bananas's version from 2015-05-29 02:45


Question Answer
Class I AntiarrhythmicsNa+ channel blockers
Class IaDisopyramide, Quinidine, Procainamide [Double Quarter Pounder]
Class IBLidocaine, Maxiletine, Tocainide, Phenytoin [Lettuce, Mayo, Tomatoes Please]
Class ICFlecainide, Propafenone [Fries Please!]
Class IIBeta blockers [olol]
Class IIIK+ Blockers: Amiodarone, Ibutilide, Dronedarone, Sotalol [AIDS]
Class IVNon-dihydropyridine CCB: Diltiazam, Verapamil [Ditzy Vera]
What are the 4 classes of antiarrhythmics?Na+ block, Beta block, K+ block, CCB
[No Bad Boy Keeps Clean]
What does Ia do to the AP?Lengthens the AP (right shift)
What does Ib do to the AP?Shortens AP (left shit)
What does Ic do to the AP?Slows down phase 0 depolarization
Who needs a Ia?Ventricular arrhythmia, WPW (Procainamide)
Who needs Ib?V-tach, Post MI
Who needs Ic?Paroxysmal A-fib, Recurrent arrhthymias, Post-MI
What do beta blockers do?Phase 4: Decrease MI mortality, Prevent tachyarrhythmias
What does III do?Phase 3: Prevents re-entry, Decrease AP duration
What is III used for?WPW, A-fib, V-tach (sotalol), A-flutter (Ibutilide)
What does class IV do?Phase 0: Slow upstrokes, Increase refractory period between AP's. Prolongs PR interval.
What are class IV used for?PSVT, A-fib
Which antiarrhythmics prolong QT?Class Ia and III [Torsades de Pointes!]
What is Sotalol used for?V-Tach and A-Fib [AIDS]
What is Ibutilide used for?Atrial flutter, A-Fib [AIDS]

Lipid lowering agents

Question Answer
Statin MechanismInhibits HMG CoA reductase (cholesterol synthesis)
Causes hepatocytes to increase expression of LDL receptors
StatinsRosuvastatin, Atorvastatin, Simvastatin
↓↓ LDL
Side effects of StatinsHepatotoxic
Muscle Toxic
Activates PPAR-alphaFibrates
Side effects of FibratesMuscle toxicity and Gallstones
Bind bile acids in the intestine to block reabsorptionCholestyramine
↓ LDLBile acid binders
Side effects of Bile Acid BindersNausea, Bloating, Cramping, Impaired absorption of ADEK
Decrease FA synthesis and releaseNiacin (B3)
Side effects of NiacinFlushing, Pruritis, Hepatotoxic
↓ TriglyceridesOmega-3 Fatty Acids
What is the mechanism of Bile-acid-binding resins?Bind bile causing the liver to make (and use up) cholesterol


Question Answer
Inhibit CalcineurinCyclosporine, Tacrolimus, Pimecrolimus
Binds CyclophilinCyclosporine: Binds cyclophilin to block Calcineurin complex, inhibiting IL-2 transcription and T-cell proliferation
Toxicity of CyclosporineNephrotoxic: Vasoconstricts afferent and efferent.
Gingival hyperplasia, hirsutism
Binds FK-binding proteinTacrolimus and Pimecrolimus: Bind FKBP to block Calcineurin complex, inhibiting IL-2 transcription and T-cell proliferation
Side effects of TacrolimusNephrotoxicity
(no gingival hyperplasia or hirsutism)
mTOR inhibitorSirolimus (Rapamycin): binds mTOR receptor on T cells so they can't respond to IL-2
Side effects of SirolimusAnemia, Thrombocytopenia
Which Calcineurin inhibitor is not nephrotoxic?Sirolimus [Kidney "sir"-vives]
Antimetabolite of 6-mercaptopurineAzothioprine: Blocks purine synthesis [AzothioPURINE]
Side effects of AzothioprineBone marrow suppression: Leukopenia, anemia and thromboytopenia
Allopurinol is contraindicated withAzothioprine.
6-MP is degraded by XO and allopurinol inhibits XO. Results in greater toxicity
Suppresses IMP dehydrogenase?Mycophenolate: Blocks guanine synthesis thereby blocking lymphocyte proliferation
Monoclonal antibody targeting TNF-alphaAdalimumab, Infliximab
Decoy TNF-alpha receptorEtanercept
Monoclonal antibody targeting IgEOmalizumab
Monoclonal antibody targeting CD20Rituximab: CD20 is a B-cell marker
Monoclonal antibody targeting HER2Trastuzumab [Her-2, Traz-2-mab]
Causes phocomeliaThalidomide
Inhibits IL-2Tacrolimus and Cyclosporine


Question Answer
Treats Transplant rejectionCyclosporine, Tacrolimus, Mycophenolate
Treats Kidney transplant rejection prophylaxisSirolimus, Daclizumab, Azathioprine
Treats RACyclosporine, Azathioprine, Adalimumab/Inflixumab, Rituximab
Treats SLEAzathioprine
[ Off-label: Mycophenolate and Cyclosporine]
Treats Crohn'sAzathioprine
Treats GlomerulonephritisAzothioprine
Treats Seronegative arthopathiesAdalimumab, Infliximab, Etanercept
Treats Refractory AsthmaOmalizumab
Antidote for digoxin?Digoxin immune fab
Treats LymphomasRituximab


