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DIT
Study Guide- Phase 2 - Pharm
159
Medical
Professional
05/17/2013

Additional Medical Flashcards

 


 

Cards

Term

Cholinergic agonist

Muscarinic receptor agonist

promote Parasympathetic activity

 

Definition

Bethanechol

Carbachol

Pilocarpine

Methacholine

Term
Bethanechol
Definition

MOA: Cholinergic agonist

Uses: Post-op and neurogenic ileus

Urinary retention

Term
Carbachol
Definition

MOA: Cholinergic agonist

Uses: Glaucoma, Pupillary contraction, Relief of intraocular pressure

Term
Pilocarpine
Definition

MOA: Direct Muscarinic Agonist

Potent simulator of sweat, tears, saliva

Term
Methacholine
Definition

MOA: Direct Cholinergic agonist

Challenge test for ASTHMA diagnosis

Term

Indirect Agonist

(Anticholinersterases)

 

All Increase Endogenous ACh

Definition

Neostigmine

Pyridostigmine

Edrophonium

Physostigmine

Donepzil

Term
Neostigmine MOA & uses:
Definition

MOA: Anti-AChE

Post-op & neurogenic ileus & urinary retention

myasthenia gravis

reversal of NMJ blockade

 

NO CNS penetration

Term
Pyridostigmine MOA & uses:
Definition

MOA: Anti-AChE

Myasthenia gravis (long-acting)

 

NO CNS penetration

Term
Edrophonium MOA & uses:
Definition

MOA: Anti-AChE

Diagnose Myasthenia Gravis

Term
Physostigmine MOA & uses:
Definition

MOA: Anti-AChE

Glaucoma

Atropine overdose

 

DOES cross BBB --> CNS

Term
Cholinomimetic agents have common warning:
Definition

Watch out for:

COPD exacerbation

Asthma

Peptic ulcers

Term

DUMBBELSS

 

Sx of excessive ACh stimulation

Definition

Diarrhea

Urination

Miosis

Bradycardia

Bronchspasms

Excitation of CNS & Skeletal m

Lacrimation

Sweating

Salivation

Term
Antidote to excessive ACh (DUMBBELSS) Sx
Definition

Atropine + Pralidoxime

 

Pralidozime - MOA= reactivates inhibited AChE

Term

Alzheimer Disease meds

and MOA

Definition

MOA: Inhibit ACHE

Inc the levels of Endogenous ACh

 

Donepezil

Galantamine

Rivastigmine

Term
Oxybutynin MOA & uses:
Definition

MOA: Anti-muscarinic

Uses: Urge type urinary incontinence

Term
Atropine MOA & uses:
Definition

MOA: Anti-muscarinic

Uses: organophosphate poisoning

Term
Donepezil MOA & uses:
Definition

MOA: Anti-AChE

Use: tx Alzheimers disease

Term
Pralidoxime MOA & uses:
Definition

MOA: Regenerator of AChE

uses: 2nd choice for organophosphate poisoning if Atropine does not work

Term
Darifenacin MOA:
Definition
MOA: muscarinic antagonist
Term
Ipratropium MOA & uses:
Definition

MOA: muscarinic antagonist

uses:improves FEV1 in COPD bc dec bronchoconstriction

Term
Tiotropium MOA & use:
Definition

MOA: muscarinic antagonist

use: improve FEV1 in COPD bc dec bronchoconstriction

Term
2 muscarinic antagonists that improve FEV1 in COPD pt
Definition

Ipratropium

Tiotropium

Term
Tropicamide MOA
Definition
Muscarinic antagonist
Term
Benztropine MOA
Definition
Muscarinic antagonist
Term
Scopolamine MOA
Definition
Muscarinic antagonist
Term
Tolterodine MOA & use:
Definition

MOA: muscarinic antagonist

use: urge type urinary incontinence

Term
3 anticholinergics used for URGE type urinary incontinence:
Definition

Oxybutynin

Tolterodine

Darifenacin

Term
Trospium MOA & use:
Definition

MOA: muscarinic antagonist

uses: tx URGE type urinary incontinence

Term
Rivastigmine MOA & use
Definition

MOA: Anti-AChE

use: tx Alzheimer dz

Term
Homatropine MOA
Definition
MOA: muscarinic antagonist
Term
Other drugs that have Anti-cholinergic side effects:
Definition

