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Meds Flashcards

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1
Q

finasteride

A

5-alpha-reductase inhibitor that decreases local conversion of TT to DHT in prostate –> shrinks prostate

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2
Q

phenylpehrine

A

alpha-agonist w/alpha-1 selectivity … sympathomimetic

-

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3
Q

alpha-1 adrenergic agonist examples (4)

A

methoxamine
methylnorepinephrine
phenylephrine
midodrine

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4
Q

alpha-1 adrenergic mechanism and outcomes

A

PLC stimulation –> PIP2, IN3, DAG, Ca

  • smooth muscle contraction
  • vasoconstriction (pressors)
  • mydriasis
  • glycogenolysis and gluconeogenesis
  • Na reabsorption
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5
Q

alpha-2 adrenergic agonist examples

A

clonidine
guanfacine
methyldopa
guanethidine

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6
Q

alpha-2 mechanism and outcomes

A

inhibits adenylyl cyclase
sympatholytic

  • inhibit insulin release
  • induce glucagon release
  • contract sphincters
  • increased thrombocyte aggregation
  • presynaptic inhibition of NE in CNS
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7
Q

beta-1 agonist ex

A

dobutamine
xamoterol
denopamine

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8
Q

beta-1 agonist mechanism

A

adeneylyl cyclase activation (cAMP increase)

  • increase HR, conduction velocity, and contractility
  • increase renin from JGA
  • increase ghrelin from stomach
  • ## lipolysis in adipose
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9
Q

beta-2 agonist ex

A
  • salbutamol
  • salmeterol
  • isoproterenol
  • terbutaline
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10
Q

Short acting benzos (time and ex) (3)

A

< 10hrs

  1. alprazolam
  2. triazolam
  3. oxazepam
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11
Q

medium acting benzos (t and ex) (3)

A

10-20hrs

  1. estazolam
  2. lorazepam
  3. temazepam
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12
Q

long acting benzos (t and ex) (4)

A

days

  1. diazepam
  2. chlordiazepoxide
  3. clorazepate
  4. flurazepam
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13
Q

class Ia anti-arrhytmic (3)

A
  1. disopyramide
  2. quinidine
  3. procainamide

(Double Quarter Pounder)

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14
Q

class Ib anti-arrhthmic (3)

A
  1. lidocaine
  2. tocainide
  3. mexiletine

(Lettuce, Tomatoes, Mayo)

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15
Q

class Ic anti-arrythmic (2)

A
  1. moricizine
  2. flecainide
  3. propafenone

(More Fries Please)

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16
Q

class IV anti-arrythmic (2)

A
  1. dilt

2. verapamil

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17
Q

class II anti-arrythmic (4)

A
  1. metoprolol
  2. propranolol
  3. atenolol
  4. carvedilol
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18
Q

class III anti-arrythmic (4)

A
  1. amio
  2. sotalol
  3. dofetilide
  4. ibutilide
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19
Q

zodivudine (ZDV) aka azidothymidine (AZT)

A

NRTI

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20
Q

ganciclovir

A

antiviral med that treats CMV by acting as a dGTP competitive inhibitor

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21
Q

Metformin

A
  • increases glycolysis
  • decrease GI glucuose absorption
  • decrease gluconeogenesis
  • lactic acidosis

absolutely contraindicated in pts with renal failure or any other situations that may precipitate lactic acidosis:

  1. liver dysfunction
  2. chf
  3. alcoholism
  4. sepsis

b/c heart, liver, and kidneys use lactate to metabolize ATP

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22
Q

chlorpromazine eye ADR

A

corneal deposits

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23
Q

thioridazine eye ADRs

A

retinal deposits resembling retinitis pigmentosa

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24
Q

zipradisone ADRs

A
  • prolonged QT
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25
olanzapine ADRs
- WT gain
26
clozapine ADRs
- agranulocytosis | - seizures
27
Physostigmine
AchE inhibitor peripherally and centrally (can cross BBB) | used to counteract atropine's mucarininc cholinergic blockade
28
atropine
muscarinic cholinergic blockade | can be used to reverse muscarinic effects of organophosphate toxicity
29
xanthine oxidase inhibitor
allopurinol
30
uricosuric drugs
probenecid sulfinpyrazone -long term serum uric acid lowering therapy - need good renal function
31
ergonovine
ergot alkaloid that constricts vascular smooth muscle by stimulating both alpha-adrenergic and serotonergic receptors
32
non-selective alpha blockers
- phentolamine - tolazoline - trazodone - typical and atypical antipsychotics
33
alpha-1 blockers
tamsulosin terazosin alfuzosin prazosin
34
alpha-2 blockers
mirtazapine yohimbine idazoxan atipamezole
35
diphenoxylate
opiate anti-diarrheal binds to mu opiate rec in GI to slow motility ADR bloating and mild sedation
36
kaolin-pectin and attapulgite
adsorbents that adsorb fluids, toxins, nutrients, and digestive juices to prevent diarrhea
37
bismuth subsalicylate
treat secretory diarrhea
38
doxazosin
alpha-1 blocker for HTN and urinary retention of BPH
39
Mebendazole
treats helminths | Enterobius vermicularis
40
Diethylcarbamazine
treats loa loa (loiasis | and wucherenia bancrofti (lymphatic filariasis infections
41
Ivermectin
treats strongyloides stercoralis and onchocerca volvulus (onchocerciasis)
42
Nifurtimox
treats trypanosomes like Chagas (trypanosoma cruzi)
43
Praziquantel
treats schistosoma (schitosomiasis) clonorchis sinesis (clonorchiasis) and paragoniimus westermani (paragonimiasis)
44
Milrinone 1. mechanism 2. some effects
1. PDE3 inhibitor --> elevated cAMP | 2. vasodilation, inotropic
45
Chlorpheniramine
1st gen antihistamine that blocks central and peripheral H1 receptors can be sedating b/c easily crosses BBB
46
Loratadine
2nd gen antihistamine that can't cross BBB so no sedations
47
Ranitidine
H2 receptor antagonist that inhibits gastric acid secretion
48
Phenytoin treats? | how?
grand mal (tonic-clonic) sz's, partial sz's, status epilepticus by blocking VG-Na channels
49
Phenytoin toxicitiy
cerebellum and vestibular system --> ataxia and nystagmus
50
Phenytoin ADRs
1) gingival hyperplasia, hirsuitism | 2) metagloblastic anemia (2/2 folic acid metabolism deF)
51
Phenytoin and cyt p450
induces p450 --> increases metabolism and decreases blood level of many meds
52
phenytoin and pregnancy
can cause fetal hydantoin syndrome
53
Lithium toxicity
NMJ excitability (irregular coarse tremors, fascicular twitching, rigid motor agitation, ataxia) - Nephrogenic diabetes insipitus - hypothryoidism - cardiac conduction defects
54
Prednisone ADRs (5)
- hyperglycemia - wt gain - depression - fluid retention w/edema - osteoporosis
55
cocaine mechanism
blocks re-uptake of NE, 5-HT, and Dopa into CNS
56
Methimazole 1) mechanism 2) ADRs (3)
inhibits thyroid hormone synthesis by supprsesing iodination and couple of tyrosine - edema, rash, agranulocytosis
57
cholinergic syndrome
``` DUMBELS - muscarinic Diarrhea and diarphoresis Urination Miosis Bronchospasm and baradycardia Emesis Lacrimation Salivation ``` muscle fasciculations and paralysis - nicotinic
58
pralidoxime
reverses muscarinic and nicotinic effects of organophsphates by restoring cholineresterase from the bound toxin
59
naloxone 1. reverses what and how 2. what receptors 3. how soon does it work 4. how long does it work 5. vs. naltrexone
