Pharm-Rami
What are the side effects of pazosin and tamsulosin?
"First dose" syncope
What are side effects of alpha-glucosidase inhibitors?
GI upset
What is a common side effect of 50S inhibitor?
GI upset
What are side effects of bile acid resins?
GI upset, decreased fat-soluble vitamin absorption and folic acid
What are side effects of celcoxib?
GI upset, interstitial nephritis, increased risk of thrombosis
What are 2 side effects of metformin?
GI upset, lactic acidosis (contraindicatied in renal patients based on excretion)
What cacner is C-kit associated with?
GIST
What do typical anti-psychotics cause? SE
Galactorrhea and amenorrhea, blockade symptoms, neurolepticmalignant syndrome
A GAL is DONE with the STIGMA, she is TAKING care of her granmda with Alzheimers means what?
Galantamine, Donepezil, Rivastigmine, and Tacrine are all used to treat Alzheimers
What are side effects of fibrates?
Gallstone formation
What drugs cause agranulocytosis?
Ganciclovir, clozapine, carbamazepine, colchicine, methimazole, PTU (gangs cccrush myeloblasts and promyelocytes)
What are the fibrates?
Gemfibrozil, -fibrates
What cephalosporin can treat anaerobes and H. Influenza?
Gen 2
what is the main thing that hexamethonium causes?
Hypotension (used to treat hypertension emergencies in past)
What are side effects of verapamil and diltiazem?
Hypotension/heartblock
What is levothyroxine used for?
Hypothyroidism
During a prolonged surgical procedure performed under halothane general anesthesia, a patient experiences a fall in blood pressure. The anesthesiologist administers a pressor agent by s.c. injection that does not stimulate cardiac beta-1 receptors. This drug was: doxazosin, isoproterenol, phentolamine, phenylephrine, phenelzine
Pnehylephrine
What diureteic causes gynecomastia?
K sparing diuretic - aldosterone receptor antagonist
What do you give with flutamide to conteract the increase in LH levels caused by lower testosterone?
Leoprolide
What can metformin also be used in?
Polycystic ovarian syndrome
What produces oxytocin, how does it act, what else can it be used for?
Posterior pituitary, stimulate uterine contraction to induce labor, stimulate breast milk "let down", control post-partum uterine hemorrhage
What does gabapentin treat?
Postherpetic neuralgia, neuropathic pain, partial seizures
In what population is tamoxifen most effective?
Postmenopausal women
What decreases prostatic and bladder neck contraction and decrease blood pressure
Prazosin, tamsulosin
What are 2 uses of ursodiol?
Primary biliary cirrhosis, cholesterol gallstones
What do you give to preven further gouty attacks?
Probenecid, allopurinol
What are the 8 sulfa drugs?
Probenecid, furosemide, acetazolamide, celecoxib, thiazide, sulfonamide, sulfasalazine, sulfonylurea
What is the effect of aminocaproic acid?
Promote clotting
What does fibrinolytic agents do?
Promote conversion of plasminogen to plasmin
What treats tachycardia associated with hyperthyroidism and chronic migraines?
Propanolol
What does flutamide treat?
Prostate cancer
What are the uses of bosentan?
Pulmonary arterial hypertension
What does 6-mercaptopurine treat?
Leukemias (ALL), non-Hodgkin lymphoma, inflammatory bowel disease and psoriasis (immunosuppressant)
W is the first line treahattment fffor parkinsonism?
Levodopma
What are side effects of busulfan?
Pulmonary fibrosis, adrenal insufficiency+hyperpigmentation, seizures
What are side effects of bleomycin?
Pulmonary fibrosis, anaphylaxis
What are 4 side effects of phenytoin?
Nystagmus, gingival hyperplasia, drug-induced lupus, teratogen
What are 3 anti-obesity agents?
Orlistat, sibutramine, fen-phen
What does raloxifene treat?
Osteoporosis and reduces risk of breast cancer, without increased risk kof endometrial cancer
What is the use of bisphosphonates?
Osteoporosis, hypercalcemic bone metastasis
What are the symptoms of Cushing syndrome?
Osteoporosis, hyperglycemia, fat restribution, buffalo hump and moon facies, impaired wound healing
What is a side effect of anastrazole?
Osteoporosis, increased CV events, hyperlipidemia
What are 3 side effects of loop diuretics?
Ototoxic, hyperuricemia, sulfa allergy
What does paclitaxel treat?
Ovarian and breast cancer and used to coat coronary artery stents
What do you think the symptoms of pheochromocytoma are, given that it involves adrenaline secreting tumor?
Palpitations
What can didanosine (NRTI) cause?
Pancreatitis
Is succinylcholineor pancuronium a non-depolarizing neuromuscular blocker?
Pancuronium (succinylcholine depolarizing)
Given that MAOb breaks down dopamine, what do you think inhibiting MAOb could also treat?
Parkinsons
WWhere does vernicline act
Partial agonist and antagonist at nicotinic acetylcholine receptors found in brain
What causes drug-induced coombs positive hemolytic anemia? 2
Penicillin, a-methyldopa
Which drugs cause a Coombs positive hemolytic anemia?
Penicillin, chloroquine
What is a side effect of gabapentin?
Peripheral edema
What is the side effect of amlodipine?
Peripheral edema
What is a side effect of vincristine?
Peripheral neuropathy, myelosuppression (rare)
What phases do class IA act on?
Phase 0 and phase 3
What phase do class IB drugs act on?
Phase 3 (Na)
What phase do class III affect and what ion channel?
Phase 3, potassium
What phase do class IC affect?
Phase O (sodium inside)
What phase do class IV affect?
Phase4
What adrenergic agonists activate a1?
Phenaleyephrine, MIdodrine
What treats pheochromocytoma?
Phenoxybenzamine
What adrenergic drug causes mydriasis like tropicamide and homatropine does?
Phenylephrine
What dilates pupils (mydriasis)?
Phenyleyephrine
What is used to dilate pupils (mydriasis)?
Phenyleyephrine
What is used to treat status epilepticus, partial seizures?
