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First Aid Drugs

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riosju10's version from 2016-06-11 13:46

Classic SE

Question Answer
dilated cardiomyopathydoxo/daunorubicin
pulmonary fibrosisbleomycin, amiodarone, busulfan
hot flashestamoxifen and clomiphene
hypothyroidismlithium and amiodarone
gingival hyperplasia, hirsuitismphenytoin
photosensitivtysulfonamides, amiodarone, tetracycline
SLEhydralizine, INH, procainamide, phenytoin
faconi's syndrome (abnormal reabsorption of solutes in PCT)expired tetracyclines
DILi and demeclocycline
dilsulfiram like reactionmetornidazole, procarbzeine, 1st gen. sulfonylureas
neprho + ototoxaminoglycosides, vancomycin, loop dirutics, cisplatin
yellow visiondigoxin
garlic breatharsenic poisoning
memorize

P450 interactions

Question Answer
Barbituatratesinducer
st. john's wortinducer
phenytoininducer
rifampininducer
griseofulvininducer
carbamazepineinduc
protease inhibitors (-navirs)inhibitor
ketoconazoleinhibitor
erythromycin (macrolides)inhibitor
grapefruit juiceinhibitor
sulfonamidesinhibitor
cimetidineinhibitor
isoniazideinhibitor
-azolesinhibitor
ciprofloxacininhibitor
drugs metabolized by acetylationisoniazid, rifampin, 5-FU
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Cephalosporin Generations

Question Answer
cefazolin1
cephalexin1
cefoixtin2
cefaclor2
cefuroxime2
ceftriaxone3
ceftaxime3
ceftazidime3
cefepime4
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Atbx mechs

Question Answer
aminoglycosidesbinds to 30S and distorts to prevent initiation
tetracyclinesinterferes with aminoacyl-tRNA binding to A site (30S)
chloramphenicolinterferes with the formation of peptide bonds (inhibits peptidyl transferase) (works on 50S)
macrolidesblocks translocation (binds to 50S)
clindamycinbinds to inhibits 50S
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All Mabs

Question Answer
daclizumabmab @ IL-2 receptors
basiliximabmab @ IL-2 receptors
muromonabmab @ cd3 > blocks T-cells from interacting with macrophages
trastuzumabmab @ her2, cardiotox
imatinibmab @ BCR-abl RTK; CML
rituximabmab @ cd20, B-cell neoplasms and RA
adalimumabmab @ TNF; RA, psoriasis, AS
infliximabmab @ TNF; can reactivate TB
abciximabmab @ IIb/IIIa > prevents platelet aggregation
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Tricky T's

Question Answer
TamsulosinFlomax; α1a blocker
TemazepamRx for inability to stay asleep
Terbutalineβ-2 agonist; asthma, suppression of premature labor
Tolazolinereversible α2 blocker
TolcaponeCOMT inhibitor
Tolterodineantimuscarinic t used to releive bladder spasms
Topiramateantiepileptic used for treating bipolar
TranylcypromineMAOI; direct sympathomimetic action and releases NE
Trazodoneatypical, NE and weak 5-HT reuptake inhibitor; active metabolite-CPP > causes 5-HT antagonism at low doses and agonist and high doses; priapism
TriazolamRx for recurring insomnia; tolerance, rebound insomnia
Ticlopidinelike clopidogrel
Tacrolimusimmunosuppresamnt
Thioridazinetypical antipsycotic
Triamerenepotassium sparing diuretic that works by by blocking Na channels
Tropicamideantimuscarinic for glaucoma
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Autonomic

