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Pharmacology

UWORLD Pharmacology review

QuestionAnswer
Lidocaine is a class _____ antiarrhythmic that binds to ______________ channels and _____________________________. IB; inactivated Sodium (Na+); rapidly dissociates
Lidocaine and other IB antiarrhythmics are used for: Treatment of ventricular arrhythmias induced by rapidly depolarizing and ischemic myocardium
Adenosine is used to treat: PSVT
MoA of Adenosine: causes transient conduction delay though AV node
What is the mode of action of Digoxin: 1. Enhanced vagal tone --> increased effective refractory period 2. Decreased conduction velocity through AV node
Digoxin is used to treat: Supraventricular arrhythmias (SVT)
Dialtemzam is a class _____ antiarrhythmic. IV
What si the mode of action of Diltiazem: 1. Slow sinus rate 2. Prolongs conduction through AV node 3. Decreased myocardial contractility
What is the MoA of Diltiazem? Used as rate-control agent for management of atrial arrhythmias (afib and aflutter)
What are the 3 common Class IA antiarrhythmics? Procainamide, Disopyramide and Quinidine.
Class IA antiarrhythmics: Bind to Na+ channels in the OPEN state and more specific for suppressing arrhythmias arising from areas of normal autonomacity.
What other ionic effect is present in Class IA antiarrhythmics besides sodium blockage? K+- channel blocking
What is the MC treatment for HIT (Heparin-induced therapy)? Direct Thrombin inhibitors (DTIs)
What is the most common Direct thrombin inhibitor? Argatroban
Which anticoagulant is the MCC of thrombocytopenia in hospitalized patients? Heparin
HIT: serious disorder caused by antibodies to heparin and platelet factor IV
What are examples of Direct Thrombin Inhibitors (DITs)? hirudin, Lepirudin, and Argatroban
GP IIb/IIIa inhibitors: inhibit binding GP IIb/IIIa with fibrinogen and fibronectin
What are some common GP IIb/IIIa inhibitors? Abciximab, Eptifibatide, and Tirofiban
What is the MC use for GP IIb/IIIa inhibitors? Percutaneous Intervention (PCI) in acute coronary syndrome
Abciximab is an ________________________. GP IIb/IIIa inhibitor
What are two common SERMs? Tamoxifen and Raloxifene
Tamoxifen is an selective estrogen receptor modulator
Mode of action of Tamoxifen in breast cancer? Competitive inhibitors of Estrogen binding to estrogen receptors
What is an important side effect of Tamoxifen? Estrogenic effect on uterus and can cause endometrial hyperplasia and cancer
What are common adverse effects of SERM therapy? 1. Hot flashes 2. Venous thromboembolism 3, Endometrial hyperplasia and cancer (Tamoxifen only)
Raloxifene is used in post-menopausal women because? It helps with Osteoporosis
Tamoxifen can adversely develop: Endometrial hyperplasia and/or cancer.
Nucleoside analogue; Treatment of primary genital herpes Acyclovir
What is the mode of action of Acyclovir? It incorporate, the nucleoside analogues, to the newly replicating viral DNA and ultimately terminate viral DNA chain synthesis
Virus-encoded thymidine kinase? Enzyme used by Acyclovir to convert acyclovir into acyclovir monophosphate.
Cpss is? steady-state plasma concentration
WHat is the equation for maintenance dose? Cpss x CL = ------------------ [Bioavailability fraction]
What is the value of bioavailability in an IV drug? 1
Loading dose = Vd x Cpss = ----------------------- [bioavailability fraction]
How is the loading dose altered in renal patients? It remains unchanged
Is Maintenance dose decreased or increased in Renal patients? Decreased
In a renal patient the loading dose _____________________, and the maintenance dose is _____________________. Remains unchanged; Decreased
What are the two main categories of anticonvulsants? 1. Narrow Spectrum 2. Broad Spectrum
What are the uses for Narrow Spectrum Anticonvulsants? Treatment of simple and Complex seizures
What are the Narrow spectrum anticonvulsants? - Carbamazepine - Gabapentin - Phenobarbital - Phenytoin
Carbamazepine, Gabapentin, Phenobarbital and Phenytoin are ________________________, wich are used to treat ___________ and ________ seizures. Narrow Spectrum; Simple and Complex
Which are the Broad spectrum anticonvulsants? 1. Lamotrigine 2. Levetiracetam 3. Topiramate 4. Valproic acid
For which kind of seizures are Broad spectrum anticonvulsants used for? 1. Tonic-clonic seizure 2. Myoclonic
What drug is used for Absence seizure? Ethosuximide
Ethosuximide is considered and _________--spectrum anticonvulsant. Broad
Lamotrigine, Levetiracetam, Topiramate, and Valproic acid are _________ spectrum anticonvulsants, used to treat _____________ and ___________ seizures Broad; Tonic-clonic and Myoclonic seizures.