Phenytoin
What does phenoxybenzamine treat?
Pheochromocytoma
What is the mechanism of M1/M3 and a1?
Phospholipase C to increased IP3 and DAG to increased intracellular Ca
Does neostigming or physostigmine cross BBB?
Physostigmine
What is the antidote of succinylcholine?
Physostigmine
How do you treat atropine poisoning?
Physostigmine (cholinesterase inhibitor)
A 52 year old man undergoes radiotherapy to treat a tumor in his neck. A side effect of his treatment is the development of salivary gland hypofunction, with associated dry mouth. A drug that could be used to treat this patient's condition is: atropine, diphenhydramine, ipratropium, nicotine, pilocarpine?
Pilocarpine
What is used to treat both hypertension and bradycardia?
Pindolol
What is the effect of dipyridamole?
Platelet aggregation and thrombus formation is inhibited and vasodilation is promoted
What are 4 side effects of amiodarone (class III)?
Pulmonary fibrosis, hepatotoxicity, thyroid dysfunction, photosensitivity
What 5 drugs cause hyperuricemia?
Pyrazinamide, thiazide, furosemide, niacin, cyclosporine
A year later Brian returns for a follow-up visit. His muscle weakness has become gradually more severe, to the point that he now requires some form of chronic treatment for relief of muscle weakness. A drug that would be a good choice for maintenance therapy, and would not cross the blood-brain barrier is: Edrophonium, glycopyrrolate, nicotine, physostigmine, pyridostigmine
Pyridostigmine
What are the class IA drugs?
Quinidine, procainamide, pisopyramide
What is the side effect for SSRI block of histamine, adrenergic, muscarinic blockades respectively?
Sedation, postural hypotension, urinary retention and dry mouth
What is a side effect of imipenem?
Seizures in renally insufficient patients
What receptors do atypical anti-psychotics block?
Serotonin and dopamine
What do SSRIs and MAOi lead to?
Serotonin syndrome (changes in mental status, muscle stiffness, hyperthermia)
What kind of drug is subtramine?
Serotonin, NE, and dopamine reuptake inhibitor
What is a side effect of SSRIs?
Sexual dysfunction
What are 3 uses of zolpidem? (zoldipam aka ambien)
Short-term treatment for insomnia, mild anterograde amnesia, hallucinations
What are the 4 side effects of the -cyclines?
Teeth discoloration, bone deformity in children, Fanconi syndrome, photosensitivity
What is a big side effect of warfariN?
Teratogen
What are side effects of thalidomide?
Teratogen, contraindicated in pregnancy
What are side effects of methotrexate? 3
Teratogen, pulmonary toxicity, bone marrow suppresion
What is used to delay preterm labor by reducing uterine contractions?
Terbutaline
What relaxes smooth muscle in both lungs and uterus by directly-acting on receptor?
Terbutaline
What does vinblastine treat?
Testicular cancer, lymphomas
What is bleomycin used for?
Testicular tumors
What is the first line treatment for hypertension, nephrogenic diabetes insipidus, and recurrent kidney stones?
Thiazide diuretics
What are side effects of vigabatrin?
Visual field constriction and visual loss (think vis-gabatrin)
What is a side effect specific to mirtazapine?
Weight gain (heavy as a pine tree)
What is a conraindication of succinylcholine?
When given with halothane, it can cause malignant hyperthermia
What does dactinomycin treat?
Wilms tumor and Ewing Sarcoma
What are 3 indications for class IA anti-arrhythmics?
Wolf-Parkinson White Syndrome, atrial fibrillation, ventricular tachycardia
Can doxycycline be used in patients that are renally insufficent?
Yes, it is fecally eliminated
What inhibits neuraminidase and is used in treatment of influenza A and B?
Zanamivir
What NRTI do you give PREGNANT women?
Zidovudine
What receptor does phenylephrine and midodrine act on?
a1 agonist
What are alpha-glucosidase inhibitors?
acarbose and miglitol
since physostigmine crosses the BBB, what is it used for ?
antidote to a atropine overdose
insomnia at the beginning of the night, or hypersomnia, increased appetite, weight gain, worse in evening, reactive mood, interpersonal hypersenstiviity is characteristic?
atypical depression
what is benzodiazepine moa
enhances GABA, leads to INC chloride ion flow, leads to hyperpolarization, leads to DEC activity of neurons in CNS
What are 3rd generation sulfonylureas?
glimepiride
Name the typical antipsychotics
haloperidol, fuphenazine, chloromazine, thioridazine
what should you avoid when using lithium?
having a baby (it is a teratogen)
What is Vigabatrin used for?
infantile spasms in children
What are the side effects of terbutaline?
Tachycardia, tremor
What are 3 symptoms of hyperthyroidism?
Tachycardia, weight loss, diarrhea
What are the sites of ewing sarcoma?
Diaphysis in long bones (femur, tibia), flat bones (pevlis, calcaneum), onion skin
What is a side effect of colchicine?
Diarrhea
what is Side effect of bathenchol?
Diarrhea
What does methotrexate inhibit?
Dihydrofolate reductase
What are some first generation anti-histamines?
Diphenhydramine, promethazine, meclizine, hydroxyzine, doxylamine
What are 2 anti-diarrheal agents?
Diphenoxylate and loperamide
What opioids are used for diarrhea?
Diphhenoxylate (analogue of meperidine)
What is rivaroxaban?
Directly inhibit factor Xa
What does ketoconazole do, SE?
Disrupt gonadal and adrenal steroid synthesis, gynecomastia
What do you give to optimize preload?
Diuretics (loop diuretics, aldosterone antagonists), venodilators (nitroglycerin, morphine)
A patient in cardiogenic shock is given a beta-1 selective agonist to increase stroke volume. What drug has given?
Dobutamine
What can treat cardiogenic shock?
Dobutamine
What are the 3 macrolides?
Erythromycin, clarithromycin, azithromycin
What is a short acting B1-receptor antagonist?
Esmolol
What are 4 characteristics of malignant hyperthermia?
