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Drugs- Basic High Yield Stuff for Boards > Pharmacology 2- systems > Flashcards

Pharmacology 2- systems Flashcards

1
Q

Overdose:

Acetaminophen(1)

A

N-acetylcysteine (replenishes gluathione to remove toxic NAPQ1)

(pt: suicide/ chronic pain pt)
(symp: N/V/increase LFTs, ASTs, ALTs, Bilirubin)

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2
Q

Overdose:

AchE inhib/ Organophosphates(2)

A

Atropine>pralidoxime

DUMBBeLSS- doesn’t correct ‘e’

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3
Q

Overdose:

Amphetamines (basic) (1)

A

NH4CL (acidify urine)

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4
Q

Overdose:

Antimuscarinic/Anti-cholinergic agents(2)

A
  1. Physostigmine
  2. control Hyperthermia (hot as a hare)
    (rhyming symptoms)
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5
Q

Overdose:

Arsenic(2)

A
  1. Dimercaprol
  2. Succimer
    * same as Mercury poisoning
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6
Q

Overdose:

Benzodiazepines(1)

A

bind GABA–> increase freq. of GABA binding

Flumazenil

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7
Q

Overdose:

BBs (3)

A
  1. saline
  2. atropine- antag parasymp to cancel out depressed SNS
  3. Glucagon–>increase Gs/cAMP

(pt: usually an accident)

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8
Q 
Overdose: 
Carbon Monoxide(2)
A
  1. 100% O2
  2. Hyperbaric O2- increase pressure to increase O2 dissolved

(Combustion/fire, causes change in mental status)
(PulseOx shows 100% sat –> must check carboxyhemoglobin)

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9
Q

Overdose:

Copper(2)

A
  1. Penicillamine
  2. Trientine

(like in wilson’s disease)

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10
Q

Overdose:

Cyanide(2)

A
  1. Nitrite + Thisulfate
  2. Hydroxocobalamine

(cyanide inhib Complex 4 in electron transport chain)

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11
Q

Overdose:

Digitalis (digoxin) (1)

A

Anti-dig Fab fragments

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12
Q

Overdose:

Gold (3)

A
  1. Penicillamine
  2. dimercaprolol (BAL)
  3. Succimer

(chelated by anything)

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13
Q

Overdose:

Heparin (1)

A
  1. protamine sulfate
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14
Q

Overdose:

Iron (3)

A

“Defer-“

  1. Deferoxamine
  2. Deferasirox
  3. Deferiprone
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15
Q

Overdose:

Lead (4)

A
  1. EDTA
  2. Dimercaprol
  3. Succimer
  4. Penicillamine

(source: paint-old house/batteries-industry worker/moonshine-drunks)
(easily absorbed)

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16
Q

Overdose:

Mercury(2)

A
  1. Dimercaprol

2. Succimer

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17
Q

Overdose:

Methanol/ Ethylene glycol(antifreeze) (2)

A
  1. Fomepizole > ethanol
  2. dialysis

(kids drink antifreeze–>oxalic acid precipitates in renal tubules requiring dialysis)

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18
Q

Overdose:

Methemoglobin(2)

A
  1. Methylene blue
  2. Vitamin C
    (both act as electron donors to turn back to Fe+2)

(Iron in Hb is at Fe+3–>arterial blood is chocolate colored)

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19
Q

Overdose:

Opioids

A

Naloxone

symp: RR less than 12, miosis, change mental status, hypotension

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20
Q

Overdose:

Salicylates (2)

A
  1. NaHCO3 (alkalinize urine)

2. Dialysis

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21
Q

Overdose:

TCAs (1)

A

NaHCO3(plasma alkalination)

sump: depression, check for prolonged QRS on EKG

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22
Q

Overdose:

Warfarin (small/lipophilic molecule) (2)

A
  1. Vit K (delayed effect)

2. fresh frozen plasma (immediate effect)