1. opioid intoxication or overdose by acting as pure opioid receptor antagonist 2. mu recetpors 3. minutes 4. 1-4 hours 5. naloxone is shorter acting - better for emergencies
60
Calcipotriene - what is it and how does it work - treats what
- topical vit D analog that binds to vitD receptor, a nuclear TF that causes inhibition of keratinocyte proliferation and stimulates keratinocyte differentiation - also, inhibits T cell proliferation and other inflammatory mediators - psoriasis
61
cyclosporine - mechanism - treats what
- inhibits NFAT (nuclear factor of activated T cells) from entering nucleus --> impairs production of IL-2 --> therefore prevents activation of T cells - treats psoriasis among others
62
Etanercept | - mechanism
- binds TNF alpha
63
pyridostigmine - mechanism - treats
- cholinesterase inhibitor (globally) | - myasthenia gravis (but this only needs the nicotinic effect, so may have mAchR mediated ADRs)
64
scopolamine - mechanism - another similar med
- selective muscarinic AchR antagonist that reduces effects of global cholinesterase inhibitors - hyoscyamine
65
pilocarpine | - mechanism
non-selective mAchR agonist
66
ribavirin - mechanism - treats
- nucleoside antimetabolite drug that interfers w/duplication of viral genetic material - chronic HCV and RSV
67
raltegravir - mechanism - treats
- integrase inhibitor that inhibits integration of viral DNA into host genome - HIV
68
indinavir - mechanism - treats
- inhibits viral protease activity | - HIV
69
amantadine - mechanism - treats
- prevents uncoating of influenza A virion after endocytosis | - influenza A
70
enfuvirtide - mechanism - treats
- prevents viral entry into target cell | - HIV fusion inhibitor
71
inhaled anesthetics - leads to increase in blood flow to where? - decreases in what (4)
cerebral blood flow - 1. GFR 2. RPF 3. LVEF 4. hepatic blood flow
72
pentazocine | - mechanism
opioid marcotic w/partial agonist activity and weak antgaonist activity at mu receptors
73
misoprostol - mechanism - used for (4)
- PGE1 analog | - prevent gastric ulcers, treat missed miscarriages, induce labor, induce abortion
74
What meds can cause Cushing Syndrome (2)
- glucocorticoids | - HAART therapy
75
What treats absence seizures
Ethosuximide
76
Ethosuximide - mechanism - BM suppression?
- blocks T-type CaCh in thalamic neurons | - NO
77
Carbamazepine - mechanism - treats what - possible ADRs
- blocks VG-NaCh in cortical neurons and stabilizes it in inactive state - simple/complex partial seizures; managing generalized tonic-clonics; mood stabilizer in BPD; treats trigeminal neuralgia - BM suppression; heptaotoxic (LFT check); ADH-secretion (SIAHD)
78
Isoniazid chemically similar to what vitamin | - what does it do
B6 (pyridoxine) | - part of TB regiment, but it depletes B6
79
What reverses TCA-associated cardiac abnormalities
Soidum bicarb - can correct QRS prologation - reverse HoTN - treat V-dysrhythmias
80
which TB drug causes visual changes - what changes are they - how does it affect mycobacterium - how do to treat visual changes
- Ethambutol - optic neuritis, color blindness, central scotoma - inhibits arabinosyl transferase, which is required for cell wall carbohydrate synthesis - discontinuation usually leads to improvement
81
Primidone - what is it - what is it metabolzied to
- antiepileptic | - phenobarbital and phenylethylmalonamide
82
Three classes of antimetabolites
1. Folate antagonist 2. Purine analogs 3. Pyrimidine analogs
83
Folate antagonist (1)
methotrexate
84
Purine analogs (3)
1. 6-thiopurines (6-MP, 6-GP) 2. fludarabine - CLL 3. cladribine - HCL
85
Pyrimidine analogs (4)
1. 5-fluorouracil 2. capecitabine 3. cytarabine 4. gemcitabine
86
lomustine 1. class 2. mechanism 3. activation 4. CNS permeation?
1. nitrosurea 2. DNA alkylation and cross-bridge formation 3. non-enzymatic hydroxylation in liver 4. penetrates well 2/2 lipophilicity
87
cisplatin 1. class 2. activation requirements
1. platinum-tontaining chemo agent | 2. needs to by hydrated in environments w/low chloride concentration
88
MTX mechanism