Question Answer
Acute mania monotherapyMood stabilizers: Lithium

MSK drugs

Question Answer
EtanerceptTNF-alpha inhibitor: Fusion protein that links TNF alpha receptor to Fc IgG
Soluble decoy receptor


Question Answer
Partial Mu agonistPentazocine. Acts as antagonist against morphine (can cause opioid withdrawal)



Question Answer
BronchospasmB2 blockers
Asthma attackB2 agonist (nebulizer or inhaler)
AlbuterolB2 agonist
LevalbuterolSteroisomer of albuterol. Less B1 side effects (less tachycardia)
SalmeterolLong acting B2 agonist used for asthma prophylaxis
Decrease inflammation?Corticosteroids
Inhibit synthesis of cytokines
Inhibit TNF-alpha production
Inhaled corticosteroidsDaily basis to decrease inflammation
- Fluticasone
- Budesonide
- Beclomethasone
Systemic steroidsSevere chronic asthma or acute asthma exacerbation with inhaled B2 agonists
Dosing systemic steroids?Taper slowly to prevent rebound bronchospasm. Give with B2 agonists.
CromolynPrevents release of mediators from mast cells to prevent inflammation
Muscarinic antagonistBronchodilation: Decrease vagal (PS tone in lungs)
Decrease mucous secretion
Used in COPD and asthma
Which drug provides longterm control of atopic asthmathe -Lukasts. Increase airway caliber and reduce mucosal inflammation.
Leukotriene antagonistZafirlukast, Montelukast
Zileuton5-lipoxygenase inhibitor: blocks synthesis of leukotrienes
ZafirlukastPrevent chemotactic and bronchospastic effects of Leukotriene D4
Allergic rhinitis
Approved for kids >2
MontelukastPrevent chemotactic and bronchospastic effects of Leukotriene D4
Allergic rhinitis
Approved for kids >5
Mechanism of TheophyllinePDE inhibitor, inhibits intracellular cAMP
Side effects of TheophyllineNarrow therapeutic index
Cardiotoxic: Tachycardia, Hypotension
Neurotoxicity: Seizures
Dosing of TheophyllineMetabolized by P450's
Blocks adenosine
ExpectorantsLoosen up sputum
GuaifenesinLoosens up sputum
N-acetylcysteineCleaves disulfide bonds within mucous glycoproteins
Other uses for N-acetylcystein?Acetaminophin overdose
Prevents contrast induced renal nephropathy


Question Answer
H1 blockers (antihistamines)Reversible inhibitor of H1
1st generation H1 blockersDiphenhydramine
Uses for 1st gen H1 blockersAllergic rhinitis
MOtion sickness
Sleep aid
Sx: Anti-muscarinic
2nd generation H1 blockersLoratadine
What do H1 blockers treat?Allergic rhinitis
CyproheptadineAntihistamine used for ~Appetite stimulant and antidote for serotonin syndrome
PromethazineAntihistamine used for N/V
ChlorpheiniramineAntihistamine used for OTC allergy and cold
HydroxazineAntihistamine used for sedation and itching
MeclizineAntihistamine used for vertigo
DextromethorphanSynthetic morphine derivative with no analgesic effects
Used as a cough suppressant
Alpha agonistsNasal decongestant
Constrict dilated arterioles in nasal mucosa
Alpha agonistsPhenylephrine


Question Answer
Treatment options for PAH1. Bosentan
2. Prostaglandin analogue
3. PDE-antagonist
4. Dihydropyridine CCB
First line Treatment of idiopathic PAHBosentan or Ambrisentan
Bosentan mechanismEndothelin receptor antagonist: blocks vasoconstriction
Prostaglandin analoguerelax smooth muscle and dilate vessels (pulmonary artery)
SildenafilPDE-antagonist causes vasodilation
NifedipineDihydropyridine CCB
Treatment for Altitude sickness?Acetazolamide: CA inhibitor
Increases renal excretion of HCO3- to respond to metabolic alkalosis
Treatment for the bends?Hyperbaric O2
Application of Hyperbaric O2?1. Decompression sickness (the bends)
2. Arterial emboli
3. CO poison
4. Gas gangrene
5. Osteomyelitis


Question Answer
Which inflammatory mediators are targeted to reduce bronchospasm in asthmatics?Leukotrienes (LTC4, LTD4, LTE4)
What is the mechanism of zafirlukast and montelukast?Leukotriene D4 antagonist
Which drug provides longterm control of atopic asthmathe -Lukasts. Increase airway caliber and reduce mucosal inflammation.
Which drug provides short term relief of bronchoconstriction?Ipratropium
What is the mechanism of IpratropiumAntimuscarinic that blocks M3 in airway SM and submucosa
Decreases mucus production
Relieves bronchoconstriction short termIpratropium or Albuterol
What medication works best to reduce inflammation in bronchial asthma?Glucocorticoids
Systemic: Treat acute exacerbations
Inhaled: Prevent acute exacerbations
FluticasoneGlucocorticoid used to treat Inflammation in presistent bronchial asthma
AlbuterolShort acting B2 agonist. First line for acute bronchial asthma.