Neutropenia

1a
A common side effects of
Interferon (INF)
treatment is?
1b
TMP-SMZ
2a
Antimicrobial
prophylaxis for a history
of recurrent UTIs
2b
Ceftriaxone
3a
Antimicrobial
prophylaxis for
Gonorrhea
3b
Rifampin (DOC),
minocycline
4a
Antimicrobial
prophylaxis for
Meningococcal infection
4b
TMP-SMZ (DOC),
aerosolized pentamidine
5a
Antimicrobial
prophylaxis for PCP
5b
Benzathine penicillin G
6a
Antimicrobial
prophylaxis for Syphilis
6b
Yes
7a
Are Aminoglycosides
Teratogenic?
7b
No
8a
Are Ampicillin and
Amoxicillin penicillinase
resistant?
8b
No
9a
Are Carbenicillin,
Piperacillin, and
Ticarcillin penicillinase
resistant?
9b
No, but they are less
susceptible than the other
Beta lactams
10a
Are Cephalosporins
resistant to penicillinase?
10b
Yes
11a
Are Methicillin, Nafcillin,
and Dicloxacillin
penicillinase resistant?
11b
Mycobacterium
tuberculosis, the only
agent used as solo
prophylaxis against TB
12a
Clinical use of Isoniazid
(INH)?
12b
Pseudomembranous
colitis (C. difficile), fever,
diarrhea
13a
Common side effects
associated with
Clindamycin include?
13b
GI upset,
Superinfections, Skin
rashes, Headache,
Dizziness
14a
Common toxicities
associated with
Fluoroquinolones?
14b
Teratogenic,
Carcinogenic, Confusion,
Headaches
15a
Common toxicities
associated with
Griseofulvin?
15b
Glycoproteins from
leukocytes that block
various stages of viral
RNA and DNA synthesis
16a
Describe the MOA of
Interferons (INF)
16b
Only in limited amounts
17a
Do Tetracyclines
penetrate the CNS?
17b
AmOxicillin has greater
Oral bioavailability
18a
Does Ampicillin or
Amoxicillin have a
greater oral
bioavailability?
18b
No
19a
Does Amprotericin B
cross the BBB?
19b
No
20a
Does Foscarnet require
activation by a viral
kinase?
20b
Nephrotoxicity
21a
Foscarnet toxicity?
21b
Leukopenia,
Neutropenia,
Thrombocytopenia,
Renal toxicity
22a
Ganciclovir associated
toxicities?
22b
Chronic Hepatitis A and
B, Kaposi's Sarcoma
23a
How are Interferons
(INF) used clinically?
23b
Gram +, Gram -,
Norcardia, Chlamydia
24a
How are Sulfonamides
employed clinically?
24b
Triple Therapy' 2
Nucleoside RT Inhibitors
with a Protease Inhibitor
25a
How are the HIV drugs
used clinically?
25b
Primaquine
26a
How are the Latent
Hypnozoite (Liver) forms
of Malaria (P. vivax,
P.ovale) treated?
26b
Pyridoxine (B6)
administration
27a
How can Isoniazid
(INH)-induced
neurotoxicity be
prevented?
27b
Fast vs. Slow Acetylators
28a
How can the t1/2 of INH
be altered?
28b
With supplemental Folic
Acid
29a
How can the toxic effects
of TMP be ameliorated?
29b
Pretreat with
antihistamines and a
slow infusion rate
30a
How can Vancomycin-
induced 'Red Man
Syndrome' be prevented?
30b
As PABA antimetabolites
that inhibit
Dihydropteroate
Synthase, Bacteriostatic
31a
How do Sulfonamides act
on bacteria?
31b
Inhibt Assembly of new
virus by Blocking
Protease Enzyme
32a
How do the Protease
Inhibitors work?
32b
Ganciclovir is more toxic
to host enzymes
33a
How does Ganciclovir's
toxicity relate to that of
Acyclovir?
33b
With an amino acid
change of D-ala D-ala to
D-ala D-lac
34a
How does resistance to
Vancomycin occur?
34b
HSV, VZV, EBV,
Mucocutaneous and Genital
Herpes Lesions, Prophylaxis
in Immunocompromised
pts
35a
How is Acyclovir used
clinically?
35b
Prophylaxis for Influenza
A, Rubella; Parkinson's
disease
36a
How is Amantadine used
clinically?
36b
Intrathecally
37a
How is Amphotericin B
administered for fungal
meningitis?
37b
Wide spectrum of systemic
mycoses: Cryptococcus,
Blastomyces, Coccidioides,
Aspergillus, Histoplasma,
Candida, Mucor
38a
How is Amphotericin B
used clinically?
38b
Meningitis (H. influenza,
N. meningitidis, S.
pneumoniae), Conserative
treatment due to toxicities
39a
How is Chloramphenical
used clinically?
39b
CMV Retinitis in IC pts
when Ganciclovir fails
40a
How is Foscarnet used
clinically?
40b
Phosphorylation by a
Viral Kinase
41a
How is Ganciclovir
activated?
41b
CMV, esp in
Immunocompromised
patients
42a
How is Ganciclovir used
clinically?
42b
Oral treatment of
superficial infections
43a
How is Griseofulvin used
clinically?
43b
Pentavalent Antimony
44a
How is Leishmaniasis
treated?
44b
for RSV
45a
How is Ribavirin used
clinically?
45b
1. Mycobacterium tuberculosis
2. Delays resistance to
Dapsone when used of Leprosy
3. Used in combination with
other drugs
46a
How is Rifampin used
clinically?
46b
Used in combination
therapy with SMZ to
sequentially block folate
synthesis
47a
How is Trimethoprim
used clinically?
47b
For serious, Gram +
multidrug-resistant
organisms
48a
How is Vancomycin used
clinically?
48b
Suramin
49a
How would you treat
African Trypanosomiasis
(sleeping sickness)?
49b
Premature infants,
because they lack UDP-
glucuronyl transferase
50a
In what population does
Gray Baby Syndrome
occur? Why?
50b
No
51a
Is Aztreonam cross-
allergenic with
penicillins?
51b
Yes
52a
Is Aztreonam resistant to
penicillinase?
52b
No
53a
Is Aztreonam usually
toxic?
53b
Yes
54a
Is Imipenem resistant to
penicillinase?
54b
No - duh
55a
Is Penicillin penicillinase
resistant?
55b
Penicillin-G
56a
IV Penicillin
56b
Foscarnet =
pyroFosphate analog
57a
Mnemonic for Foscarnet?
57b
1)Binds penicillin-binding
proteins 2) Blocks
transpeptidase cross-
linking of cell wall 3)
Activates autolytic enzymes
58a
MOA for Penicillin (3
answers)?
58b
Penicillin, Cephalosporins,
Vancomycin,
Aminoglycosides,
Fluoroquinolones,
Metronidazole
59a
MOA: Bactericidal
antibiotics
59b
Penicillin, Ampicillin,
Ticarcillin, Pipercillin,
Imipenem, Aztreonam,
Cephalosporins
60a
MOA: Block cell wall
synthesis by inhib.
Peptidoglycan cross-
linking (7)
60b
Quinolones
61a
MOA: Block DNA
topoisomerases
61b
Rifampin
62a
MOA: Block mRNA
synthesis
62b
Sulfonamides,
Trimethoprim
63a
MOA: Block nucleotide
synthesis
63b
Bacitracin, Vancomycin
64a
MOA: Block
peptidoglycan synthesis
64b
Aminoglycosides,
Tetracyclines
65a
MOA: Block protein
synthesis at 30s subunit
65b
Chloramphenicol,
Erythromycin/macrolides,
Lincomycin, Clindamycin,
Streptogramins
(quinupristin, dalfopristin)
66a
MOA: Block protein
synthesis at 50s subunit
66b
Polymyxins
67a
MOA: Disrupt
bacterial/fungal cell
membranes
67b
Amphotericin B,
Nystatin,
Fluconazole/azoles
68a
MOA: Disrupt fungal cell
membranes
68b
Polymyxin B, Polymyxin
E
69a
Name common
Polymyxins
69b
Erythromycin,
Azithromycin,
Clarithromycin
70a
Name several common
Macrolides (3)
70b
Sulfamethoxazole (SMZ),
Sulfisoxazole, Triple
sulfas, Sulfadiazine
71a
Name some common
Sulfonamides (4)
71b
Tetracycline,
Doxycycline,
Demeclocycline,
Minocycline
72a
Name some common
Tetracyclines (4)
72b
Gentamicin, Neomycin,
Amikacin, Tobramycin,
Streptomycin
73a
Name the common
Aminoglycosides (5)
73b
Fluconazole,
Ketoconazole,
Clotrimazole,
Miconazole, Itraconazole
74a
Name the common
Azoles
74b
Ciprofloxacin,
Norfloxacin, Ofloxacin,
Grepafloxacin, Enoxacin,
Nalidixic acid
75a
Name the common
Fluoroquinolones (6)
75b
Nevirapine, Delavirdine
76a
Name the common Non-
Nucleoside Reverse
Transcriptase Inhibitors
76b
Zidovudine (AZT),
Didanosine (ddI),
Zalcitabine (ddC), Stavudine
(d4T), Lamivudine (3TC)
77a
Name the common
Nucleoside Reverse
Transcriptase Inhibitors
77b
Saquinavir, Ritonavir,
Indinavir, Nelfinavir
78a
Name the Protease
Inhibitors (4)
78b
Protease Inhibitors and
Reverse Transcriptase
Inhibitors
79a
Name two classes of
drugs for HIV therapy
79b
Staphlococcus aureus and
Clostridium difficile
(pseudomembranous
colitis)
80a
Name two organisms
Vancomycin is commonly
used for?
80b
Penicillin-V
81a
Oral Penicillin
81b
Modification via
Acetylation, Adenylation,
or Phosphorylation
82a
Resistance mechanisms
for Aminoglycosides
82b
Beta-lactamase cleavage
of Beta-lactam ring
83a
Resistance mechanisms for
Cephalosporins/Penicillins
83b
Modification via
Acetylation
84a
Resistance mechanisms
for Chloramphenicol
84b
Methylation of rRNA
near Erythromycin's
ribosome binding site
85a
Resistance mechanisms
for Macrolides
85b
Altered bacterial
Dihydropteroate
Synthetase, Decreased
uptake, or Increased PABA
synthesis
86a
Resistance mechanisms
for Sulfonamides
86b
Decreased uptake or
Increased transport out
of cell
87a
Resistance mechanisms
for Tetracycline
87b
Terminal D-ala of cell
wall replaced with D-lac;
Decreased affinity
88a
Resistance mechanisms
for Vancomycin
88b
Hemolysis (if G6PD
deficient), Neurotoxicity,
Hepatotoxicity, SLE-like
syndrome
89a
Side effects of Isoniazid
(INH)?
89b
Binds to the
Pyrophosphate Binding
Site of the enzyme
90a
Specifically, how does
Foscarnet inhibit viral
DNA pol?
90b
Inhibition of 50S
peptidyl transferase,
Bacteriostatic
91a
The MOA for
Chloramphenicol is?
91b
Megaloblastic anemia,
Leukopenia,
Granulocytopenia
92a
Toxic effects of TMP
include?
92b
Hormone synthesis
inhibition (Gynecomastia),
Liver dysfunction (Inhibits
CYP450), Fever, Chills
93a
Toxic side effects of the
Azoles?
93b
Delirium, Tremor,
Nephrotoxicity
94a
Toxicities associated with
Acyclovir?
94b
Rash,
Pseudomembranous
colitis
95a
What additional side
effects exist for
Ampicillin?
95b
Aminoglycosides
96a
What antimicrobial class
is Aztreonam
syngergestic with?
96b
Ataxia, Dizziness, Slurred
speech
97a
What are Amantadine-
associated side effects?
97b
Beta-lactam antibiotics
98a
What are
Aminoglycosides
synergistic with?