Question Answer Column 3
bethanecholdirect chol agonistpost-op ileus and urinary retention (bowel and bladder)
carbacholdirect chol agonistglaucoma, pupillary contraction
carpinedirect chol agonistopen angle and narrow angle glaucoma, resistant to AChE; (PILE on the tears and sweat)
methacholinedirect chol agonistchallenge test for asthmatics (closes down airways)
neostigmineanticholinesterase (indirect chol agonist)post-op, MG (no CNS penetration)
pyriodstigmineanticholinesterase (indirect chol agonist)MG (no CNS penetration)
edrophoniumanticholinesterase (indirect chol agonist)diagnosis of MG (very short acting)
physostigmineanticholinesterase (indirect chol agonist)glaucoma and atropine OD (PHYS for EYES)
echothiophateanticholinesterase (indirect chol agonist)glaucoma
atropinemuscarinic blockerrelaxation of iris sphincter > mydriasis
tropicamidemuscarinic blockerrelaxation of iris sphincter > mydriasis
benzotropinemuscarinic blockerrelaxation of iris sphincter > mydriasis
scopolaminemuscarinic blockermotion sickness
ipratropiummuscarinic blockerasthma and COPD help (I pray I can breathe soon!)
oxybutyninmuscarinic blockerreduce urinary uregency
glycopyrrolatemuscarinic blockerreduce urinary urgency
methscopolaminemuscarinic blockerpeptic ulcer Rx
pirenzepinemuscarinic blockerpeptic ulcer Rx
propathelinemuscarinic blockerpeptic ulcer Rx
mecamylaminenicotinic blockernon-depolarizing ganglion blocker
epinephrineallopen angle glaucoma, asthma
norepinephrinesympathetic agonist α more than βhypotension
isoproterenolsympathetic agonist isolates on βAV block
dobutaminesympathetic β agonist (β1 more)shock
phenylephrineα1 agonist (more than α2)pupillary dilation, vasoconstriction, nasal decongestion
metaproteranolselective β2 agonistacute asthma
albuterolselective β2 agonistacute asthma
salmeterolselective β2 agonistlong term Rx of asthma
terbutalineselective β2 agonistreduce pre-mature contractions of uterus
ritodrineβ2 agonistreduce pre-mature contractions of uterus
amphetaminereleases stored catecholaminesnarcolepsy, obesity, ADD
ephedrinereleases stored catecholaminesnasal decongestion, urinary incontinence, hypotension
cocainecatecholamine uptake inhibitorvasoconstriction, local anesthetic
clonidinecentral α2 agonist ∴ decreases adrenergic outflowhypertension
phenoxybenzamineirreversible nonselective α blockerpheochromocytoma
phentolaminereversible nonselective α blockerpheochromocytoma
prazosinα1 blockerHTN, BPH
terazosinα1 blockerHTN, BPH
doxazosinα1 blockerHTN, BPH
mirtazapineα2 blockerdepression
timololnonselective β blockerreduces aqueous humor production in glaucoma
nadololnonselective β blocker
selective β1 blockersacebutolol, betaxolol, esmolol, atenolol, metoprolol
acebutololβ1 blockerbetter if PT. has coexisting pulmonary disease
betaxolol β1 blockerbetter if PT. has coexisting pulmonary disease
esmolol β1 blockerbetter if PT. has coexisting pulmonary disease
atenolol β1 blockerbetter if PT. has coexisting pulmonary disease
metoprololβ1 blocker better if PT. has coexisting pulmonary disease
carvedilolα and β blocker
labetalolα and β blockerHTN emergency
pindololβ blocker with partial β-agonismcontraindciated in angina
acebutulolβ blocker with partial β-agonismcontraindciated in angina
donepezilselective cholinesterase inhibitor: alzheimer's treatment
tacrin selective cholinesterase inhibitor: alzheimer's treatment
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Cardio