Baclofen: GABA-B agonist that can treat muscle spasticity, which is characterized by increased muscle tone and muscle spasms
Example of a GABA - B agonist Baclofen
Fluphenazine: dopamine antagonist that can treat Tourette syndrome
What is a common drug to treat Tourette syndrome? Fluzephine
What is Tourette's syndrome? Disorder characterised by motor or phonic tics that persists for more than 1 year.
Benzodiazepine withdrawal? Characterised by anxiete, tremor, insomnia, and sympathetic hyperactivity (diaphoresis, palpitation)
What is a commonly used Benzodiazepine, that upon withdrawal commonly causes symptoms of withdrawal? Lorazepam
What are serious accompanying symptoms of Benzodiazepine withdrawal? Psychosis, seizures,and death
Opioid withdrawal? characterized by nausea, vomiting, diarrhea, lacrimation l dilated pupils, and piloerection.
Common aminoglycoside? Gentamicin
What is the most common way for acquiring resistance of aminoglycosides? antibiotic-modifying enzymes
What do the antibiotic-modifying enzymes do? add chemical groups (methyl) to the antibiotic , which diminishes its ability to bid to the 16S ribosomal RNA (aminoglycosides) within the 30S ribosomal subunit.
What is the most common origin of antibiotic-modifying enzymes? Most arise via transfer of plasmids or transposons rather than chromosomal mutation.
Vancomycin mode of resistance: mutated peptidoglycan wall (D-ala-D-lac)
Tetracyclines mode of resistance: Impaired influx/ increased efflux
Rifamycins mode of resistance: mutated RNA polymerase
Bisphosphonates include: Alendronate and Risedronate
What are some associated adverse effects of Bisphosphonate (Alendronate) therapy? 1. Erosive (hemorrhagic) esophagitis 2. Increased risk of Osteonecrosis of the Jaw and, 3. Atypical femoral fractures + Hypocalcemia
Osteonecrosis of the Jaw is often associated with the use of ___________________. Bisphosphonates
What is the drug of choice for Status epilepticus? IV Lorazepam
What is the MOA of Lorazepam? Enhance the effect of GABA at the GABA-A receptor, leading to INCREASED CHLORIDE EFFLUX, and suppression of action potential firing.
What receptor is blocked by Lorazepam? GABA-A
The blockage of the GABA-A receptor by Lorazepam leads to: Increased Cl- efflux --> suppression of AP
Benzodiazepine, such as Lorazepam, work on the _____________ membrane. Post-synaptic
What are the Presynaptic Ionic channels? 1. Voltage-gated CALCIUM channel 2. Voltage-gated SODIUM channel
What drug commonly blocks the Presynaptic Voltage-gated Calcium channels? Gabapentin
Phenytoin blocks the _______________-voltage-gated __________- channel. Presynaptic voltage-gated Na+ channel.
What are the 5 main receptors that cause vomiting? 1. M1 (muscarinic) 2. D2 (dopaminergic) 3. H1 (histaminic) 4. 5-HT3 (serotonergic) 5. Neurokinin (NK1)
What are the two vomiting receptors targeted in chemotherapy-induced vomiting? 5-HT3 and NK1 receptors
What drug is used to block the M1 receptor in treatment of vomiting? Scopolamine
For which condition is Scopolamine used for? Motion sickness
Which receptor is blocked by Scopolamine? M1 muscarinic
WHat are 3 antiemetic antihistamine drugs? 1. Diphenhydramine 2. Meclizine 3. Promethazine
What is the drug of choice of Promethazine? Hyperemesis gravidarum
Diphenhydramine and Meclizine are __________________, used in the treatment of ________________. H1 antihistamines; emesis
What are the 2 main D2 -receptor antagonist antiemetics? Prochlorperazine and Metoclopramide
Ondansetron and Granisetron are? Serotonin (5-HT3) receptor antiemetics, used for Chemotherapy-induced emesis
Serotonin antiemetics include? Ondansetron and Granisetron
NK-1 (neurokinin) receptor antagonists include? Used for? 1. Aprepitant and Fosaprepitant Used for Chemotherapy induced emesis
a-1 and a-2 adrenergic antagoisnt Phenoxybenzamine
Phenoxybenzamine: irreversible a-1 & a-2 adrenergic antagonist that effectively reduces the arterial vasoconstriction induced by NE
Phenoxybenzamine is considered an ________________________. Non-competitive inhibitor
Irreversible inhibitor is another way to name _________________. Non-competitive inhibitor
Non-competitive inhibitor effects ______________________- Cannot be overcomed with increased concentration of drug due toe the binding to an allosteric site.