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23
Q

Overdose:

tPA(1)

A

Aminocaproic acid (mimics plasminogen binding site)

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24
Q

Overdoses treated with chelation (6)

A
  1. copper
  2. arsenic
  3. gold
  4. lead
  5. mercury
  6. iron
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25
Q 
Drug induced: 
Coronary vasospasms (3)
A
  1. cocaine
  2. Sumatriptan
  3. ergot alkaloids
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26
Q 
Drug induced: 
cutaneous flushing (5)
A

“Opposite of bob VANCE, VANCE refrigeration”

  1. Vancomycin
  2. Adenosine
  3. Niacin
  4. Ca+2 channel blockers
  5. Echinocandins (not really used)
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27
Q 
Drug induced: 
Dilated cardiomyopathy(2)

Prevent w:

A

Anthracyclines:

  1. Doxorubicin
  2. Daunorubicin

prevent w/ dexrazoxan (chelator to bind free Fe+2)

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28
Q

Drug induced:
Torsades de pointes (5)

Precaution to take before drug use

A 
"ABCDE"
Anti"a"rrhythmics (class Ia, III)
Anti"b"iotics (macrolides)
Anti"c"ychotics (haloperidol)
Anti"d"epressants (TCAs)
Anti"e"metics (ondansetron)

*always do EKG before giving any of these drugs

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29
Q

Drug induced:
Adrenocortical insuff.
What patient population?

A

HPA suppression 2ary to glucocorticoid withdrawal (like prednisone)

  • long term prednison: lupus, RA, vasculitis
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30
Q 
Drug induced: 
Hot Flashes (2)
A
  1. Tamoxifen
  2. Clomiphene
    (antagonize E-R, used for breast cancer)
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31
Q

Drug induced:

Hyperglycemia (5)

A

“Taking Pills Necessitates Having blood Checked”

  1. Tacrolimus
  2. Protease Inhibitors
  3. Niacin
  4. HCTZ
  5. Corticosteroids
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32
Q

Drug induced:

Hypothyroidism (3)

A
  1. Lithium (inhib T3/T4)
  2. Amiodarone (class III antiarrhythmia, inhib 5’ deiodinase in periphery)
  3. Sulfonamides (binds thyroid peroxidase)
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33
Q

Drug induced:

Acute cholestatic hepatitis/jaundice(1)

A

Erythromycin (metabolite in bile)

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34
Q

Drug induced:
Diarrhea (12)
Issue

A
  1. Acamprosate
  2. Acarbose (a-glucosidase inhib)
  3. Cholinesterase inhib (increase Ach)
  4. Colchicine (decrease microtubule polymerization= sloughing off for GOUT tx)
  5. Erythromycin (binds Motilin-R to increase sm. muscle contractions)
  6. Ezetimibe
  7. metformin (increase 5-HT)
  8. misoprostol
  9. orlistat(lipase inhib similar to acarbose)
  10. pramlintide (amylin-like to slow gastric emptying)
  11. Quinidine
  12. SSRI (increase 5-HT)
    * high non-compliance rate
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35
Q

Drug induced:

Focal to massive hepatic necrosis(4)

A

‘Liver HAVAc’

  1. Halothane
  2. Amanita phalloides (death cap- inhib RNA pol II(mRNA))
  3. Valproic Acid
  4. Acetaminophen
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36
Q

Drug induced:

Hepatitis(5)

A
  1. Rifampin
  2. isoniazid
  3. Pyrazinamide
  4. Statins
  5. Fibrates

(1-3 tx TB, 4-5 tx dylipidemia)

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37
Q

Drug induced:

Pancreatitis (6)

A

“Drugs Causing A Violent Abdominal Distress”

  1. Didanosine
  2. Corticosteroids
  3. Alcohol
  4. Valproic Acid (tx: epilepsy, bipolar)
  5. Azathioprine
  6. Diuretics (furosemide, HCTZ)
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38
Q

