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Step 1 Pharm
| Question | Answer |
|---|---|
| Child born with transposition of the great vessels and PDA. how do you keep them alive? | give PGE1 analog to keep PDA open. ex. alprostadil, misoprostol |
| mech and effects of acetazolamide? | carbonic anhydrase inhibtors, increases sodium and potassium clearance without affecting water |
| action of thiazdie diuretics? | inhibit Na/Cl cotransporter (distal tubule) , incr na and K excretion without affecing H20 |
| action of loop diuretics? | inhibit Na/K/Cl cotransporter (thick ascending limb), incr sodium and potassium excretion |
| What renal drugs might cause hypercalcemia with a predisposing condition? | thizides, unclear mech but they act in the distal convoluted tubule |
| action of docusate sodium? | stool softener, often given with pain killers |
| Classes which cause constipation? | opiates, Ca+ channel blockers, anticholinergics, TCAs, antipsychotics |
| What lab should be monitored in a patient on lithium? | thyroid stimulating hormone, could cause hypothyroid |
| What labs should be followed for a patient on valproate? | liver transaminases, platelet count |
| What is the primary antiplatelet effect of aspirin? | mainly is decreased TXA2, irreverisbly inhibits cyclooxygenase |
| What nucelotide's synthesis is mainly inhibited by 5-FU? | Thymine (could be uracil if question asks about RNA as opposed to DNA) |
| breakout of respiratory illness in daycare of 10 month year old. Pathogen and DOC? | like RSV.Tx: Palivizumab (inhibits RSV fusion) |
| Abatacept, mech and use? | selective costimulation modulator that inhibits T cell activation for RA |
| Mech and use of Daclizumab? | mab for IL-2 receptor, prevents tissue rejection in transplant patients |
| Mech of sirolimus? | inhibits T cell proliferation by binding serine threonine kinase neccessary for progression of t cell cell cycle |
| Mech and major SE of cyclosporine? | inhibits IL 1, 2 receptor production. inhibits t cell/macrophage interactions. Major SE: nephrotoxicity esp in renal failure pt. |
| A patient taking steroids has a family hx of diabetes and is concerned about osteoporosis. Besides DEXA, what test should be ordered? | serum glucose ( steroids can sometimes mask DM sx) |
| What abtx are P450 inhibitors (ex in the context of incr warfarin conc)? | ketoconazole, amiodarone, diltizaem, iosoniazid, fluoxetine, fluroquinolones |
| What drugs are p450 inducers? | carbamazepine, phenytoin, phenobarbital, rifampin. St. Johns Wort as well |
| What is the only macrolide that IS NOT a p450 inhibitor? | azithromycin |
| What is the blood pressure med of choice for a patient with emphysema? | Beta 1 selectives: metoprolol, atenolol |
| What is the second line drug if a patient develops heparin induced thrombocytopenia? | bivalirudin (neutralizes thromnin) |
| What cause heparin induced thrombocytopenia? | IgG autoAb against platelet factor 4 |
| Use of alteplase? | throbolytic agent in acute MI, PE, binds to fibrinogen and activates plamin |
| What is enoxaparin? | low molecular weight heparin |
| What is filgrastim? | recombinant GCSF used to tx neutropenia secondary to cancer chemotherapy |
| What drug can prolong life in ALS? | riluzole (inhibits glutamate receptor and glutamate release) |
| What does ACh do to blood vessels? | causes EDRF reease via M3= vasodilation |
| What is the effect of isoproterenol on the vasculature? | decr BP by clocking Beta 2 receptors |
| What is the action of epinephrine on receptors? | agonist at all alpha and all beta. |
| What is the mech of phentolamine on receptors? | antagonist at alpha 1 and 2 |
| What is the action of NE on receptors? | agonist at alpha 1, 2, beta 1. |
| action of phenylephrine at receptors? | alpha 1 agonist |
| Tx for atrial fib? | stabilize with diltizaem, initially anticoagulate with heparin, long term anticoagulate with warfarin |
| What is the mech, action and use of cinacalcet? | calcimimetic agent that incr sensitivity of calcium sensing receptor. used in correct electrolytes in secondary hyperparathyroidism (end stage renal disease) |
| What types of drugs used for migraines could exacerbate COPD? | beta blockers ( due to bronchoconstriction) |
| What does nitrogen mustard antineoplastic mean? | ifosfamide, cyclophosphamide. can coth cause hemorrhagic cystitis |
| What is leucovorin used for? | dimish toxicty of MTX |
| What is the anxiolytic mechanism of benzodiazepines? | increases the frequency of GABA(a) channel opening |
| How do amphetamines treat narcolepsy? | increase release of norepi from noradrenergic neurons (in part) as well as release serotonin and dopamine ( dopa is addictive) |