98b
Severe Gram - rod
infections.
99a
What are
Aminoglycosides used for
clinically?
99b
Nephrotoxicity (esp. with
Cephalosporins),
Ototoxicity (esp. with
Loop Diuretics)
100a
What are common serious
side effects of
Aminoglycosides and what
are these associated with?
100b
Fever/Chills,
Hypotension,
Nephrotoxicity,
Arrhythmias
101a
What are common side
effects of Amphotericin
B?
101b
GI intolerance (nausea,
diarrhea), Hyperglycemia,
Lipid abnormalities,
Thrombocytopenia
(Indinavir)
102a
What are common side
effects of Protease
Inhibitors?
102b
BM suppression
(neutropenia, anemia),
Peripheral neuropathy
103a
What are common side
effects of RT Inhibitors?
103b
-Hypersensitivity reactions -
Hemolysis -Nephrotoxicity
(tubulointerstitial nephritis) -
Kernicterus in infants Displace
other drugs from albumin (e.g.,
warfarin)
104a
What are common toxic
side effects of
Sulfonamides? (5)
104b
GI discomfort, Acute
cholestatic hepatitis,
Eosinophilia, Skin rashes
105a
What are common
toxicities associated with
Macrolides? (4)
105b
GI distress, Tooth
discoloration and Inhibition
of bone growth in children,
Fanconi's syndrome,
Photosensitivity
106a
What are common
toxicities associated with
Tetracyclines?
106b
Well tolerated in general but
occasionally, Nephrotoxicity,
Ototoxicity, Thrombophlebitis,
diffuse flushing='Red Man
Syndrome'
107a
What are common
toxicities related to
Vancomycin therapy?
107b
1.Gram - rods of the
Urinary and GI tracts
(including Pseudomonas)
2.Neisseria 3. Some Gram
+ organisms
108a
What are
Fluoroquinolones
indicated for? (3)
108b
Hypersensitivity
reactions
109a
What are major side
effects of Methicillin,
Nafcillin, and
Dicloxacillin?
109b
Staphlococcus aureus
110a
What are Methicillin,
Nafcillin, and
Dicloxacillin used for
clinically?
110b
Resistant Gram -
infections
111a
What are Polymyxins
used for?
111b
Rifampin, Ethambutol,
Streptomycin,
Pyrazinamide, Isoniazid
(INH)
112a
What are the Anti-TB
drugs?
112b
Systemic mycoses
113a
What are the clinical
indications for Azole
therapy?
113b
Gram + cocci, Proteus
mirabilis, E. coli,
Klebsiella pneumoniae
(PEcK)
114a
What are the clinical uses
for 1st Generation
Cephalosporins?
114b
Gram + cocci, Haemophilus
influenza, Enterobacter
aerogenes, Neisseria species, P.
mirabilis, E. coli, K. pneumoniae,
Serratia marcescens ( HEN
PEcKS )
115a
What are the clinical uses
for 2nd Generation
Cephalosporins?
115b
1) Serious Gram - infections
resistant to other Beta
lactams 2) Meningitis (most
penetrate the BBB)
116a
What are the clinical uses
for 3rd Generation
Cephalosporins?
116b
Gram - rods: Klebsiella
species, Pseudomonas
species, Serratia species
117a
What are the clinical uses
for Aztreonam?
117b
Gram + cocci, Gram -
rods, and Anerobes
118a
What are the clinical uses
for Imipenem/cilastatin?
118b
-Upper respiratory tract
infections -pneumonias -STDs:
Gram+ cocci (streptococcal
infect in pts allergic to penicillin)
-Mycoplasma,
Legionella,Chlamydia, Neisseria
119a
What are the Macrolides
used for clinically?
119b
Cephalosporin: 1) has a 6
member ring attached to the
Beta lactam instead of a 5
member ring 2)has an extra
functional group ( attached to
the 6 member ring)
120a
What are the major
structural differences
between Penicillin and
Cephalosporin?
120b
GI distress, Skin rash,
and Seizures at high
plasma levels
121a
What are the major toxic
side effects of
Imipenem/cilastatin?
121b
1) Hypersensitivity reactions 2)
Increased nephrotoxicity of
Aminoglycosides 3) Disulfiram-
like reaction with ethanol (those
with a methylthiotetrazole
group, e.g., cefamandole)
122a
What are the major toxic
side effects of the
Cephalosporins?
122b
Neurotoxicity, Acute
renal tubular necrosis
123a
What are the side effects
of Polymyxins?
123b
Minor hepatotoxicity,
Drug interactions
(activates P450)
124a
What are the side effects
of Rifampin?
124b
Disulfiram-like reaction
with EtOH, Headache
125a
What are toxic side
effects for
Metronidazole?
125b
Aplastic anemia (dose
independent), Gray Baby
Syndrome
126a
What are toxicities
associated with
Chloramphenicol?
126b
Giardiasis, Amoebic
dysentery (E. histolytica),
Bacterial vaginitis
(Gardnerella vaginalis),
Trichomonas
127a
What conditions are
treated with
Metronidazole?
127b
Oxygen
128a
What do
Aminoglycosides require
for uptake?
128b
Mebendazole/Thiabendazole,
Pyrantel Pamoate
129a
What do you treat
Nematode/roundworm
(pinworm, whipworm)
infections with?
129b
Pentamidine
130a
What drug is given for
Pneumocystis carinii
prophylaxis?
130b
AZT, to reduce risk of
Fetal Transmission
131a
What drug is used during
the pregnancy of an
HIV+ mother?, Why?
131b
Praziquantel
132a
What drug is used to treat
Trematode/fluke (e.g.,
Schistosomes,
Paragonimus, Clonorchis)
or Cysticercosis
132b
Increases coumadin
metabolism
133a
What is a common drug
interaction associated
with Griseofulvin?
133b
Blocks Influenza A and
RubellA; causes problems
with the cerebellA
134a
What is a mnemonic to
remember Amantadine's
function?
134b
It must be
Phosphorylated by Viral
Thymidine Kinase
135a
What is a prerequisite for
Acyclovir activation?
135b
Hemolytic anemia
136a
What is a Ribavirin
toxicity?
136b
RESPIre
137a
What is an acronym to
remember Anti-TB
drugs?
137b
Interstitial nephritis
138a
What is an additional
side effect of Methicillin?
138b
GI upset
139a
What is an occasional
side effect of Aztreonam?
139b
Anaerobic infections
(e.g., B. fragilis, C.
perfringens)
140a
What is Clindamycin
used for clinically?
140b
Pseudomonas species
and Gram - rods
141a
What is clinical use for
Carbenicillin,
Piperacillin, and
Ticarcillin?
141b
Recurrent UTIs, Shigella,
Salmonella,
Pneumocystis carinii
pneumonia
142a
What is combination
TMP-SMZ used to treat?
142b
Clavulanic acid
143a
What is combined with
Ampicillin, Amoxicillin,
Carbenicillin, Piperacillin,
and Ticarcillin to enhance
their spectrum?
143b
Cryptococcal meningitis
in AIDS patients and
Candidal infections of all
types
144a
What is Fluconazole
specifically used for?
144b
Cilastatin
145a
What is Imipenem always
administered with?
145b
Blastomyces,
Coccidioides,
Histoplasma, C. albicans;
Hypercortisolism
146a
What is Ketoconazole
specifically used for?
146b
Bismuth and Amoxicillin
or Tetracycline; against
Helobacter pylori
147a
What is Metronidazole
combined with for 'triple
therapy'? Against what
organism?
147b
Antiprotozoal: Giardia,
Entamoeba, Trichomonas,
Gardnerella vaginalis
Anaerobes: Bacteroides,
Clostridium
148a
What is Metronidazole
used for clinically?
148b
Cestode/tapeworm (e.g.,
D. latum, Taenia species
Except Cysticercosis
149a
What is Niclosamide
used for?
149b
Chagas' disease,
American
Trypanosomiasis
(Trypanosoma cruzi)
150a
What is Nifurtimox
administered for?
150b
DHPG (dihydroxy-2-
propoxymethyl guanine)
151a
What is the chemical
name for Ganciclovir?
151b
Extended spectrum
penicillin: certain Gram
+ bacteria and Gram -
rods
152a
What is the clinical use
for Ampicillin and
Amoxicillin?
152b
Topical and Oral, for Oral
Candidiasis (Thrush)
153a
What is the clinical use
for Nystatin?
153b
Bactericidal for: Gram +
rod and cocci, Gram -
cocci, and Spirochetes
154a
What is the clinical use
for Penicillin?
154b
Hypersensitivity
reactions
155a
What is the major side
effect for Ampicillin and
Amoxicillin?
155b
Hypersensitivity
reactions
156a
What is the major side
effect for Carbenicillin,
Piperacillin, and
Ticarcillin?
156b
Hypersensitivity
reactions
157a
What is the major toxic
side effect of Penicillin?
157b
Buy AT 30, CELL at 50'
158a
What is the memory aid
for subunit distribution
of ribosomal inhibitors?
158b
INH: Injures Neurons
and Hepatocytes
159a
What is the memory key for
Isoniazid (INH) toxicity?
159b
GET on the Metro
160a
What is the memory key
for Metronidazole's
clinical uses?
160b
VACUUM your Bed
Room'
161a
What is the memory key
for organisms treated
with Tetracyclines?
161b
1. RNA pol inhibitor 2.
Revs up P450 3.
Red/orange body fluids 4.
Rapid resistance if used
alone
162a
What is the memory key
involving the '4 R's of
Rifampin?'
162b
Inhibit viral DNA
polymerase
163a
What is the MOA for
Acyclovir?
163b
Binds Ergosterol, forms
Membrane Pores that
Disrupt Homeostatis
164a
What is the MOA for
Amphotericin B?
164b
Same as penicillin.
Extended spectrum
antibiotics
165a
What is the MOA for
Ampicillin and
Amoxicillin?
165b
Same as penicillin.
Extended spectrum
antibiotics
166a
What is the MOA for
Carbenicillin,
Piperacillin, and
Ticarcillin?
166b
Blocks Peptide Bond
formation at the 50S
subunit, Bacteriostatic
167a
What is the MOA for
Clindamycin?
167b
Same as penicillin. Act as
narrow spectrum
antibiotics
168a
What is the MOA for
Methicillin, Nafcillin, and
Dicloxacillin?
168b
Forms toxic metabolites
in the bacterial cell,
Bactericidal
169a
What is the MOA for
Metronidazole?
169b
Binds ergosterol, Disrupts
fungal membranes
170a
What is the MOA for
Nystatin?
170b
Inhibits DNA dependent
RNA polymerase
171a
What is the MOA for
Rifampin?
171b
Inhibits formation of
Initiation Complex,
causes misreading of
mRNA, Bactericidal
172a
What is the MOA for the
Aminoglycosides?
172b
Inhibit Ergosterol
synthesis
173a
What is the MOA for the
Azoles?
173b
Beta lactams - inhibit cell
wall synthesis,
Bactericidal
174a
What is the MOA for the
Cephalosporins?
174b
Inhibit DNA Gyrase
(topoisomerase II),
Bactericidal
175a
What is the MOA for the
Fluoroquinolones?
175b
Blocks translocation,
binds to the 23S rRNA of
the 50S subunit,
Bacteriostatic
176a
What is the MOA for the
Macrolides?
176b
Binds 30S subunit and
prevents attachment of
aminoacyl-tRNA,
Bacteriostatic
177a
What is the MOA for the
Tetracyclines?
177b
Inhibits bacterial
Dihydrofolate Reductase,
Bacteriostatic
178a
What is the MOA for
Trimethoprim (TMP)?
178b
Inhibits cell wall
mucopeptide formation,
Bactericidal
179a
What is the MOA for
Vancomycin?
179b
Blocks viral
penetration/uncoating;
may act to buffer the pH
of the endosome
180a
What is the MOA of
Amantadine?