Drug induced:

Esophagitis (3)

A
  1. Tetracyclines (esp. Doxy)
  2. Bisphosphonates (in osteoporosis pt.)
  3. Potassium Chloride (not used)

*Caustic effect minimized with upright posture and adequate water ingestion

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39
Q 
Drug induced: 
Pseudomemb Colitis (3)
A
  1. Clindamycin
  2. Ampicillin
  3. Cephalosporins

*all abx predispose to superinfection by resistant C.diff

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40
Q 
Describe C.Diff
Gram stain
Does it form spores?
anaerobic/aerobic
toxin
treatment(2)
A
  • Gram +
  • spore forming anaerobic bacteria (hangs around in hospitals)
  • Produces Toxin A to disrupt tight junctions and H2O leaks out
  • Treat: Metronitazole or Vancomycin (PO)
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41
Q

Drug induced:
Agranulocytosis (6)
What is defined as agranulocytosis?

A

“Can Cause Pretty Major Collapse of Granulocytes”

  1. Clozapine
  2. Carbamazepine
  3. Propylthiouracil (similar to pyrimidine)
  4. Methimazole (similar to pyrimidine)
  5. Colchicine
  6. Ganciclivir (similar to purine)

*Agranulocytosis= Neutrophils

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42
Q 
Drug induced: 
Aplastic Anemia(6)
A

” Can’t Make New Blood Cells Properly”

  1. Carbamazepine
  2. Methimazole
  3. NSAIDs
  4. Benzene (Gas exposure)
  5. Chloramphenicol (smilar Benzene rink and cross BBB)
  6. Propylthiouracil
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43
Q

Drug induced:

Direct Coombs-positive Hemolytic anemia (2)

A
  1. Methyldopa

2. Penicillin

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44
Q

Drug induced:

Gray Baby syndrome

A

Chloramphenicol

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45
Q

Drug induced:

Hemolysis in G6PD deficiency(7)

A

“Hemolysis IS D PAIN’

  1. Isoniazid
  2. Sulfonamides
  3. Dapsone
  4. Primaquine
  5. Aspirin
  6. Ibuprofen
  7. Nitrofurantoin
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46
Q 
Drug induced: 
Megaloblastic Anemia (3)
A

“having a BLAST with PMS”

  1. Phenytoin
  2. Methotrexate
  3. Sulfa drugs/TMP

*all cause decreased folate

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47
Q

Drug induced:

Thrombocytopenia(1)

A

Heparin (HIT)

48
Q 
Drug induced: 
Thrombotic complications (2)
A
  1. OCPs

2. Hormone Replacement Therapy

49
Q

Classic G6PD vignettes to be cautious of:

  1. UTI
  2. Chronic pain
  3. TB
A
  1. avoid Bacrim and Nitrofurantoin
  2. avoid aspirin/ibuprofen
  3. avoid Isoniazid
50
Q

How does Heparin cause HIT?

Treatment?

A

platelet-factor 4 bind Heparin trigger Abs to bind causing:

  1. platelets destroyed in spleen–>thrombocytopenia
  2. platelets activated (decrease platelets but increase risk of thrombosis)

Tx: stop heparin, admin argotroban

51
Q 
Drug induced: 
Fat redistribution (2)
A

“FAT PiG”

  1. Protease Inhibitor
  2. Glucocorticoids
52
Q 
Drug induced: 
Gingival Hyperplasia (3)
A
  1. Phenytoin (50%)
  2. Ca+2 channel blocker (rare)
  3. Cyclosporine (30%)
53
Q

Drug induced:

Hyperuricemia (gout) (5)

A

“Painful Tophi & Feet Need Care”

  1. Pyrazinamide
  2. Thiazides
  3. Furosemide
  4. Niacin
  5. Cyclosporine
54
Q

Drug induced:

Myopathy (8)

