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Penicillin G,V toxicity sulfa allergy; Ig-E mediated hemolytic anemia; interstitial nephritis
m.o.a. of penicillin inhibits bacterial peptidoglycan cross-linking
Aminopenicillins (ampi, amoxi) penicillinase sens. or insensitive? Penicillinase sensitive.
aminopenicillins toxicity hypersensitivity, rash, pseudom. colitis
Penicillinase-resistant penicillins. toxicity nafcillin, oxacillin, dicloxacillin. allergy, int. nephritis.
Antipseudomonas. penicillinase sens. or insens? ticarcillin, piperacillin. penicillinase sens.
b-lactamase inhibitors clavulanic acid, sulbactam, tazobactam
which cephalosporin covers MRSA? ceftaroline (5th gen)
cephalosporin used prior to surgery to prevent s.aureus cefazolin (1st gen)
cephalosporins + aminoglycosides (toxicity) nephrotoxicity
cephalosporins cause which vit. deficiency? vit. K
monobactam. used against ___ aztreonam. against G negatives, ONLY
carbapenems, penicillinase sens. or insens? Penicillinase Insensitive
Carbapenems are administered with ____ to decrease ____ cilastatin, to decrease renal inactivation by dihidropeptidasese
why don't we give carbapenems often? seizures (less with meropenem)
Vancomycin m.o.a. cell wall synth. inhibitor, by inhibiting transglycosylation NOT transpeptidation
vanco toxicity Red man syndrome (face flushing) + nephrotoxicity, ototoxicity, thrombophlebitis.
Vanco resistance D-ala modification to D-lac.
Protein synth. inhibitors. 30S, 50S. buy AT (aminoglycosides, Tetracyclins) 30, CCEL (chloramphenicol, clindamycin, erythromycin (macrolides) Linezolid) 50
Aminoglycosides (names) GNATS - gentamicin, neomycin, amikacin, tobramycin, streptomycin
Aminoglycosides are ineffective against _________, because ___ anaerobes. Need O2 for uptake
Aminoglycosides treat Severe G- infections. D.o.c. for bubonic plague and tularemia
Aminoglycosides toxicity NNOT - Nephro, Neuromuscular block, Oto, Taratogen
Resistance to Aminoglycosides Transferase enzymes inactivate by acetylation, phosphorylation, adenylation
Tetracyclins cannot be taken with Milk (Ca), Antacids (Mg,Ca) Iron - divalent cations inhibit absorption in gut
Tetracyclins toxicity Teeth discoloration, inhibition of bone growth, photosensitivity
Which drugs have photosensitivity? Tetracyclins, sulfonamides, quinolones
Tetracyclin Resistance Decrease uptake or pump it out
Macrolides (names) azithromycin, clarithromycin, erythromycin
aminoglycosides block Initiation (A - first letter in alphabet)
Tetracyclins block Elongation (attachment of aa-tRNA)
Macrolides block----. which other drug does this? Translocation (macroSLIDES) Clindamycin
Chloramphenicol blocks Peptide bond formation
Which tetracyclin can be given to patients w/ renal F.? Doxycycline. excreted in bile
Macrolides Toxicity MACRO: gi MOTILITY, Arrhythmia (prolonged QT), Cholestatic hepatitis, Rash, Eosinophillia
Macrolides increase serum concentration of -_________ Theophyllines and oral anticoagulants. Erythromycin - statins.