180b
Inhibits cell wall
synthesis ( binds to
PBP3). A monobactam
181a
What is the MOA of
Aztreonam?
181b
Inhibits Viral DNA
polymerase
182a
What is the MOA of
Foscarnet?
182b
Inhibits CMV DNA
polymerase
183a
What is the MOA of
Ganciclovir?
183b
Interferes with
microtubule function,
disrupts mitosis, inhibits
growth
184a
What is the MOA of
Griseofulvin?
184b
Acts as a wide spectrum
carbapenem
185a
What is the MOA of
Imipenem?
185b
Decreases synthesis of
Mycolic Acid
186a
What is the MOA of
Isoniazid (INH)?
186b
Bind cell membrane, disrupt
osmotic properties, Are
Cationc, Basic and act as
detergents
187a
What is the MOA of
Polymyxins?
187b
Inhibits IMP
Dehydrogenase
(competitively), and
therefore blocks Guanine
Nucleotide synthesis
188a
What is the MOA of
Ribavirin?
188b
Inhibit RT of HIV and
prevent the incorporation
of viral genome into the
host DNA
189a
What is the MOA of the
RT Inhibitors?
189b
GI discomfort
190a
What is the most
common cause of Pt
noncompliance with
Macrolides?
190b
Malaria (P. falciparum)
191a
What is treated with
Chloroquine, Quinine,
Mefloquine?
191b
Anaerobes
192a
What microorganisms
are Aminoglycosides
ineffective against?
192b
Vibrio cholerae Acne Chlamydia
Ureaplasma Urealyticum
Mycoplasma pneumoniae Borrelia
burgdorferi (Lyme's) Rickettsia
Tularemia
193a
What microorganisms
are clinical indications
for Tetracycline therapy?
193b
Gram + and Anerobes
194a
What microorganisms is
Aztreonam not effective
against?
194b
Tendonitis and Tendon
rupture
195a
What musculo-skeletal
side effects in Adults are
associated with
Floroquinolones?
195b
Dopamine; causes its
release from intact nerve
terminals
196a
What neurotransmitter
does Amantadine affect?
How does it influence
this NT?
196b
Enterobacter
197a
What organism is
Imipenem/cilastatin the
Drug of Choice for?
197b
Dermatophytes (tinea,
ringworm)
198a
What organisms does
Griseofulvin target?
198b
Giant Roundworm
(Ascaris), Hookworm
(Necator/Ancylostoma),
Pinworm (Enterobius)
199a
What parasites are
treated with Pyrantel
Pamoate (more specific)?
199b
Onchocerciasis ('river
blindness'--rIVER-
mectin)
200a
What parasitic condition is
treated with Ivermectin?
200b
Pregnant women,
Children; because animal
studies show Damage to
Cartilage
201a
What populations are
Floroquinolones
contraindicated in? Why?
201b
Milk or Antacids, because
divalent cations inhibit
Tetracycline absorption
in the gut
202a
What should not be taken
with Tetracyclines? /
Why?
202b
Triple sulfas or SMZ
203a
What Sulfonamides are
used for simple UTIs?
203b
When pts have Low
CD4+ (< 500 cells/cubic
mm) or a High Viral Load
204a
When is HIV therapy
initiated?
204b
1. Meningococcal carrier
state 2. Chemoprophylaxis
in contacts of children with
H. influenzae type B
205a
When is Rifampin not
used in combination with
other drugs?
205b
Keratin containing
tissues, e.g., nails
206a
Where does Griseofulvin
deposit?
206b
Neomycin
207a
Which Aminoglycoside is
used for Bowel Surgery ?
207b
1) Aminoglycosides =
bactericidal 2)
Tetracyclines =
bacteriostatic
208a
Which antimicrobial
classes inhibit protein
synthesis at the 30S
subunit? (2)
208b
1) Chloramphenical =
bacteriostatic 2) Erythromycin
= bacteriostatic 3) Lincomycin
= bacteriostatic 4)cLindamycin
= bacteriostatic
209a
Which antimicrobials
inhibit protein synthesis
at the 50S subunit? (4)
209b
G6PD deficient
individuals
210a
Which individuals are
predisposed to
Sulfonamide-induced
hemolysis?
210b
AZT
211a
Which RT inhibitor
causes Megaloblastic
Anemia?
211b
Non-Nucleosides
212a
Which RT inhibitors
cause a Rash?
212b
Nucleosides
213a
Which RT inhibitors
cause Lactic Acidosis?
213b
Doxycycline, because it is
fecally eliminated
214a
Which Tetracycline is
used in patients with
renal failure? / Why?
214b
Due to the presence of a
bulkier R group
215a
Why are Methicillin,
Nafcillin, and
Dicloxacillin penicillinase
resistant?
215b
To inhibit renal
Dihydropeptidase I and
decrease Imipenem
inactivation in the renal
tubules
216a
Why is Cilastatin
administered with
Imipenem?
216b
-S-phase anti-metabolite Pyr
analogue -Colon, solid
tumors, & BCC/ -
Irreversible
myelosuppression
217a
List the mechanism,
clinical use, & toxicity of
5 FU.
217b
-inhibits HGPRT (pur.
Syn.) - Luk, Lymph,
218a
List the mechanism,
clinical use, & toxicity of
6 MP.
218b
-DNA intercalator -
testicular & lymphomas -
Pulmonary fibrosis mild
myelosuppression.
219a
List the mechanism,
clinical use, & toxicity of
Bleomycin.
219b
-Alkalates DNA -CML -
Pulmonary fibrosis
hyperpigmentation
220a
List the mechanism,
clinical use, & toxicity of
Busulfan.
220b
-Alkalating agent -
testicular,bladder,ovary,&
lung -Nephrotoxicity &
CN VIII damage.
221a
List the mechanism,
clinical use, & toxicity of
Cisplatin.
221b
-Alkalating agent -NHL,
Breast, ovary, & lung. -
Myelosuppression, &
hemorrhagic cystitis.
222a
List the mechanism,
clinical use, & toxicity of
Cyclophosphamide.
222b
-DNA intercalator -
Hodgkin's, myeloma,
sarcoma, and solid tumors
-Cardiotoxicity & alopecia
223a
List the mechanism,
clinical use, & toxicity of
Doxorubicin.
223b
-Topo II inhibitor(GII
specific) -Oat cell of Lung &
prostate, & testicular -
Myelosuppression & GI
irritation.
224a
List the mechanism,
clinical use, & toxicity of
Etoposide.
224b
-S-phase anti-metabolite
folate analogue -Luk, Lymp,
sarc, RA, & psoriasis / -
Reversible
myelosuppression
225a
List the mechanism,
clinical use, & toxicity of
Methotrexate.
225b
-Alkalate DNA -Brain
tumors -CNS toxicity
226a
List the mechanism,
clinical use, & toxicity of
Nitrosureas.
226b
-MT polymerization
stabilizer -Ovarian & breast
CA -Myelosupperession &
hypersensitivity.
227a
List the mechanism,
clinical use, & toxicity of
Paclitaxel.
227b
-Triggers apoptosis -CLL,
Hodgkin's in MOPP -
Cushing-like syndrome
228a
List the mechanism,
clinical use, & toxicity of
Prednisone.
228b
-Estrogen receptor
antagonist -Breast CA -
increased endometrial CA
risk
229a
List the mechanism,
clinical use, & toxicity of
Tamoxifen.
229b
-MT polymerization inhibitor(M
phase) -MOPP, lymphoma,
Willm's & choriocarcinoma -
neurotoxicity and
myelosuppression
230a
List the mechanism,
clinical use, & toxicity of
Vincristine.
230b
-Alkalating agents+cisplatin
-Doxorubicin+Dactinomycin
-Bleomycin -Etoposide
231a
Which cancer drugs effect
nuclear DNA (4)?
231b
- Methotrexate - 5 FU - 6
mercaptopurine
232a
Which cancer drugs
inhibit nucleotide
synthesis(3)?
232b
-Steroids -Tamoxifen
233a
Which cancer drugs work
at the level of mRNA(2)?
233b
-Vinca alkaloids(inhibit
MT) -Paclitaxel
234a
Which cancer drugs work
at the level of proteins(2)?
234b
hypertension, CHF,
diabetic renal disease
235a
ACE inhibitors- clinical
use?
235b
reduce levels of Angiotensin
II, thereby preventing the
inactivation of bradykinin (a
potent vasodilator); renin
level is increased
236a
ACE inhibitors-
mechanism?
236b
fetal renal damage, hyperkalemia,
Cough, Angioedema, Proteinuria,
Taste changes, hypOtension,
Pregnancy problems, Rash,
Increased renin, Lower
Angiotensin II (CAPTOPRIL)
237a
ACE inhibitors- toxicity?
237b
glaucoma, urinary
alkalinization, metabolic
alkalosis, altitude
sickness
238a
Acetazolamide- clinical
uses?
238b
acts at the proximal convoluted
tubule to inhibit carbonic
anhydrase. Causes self-limited
sodium bicarb diuresis and
reduction of total body bicarb
stores.
239a
Acetazolamide-
mechanism?
239b
proximal convoluted
tubule
240a
acetazolamide- site of
action?
240b
hyperchloremic
metabolic acidosis,
neuropathy, NH3
toxicity, sulfa allergy
241a
Acetazolamide- toxicity?
241b
ACIDazolamide' causes
acidosis
242a
Acetazolamide causes?
242b
DOC in diagnosing and
abolishing AV nodal
arrhythmias
243a
Adenosine- clinical use?
243b
collecting ducts
244a
ADH antagonists- site of
action?
244b
cyanide toxicity (releases
CN)
245a
adverse effect of
Nitroprusside?
245b
impotence, asthma, CV
effects (bradycardia, CHF,
AV block), CNS effects
(sedation, sleep
alterations)
246a
adverse effects of beta-
blockers?
246b
fetal renal toxicity, hyperkalemia,
Cough, Angioedema, Proteinuria,
Taste changes, hypOtension,
Pregnancy problems, Rash,
Increased renin, Lower
Angiotensin II (CAPTOPRIL)
247a
adverse effects of
Captopril?
247b
dry mouth, sedation,
severe rebound
hypertension
248a
adverse effects of
Clonidine?
248b
severe orthostatic
hypotension, blurred
vision, constipation,
sexual dysfunction
249a
adverse effects of
ganglionic blockers?
249b
orthostatic and exercise
hypotension, sexual
dysfunction, diarrhea
250a
adverse effects of
Guanethidine?
250b
nausea, headache, lupus-
like syndrome, reflex
tachycardia, angina, salt
retention
251a
adverse effects of
Hydralazine?
251b
hypokalemia, slight
hyperlipidemia,
hyperuricemia, lassitude,
hypercalcemia,
hyperglycemia
252a
adverse effects of
Hydrochlorothiazide?
252b
K+ wasting, metabolic
alkalosis, hypotension,
ototoxicity
253a
adverse effects of Loop
Diuretics?
253b
fetal renal toxicity,
hyperkalemia
254a
adverse effects of
Losartan?
254b
sedation, positive
Coombs' test
255a
adverse effects of
Methyldopa?
255b
hypertrichosis,
pericardial effusion,
reflex tachycardia,
angina, salt retention
256a
adverse effects of
Minoxidil?
256b
dizziness, flushing,
constipation (verapamil),
nausea
257a
adverse effects of
Nifedipine, verapamil?
257b
first dose orthostatic
hypotension, dizziness,
headache
258a
adverse effects of
Prazosin?
258b
sedation, depression,
nasal stuffiness, diarrhea
259a
adverse effects of
Reserpine?
259b
pulmonary fibrosis, corneal deposits,
hepatotoxicity, skin deposits resulting
in photodermatitis, neurologic
effects, consitpation, CV
(bradycardia, heart block, CHF), and
hypo- or hyperthyroidism.
260a
Amiodarone- toxicity?
260b
sedation, sleep
alterations
261a
Beta Blockers- CNS
toxicity?