A
  1. Fibrates (combo w/ statins is worse)
  2. Niacin
  3. colchicine
  4. hydroxychloroquine (treats lupus)
  5. IFN-a
  6. penicillamine
  7. statins (combo w/ fibrates is worse)
  8. glucocorticoids
55
Q

Drug induced:

Osteoporosis (2)

A
  1. Coricosteroids (increase osteoblast apoptosis)
  2. Heparin (stim osteoclast after longtime)
  • pt. on glucocorticoids should be taking a Bisphosphonate
56
Q

Drug induced:

Photosensitivity(4)

A

“SAT For PHOTO”

  1. Sulfonamides
  2. Amiodarone
  3. Tetracyclines
  4. 5-FU (cream)
57
Q

Drug induced:

Rash (Steven-Johnson) (9)

A

“CLAPPPERS”

  1. CARBAMAZEPINE
  2. LAMOTRIGINE
  3. ALLOPURINOL
  4. PHENYTOIN
  5. PHENOBARBITAL
  6. PENICILLIN
  7. ETHOSUXIMIDE
  8. RASH
  9. SULFA DRUGS
58
Q

Drug induced:

SLE-like syndrome

A

“Having Lupus is SHIPP-E”

  1. Sulfa drugs
  2. Hydralazine
  3. Isoniazid
  4. Procainamide
  5. Phenytoin
  6. Etanercept
59
Q 
Drug induced: 
Teeth discoloration(1)
A

Tetracycline

60
Q

Drug induced:

Tendonitis, Tendon Rupture, Cartilage damage(1)

A

Fluroquinolones (inhib fibroblasts)

*esp. in elderly,

61
Q

Drug induced:
Cinchonism(2)
What is the cinchonism triad?

A
  1. Deaf 2. Tinnitus 3. Blurred Vision
  2. Quinidine
  3. Quinine (less potent)
    * derived from the cinchona tree
62
Q

Drug induced:

Parkinson-like syndrome(3)

A

“Cogwheel rigidity of ARM”

  1. Antipsychotics
  2. Reserpine
  3. Metoclopramide

symp=’ TRAP’

63
Q

Drug induced:

Seizures (5)

A

“with seizures, I BITE My tongue”

  1. Isoniazid (B6 def)
  2. Bupropion, Benzo&Alcohol withdrawal
  3. Imipenem/cilastatin (direct GABA inhib)
  4. Tramadol
  5. Enflurane (decrease neuro responsiveness to GABA)
  6. Metoclopramide
64
Q 
Drug induced: 
Tardive Dyskinesia(facial/oral movements)
A
  1. Antipsych
  2. Metoclopramide

*classic vignette of schizophrenic pt with abnormal facial movements

65
Q

Drug induced:
DI (2)
overall MOA

A
  1. Lithium
  2. Demeclocycline
    * inhib principle cells in collecting tubule when ADH bind V2 (via Adenyl Cyclase inhib)
66
Q 
Drug induced: 
Fanconi Syndrome(5)
A
  1. Tenofovir
  2. Ifosfamide (alkylizing agent that cross links DNA at Guanine N-7)
  3. Tetracycline (expired)
  4. Heavy metals/ Wilson’s disease

*# 1&2 both cause dysfunction of PCT (decrease AA, glucose, bicarb, phos)

67
Q

Drug induced:
Hemorrhagic cystitis (2)
HOW TO PREVENT!!!!

A
  1. Cyclophosphamide
  2. Ifosfamide
    *both decrease GSH (increase reactive oxygen species)
    (both are alkylizing agents that cross links DNA at Guanine N-7)
    Prevent with cadmic Mesna
68
Q 
Drug induced: 
Interstitial Nephritis(3)

What would be present on urinalysis?

A
  1. Methicillin (beats up too many kidneys)
  2. NSAIDs
  3. furosemide

-eosinophils

69
Q

Drug induced:

SIADH (3)

A

“Can’t Concentrate Serum Sodium”

  1. Carbamazepine
  2. Cyclophosphamide
  3. SSRIs
70
Q

Explain why B6 must be coadministered when giving Isoniazid.
How does this contribute to CNS effects/seizures?

