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***PHARMA***

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alapaj's version from 2017-06-18 16:46

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β lactams

Question Answer
PC-MoCPenicillin
PC-MoCCephalosporins
PC-MoCMonobactams
PC-MoCCarbapenems
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β lactamase inhibitors

Question Answer
CTSClavulanic acid
CTSTazobactam
CTSSulbactam
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common combinations

AU-TI-ZOAC/TC/PT
augumentinamoxicillin + clavulanic acid
timentinticarcillin + clavulanic acid
zostynpiperacillin + tazobactam
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Cell wall inhibition

groupgroupgroup
β lactamsBacitracinVancomycin
-Penicillins
-Cephalosporins
-Monobactams(azteronam)
-Carbapenems (MEDI - meropenem, ertapenem, doripenem, imipenem)
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Cephalosporins

1st gen.2nd gen.3rd gen.4th gen.5th gen.
cefazolincefaclorcefotaximecefepimeceftardine
cefadroxilcefuroximeceftriaxoneceftobiprole
cefixime
ceftibuten
ceftazidime
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protein synthesis inhibition

Aminoglycosides(amikacin, gentamycin, neomycin, streptomycin)
Tetracyclines(doxycycline)
Macrolides(azithromycin, erythromycin, clarithromycin)
Clindamycin
Streptogramins(quinupristin - dalfopristin)
Chloramphenicol
Linezolid

Avoid during pregnancy

Mnemonicantibiotic
MAN C TEST QVMetronidazole
MAN C TEST QVAminoglycosides
MAN C TEST QVNitrofurantoin
MAN C TEST QVChloramphenicol
MAN C TEST QVTetracyclines
MAN C TEST QVErythromycin
MAN C TEST QVSulfonamides
MAN C TEST QVTrimethoprim
MAN C TEST QVQuinolones
MAN C TEST QVVancomycin
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microorganisms causing infections

Meningitis - Small NHLOtitis media - Men'S HealthEye infection - SANG Corp Sinusitis - HISPanicPneumonia - community acquired Golden HISPanicPneumonia - atypical - MCL
S. pneumoniaeM. catharralisS. aureusH. influenzaS. aureusM. pneumoniae
N. meningitidisS. pneumoniaeN. gonnorheaS.pneumoniaH. influenzaChlamydia pneum.
H. influenzaeH .inflenzaeChlamydia trochomatisS.pneumoniaLeg. pneumophila
L. monocytogenes
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Upper respiratory tract - High SchoolSkin infection PSS społemGastritisFood poisoningUTISTD
H. influenzaP. aeruginosaH. pyloriP. aeruginosaT. pallidum
S. pyogenesS. aureusE. coliN. gonnorheae
S. pyogenesC. trochomatis
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Characteristic adverse effects

Question Answer
penicillinsSteven Johnson's syndrome
prokaine penicillinHoigne's syndrome
prokaine penicillin (IM)Nikolau syndrome
cephalosporinsdisulfiram like effect
vancomycinered man syndrome
tetracyclinesdental stains, bone accumulation
clindamycinclostridium difficile collitis
chloramphenicolgray baby syndrome (aplastic anemia)
sulfonamides <1%Steven Johnson's syndrome <1%
sulfonamideskernicterus
fluoroquinolonesdamage to growing cartilage
metronidazolemetalic taste, disulfiram like effect
interferonsflu like symptoms
cisplatinsevere GI symptoms
aminoglycosidesototoxicity & nephrotoxicity
tetracyclines 2phototoxicity
ethambutoloptical neuritis
isoniazydpolyneuritis
paranyzamidegout (dna moczanowa)
rifampinorange tears & sweat & urine
doxorubicinchronic & acute cardiotoxicity
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abbreviations

questionanswer
EC50potency
E maxefficacy
TD 50toxic dose
ED50therapeutic dose
LD 50lethal dose
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questions

questionanswer
staphylococcal active penicillinscloxacillin, oxacillin, naficillin
graded dose is used to measuremaximal efficacy
graded dose is calculated inindividuals
quantal dose is used to measuremedian effective dose
quantal dose is calculated inpopulation
pharmacodynamicswhat drug does to the body
therapeutic indexratio between toxic dose and therapeutic dose
therapeutic windowrange between
3 main macrolidesclarithromycin, azithromycin, erythromycin
Cell cycle non specific cancer drugsalkalyting agents, antibiotics - anthracyclines, mitomycin
atypical bacteriaMycoplasma, Chalmydia, Rickettsia
atypical bacteria treatmentmacrolides, lincosamides, tetracyclines, fluoroquinolones
drugs category xtetracyclines, fluoroquinolones, chloramphenicol
postantibiotic effect
drug metabolism phase 1oxidtation, hydrolysis, reduction
drug metabolism phase 2conjugation, sulfation, acetylation, glucorinidation
sulfonamides action
trimethoprim action
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! ! ! CREDIT 2 ! ! !

