Pharmacology Quick Hits

Study online at quizlet.com/_enw56

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

23 year old male with recurrent

epistaxis, skin discoloration,
AVMs and telangiectasias. What
is the inheritance of this
condition?

Osler-Weber-Rendu
syndrome or hereditary
hemorrhagic
telangiectasia is
autosomal DOMINANT

A drug infused at a constant

(IV) rate, eliminated via first
order kinetics with a half life of
10hrs will take how long to reach
95% of steady state?

40 hrs; 1 half life =

50%, 2 = 75%, 3 =
87.5%, 4=95% of steady
state

Antidote to digoxin toxicity?

SLOWLY normalize
K+, lidocaine, cardiac
pacer, anti-dig Fab
fragments, and Mg2+

Blurry yellow vision is

associated with what cardiac
drug?

Digoxin, also nausea,

vomiting, and diarrhea

Bugs susceptible to
ampicillin/amoxicillin?

Haemophilus
influenzae, E.Coli,
Listeria
monocytogenes,
Proteus mirabilis,
Salmonella, Shigella,
enterococci

Cefamandole and alcohol

presentation?

Disulfiram-like rxn

Ceftaxidime is used to treat

what conditions?

Pseudomonas

Ceftriaxone is used to treat what

conditions?

Meningitis and
gonorrhea

Child with puritic xanthomas,

pancreatitis and abdominal
pain. What is the enzyme
deficiency?

Lipoprotein Lipase or
altered apolipoprotein
C-II. No increased risk
of atherosclerosis

Clonidine is used to treat what

drug withdrawal?

Opiate withdrawal

Define volume of distribution.

How much drug is in

the body compared to
how much drug is in
the plasma (how far
does it goooo)

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

Do b-blockers or a-blockers
cause impotence and
exacerbation of asthma

b-blockers

Exposure to polyvinyl chloride,

arsenic, and ThO2 (Thorotrast),
and positive staining with CD31
(PECAM1)

Liver angiosarcoma.
HIGHLY LETHAL

How are bugs resistant to

penicillins?

beta-lactamase cleaves
the b-lactam ring

25.

26.

27.

28.

29.

30.

How do b-blockers
reduce renin
secretion?

Decreased B receptor activation on

JG cells reduces renin release

How do b-blockers
treat angina pectoris?

inhibition of B1 receptors reduces

heart rate and contractility, this
decreases o2 consumption

How do you
CALCULATE
clearance?

CL = Vd x Ke where Ke is an
elimination constant

How do you calculate

half life?

t1/2 = (0.7 x Vd)/CL

How do you calculate

loading dose?

LD = Target plasma concentration

x the volume of distribution/
bioavailability

How do you calculate

maintenance dose?

Target plasma concentration x the

clearance/ the bioavailability

How do you calculate

the volume of
distribution?

Volume of distribution = amount of

drug in body/plasma drug
concentration

How does kidney and

liver disease impact
Vd?

Plasma-protein bound drugs can

be altered by liver and kidney
disease. As protein drops, the
volume of distribution will
increase.

How is digoxin
eliminated?

Renal (urine)

How is resistance
conferred to
Vancomycin?

amino acid change from D-ala Dala to D-ala D-lac

Hypertension in
pregnancy?

Hydralazine

In diabetics what
pharmacotherapy is
standard of care for
treatment of
hypertension?

First ACE inhibitors, ARBs,

calcium channel blockers,
diuretics, b-blockers (mask
hypoglycemia), alpha blockers

In what obstetric
condition do we use
Terbutaline?

Premature contractions

Is vancomycin
batericidal?

yes

List the direct

sympathomimetics

Epinephrine, Norepinephrine,
Isoproterenol, Dopamine,
Dobutamine, Phenylephrine,
Metaproterenol, albuterol,
salmeterol, terbutaline

List the first

generation
antihistamines.

diphenhydramine,
chlorpheniramine,
dimenhydrinate, hydroxyzine,
meclizine

List the second

generation
antihistamines,

Loratidine, fenofexidine,
desloratiadine, cetirizine (end in adine)

32.

