Pharmacology USMLE 2 Flashcards

Terms Definitions
Amphotericin B
pg 317
Nonsurgical antimicrobial prophylaxis
Oncologic Drugs
pg 333-336
Drug reactions
p. 339
antidote for gold
Elimination of Drugs
p. 288
Carbenicillin, piperacillin, ticarcillin
p. 292
inhibits dihydrofolate reductase --> ↓dTMP --> ↓DNA synthesis; uses: leukemias, lymphomas, abortion, ectopic pregnancy, rheumatoid arthritis, psoriasis
Pharmacokinetics of carbamazepine
Induces P450
Pentavalent Antimony
How is Leishmaniasis treated?
Is Imipenem resistant to penicillinase?
GI distress, mouth ulcers, antiplatelet actions
These drugs disrupt the bacterial/fungal cell membranes
mechanism of action of scopolamine
Antianginal drugs
Nitroglycerin, isosorbide, CCBs (nifedipine), β-blockers and carvedilol
expectorant; doesn’t suppress cough reflex
What antihypertensive agent produces cyanide and thiocyanate as byproducts?
Isotretinoin is a terrible ______
Which drug(s) cause this reaction: Pseudomembranous colitis?
What do Aminoglycosides require for uptake?
Mannitol- mechanism?
osmotic diuretic- increase tubular fluid osmolarity, thereby increasing urine flow
Antimicrobial prophylaxis for Meningococcal infection
Rifampin (DOC), minocycline
Which drugs causes cardiotoxicity, alopecia, and myelosuppression?
Doxorubicin (adriamycin)
Induce P-450 system (6)
barbiturates, phenytoin, carbamazepine, rifampin, griseofulvin, quinidine
Cough suppressant, analgesia, use in combination with NSAIDs
Uses of thiazides
Hypertension, CHF, nephrolithiasis (calcium stones), nephrogenic diabetes insipidus
GLP-1 receptor full agonist --> augments insulin secretion; hypoglycemia when used with sulfonylureas
Partial 5HT1a agonist used for generalized anxiety disorder
Name the antimicrobial agent whose major side effect is listed.
• Hemolytic anemia
Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?
fetal renal damage, hyperkalemia, Cough, Angioedema, Proteinuria, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower Angiotensin II (CAPTOPRIL)
ACE inhibitors- toxicity?
What antimuscarinic agent is used in asthma and COPD?
Ca2+ channel blockers- clinical use?
hypertension, angina, arrhythmias
How does this drug work?
inhibits 50S peptidyltransferase
Acetaldehyde itself can be metabolized by acetaldehyde dehydrogenase to ----- -----.
acetic acid.
What is digoxin's effect on the intracellular calcium level?
-------- is used during pregnancy to reduce risk of fetal transmission.
anti cancer drug that acts on microtubules (prevent assembly)
Digoxin MOA
Inhibits cardiac Na/K ATPase --> increase intracellular Na --> decrease Na/Ca exchange --> increase intracellular Ca --> increase Ca release on sarcoplasmic reticulum --> increase contractile force. It also inhibits neuronal Na/K ATPase which increases vagal and sympathetic stimulation.
Side effects of trimethoprim
Bone marrow suppression, enterocolitis
↑ target cell sensitivity to glucose via PPARs; side effects: weight gain, edema, hepatotoxicity, CV toxicity
What androgen receptor blocker is used in the treatment of prostatic cancer?
Are the following responses associated with histamines H1 or H2 receptor activation?
• SA nodal activity
H 2
Malaria (P. falciparum)
What is treated with Chloroquine, Quinine, Mefloquine?
For Warfarin what is the Structure
Small lipid-soluble molecule
What is Ketoconazole specifically used for?
Blastomyces, Coccidioides, Histoplasma, C. albicans; Hypercortisolism
What are the Anti-TB drugs?
Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid (INH)
What is treated with Chloroquine, Quinine, Mefloquine?
Malaria (P. falciparum)
name three Antiarrhythmic drugs in class IV.