characteristic adverse effects

drug familyeffect
α blockersorthostatic hypotension
parasympathomimetics adverse effectsDUMB BELLS
parasympatholytics adverse effectscan't pee, see, spit, shit
atropineacute glaucoma
desfluranebronchoconstriction
halothanecardiac arrythmias, malignant hyperthermia
propofolpain at the injection site
olanzepinemetabolic syndrome, HTN, weight gain
risperidonecardiac arrythmias
ziprasidonecardiac arrythmias
clozapineagranulocytosis
lithiumcardiac arrest
typical neurolepticsneuroleptic malignant syndrome
aspirinReye syndrome, peptic ulcer, salicylism
aspirin toxic doserespiratory depression
opioidsconstipation, respiratory depression
acetaminophen poisoningliver failure
antidepressantsserotonin syndrome
COX2 inhibitorsMI
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antidotes

overdosed substanceantidote
granulophosphate (cholinergic poisoning)atropine
atropinephysostygmine(cross bbb)
malignant hyperthermiadantrolene
benzodiazepinesflumazenil
barbituratesno andidote
paracetamolN-acetylcysteine
morphinenaloxone
aspirineIV fluids & Na2CO3
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drugs mechanism of action

Question Answer
ketamineNMDA receptor
inhalational agentsGABA A receptor
opioids 1close Ca ++ channels
opioids 2open K+ channels --> hyperpolarisation
local anesthesiablock sodium channels (volume gated)
barbituratesincrease time of opening chloride channels
benzodiazepinesincrease frequency of opening chloride channels
lithiumnon-competitive inhibition of inositol (monophosphatase enzyme)
typical neuroleptics (+)D2 receptors
atypical neuroleptics(+)(--)5HT (serotonin) receptors
MAOidecrease plasma [3-O-methyldopa] which would compete with levodopa to enter CNS
Alzheimer drugsACh esterase inhibitors
memantineNMDA inhibitor
bupropioninhibits dopamine and NE reuptake
mirtazepineblock serotonin receptors and α2 receptors causing NE release
celecoxibselective COX2 inhibition
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Neurotransmitters and their function

Question Answer
adrenalinefight or flight
noradrenalineconcentration
dopaminepleasure
serotoninmood
GABAcalming
acetylocholinelearning
glutamatememory
endorphinseuphoria
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facts

Question Answer
MACmedial alveolar concentration, inversely proportional to potency
oli/gas partition coefficientdetermines solubility of the drug in adipose tissue; the higher solubility the higher potency
blood/gas partition coefficienthigh means slow induction and slow recovery(halothane) and opposite
IV anestheticsrapidly induced anesthesia; must be induced slowly
α1 & β1sympathetic system excitatory receptors
α2 & β2sympathetic system inhibitory receptors
ADHD treatmentmethylphenidate
lorazepan, oxazepanno active metabolites
positive symptoms of schizophreniaparanoid delusions, hallucinations, disorganized speech, disorganized or catatonic behavior
negative symptoms of schizophrenialoss of emotions, showing withdrawal, loss of speech, loss of motivation
opioid receptorsG protein receptor
muscarinic receptorsG protein receptor
nicotinic receptorion channel receptor
aspirineamong all NSAIDs is the one that binds irreversibly
COX2 selective drugscelecoxib
paracetamol single dose adults
paracetamol single dose children
paracetamol daily children
paracetamol daily adults
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therapeutic use of drugs

Question Answer
glaucomapilocarpine
trigeminal neuralgia & bipolar diseasecarbamazepine
nasal stuffinessnaphazoline, phenylephrine, oxymetazoline (decongestants)
diarrhea (OTC)loperamide
myasthenia gravisendrophonium, pyridostygmine, neostygmine
benign prostatic hyperplasia & HTNprazosin, doxazosin, terazosin
main antitussive agentdextrometorphan
ethosuximideabsence seizures
GI, postoperative ileusbethanecol, neostygmine
dry mouth (Sjorgen syndrome)cevimeline
reverse pharmacologic paralysisneostygmine
Alzheimer'sdonepezil, galantamine, rivastigmine
Parkinson's diseasebenzatropine
motion sicknessscopolamine
opthalmology disorderstropicamide
respiratoy disorders (bronchospasm)ipratropium, tiotropium
CDV disordersatropine
GI disorders (gastric ulcer)pirenzapine
urinary disorderssolifenacin, darifenacin, oxybutynin, tolterodine, trospium
surgical relaxation, intubationneuromuscular blockers
cerebral palsy, MS, strokespasmolytic drugs
bronchospasm (asthma)fenoterol, salbutamol, salmeterol
anaphylactic shockepinephrine
local anestheticsepinephrine
prevention of premature laborsalbutamol
HTNclonidine, proplanolol
Hypotensiondopamine
advanced life supportepinephrine
narcolepsymodafinil
ADHDmethylphenidate
chronic HTNprazosin family
pheochromocytomaphenoxybenzamine, phentolamine
Raynaud's diseaseprazosin
opioids withdrawal
alcohol withdrawal
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adrenoreceptordrugs acting on it
α1 & 2naphazoline
α1phenylephrine, methoxamine, oxymethazoline
α2clonidine
β1 & 2isoproterenol
β1dobutamine
β2salmeterol, formoterol, terbutaline
α & βadrenaline, noradrenaline, amphetamine, ephedrine, dopamine
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sympatolytics drugs