MOA of aztreonam?

Monobactam resistant to Blactamases. Inhibits cell wall

synthesis by binding PBP3. DOES
NOT CROSS REACT WITH
PENICILLINS

33.

MOA of Imipenem?

broad spectrum, b-lactamase

resistant, carbapenem. administer
with cilastain (inhibits renal
dehydropeptidase I)

31.

34.

Name three a1
selective alpha
blockers

Prazosin, terazosin, doxazosin

Name two indirect

sympathomimetics
that release stored
catecholamines.

Amphetamine and Ephedrine

On which receptors
do Metaproterenol,
albuterol,
salmeterol and
terbutaline work?

Mostly B2, some B1 (think asthma).

Metaproterenol and albuterol are
shortacting, Salmeterol is long-term.
Terbutaline is used to reduce
premature contractions.

On which receptors
does Dobutamine
work?

Mostly B1, some action at a1, a2

On which receptors
does Dopamine
work?

a1 and a2 in high dose, b1 and b2 in

medium dose, and D1(in low dose)

On which receptors
does Epinephrine
work?

a1, a2, b1, b2 (less than the others)

On which receptors
does Isoproterenol
work?

b1, b2

On which receptors
does
Norepinephrine
work?

a1, a2, b1 (less than the others). No

action on B2

On which receptors
does phenylephrine
work?

Mostly a1, some a2

On which receptors
does Ritodrine
work?

B2

Patient is given Niacin for

hypercholesteremia. How
would it effect their
hypertension, DMII, and
gout?

HTN: Niacin is
vasodilatory, beware of
orthostatic hypotension
when used in conjunction
with anti-hypertensives
DMII: Niacin increases
insulin resistance, requiring
higher doses of drugs
Gout: Niacin can cause
hyperuricemia, beware in
gout

Patient treated with both

cephalosporin and
aminoglycosides.
Hematuria, fatigue. Dx?

Increased nephrotoxicity of
cephalosporins if used with
aminoglycosides

Patient with excess orotic

acid in urine and
megaloblastic anemia. What
do you supplement with?

uridine, this is orotic

aciduria

Patient with gram +,

coagulase negative, catalase
positive infective
endocarditis post valve
replacement. What do you
treat with?

Infection is likely Staph.

epidermidis, and is likely
resistant since it was
nosicomially acquired to all
the major ones. Give
Vancomycin.

Patient with methacillin

sensitive staph. aureus.
Treatment?

Penicillinase-resistant
penicillins (nafcillin)

Patient with painless lesion

on genitalia, treated with
penicillin. Presents with
ecchymoses of skin, fever,
and hypotension. Dx?

Syphilis treated with

penicillins result in massive
die-off = Jarish-Herxheimer
rxn

Pharmacologic causes of
hyperuricemia?

Hydrochlorothiazide,
pyranzamine, niacin,
cyclosporine

Pt with HTN and renal

disease, what is a
sympathetic autonomic
nervous system agent useful
in treating this?

Clonidine or alphamethyldopa.

Side effects of a1 selective

alpha blockers?

1st-dose hypotension,
dizziness, headache

53.

Side effects of Dicloxacillin?

Hypersensitivity,
methicillin-interstitial
nephritis

54.

Side effects of hydralazine?

Compensatory tachycardia
(contraindicated in
angina/CAD), fluid
retention, nausea,
headache, angina. LUPUS
like syndrome

44.

45.

46.
35.

47.
36.

37.

38.

39.

40.

41.

42.

43.

48.

49.

50.

51.

52.

55.

56.

57.

58.

59.

60.

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

71.

Spectrum of aztreonam?

GRAM NEGATIVE RODS

ONLY

Terbutaline and what

other sympathomimetic
is used to reduce
premature contractions?