1st generation H1 blockers: diphenhydramine, doxylamine, chlorpheniramine

Neuroleptics- Thoridazine, Chlorpromazine

Tricyclic anti-depressants

Amantidine

Term
Which pts should NOT get Atropine:
Definition
pts with: BPH, Hyperthermia (fever), ACUTE angle Glaucoma, Elderly, GI obestruction (ileus)
Term
Scopolamine MOA & use:
Definition

MOA: inhibit parasympathetics

motion sickness & dec oral secretions

Term
Anti-parasympathetic Sx:
Definition

Hot as a Hare - fever

Red as a Beet - flushing

Blind as a Bat - cycloplegia, mydriasis, no accomidation

Dry as a Bone - dec salivation

Mad as a Hatter - delerium

Bloated as a Toad - constipation & urinary retention

Tachycardia

Term

Antiarrhythmics type 3

K+ channel blockers - MOA

Definition

Ibutilide, Sotalol, Bretylium, Amiodarone, Dofetilide

"K IS BAD"

INC AP duration- phase3 of graph

INC QT interval: Torsades de pointes;

Monitor PFTs, LFTs, TFTs for Amiodarone

Term
Isoproterenol MOA
Definition

Non specific B agonist

works on both B1 and B2;

B1= Inc cardiac contracility; B2= vaso/broncho-dilation

Term
Digoxin toxicity
Definition

visual color changes, nausea, vomiting, anorexia, arrhythmias, Hyperkalemia

[The amt of serum K corresponds directly to amt digoxin]

tx: Mg or anti-digoxin Ab fragments

DO NOT give Sodium-Gluconate

Term
Isosorbide-5-mononitrate
Definition
Oral Nitrate with close to 100% bioavailability
Term
If patient just had MI and is now having arrhythmias give:
Definition

Lidocaine or Amiodarone

MOA: selectively depresses depolarization in myocardial cells

stops ventricular tachycardia

Term
Adenosine
Definition
Paroxysmal Supraventricular tachycardia
Term
B-blockers effect on EKG
Definition

Slow down AV conduction

Prolong atrial depolarization

EKG- Inc PR interval

Therefore, Dec HR

Term
What drugs induce long QT interval- Torsades de pointes
Definition
Quinidine & Sotalol
Term
Pharmacokinetic definition
Definition
What the BODY does to the drug
Term
Pharmacodynamics definition
Definition
What the DRUG does to the body
Term
Drugs that can cause SLE-like syndrome
Definition
Hydralazine, Procanamide, Isoniazid
Term
Adenosine
Definition

MOA: Inc K out of cell --> hyperpolarization

used for dx & tx SVT

toxicity: flushing, hypotension, chest pain

Term
Mg
Definition
tx for Torsades de pointes & Digoxin toxicity
Term
hydrochlorothiazide
Definition

MOA: inhibit NaCl reabsorption in early distal tubule

SE: High BLOOD uric acid, calcium, LDL, glucose

LOW BLOOD K, Na, and hypotension

Term
Anthracycline chemo drugs:
Definition

Doxorubicin, Daunorubicin

MOA: intercalates btwn DNA base pairs and blocks replication; generates free radicals --> dec DNA replication

SE: Dilated cardiomyopaty

Term

Best LONG-term treatment for

1. Pt with Essential HTN WITH CHF or diabetes

2. Pt with Essential HTN without CHF or diabetes

Definition

1. ACE inhibitor

2. Thiazide diuretic

Diuretics can be used for Sx relief of acute CHF, but not LONG-term

Term
Side effects of high doses of all Nitrates
Definition

Throbbing Headache & Cutaneous flushing

Nitrates work on VENOdilation, but at high high doses, they can cause arteriodilation --> side effects

Term
Lithium Teratogen
Definition

Used for tx Bipolar


Causes: Ebstein anomaly = atrialization of RV, bad tricuspid valve

Term
B1 selective antagonist
Definition

Acebutolol, Betaxolol, Esmolol, Atenolol, Metoprolol

A BEAM of B1 blockers; good for comorbid pulmonary dz

Term
Non-selective B antagonist
Definition

Propranolol, Timolol, Nadolol, Pindolol,

Please Try Not being Picky

SE: bad for asthma or COPD pts

Term
If I want to Inc survival rate of pt with CHF, what do I give?
Definition
Spironolactone or Carvedilol (a-&B-blocker)
Term
Seligiline
Definition