Hyperthermia, tachycardia, acidosis, and muscle breakdown
What is PTU and methimazole used for?
Hyperthyroidism
What are 3 side effects of thiazide diuretics?
Hyperuricemia, hyperglycemia, metabolic alkalosis
What are side effects of thiazolidinediones and sulfonylureas?
Hypoglycemia
What is aside effect of vasopressin?
Hyponatremia
What is a side effect of nesiritide?
Hypotension
What is a side effect of propofol?
Hypotension
What are 3 symptoms of hypothyroidism?
Bradycardia, weight gain, constipation
What does nitrosureas treat?
Brain tumors (cross BBB)
What do lipoprotein lipases do?
Breaks down TG into VLDL and chylomicrons, which are removed from circulation
What does trastuzumab treat?
Breast cancer
What are examples of solid tumors?
Breast, ovarian
What does theophylline cause?
Bronchodilation
What 2 things does albuterol do?
Bronchodilation, treat hyperkalemia
What cancer is Bcr-ABL associated with?
CML
What does busulfan treat?
CML (Philadelphia Chromosome)
What does hydroxyurea?
CML (Philly), melanoma as well as sickle cell
What does imatinib treat?
CML, GISTs
What 6 drugs cause aplastic anemia?
CMNBCP, carbamazepine, methimazole, NSAIDs, benzene, chloremphenicol, PTU
What are the endings of meglitinides?
-glinide
What are the endings of DPP-4 inhibitors?
-gliptin
What are nitrsureas?
-mustine (carmustine)+streptozocin
What are the endings of ACE-inhibitors?
-prils
What are the endings for direct thrombin inhibitors?
-rudin, -gatroban, -gatran
What are the endings of ARBs?
-sartans
WHat is the suffix for synthetic corticosteroids?
-sone, -solone
What is a normal anion gap?
10-12
how long does it take for anti depressants to work?
3-4 weeks
What does zileuton inhibit?
5-lipoxygenase
What does finasteride inhibit?
5alpha-reductase
Which receptor phenylephrine works on basesd on its usage?
A1 receptor
How is methyldopa an adrenergic agonist but can treat hypertension?
A2 receptor is inhibitory
What is the mechanism of M2 and A2?
AC inhibited to decreased cAMP mechanism
What has been shown to decrease mortality in postmyocardial infarction patients?
ACEi
WWhat can be used to treat hypertension, CHF anddiabetic nephropathy?
ACEis, ARBs
What are inhibitors of cytochrome P-450 interactions? 10
ACUTE alcohol abuse, ritonavir, amiodarone, cimetidine, ketoconazole, sulfonamide, isoniazid, grapefruit juice, quinidine, macrolides (AAA racks in GQ magazine)
What does vincristine treat?
ALL, lymphomas (part of MOPP protocol)
What does cytarabine treat?
AML
What is idarubicin used for?
AML
What binds to GP IIb/IIIa receptor complex, inhibiting the binding of fibrogen and von willebrand factor to the receptor inhibiting platelet aggregation?
Abciximab
What does dinoprostone used for?
Abortifacient
What does ethosuximide treat?
Absence seizures (sux to be absent)
What is the action of fondaparinux?
Accelerate selective action of anti-thrombin III by inhibiting factor Xa
What do you give for an antidote for acetaminophen poisoning?
Acetylcysteine
What does heparin act on?
Activate anti-thrombin III
What does Nm/Nn do?
Activation of Na/K channels
What does benztropine do?
Acts at M1 receptors in the corpus striatum (treats Parkinson's by improving tremor & rigidity, no effect on bradykinesia)
What does cytarabine do?
Acts to competitively inhibit DNA polymerase and thus DNA synthesis
What are uses of theophylline?
Acute and chronic asthma, SE: cardiac arrhythmias, narrow therapeutic index
What is a side effect of macrolides?
Acute cholestatic hepatitis (jaundice)
What is an indication for abciximab?
Acute coronary syndrome
What is bivalirudin used for?
Acute coronary syndromes during cardiac catherization
What does nesiritide treat?
Acute decompensated heart failure
Whhat does it treat?
Acute decompensated heart failure
What is daunorubicin used for?
Acute leukemia and neuroblastoma
What does 5-fluorouracil treat?
Adenocarcinoma (colon, among others)
What is ezetimibe used for?
Adjunct for hypercholesterolemia
Where does danazol act?
Agonist at androgen and progesterone receptors
Aside from ipratropium, what adrenergic drugs treat COPD and asthma?
Albuterol, salmeterol
Which drug given in conjunction with 6-MP would increase serum levels of 6-MP and thus be contraindicated?
Allopurinol
As a cardiovascular drug, dopamine can produce remarkedly different effects depending on the dose administered. At high doses the predominant effect of dopamine would be to cause vasoconstriction by stimulating: Alpha adrenergic receptors, beta-1 adrenergic receptors, beta-2 adrenergic receptors, dopamine receptors
Alpha adrenergic (remember: Abinephrine)
What can protease inhibitors cause?
Altered distribution of fat, insulin resistance (glucocorticoid-like), NEUROPATHY
What does tacrine treat?
Alzheimer's (similar is donepezil, galantamine, rivastigmine)
What is memantine used for?
Alzheimers
What's an antibiotic that you do not wantto give in renally insufficient people, that aztreonam might be a great alternative for?
Aminoglycosides (Gentamicin)
what are the TCAs?
Amitriptyline, nortriptyline, imipramine, doxepin, trazodone (actually a tetracyclic antidepressant)
What does inhibiton of PGE2 cause?
Analgesia and anti-pyretic
What are side effects of danazol?
Androgenic side effects (masculinization, hirsutism, acne)
What is promethazine used for?
Anti-emetic
What are substrates of cytochrome P-450 interactions?
Anti-epileptics, theophylline, warfarin, OCPs (always think when outdoors)
What does buspirone treat?
Anxiety in conjunction with SSRIs
What do you give to reduce afterload?