Ritodrine.

Timolol is used to treat

what condition?

Glaucoma by decreasing the

secretion of aqueous humor

Treatment for CHF?

Diuretics handle excess fluid,

ACE inhibitors and b-blockers
handle cardiac remodeling ,
potassium sparing diuretics

Treatment for essential

HTN?

72.

73.

Diuretics, ACE inhibitors,

angiotension II receptor
blockers, calcium channel
blockers

Vein where the PO2

differs the most from the
aorta?

Coronary sinus

What antimicrobials
block cell wall synthesis
by inhibition of
peptidoglycan crosslinking?

Penicillin, Methicillin,
ampicillin, piperacillin,
cephalosporin, azetreonam,
imipenem

What antimicrobials
block DNA
topoisomerase?

Fluoroquinolones

What antimicrobials
block mRNA synthesis?

Rifampin

What antimicrobials
block nucleotide
synthesis?

Sulfonamides, trimethoprim

What antimicrobials
block peptidoglycan
synthesis?

Bacitracin, vancomycin

What antimicrobials
block protein synthesis
at the 30S subunit?

Aminoglycosides, tetracyclines

What antimicrobials
damage DNA?

Metronidazole

What antiplatlet
agregation agent also
vasodilates?

Cilostazol and dipyridamole:

PDE III inhibitors that increase
cAMP in platelets

What are four K+

channel blockers (class
III anti-arrhythmics)

Ibutilide, Sotaolol, Bretylium,

Amiodarone, Dofetilide: K IS
BAD

What are some CV side

effects of b-blockers?

bradycardia, AV block, CHF

What are the 1st

generation
cephalosporins?

Cefazolin and cephalexin; used

to treat proteus mirabilis, e.coli,
and klebsiella pneumonia

74.

75.

76.

77.

78.

79.

80.

81.

82.

83.

84.

What are the 2nd

generation
cephalosporins?

Cefoxitin, cefaclor, cefuroxime:

used to treat H. flu, Enterobacter
aerogenes, neisseria, proteus, E.
coli, klebsiella, Serratia.

What are the 3rd

generation
cephalosporins?

Ceftriaxone, cefotaxime,
ceftazidime

What are the b1

selective antagonists?

Acebutolol, Betaxolol, Esmolol,

Atenolol, Metoprolol

What are the calcium

channel blockers that
impact vasculature
more than cardiac
muscle?

Nifedipine, verapamil, diltiazem,

amlodipine, felodipine.

What are the fourth

generation
cephalosporins?

Cefepime

What are the

indications for
Amphetamine?

Narcolepsy, obesity, ADD

What are the

indications for bblockers?

Hypertension, Angina pectoris,

MI, SVT, CHF, Glaucoma

What are the

indications for
Ephedrine?

Nasal decongestion, urinary

incontinence, hypotension

What are the

indications for
Hydralazine?

Severe HTN, CHF, FIRST LINE

for HTN in pregnancy with
methyldopa. Can be used to
prevent reflex tachy. with beta
blockers.

What are the

indications for
Mirtazapine?

Depression

What are the

indications for
phenoxybenzamine?

Pheochromocytoma (use before

tumor removal)

What are the

indications for
phentolamine?

Used to treat pts on MAO

inhibitors who eat tyramine. Side
effects include decreased TPR and
reflecx tachy.

What are the major

P450 inducers?

Quinidine, Barbituates, St. Johns

wort, Phenytoin, Rifampin,
Giseofulvin, Carbamazepine,
Chronic alcohol use, Primidone,
smoking
[Queen Barb Steals Phen-phen
and Refuses Greasy Carbs]

85.

86.

87.

88.

89.

90.

91.

92.

93.

94.

95.

96.

97.

98.

99.

What are the major

P450 inhibitors?