MOA:  MAO inhibitor, type B

preferntially metabolizes NE > serotonin ; Inc Dopamine levels

use: adjuvant with L-dopa for Parkinson dz

Term
Verapamil
Definition

Ca channel blocker; used for RATE CONTROL for A-fib w rapid Ventricular response; Dec conduction through AV node (can cause 1,2,3 AV block), Potent -Inotrope (Do NOT use for CHF); Slows Phase 0 & Phase 2 = No change to QT interval;

SE: Constipation & AV Block & gingival hyperplasia

Term
Sildenafil, Vardenafil & Nitrate MOAs:
Definition

Sil/Vardenafil: Inhibit cGMP phosphodiesterase

Nitrates: nitrates --> NO causes Inc cGMP (veins)

Use of both is CONTRindicated

Term
If Aspirin allergy, which med do you use for anti-thrombosis?
Definition

Clopidogrel

MOA: inhibits platelet aggregation by irreversibly blocking ADP receptors on platelets

Use if Aspirin allergy: bronchoconstriction & wheezing

Term
Class 1A antiarrythmics (Na channel blockers)
Definition

Disopyramide, Quinidine, Procainamide

"Double Quarter Pounder"

Inc AP duration; Inc QT interval

Term
Class 1B antiarrythmics (Na channel blockers)
Definition

Lidocaine, Tocainide, Mexiletine

"Lettuce, Tomato, Mayo"

Dec AP

Term
Class 1C antiarrhythmics (Na channel blockers)
Definition

Moricizine, Flecainide, Propafenone

"More Fries Please"

No affect on AP

Do not use Post-MI

Term
Phenoxybenzamine
Definition

MOA: alpha-blocker

use: Pheochromocytoma

Term
EPinephrine
Definition
binds to alpha and beta receptors
Term
2 Anti-Leukotriene receptor drugs
Definition

Zafirulukast

Montelukast - good for children

good to for tx asthma since decrease bronchial tone

Term
Isoniazid
Definition

MOA: Dec syn of mycolic acid; requires microbe to have catalase peroxidase in order to fight against it

toxicity can cause: neurotoxic (peripheral neuropathy), hepatotoxic, lupus

Prevent toxicity by supplementing Vit B6 (Pyridoxine)

The only med used as sole prophylaxis for TB

Term
Heparin/Enoxaparine
Definition

MOA: activates antithrombin3

improves binding of antithrombin3 to factor 2 (thrombin) & factor 10.

Enoxaparine- LMWH

use: PE, stroke, MI, DVT, pregnancy

Monitor: PTT

antidote: Protamine sulfate (+charge binds to Hep-)

Term
Lepirudin or Bivalirudin
Definition

Hirudin derivates

MOA: directly inhibit thrombin (factor 2)

alternative to heparin for anticoagulating pts with Heparin-Induced Thrombocytopenia

Term
Warfarin
Definition

MOA: disrupts carboxylation of Vit K depend clotting factors (2, 7, 9, 10) & proteins C, S.

Metabolized by cytochrome p450

Extrinsic pathway; INC PT

antidote: Vit K; for rapid reversal: Fresh Frozen plasma

Term
Rituximab
Definition

MOA: monoclonal Ab against CD20

Non-hodgkin lymphoma, RA

Term
Imatinib
Definition

MOA: Philadelphia chromosome bcr-abl tyrosine kinase inhibitor

use: CML, GI stromal tumors

Term
Clomiphene
Definition

MOA: Estrogen receptor modulator

prevents neg feedback to hypothalamus by estrogen so the body will continue to make more estrogen.