Arteriolar vasodilators (CCB, hydralazine), mixed vasodilators (ACE inhibitors, ARBs, nitroprusside)
How would you treat an overdose of cholinesterase inhibitors?
Atropine
While on a medical mission in Syria, you are exposed to the nerve gas Sarin. Effective treatment typically involves the i.m. administration of: Atropine+pralidoxime, atropine+trimethaphan, pilocarpine+pralidoxime, tubocurarine+trimethaphan, varenicoline+tubocurarine?
Atropine+pralidoxime
What does MAOi treat?
Atypical dpression
What are the uses of etanercept?
Autoimmune diseases (rheumatoid arthritis)
What are the uses of infliximab?
Autoimmune diseases (rheumatoid arthritis, inflammatory bowel disease)
What is a structural analogue of 6-MP, which gets converted to 6-MP within the cell. It is used as an immunosuppressant in autoimmune diseases?
Azathioprine
What do you give to a patient who is renally insufficient or allergic to penicillin?
Aztreonam
Why does propanolol causefasting hypoglycemia?
B2 antagonism, decrease glycogenolysis
Isoniazid causes peripheral neuropathy because it depltees the body of which vitamin
B6
What does finasteride treat (3)?
BPH, prostate cancer, early-male pattern baldness
What increases urination, treats neurogenicn ileus?
Bathanechol
What is an inhaled corticosteroid used to treat chronic asthma?
Beclomethasone
A patient suffering from a severe AV heart conduction disturbance is given an IV bolus of isoproterenol. A recording of the patient's blood pressure is shown below. Stimulation of which adrenergic receptor subtype is responsible for producing the fall in diastolic blood pressure? Alpha-1, alpha-2, beta-1, beta-2
Beta-2
During fight or flight situations the adrenal gland releases significant amounts of epinephrine into the bloodstream. Epinephrine in turn stimulates a variety of adrenergic receptors. Which vascular receptor subtype is not normally innervated, but when stimulated by epinephrine results in vasodilation & increased regional blood flow to skeletal muscle? Alpha-1, Alpha-2, beta-1, beta-2
Beta-2
What do you give to optimize heart rate?
Beta-blockers (metoprolol, carvedilol)
Where does thiazolidinediones act and what does it do?
Bind to PPAR-g, upregulation of genes that lead to decrease in insulin resistance
What does amphotericin do?
Bind to ergosterol,alter permeability of fungal cell membrane
What does vincristine and vinblastine do?
Bind to tubulin - depolymerize the mitotic spindle
What does paclitaxel do?
Binds to tubulin, stabilize and polymerize mitotic spindle
What does lithium treat?
Bipolar disorder
What are side effects of pioglitazone?
Bladder cancer
Where does ondanstron act?
Block 5-HT3 receptors
What does metoclopramide do?
Block D2 dopamine receptors
What channels do class IA drugs act on?
Block activated sodium channel
What does nefazodone, venlafaxine and maprotiline do (mechanism)?
Block reuptake of NE and serotonin
What is the mechanism of cocaine?
Blocks Na/K atpase that is responsible for reuptake of NE, serotonin and dopamine
What is the mechanism of action of tetracyclines?
Blocks aminoacyl-tRNA from binding to ribosome
What is a side effect of cytarabine?
Bone marrow suppresion leading to pancytopenia
What is a side effect of 5-fluorouracil?
Bone marrow suppression
What is a side effect of etoposide?
Bone marrow suppression
What is a side effect of vinblastine?
Bone marrow suppression
What is ai side effect of paclitaxel?
Bone marrow suppression
What does sildenafil inhibit?
CGMP-specific phosphodiesterase type 5
What does carvedilol treat?
CHF and hypertension
What are inducers of cytochrome P-450? 8
CHRONIC ALCOHOL, St. John's wort, phenytoin, phenobarbital, nevirapine, rifampin, griseofulvin, carbamazepine (Chronic alcoholics steal phen-phen and never refuse greasy carbs)
What is the use of interferon-a (produced by leukocytes)?
Cancers (Kaposi's sarcoma) and chronic Hepatitis B and C
What is used to treat glaucoma and alkalinize the urine?
Carbonic anhydrase inhibitors
What are the side effects of cocaine?
Cardiac arrhythmias and hypertension
What is an indication of dipyridamole?
Cardiac stress test
What are side effects of trastuzumab?
Cardiac toxicity
What is a side effect of anthracyclines?
Cardiac toxicity
What is a gen 4 cephalosporin?
Cefepime
What is a use of vasopressin?
Central diabetes insipidus
What is a side effect of MAOi?
Cheese effect from tyramine (hypertensive crisis with cheese due to tyramine in cheese stimulates EPI and NE release) (MAOiSE likes cheese)
What are the ages of ALL, CLL, AML, CML?
Child, Old adult, 60s, 40-85
What is infliximab?
Chimeric antibody that inhbiits TNF-a binding
What are the 1st generation of sulfonylureas?
Chlorpropamide, tolbutamide, tulazamide
What are 3 bile acid resins?
Cholestyramine, colestipol, colesevelam
What does latonoprost treat?
Chronic glaucoma
What is the use of interferon-gamma?
Chronic granulomatous disease
What is a side effect of quinidine?
Cinchonism
What class anti-arrhythmic drugs cause a prolonged QT interval?
Class IA, Class III
What class anti-arrhytmics cause shortened QT interval
Class IB
What is cilostazol indicated for?
Claudication
What activates a2?
Clonidine
What irreversibly inhibits the binding of ADP to platelet P2Y receptor, blocking ADP-mediated platelet aggregation
Clopidogrel
What opioids are cough suppressants?
Codeine and dextromethorphan
What is used for acute GOUT attacks?
Colchicine, NSAIDS (indomethacin, naproxen)
What is the action of demeclocycline to treat SIADH?
Competitive antagonist at the V2 receptors
Where does flutamide act?
Competitive antagonist at the androgen receptor
What is tamoxifen?
Competitive estrogen-receptor antagonist
What is imatinib?
Competitive inhibitor of tyrosine kinase enzymes
What is the mechanism of hexamethonium (mecamylamine, trimethaphan)?