folic acid analog that inhibits dihydrofolate reductase w/out metabolic conversion
89
mercaptopurine 1. class 2. activated by 3. inactivated by
1. purine analog 2. hypoxanthine-guanine phosphoribosyl transferase 3. xanthien oxidase
90
cladribine 1. class 2. resistant to? 3. used for?
1. purine analog 2. resists degradation by adenosine deaminase 3. hairy cell leukemia
91
deferoxamine - what does it do - what is it antidote for
- specific chelator of iron | - antidote for serious iron poisoning
92
TCA toxicity treated by?
so`dium bicarbonate
93
how is acetaminophen detoxed in liver
cyt P450 metabolizes it to NAPQI that the liver puts through sulfation and glucuronide conjugation
94
antidote for acetaminophen toxicity | - mechanism
NAC (N-acetyl cysteine) | - provides sulfhydryl groups
95
polyethylene glycol - mechanism - other examples
- osmotic laxative | - magnesium hydroxide (magnesium citrate)
96
drug-induced lupus erythematous (5)
1. hydralazine 2. procainamide 3. isoniazid 4. minocycline 5. quinidine
97
findings for drug-induced lupus erythematous (4)
1. new onset lupus sxs 2. ANA and anti-histone antibodies 3. anti-dsDNA rarely seen 4. exposure to the drug
98
halothane can cause? | how?
massive hepatic necrosis - halothane metabolite direct damage to liver - formation of autoantibodies to liver proteins
99
what meds can cause coronary steal phenomenon
adenosine | dipyridamole
100
shortest acting benzo
triazolam
101
what causes orthostatic hypotension and lightheadedness
blockade of alpha-1 adrenergic receptors
102
extrapyramidal sxs
over-blockade of dopamine receptors 2/2 antipsychotics
103
octeotride - what is it - mechanism
- somatostatin | - potent inhibitor of GH, glucagon, and insulin
104
common precipitating factors of G6PD deficiency anemia (4)
1. infectins 2. drugs (dapsone, antimalarials, sulfonamide abx (TMP-SMX) 3. DKA 4. favism
105
hyroxyurea - what does it do - when is it used
- increases fetal hemoglobin in an not understood way | - in pts with sickle cell anemia w/frequent pain crises
106
clomiphene - mechanism - used for?
- selective estrogen receptor modulator - prevents negative feedback inhibition of hypothalamus --> allows increased release of gonadtotropin (FSH, LH) --> aids in ovulation
107
leflunomide inhibits?
dihydroorotate dehydrogenase ... therefore, inhibits pyrimidine synthesis
108
mycophenolate and ribavirin inhibit?
IMP dehydrogenase --> inhibits GMP synthesis during de novo purine synthesis
109
hydroxyurea inhibits?
ribonucleotide reductase --> screws up de novo pyrimidine synthesis
110
6-mercaptopurine (6-MP) inhibits?
de novo purine synthesis ... stops it right at the beginning
111
5-fluorouracil (5-FU) inhibits?
thymidylate synthase --> decreases dTMP formation --> inhibits de novo pyrimidine synthesis
112
MTX, TMP, pyrimethamine inhibit what?
Dihydrofolate reductase --> decreases DHF conversion to THF which is needed for dTMP formation
113
meds that act on microtubules (5)
"Microtubules Get Constructed Very Poorly" 1. Mebendazole (anti-helminth) 2. Griseofulvin (anti-fungal) 3. Colchicine (anti-gout) 4. Vincristine/Vinblastine (anti-cancer) 5. Paclitaxel (anti-cancer)
114
Fomepizole - inhibits what? - used for ?
- inhibits alcohol dehydrogenase | - antidote for methanol or ethylene glycol poisoning
115
disulfiram (Antabuse) - inhibits what? - used for?
- acetaldehyde dehydrogenase, therefore excess acetaldehyde | - makes you feel more hungover w/alcohol, treats chronic alcoholism
116
Clomifene - what is it - used for? - ADR
- SERM (inhibits EstR's in hypothalamus --> inhibits negative feedback) --> upregulation of HPA gonad axis - ovulation induction and reversal of anovulation - hot flush
117
Tamoxifen - receptors - used for?
- estrogen receptor antagonism in breast but agonism in endometrium
118
Amiodarone toxicity - check what? - causes what?
- LFTs, PFTs, TFTs - Transaminitis - Interstital lung disease - Hypo/Hyperthyroidism b/c Amiodarone ~ Throxine (T4)
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