coronary_______; and it has been shown to decrease the incidence or

recurrence of___ ____.

it is used for acute coronary syndrome; coronary stenting.Decreases incidence or recurrence of thrombotic stroke

Q3956:Ticlopidine is associated with_________ as a sideeffect.

Ticlopidine causes neutropenia and it is reserved for thosewho cannot tolerate aspirin.

Q3957:Abciximab binds to __________ on activatedplatelets.

gp IIb/Iia

Q3958:It is used for ___________ and ________ ____________________ ___________

acute coronary syndromes and percutanous transluminalcoronary angioplasty

Q3959:toxiciites are _______ and ________

bleeding and thrombocytopenia

Q3960:It ________ and (reversibly/irreversibly) inhibitsCOX1 and COX2 to prevent the conversion of _______ to

prostaglandins.

acetilates and irreversably inhibits COX-1 and COX-2

Q3961:T/F: aspirin has an effect of PT; PTT

false it has no effect

Q3962:What are the 4 A's of aspirin and NSAIDS in general

Antipyretic; Analgesic; Anti-inflam; antiplatelet

Q3963:Important toxicities include _________; bleeding;hyperventilation; __________- in children; and CN ____

toxicity

gastric ulceration; bleeding; hyperventilation; Reyes syndromeand tinnitus (CNVIII).

Q3964:Hydrocortisone; prednisone; triamcinolone;dexamtasone; bleclomethasone are examples of what kind of

drugs?

Glucocorticoid

Q3965:Glucocorticoids decrease the production of ___ and____

Leukotrienes and prostanglandins

Q3966:To treat Addison's disease; inflammation; immunesuppression; asthma; use ____

Glucocorticoids

Q3967:An important side-effect of Glucocortioid usage is____

Iatrogenic Cushing's Syndrome

Q3968:Buffalo hump; moon facies; truncal obesity; muscleswasting; thin skin; easy bruisability; osteoporosis;

adrenocortical atrophy; peptic ulcers characterize whatsyndrome?

Cushing's Syndrome

Q3969:Which two drugs inhibit cGMP phosphodiesterase;leading to smooth muscle relaxation in the corpus cavernosum

and penile erection?

Sildenafil and Verdenafil --they fill the penis

Q3970:What class of drugs are used tto treat erectiledysfunction

cGMP Inhibitors

Q3971:CGMP inibitors taken with ____have a high risk ofliofe-threeatening hypotension

nitrates

Q3972:Which drugs is a partial agonist of estrogen recpetorsin the pituitary gland; stimulating increase in LH and FSH;

which stimulates ovulation to treat infertility

clomiphene

Q3973:Clomiphene's side effects include:

Hotflashes; ovarian enlargment; multiple simultaneouspregnancies; visual disturbances

Q3974:What abortifacient is a competitite inhibitor ofpreogestins at progesterone recpetor and may lead to heavy

menstrual-like bleeding?

Mifepristone (RU486)

Q3975:The advantage of this drug is that it is reliable;decreases incidence of ectopic pregnancy; decreases risk of

pelvic infections; and regulates menses; however it also putsyou in a hypercoagulable stat and may increase your

trigylcerides; weight; and blood pressure

Oral Contracpetices - syntheitc progestins/estrogen

Q3976:____is converted to uric acid which leads to gout

Xanthine (converted from excess purines)

Q3977:This drug depolymerizes microtubules; impairingleukocyte chemotaxis and degranulation; and used to treat

acute gout

Colchicine

Q3978:This drugs inhibits reabsorption of uric acid and usedto treat chronic gout

Probenecid

Q3979:This drug is used to treat chronic gout; but also inhbitssecretion of penicillin

Probenecid

Q3980:This drugs inhibits xanthine oxidase decreasing theconversion fo xanthine to uric acid

Allopurinol

Q3981:What are the cell cycle specific oncologic drugs

antimetabolites; plant alkaloids; stroid hormones; bleomycin;paclitaxel; etoposide

Q3982:What are the cell cycle Nonspecific oncologic drugs?

alkylating agents and antibiotics

Q3983:____is an S-phase-specific anti-metabolite that is anfolic acid analog that inhibits dihydrofolate reducate

decreasing dTMP(thymidine and purines) and decreaingDNA/prtein synthesis.

