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QuestionAnswer
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