What are common finding in Renal Artery Stenosis (RAS)? Severe hypertension and Abdominal bruits
RAS causes the activation of the __________ system. RAAS
Activation of the RAAS system causes: 1. Increased RENIN secretion --> Increase in AT1 and AT2, which lead to an increased BP (blood pressure) 2. The increased BP leads to --> Increased Aldosterone secretion 3 Increased Aldosterone: - Increase renal Na+ reabsorption --> Relative Hypokalemia - Increase K+ and H+ secretion --> Metabolic alkalosis
Activation of RAAS system is seen ultimately with: Relative Hypokalemia and metabolic alkalosis
Ganciclovir: 1st line of treatment for CMV colitis and CMV-retinitis
MOA of Ganciclovir? Block CMV DNA polymerase
SE of Ganciclovir: Besides blockage of CMV-DNA pol, it can ALSO (lesser degree) block the Host's DNA polymerase, thus causing hematologic abnormalities.
What are the hematologic abnormalities caused by adverse effect of Ganciclovir? Neutropenia, anemia, and thrombocytopenia
The fatigue and recurrent infection status of a patient with chronic treatment of CMV-colitis, may be due to what kind of drug interaction? Ganciclovir indirect blockage of Host's DNA polymerase causing Neutropenia and anemia.
What is the side effects seen with Vincristine? Peripheral neuropathy and Neurotoxicity
SE of Bleomycin Pulmonary fibrosis and flagellate skin discoloration
SE of Doxorubicin Congestive heart failure
SE of Cyclophosphamide Hemorrhagic cystitis
Daptomycin is used for: Lipopeptide antibiotic with activity limited to gram positive organisms, including MRSA
Daptomycin MOA: 1. Depolarization of bacterial cellular membrane 2. Inhibition of DNA, RNA, and protein synthesis
What are associated SE of Daptomycin? 1. Increased creatine kinase (CK) 2. Increased incidence of Myopathy
Phenylephrine is an ____________________________. Selective a-1 receptor agonist
What is caused or produced by Phenylephrine? 1. Increase of Peripheral vascular resistance and Systolic PB 2. Decrease in Pulse pressure and Heart rate
What are the low Potency (Non-neurological) 1st generation antipsychotics? 1. Chlorpromazine 2. Thioridazine
What are some side effects associated with Low Potency 1st generation antipsychotics? - Sedation (histamine blockage) - Anticholinesterase -Orthostatic hypotension (a-1 blockade)
Which drugs are considered High Potency (Neurological) 1st generation antipsychotics? Haloperidol and Fluphenazine
What are some SE associated with Haloperidol and Fluphenazine? 1. EPS symptoms such as: - Acute dystonia - Akathisia - Parkinsonism
MRSA is can be treated with ____________________. Daptomycin
Foscarnet is an: analogue of PYROPHOSPHATE that can chelate Ca2+ and promote nephrotoxic renal Mg2+ wasting
The __________________ and _______________- caused by _______________, may lead to development of ___________________. Hypocalcemia and Hypomagnesemia; Foscarnet; Seizures
What is the treatment for Serotonin Syndrome? Cyproheptadine
Bosentan is: Competitive inhibitor of Endothelin receptors
What is the Bosentan used for? Treatment of Pulmonary Arterial hypertension (PAH)
What are some NON-Benzodiazepine drugs? Zolpidem, Zaleplon, Eszopiclone
What is the MOA of nonbenzodiazepines? Stimulate GABA-A receptors
What is the clinical used of Zolpidem? As a nonbenzodiazepine, used primarily hypnotics and don nor preuce the anxiolytic, muscle relaxant or anticonvulsants effects associated with benzodiazepines
Why are non benzodiazepines used for treatment of insomnia and not the benzodiazepines? Non-benzodiazepines DO NOT produce anxiolytic, muscles relaxant, or anticonvulsant effects.