Use: women with PCOS who want to be pregnant

Term
B blockers & hyperthyroid
Definition

Dec HR, Dec anxiety

Dec peripheral conversion T4 --> T3; so overall less net thyroid hormone effect

Term
Raltegravir
Definition

HIV drug

MOA: Integrase inhibitor

cannot integrate into the host DNA --> no mRNA syn

Term
Efavirenz, Tenofovir, Lamivudine
Definition

HIV drug

MOA: Reverse transcriptase inhbitor

No complementary DNA syn of virus

Term
Maraviroc
Definition

HIV drug

MOA: CCR5 receptor inhibitor --> HIV cannot bind to host plasma membrane

Term
Saquinavir, Ritonavir
Definition

HIV drug

MOA: Protease inhibitor -->blocks proteolytic cleavage of virion

Term
Enfuvirtide
Definition

HIV drug

MOA: Fusion inhibitor --> HIV virion cannot fuse with host plasma membrane

Term
Theophylline toxicity
Definition

Sx: cardiac arrhythmias, seizures, abdominal pain, diarrhea, vomiting

antidote: gastric lavage, charcoal and cathartics, b-blockers

Term
Iron Poisoning
Definition
Sx: hematemesis, melena
Term
Beta Blocker toxicity
Definition

Sx: bradycardia, hypotension, CV collapse

antidote: Glucagon- Inc intracell cAMP and Inc cardiac contractility

Term
Opiod toxicity
Definition

Sx: severe sedation, respiratory depression, miosis

antidote: supportive care & give Naloxone/Naltrexone/Nalmefene

Term
Acetaminophen toxicity
Definition

Sx:liver damage

antidote: N-acetyl-cysteine (glutathione donor)

Term
Sumatriptan
Definition

MOA: post synaptic 5-HT receptor agonist

tx: Acute migraines

inhibits vasoactive peptides (CGRP & substance P) release from pre-synaptic neuron

INC vasoconstriction

do not use in CAD or Prinzmetal angina pts

Term
p-450 inducers
Definition
Quinidine, Barbituates, St. Johns Wort, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, Chronic EtOH, Phenobarbital
Term
p-450 Inhibitors
Definition

Erythromycin, Macrolides, Amiodarone, Grapefruit juice, Isoniazid, Cimetidine, Ritonavir, Acute Alcohol abuse, Cipro, Ketoconazole (azoles), Sulfonamides

E-MAGIC ROCKS

Term
Statins and p450
Definition
All statins (except Pravastatin) are metabolized via p450 liver cytochrome. So do not concurrently use a p450 inhibitor bc can cause toxicity
Term
Fludrocortisone
Definition
synthetic mineralcorticoid (aldosterone)
Term
Benzodiazepines
Definition

MOA: bind to GABAa receptors in CNS and enhance inhibitory effect of GABA.

uses: hyponotics (insomnia), anxiolytics (panic/anxiety), anticonvulsants (alcohol related seizures)

SE: daytime drowsiness, falls

Term

Short acting Benzodiazepines

(<10 hrs)

Definition

MOA: binds to GABAa receptors in CNS and enhances inhibitory effect of GABA

Alprazolam, Triazolam, Oxazepam

less daytime sleepiness, high addiction risk

Term

Medium acting Benzodiazepines

(10-20hrs)

Definition

MOA: bind to GABAa receptors in CNS and enhance inhibitory effect of GABA

Esazolam, Lorazepam, Temazepam

SE: moderately severe side effects

Term

Long-acting Benzodiazepine

(days)

Definition

MOA: inhibit GABAa receptor, enhance GABA inhibitiory effects

Chlordiazepoxide, Clorazepate, Diazepam, Flurazepam

SE: HIGH daytime drowsiness, Less addiction

Term
Methyltestosterone
Definition

Anabolic steroids - think this when professional athlete

Comedonal nodular eruptions = pimples

Term
If hypoglycemic loss of consciousness
Definition

Give IM Glucagon

(only give IM glucose if patient is still conscious)

Term
Zolpidem
Definition

Short acting hypnotic (sleep aid) - short term insomnia

not related to benzodiazepines but same MOA

MOA: bind to same portion of GABAa receptor and enhance inhibitory action of GABA

p450 metabolism

Less tolerance and addiction

Term
Opiod analgesics
Definition

Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine

MOA: agonist at opiod receptors; OPEN K channels, close Ca channels --> block synaptic transmission. Inhibit ACh, NE, 5-HT, Glutamate, substance P release

antidote: Naloxone or Naltrexone

Term
Methadone
Definition

treats Heroin addiction

MOA: mu receptor agonist; potent, long-acting opiate with good oral bioavailability

LONG-half life = dec withdrawl Sx

Term
Hirsuitism
Definition

due to Inc testosterone levels-> Inc DHT (5-a-reductase)

MOA Spironolactone: blocks androgen receptors at hair follicles & Dec testosterone prod; K-sparing diuretic