| What are the 3 major actions of drugs like amitryptyline, nortryptiline, doxepin? | TCAs. 1. inhibit NE and Serotonin reuptake at presynaptic neuron 2. induce sedation 3. induce central and peripheral anticholinergic actions |
| What is the mech of risendronate, when is it used? | DOC in post menopausal osteoporosis, inhibits osteoclast activity |
| What is the mech of losartan? | angiotensin receptor antagonist |
| What is exenatide? When might it cause hypoglycemia? | glucagon like peptide. used in DM2, can get hypoglycemia if administered with a sulfonylurea |
| What is glimepiride? | sulfonylurea used in type 2 DM |
| What is sitagliptin? | orally active inhibitor of dipeptidyl peptidase indicated for DM2 |
| What is the mech of amiloride? | blocks ENaC channels in collecting duct, K+ sparing diuretic |
| What are the major Se of vincristine vs vinblastine? | vincristine: neurotoxic. vinblastine: GI, alopecia, bone marrow surpression |
| What is the mech of doxorubicin? | inserts b/w DNA strands, causes breakage and damge. anit tumor. |
| What is the mech of bleomycin? | complexes iron formin ROS and induces breaks in the DNA strand |
| What anti tumor dugs cause DNA crosslinking?> | busulfan, cisplatin, carmustine, cyclophosphamide |
| elevated levels of 5HIAA in urine indicate? | carcinoid syndrome, treat with octreotide |
| What is the mech and use of alosetron? | 5-Ht3 antagonist used for diarrhea predominant IBS, serious side effects |
| What is the mech and use of dronabinol? | orally active cannabinoid used as antiemetic and antianorexic in chemopt |
| What is the mech and use of famotidine? | H2 antagonist that decr gastric acid secretion used in ulcer syndormes |
| What is the mech and use of sulfasalazine? | anti inflmmatory and immunomodulatory effects. used in UC |
| What drug can both lower BP and incr aldosterone secretion? | furosemide (loop diuretics) |
| What is the mech of clonidine? | alpha 2 selective agonist, decr sympathetic tone |
| What is the mech and use of tolterodine? | competititve muscarinic receptor antagonist uded for incontinence, urgency, neurogenic bladder |
| What is the mech of GABA (A) receptorS? | ligand gated channel which incr Cl flux and stabilizes membrane |
| What is the mech of nicotinic cholinergic receptors? | ligand gated ion channels which incr sodium influx, leading to excitation |
| How does amohetamine incr BP? | causes release of NE |
| What is the mech of prazocin? | competitive alpha 1 receptor blocker, used to tx htn |
| What is the action of pnehoxybenzamine? | noncompetitive alpha 1 blockers |
| What is the mech and use of prochlorperazine? | anitemetic that blocks dopamine receptors in the chemoreceptor trigger zone |
| What is the mech of granisetron and use? | 5HT3 antagonist used as an antiemetic in chemotherapy |
| What is the mech and use of meclizine? | H1 antagonist used to tx motion sickeness and true vertigo |
| What is the use of megestrol? | progestation agent used to stimulate appetite in cachexia |
| What is the mech and use of scopolamine? | antimuscarinic and antiemetic for motion sickeness. not for chemo |
| What causes tardive dyskinesia? | antipsycotics ( flupheniazine, haloperidol) or dopamine antagonists ( metoclopramide, prochlroperazine) |
| What are the 3 Cs of TCA OD? | coma, convulsions, cardiotoxicity |
| What is the class of olanzapine, risperidone, clozapine, quetipine, ziprasidone? | atypical antipsychotics |
| What are the major SE that could be seen in thizide diuretic tx? | metabolic alkalosis, hypokalemia, incr in aldosterone |
| Major SE of bleomycin? | pulmonary fibrosis |
| What is the mech of zilueton? | interupts LTA pathway by inhiobitng 5-lipoxygenase |
| What is the action of zafirlukast and montelukast? | inhibit binding of LTD 4 to its receptor |
| What is the mech of amlodipine? | Ca+ channel blockers of peripheral SMM for HTN |
| How is an amphetamine OD tx? | ammonium chloride. amphetamines are weak bases so a weak acid can tx |
| What are the Sx of diphenhydramine OD? | anticholinergic: psychosis, urinary retention, abdominal crampinf, mydriasis |
| What is the keyy difference b/w and OD of diphenhydramine and one of cocaine, amphetamine, methylphenidate? | skin. wet with stimulants and dry with anticholinergics |
| What is the class and mech of cyclobenzaprine? What class would its SE be similar to? | centrally acting skelatal m relaxant, sim SE to TCAs. dry mouth, drowsiness, sdizziness, fatigue, tachycardia, urinary retion |
Created by:
tjs2123
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