Ramelteon Melatonin receptor agonist
Suvorexant Orexin receptor antagonist
Cilostazol is a phosphodiesterase inhibitor that inhibits platelet aggregation and acts as a direct arterial vasodilator.
What is the common use for Cilostazol> PAD (Peripheral arterial disease)
What is the most common drug used for treating PAD? Cilostazol
Along with Cilostazol, the treatment of PAD is usually accompanied by: Antiplatelet agent, such as Aspirin or Clopidogrel, for secondary prevention of coronary heart disease and stroke
What is prevented by the addition of Aspirin to Cilostazol therapy for PAD? SECONDARY prevention of coronary heart disease and stroke
Cidofovir is: Nucleoside monophosphate (nucleotide) that requires only cellular kinases for activation
What are nucleotides? Nucleosides with 1 or more attached phosphates
What are common nucleotide drugs? Cidofovir and Tenofovir
Suffix used for "nucleotide" drugs? -FOVIR
Which are the acyclovir prodrugs? Ganciclovir, Famciclovir, Valacyclovir
What do Acyclovir and acyclovir prodrugs require for their activation? Herpes Viral kinase and Cellular kinase
What are two Cell-dependent Nucleosides? Zidovudine and Lamivudine
Activated Nucleotide analogue causes ----> 1. Inhibition of DNA polymerase 2. Causes chain termination
Aminoglycosides: Inhibit genetic code and reading protein synthesis by dindin to the Prokaryotic 30S ribosomal subunit
What are the associated adverse effects seen with Aminoglycosides? 1. Ototoxicity --> Hearing loss and tinnitus (especially with loop diuretics) 2. Nephrotoxicity 3. Neuromuscular blockade 4. Teratogen
The use of ____ a _________________ diuretic increases the risk of developing Ototoxicity if combined with __________, an _____________. Furosemide -- Loop diuretic; Gentamicin -- Aminoglycoside
Mode of Resistance of Aminoglycosides such as gentamicin? Bacterial transferase enzymes (antibiotic-modifying) inactive the drug by acetylation, phosphorylation, or adenylation
What is the clinical use for Aminoglycosides? 1. Severe gram negative infections 2. Neomycin for Bowel surgery
Sevelamer: Non-absorbable anion-exchange resin that binds intestinal phosphate to reduce its absorption
What is a common drug used in CKD patients in order to reduce phosphate levels? Sevelamer
What are the two kinds of Phosphate binders? 1. Calcium-containing : calcium carbonate and acetate 2. Non-calcium contain: Sevelamer and Lanthanum
Sevelamer and Lanthanum are: Non-calcium containing phosphate binders.
Benzodiazepines bind to the ________________ -site, which: Benzodiazepine binding site; ALLOSTERICALLY modulates the binding to GABA, resulting in INCREASED frequency of Chloride ion channel opening
Increased FREQUENCY of Cl- channel opening is caused by: Benzodiazepines
What causes he hyperpolarization and inhibition of action potential when using benzodiazepines? The influx of Cl- into the neurons
The increased Cl- influx to neuron causes: 1. Neuronal hyperpolarization 2. Inhibition of Action Potential
Valproic acid: Reduce GABA catabolism
Which drugs are examples of direct blockage of the lumen of ion channels? Amiloride and Verapamil
Amiloride: affects the epithelial Na+ channels in the Distal portions of the nephron
Verapamil calcium channel bloker
Verapamil and Amiloride are examples of: Drugs that physically block the ion channel lumen
Zidovudine is a Cell-dependent nucleoside
Nucleoside RT inhibitor example: Zidovudine
What drug is commonly used in HIV + mothers during labor in order to prevent HIV transmission? Zidovudine
Zidovudine features are: Thymidine analogue that does not have a the normal 3-OH group found in thiamine
The addition of nucleotides to the growing DNA chain is done by forming _________________________ at the 3'end. Phosphodiester bonds
The addition of Zidovudine to HIV therapy, works by: Inability to form Phosphodiester bonds due to its abnormal 3-OH group.