Methotrexate

Q3984:____is an S-phase-specific anti-metabolite that is apyrmidine analog which complexed to folic acid; inhibitingthymidylate synthase; decreasing dTMP and decreasing

DNA/protein synthesis

5-Fluorouracil (5-FU)

Q3985:Myelosuppression by methotrxate is reversible with____

leucovorin (folinic acid) rescue

Q3986:Which drug blocks purine synthesis and is used totreat leukemias; lymphomas (not CLL or Hodgkins)

6-mercaptopurine (6-MP)

Q3987:Which drug alkylates DNA and is used to treat CML?

Busulfan

Q3988:Which drug inhibits DNA polymerase and is used totreat AML?

cytarabine

Q3989:This drug used to treat Leukemias and Lymphomas ismetaboilized by xanthine oxidase

6-mercaptopurine (6-MP)

Q3990:Used to treat leukemias; lymphomas; choricarcinoma;sacromas; rheumatoid arthritis; psoriasis; and can be an

abortifacient; it may lead to myelosuppression

Methotrexate

Q3991:Used to treat colon cancer and other solid tumors;basal cell carcinoma (topically)

5-Fluorouracil (5-FU)

Q3992:Myelosuppression by 5-FU is ______

Not reversible

Q3993:This drug used to treat AML may lead to leukopenia;thrombocytopenia; megaloblastic anemia?

cytarabine

Q3994:This drugs used to treat CML may lead to pulmonaryfibrosis and hyperpigmentation?

Busulfan

Q3995:____is an alkylating agent acivated by liver thatcovalently x-links DNA at guanine N-7; and is used to treat

non-hodgkin's lymphoma; breast/ovarian carcinomas

cyclophosphamides

Q3996:____ alkylates DNA after bioactivation and can crossthe BBB and treats brain tumors (glioblastoma multiforme)

Nitrosoureas (Carmustine; lomustine; semustine;streptozocin)

Q3997:____acts like an alkylating agent; x-linking viahyrdolysis of Cl and platinum; used to treat testicular;

bladder; lung carcinomas

Cisplatin

Q3998:This alkylating agent can cause myelosuppression andhemorhagic cystitis

cyclophosphamides

Q3999:This combination of drugs is used to treat Hodgkin'sand myelomas; sarcomas; and solid tumors (breast; ovary;

lung)

ABVD: Adriamycin; Bleomycin; Vinblastine; Dacarbazine

Q4000:____noncovalently intercalates in DNA; creatingbreaks to decrease replication and transcription

Doxorubicin (adriamycin)

Q4001:____intercalates DNA strands and induces free radicalfromation which causes strand breaks

Bleomycin; Dactinomycin

Q4002:Which drugs causes cardiotoxicity; alopecia; andmyelosuppression?

Doxorubicin (adriamycin)

Q4003:Which drug is used to trat oat cell carcinoma of thelung and prostate/testicular carcinoma?

Etoposide

Q4004:This combination of drugs is used to treat lymphoma;CLL; Hodgkin's; Wilm's tumor; choriocarcinoma

MOPP (Mustargen; Oncovin (Vincristine); Procarbazine(Matulane); Prednisone)

Q4005:Which glucocorticoid may trigger apoptosis and mayeven work on nondividing cells

Prednisone

Q4006:This drug is a G2-phase specific inhibitor ofTopisiomerase II; leaving double strand breaks in DNA

following DNA replication

Etoposide

Q4007:This drug used to treat testicular cancer andlymphomas may cayse pulmonary fibrosis; skin chnages; and

myelosuppression

Bleomycin; Dactinomycin

Q4008:This drugs used as an immunosuppressant and inlymphomas may cause acne; osteoporosis; hypertension;

peptic ulcers; hyperglycemia; psychosis?

Prednisone

Q4009:____is an estrogen receptor mixed agonist/antagonistthat blocks the binding of estrogen to ER+ cells.

Tomoxifen/Raloxifene

Q4010:____is n M-phase-specific alkaloid that binds totubulin and blocks polymerization of microtubules;

preventing spindle formation

Vincristine and Vinblastine

Q4011:____is an M-phase-specific agen that binds to tubulinand hyperstabilizes the polymerized microtubules; so that the

mitotic spindle cannot break down

Paclitaxel

Q4012:What drugs is used to treat breast cancer; but mayincreas the risk of endometrial carcinomas and hot flashes

Tomoxifen

Q4013:Side-effects of Vinblastine include….