Competitively inhibit activation of Nn-receptors on the post-synaptic neuron of the autonomic ganglia - block outflow to both sympathetic and parasympathetic neurons
What is the MOA of bosentan (-sentan drugs)?
Competitively inhibits the binding of endothelin-I to endothelin receptors
What are the 4 affects of sympathetic system?
Contraction, uterine relaxation, mydriasis, bronchodilation
What is a side effect of sumatriptan?
Coronary vasospasm (contraindicated in CAD patients)
What is a congenital syndrome where babies have difficulty conjugating bilirubin?
Crigler-Najjar syndrome (jaundice + encephalopathy)
What results in a non-depolarizing NM blockade?
Curare
Since ketoconazole disrupts gonadal and adrenal steroid synthesis what else can it be used to treat?
Cushing's syndrome
What is a side effect of nitroprusside
Cyanide toxicity
Since phentolamine is short-acting what do you think its main use is?
Diagnose pheochromocytoma
what are the characteristics of typical antipsychotics (receptor blocked, SE, and symptoms effective against)
D2 receptor block, extrapyramidal side effects and hyperprolactinemia, and effective against positive symptoms
What is the MOA of anthracyclines?
Damage DNA (block DNA and RNA synthesis)
What is the antidiote for neuroleptic malignant syndrome?
Dantrolene
What heart mechanism is nitroprusside fixing?
Decrease preload and afterload
What is the effect of statins?
Decrease total cholesterol, and LDL levels
What does ezetimibe do?
Decreases absorption of cholesterol in the small intestine (decrease serum LDL)
What heart mechanism is it fixing?
Decreases preload
What is the mechanism of probenecid?
Decreases reabsorption of uric acid in the PCT (by blocking active transport of uric acid)
What is terbutaline used for?
Delay preterm labor by reducing uterine contraction
What drugs cause nephrogenic diabetes insipidus?
Demeclocycline, lithium
What does phase O and phase 3 stand for in AP of cardiac muscles?
Depolarization, repolarization
What is used to diagnose CUshing's syndrome?
Dexamethasone suppression test
What do you give to decrease free radicals during anthracycline administration?
Dexrazoxane
What acts on similar receptors as epinephrine
Dopamine
What are the 3 anthracyclines?
Doxorubicin, daunorubicin, idarubicin
What is a side effect of procainamide?
Drug-induced lupus
What is a B1-agonist, used for cardiac stress test?
Dubutamine
What do thiazolidinediones cause as a side effect?
Edema
What is used to diagnose myasthenia gravis?
Edrophonium
What is a side effect specific to venlafaxine?
Elevated BP and HR (Fax me your EKG)
What are the 2 uses of danazol?
Endometriosis, hereditary angioedema
What does impramine treat?
Enuresis (promise me you will stop wetting the bed)
True or false: Ephedrine stimulates CNS
Ephedrine
A 16 year old patient arrives in the emergency department suffering from an anaphylactic reaction. The patient is having difficulty breathing, has severe urticaria, and is hypotensive. Which of the following is a drug of choice for treating this patient's potentially life-threatening condition?
Epinephrine
What is an a-agonist at high doses and b agonist at low doses?
Epinephrine
What treats bronchospasm and anaphylaxis?
Epinephrine
What is an alpha agonist at high doses and beta agonist at low doses?
Epinephrine, dopamine
How do you determine a skeletally mature foot from skeletally immature on X-ray?
Epiphysis at base of first met and at each of heads of lesser mets are the last to fuse in feet between ages 17-20
Wht does sildenafil treat? 2
Erectile dysfunction and pulmonary arterial hypertension
What does thalidomide treat?
Erythema nodosum leprae: multiple myeloma
Do local anesthetics esters or amides have a short duration of action?
Esterr
What causes retrobulbar neuritis (decreased visual-acuity and red-green color blindness)?
Ethambutol
Patient taking clindamycin has GI symptoms and reports to the ER. She is later diagnosed with a type of membranous inflammation, and given another typeofmedication to treat the inflammation. The doctor advised the patient to not ingest any .... while taking this medication.
Ethanol (disulfiram-like reaction)-metronidazole
What is the use of guaifensin?
Expectorant to help clear phlegm
What are 2nd generation histamine blockers
Fexofenadine, loratadine, cetirizine
What do you give for a benzo overdose?
Flumazenil
What are the 6 SSRIs?
Fluoxetine, paroxetine, sertraline, fluvoxamine, escitalopram, citalopram
What are side effects of niacin? 2
Flushing, hyperuricemia
What do you give someone who is allergic to heparin?
Fondaparinux (or rivaroxaban)
What is the side effect of atropine?
Hyperthermia, decreased salivation, cycloplegia, psychosis, tachycardia
What do cisplatin and carboplatin treat?
Genitourinary tumors
What is leucovorin used for?
Given with methotrexate to minimize bone marrow suppression
How is insulin secreted?
Glucose enters cell, metabolizes to ATP, ATP binds K channel and closes it so K can't flow into cell, which leads to depolarization, depolarization leads to Ca release intracellularly, Ca promotes exocytosis of insulin
What are 2nd generation sulfonylureas?
Glyburide, glipizide
What does leoprolide do?
GnRH agonist
What does buspirone act on?
H-HT1A as a partial agonist
What are statins?
HMG-CoA reducatase inhibitors
What are side effects of ketamine
Hallucinations, cardiac/resp. Depression
What are 4 drugs that can cause fulminant hepatic necrosis?
Halothane, acetominophen, valproic acid, death cap mushroom
What is cushing's disease?
Having increased cortisol levels due to overactive ACTH
What are side effects of rosiglitazone?
Heart attacks
What does digoxin treat?
Heart failure
What are side effects of cyclophosphamide?
Hemorrhagic cystitis, bone marrow suppression
What is a big side effect of heparin?
Heparin-induced thrombocytopenia
What is agratroban used for?
Heparin-induced thrombocytopenia
What are side effects of valproic acid?