Resistance to macrolides Methylation of rRna binding site
Which antibiotics cause interstitial nephritis? Penicillin G, V. Oxicillin, nafcillin, dicloxacillin, sulfonamides (tubulointerstitial nephritis)
m.c. side effect of streptokinase hemorrhage
potassium sparing duretics amiloride, triamterene, spironolactone
usage of fenoldopam hypertensive emergency. Dopamine analog. acts on D1
Bile acid binding resins cholestiramine, colestipol, colesevelam
bile acid binding resins side effects hypertriglyceridemia, gallstones
side effects of statins hepatotoxicity, myopathy
cyp 450 inducers CRAP GPS induce me to madness!! - Carbemazepines Rifampicin Alcohol (chronic) Phenytoin Griseofulvin Phenobarbitone Sulphonylureas
cyp450 inhibitors SICKFACES.COM Group - Sodium valproate Isoniazid Cimetidine Ketoconazole Fluconazole Alcohol..binge drinking Chloramphenicol Erythromycin Sulfonamides Ciprofloxacin Omeprazole Metronidazole Grapefruit juice
Tx for ONLY systolic hypertension Thiazide diuretics, dihydropyridine ca antagonists. if the patient has DM d.o.c. is ACE/ARB
Dihydropyridine Ca Channel blockers amlodipine, nimodipine, nifedipine (DIPINES)
non-dihydropyridine Ca ch. blockers diltiazem, verapamil
drug used in subarachnoid hemrg. to prevent cerebral vasospasm nimodipine
Rx for benign prostatic hyperplasia a-blockers - Tamsulosin, 5-a-reductase inhibitors - Finasteride
Rx for Panic disorder Benzo - alprazolam
decreases nicotine craving bupropion
Baclofen GABAb drug, used in spasticity
management of status epilepticus 1. Benzo (lorazepam) 2. Add phenytoin to prevent recurrance 3. If all fails, intubate
Prevent peripheral neuropathy with isoniazid add pyridoxine
d.o.c. in absence seizure. moa ethosuximide, Ca ch.blocker
Drug most commonly causing tardive dyskinesia; least commonly causing Risperidone. Clozapine
Treat drug-induced parkinsonism benztropine
Rx for acute dystonia antihistamines (diphenhydramine), trihexyphenydil, benztropine
Ca ch. blockers Toxicity Cardiac depression, AV block, peripheral edema, flushing, dizziness, hyperprolactinemia, constipation
Hydralazine moa increases cGMP -> SM relax. -> vasodilation (arterioles>veins) = decreased afterload
Hypertension in pregnancy Rx Hydralazine, methyldopa
Prevent reflex tachycardia w/ b-blockers hydralazine
Lupus-like syndrome - which antihypertensive was used? hydralazine
Hydralazine is contraindicated in___ angina/CAD
Hypertensive emergency Nitroprusside, fenoldopam, nicardipine, labetalol
Nitroprusside moa increases cGMP via direct release of NO
Nitroprusside can cause _______- toxicity. treatment? cyanide. Rx - nitrites + thiosulfate
Monday disease industrial exposure to nitrates
minoxidil & diazoxide Direct acting vasodilators, opens ATP-d-K channels -> hyperpolarization. acts on arterioles and pancreatic B-cells ->less insulin -> hyperglycemia. Use in emergencies
Minoxidil use (non-cardiac) baldness
Diazoxide use (non-cardiac) insulinoma
Digoxin use CHF, atrial fibr.
Digoxin toxicity cholinergic (via vagus) - nausea vomiting diarrhea BLURRY VISION arrhythmia, T-inversion, AV block, hyperkalemia
Hypertension + angina b blockers
Hypertension + diabetes ACEI ARBs
Hypertension + Post-MI BBs
Hypertension + BPH a-blockers
Hypertension + Dyslipidemias a-blockers, CCBs, ARBs,ACEIs. NOT bbs and thiazides
Class I antyarrhytmics effect which phase? Phase 0 - Na channels
Class IA drugs Queen Proclaims Diso's Pyramide - Quinidine, Procainamide, Disopyramide
Class IA drugs toxicity cinchonism (headache, tinnitus w/ quinidine) SLE - procainamide. HF - Disopyramide. Torsades.
Give ___ before quinidine to _______ Digoxin. to slow down HR
Class IB drugs Lodicaine, mexiletine, tocainide
Class IA drugs close what kind of channels ACTIVE Na ch.
Class IB - type of channel INACTIVE, REFRACTORY Na ch.
Class IC - type of channel ALL KINDS OF NA CHANNELS
Best antiarrythmic Post-MI Class IB
Least cardiotoxic ant.arrh Class IB
Class IA - AP duration increases
Class IB - AP duration decreases
Class IC - AP duration no change
SLE-like syndrome - drugs Hydralazine, Isoniazid, Procainamide, Methyl-dopa. + ANA, + Anti-histone <- drug-induced specific
Class IC drugs Flecainide Propafenone - last option. ticket to heaven.
Class II antiarrythmics Beta Blockers - metoprolol, propranolol, esmolol, atenolol, timolol, carvedilol
Class II moa deacreases node activity by decreasing cAMP, Ca currents.