VinBASTine BLASTs Bone Morraow; causingmyelosuppression; as well as neurotoxicity and paralutic

ileus.

Q4014:Side effects of Paclitaxel include….

Myelosuppression and hypersensitivity

Q4015:Which drug binds to cyclophilins; blockingdifferentiation and activation of T cells mainly by inhibiting

IL2 production

cyclosporine

Q4016:This antimetabolite derivative of 6-mercaptopurineinterferes with the metabolism and synthesis of nucleic acid;

therefore toxic to proliferating lymphocytes

azathioprine

Q4017:This potent immunosuppressive drug binds to theFK-binding protein and inhibits secretion of IL2 and other

cytokines

tacrolimus (FK506)

Q4018:This drug is used to suppress organ rejection aftertransplantation; but may predispose patient to viral infections

and lymphoma

cyclosporine

Q4019:Azaothioprine is used to in what setting?

Kidney transplants; autoimmune disorders(glomerulonephritis; hemolytic anemia)

Q4020:Recombinant Cytokine- Aldesleukin (interleukin-2) isused for?

Renal cell carcinoma; metastatic melanoma

Q4021:Recombinant Cytokine- Erythropoietin (epoetin) isused for?

anemia

Q4022:Recombinant Cytokine- Filgrastim is used for?

Recovery of Bone Marrow; it is a granulocyte colonystimulating factor

Q4023:Recombinant Cytokine- alpha interferon is used for?

Hep B/C; Kaposi's sarcoma; leukemia; malgnant melanoma

Q4024:Recombinant Cytokine- beta interferon is used for?

Multiple Sclerosis

Q4025:Recombinant Cytokine- gamma interferon is used for?

Chronic Granulomatous disease

Q4026:Recombinant Cytokine- oprelvekin (interleukin2) isused for?

Thrombocytopenia

Q4027:Recombinant Cytokine- sargamostim is used for?

Recovery of Bone Marrow (it is a granulocyte-macrophagecolony stimulating factor)

Q4028:Recombinant Cytokine- thrombopoietin is used for?

Thrombocytopenia

Q4029:What is the antidote for acetaminophentoxicity/overdose

N-acetylcysteine

Q4030:What is the antidote for salicylates toxicity/overdose

Alkanize urine/dialysis

Q4031:What is the antidote for antichoinesterasetoxicity/overdose

Atropine; pralidoxime

Q4032:What is the antidote for antimuscarinic/anticholinergicagents toxicity/overdose

physostigimine salicylate

Q4033:What is the antidote for Beta-blockerstoxicity/overdose

glucagon

Q4034:What is the antidote fordigitalis toxicity/overdose

Stop digitalis; Normalize K+; lodpcaine; anti-digitialis FabFragments; Magnesium

Q4035:What is the antidote for lead toxicity/overdose

CaEDTA; dimercaprol; succimer; penicillamine

Q4036:What is the antidote for iron toxicity/overdose

Deferoxamine

Q4037:What is the antidote for aresnic/mercury/goldtoxicity/overdose

Dimercaprol (BAL); succimer

Q4038:What is the antidote for copper; arsenic; goldtoxicity/overdose

Penicillamine

Q4039:What is the antidote N-acetylcysteine used to treat?

Acetaminophen toxicity/overdose

Q4040:What is the antidote for cyanide toxicity/overdose

nitrite; hydroxocobalamin; thiosoulfate

Q4041:What is the antidote for methemoglobintoxicity/overdose

methylene blue

Q4042:What is the antidote glucagon used to treat?

Beta-blocker toxicity/overdose

Q4043:What is the antidote for carbon monoxidetoxicity/overdose

100% oxygen; hyperbaric oxygen

Q4044:What is the antidote atropine used to treat?

anticholinesterase toxicity/overdose

Q4045:What is the antidote for methanol toxicity/overdose

Ethanol; dialusis; fomepizole

Q4046:What is the antidote for opiods toxicity/overdose

Nalozone/naltrexone

Q4047:What is the antidote for ethylene glycoltoxicity/overdose

Ethanol; dialusis; fomepizole

Q4048:What is the antidote for benzodiazepinestoxicity/overdose

Flumazenil

Q4049:What is the antidote for (TCA) TricyclicAntidepressants toxicity/overdose

NaHCO3

Q4050:What is the antidote for Heparin toxicity/overdose

Protamine

Q4051:What is the antidote Deferoxamine used to treat?

