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USMLE
Comprehensive Pharm 10
| Question | Answer |
|---|---|
| MOA orlistat | inhibits pancreatic lipase |
| clinical use of orlistat | obesity management |
| toxcicity of orlistat | gi discomfort steatorrhea reduced absorption of fat soluble vitamins ha |
| MOA sibutramine | sympathommimetic 5HT and NorE reuptake inhibitor |
| uses of sibutramine | short term and long term obesity management |
| toxicity of sibutramine | htn tachycardia |
| uses of GH | GH deficiency turner's syndrome |
| uses of somatostatin | acromegaly carcinoid gastrinoma glucagonoma |
| uses of octeroitide | (aka somatostatin) acromegaly carcinoid gastrinoma glucagonoma |
| uses of adh | pituitary DI |
| MOA propylthiouracil | inhibits organification and coupling of thyroid hormone synthesis decreased peripheral conversion of T4 --> T3 |
| Which drugs block peptidoglycan cross-linking | Cephalosporin -cillins -nam/-nem |
| which drugs block peptidoglycan synthesis? | bacitracin vancomycin cycloserine |
| which drugs block bacterial/fungal cell wall synth | polymyxins |
| which drugs disrupt fungal cell membranes | amphotericin b nystatin -azoles |
| which drugs block NT synth | "Try my cell phone - I blocked the New Cleo" Sulfonamides trimethoprim |
| which drugs block DNA synth | "TOPless DANcing Queen" (insert abba song here... :) Topoisomerase Quinolones |
| which drugs block mRNA synth | rifampin |
| Which drugs block protein synth at the 50S subunit? | -mycins linezolid -gramins macrolides chloramphenicol |
| which drugs block protein synth at the 30S subunit | Aminoglycosides tetracyclines |
| MOA penicillin | it binds to penicillin binding proteins blocks the cross-linking of peptidoglycan activates autolytic enzymes |
| uses for penicillin | gram + cocci and rods GNR spirochetes |
| which penicillins are the penicillinase resistant? | Nafcillin dicloxacillin methicillin |
| clinical uses for penicillinase resistant penicillins? | S. aureus (except for MRSA) |
| why are penicillinase resistant penicillins resistant to penicillinase | bulikier R group |
| how is MRSA resistant to methicillin | altered penicillin binding protein target site |
| adverse reaction to methicillin | interstitial nephritis |
| examples of aminopenicillins | ampicillin amoxicillin |
| what is clavulanic acid | penicillinase inhibitor |
| clinical uses for aminopenicillins | "ampicillin/amoxicillin HELPS kill enterococci" H. influenza e. coli Listeria monocytogenes Proteus mirabilis Salmonella Enterococci |
| anti-pseudomonal drugs | "Take Piper in the Car, Sue" ticarcillin piperacillin carbenicillin |
| MOA cephalosporins | same as penicillins, less susceptible to penicillinases |
| uses for 1st generation cephalosporins | PEcK Proteus E coli Klebsiella |
| uses for 2nd generation cephalosporins | HEN PEcKS H. flu Enterobacter Neisseria Proteus E. coli Klebsiella Serratia |
| examples of 1st generation cephalosporins | "You FAILed the FIRST PHASE" cefazolin cephalexin |
| examples of 2nd generation cephalosporins | "Wait a SECOND! You SEE, FOX FUR is a FACt" cefoxitin cefuroxime cefaclor |
| 3rd generation cephalosporins | "If you are THIRsty, try a FOTO TAZER" Cefotaxime Ceftazidime ceftriaxone |
| clinical uses of aztreonam | klebsiella pseudomonas serratia (GNR only, nothing against gm + or anaerobes) |
| who is given aztreonam | penicillin allergic pts pts w renal insuff that can't tolerate aminoglycosides |
| what is cilastatin? | inhibits renal dihydropeptidase I always administered with imipenem |
| clinical uses for imipenem/meropenem? | gram + cocci GNR anaerobes |
| toxicity of imipenem, meropenem | gi distress rash seizures (all occcur at high plasma levels) |
| MOA aminoglycosides 'cidal/static? | inhibits formation of initiation complex --> misreads mRNA requires O2 for uptake, so won't work against anaerobes 'cidal |
| which drugs are aminoglycosides? | "Mean GNATS canNOT kill anaerobes" Gentamicin Neomycin Amikacin Tobramycin Streptomycin |
| toxicity of aminoglycosides | "Mean GNATS canNOT kill anaerobes" Nephrotoxicity (esp if used with cephalosporin) Ototoxicity (esp w/ loop diuretic) Teratogen |
| Uses for tetracyclines | VACUUM THe BedRoom Tunight V. cholera Acne Chlamydia Ureaplasma Urealyticum Mycoplasma pneumoniae Tularemia H. Pylori Borrelia Burgodorferi Rickettsia |
| MOA tetracyclines 'cidal/static? | binds 30S and prevents attachment of aminoacyl RNA static |
| foods to avoid when takin tetracyclines | don't take with milk, iron, or antacids b/c it will inhibit absorption in gut |
| which tetracycline is fecally eliminated? | doxycycline (can be used in renal failure) |
| toxicity of tetracyclines | photosensitivity gi discomfort discoloration of teeth inhibits bone growth in kids |
| contraindications of tetracyclines | pregnancy |
| what drug can act as a diuretic in SIADH | demeclocycline (ADH antagonist) |