adrenoreceptordrugs acting on it
α1 & 2phentolamine, phenoxybenzamine
α1prazosin, terazosin, doxazosin
α2mirtazapine, yohimbine, tolazoline
β1 & 2propanolol, pindolol, sotalol, timolol, nadolol, aplrenolol
β1 cardioselectivemetoprolol, atenolol, acebutolol, bisoprolol, esmolol, alprenolol, nebivolol, celiprolol, betaxolol
β2butoxamine
α & βlabetalol, carvedilol
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opioids

Question Answer
strong agonistmorphine, fentanyl, methadone, oxycodone, HEROINE
moderate/low agonistcodeine
mixed antagonist / partial agonistbuprenorphine
antagonistnaloxone, naltrexone
otherstramadol, loperamide
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schzophrenia

Question Answer
What is the function of Mesolimbic-Mesocortical dopaminergic pathway?Controls behavior and psychosis
What is the function of Nigrostriatal dopaminergic pathway?Controls voluntary movement and coordination
What is the function of the Tuberoinfundibular system?Inhibits prolactin secretion from anterior pituitary
What occurs when the mesolimbic-mesocortical dopaminergic pathway is inhibited?Antipsychotic effects
What occurs when the nigrostriatal dopaminergic pathway is inhibited?Extrapyramidal side effects
What occurs when the tuberinfundibular system is inhibited?Hyperprolactinemia
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! ! ! CREDIT 3 ! ! !

Typical adverse effects

substanceadverse effect
thioamidesagranulocytosis
methotrexateteratogenicity, bone marrow toxicity
TNF inhibitors (monoclonal)infection, MS, seizures
GCSCushing's syndrome, hoarsness, oropharyngeal candidiasis
allopurinolpotentially lethal
probenecidnephrolithiasis
β2 agonistsmuscle tremor, tachycardia, arrythmia
theophyllinetachycardia, arythmias, HTN, seizure
zileutonincreased liver enzymes
codeinconstipation, dysphagia, fatigue
mucolyticsbronchorrhea
alendronateesophagitis
antimuscarinic agentsdry mouth, constipation, orthostatic hypotension
metforminlactic acidosis
insulin secreatgogueshypoglycemia, weight gain, disulphiram like effect
α- glucosidase inhibitorsabd pain, diarrhea, flatulence
methoclopramideParkinsonian like effects
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Question Answer
METHOTHREXATETERATOGENICITY, BONE MARROW TOXICITY
METFORMINLACTIC ACIDOSIS
METOCLOPRAMIDEPARKINSONIAN LIKE EFFECTS
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Mechanism of action

drugmechanism
neostygmineACh esterase inhibitor
metoclopramidedopamine D2 receptor antagonist
omeprazoleblock H+/K+/ATPase
alosetron5-HT3 receptor antagonist
DMARDspurine and pirymidine synthesis inhibitors
cyclosporineinhibits calcineurin and therefore IL-2 which is necessary for T anb B cell proliferation
MA(adalimumab, infliximab, etanercept)TNF-α inhibitors
theophyllineinhibits PDE - phopsphodiestrase
MA anakinraIL-1 inhibitor
allopurinol, febuxostatinhibit xantine oxidase
colchicineinhibitor of microtubule assembly
probenecidblocks uric acid reabsorption
aminosalicylatesdecrease prostaglandins
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Clinical use of drugs

drugsclinical application
beclometasone, budesonideCOPD/asthma
ketoconazoleCushing's syndrome, prostate cancer
aminoglutethimideCushing's syndrome
mitotaneadrenal carcinoma
spironaloctone, eplernanonecongestive HF
levothyroxinehypothyroidism
GERD, gastroparesisprokinetic, cholinomimetics
gallstonesursodiol
DVT/DIC/MI/PEanticoagulants
HITheparin, thrombin inhibitors
postheparin bleedingprotamin sulfate
oral anti Xa inhibitorsrivaroxaban
HIT in renal failureargotraban
HIT in liver failurebivalirudin, lepirudin
PE / DVT / acute MIfibrynolytic drugs
ischemic strokeaspirin
acute GoutNSAIDs, steroids, colchicine
chronic Goutallopurinol, probenacid, colchicine
Hay fevercromolyn
COPD 1st choiceβ2 selective agonists
asthma 1st choiceCS
allegry/asthmadamizumab (monoclonal ab)
magnesium saltsconstipation
ondasetronantiemetic 1st choice
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