Step 1 DIT > 3. Pharm Basics > Flashcards

3. Pharm Basics Flashcards

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1
Q

What drug regenerates acetylcholinesterases after organophosphate poisoning?

A

Pralidoxime

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2
Q

Which anticholinesterases are used in the treatment of Alzheimer disease? (3)

A
  • donepezil
  • galantamine
  • rivastigmine
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3
Q

Which of the muscarinic antagonists can be used to improve FEV1 in a patient with COPD? (2)

A
  • ipratropium

- tiotropium

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4
Q

What anticholinergics are used in the treatment of urge-type urinary incontinence? (4)

A
  1. oxybutynin
  2. tolterodine
  3. darifenacin, solifenacin
  4. trospium

On The Darn Toilet

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5
Q

In what patient populations is atropine contraindicated? (5)

A
  1. BPH (alrdy have problems with urinary retention)
  2. hyperthermia
  3. acute angle glaucoma
  4. elderly (delirium)
  5. GI obstruction/ ileus
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6
Q

What medications have anticholinergic side effects? (4)

A
  1. first generation H1 blockers (ex. diphenhydramine)
  2. neuroleptics
  3. TCA
  4. amantadine (anti-parkinson)
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7
Q

Which receptors are stimulated by clonidine?

A

alpha-2

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8
Q

Which receptors are stimulated by dopamine?

A

low –> dopamine receptor
med –> B1, B2
high –> a1, a2

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9
Q

Which receptors are stimulated by phenylephrine

A

a1 > a2

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10
Q

Which receptors are stimulated by albuterol

A

b2 > b1

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11
Q

Which receptors are stimulated by NE

A

a1 > a2 > b1

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12
Q

Which receptors are stimulated by isoproterenol

A

b1 = b2

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13
Q

Which receptors are stimulated by epi

A

b1, b2, a1, a2

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14
Q

Which receptors are stimulated by dobutamine

A

b1 > b2

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15
Q

Which receptors are stimulated by terbutaline

A

b2 > b1

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16
Q

Which sympathomimetic is given as a nebulizer for asthma?

A
  • albuterol, levalbuterol
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17
Q

Which sympathomimetic is drug of choice for anaphylaxis?

A

epi

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18
Q

Which sympathomimetic is the most common first line agent for pts in septic shock

A

NE

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19
Q

Which sympathomimetic is given subQ for asthma?

A

terbutaline

  • also used for tocolysis (decreasing uterine tone)
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20
Q

Which sympathomimetic is used by ENT to vasoconstrict nasal vessels?

A
  • phenylephrine

- (cocaine)

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21
Q

Which selective a-blocker has less effect on blood pressure?

A

tamsulosin

selective for alpha-1A,D which is just on prostate. doesn’t affect vascular alpha-1B receptor

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22
Q

What are the common side effects of b-blockers? (3)

which pt population should use caution when taking b-blockers?

A

SE:
1. bronchospasm (asthma, COPD) - esp with non-selective b-blockers (which can block b2 –> bronchoconstriction)

  1. lower blood glucose (diabetics; may mask symptoms of hypoglycemia)
  2. brady, AV block (careful w/ CHF)
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23
Q

Which 3 enzymes are required to convert phenylalanie to dopamine?

A
  • phenylalanine hydroxylase (low in PKU)
  • tyrosine hydroxylase
  • dopamine decarboxylase
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24
Q

A patient develops paralysis after being bitten by a black widow spider. Is this a spastic or flaccid paralysis? What other autonomic symptoms might be seen?