Macrolides except azithromycin,

Amiodarone, Grapefruit juice,
Isoniazid, Cimetidine, Ritonavir,
Acute alcohol abuse, Ciprofloxacin,
Ketoconazole, Sulfonamides
[MAGIC RACKS]

What are the

nonselective (a and
b) antagonists?

carvedilol (use for CHF) and labetalol

What are the

nonselective
antagonists?

Propanolol, Timolol, Nadolol,

Pindolol

What are the partial

b-agonists?

Pindolol, Acebutolol

What are the side

effects of alphamethyldopa?

sedation, +coombs test

What are the side

effects of Aspirin?

Gastric ulceration, bleeding,

hyperventilation, Reye's syndrome,
tinnitus (CNVII), asthma, acidified
urine

What are the side

effects of clonidine?

rebound HTN, dry mouth, sedation,

bradycardia

104.

What are the side

effects of first
generation
antihistamines?

sedation, antimuscarinic, anticholinergic (blurry vision from

antimuscarinic loss of accomadation)
names all contain en/ine or en/ate

105.

What are the side

effects of
metoprolol?

hyperlipidemia, AV-block

What are the side

effects of
Mirtazapine?

Sedation, increased serum

cholesterol, increased appetite

What are the side

effects of
phenoxybenzamine?

orthostatic hypertension, reflex

tachycardia

What are the side

effects Penicillin?

Hypersensitivity, hemolytic anemia

What are the

toxicities of antiHTN calcium
channel blockers?

Cardiac depression, AV block,

peripheral edema, flushing,
dizziness, constipation

What are the

toxicities of
Hydralazine?

Compensatory tachy (contraindicated

in angina/CAD), fluid retention,
nausea, headache, angina, Lupuslike syndrome

What are the

toxicities of
Vancomycin?

Nephrotoxic, ototoxic,
thrombophlebitis, diffuse flushing
(redman) but generally well tolerated

100.

101.

102.

103.

106.

107.

108.

109.

110.

What are the two

major functions
of Digoxin?

1) Increased Inotropy by direct

inhibition of the Na/K/ATPase and
subsequent indirect inhibition of Na/Ca
antiport which increases contractility.
2) Delayed AV conductance via
increased parasympathetic tone and
depression of SA node

What calcium
channel blocker
is
contrandicated
in CHF?

verapamil, it increases the progression

of CHF

What congenital
cardiovascular
malformation is
associated with
rupture of berry
aneurysms?

Coarctation of the aorta, extreme

hypertension makes aneurysms more
likely to exist and rupture. NOTE:
marfans, ED are associated with mitral
valve prolapse, not congenital
deformities (though kaplan says
marfans is associated with ASD)

What diuretics
are protective
against diabetic
nephropathy?

ACE inhintiors

What do we treat
Klebsiella
pneumonia
with?

Cefotaxime: 3rd generation

cephalosporin

What drug class

do we
administer
hydralazine with
to prevent reflex
tachy (side effect
of hydralazine)

b-blockers

What drug class

is associated
with slowing the
progression of
compensated
CHF?

b-blockers

What drugs
should you avoid
using with
benzos?

Alcohol, barbituates, anti-epileptics,

antihistamines, Q

What ECG
findings will you
find in digoxin
toxicity?

Increased PR, decreased QT, scooping

and T wave inversion

What is a
reversible,
nonselective
alpha blocker?

Phentolamine

What is
Amlodipine?

Anti-HTN calcium channel blocker

111.

112.

What is an irreversible,
nonselective alpha
blocker?

Phenoxybenzamine

126.

What is clearance?

How fast can the drug be

eliminated divided by how much
drug is in the plasma

127.

What is contraindicated
in decompensated CHF
that is normally
standard of care for
CHF?

b-blockers, these decrease HR

and CO from their effects on
cardiac tissue

114.

What is Diltiazem?

Anti-HTN calcium channel

blocker

115.

What is Mirtazapine?

An a2 selective alpha blocker

116.