Hepatotoxic, teratogen (neural tube defects)
What are side effects of PTU and methimazole?
Hepatotoxicity, rash
What are the side effects of bosentan?
Hepatotoxicity, teratogen
What competitively inhibits activation of Nn-receptors on post-synaptic neuron of autonomic ganglia, and causes HYPOtension
Hexamethonium
What is an emergency contraceptive?
High doses of synthetic progestins (up to 72 hours)
What are 3 side effects of clomiphene?
Hot flashes, abdominal discomfort, multiple pregnancies
What are 2 side effects of carbonic anhydrase inhibitors?
Hyperchloremic metabolic acidosis, neuropathy
What are the uses of prazosin and tamsulosin?
Hypertension and BPH
What are epinephrine side effects?
Hypertension, pulmonary edema
What 2 thigns do verapamil and diltiazem treat?
Hypertension, supraventricular tachycardia
What is the use of tacrolimus?
Immunosuppressant in transplant patients, Crohn's disease
What is the use of mycophenolate mofetil?
Immunosuppressant in transplant patients, also used to treat autoimmune disorders
What is the use of cyclosporine?
Immunosuppressant in transplant patients, graft vs. host disease, rheumatoid arthritis
What is fanconi synddrome?
Inadequate reabsorption of proximal convoluted tubule
What does niacin do?
Increase HDL levels
What does milrinone cause? What is its effect
Increase contractility
What is the effect of digoxin?
Increase contractility
What does inhibition of PGI2 cause?
Increased gastric acid secretion
What is a side effect of tacrolimus?
Increased risk for infection
What are side effects of tamoxifen?
Increased risk of endometrial cancer, increased risk of thromboembolism, hot flashes
What is the mechanism of colchicine?
Induces microtubular polymerization by binding tubulin (decreased migration of leukocytes)
What is propofol used for
Induction and maintenance of anesthesia and conscious sedation
What is thiopental used for?
Induction of anesthesia
What is etomidate used for?
Inductionof anesthesia and conscious sedation
What is the hallmark and first sign of Paget disease?
Ivory vertebra, alkaline phosphatase level increase
What is the use of clomiphene?
Infertility in patients with ovulatory dysfunction
What are the uses of sulfasalazine?
Inflammatory bowel disease and rheumatoid arthritis/juvenile arthritis
What are side effects of rituximab?
Infusion reaction, acute renal failure
What does dactinomycin od
Inhibit DNA-dependent RNA polymerase
What does mirtazapine do?
Inhibit activation at alpha2-adrenergic receptors and at 5HT2 receptors
What does anastrazole do and what is the result?
Inhibit aromatase, decreased estradiol levels
What does rifampin mechanism of action?
Inhibit bacterial DNA-dependent RNA polymerase
What does etanercept do?
Inhibit binding of TNF-a and TNF-b molecules to their receptors
What does tacrolimus do?
Inhibit calcineurin via FKBP, decrease IL-2
What does cyclosporine do?
Inhibit calcineurin, decrease IL-2
Where does cylostazol act?
Inhibit cyclic AMP phosphodiesterase III
What is the end effect of progestins?
Inhibit follicular development and absence of ovulation
What is clindamycin's mechanism of action?
Inhibit formaiton of initiation complex
What does orlistat do?
Inhibit lipase (decrease intestinal fat absorption)
What does mycophenolate mofetil act on?
Inhibit monophosphate dehydrogenase via B and T lymphocytes
What is the mechanism of tiagabine
Inhibit reuptake of GABA
What is the mechanism of buproprion?
Inhibit reuptake of NE and dopamine, and nicotinic antagonist
What does hydroxurea treat?
Inhibit ribonucleotide reductase, leading to decreased DNA synthesis
What is terbinafine MAO and use?
Inhibit squalene epoxidase, onychomycosis
What is the action of isoniazid?
Inhibit synthesis of mycolic acid
What do PTU and methimazole do?
Inhibit thyroid peroxidase, inhibit peripheral conversion of T4 to T3
What does warfarin do?
Inhibit vitamin K-dependent g-carboxylation of factors 2,7,9,10 and protein C and S
What is a side effect of probenecid?
Inhibition of renal excretion of penicillin and NSAIDs
What is the mechanism of action of aminoglycosides?
Inhibits formation of initiation complex and causes mRNA misreading
What does 5-fluorouracil do?
Inhibits thymidylate synthase, disrupting DNA synthesis
What do you give to increase heart contractility?
Inotropes (dobutamine, milrinone, digoxin)
What does trazodone treat?
Insomnia (puts you out of the zone)
What is the MOA of griseofulvin?
Interferes with microtubule formation
Your 23 year old patient recently diagnosed with asthma cannot tolerate the CNS side effects of his inhaled albuterol. As an alternative, you recommend he try an inhaled quaternary antimuscarinic, and prescribe: Atropine, bethanechol, ipratropium, pyridostigmine, vaernicline
Ipratropium
Is aspirin reversible or irreversible?
Irreversible
What does vigabatrin mechanism?
Irreversibly inhibit GABA transaminase (think vi-GABA-trin)
What does omeprazole do?
Irreversibly inhibit H/K/ATP ase pump
What 7 drugs cause G6PD deficient hemolytic anemia?
Isoniazid, sulfonamides, dapsone, primaquine, aspirin, ibuprofen, nitrofurantoin
What are 2 ways to treat torsades de pointes?
Isoproterenol and magnesium
What drugs cause hypothyroidism?
Lithium, amiodarone, sulfonamide
What are side effects of troglitazone?
Liver damage
What are the uses of salmeterol?
Long acting for COPD and preventing asthma
What is the difference between enoxaparin and dalteparin and other forms of heparin?
Longer duration of action (less frequent dosing needed)
Atropine is a competitive muscarinic receptor ANTagonist that acts at what receptors?
M1-M3
Oxybuterin is a muscarinic receptor antagonist at what receptor?
M1-M3
Scopalamine is a competive muscarinc receptor that acts at what receptors?
M1-M3
Ipratropium is an antimuscarinic receptor that acts at what receptor?