What is a specific side effect of Zidovudine? Anemia
What are common side effects of all NRTIs? Bone marrow suppression and Peripheral neuropathy
Bisphosphonates MoA: chemical structure similar to PYROPHOSPHATE and attach to hydroxyapatite binding sites on bony surfaces to inhibit bone resorption by osteoclasts
Bisphosphonates work on ____________________. Osteoclasts
Bisphosphonates prevent: Bone resorption by osteoclasts
Denosumab: 1. binds to RANK-L and inhibits binding to RANK 2. Decrease differentiation and survival of Osteoclasts
Recombinant PTH analogue example: Teriparatide
What is the MoA of Teriparatide? - Stimulates maturation of Pro-Osteoblasts into bone forming osteoblasts - Increases GI calcium absorption and renal tubular Ca2+ reabsorption.
What kind of drugs have a similar chemical structure to Pyrophosphate? Bisphosphonates
What are the main two Class IC antiarrhythmics? Flecainide and Propafenone
Flecainide is: Potent sodium (Na+) channel blocker that have increased effect on faster heart rates
SE: proarrhythmic effects Class IC antiarrhythmics
What is an example of an proarrhythmic side effect found in Class IC antiarrhythmics? Prolongation of the QRS
Class IC antiarrhythmics: - Strong inhibition of Phase 0 depolarization - No changes in length of Action potential
Class IB antiarrhythmics: - Weak inhibition of Phase 0 depolarization - Shortened length of Action potential
Class IA antiarrhythmics: - Intermediate inhibition of Phase 0 depolarization - Prolonged length of action potential
What class of antiarrhythmics that block sodium channels, produce a strong inhibition of Phase 0 depolarization? Class IC
Shortened length of AP is seen with: Class IB antiarrhythmics
Prolongation in length of action potential is common in _________ sodium channel blockers antiarrhythmics. Class IA
Opiate analgesics work by: Reduce pain by binding to Mu receptors and inhibition synaptic activity in the CNS
Opioids may work on the ________________ or _____________ cell membrane of neurons. Presynaptic ; Postsynaptic
What occurs in times that opioids work on Presynaptic mu receptors? - Closedure of Voltage-gated Calcium channels and, - Decrease excitatory NT release
At times that opioids bind to postsynaptic Mu receptors, it causes: 1. Opening of K+ channels 2. Membrane Hyperpolarization
Which mu receptors need to be activated by opioids in order to close the Voltage-gated Calcium channels? Presynaptic Mu receptors
Membrane hyperpolarization and K+ channel opening in a neuron after mu receptor activation is due: Opioid binding to Postsynaptic Mu-receptors.
Bleomycin MOA: antineoplastic agent that binds to IRON and OXYGEN molecules to create FREE RADICALS that cause DNA strands to break.
MC side effect of Bleomycin is: Lung toxicity, which is presented by PULMONARY FIBROSIS
Pulmonary fibrosis caused by Bleomycin is presented with: Dyspnea and non-productive cough and PTFs show a Restrictive pattern with decreased diffusion capacity of Carbon monoxide (DLCO)
MoA of Doxorubicin 1. Binds to Topoisomerase II to cleave DNA 2. Binds to iron to generate free radicals
SE associated with Doxorubicin Dilated cardiomyopathy
Example of an anthracycline: Doxorubicin
MoA of Cisplatin Cross-links DNA to inhibit DNA synthesis
SE associated with Cisplatin: - Nephrotoxicity - Ototoxicity - Peripheral neuropathy
Cyclophosphamide MoA: Cross-links DNA to inhibit DNA synthesis
What are the most common side effects of Cyclophosphamide therapy? 1. Hemorrhagic cystitis 2. Bladder cancer
What is the mode of action of Paclitaxel? Inhibition of microtubule disassembly
What is the mode of action of Vincristine/Vinblastine? Binds to B-tubulin to inhibit microtubule formation
What is the shared side effect seen with Paclitaxel and Vincristine/Vinblastine? Peripheral neuropathy
Inhibition of microtubule assembly is seen in ____________________, while inhibition of microtubule formation due to binding of B-tubulin is associated with __________________. Paclitaxel; Vincristine/Vinblastine
BCL-2 inhibitor is used to treat __________________. CLL
What is a common BCL-2 inhibitor? Venetoclax
Mode of action of BCL-2 inhibitor? cause cancer cell death by promoting cytochrome c release form the mitochondria, which subsequently activates caspases.