A
  • spastic [stimulates release of ACh at NMJ]

- salivation, diaphoresis, lacrimation (excess ACh)

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25
what substances inhibit the reuptake of NE? (2)
cocaine | TCA
26
What substances stimulate the release of NE from neurons? (4)
calcium (normal release) amphetamine ephedrine tyramine
27
Outline the pathway by which stimulation of a Gs receptor activates protein kinase A
Gs --> adenylyl cyclase --> converts ATP to cAMP --> PKA
28
What effect will a reversible competitive antagonist have on Vmax and Km?
``` Vmax unchanged (no change in efficacy) Km increased (decreased potency) ```
29
Drug A has therapeutic index of 10:1 while drug B has TI of 2:1. Which drug would be considered safer?
Drug A
30
Which hepatic phase of metabolism is lost first by geriatric patients? Which phase is mediated by cytochrome p450
both phase 1
31
What medication inhibits acetaldehyde dehydrogenase?
disulfiram
32
what medication inhibits alcohol dehydrogenase?
fomepizole
33
What are the 7 inducers of cytochrome p450?
``` Griseofulvin Carbamazepine Phenytoin Barbiturate Rifampin St. John's Worts Chronic alcoholism ```
34
What are the 11 inhibitors of cytochrome p450?
``` Cimetidine Ritonavir (protease inhibitor) Amiodarone Ciprofloxacin Ketoconazole ``` ``` Acute alcohol Macrolides Isoniazid Grapefruit juice Omeprazole Sulfonamides ```
35
Which medication overdose can be treated with sodium bicarb?
aspirin (weak acid)
36
Which medication OD can be treated with ammonium chloride?
amphetamines (weak base)
37
What medication causes cardiotoxicity and bone marrow suppression? (2)
- doxorubicin - daunorubicin (anti-cancer drugs) --> can cause dilated cardiomyopathy
38
An African-American man who goes to Africa develops anemia after taking ppx medicine for primary disease prevention. In what enzyme is this patient deficient?
G6PD deficiency | - primaquine (malaria ppx)
39
A 65 yo male pt taking multiple medications presents with gynecomastia. Which meds can be responsible for this? (2 major ones)
- spironolactone - ketoconazole ``` Spironolactone THC (marijuana) Alcohol (chronic use) Cimetidine Ketoconazole Estrogen Digoxin ```
40
A patient presents with tinnitus, dizziness, HA, and vision changes. What drug is causing these symptoms? (2)
- quinidine (class 1A anti-arrhythmic) - quinine [cinchonism]
41
What medications are known for causing drug-induced lupus?
``` Sulfonamides Hydralazine Isoniazid Phenytoin Procainamide ```
42
What is the antidote to acetaminophen?
N-acetylcysteine (replenishes glutathione)
43
What is the antidote to salicylates?
sodium bicarb, dialysis **note: aspirin OD can lead to tinnitus
44
What is the antidote to amphetamines?
ammonium chloride
45
What is the antidote to anticholinesterases, organophosphates
atropine, pralidoxime
46
What is the antidote to antimuscarinic, anticholinergic agents?
physostigmine
47
What is the antidote to digoxin?
anti-dig Fab fragments | - K+ and Mg2+ optimization
48
What is the antidote to iron?
deferoxamine - fe- * *note: iron OD --> abd pain, hematemesis, melena, lethargy
49
What is the antidote to lead?
EDTA dimercaprol succimer penicillamine **note: lead OD --> dev delay, non-spec GI symptoms
50
What is the antidote to mercury, arsenic, gold
dimercaprol (BAL) succimer -merc-
51
What is the antidote to copper, arsenic, gold
penicillamine -copper pennies-
52
What is the antidote to carbon monoxide?
100% O2
53
What is the antidote to methemoglobin?
methylene blue, vitamin C -meth-
54
What is the antidote to cyanide
nitrite + thiosulfate, hydroxocobalamine
55
What is the antidote to methanol, ethylene glycol (antifreeze)
fomepizole (inhibits alcohol dehydrogenase) can also give ethanol, dialysis
56
What is the antidote to benzo?
flumazenil | *be careful with rapid correction b/c can cause seizures
57
What is the antidote to TCA
sodium bicarb
58
What is the antidote to heparin?
protamine sulfate -prot- (proton...hydrogen...H for heparin)
59
What is the antidote to t-PA, streptokinase?
aminocaproic acid
60
What is the antidote to theophylline
beta-blocker
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