A

Isoniazid is structurally similar to B6.
B6 is needed for conversion of Glutamate–>GABA
A decrease in GABA leads to seizures.

71
Q

Drug induced:
Dry Cough(1)
MOA
How to avoid?

A
  • ACEi
  • increase bradykinins which trigger bronchoconstriction
  • switch to ARB
72
Q

Drug induced:
Pulmonary fibrosis(6)
Which 2 are caused by Hypersensitivy Reaction (others are caused by direct damage causing fibrosis)?

A

“My Nose Cannot Breathe Bad Air”

  1. Methotrexate
  2. Nitrofurantoin (hypersensitivity Response/Pneumonitis)
  3. Carmustine
  4. Bleomycin
  5. Busulfan
  6. Amiodarone (hypersensitivity Response/Pneumonitis)
73
Q

Drug induced:

Antimuscarinic (4)

A
  1. Atropine
  2. TCAs
  3. H1-blockers (first gen)
  4. antipsych
74
Q

Drug induced:
Disulfiram-like rxn (5)
How?

A

“‘M’argaritas ‘C’ertainly ‘C’ause ‘G’reat ‘P’uking &‘S’kin-‘F’lushing”

  1. Metronidazole
  2. certain cephalosporines
  3. griseofulvin
  4. procarbazine
  5. Sulfonylureas (First-gen)

*disulfiram inhib Acetaldehyde dehydrogenase–>increase acetaldehyde–>Hangover symptoms

75
Q

Drug induced:
Nephrotoxicity/ Ototoxicity (4)
Which receptor for Nephrotox? Ototox?
How to treat chemo-agent induced?

A
  1. Aminoglycosides (esp. Neomycin)
  2. Vancomycin (via ox. stress)
  3. Cisplatin –>may respond to AMIFOSTINE treatment (free radical scavenger
  4. Loop diuretics (“Wear loop earrings”)

Nephrotox in PCT causing increase Creatinine
Ototoxicity caused by binding to NMDA-R

76
Q

P450 inducers (+) (7)

A

“Guiness, Coronas, and PBR’S lead to Chronic Alcoholism”

  1. Griseofulvin
  2. Carbemazepine
  3. Phenytoin
  4. Barbs
  5. Rifampin
  6. St. John’s wort
  7. Chronic Alcoholism
77
Q

P450 inhibitors (10)

A

“CRACK AMIGO”

  1. Ciprofloxicin
  2. Ritonavir
  3. Amiodarone
  4. Cimetidine
  5. Ketaconazole
  6. Acute Alcohol abuse
  7. Macrolides
  8. Isoniazid
  9. Grapefruit Juice
  10. Omeprazole
  11. Sulfonamides
78
Q

P450 substrates (4)

A

“Always Think When Outdoors”

  1. Anti-epileptics
  2. Theophylline
  3. Warfarin
  4. OCPs
79
Q

Sulfa drugs:

Name (8)

A

“Scary Sulfa Pharm FACTS”

  1. Sulfonamide abx
  2. Sulfasalazine
  3. Probenecid
  4. Furosemide
  5. Acetazolamide
  6. Celecoxib
  7. Thiazides
  8. Sulfonylureas
80
Q

Potential reactions to Sulfa drugs (7)

Which is most common?