M3
What receptor does pilocarpine and carbachol act on?
M3
Muscarinic agonists pilocarpine, methacholine, bethencholine all act at what receptor?
M3 (Pay My Bills 333$)
What treats orthostatic hypotension and causes supine hypertension?
MIdodrine
What is phenobarbital used for?
Manage seizures and treatment of neonatal hyperbilirubinemia
What does valproic acid treat aside from epilepsy?
Mania
What is part of the MOPP protocol to treat Hodgkin lymphoma?
Mechlorethamine, vincristine, procarbazine, prednisone
What can zidovudine cause?
Megaloblastic anemia
What does mefloquine cause?
Mental status change
An aspirin overdose causes what?
Metabolic acidosis or respiratory
What does leoprolide treat? 3
Metastatic prostate cancer, leiomyomas, infertility (when given in a pulsatile fashion)
What 3 drugs cause interstitial nephritis?
Methicillin, NSAIDs, furosemide
A 27 year old woman with a history of hypertension comes to your office to discuss her drug therapy for hypertension. Her blood pressure is currently well controlled by a combination of enalapril and hydrochlorothiazide. The reason for her visit is that she is planning to become pregnant in the near future, and she is aware that ACE inhibitors are contraindicated in pregnancy. After discussing her therapeutic options, you decide to replace her ACE inhibitor with a drug that is considered relativel safe in pregnancy, and is believed to exert its effects by multiple mechanisms including working as a false neurotransmitter. THis drug is: albuterol, alpha-methyltyrosine, methyldopa, prazosin, termbutaline
Methyldopa
What treats moderate hypertension by adrenergic neurotransmitters
Methyldopa
What treats hypertension, tachycardias, CAD, especially in patients with diabetes?
Metoprolol
What 5 drugs have disulfiram-like effect?
Metronidazole, cephalosporin, griseofulvin, procarbazine, sulfonylurea
What is used for orthostatic hypotension (fainting when you stand up), used in patients with advanced hepatic disease?
Midodrine
What is an abortifacient at high doses?
Mifepristone
What does sumatriptan treat?
Migraines and cluster headaches
What can topiramate be used to treat and how?
Migraines by inhibiting flow of sodium ions
What effects does raloxifene have?
Mixed estrogen agonist/antagonist effects
What does rituximab taret?
Monoclonal antibody against antigen CD20
What opioid is used for acute pulmonary edema
Morphine
What is the use of interferon-B (produced by fibroblasts)?
Multiple sclerosis
What are the uses of neostigmine?
Myasthenia gravis, anesthesiologists to overcome non-depolarizing neuromusclar blockade (does not cross bbb)
Patient is taking a drug for a bacterial infection and after 2 weeks complains of retrobulbar neuritis, what kind of bacteria is the patient being treated for?
Mycobacterium
What does bupivacaine cause? 2
Myocardial depression and hypotension
What are side effects of statins?
Myopathy, abnormal LFTs
What does ketamine target?
NMDA recetor antagonist
How do cardiac myocytes depolarize, and how does the SA node depolarize?
Na, Ca
What are the side effects of milrinone?
Nausea, thrombocytopenia
What reversibly inhibits acetylcholinsterase (myasthenia gravis)
Neostigmine
What is a SE of methohxyflurane and enflurane?
Nephrotoxic
What is the side effect of aminoglycosides and what makes them more toxic?
Nephrotoxic (with cephalosporin), ototoxic (with loop)
What are the side effects of cyclosporine?
Nephrotoxic, hepatotoxic, hyperglycemia
What are the side effects of vancomycin?
Nephrotoxic, ototoxic, thrombophlebitis
What are side effects of cisplatin and carboplatin?
Nephrotoxiciy, ototoxicity, neurotoxicity
What is the medication that is a synthetic human B-type natriuretic peptide?
Nesiritide
What does bathenechol treat?
Neurogenic ileus (promote urination)
What can levetiracetam also be used to treat?
Neuropathic pain
What does amitriptyline?
Neuropathic pain (am i tripping)
What does pregabalin treat?
Neuropathic pain, fibromyalgia
What receptor is sassociated with skeletal muscle contraction?
Nm (nicotinic)
What is the presynaptic recptor of adrenal medulla?
Nn
Can you give sulfonylureas to a pregnant patient?
No
Does metformin cause hypoglycemia?
No
What does ampicillin and amoxicillin cause?
Non-allergenic skin rash
What does rituximab treat?
Non-hodgkin lymphoma and CLL, also rheumatoid arthritis
What acts on a1, a2, B1 to cause increased contractility
Norepinephrine
What do TCAs block the reuptake of?
Norepinephrine and serotonin
Cocaine is an example of a drug that interferes with the major mechanism of termination of synpatically released norepinephrine. What is the cellular target that is inhibited by this drug? COMT, MAO, NET, plasma esterase, TH
Norepinephrine transporter (NET)
What does cilastatin act on?
Renal diphydropeptidase I
What is the mechanism of pralidoxime?
Reverses cholesterase inhibitor by binding to acetylcholinsterase (opposes acetylcholinesterase inhibitors)
What does zafirlukast inhibit?
Reversible inhibitor of cysteinyl leukotriene-1 receptor
What does ranitidine do, its uses, side effect?
Reversibly blocking binding of histamine to H2 receptor, GERD and PUD, gynecomastia
What is a side effect of acetylsalicylic acid (aspirin)?
Reye's syndrome (fatty liver) in kids with viral infection
What are uses of celcoxib?
Rheumatoid arthritis, osteoarthritis, reduce colonic polyps
What causes a harmless orange color to urine?
Rifampin
What 5 drugs cause hepatotoxicity?
Rifampin, isoniazid, pyrazinamide, statins,fibrates
What channels do class IV anti-arrhythmics affect?
SA and AV nodes
What are side effects of first generation anti-histamines?
SEDATION, anti-cholinergic effects (dry mouth, blurry vision)
what is trazodone side effect?
SSRI side effect and priapism (prolonged erection)
Why is benzotropine contraindicated in patients with glaucoma?