Verapamil, Diltiazem, Bepridil
Which has greater oral bioavailability?
amOxicillin (O for Oral)
name three sympathomimetic drugs used to treat hypotension
epinephrine, norepinephrin, ephedrine
what is the mechanism of propanolol
selective beta-adrenergic blocker
Rate of elimination is proportional to _______ ______ in 1st order elimination.
drug concentration
Uses of interferons
Antiviral: HBV, HCV; antiumor: Kaposi, CML, multiple myeloma, renal CA; Immunoregulatory: mutiple sclerosis
Drug interactions of GABA drugs
Life threatening respiratory depression if used with other CNS depressants (antihistaminics, opiates, beta blockers); Barbiturates induce metabolism of lipid-soluble drugs (oral contraceptives, carbamazepine, phenytoin, warfarin)
What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Classic side effect of methylcopa
Coombs positive hemolytic anemia
Ca2+ (Loops Lose calcium)
Furosemide increases the excretion of what ion?
CMV, esp in Immunocompromised patients
How is Ganciclovir used clinically?
Blocks viral penetration/uncoating; may act to buffer the pH of the endosome
What is the MOA of Amantadine?
Vibrio cholerae Acne Chlamydia Ureaplasma Urealyticum Mycoplasma pneumoniae Borrelia burgdorferi (Lyme's) Rickettsia Tularemia
What microorganisms are clinical indications for Tetracycline therapy?
Side effects of Isoniazid (INH)?
Hemolysis (if G6PD deficient), Neurotoxicity, Hepatotoxicity, SLE-like syndrome
Antiarrhythmic class II- toxicity?
impotence, exacerbation of asthma, CV effects, CNS effects, may mask hypoclycemia
Digoxin v. Digitoxin: half life?
Digitoxin 168hrs Digoxin 40 hrs
Clinical use of Isoniazid (INH)?
Mycobacterium tuberculosis, the only agent used as solo prophylaxis against TB
These drugs block the 50s ribosomal subunit
clindamycin, chloramphenicol, erythromycin, lincomycin, linezolid, streptogramins "Buy AT 30, CELL at 50"
what phase of succinylcholine neuomuscular bloackade is reversible?
phase II (repolarized but blocked)
Clinical uses of Primaquine.
Latent hypnozoite (liver) forms of malaria (Plasmodium vivax, P.ovale).
Which two anti-htn drugs do you use with B blockers to prevent reflex tachycardia, diuretic to block salt retention?
hydralizine, minoxidil
Late viral protein synthesis and processing is blocked by --------.
Methimazole (variola); protease inhibitors.
Distribution of α1 receptors
Pupil dilator muscle, arterioles of skin and viscera, veins, bladder trigone and sphincter, vas deferens, liver, kidney
Uses of class II antiarrhythmics
Prophylaxis post MI, supraventricular tachyarrhythmias
What two β2-agonists are used to produce bronchodilation?
Metaproterenol and albuterol
The PTT.
What is the lab value used to monitor the effectiveness of Heparin therapy?
Pralidoxime regenerates active cholinesterase.
Why would you use pralidoxime after exposure to an organophosphate?
NO AP duration effect. useful in V-tach that progresses to V-fib and in intractable SVT LAST RESORT
Antiarrhythmic class IC- effects?
What conditions are treated with Metronidazole?
Giardiasis, Amoebic dysentery (E. histolytica), Bacterial vaginitis (Gardnerella vaginalis), Trichomonas
What are five toxicities associated with Tacrolimus (FK506)?
1. Significant: nephrotoxicity 2. Peripheral neuropathy 3. Hypertension 4. Pleural effusion 5. Hyperglycemia.
List the specific antidote for this toxin: Methanol & Ethylene glycol
-Ethanol, dialysis, & fomepizole
What does CELL stand for?
C = Chloramphenicol, E= Erythromycin, L= Lincomycin and L= cLindamycin
What are the cell cycle specific oncologic drugs
antimetabolites, plant alkaloids, stroid hormones, bleomycin, paclitaxel, etoposide
what are the side effects of lithium
tremor, hypothyroidism, polyuria, teratogenic
The three uses for this loop diuretic?
edematous states, htn, hypercalcemia
what receptors does epinephrine act on?
alpha-1, alpha-2, beta-1, beta-2 adrenergics
what is the mechanism of most antipsychotics
block dopamine D2 receptors
Side effects of calcium channel blockers
Reflex tachychardia (nifedipine and derivatives), gingival hyperplasia (nifedipine and derivatives), constipation (verapamil)
What is phase II biotransformation?
Modification of the drug by transferases via glucoronidation, acetylation, sulfation, gluthathione conjugation.
What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension?
Metaraminol (α1, β1 )
AmOxicillin has greater Oral bioavailability
Does Ampicillin or Amoxicillin have a greater oral bioavailability?