261b
bradycardia, AV block,
CHF
262a
Beta Blockers- CV
toxicity?
262b
Beta adrenergic receptors
and Ca2+ channels
(stimulatory)
263a
Beta Blockers- site of
action?
263b
decrease
264a
Beta Blockers- BP?
264b
new arrhythmias,
hypotension
265a
Bretyllium- toxicity?
265b
hypertension, angina,
arrhythmias
266a
Ca2+ channel blockers-
clinical use?
266b
block voltage dependent L-
type Ca2+ channels of
cardiac and smooth muscle-
decreasing contractility
267a
Ca2+ channel blockers-
mechanism?
267b
Cell membrane Ca2+
channels of cardiac
sarcomere
268a
Ca2+ channel blockers-
site of action?
268b
cardiac depression,
peripheral edema,
flushing, dizziness,
constipation
269a
Ca2+ channel blockers-
toxicity?
269b
troponin-tropomyosin
system
270a
Ca2+ sensitizers'- site of
action?
270b
check PFTs, LFTs, and
TFTs
271a
Cautions when using
Amiodarone?
271b
increased AP duration,
increased ERP increased
QT interval. Atrial and
ventricular.
272a
Antiarrhythmic class IA
effects?
272b
post MI and digitalis
induced arrhythmias
273a
Antiarrhythmic class IB-
clinical uses?
273b
decrease AP duration,
affects ischemic or
depolarized Purkinje and
ventricular system
274a
Antiarrhythmic class IB-
effects?
274b
local anesthetic. CNS
stimulation or
depression. CV
depression.
275a
Antiarrhythmic class IB-
toxicity?
275b
NO AP duration effect.
useful in V-tach that
progresses to V-fib and in
intractable SVT LAST
RESORT
276a
Antiarrhythmic class IC-
effects?
276b
proarrhythmic
277a
Antiarrhythmic class IC-
toxicity?
277b
decrease the slope of phase
4, increase PR interval (the
AV node is particularly
sensitive)
278a
Antiarrhythmic class II-
effects?
278b
blocking the beta
adrenergic receptor leads
to decreased cAMP, and
decreased Ca2+ flux
279a
Antiarrhythmic class II-
mechanism?
279b
impotence, exacerbation
of asthma, CV effects,
CNS effects, may mask
hypoclycemia
280a
Antiarrhythmic class II-
toxicity?
280b
increase AP duration,
increase ERP, increase QT
interval, for use when other
arrhythmics fail
281a
Antiarrhythmic Class III-
effects?
281b
prevention of nodal
arrhythmias (SVT)
282a
Antiarrhythmic class IV-
clinical use?
282b
decrease conduction
velocity, increase ERP,
increase PR interval
283a
Antiarrhythmic class IV-
effects?
283b
AV nodal cells
284a
Antiarrhythmic class IV-
primary site of action?
284b
constipation, flushing,
edema, CV effects (CHF, AV
block, sinus node
depression), and torsade de
pointes (Bepridil)
285a
Antiarrhythmic class IV-
toxicity?
285b
diuretics, sympathoplegics,
vasodilators, ACE
inhibitors, Angiotensin II
receptor inhibitors
286a
classes of
antihypertensive drugs?
286b
NO
287a
decrease Digitoxin dose
in renal failure?
287b
YES
288a
decrease Digoxin dose in
renal failure?
288b
Na/K ATPase
289a
Digitalis- site of action?
289b
Digitoxin>95% Digoxin
75%
290a
Digoxin v. Digitoxin:
bioavailability?
290b
Digoxin=urinary
Digitoxin=biliary
291a
Digoxin v. Digitoxin:
excretion?
291b
Digitoxin 168hrs Digoxin
40 hrs
292a
Digoxin v. Digitoxin: half
life?
292b
Digitoxin 70% Digoxin
20-40%
293a
Digoxin v. Digitoxin:
protein binding?
293b
very short acting
294a
Esmolol- short or long
acting?
294b
Diuresis in pateints with
sulfa allergy
295a
Ethacrynic Acid- clinical
use?
295b
not a sulfonamide, but
action is the same as
furosemide
296a
Ethacrynic Acid-
mechanism?
296b
NO HYPERURICEMIA,
NO SULFA ALLERGY;
same as furosemide
otherwise
297a
Ethacrynic Acid-
toxicity?
297b
Sulfonamide Loop Diuretic.
Inhibits ion co-transport system of
thick ascending loop. Abolishes
hypertonicity of the medulla,
thereby preventing concentration
of the urine.
298a
Furosemide- class and
mechanism?
298b
edematous states (CHF,
cirrhosis, nephrotic
syndrome, pulm edema),
HTN, hypercalcemia
299a
Furosemide- clinical use?
299b
Ototoxicity, Hypokalemia,
Dehydration, Allergy
(sulfa), Nephritis
(interstitial), Gout
300a
Furosemide- toxicity?
(OH DANG)
300b
Ca2+ (Loops Lose
calcium)
301a
Furosemide increases the
excretion of what ion?
301b
decrease myocardial O2
consumption by: 1-decreasing
end diastolic volume 2-
decreasing BP 3- decreasing HR
4-decreasing contractility 5-
decreasing ejection time
302a
how do we stop angina?
302b
vasodilator- increases
cGMP to induce smooth
muscle relaxation
(arterioles>veins; afterload
reduction)
303a
Hydralazine- class and
mechanism?
303b
severe hypertension,
CHF
304a
Hydralazine- clinical use?
304b
compensatory
tachycardia, fluid
retention, lupus-like
syndrome
305a
Hydralazine- toxicity?
305b
HTN, CHF, calcium
stone formation,
nephrogenic DI.
306a
Hydrochlorothiazide-
clinical use?
306b
Inhibits NaCl
reabsorption in the early
distal tubule. Decreases
Ca2+ excretion.
307a
Hydrochlorothiazide-
mechanism?
307b
Hypokalemic metabolic alkalosis,
hyponatremia, hyperGlycemia,
hyperLipidemia, hyperUricemia,
hyperCalcemia, sulfa allergy.
308a
Hydrochlorothiazide-
toxicity? (hyperGLUC,
plus others)
308b
torsade de pointes
309a
Ibutilide- toxicity?
309b
depresses ectopic
pacemakers, especially in
digoxin toxicity
310a
K+- clinical use?
310b
hyperaldosteronism, K+
depletion, CHF
311a
K+ sparing diuretics-
clinical use?
311b
cortical collecting tubule
312a
K+ sparing diuretics- site
of action?
312b
hyperkalemia, endocrine
effects (gynecomastia,
anti-androgen)
313a
K+ sparing diuretics-
toxicity?
313b
thick ascending limb
314a
loop diuretics
(furosemide)- site of
action?
314b
ARF, shock, drug
overdose, decrease
intracranial/intraocular
pressure
315a
Mannitol- clinical use?
315b
anuria, CHF
316a
Mannitol-
contraindications?
316b
osmotic diuretic-
increase tubular fluid
osmolarity, thereby
increasing urine flow
317a
Mannitol- mechanism?
317b
proximal convoluted
tubule, thin descending
limb, and collecting duct
318a
mannitol- site of action?
318b
pulmonary edema,
dehydration
319a
Mannitol- toxicity?
319b
effective in torsade de
pointes and digoxin
toxicity
320a
Mg+- clinical use?
320b
propanolol, esmolol,
metoprolol, atenolol,
timolol
321a
name five Antiarrhythmic
drugs in class II?
321b
Lovastatin, Pravastatin,
Simvastatin, Atorvastatin
322a
name four HMG-CoA
reductase inhibitors.
322b
Quinidine, Amiodarone,
Procainamide,
Disopyramide
323a
name four
Antiarrhythmic drugs in
class IA.
323b
Sotalol, Ibutilide,
Bretylium, Amiodarone
324a
name four
Antiarrhythmic drugs in
class III.
324b
Captopril, Enalapril,
Lisinopril
325a
name three ACE
inhibitors?
325b
Nifedipine, Verapamil,
Diltiazem
326a
name three calcium
channel blockers?
326b
Lidocaine, Mexiletine,
Tocainide
327a
name three
Antiarrhythmic drugs in
class IB.
327b
Flecainide, Encainide,
Propafenone
328a
name three
Antiarrhythmic drugs in
class IC.
328b
Verapamil, Diltiazem,
Bepridil
329a
name three
Antiarrhythmic drugs in
class IV.
329b
Spironolactone,
Triamterene, Amiloride
(the K+ STAys)
330a
name three K+ sparing
diuretics?
330b
cholestyramine,
colestipol
331a
name two bile acid resins.
331b
Gemfibrozil, Clofibrate
332a
name two LPL
stimulators.
332b
Nitrates
333a
Nifedipine has similar
action to?
333b
cardiac muscle:
Verapamil>Diltiazem>Nifedipine
334a
preferential action of the
Ca2+ channel blockers at
cardiac muscle?
334b
vascular sm. Mus.:
Nifedipine>Diltiazem>Verapamil
335a
preferential action of the
Ca2+ channel blockers at
vascular smooth muscle?
335b
reversible SLE-like
syndrome
336a
Procainamide- toxicity?
336b
cinchonism: HA, tinnitus,
thrombocytopenia, torsade
de pointes due to increased
QT interval
337a
Quinidine- toxicity?
337b
blocks SR Ca2+ channels
338a
Ryanodine- site of
action?
338b
torsade de pointes,
excessive Beta block
339a
Sotalol- toxicity?
339b
competitive inhibirot of
aldosterone in the
cortical collecting tubule
340a
Spironolactone-
mechanism?
340b
distal convoluted tubule
(early)
341a
thiazides- site of action?
341b
block Na+ channels in
the cortical collecting
tubule
342a
Triamterene and
amiloride- mechanism?
342b
Beta Blockers
343a
Verapamil has similar
action to?
343b
Hydralazine and
Minoxidil
344a
what two vasodilators require
simultaneous treatment with
beta blockers to prevent reflex
tachycardia and diuretics to
prevent salt retention?
344b
carbonic anhydrase
inhibitors, K+ sparing
diuretics
345a
which diuretics cause
acidosis?
345b
loop diuretics, thiazides
346a
which diuretics cause
alkalosis?
346b
thiazides, amiloride
347a
which diuretics decrease
urine Ca2+?
347b
loop diuretics,
spironolactone
348a
which diuretics increase
urine Ca2+?
348b
all except the K+ sparing
diuretics Spironolactone,
Triamterene, Amiloride
349a
which diuretics increase
urine K+?
349b
all of them
350a
which diuretics increase
urine NaCl?
350b
Acetaminophen has
antipyretic and analgesic
properties, but lacks anti-
inflammatory properties.
351a
Acetaminophen has what
two clinical uses and
lacks what one clinical
use of the NSAIDs?
351b
Yes, it does not cross the
placenta.
352a
Can Heparin be used
during pregnancy?
352b
No, warfarin, unlike
heparin, can cross the
placenta.
353a
Can Warfarin be used
during pregnancy?
353b
Short.
354a
Does Heparin have a
long, medium, or short
half life?
354b
Long.
355a
Does Warfarin have a
long, medium, or short
half life?