What is nesiritide?

An analong of BNP, increases

cGMP used for CHF

117.

What is Nifedipine?

Anti-HTN calcium channel

blocker

What is the
bioavailability (F) of a
drug administered via
IV?

100%

What is the ending

associated with a1
selective alpha blockers?

-zosin

What is the ending

associated with bblockers?

lol!

What is the half life of

digoxin?

40 hrs

What is the indication

for doxazosin?

HTN and urinary retention in

BPH

What is the mechanism

of action of
hydralazine?

increased cGMP --> smooth

muscle relaxation--> increase
CO:: decreases afterload by
preferentially vasodilating
arterioles

113.

118.

119.

120.

121.

122.

123.

124.

125.

128.

129.

130.

131.

132.

133.

What is the mechanism

of resistance in MRSA?

altered penicillin binding

protein target site

What is the MOA of

Clonidine and alphamethyldopa?

Centrally acting a2-agonists,

decrease central adrenergic
outflow. Useful in HTN, esp.
with renal disease.

134.

135.

136.

137.

138.

What is the MOA

of clopidogrel?

Inhibits platelet agreggation by

irreversibily blocking ADP receptors.
Inhibits fibrinogen binding by
preventing glycoprotein IIb/IIa
expression.

What is the MOA

of cocaine?

uptake inhibitor, causes

vasoconstriction and local anesthesia

What is the MOA

of Diazoxide?

K+ channel opener -->relaxes SM,

also prevents release of insulin from
b-islet causing hyperglycemia

What is the MOA

of Dofetilide?

K+ channel blocker: Increased AP

duration Increased ERP, Used when
other antiarrhythmiscs fail, increased
QT interval --> risk of torsades

What is the MOA

of Fenlodipine?

Dopamine1 selective receptor

antagonist. Three effects: decreases
TPR, Increases sodium/water
excretion, increases renal blood flow.

What is the MOA

of Hydralazine?

Increases cGMP --> smooth muscle

relaxation. Vasodilates arterioles
MORE than veins to cause a reduction
in afterload and subsequent increase
in CO.

what is the MOA of

Nitroprusside?

Shortacting, increase cGMP via direct

release of NO. CN toxicity can be
treated with sodium thiosulfate,
nitrite, or hydroxocobalamin.

What is the MOA

of Penicillin G?

Binds penicillin-binding proteins,

blocks transpeptidse cross-linking of
peptidoglycan. Inactivates autolytic
enzymes

What is the MOA

of ticlopidine?

Inhibits platelet agreggation by

irreversibily blocking ADP receptors.
Inhibits fibrinogen binding by
preventing glycoprotein IIb/IIa
expression.

What is
Verapamil?

Cardiac calcium channel blocker

What key
electrolyte
imbalance must be
corrected slowly in
digoxin toxicity?

K+

What percent of
digoxin is bound to
protein?

20-40%

What should you

check if your
patient is on
K+channel
blockers?

PFTs, LFTs, TFTs

What three drugs are used for the treatment of Malignant

HTN?

Fenlodipine, Nitroprusside, Diazoxide

What toxicity is associated with ticlopidine?

Neutropenia

What two b-blockers are indicated in the treatment of

SVT?

Propranolol and esmolol

What vitamin deficiency is associated with

cephalosporin use?

Vitamin K

Which antiarrythmic carries a risk of pulmonary

fibrosis?

Amiodarone

Which has a greater bioavailablity: ampicillin or

amoxacillin?

Amoxicillin

145.

Why are we careful with b-blockers in diabetics?

can mask signs and symptoms of hypoglycemia

146.

Why does quinidine affect digoxin toxicity?

P450 inhibitor, displaces digoxin from tissue binding sites

147.

Why would we use meropenem instead of imipenem?

meropenem is stable to dehydropeptidase I and has a reduced risk of

seizures

139.

140.
141.

142.

143.

144.