In men: it causes gynecomastia & small testicles

 

Term
6-mercaptopurine
Definition

ALL, lymphomas (not CLL or Hodgkins)

MOA: Purine (thiol) analog --> Dec de novo purine syn

activated by HGPRT

Metabolized by: Xanthine Oxidase

WARNING: dec dosage when used with ALLOPURINOL

Term
Allopurinol
Definition

MOA: Inhibits Xanthine Oxidase; dec Uric acid

Dec dose of 6-mercaptopurine if used together

 

Term
6-thioguanine (6-TG)
Definition

MOA: purine (thiol) analog --> dec de novo purine syn

use: ALL

OKAY to use with Allopurinol (6-TG is not affected by xanthine oxidase)

Term
Methotrexate (MTX)
Definition

MOA: Folic acid analog- inhibits dihydrofolate reductase

dec DNA syn & dec protein syn

use: leukemia, lymphoma, abortion, ectopic preg, RA

toxicity: myelosuppression can be reversed w Leucovorin; Macrovesicular fatty change in liver

Term
5-Fluorouracil (5-FU)
Definition

MOA: pyrimidine analog; covalently complexes with folic acid --> inhibits thymidylate synthase --> dec DNA syn & dec protein syn

synergistic with MTX

toxicity: myelosuppression - reversible w Thymidine

 

Term
Amphotericin B
Definition

MOA: binds to ergosterol in cell wall --> fungal wall lysis

use: systemic mycoses

MUST give K & Mg to maintain kidneys

toxicity: fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia. Use Lipsomal amphotericin to reduce toxicity

Term
PID tx:
Definition

treat for BOTH C. trachomatis & N. gonorrhea

C trachomatis- Azithromycin/Doxycycline

N. gonorrhea- 3rd gen Cephalosporin

If both are not treated --> infertility

Term

Typical Anti-psychotics (neuroleptics)

High & Low potency

Definition

High: Triflupperazine, Fluphenazine, Haloperidol

(Try to Fly High) - extrapyramidal Sx

Low: Chlorpromazine, Thioridazine (Cheating Thieves are Low)

Term

Typical Anti-psychotics (neuroletpics)

High potency

Definition

MOA: block Dopamine D2 receptors (Inc cAMP)

Trifluoperazine, Fluphenazine, Haloperidol

Extrapyramidal Sx: Dystonia (4hr), Akinesia (4d), Akathisia (4wk), Tardive dyskinesia (4mo)

tx: Benzitropine - gets rid of Akinesia

 

by blocking D2, you inc ACh, so muscles have more ACh --> EPS

Term

Typical Antipsychotics (neuroleptics)

Low potency

Definition

MOA: block Dopamine D2 receptors

Chlorpromazine, Thioridazine

Chloropromazine- Corneal deposits

Thioridazine- reTinal depostis

No EPS Sx

Term
Atypical antipsychotics
Definition

MOA: unknown, effects on 5-HT, dopamine, a, H1 receptors

Olanzapine, Clozapine, Quetiapine, Risperidone, Aripiprazole, Ziprasidone

use: improves Positive & Negative Sx; does not cause

Clozapien - check WBC bc can cause agranulocytosis

Risperidone- causes Amenorrhea, bc blocks dopamine, so inc prolactin --> no mentrual cycle

Term
Schizophrenia Positive & Negative Sx
Definition

Positive: Hallucinations (auditory), Delusions, disorganized Speech & behavior

Negative: Dec emotional range, lack of speech, loss on interest in living

 

Atypical (2nd gen) antipsychotics - improve Pos & Neg Sx

Term
Cocaine overdose & High BP/ Inc HR
Definition

DO NOT give B-blockers

Give Phentolamine: a1 blocker -> Dec BP

Term
Bisphosphonates
Definition

Etidronate, Pamidronate, Alendronate, Risedronate, Zoledronate (IV)

MOA: Inhibits osteoclastic activity; Dec formation & resorption of hydroxyapatite

toxicity: osteonecrosis of jaw, n/d

Term
Cyclosporine
Definition

MOA: inhibits Calcineurin --> prevents IL-2 prod

so blocks T cell diff and activation

use: suppresses organ rejection after transplant

Term
Tacrolimus
Definition

MOA: Binds to FK binding protein --> inhibits IL-2

uses: immunosuppresion during transplant

Term

Mifepristone (RU-486)