Iron toxicity/overdose

Q4052:What is the antidote for warfarin toxicity/overdose

vitamin K; fresh frozen plasma

Q4053:What is the antidote Naloxone/naltrexone used totreat?

opioid toxicity/overdose

Q4054:What is the antidote for tPA/streptokinasetoxicity/overdose

aminocaproic acid

Q4055:What is the antidote Physostigmine salicylate used totreat?

Antimuscarinic/anticholinergic agents toxicity/overdose

Q4056:What is the antidote Flumazenil used to treat?

Benzodiazepine toxicity/overdose

Q4057:What is the antidote Protamine used to treat

Heparin toxicity/overdose

Q4058:Children living in old houses might eat the paint chipswhich could cause ____

Lead Poisoning

Q4059:Signs of Lead poisoning include:

Lead Lines on gingivae and epiphyses of Long bones;Encephalopathy and Erythrocyte Basophilic stippling;

Abdominal colic and sideroblastic Anemia; Wrist and FootDrop

Q4060:1st line of Treatment for Lead Poisoning include

Dimercaprol and EDTA

Q4061:Weak acids; such as phenobarbitol; methotreaxate;aspirin; alkanize urine with ____ to increase clearance

bicarbonate

Q4062:Weak bases; such as amphetamines; acidify urine withNH4Cl to ____ clearance

increase

Q4063:AUTHOR

Lakshmi Swamy

Q4064:Drugs causing Pulmonary fibrosis (3)

bleomycin; amiodarone; busulfan

Q4065:Drugs causing Hepatitis (2)

isoniazid; halothane

Q4066:Drugs causing Focal to massive hepatic necrosis (4)

halothane; valproic acid; acetaminophen; amanita phalloides

Q4067:Drugs causing Anaphylaxis (1)

penicillin

Q4068:Drugs causing SLE-like syndrome (4). [mnemonic: it'snot HIPP to have lupus]

hydralazine; INH; procainamide; phenytoin

Q4069:Drugs causing Hemolysis in G6PD-deficient patients(8)

sulfonamides; INH; aspirin; ibuprofen; primaquine;nitrofurantoin; pyrimethamine; chloramphenicol

Q4070:Drugs causing Thrombotic complications (1 class)

OCPs (e.g. estrogens and progestins)

Q4071:Drugs causing Adrenocortical insufficiency(withdrawal of what class of drugs causes adrenocortical

insufficiency?)

withdrawal of glucocorticoids causes hypothalamic-pituitary-axis suppression

Q4072:Drugs causing Photosensitivity reactions (3)[mnemonic: SAT for a photo]

Sulfonamides; amiodarone; tetracycline

Q4073:Drugs causing Induce P-450 system (6)

barbiturates; phenytoin; carbamazepine; rifampin;griseofulvin; quinidine

Q4074:Drugs causing Inhibit P-450 system (6; including onefruit)

cimetidine; ketoconazole; grapefruit; erythromycin; INH;sulfonamides

Q4075:Drugs causing Tubulointerstitial nephritis (5)

sulfonamides; furosemide; methicillin; rifampin; NSAIDs(except aspirin)

Q4076:Drugs causing Hot flashes (1)

Tamoxifen

Q4077:Drugs causing Cutaneous flushing (4)

niacin; Ca++ channel blockers; adenosine; vancomycin

Q4078:Drugs causing Cardiac toxicity (2)

doxorubicin (adriamycin); daunorubicin

Q4079:Drugs causing Agranulocytosis (3; all start with letterC)

clozapine; carbamazepine; colchicine

Q4080:Drugs causing Stevens-Johnson syndrome (3)

ethosuximide; sulfonamides; lamotrigine

Q4081:Drugs causing Cinchonism (2)

quinidine; quinine

Q4082:Drugs causing Tendonitis; tendon rupture and cartilagedamage (kids) (1)

fluoroquinolones

Q4083:Drugs causing Disulfiram-like reaction (4)

metronidazole; certain cephalosporins; procarbazine;sulfonylureas

Q4084:Drugs causing Otoxicity and nephrotoxicity (3)

aminoglycosides; loop diuretics; cisplatin

Q4085:Drugs causing Drug-induced Parkinson's (4)

haloperidol; chlorpromazine; resperine; MPTP

Q4086:Drugs causing Torsades de pointes (two subclasses ofantiarrhythmics)