A

1= urticaria/hives

range from mild-severe

  1. F
  2. UTI
  3. Sevens-Johnsons (type4 hypersens via CD8+)
  4. hemolytic anemia (3% will have rxn via Hapten)
  5. Thrombocytopenia
  6. Agranulocytosis
  7. Urticaria/Hives(type1 hypersens via IgE)
81
Q

Drug Name Endings, example:

Ergosterol synthesis inhibitor

A

-azole

Ketoconazole

82
Q

Drug Name Endings, example:

Antiparasitic/antihelminthic

A

-bendazole

Mebendazole

83
Q

Drug Name Endings, example:

peptidoglycan synthesis inhibitor

A

-cillin

Ampicillin

84
Q

Drug Name Endings, example:

Protein synthesis inhibitor

A

-cycline

Tetracycline

85
Q

Drug Name Endings, example:

Neuraminidase Inhibitor

A

-ivir

Oseltamivir

86
Q

Drug Name Endings, example:

Protease inhibitor

A

-navir

Ritonavir

87
Q

Drug Name Endings, example:

DNA polymerase inhibitor

A

-ovir

Acyclovir

88
Q

Drug Name Endings, example:

Macrolide abx

A

-thromycin

Azithromycin

89
Q

Drug Name Endings, example:

Inhalational general anesthetic

A

-ane

Halothane

90
Q

Drug Name Endings, example:

Typical antipsychotic

A

-azine

Thioridazine

91
Q

Drug Name Endings, example:

Barbituate

A

-barbital

Phenobarbital

92
Q

Drug Name Endings, example:

Local anesthetic

A

-caine

Lidocaine

93
Q

Drug Name Endings, example:

SSRI

A

-etine

Fluoxetine

94
Q

Drug Name Endings, example:

TCA (2)

A

-ipramine, -triptyline

Imipramine, amitryptyline

95
Q

Drug Name Endings, example:

5-HT 1b/1d agonists

A

-triptan

Sumatriptan

96
Q

Drug Name Endings, example:

Benzodiaepine(2)

A

-zepam, -zolam

Diazepam, Alprazolam

97
Q

Drug Name Endings, example:

Cholinergic agonist

A

-chol

Bethanechol, carbachol

98
Q

Drug Name Endings, example:

Non-depolarizing paralytic (2)

A

-curium, -curonium

Atracurium, Vecuronium

99
Q

Drug Name Endings, example:

BB

A

-olol

Propranolol

100
Q

Drug Name Endings, example:

AchE inhibitor

A

-stigmine

Neostigmine

101
Q

Drug Name Endings, example:

B2-agonist

A

-terol

Albuterol

102
Q

Drug Name Endings, example:

a1-angtagonist

A

-zosin

Prazosin

103
Q

Drug Name Endings, example:

PDE-5 inhib

A

-afil

Sildenafil

104
Q

Drug Name Endings, example:

Dihydropyridine Ca+2 Channel blocker

A

-dipine

Amlodipine

105
Q

Drug Name Endings, example:

ACEi

A

-pril

Captopril

106
Q

Drug Name Endings, example:

Angiotensin-II Receptor Blocker

A

-sartan

Losartan

107
Q

Drug Name Endings, example:

HMG-CoA reductase inhibitor

A

-statin

Atorvastatin

108
Q

Drug Name Endings, example:

Direct factor ‘Xa’ inhibitors

A

-‘xa’ban

Apixaban, edoxaban, rivaroxaban

109
Q

Drug Name Endings, example:

Bisphosphonate

A

-dronate

Alendronate

110
Q

Drug Name Endings, example:

PPAR-gamma activator

A

-glitazone

Rosiglitazone

111
Q

Drug Name Endings, example:

Proton pump inhib

A

-prazole

Omeprazole

112
Q

Drug Name Endings, example:

Prostaglandin analog

A

-prost

Latanoprost

113
Q

Drug Name Endings, example:

H2-antagonist

A

-tidine

Cimetidine

114
Q

Drug Name Endings, example:

Pituitary Hormone

A

-tropin

Somatotropin

115
Q

Drug Name Endings, example:

Chimeric monoclonal Ab

A

-ximab

Basiliximab

116
Q

Drug Name Endings, example:

Humanized monoclonal Ab

A

-zumab

Daclizumab

Drugs- Basic High Yield Stuff for Boards (20 decks)

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