Since they are active at all 3 receptors, SE profile will resemble cholinergic blockade (atropine-like effects): sedation, blurred vision, psychosis, urinary retention, tachycardias
What does etoposide treat?
Small cell lung carcinoma
What does buproprion treat?
Smoking cessation
What does nitroprusside do?
Smooth muscle relaxation of peripheral veins and arteries
What does cyclophosphamide treat?
Solid and hematologic malignancies
What is doxorubicin used for?
Solid tumors and hematologic malignancies
What are the potassium sparing diuretics for aldosterone receptor antagonist?
Spironolactone, eplerenone
What are 3 side effects of ezetimibe?
Steatorrhea, myalgia, elevated LFT
What is a side effect of lamotrigine?
Steven Johnsons syndrome
What does fibrates do?
Stimulate lipoprotein lipase, decrease TG levels
What does synthetic erythropoetin do?
Stimulates bone marrow to enhance erythroid proliferation and differentiation
You are suddenly frightened by a neighborhood dog while jogging through your neighborhood. Which physiological response will likely occur? Constriction of skeletal muscle arterioles, decrease in pain threshold, decreased fat metabolism, miosis, stimulation of glycogen breakdown by the liver
Stimulation of glycogen breakdown by the liver
What are 4 fibrinolytic agents?
Streptokinase, urokinase, alteplase, reteplase
What 3 drugs cause STevens-Johnsons syndrome?
Sulfa drugs, penicillin, allopurinol
What 6 drugs cause SLE-like syndrome?
Sulfa, hydralazine, isoniazid, procainamide, phenytoin, etanercept
What 6 drugs cause drug-induced lupus?
Sulfa, hydralazine, isoniazid, procainamide, phenytoin, etanercept
What is sulfasalazine metabolized into?
Sulfapyridine and 5-ASA
What does cyclophosphamide?
Suppresses B and T cell function
What is octreotide?
Synthetic analogue of somatostatin, inhibits many hormones to treat a variety of endocrine disorders
What causes stevens johnson syndrome, hemolytic anemia, kernicterus in newborns?
TMP-SMX
What is a B anatagonist opthalmic solution used to treat glaucoma?
Timolol
What is used to treat glaucoma?
Timolol
How is pilocarpine and carbachol given and what does it treat?
Topically to eye, treat glaucoma (acts at M3) (timolol also treats glaucoma B1-B2 antagonist)
What does isoproterenol treat?
Torsades de pointes
what are the MAOis?
Tranylcypromine, Phenelzine, Isocarboxazid
What does misoprostol?
Treat gastric ulcers, abortifacient with methotrexate (increase mucosal protection)
What does alprastadil?
Treats erectile dysfunction
What are the potassium sparing diuretics that block sodium channels?
Triamterene, amiloride
What can carbamazepine be used treat aside from seizures?
Trigeminal neuralgia
What is bleomycin do?
Trigger formation of oxygen free radicals, hence DAMAGES DNA
what two anti-muscarinic agents are used for a retinal exam? this is bc they cause temporary mydriaisis and cycloplegia
Tropicamide and homatropine (remember so does phenyleyeprhine)
What causesTourette's syndrome?
Typical anti-psychotics
What does oxybutynin treat?
Urinary incontinence and hyperhidrosis (M3 muscarinic receptor antagonist
What are uses of diphenhydramine?
Urticaria, allergic reactions, motion sickness
What is the difference between preload and afterload?
Venous return, blood pressure
What is meclizine used for?
Vertigo and motion sickness
What are the typical antipsychotics MOA?
blocks D2 receptors and inhibits histaminergic, cholinergic, and a-adrenergic receptors
Ipratropium has what use?
bronchodilation, treats COPD and asthma (used for people who cant take adrenergic agents)
anytime you see a drug that acts on all 3 muscarinic receptors what should you think of?
cholinergic blockade (atropine like effects: sedation, blurred vision, psychosis, urinary retention, tachycardias)
What are the atypical antipsychotics?
clozapine, risperidone, olanzapine, quetiapine
what does fluoxetine inhibit?
cytochrome P-450 (which enhances drugs metabolized in liver)
what is antidote for neuroleptic malignant syndrome?
dantrolene
What do SSRIs treat?
depression and OCD
What is the monamine hypothesis of depression?
depression results from underactivity of serotonin and Norepinephrine (problem is not all respond to monamine agonists)
MAOb
dopamine
what is side effect of levetiracetam?
drowsiness and depression
insomnia in the middle of the night, loss of appetite, weight loss, worse in morning, non reactive mood, abscence of interpersonal sensitivity is characteristic?
endogenous depression
What are hematologic malignancies?
leukemia, myeloma, lymphoma
What does sirolimus inhibit?
mTOR
What does trasuzumab target?
monoclonal antibody against HER-2/neu (erb-B2) receptor
what are the heterocylic anti depressants?
nefazodone, mirtazapine, venlafaxine, maprotiline
How do you treat myasthenia gravis?
neostigmine, pyridostigmine
What are side effects of GLP-I analagues?
pancreatitis, hypoglycemia, weight loss
Neostigmine and physostigmine both cross the BBB, what is the difference between the two?
physostigmine crosses BBB (Psychostigmine)
when you think adrenergic blockade you should think?
postural hypertension and cardiac arrythmias
dopamine inhibits what release from the pituitary?
prolactin
Does acetaminophen reversibly or irreversibly inhibits COX1 and COX2?
reversibly
when you think histamine blockade you should think?
sedation
what is a MAOi used with levadopa for parkinsons?
selegiline
MAOa
serotonin and NE
what are characteristics of atypical antipsychotics (receptor, side effects, symptoms effective against)
serotonin, D4, weak d2, less side effects, effective against positive and negative symptoms
What is a reversible allosteric inhibitor of P2Y12 receptor?
ticagrelor
What enzyme does etoposide treat?
topoisomerase II
What is scopolamine used for?
treats motion sickness
when you think of muscarinic blockade you should think?
urinary retention, dry mouth,