 

Definition

MOA: Progestin inhibitor at progesterone receptors

Use: abortion; Given with Misoprostol (PGE1)

Term
Desmopressin (DDAVP)
Definition

MOA: inc vWF release from endothelial cells

controls bleeding for mild forms of von Willebrand disease

von Willebrand Factor - secreted from endothelial cells, attaches to factor 8, Inc stability of factor 8; helps with platelet aggreg to endothelial cells --> platelet plug

Term
pts with von Willebrand disease present with:
Definition
bleeding during minor surgeries: tooth extraction
Term

Opiate/Narcotic Withdrawl

(Heroin, Morphine)

Definition

Abd pain, N/V, diarrhea, piloerection, pupil dilation, diaphoresis, fever

tx: Methadone- long acting oral opiate; has withdrawl Sx

Suboxone- Naloxone+Buprenorphine (partial agonist)- long acting with less withdrawl Sx

Term
Antibiotics that inhibit 50S
Definition
Streptogramins, Chloramphenecol, Linezolid, Macrolides, Clindamycin
Term
Antiobiotics that inhibit 30S
Definition
Tetracyclines, Aminoglycosides
Term
Tetracycline
Definition

MOA: bacteriostatic, binds to 30S ribosome subunit, prevents aminoacyl-tRNA from binding to complementary mRNA

Inhibits peptide bond syn.

resistance is plasmid mediated

Term
Niacin
Definition

Niacin --> Nicotinic acid --> Gouty arthritis;

SE: facial flushing & warmth- can be avoided with taking aspirin prior to niacin; Dec hepatic syn of VLDL & triglycerides & Inc HDL syn

Term
Thiopental
Definition
IV, induces anesthesia; highly lipid soluble; quickly enters brain then is reditributed to skeletal m; the redistribution is why it is cleared so quickly from the blood
Term
Glucose, Na, Urea
Definition

Net tubular reabsorption

Excreted amt << Reabsorbed/Filtered amt

Term
Inulin & Mannitol in kidneys
Definition

Not secreted or reabsorbed in renal tubules;

filtered amt = excreted amt

Term
PAH & Creatinine
Definition

Net Tubular Secretion

Excreted amt >> Filtered/absorbed amt

Term
Diphenhydramine
Definition
Anti-muscarinic; inhibits ACh receptors; if toxic- Hot as a Hare, Dry as a Bone, Bloated as a Toad, Tachycardia
Term
Fluoroquinolones
Definition

inhibit DNA gyrase (prokaryotic topoiromerase III)

topoisomerases put nicks in the DNA to relieve supercoils

Term

Anti-psychotic (neuroleptic)

tx: Positive Sx of Schizophrenia

Definition

Low potency: Chlorpromazine & Thioridazine

MOA: block D2 receptos (Inc cAMP)

Chlorpromazine = Corneal deposits

Thioridazine = reTinal deposits

Do not cause Extrapyramidal side effects

Term
K sparing diuretics
Definition

Can cause HyperKalemia; especially if pt has renal disfunction or is taking ACE inhibitors

Spionolactone, Triamterene, Amiloride

Term
Meds that can cause HYPERKalemia
Definition
Nonselective B-adrenergic blockers, ACEi, ARBs, K sparing diuretics, Cardiac glycosides (digoxin), NSAIDs
Term
Methotrxate v Corticosteroids
Definition

Methotrexate MOA: folic acid analog; inhibits dihydrofolate reductase -->dec DNA, dec protein syn. Slow, takes weeks to work.

Corticosteroid MOA: blocks Phospholipase A2 --> no PG, prostacyclines, thromboxane syn. Fast acting relief

Term
Tissue Plasminogen activator (t-PA)
Definition

converts Plasminogen --> plasmin

Plasmin breaks down fibrin --> thrombolysis

only attacks clots bc only active when fibrin is present

Term
Acute InterstitialNephritis (AIN)
Definition

Fever, rash, oliguria at 1-3wks after intiation of tx with B-lactam, NSAIDs, Sulfonamides, Rifampin or Diruetic.