355b
Large anionic polymer,
acidic
356a
For Heparin what is the
Structure
356b
Paranteral (IV, SC)
357a
For Heparin what is the
Route of administration
357b
Rapid (seconds)
358a
For Heparin what is the
Onset of action
358b
Activates antithrombin
III
359a
For Heparin what is the
Mechanism of action
359b
Acute (hours)
360a
For Heparin what is the
Duration of action
360b
Yes
361a
For Heparin what is the
Ability to inhibit
coagulation in vitro
361b
Protamine sulfate
362a
For Heparin what is the
Treatment for overdose
362b
aPTT (intrinsic pathway)
363a
For Heparin what is the
Lab value to monitor
363b
Blood
364a
For Heparin what is the
Site of action
364b
Small lipid-soluble
molecule
365a
For Warfarin what is the
Structure
365b
Oral
366a
For Warfarin what is the
Route of administration
366b
Slow, limited by half lives
of clotting factors
367a
For Warfarin what is the
Onset of action
367b
Impairs the synthesis of
vitamin K-dependent
clotting factors
368a
For Warfarin what is the
Mechanism of action
368b
Chronic (weeks or
months)
369a
For Warfarin what is the
Duration of action
369b
No
370a
For Warfarin what is the
Ability to inhibit
coagulation in vitro
370b
IV vitamin K and fresh
frozen plasma
371a
For Warfarin what is the
Treatment for overdose
371b
PT
372a
For Warfarin what is the
Lab value to monitor
372b
Liver
373a
For Warfarin what is the
Site of action
373b
Rare.
374a
Is toxicity rare or
common whith Cromolyn
used in Asthma
prevention?
374b
1. Hydrocortisone 2.
Predisone 3. Triamcinolone
4. Dexamethasone 5.
Beclomethasone
375a
List five common
glucocorticoids.
375b
Penicillin.
376a
Secretion of what drug is
inhibited by Probenacid
used to treat chronic
gout?
376b
The COX-2 inhibitors
should not have the
corrosive effects of other
NSAIDs on the
gastrointestinal lining.
377a
The COX-2 inhibitors
(celecoxib, rofecoxib) have
similar side effects to the
NSAIDs with what one
exception?
377b
Sulfonylureas are oral
hypoglycemic agents, they
are used to stimulate release
of endogenous insulin in
NIDDM (type-2).
378a
What are are the
Sulfonylureas (general
description) and what is
their use?
378b
1. Reliable (<1% failure) 2.
Lowers risk of endometrial and
ovarian cancer 3. Decreased
incidence of ectopic pregnancy 4.
Lower risk of pelvic infections 5.
Regulation of menses
379a
What are five advantages
of Oral Contraceptives
(synthetic progestins,
estrogen)?
379b
1. Taken daily 2. No protection
against STDs 3. Raises
triglycerides 4. Depression,
weight gain, nausea, HTN 5.
Hypercoagulable state
380a
What are five
disadvantages of Oral
Contraceptives (synthetic
progestins, estrogen)?
380b
1. Gastric ulceration 2.
Bleeding 3.
Hyperventilation 4. Reye's
syndrome 5. Tinnitus (CN
VIII)
381a
What are five possible
toxic effects of Aspirin
therapy?
381b
1. Significant:
nephrotoxicity 2.
Peripheral neuropathy 3.
Hypertension 4. Pleural
effusion 5. Hyperglycemia.
382a
What are five toxicities
associated with
Tacrolimus (FK506)?
382b
1. Better bioavailability 2. 2 to
4 times longer half life 3. Can
be administered
subcutaneously 4. Does not
require laboratory monitoring
383a
What are four advantages
of newer low-molecular-
weight heparins
(Enoxaparin)?
383b
1. Antipyretic 2.
Analgesic 3. Anti-
inflammatory 4.
Antiplatelet drug.
384a
What are four clinical
activities of Aspirin?
384b
1. Addison's disease 2.
Inflammation 3. Immune
suppression 4. Asthma
385a
What are four clinical
uses of glucocorticoids?
385b
1. Peptic ulcer 2. Gastritis
3. Esophageal reflux 4.
Zollinger-Ellison
syndrome
386a
What are four conditions
in which H2 Blockers are
used clinically?
386b
1. Cimetadine 2.
Ranitidine 3. Famotidine
4. Nizatidine
387a
What are four H2
Blockers?
387b
1. Tolbutamide 2.
Chlorpropamide 3.
Glyburide 4. Glipizide
388a
What are four
Sulfonylureas?
388b
1. Streptokinase 2.
Urokinase 3. tPA
(alteplase), APSAC
(anistreplase)
389a
What are four
thrombolytics?
389b
1. Hot flashes 2. Ovarian
enlargement 3. Multiple
simultaneous pregnancies 4.
Visual disturbances
390a
What are four unwanted
effects of Clomiphene
use?
390b
1. Buffalo hump 2. Moon facies 3.
Truncal obesity 4. Muscle
wasting 5. Thin skin 6. Easy
bruisability 7. Osteoporosis 8.
Adrenocortical atrophy 9. Peptic
ulcers
391a
What are nine findings of
Iatrogenic Cushing's
syndrome caused by
glucocorticoid therapy?
391b
Headache, flushing ,
dyspepsia, blue-green
color vision.
392a
What are signs of
Sildenafil (Viagra)
toxicity?
392b
Acute coronary syndrome;
coronary stenting.
Decreases the incidence or
recurrence of thrombotic
stroke.
393a
What are the clinical uses
for Ticlopidine,
Clopidogrel?
393b
1. Peptic ulcer 2. Gastritis
3. Esophageal reflux 4.
Zollinger-Ellison
syndrome
394a
What are the four
conditions in which
Omeprazole,
Lansoprazole is used?
394b
1. Infertility (pulsatile) 2.
Prostate cancer
(continuous: use with
flutamide) 3. Uterine
fibroids
395a
What are three clinical
uses of the Leuprolide?
395b
1. Antipyretic 2.
Analgesic 3. Anti-
inflammatory
396a
What are three clinical
uses of the NSAIDs?
396b
Ibuprofen, Naproxen,
and Indomethacin
397a
What are three common
NSAIDS other than
Aspirin?
397b
1. Bleeding 2.
Teratogenicity 3. Drug-
drug interactions
398a
What are three
complications of
Warfarin usage?
398b
1. Bleeding 2.
Thrombocytopenia 3.
Drug-drug interactions
399a
What are three possible
complications of Heparin
therapy?
399b
1. Renal damage 2. Aplastic anemia
3. GI distress
400a
What are three possible
toxicities of NSAID
usage?
400b
1. Antiandrogen 2.
Nausea 3. Vomiting
401a
What are three toxicities
of Leuprolied?
401b
1. Skin rash 2.
Agranulocytosis (rare) 3.
Aplastic anemia
402a
What are three toxicities
of Propylthiouracil?
402b
1. Aluminum hydroxide: constipation
and hypophosphatemia 2.
Magnesium hydroxide: diarrhea 3.
Calcium carbonate: Hypercalcemia,
rebound acid increase - All may cause
hypokalemia
403a
What are three types of
antacids and the
problems that can result
from their overuse?
403b
1. Heavy bleeding 2. GI
effects (n/v, anorexia) 3.
Abdominal pain
404a
What are three unwanted
effects of Mifepristone?
404b
1. Acarbose 2. Miglitol
405a
What are two Alpha-
glucosidase inhibitors?
405b
1. Kidney transplantation 2.
Autoimmune disorders
(including
glomerulonephritis and
hemolytic anemia)
406a
What are two clinical
uses of Azathioprine?
406b
Rheumatoid and
osteoarthritis.
407a
What are two conditions
in which COX-2
inhibitors might be used?
407b
1. Pioglitazone 2.
Rosiglitazone.
408a
What are two Glitazones?
408b
Inhibits organification and
coupling of thyroid hormone
synthesis. Also decreases
peripheral conversion of T4 to
T3.
409a
What are two
mechanisms of action of
Propythiouracil?
409b
1. Phospholipase A2 is
prevented from releasing
arachidonic acid 2. Decreases
protein synthesis thus lowering
amount of Cyclooxygenase
enzymes
410a
What are two processes
Corticosteroids inhibit
leading to decreased
inflammation?
410b
1. Predisposes to viral
infections and lymphoma 2.
Nephrotoxic (preventable
with mannitol diuresis)
411a
What are two toxicities
associated with
Cyclosporine?
411b
1. Weight gain 2.
Hepatotoxicity
(troglitazone)
412a
What are two toxicities of
the Glitazones?
412b
1. Hypoglycemia (more
common with 2nd-generation
drugs: glyburide, glipizide) 2.
Disulfiram-like effects (not seen
with 2nd-generation drugs).
413a
What are two toxicities of
the Sulfonylureas?
413b
Sucralfate cannot work in the
presence of antacids or H2
blockers because it requires an
acidic environment to polymerize.
414a
What are two types of
drugs that interfere with
the action of Sucralfate
and why?
414b
Can affect absorption,
bioavailability, or urinary
excretion of other drugs by
altering gastric and urinary pH
or by delaying gastric emptying.
415a
What can result due to
antacid overuse?
415b
Lipoxygenase
416a
What enzyme does
Zileuton inhibit?
416b
Cyclooxygenases (COX I,
COX II).
417a
What enzymes are
inhibited by NSAIDs,
acetaminophen and COX
II inhibitors?
417b
GI side effects. (Note:
Indomethacin is less
toxic, more commonly
used.)
418a
What is a common side
effect of Colchicine used to
treat acute gout, especially
when given orally?
418b
Diarrhea
419a
What is a common side
effect of Misoprostol?
419b
Overdose produces hepatic
necrosis; acetaminophen
metablolite depletes
glutathione and forms toxic
tissue adducts in liver.
420a
What is a possible result
of overdose of
Acetaminophen?
420b
GI disturbances.
421a
What is a possible
toxicity of Alpha-
glucosidase inhibitors
used in type-2 diabetes?
421b
Neutropenia
(ticlopidine); reserved for
those who cannot tolerate
aspirin.
422a
What is a possible
toxicity of Ticlopidine,
Clopidogrel usage?
422b
Bleeding.
423a
What is a sign of toxicity
with the use of
thrombolytics?
423b
1. In liver, increases storage of
glucose as glycogen. 2. In muscle,
stimulates glycogen and protein
synthesis, and K+ uptake. 3. In
adipose tissue, facilitates
triglyceride storage.
424a
What is action of insulin
in the liver, in muscle,
and in adipose tissue?
424b
1. Suppresses organ
rejection after
transplantation 2. Selected
autoimmune disorders.
425a
What is are two clinical
uses of Cyclosporine?
425b
Antileukotriene; blocks leukotriene
receptors.
426a
What is the category and
mechanism of action of
Zafirlukast in Asthma
treatment?
426b
Antileukotriene; blocks
synthesis by
lipoxygenase.
427a
What is the category and
mechanism of action of
Zileuton in Asthma
treatment?
427b
Inhalational general
anesthetic.
428a
What is the category of
drug names ending in -
ane (e.g. Halothane)
428b
Benzodiazepine.
429a
What is the category of
drug names ending in -
azepam (e.g. Diazepam)
429b
Phenothiazine
(neuroleptic, antiemetic).
430a
What is the category of
drug names ending in -
azine (e.g.
Chlorpromazine)
430b
Antifungal.
431a
What is the category of
drug names ending in -
azol (e.g. Ketoconazole)
431b
Babiturate.
432a
What is the category of
drug names ending in -
barbital (e.g.
Phenobarbital)
432b
Local anesthetic.
433a
What is the category of
drug names ending in -
caine (e.g. Lidocaine)
433b
Penicillin.
434a
What is the category of
drug names ending in -
cillin (e.g. Methicillin)
434b
Antibiotic, protein
synthesis inhibitor.
435a
What is the category of
drug names ending in -
cycline (e.g. Tetracycline)
435b
Tricyclic antidepressant.
436a
What is the category of
drug names ending in -
ipramine (e.g.
Imipramine)
436b
Protease inhibitor.
437a
What is the category of
drug names ending in -
navir (e.g. Saquinavir)
437b
Beta antagonist.
438a
What is the category of
drug names ending in -
olol (e.g. Propranolol)
438b
Butyrophenone
(neuroleptic).
439a
What is the category of
drug names ending in -
operidol (e.g.
Haloperidol)
439b
Cardiac glycoside
(inotropic agent).
440a
What is the category of
drug names ending in -
oxin (e.g. Digoxin)
440b
Methylxanthine.
441a
What is the category of
drug names ending in -
phylline (e.g.