Class III (sotalol); class IA (quinidine) antiarrhythmics

Q4087:Drugs causing Aplastic anemia (3)

chloramphenicol; benzene; NSAIDs

Q4088:Drugs causing Neuro/nephrotoxicity (1)

polymyxins

Q4089:Drugs causing Pseudomembranous colitis (2)

clindamycin; ampicillin

Q4090:Drugs causing Gynecomastia (5) [mnemonic: SomeDrugs Create Awesome Knockers]

spironolactone; digitalis; cimetidine; chronic Alcohol use;estrogens; ketoconazole

Q4091:Drugs causing Atropine-like side effects (1)

tricyclics

Q4092:Drugs causing Cough (1)

ACE inhibitors (losartan --> no cough)

Q4093:Drugs causing Gingival hyperplasia (1)

phenytoin

Q4094:Drugs causing Diabetes insipidus (1)

lithium

Q4095:Drugs causing Tardive dyskinesia (1)

antipsychotics

Q4096:Drugs causing Fanconi's syndrome (1)

tetracycline

Q4097:Drugs causing Gray baby syndrome (1)

chloramphenicol

Q4098:Drugs causing Extrapyramidal side effects (3)

chlorpromazine; thioridazine; haloperidol

Q4099:Drugs causing Osteoporosis (2)

corticosteroids; heparin

Q4100:Ethylene glycol is converted to ------- ------ by alcoholdehydrogenase. This product can lead to acidosis and

nephrotoxicity.

oxalic acid.

Q4101:Alcohol dehyrogenase also converts methanol toformaldehyde and formic acid; which can cause severe -----

and damage to the -------.

acidosis. retina

Q4102:Ethanol competes with ethylene glycol and methanol(if present) for alcohol dehydrogenase. ADH action on EtOH

produces -------.

acetaldehyde

Q4103:What symptoms does acetaldehyde cause?

nausea; vomiting; headache; hypotension

Q4104:Acetaldehyde itself can be metabolized byacetaldehyde dehydrogenase to ----- -----.

acetic acid.

Q4105:Acetaldehyde dehydrogenase is inhibited by whatdrug?

disulfiram.

Q4106:Clinical use of echinacea

common cold

Q4107:Clinical use of ephedra

as for ephedrine

Q4108:Clinical use of feverfew

migraine

Q4109:Clinical use of ginko

intermittent claudication

Q4110:Clinical use of kava

chronic anxiety

Q4111:Clinical use of milk thistle

viral hepatitis

Q4112:Clinical use of saw palmetto

benign prostatic hyperplasia

Q4113:Clinical use of St. John's wort

mild to moderate depression

Q4114:Clinical use of dehyroepiandrosterone

symptomatic improvement in females with SLE or AIDS

Q4115:Clinical use of Melatonin

jet lag; insomnia

Q4116:echinacea toxicity

GI distress; dizziness; and headache

Q4117:ephedra toxicity

CNS and cardiovascular stimulation; arrhythmias; stroke andseizures at high doses.

Q4118:feverfew toxicity

GI distress; mouth ulcers; antiplatelet actions

Q4119:ginko toxicity

GI distress; anxiety; insomnia; headache; and antiplateletactions

Q4120:kava toxicity

GI distress; sedation; ataxia; hepatotoxicity; phototoxicity;dermatotoxicity

Q4121:milk thistle toxicity

loose stools

Q4122:saw palmetto toxicity

GI distress; decreased libido; hypertension

Q4123:St. John's wort toxicity

GI distress and phototoxicity; serotonin syndrome withSSRIs

Q4124:dehyroepiandrosterone toxicity

Androgenization (premenopausal women); estrogenic effects(postmenopausal); feminization (young men)

Q4125:Melatonin toxicity

Sedation; suppresses midcycle LH; hypoprolactinemia

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