Interstital edema with lymphocytes, macrophages, plasma cells, eosinophils. IgE-mediated hypersensitivity AND cell-mediated rxns --> cause AIN

Term
Octreotide
Definition

Somatostatin analog

MOA: inhibits GI and pancreatic hormones.

tx: Serotonin syndrome (wheezing, diarrhea, facial flushing, asthma) in pts with carcinoid tumors (appendix/liver); treats: acute variceal bleeds, acromegaly

Term
Disulfiram
Definition

MOA: inhibits acetaldehyde dehydrogenase

Use: help EtOH addicts to quit; causes hangovers!!!

Term
Fomepizole
Definition

MOA: inhibts alcohol dehydrogenase; antidote for methanol or ethylene glycol poisoning.

ethylene glycol toxicity= kidney; creates Ca-oxalate stones!

Term
Mineralcorticoid excess
Definition
Inc Aldosterone prod; causes: Na retention but normal Na levels, HTN, HypoKalemia, Metabolic Alkalosis- due to Aldosterone escape; Aldosterone is made in Glomerulosa of adrenal glands
Term
Aspirin
Definition

IRREVERSIBLE COX1 & COX2 INHIBITOR;

at low doses it only blocks COX1, but at higher doses it blocks COX2 also; always irrevrsible. All other NSAIDS are reversible

Term
Lab test to determine if Menopause
Definition
HIGH LH; the ovaries are no longer sensitive to LH, so LH levels will increase --> bc ovaries are not resposive. Ovaries do not work --> low estrogen; Sx: atrophic vaginitis, hot flashes.
Term
Acyclovir
Definition

MOA: HSV & VZV use thymadine kinase to monophorphorylate acyclovir --> activate acyclovir

 

EBV & CMV does not have thymadine kinase, so cannot activate acyclovir

Term
Bile Acid Resins
Definition

Cholestyramine, Colestipol, Colesevelam

MOA: prevents intestinal absorption of bile acids, liver must use cholesterol to make more bile;

SE: cholesterol gallstones!

do not use in pts with previous gallbladder hx

Term
Fibrates
Definition

Gemfibrozil, Clofibrate, Bezafibrate

MOA: upregulates LPL -> Inc Triglyceride clearance

Dec in triglyrcerides

SE: cholesterol gallstones

Do not use in pts with previous gallstone hx 

Term

Acute Gout

Chronic Gout

Definition

Acute: NSAIDS (Indomethacin), Cochicine

Chronic: Allopurinol

 

Term
Oral estradiol for Menopause
Definition
Term
hereditary spherocytosis
Definition

defect in RBA membrane- ankyrin & spectrin

small, low MCV, NO central pallor

positive osmotic fragility test; aplastic crisis with B19 infection

Term

Conns syndrome = metabolic alkalosis

salicylates = anion gap metabolic acidosis

Definition
Term
HPV virulence factor
Definition
prod E6 and E7 which inhibit p53 & Rb, so there is no regulation on of cell division -->squamous cell carcinoma
Term
Cholestyramine
Definition

MOA:  bile acid sequestrant, which binds bile in the gastrointestinal tract to prevent its reabsorption

Stops the itching assoc with excess bile


Term
Coronary Steal Phenom
Definition

Adenosine & Dipyridamole - myocardial perfusion imaging

vasodilation of coronary arterioles in nonischemic regions. leads to dec perfusion pressure within the collateral microvessels supplying the ischemic myocardium, diverting blood flow away from the ischemic areas --> non-ischemic areas.

Term
tx for combined Tonic-Clonic & Absence seizures
Definition
Valproic Acid
Term
Lithium with which 3 drugs can cause Li toxicity?
Definition
NSAIDS, ACEi, Thiazide diruetics
Term
Modafenil
Definition
Tx: Narcolepsy
Term
HIV related CMV retinitis
Definition

Gancyclovir, Foscarnet, Cidovovir

Foscarnet- causes HYPOcalemia, HYPOMg

Term
Phenytoin SE
Definition

SE: generalized lymphadenopathy, no serum sickness, hirsuitism, coarsening facial features, acneform skin rash, gingival hyperplasia.

WHat does Phenytoin treat?: tonic-clonic & psychomotor seizures

Term
Aresenic poisoning antidote
Definition
Dimercaprol
Term
Zolpidem
Definition

tx: Insomnia; Non-benzodiazepine hypnotic

SE: strange sleep behavior, eating, talking on phone & sleep walking

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