Theophylline)
441b
ACE inhibitor.
442a
What is the category of
drug names ending in -
pril (e.g. Captopril)
442b
Beta-2 agonist.
443a
What is the category of
drug names ending in -
terol (e.g. Albuterol)
443b
H2 antagonist
444a
What is the category of
drug names ending in -
tidine (e.g. Cimetidine)
444b
Tricyclic antidepressant.
445a
What is the category of
drug names ending in -
triptyline (e.g.
Amitriptyline)
445b
Pituitary hormone.
446a
What is the category of
drug names ending in -
tropin (e.g.
Somatotropin)
446b
Alpha-1 antagonist
447a
What is the category of
drug names ending in -
zosin (e.g. Prazosin)
447b
Nonspecific beta-agonist;
desired effect is the relaxation
of bronchial smooth muscle
(Beta 2). Adverse effect is
tachycardia (Beta 1).
448a
What is the category,
desired effect, and adverse
effect of Isoproterenol in
the treatment of Asthma?
448b
Beta 2 agonist; desired effect is
the relaxation of bronchial
smooth muscle (Beta 2). Use
during acute exacerbation.
449a
What is the category,
desired effect, and period
of use of albuterol in the
treatment of Asthma?
449b
Methylzanthine; desired effect is
bronchodilation, may cause
bronchodilation by inhibiting
phosphodiesterase, enzyme
involved in degrading cAMP
(controversial).
450a
What is the category,
desired effect, and possible
mechanism of
Theophylline in treating
Asthma?
450b
Muscarinic antagonist;
competatively blocks
muscarinic receptors,
preventing
bronchoconstriction.
451a
What is the category,
mechanism of action, and
effect of Ipratroprium in
Asthma treatment?
451b
Corticosteroids; prevent production
of leukotrienes from arachodonic
acid by blocking phospholipase A2.
Drugs of choice in a patient with
status asthmaticus (in combination
with albuterol.)
452a
What is the category,
mechanism of action, and
particular use of
beclomethasone and prednisone
in Asthma treatment?
452b
Beta 2 agonist; used as a
long-acting agent for
prophylaxis. Adverse
effects are tremor and
arrhythmia.
453a
What is the category,
method of use, and adverse
effects of Salmeterol in
Asthma treatment?
453b
Prevention of NSAID-
induced peptic ulcers,
maintains a PDA.
454a
What is the clincial use
for Misoprostol?
454b
Treatment of infertility.
455a
What is the clinical use
for Clomiphene?
455b
Immediate
anticoagulation for PE,
stroke, angina, MI, DVT.
456a
What is the clinical use
for Heparin?
456b
Erectile dysfunction.
457a
What is the clinical use
for Sildenafil (Viagra)?
457b
Peptic ulcer disease.
458a
What is the clinical use
for Sucralfate?
458b
Chronic anticoagulation.
459a
What is the clinical use
for Warfarin?
459b
Abortifacient.
460a
What is the clinical use of
Mifepristone (RU486)?
460b
Potent
immunosuppressive used
in organ transplant
recipients.
461a
What is the clinical use of
Tacrolimus (FK506)?
461b
Increase target cell
response to insulin.
462a
What is the effect of the
Glitazones in diabetes
treatment?
462b
Finasteride inhibits 5 Alpha-
reductase, this decreases the
conversion of testosterone to
dihydrotestosterone, useful
in BPH
463a
What is the enzyme inhibited,
the effect of this inhibition, and
the clinical use of the
antiandrogren Finasteride?
463b
The PTT.
464a
What is the lab value
used to monitor the
effectiveness of Heparin
therapy?
464b
The PT.
465a
What is the lab value
used to monitor the
effectiveness of Warfarin
therapy?
465b
Early myocardial
infarction.
466a
What is the main clinical
use for the thrombolytics?
466b
Aluminum sucrose sulfate
polymerizes in the acid
environment of the stomach and
selectively binds necrotic peptic
ulcer tissue. Acts as a barrier to
acid, pepsin, and bile.
467a
What is the mecanism of
action of Sucralfate?
467b
Selectively inhibit cyclooxygenase
(COX) isoform 2, which is found in
inflammatory cells nad mediates
inflammation and pain; spares
COX-1 which helps maintain the
gastric mucosa.
468a
What is the mecanism of
action of the COX-2
inhibitors (celecoxib,
rofecoxib)?
468b
Prevents release of mediators
from mast cells. Effective only
for the prophylaxis of asthma.
Not effective during an acute
attack.
469a
What is the mecanism of
action, effective period, and
ineffective period of use for
Cromolyn in treating
Asthma?
469b
Flutamide is a nonsteroidal
competitive inhibitor of
androgens at the
testosterone receptor, used
in prostate carcinoma.
470a
What is the mechanism
of action and clinical use
of the antiandrogen
Flutamide?
470b
Inhibit steroid synthesis,
used in the treatment of
polycystic ovarian
syndrome to prevent
hirsutism.
471a
What is the mechanism of
action and clinical use of
the antiandrogens
Ketoconazole and
Spironolactone?
471b
Reversibly inhibits
cyclooxygenase, mostly in
CNS. Inactivated
peripherally.
472a
What is the mechanism
of action of
Acetaminophen?
472b
Inhibits xanthine
oxidase, decresing
conversion of xanthine to
uric acid.
473a
What is the mechanism
of action of Allopurinol
used to treat chronic
gout?
473b
Acetylates and irreversibly
inhibits cyclooxygenase (COX I
and COX II) to prevent the
conversion of arachidonic acid
to prostaglandins.
474a
What is the mechanism
of action of Aspirin?
474b
Clomiphene is a partial agonist at
estrogen receptors in the pituitary
gland. Prevents normal feedback
inhibition and increses release of
LH and FSHfrom the pituitary,
which stimulates ovulation.
475a
What is the mechanism
of action of Clomiphene?
475b
Depolymerizes
microtubules, impairing
leukocyte chemotaxis and
degranulation.
476a
What is the mechanism
of action of Colchicine
used to treat acute gout?
476b
Binds to cyclophilins (peptidyl
proline cis-trans isomerase),
blocking the differentiation and
activation of T cells mainly by
inhibiting the production of IL-2
and its receptor.
477a
What is the mechanism
of action of
Cyclosporine?
477b
Heparin catalyzes the
activation of
antithrombin III.
478a
What is the mechanism
of action of Heparin?
478b
Competitive inibitor of
progestins at
progesterone receptors.
479a
What is the mechanism
of action of Mifepristone
(RU486)?
479b
Misoprostol is a PGE1
analog that increases the
production and secretion of
the gastic mucous barrier.
480a
What is the mechanism
of action of Misoprostol?
480b
Reversibly inhibit
cyclooxygenase (COX I
and COX II). Block
prostaglandin synthesis.
481a
What is the mechanism
of action of NSAIDs
other than Aspirin?
481b
Irreversibly inhibits
H+/K+ ATPase in
stomach parietal cells.
482a
What is the mechanism
of action of Omeprazole,
Lansoprazole?
482b
Inhibits reabsorption of
uric acid.
483a
What is the mechanism
of action of Probenacid
used to treat chronic
gout?
483b
Inhibits cGMP
phosphodiesterase, casuing
increased cGMP, smooth muscle
relaxation in the corpus
cavernosum, increased blood
flow, and penile erection.
484a
What is the mechanism
of action of Sildenafil
(Viagra)?
484b
Inhibit intestinal bursh border
Alpha-glucosidases; delayed
hydrolysis of sugars and
absorption of sugars leading to
decresed postprandial
hyperglycemia.
485a
What is the mechanism
of action of the Alpha-
glucosidase inhibitors?
485b
Decrease the production of
leukotrienes and
protaglandins by inhibiting
phospholipase A2 and
expression of COX-2.
486a
What is the mechanism
of action of the
glucocorticoids?
486b
Reversible block of
histamine H2 receptors
487a
What is the mechanism
of action of the H2
Blockers?
487b
Close K+ channels in Beta-cell
membrane leading to cell
depolarization causing insulin
release triggered by increase in
Calcium ion influx.
488a
What is the mechanism
of action of the
Sulfonylureas?
488b
Directly of indirectly aid conversion
of plasminogen to plasmin which
cleaves thrombin and fibrin clots.
(It is claimed that tPA specifically
converts fibrin-bound plasminogen
to plasmin.)
489a
What is the mechanism
of action of the
thrombolytics?
489b
Inhibits platelet
aggregation by irreversibly
inhibiting the ADP
pathway involved in the
binding of fibrinogen.
490a
What is the mechanism
of action of Ticlopidine,
Clopidogrel
490b
Warfarin interferes with the
normal synthesis and gamma-
carboxylation of vitamin K-
dependent clotting factors II, VII,
IX, and X, Protein C and S via
vitamin K antagonism.
491a
What is the mechanism
of action of Warfarin
(Coumadin)?
491b
Antimetabolite derivative of
6-mercaptopurine that
interferes with the
metablolism and synthesis
of nucleic acid.
492a
What is the mechanism
of Azathioprine?
492b
GnRH analog with agonist
properties when used in pulsatile
fashion and antagonist properties
when used in continuous fashion,
causing a transient initial burst of
LH and FSH
493a
What is the mechanism
of Leuprolide?
493b
Similar to cyclosporine;
binds to FK-binding
protein, inhibiting
secretion of IL-2 and other
cytokines.
494a
What is the mechanism
of Tacrolimus (FK506)?
494b
Sildenafil fills the penis
495a
What is the memory key
for the action of
Sildenafil (Viagra)?
495b
AluMINIMUM amount
of feces.
496a
What is the memory key
for the effect of
aluminum hydroxide
overuse?
496b
Mg = Must go to the
bathroom.
497a
What is the memory key
for the effect of
magnesium hydroxide
overuse?
497b
WEPT: Warfarin affects
the Extrinsic pathway
and prolongs the PT.
498a
What is the memory key to
remember which pathway
(extrinsic vs. intrinsic) and
which lab value Warfarin
affects?
498b
Mechanism unknown; possibly
inhibits gluconeogenesis and
increases glycolysis; effect is to
decrease serum glucose levels
499a
What is the possible
mechanism and effect of
Metformin in treating
diabetes?
499b
Indomethacin is used to
close a patent ductus
arteriosus.
500a
What is the specific
clinical use of
Indomethacin in
neonates?
500b
Protamine Sulfate is used for
rapid reversal of
heparinization (positively
charged molecule that binds to
negatively charged heparin).
501a
What is used to reverse
the action of Heparin?
501b
Those patients who are
taking nitrates.
502a
What patients are at risk
for life threatening
hypotension when taking
Sildenafil (Viagra)?
502b
Leukotrienes increasing
bronchial tone.
503a
What process does
Zafirlukast interfere
with?
503b
Chronic gout.
504a
What type of gout is
treated with Allopurinol?
504b
Acute gout.
505a
What type of gout is
treated with Colchicine?
505b
Chronic gout.
506a
What type of gout is
treated with Probenacid?
506b
Misoprostol is
contraindicated in women of
childbearing potential
because it is an
abortifacient.
507a
What type of patient
should not take
Misoprostol and why?
507b
Cimetidine is a potent inhibitor
of P450; it also has an
antiandrogenic effect and
decreases renal excretion of
creatinine. Other H2 blockers are
relatively free of these effects.
508a
Which H2 Blocker has
the most toxic effects and
what are they?
508b
Because they require
some residual islet
function.
509a
Why are the Sulfonylureas
inactive in IDDM (type-1)?
509b
-Disulfram & also sulfonylureas,
metronidazole
510a
Acetaldehyde is
metabolized by
Acetaldehyde
dehydrogenase, which drug
inhibs this enzyme?
510b
-Weak Acids>Alkinalize
urine(CO3) to remove more
-Weak bases>acidify urine
to remove more
511a
Explain pH dependent
urinary drug
elimination?