Question Answer
hydralazine↑ cGMP > vasodilates arterioles > reduces afterload; anti-HTN for pregnant women
administer hydralazine with ____ because of ____.β blocker because of reflex tachycardia
hydralazine SElupus!, compensatory tachycardia
SE of amlodipine/nifedipineperipheral edema
SE of all CCBsconstipation
isorbide dinatrateincreases cGMP in veins > reduction in preload, agina, pulmonary edema
nitroprusside↑ cGMP via direct release of NO; can cause cyanide tox
fenoldopamD1 agonist > relaxes renal vascular smooth muscle; HTN emergency
diazoxideK channel opener; hyperpolarizes vascular smooth muscle; hyperlgycemia
niacin mechinhibits lipolysis in adipose tissues; reduces hepatic vldl secretion
niacin SEhyperglycemia, hyperuricemia
cholestyramine, colestipol, colesevelam main effectresins=lower LDL
resins main SE other than GI upsetcholesterol gallstones (because causes more cholesterol to be made in bile)
ezetimibe main effectlower LDL (nothing else actually)
fibrates main effectlower TG
fibrates mechanismupregulate LPL
use of digoxinCHF and atrial fibrillation (because it decresses conduction of AV node)
digoxin SEcholinergic effects, yellow vision
digoxin effects on ECG↑ PR, ↓ QT, hyperkalemia (pointed T waves)
digoxin and K?don't use with hypokalemia (will bind more to channel)
class IA drugsdouble quarter pounder; disopyramide, quinidine, procainamide
class IA effect on AP↑ QT (like class III) and lengthen overall AP
procainamide SElupus
class IB drugstomato, lettuce, mayo; tocainide, lidocaine, mexiletine
class IB effect on APshorter AP
class IC drugsextra fries please; encainide, flecanide, propafenone
class IC indicationcan only give to pts without structural abnormalities (i.e. not after MI)
Class IC effect on APno effect
hyperkalemia and class I antiarrhythmicsincreased toxicity
sotalolclass III
ibutilideclass III
bretyliumclass III
dofetilideclass III
flecanideclass IC
amiodaroneclass III (with properties of other classes)
class III affect on APlooks like IA (↑ AP and ↑ QT) - used when others fail
amiodarone SEpulmonary fibrosis, hepatox, thyroid issues (remember iodine), blue skin!
antiarrhythmic that works on nodesclass IV
adenosine mechincreasaes K out of cells > hyperpolarization
theophyllineblocks effects of adenosine
Mg can be used to Rx ____ toxdigoxin
Why do you not combine statins and fibrates?increased risk of myositis and rhabdomyolysis
No ____ in variant angina.beta blockers
Amiodarone and torsades?actually low incidence
Antidote for beta blocker overdose?glucagon
quinidine SEhemolytic anemia
memorize

Endocrine

Question Answer
lisprorapid acting insulin
aspartrapid acting insulin
regular insulinquick (but not rapid) acting insulin
NPHintermediate insulin
glarginelong-acting insulin
detemirlong-acting insulin
tolbutamide1st generation sulfonylurea
chlorpropramide1st generation SU
1st generation SU SE?disulfiram rxn
mechanism of SU?closes K channels > cell membrane depolarizes > ca influx > release of insulin
metforminbiguinide; decreased gluconeogenesis, increased glucose uptake
SE of metforminlactic acidosis ∴ contraindicated in renal failure
glitazones mech↑ insulin sensitivity via PPAR-γ receptor (transcription factor)
glitazones SEweight gain, edema, hepatotox, CV tox
acarboseα-glucosidase inhibitor
miglitolα-glucosidase inhibitor
pramlintideamylin analog > ↓ glucagon
exenatideGLP-1 analog > ↑ insulin and ↓ glucagon
exenatide SEpancreatitis
propylthiouracilinhibits thyroperoxidase; also decreases peripheral conversion of T4 to T3!; use propylthiouracil if pregnant
SE of hyperthyroid drugsskin rash, agranulocytosis, aplastic anemia
methimazoleinhibits thyroperoxidase; safer but teratogen
demeclocyclineADH blocker; used for SIADH; can cause DI; member of tetracycline family > photosensitivity, bone and teeth abnormalities
glucocorticoid mechinhibits phospholipase A2 > less of all inflammatory molecules
memorize

Heme

Question Answer
Follow ____ while pt. is on heparinPTT
Follow ____ while pt. is on warfarinPT
anticoagulant during pregnancyheparin
HIT?heparin induced thrombocytopenia; use lepirudin or bivalirudin instead
antidote to heparinprotamine sulfate
antidote to enoxaparinnone
heparin mechactivates antithrombin > ↓ thrombin and Xa
-rudinleech; directly inhibit thrombin
SE of warfarinskin necrosis
warfarin inhibits production of these six factors. Which goes first?II, VII, IX, X, C, S
streptokinaseactivates plasmin
urokinaseactivates plasmin
anistreplaseactivating plasmin
aminocaproic acidreversing tPA
ASAacetylates Cox-1 and cox-2 (irreversible); ↑ bleeding time
clopidogrelirreversibly blocks ADP receptors > inhibits platelet aggregation; inhibits IIb/IIIa expression > inhibits fibrinogen binding
ticlopidinesee clopidogrel, SE: neutropenia
abciximabbinds to IIb/IIIa > prevents platelet aggregation
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Onc