Rituximab: antibody against B-cell marker CD20
Olaparib: Inhibits poly-ADP ribose polymerase, the enzyme that repairs single-stranded DNA breaks
Bortezomib: Proteasome inhibitor that prevents destruction of Ubiquitinated intracellular proteins.
Which organs have rapid drug distribution? Brain, Liver, kidneys, lungs, and heart
Why do the brain, liver, lungs, kidney, and heart have a rapid drug distribution? Due to accelerated and/or rapid blood flow
Which organs are depicted as poorly vascularized, thus with slow drug distribution? Those with reduced blood flow such as Skeletal muscle, fat, and bone.
Which type of drugs bind to antithrombin and increase the activity against factor Xa? Unfractionated Heparin and LMWH
What is the action of Unfractionated Heparin and LMWH? bind to ANTITHROMBIN in order to increase its activity against Factor Xa
What is a key feature of Unfractionated Heparin, not shared by LMWH? Only Unfractionated heparin binds to both, ANTITHROMBIN and THROMBIN to allow antithrombin to inactivate thrombin
Unfractionated Heparin binds to: Antithrombin and Thrombin, both
Unfractionated heparin binding to antithrombin and thrombin causes? Antithrombin to inactivate thrombin.
Common cardiac use of Atropine? Bradycardia
How is bradycardia treated by Atropine? Decreases vagal influence of SA and AV nodes (increase HR)
What is a common side effect of Atropine Increase intraocular pressure
Acute Closed-angle Glaucoma: Presents with UNILATERAL eye pain and visual disturbances (Halos).
What kind of individuals have higher risk of developing Closed-angle glaucoma when treated with Atropine? Inuit and Asian descent
Inhibit enterohepatic circulation of bile acids Bile acid-binding resins
What is a adverse effect of Bile acid resin monotherapy? Increased hepatic production of TGs---> Hypertriglyceridemia.
Bile acid resins cause: 1. Diversion of hepatic cholesterol to synthesis of newl bile acids 2. Increase uptake of cholesterol from circulation 3. Reduced blood LDL levels
What kind of drugs precipitate Neuroleptic Malignant Syndrome (NMS)? Dopamine antagonist
How is NMS similar in symptoms to Serotonin Syndrome? BOTH present with altered mental status and sympathetic hyperactivity.
What are the distinguishable features of NMS? 1. Diffuse muscle rigidity 2. Hyporeflexia
What is the common treatment for NSM? Dantrolene and Benzodiazepines
What is the precipitant for Serotonin Syndrome? Serotonergic agent
What are the distinguishing features of Serotonin syndrome? Clonus and hyperreflexia
Why does Buprenorphine causes precipitation of opioid withdrawal syndrome? It has a partial agonist effect that causes the displacement of other opiates used concurrently
Effects of competitive inhibition cause changes in: Potency
A left shift in drug curve graph, means? Increase in Potency
A up or down shift in a drug-curve graph, represents: Change in Efficacy
Changes in Efficacy have the same Vmax
A change in efficacy is accomplished by _____________________ inhibition, which a change in potency is done by ________________ inhibition. Efficacy ----> Non-competitive Potency -----> Competitive
The suffix "mab" represents: Monoclonal antibody
" -cept" represents: Receptor molecule
"-nib" suffix indicates: Kinase inhibitor
Etanercept: Receptor molecule that acts as a decoy receptor.
Etanercept is: Fusion protein of TNF-a receptor to IgG1
What effects occur on WBC count with the chronic use of corticosteroids? Increase Neutrophil count Decrease lymphocyte, monocyte, basophil, and eosinophil counts
Why the increase levels of Neutrophils in patients on corticosteroids? Due to the "demargination" of neutrophils previously attached to the vessel wall
"Demargination" is associated with: The increase levels of neutrophils seen in corticosteroid use
Skin effects of corticosteroids; 1. Central obesity, "buffalo" hump 2. Skin atrophy, bruisability (decreased collagen and fibroblast) 3. Proximal muscle weakness
What are the endocrine effects on chronic use of corticosteroids? - HPA axis suppression - Hyperglycemia -Hypogonadism - Osteoporosis (decreased bone formation , and decrease Ca/Phosphate absorption)
What is the main immune effect of chronic use of corticosteroids? Neutrophilia (neutrophil demargination)
What some CNS effects seen in prolonged corticosteroid use? Hypomania, Psychosis, and Sleep disturbance
Prolonged use of corticosteroids may increase the ____________ production. Surfactant
What drugs contribute to long-term survival in patients with HF due to LV systolic dysfunction? 1. B-blockers --> carvedilol, metoprolol 2. ACE inhibitors --> " -pril" 3. ARBs ----> Losartan 4. Aldosterone antagonists ---> Spironolactone, Eplerenone
Which two kind of cardiac/renal medications have not proven any long-term survival benefits? Calcium channel blockers and Diuretics (except for K+ sparing)
Fenoldopam: Selective Peripheral Dopamine-1 receptor agonist.