511b
-Airway -Breathing -
Circulation -Dextrose
(thiamine & narcan) -
ABCD
512a
How do you treat coma
in the ER (4)?
512b
-Infections -Trauma -
Seizures -CO -Overdose -
Metabolic -Alcohol (IT'S
COMA)
513a
In coma situations you
rule out what (7)?
513b
-A57Blue lines in gingiva &
long bones -
Encephalopathy & Foot
drop -Abdominal colic / -
Sideroblastic anemia
514a
List some specifics of
lead poisoning(4)?
514b
-N-acetylcystine
515a
List the specific antidote
for this toxin:
Acetaminophen
515b
-Ammonium Chloride
516a
List the specific antidote
for this toxin:
Amphetamine
516b
-Atropine & pralidoxime
517a
List the specific antidote
for this toxin:
Anticholinesterases
(organophosphate.)
517b
-Physostigmine salicylate
518a
List the specific antidote
for this toxin:
Antimuscarinic
(anticholinergic)
518b
-Dimercaprol, succimer
519a
List the specific antidote
for this toxin: Arsenic (all
heavy metals)
519b
-Flumazenil
520a
List the specific antidote
for this toxin:
Benzodiazepines
520b
-Glucagon
521a
List the specific antidote
for this toxin: Beta
Blockers
521b
-100% oxygen,
hyperbaric
522a
List the specific antidote
for this toxin: Carbon
monoxide
522b
-Penicillamine
523a
List the specific antidote
for this toxin: Copper
523b
-Nitrate,
hydroxocobalamin
thiosulfate
524a
List the specific antidote
for this toxin: Cyanide
524b
-Normalize K+,
Lidocaine, & Anti-dig
Mab
525a
List the specific antidote
for this toxin: Digitalis
525b
-Protamine
526a
List the specific antidote
for this toxin: Heparin
526b
-Deferoxamine
527a
List the specific antidote
for this toxin: Iron
527b
-EDTA, dimercaprol,
succimer, &
penicillamine
528a
List the specific antidote
for this toxin: Lead
528b
-Ethanol, dialysis, &
fomepizole
529a
List the specific antidote
for this toxin: Methanol
& Ethylene glycol
529b
-Methylene blue
530a
List the specific antidote
for this toxin:
Methemoglobin
530b
-B51Naloxone /
naltrexone (Narcan)
531a
List the specific antidote
for this toxin: Opioids
531b
-Alkalinize urine &
dialysis
532a
List the specific antidote
for this toxin: Salicylates
532b
-Aminocaproic acid
533a
List the specific antidote
for this toxin: TPA &
Streptokinase
533b
-NaHCO3
534a
List the specific antidote
for this toxin: Tricyclic
antidepressants
534b
-Vitamin K & fresh frozen
plasma
535a
List the specific antidote
for this toxin: Warfarin
535b
-Acetaldehyde -Nausea,
vomiting, headache, &
hypotension
536a
What are the products
and their toxicities of the
metabolism of ethanol by
/ alcohol dehydrogenase?
536b
-Oxalic acid -Acidosis &
nephrotoxicity
537a
What are the products and
their toxicities of the
metabolism of Ethylene
Glycol by / alcohol
dehydrogenase?
537b
-Formaldehyde & formic
acid -severe acidosis &
retinal damage
538a
What are the products and
their toxicities of the
metabolism of Methanol by
/ alcohol dehydrogenase?
538b
-Glucocorticoid
withdrawal
539a
Which drug(s) cause this
reaction: Adrenocortical
Insufficiency
539b
-Cloazapine -carbamazapine -
colchicine -PTU
540a
Which drug(s) cause this
reaction: Agranulocytosis
(3)?
540b
-Penicillin
541a
Which drug(s) cause this
reaction: Anaphylaxis?
541b
-Chloramphenicol -benzene -
NSAIDS -PTU -phenytoin
542a
Which drug(s) cause this
reaction: Aplastic anemia
(5)?
542b
-Tricyclic antidepressants
543a
Which drug(s) cause this
reaction: Atropine-like
side effects?
543b
-Daunorubicin &
Doxorubicin
544a
Which drug(s) cause this
reaction: Cardiac toxicity?
544b
-Quinidine -quinine
545a
Which drug(s) cause this
reaction: Cinchonism
(2)?
545b
-ACE inhibitors
(Losartan>no cough)
546a
Which drug(s) cause this
reaction: Cough?
546b
-Niacin -Ca++ channel
blockers -adenosine -
vancomycin
547a
Which drug(s) cause this
reaction: Cutaneous
flushing (4)?
547b
-Lithium
548a
Which drug(s) cause this
reaction: Diabetes
insipidus?
548b
-Metronidazole -certain
cephalosporins -
procarbazine -
sulfonylureas
549a
Which drug(s) cause this
reaction: Disulfram-like
reaction (4) ?
549b
-Haloperidol -
chlorpromazine -
reserpine -MPTP
550a
Which drug(s) cause this
reaction: Drug induced
Parkinson's (4) ?
550b
-Chlorpromazine -
thioridazine -haloperidol
551a
Which drug(s) cause this
reaction: Extrapyramidal
side effects (3)?
551b
-Tetracycline
552a
Which drug(s) cause this
reaction: Fanconi's
syndrome?
552b
-Halothane -Valproic
acid -acetaminophen -
Amantia phalloides
553a
Which drug(s) cause this
reaction: Focal to
massive hepatic necrosis
(4)?
553b
-Sulfonamides -INH -ASA -
Ibuprofen -primaquine -
nitrofurantoin /-
pyrimethamine -
chloramphenicol
554a
Which drug(s) cause this
reaction: G6PD
hemolysis(8)?
554b
-Phenytoin
555a
Which drug(s) cause this
reaction: Gingival
hyperplasia?
555b
-Chloramphenicol
556a
Which drug(s) cause this
reaction: Gray baby
syndrome?
556b
-Cimetidine -
ketoconazole -
spironolactone -digitalis -
EtOH -estrogens
557a
Which drug(s) cause this
reaction: Gynecomastia
(6)?
557b
-Isoniazid
558a
Which drug(s) cause this
reaction: Hepatitis?
558b
-Tamoxifen
559a
Which drug(s) cause this
reaction: Hot flashes?
559b
-polymyxins
560a
Which drug(s) cause this
reaction: Neuro and
Nephrotoxic?
560b
-Corticosteroids -heparin
561a
Which drug(s) cause this
reaction: Osteoporosis (2)?
561b
-aminoglycosides -loop
diuretics -cisplatin
562a
Which drug(s) cause this
reaction: Oto and
Nephrotoxicity (3)?
562b
-Barbiturates -phenytoin
-carbamazipine -rifampin
-griseofulvin -quinidine
563a
Which drug(s) cause this
reaction: P450
induction(6)?
563b
-Cimetidine -ketoconazole -
grapefruit juice -
erythromycin -INH -
sulfonamides
564a
Which drug(s) cause this
reaction: P450
inhibition(6)?
564b
-Tetracycline -
amiodarone -
sulfonamides
565a
Which drug(s) cause this
reaction:
Photosensitivity(3)?
565b
-Clindamycin
566a
Which drug(s) cause this
reaction:
Pseudomembranous
colitis?
566b
-Bleomycin -amiodarone
-busulfan
567a
Which drug(s) cause this
reaction: Pulmonary
fibrosis(3)?
567b
-Hydralazine -
Procainamide -INH -
phenytoin
568a
Which drug(s) cause this
reaction: SLE-like
syndrome?
568b
-Ethosuxamide -
sulfonamides -
lamotrigine
569a
Which drug(s) cause this
reaction: Stevens-
Johnson syn. (3)?
569b
-Antipsychotics
570a
Which drug(s) cause this
reaction: Tardive
dyskinesia?
570b
-Fluoroquinolones
571a
Which drug(s) cause this
reaction: Tendonitis and
rupture?
571b
-Oral Contraceptives
572a
Which drug(s) cause this
reaction: Thrombotic
complications?
572b
-Class III
antiarrhythmics (sotalol)
-class IA (quinidine)
573a
Which drug(s) cause this
reaction: Torsade de
pointes (2)?
573b
-Sulfonamides -
furosemide -methicillin -
rifampin -NSAIDS (ex.
ASA)
574a
Which drug(s) cause this
reaction:
Tubulointerstitial
Nephritis (5)?
574b
Constant FRACTION
eliminated per unit
time.(exponential)
575a
Describe first-order
kinetics?
575b
-reduction, oxy, &
hydrolysis -H2O sol.
Polar product -P450
576a
Describe Phase I
metabolism in liver(3)?
576b
-acetylation, glucuron., &
sulfation -Conjugation -
Polar product
577a
Describe Phase II
metabolism in liver(3)?
577b
- Act on same receptor -
Full has greater efficacy
578a
Explain differences
between full and partial
agonists(2).
578b
- partial agonist can have
increased, decreased, /A21or equal
potency as full agonist. - Potency is
an independent factor.
579a
Explain potency in
relation to full and partial
agonists(2).
579b
- ED 50 is less than the
Km (less than 50% of
receptors)
580a
How do spare receptors
effect the Km?
580b
Md= (CpxCL)/F Cp=
plas. Conc. CL=clear.
F=bioaval.
581a
How do you calculate
maintenance dose?
581b
-Shifts the curve to the
right -increases Km
582a
How does a competitive
antagonist effect an
agonist?
582b
- Shifts the curve down -
reduces Vmax
583a
How does a
noncompetitive
antagonist effect an
agonist?
583b
-Phase I (clinical tests) -
Phase II -Phase III -
PhaseIV (surveillance)
584a
Name the steps in drug
approval(4)?
584b
In 4 half-lifes= (94%)
T1/2 = (0.7x Vd)/CL
585a
Steady state
concentration is reached
in __ number of half-lifes
585b
-Constant AMOUNT
eliminated per unit time.
-Etoh & ASA
586a
What is the definition of
zero-order kinetics?
Example?
586b
CL= (rate of elimination
of drug/ Plasma drug
conc.)
587a
What is the formula for
Clearance (CL)
587b
Vd= (Amt. of drug in
body/ Plasma drug conc.)
588a
What is the formula for
Volume of distribution
(Vd)
588b
Ld= (CpxVd)/F
Cp=plasma conc. F=
Bioaval.
589a
What is the loading dose
formula?
589b
Epinephirine(Alpha1,2
and Beta 1,2)
590a
A 12yo patient was treated
for a reaction to a bee sting,
what drug provides the best
coverage of
sympathomimetic receptors?
590b
Dopamine
591a
A 57 yo heart failure pt develops
cardiac decompensation, what
drug will give you adequate
perfusion of his kidneys as well
as tx for his Hypotension
591b
scopolamine
592a
A fellow passenger on a
Carnival cruise ship looks
pale and diaphoretic, what
antimuscarinic agent would
you give them?
592b
Atropine pts are suffering
from Cholinestrase
inhibitor poisining (Nerve
gas/Organophosphate
poisining)
593a
A group of pts are rushed into the ER
complaining of excessive sweating,
tearing, salivation, HA, N and V,
muscle twitching, difficulty breathing
and diarrhea. What drug would be
the most effective immediate tx
593b
Succinylcholine
594a
As an Anes you want to use
a depolarizing
neuromuscular blocking
drug on your pt, what do
you use
594b
Prevents the release of Ca
from SR of skeletal
muscle
595a
MOA of Succinylcholine
595b
Centrally acting alpha
agonist, thus causing a
decrease in central
adrenergic outflow, spairing
renal blood flow
596a
Clonidine is the preferred
sym pathomimetic tx of
HTN in pts with renal
disease, why??
596b
Indirect agonist, uptake
inhibitor
597a
Cocaine casues
vasoconstriction and
local anesthesia by what
mechanism
597b
TCA
598a
Cocaine shares is
mechanism of action with
what antidepressant
598b
Beta1 more than B2
599a
Dobutamine used for the
tx of shock acts on which
receptors
599b
No, it inhibits the release
of Nor Epi
600a
Guanethidine enhances
the release of Norepi?