Question Answer
M phase drugsvinca alkaloids and taxols
G1 drugsnone
S phase drugsantimetabolites, etoposide
G2 drugsetoposide, bleomycin
methotrexatefolic acid analog > inhibits DHF reductase > ↓ dTMP
non-onc MTX usesabortion, ectopic pregnancy, RA, psoriasis
MTX SEreversible myelosuppression, fatty change in liver (LFTs), teratogen
leucorvinfolinic acid; reverses MTX myeloid suppression
MTX vs. 5-FU usageleukemias vs. solid
5-FUbioactivated to 5F-dUMP > complexes folic acid > ↓ dTMP
5-FU tox reversalNOT leucovorin, thmidine!
5-FU SEphotosensitivity
6-MPthiol analog > down de novo purine synth
6-MP drug interaction?metabolized by xanthine oxidase ∴ increased when taking allopurinol
6-MP SEbone marrow, GI, liver, tox
cytarabine (ara-C)inhibits DNA polymerase
ara-C SEmegaloblastic anemia
dactinomycinintercalates into DNA; childhood-tumors
doxorubicingenerates free radicals > breaks DNA; Hodgkins, cardio tox
adriamycinsame as doxorubicin
bleomycininduces free radicals > breaks DNA; used to Rx testicular ca and Hodkins; pulmonary fibrosis
etoposideinhbits topoisomerase II; alopecia
cyclophosphamidecross-links DNA at guanine N-7
cyclophosphamide SE? Rx with?hemorrhagic cystis > mesna
Rx brain tumors?nitrosureas (-mustines and streptozocin)
streptozocinanti-brain tumor nitrosurea, gets activated by liver
-mustinesanti-brain tumor nitrosureas, get activated by liver
busulfanalkylates DNA, CML, pulmonary fibrosis, hyperpigmentation
vincristine SEneurotoxicity (peripheral neuropathy), paralytic ileus
vinblastine SEbone marrow suppression
vinca alkaloid mechanismbind to tubulin in M-phase - mitosis spindles cannot form
paclitaxel mechhyperstabilize already built microtubules (anaphase cannot occur)
cisplatincross-links DNA, nephrotox, acoustic nerve damage
carboplatincross-links DNA, nephrotox, acoustic nerve damage
hydroxyureainhibits ribonucleotide reductase > ↓ DNA synth
why is raloxifene better than tamoxifen for breast cancer?antagonist at endometrium > no higher risk of endometrial cancer
trastuzumabmab @ her2, cardiotox
imatinibmab @ BCR-abl RTK; CML
rituximabmab @ cd20, B-cell neoplasms and RA
memorize

Immune System

Question Answer
Cyclosporin mechbinds cyclophilin > inhibits calcineurin > decrease IL-2
cyclosporin SEnephrotoxicity
tacrolimus mechbinds FKBP > inhibits calcineurin > decrease IL-2
tacrolimus SEnephrotox, peripheral neuropathy, HTN, pleural effusion, hyperglycemia
sirolimus mechbinds to mTOR > inhibits T-cell proliferation
sirolimus SEhyperlipidemia, thrombocytopenia, leukopenia
daclizumabmab @ IL-2 receptors
basiliximabmab @ IL-2 receptors
azathioprineprecursor to 6-MP > blocks purine synthesis
azathioprine drug interactiontox ↑ in presence of allopurinol
muromonabmab @ cd3 > blocks T-cells from interacting with macrophages
aldesleukinIL-2 renal cell carcinoma, metastatic melanoma
filgrastimrecovery of bone marrow (G-CSF)
sargramostimrecovery of bone marrow (GM-CSF)
α-INFhepatits B and C, kaposi sarcoma, leukemia
β-INFmultiple sclerosis
γ-INFchronic granulomatous disease
romiplostimthrombocytopenia
oprelvekinIL-11
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