Hypertensive emergency is considered with: BP > 180/120 mm Hg + End-organ damage.
What is a common drug given to CKD patient with a persistent BP of 200/120 mm Hg? Fenoldopam
What are the expected effects of Fenoldopam? 1. Arteriolar dilation 2, Increases renal perfusion 3. Promotes diuresis and Natriuresis
Why is Fenoldopam used in renal insufficiency patients? It provides benefit to the kidney function by: - Increasing the renal perfusion and - Promoting diuresis and Natriuresis
What is the difference between Hydralazine and Fenoldopam use in Hypertensive emergencies? Fenoldopam is usually used in renal insufficiency patients, due to its effects on the kidneys, while Hydralazine doe not provide such benefits.
What are the associated side effects of Hydralazine? Reflex tachycardia and Sodium and fluid retention
What is the 1st line of treatment for Trigeminal neuralgia? Carbamazepine
What is the MoA of Carbamazepine? Inhibits neuronal high-frequency firing by reducing the ability of Na+ channels to recover form inactivation
What are two common side effects of Carbamazepine? 1. Bone marrow suppression 2. SIADH which leads to Hyponatremia
Which drugs block the NMDA receptors? Ketamine, Felbamate, and Memantine
What is the common use of Memantine? Treatment of Alzheimer dementia
Felbamate is an _____________ blocker that is used an an ________________. NMDA receptor blocker; Anticonvulsant
Ketamine is used as an general anesthetic
What drug irreversibly blocks P2Y component of ADP receptors on the platelet surface and prevents platelet aggregation? Clopidogrel
What receptors are blocked by Clopidogrel? P2Y
What drugs are used to prevent Thrombotic events? Apixaban( direct factor Xa inhibitor), and Warfarin
Which kind of drugs are used in acute coronary syndrome? LMWH
Inhibition of platelet aggregation is done by? Aspirin and Clopidogrel
What is the mode of action of Metformin? 1. Inhibits mitochondrial glycerophosphate dehydrogenase and complex I 2. Upregulates AMP-attached protein kinase
What are the metabolic effects seen with Metformin? 1. Decrease hepatic glucose production 2. Increase peripheral glucose uptake/ utilization
What are some adverse effects seen with Metformin? - Diarrhea - Lactic acidosis (increased risk of renal insufficiency)
How is metformin excreted? Renal clearance
Oseltamivir is an: Neuraminidase inhibitor
What is a common antiviral used for Influenza A and B? Oseltamivir
What is the action of Oseltamivir? Prevents newly formed virios for infected host cells and impairs viral penetration of mucous secretion that overlie the respiratory epithelium
Amantadine Impairs viral uncoating; used in Parkinson dementia
What is a common antiviral used in Parkinson dementia? Amantadine
Amantadine is used to treat _______________________ ____________. Parkinson dementia
What is the most common cause of death due to overdose of TCA? cardiac arrhythmias and refractory hypotension due to inhibition of Fast Na+ channel in cardiac myocytes.
What are the clinical signs of inhibitory effects of muscarinic ACh receptors due to TCA overdose? Tachycardia, delirium, dilated pupils, flushing, decreased sweating, hyperthermia, ileus, and urinary retention.
What is PD-L1? Ligand the bids to PD-1 on cytotoxic T-cells and inhibit their response.
What is the relation between on PD-L1 and cancer cells? Cancer cells avoid immune recognition by overexpressing PD-L1.
What is the clinical features Hypokalemia? Muscle weakness, cramps and possible rhabdomyolysis.
What is caused by Thiazide diuretics? Decrease of intravascular fluid volume which lead to Aldosterone production which case Increased K+ and H+ secretion in urine
Relative Hypokalemia and metabolic alkalosis is common in the use of __________________________ diuretics. Thiazide
Created by: rakomi