600b
It acts presynaptically to
increase NE release.
601a
How does angiotensin II
affect NE release?
601b
Prevents the release of
ACh, which results in
muscle paralysis.
602a
How does botulinum
toxin result in respiratory
arrest?
602b
Prevents the release of
calcium from the
sarcoplasmic reticulum of
skeletal muscle.
603a
How does dantrolene
work?
603b
NE acts presynaptically on
alpha-2 receptors to inhibit its
own release. ACh also acts
presynaptically through M1
receptors to inhibit NE release.
604a
How does NE modulate
its own release? What
other neurotransmitter
has this same effect?
604b
Hemicholinium inhibits the
transport of choline into the
nerve, thus inhibiting
formation of ACh.
605a
How would
hemicholinium treatment
affect cholinergic
neurons?
605b
Give an
antichloinesterase -
neostigmine,
edrophonium, etc
606a
How would you reverse
the effect of a
neuromuscular blocking
agent?
606b
It would increase to ~ 100 beats/min.
Both sympathetic and vagal
stimulation would be knocked out,
but the SA node has an intrinsic pace
of 100 beats/min, which is normally
checked by vagal stimulation.
607a
If a patient is given
hexamethonium, what
would happen to his/her
heart rate?
607b
Stimulates beta
adrenergic receptors
608a
Isopoterenol was given to
a patient with a
developing AV block,
why?
608b
Binding to the
presynaptic alpha 2
release modulating
receptors
609a
Norepi feedbacks and
inhibits the presynaptic
receptor by what
mechanism
609b
Blocks Norepi, but not
Dopamine
610a
Reserpine will block the
syntheis of this drug and
but not its precursor.
610b
Amphetamine and
Ephedrine
611a
These drugs acts indirectly
by releasing strored
catecholamines in the
presynaptic terminal
611b
physostigmine
612a
What anticholinesterase
crosses the blood-brain-
barrier?
612b
Ipratropium
613a
What antimuscarinic
agent is used in asthma
and COPD?
613b
Ipratropium
614a
What antimuscarinic
drug is useful for the tx of
asthma
614b
Diarrhea, Urination, Miosis,
Bronchospasm, Bradycardia,
Excitation of skeletal muscle and
CNS, Lacrimation, Sweating, and
Salivation = DUMBBELS; also
abdominal cramping
615a
What are the classic
symptoms of cholinesterase
inhibitor poisoning
(parathion or other
organophosphates)?
615b
Activates cholinergic receptors
on bladder and bowel smooth
muscle, alleviating post-op and
neurogenic ileus and urinary
retention.
616a
What are the clinical
indications for
bethanechol?
616b
Post-op and neurogenic ileus and
urinary retention, myasthenia
gravis, and reversal of
neuromuscular junction
blockade (post-op) through
anticholinesterase activity.
617a
What are the clinical
indications for
neostigmine?
617b
narcolepsy, obesity, and
attention deficit disorder
(I wouldn't recommend
this)
618a
What are the indications
for using amphetamine?
618b
Tubocurarine, atracurium,
mivacurium, pancuronium,
vecuronium, rapacuronium
619a
What are the
nondepolarizing
neuromuscular blocking
drugs?
619b
Phase 1 = prolonged depolarization,
no antidote, effect potentiated by
anticholinesterase; Phase 2 =
repolarized but blocked, an
anticholinesterase is the antidote for
this phase.
620a
What are the phases of
succinylcholine
neuromuscular blockade?
620b
amphetamine and
ephedrine
621a
What are two indirect
acting adrenergic
agonists?
621b
Albuterol, tertbutaline
622a
What beta 2 agonist will
help your 21yo Astma pt?
622b
Botulinum
623a
What cholinergic
inhibitor acts by directly
inhibiting Ach release at
the presynaptic terminal
623b
Edrophonium
624a
What cholinomimetic is
useful in the diagnosis of
Myasthenia Gravis
624b
Carbachol, pilocarpine,
physostigmine,
echothiophate
625a
What cholinomimetics
might your pt be taking
for his glaucoma
625b
anticholinesterase
glaucoma
626a
What class of drug is
echothiophate? What is
its indication?
626b
In treatment of malignant
hyperthermia, due to concomitant
use of halothane and
succinylcholine. Also in neuroleptic
malignant syndrome, a toxicity of
antipsychotic drugs.
627a
What conditions would
you use dantrolene?
627b
edrophonium (extremely
short acting
anticholinesterase)
628a
What drug is used to
diagnose myasthenia
gravis?
628b
Neostigmine,
pyridostigmine
edrophonium,
physostigmine
echothiophate
629a
What drugs target
anticholinesterase
629b
Theoretically it could be
used to block the cephalic
phase of acid secretion
(vagal stimulation).
630a
What effect would
atropine have on a
patient with peptic ulcer
disease?
630b
None. No, because atropine
would block the
postganglionic muscarinic
receptors involved in sweat
gland stimulation.
631a
What effect would atropine
have on the preganglionic
sympathetic activation of
sweat glands? Would this
person sweat?
631b
Acetylcholinesterase;
ACh is broken down into
choline and acetate.
632a
What enzyme is
responsible for the
breakdown of ACh in the
synaptic cleft?
632b
Acetylcholine esterase
633a
What enzyme is
responsible for the
degredation of Ach
633b
Choline acetyltransferase
634a
What enzyme is
responsible for the
production of Ach from
Acetyl CoA and Choline
634b
Treatment of hypertension,
especially with renal disease
(lowers bp centrally, so flow
is maintained to kidney).
635a
What is the clinical utility
of clonidine?
635b
The only local anesthetic
with vasoconstrictive
properties.
636a
What is the clinical utility
of cocaine?
636b
Dobutamine has more of an affintiy
for beta-1 than beta-2, and is used
for treating heart failure and shock.
Albuterol and terbutaline is the
reverse, and is used in treatment of
acute asthma.
637a
What is the difference
between the affinity for beta
receptors between
albuterol/terbutaline and
dantroline?
637b
Prefers beta's at low doses,
but at higher doses alpha
agonist effects are
predominantly seen.
638a
What is the difference in
receptor affinity of
epinephrine at low
doses? High doses?
638b
Increased systolic and pulse
pressure, decreased
diastolic pressure, and little
change in mean pressure.
639a
What is the effect of
epinephrine infusion on
bp and pulse pressure?
639b
It inhibits release of NE.
640a
What is the effect of
guanethidine on
adrenergic NE release?
640b
Increases mean, systolic,
and diastolic bp, while
there is little change in
pulse pressure.
641a
What is the effect of
norepinephrine on bp
and pulse pressure?
641b
They inhibit reuptake of NE
at the nerve terminal (as
does cocaine).
642a
What is the effect of TCA's
on the adrenergic nerve?
642b
Succinylcholine
643a
What is the only
depolarizing
neuromuscular blocking
agent?
643b
It affects beta receptors
equally and is used in AV
heart block (rare).
644a
What is the receptor
affinity and clinical use of
isoproterenol?
644b
SLUD (salivation,
Lacrimation, urination,
Defecation)as well as airway
secretion, GI motility, acid
secretions
645a
What physiological
effects was the Anes
using Atropine to tx
645b
Bethanechol,
Neostigmine,
physostigmine
646a
What reversal agent
could a Anes give to
reverse the effects of
Atropine
646b
Atropine would also block the
receptors in the ciliary muscle,
causing an impairment in
accommodation (cycloplegia).
647a
What side effect of using
atropine to induce
pupillary dilation would
you expect?
647b
Norepinephrine
(Alpha1,2 and beta 1)
648a
What sympathomimetic
would you not prescribe for
hypotension in a pt with
renal artery sclerosis.
648b
Hexamethonium is a
nicotinic antagonist, and
thus is a ganglionic
blocker.
649a
What type of neurological
blockade would
hexamethonium create?
649b
Initially vasoconstriction would
increase bp, but then it acts on
central alpha-2 receptors to
decrease adrenergic outflow
resulting in decreased bp.
650a
What would be the effect
on blood pressure with
infusion of the alpha -2
agonist clonidine?
650b
atropine, homatropine,
tropicamide
651a
Which antimuscarinic
agents are used in
producing mydriasis and
cycloplegia?
651b
Epinephrine
652a
Which drug increases Sys
BP w/o affecting Pulse
Pressure
652b
Norepinephrine
653a
Which of epi, norepi, or
isoproterenol results in
bradycardia?
653b
Dry flushed skin, due to
inhibition of sympathetic post-
ganglionic blockade on
muscarinic receptors of sweat
glands. All others are opposite of
what would be expected.
654a
Which of the following would
atropine administration cause?
Hypothermia, bradycardia,
excess salivation, dry flushed
skin, or diarrhea
654b
Norepinephrine
655a
Which of these three drugs
will cause a reflex
bradycardia in your pt
(Norepi, Epi, or
Isoporterenol)
655b
alpha-1 > alpha-2; used
as a pupil dilator,
vasoconstrictor, and for
nasal decongestion
656a
Which receptors does
phenylephrine act upon?
656b
Epinephrine to treat
anaphylaxis. Also useful if
you have open angle
glaucoma, asthma, or
hypotension.
657a
While at a tail gait party, you
bite into a sandwich that a
yellow jacket is also enjoying.
Knowing your allergy to this
creature, what should you do?
657b
These B-2 agonists cause
respiratory smooth
muscle to relax.
658a
Why are albuterol and
terbutaline effective in tx
of acute asthmatic
attacks?
658b
Blocking muscarinic receptors
in the circular fibers of the eye,
results in unopposed action of
radial muscles to dilate.
659a
Why does atropine dilate
the pupil?
659b
NE increases bp, which
stimulates baroreceptors in the
carotid sinus and the aorta. The
CNS signals through vagal
stimulation to decrease heart
rate.
660a
Why does NE result in
bradycardia?
660b
They activate the ciliary
muscle of the eye (open
angle) and pupillary
sphincter (narrow angle).
661a
Why is carbachol and
pilocarpine useful in
treatment of glaucoma?
661b
As an anticholinesterase
it increases endogenous
ACh and thus increases
strength.
662a
Why is pyridostigmine
effective in the treatment
of myasthenia gravis?
662b
Reserpine inhibits
dopamine transport into
vesicles, attenuating its
conversion to NE by
dopamine beta-hydroxylase.
663a
Why is reserpine effective
in treating HTN?
663b
Stimulating beta receptors
stimulates heart rate, but
beta receptor induced
vasodilation reduces
peripheral resistance.
664a
Why is there a drop in
systolic, mean, and
diastolic bp with infusion
of isoproterenol?
664b
Parkinson patients benefit
from antimuscarinic agents
through its inhibitory action
within the indirect pathway.
665a
Why would a patient with
cog-wheel rigidity and a
shuffling gait be given
benztropine?
665b
Receptors = D1=D2>beta>alpha,
thus increasing heart rate (beta)
and blood pressure (alpha
vasoconstriction) while
maintaining kidney perfusion
(dopamine receptors)
666a
Why would dopamine be
useful in treating shock?
666b
Useful in muscle paralysis
during surgery or
mechanical ventilation.
667a
Why would you give a
drug like pancuronium or
succinylcholine?
667b
Pralidoxime regenerates active
cholinesterase.
668a
Why would you use
pralidoxime after
exposure to an
organophosphate?
668b
No, hemicholinum block
the uptake of Choline and
thus Ach synthesis
669a
Will Hemicholinum
affect the release of
stored Ach during
Cholinergic Stimulation
669b
No. Atropine is used to
reduce urgency in mild
cystitis. So it would
aggravate the urinary
retention.
670a
Would blockade of
muscarininc receptors in
the bladder be useful in
treating urinary retention?
670b
Scopolamine
671a
Your patient wants an
effective drug to treat his
motion sickness, what
would you prescribe
671b