These B-2 agonists cause respiratory smooth muscle to relax.
Why are albuterol and terbutaline effective in tx of acute asthmatic attacks?
What is the mechanism of action of Acetaminophen?
Reversibly inhibits cyclooxygenase, mostly in CNS. Inactivated peripherally.
What is the clinical use for Heparin?
Immediate anticoagulation for PE, stroke, angina, MI, DVT.
Which cancer drugs work at the level of proteins(2)?
-Vinca alkaloids(inhibit MT) -Paclitaxel
What are the two major toxicities?
Nephrotoxicity (esp. when used with cephalosporins) and Ototoxicity (esp. when used with loop diuretics). amiNOglycosides
Adverse effects of ACE-I Captorpil? Think CAPTOPRIL
C: cough, A: angioedema, P: proteinuria, T: taste changes, O: hypOtension, P: pregnancy problems like fetal renal damage, R: rash, I: increased renin, L: lower angiotensin. Also hyperkalemia.
what types of seizures is phenytoin indicated for
simple and complex partial, tonic-clonic, status epilepticus
Is it bactericidal or bacteriastatic and why?
Bactericidal because it blocks cross linkage and elongation of peptidoglycan by binding D-ala D-ala protion of cell wall.
Formula: half life
t1/2 = 0.7/k or t1/2 = 0.7 x Vd/Cl
True or false? All aluminum-containing antacids can cause hypophosphatemia.
True. Aluminum reacts with PO4, resulting in AlPO4, an insoluble compound that cannot be absorbed.
Overdose produces hepatic necrosis; acetaminophen metablolite depletes glutathione and forms toxic tissue adducts in liver.
What is a possible result of overdose of Acetaminophen?
amount of drug in body/_______ = Vd
plasma drug concentration (note: Vd is Volume of Distribution)
Recombinant Cytokine- Filgrastim is used for?
Recovery of Bone Marrow; it is a granulocyte colony stimulating factor
what agents are used to reverse neuromuscular blockade by succinylcholine?
cholinesterase inhibitors in phase II (ex -- neostigmine)
What is meant by the "duality" of partial agonists?
Partial agonists can compete with full agonists for its receptor, lowering the maximal response, therefore it acts as an antagonist in the presence of a full agonist.
What is the only diuretic that works on the blood side of the nephron?
Spironolactone (binds to aldosterone receptors)
Atropine would also block the receptors in the ciliary muscle, causing an impairment in accommodation (cycloplegia).
What side effect of using atropine to induce pupillary dilation would you expect?
Why is there a drop in systolic, mean, and diastolic bp with infusion of isoproterenol?
Stimulating beta receptors stimulates heart rate, but beta receptor induced vasodilation reduces peripheral resistance.
A loading dose is calculated using this formula.
(Cp)(Vd)/F (note: Cp = target plasma concentration, and F = bioavailability)
What is the effect of the following drugs: 1. Positive inotropic drugs 2. Beta blockers 3. Ace inhibitors 4. AII antagonists 5. Vasodilators and 6. Diuretics
1. Increases cardiac output. 2. Inhibit renin release. 3. Inhibit ACE 4. Inhibits effects of AngII including increasing the preload, increasing the afterload and remodelling. 5. Decrease the preload and afterload. 6. Decrease the preload and afterload
True or false? Gynecomastia is a side effect of cimetidine.
True. Cimetidine can decrease androgen production and lead to gynecomastia.
Inhibit steroid synthesis, used in the treatment of polycystic ovarian syndrome to prevent hirsutism.
What is the mechanism of action and clinical use of the antiandrogens Ketoconazole and Spironolactone?
While at a tail gait party, you bite into a sandwich that a yellow jacket is also enjoying. Knowing your allergy to this creature, what should you do?
Epinephrine to treat anaphylaxis. Also useful if you have open angle glaucoma, asthma, or hypotension.
What is the significance of the redistribution rate?
A second dose of a CNS drug redistributes to fat in lesser amount because fat is "saturated" therefore allowing more drug to enter the CNS and increasing the duration of action.
This H2 blocker is the only one that has many side effects which include potent inhibition of ______, _____ effects, and _____ renal excretion of creatinine.
cimetedine is a potent inhibitor of P450, it has antiandrogenic effect and decrease renal excretion of creatinine. Other H2 blockers are relatively free of these effects.
What does it mean if EC50 and Kd are equal?
The system does not have spare receptors
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