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,