Class II phase Phase 4
Class II toxicity IMPOTENCE, exacerbation of COPD/ASTHMA, bradycardia, AV block, CNS
which drug masks signs of hypoglycemia BBs
which BB can cause dyslipidemia metoprolol
Treat BB overdose glucagon
antiarrhythmic contraindicated in cocaine users BBs (unopposed a-agonist activity)
Class III antiarrhythmics K channel blockers - AIDS - Amiodarone, Ibutilide, Dofetilide, Sotalol. used when others fail.
drugs causing torsades Class IA, Class III (sotalol, ibutilide), antihistamines, TCAs, antipsychotics (thioridazine)
Amiodarone toxicity Pulmonary fibrosis, hepatotox, thyroid, Blue deposits (smurf skin) Ridiculously long half life - 80 days
Drugs causing pulmonary fibrosis amiodarone and bleomycin
Class IV antiarrhythmics Verapamil, diltiazem (non-dihydropyridine Ca blockers). Used to prevent nodal arrhythmias
Adenosine moa Gi -> low cAMP -> low PKA -> K goes out -> hyperpolarization -> low Ca current. very short acting. causes bad bronchospasm
Adenosine use DOC in diagnosing/abolishing SUPRAVENTRICULAR TACHYCARDIA.
Mg2+ use in heart Torsades and digoxin toxicity (competes with Ca)
which antidepressant causes painful, long-lasting erection? trazodone
brimonidine A2-agonist. decrease AH production. used in glaucoma. SE: foreign object sensation, blurry vision
B-blockers used in glaucoma timolol, betaxolol, carteolol. decrease AH production
which diuretic is used in glaucoma. moa acetazolamide. decease carbonic anhydrase, decrease AH synth.
moa of cholinomimetics in glaucoma increase outflow of AH
cholinomimetics in glaucoma pilocarpine, carbachol, physostigmine, echothiphate
glaucoma emergency pilocarpine
prostaglandin in glaucoma. moa. SE letanoprost (PGF2a). increase AH outflow. SE: dark iris
moa of opioid analgestics act at mu, delta, kappa receptors. open K, close Ca channels -> decrease synaptic transmission -> inhibit release of ACh, norepi, 5-HT, glutamate, substance P
opioid an. for cough suppression dextromethorphan
opioid for diarrhea loperamide, diphenoxylate
opioid OD rx naloxone, naltrexone
Butorphanol partial mu agonist. full kappa agonist. less resp depression than full agonists. used in migraine, labor pains. not reversed with naloxone
tramadol very weak opioid agonist. can cause SEROTONIN SYNDROME. used in chronic pain
which epilepsy drugs cause Stevens-Johnson? Ethosuximide, phenytoin, carbamazepine, lamotrigine.
Stevens Johnson fever, bulla, necrosis, sloughing of skin. Eye, lips.
1st line for trigeminal n. carbamazepine
1st line epilepsy drug in neonates phenobarbital
epilepsy drug causing kidney stones topiramate
epilepsy drugs effecting Na channels phenytoin, valproic, topiramate, lamotrigine
epilepsy drugs effecting Ca channels ethosuximide, gabapentin
barbiturates moa GABAa. increase DURATION of Cl channels. decrease neuron firing.
barbs contraindicated in porphyria
benzos moa GabaA, increase FREQUENCY of CL channel opening. decrease REM
OD of benzos, Rx FLUMAZENIL
Insomnia rx Nonbenzo hypnotics. ZZZZs - Zolpidem, Zaleplon, esZopiclone
Rx for High cholesterol Resins or ezetimibe
Rx for high triglycerides gemfibrozil (fibrates)
High trigl + cholesterol statins + ezetimibe
which lipid lowering agent causes face flushing? and how to minimize this? niacin. give aspirin
which lipid lowering agent causes hyperuricemia? niacin
resins are contraindicated in hypertriacylglycideremia
fibrates are contraindicated in hypercholesterolemia
orlistat moa and use decreased pancreatic lipase. weight loss
sibutramine moa and use increase NE, 5-HT -> anorexic -> weight loss
medication that decreases HR but has no effect on contractility and relaxation. which phase? Ivabradine. Phase 4
Created by: anamakharashvili



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