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A common side effects of

Neutropenia
INF treatment is?

Antimicrobial prophylaxis
for a history of recurrent TMP-SMZ
UTIs

Antimicrobial prophylaxis
Ceftriaxone
for Gonorrhea

Antimicrobial prophylaxis
Rifampin (DOC),
for Meningococcal
minocycline
infection
Antimicrobial prophylaxis TMP-SMZ (DOC),
for PCP aerosolized pentamidine

Antimicrobial prophylaxis
Benzathine penicillin G
for Syphilis

Are Aminoglycosides
Yes
Teratogenic?

Are Ampicillin and


Amoxicillin penicillinase No
resistant?
Are Carbenicillin,
Piperacillin, and Ticarcillin No
penicillinase resistant?

No, but they are less


Are Cephalosporins
susceptible than the other
resistant to penicillinase?
Beta lactams

Are Methicillin, Nafcillin,


and Dicloxacillin Yes
penicillinase resistant?

Mycobacterium
Clinical use of Isoniazid tuberculosis, the only
(INH)? agent used as solo
prophylaxis against TB
Common side effects Pseudomembranous colitis
associated with (C. difficile), fever,
Clindamycin include? diarrhea

Common toxicities GI upset, Superinfections,


associated with Skin rashes, Headache,
Fluoroquinolones? Dizziness

Common toxicities
Teratogenic, Carcinogenic,
associated with
Confusion, Headaches
Griseofulvin are…...?

Glycoproteins from
Describe the MOA of leukocytes that block
Interferons (INF) various stages of viral RNA
and DNA synthesis
Do Tetracyclines penetrate
Only in limited amounts
the CNS?

Does Ampicillin or
AmOxicillin has greater
Amoxicillin have a greater
Oral bioavailability
oral bioavailability?

Does Amprotericin B cross


No
the BBB?

Does Foscarnet require


activation by a viral No
kinase?
Foscarnet toxicity? Nephrotoxicity

Leukopenia, Neutropenia,
Ganciclovir associated
Thrombocytopenia, Renal
toxicities?
toxicity

How are INFs used Chronic Hepatitis A and B,


clinically? Kaposi's Sarcoma

How are Sulfonamides Gram +, Gram -,


employed clinically? Norcardia, Chlamydia
Triple Therapy' 2
How are the HIV drugs
Nucleoside RT Inhibitors
used clinically?
with a Protease Inhibitor

How are the Latent


Hypnozoite (Liver) forms Primaquine
of Malaria (P. vivax,
P.ovale) treated?

How can Isoniazid (INH)-


Pyridoxine (B6)
induced neurotoxicity be
administration
prevented?

How can the t1/2 of INH


Fast vs. Slow Acetylators
be altered?
How can the toxic effects With supplemental Folic
fo TMP be ameliorated? Acid

How can Vancomycin- Pretreat with


induced 'Red Man antihistamines and a slow
Syndrome' be prevented? infusion rate

As PABA antimetabolites
How do Sulfonamides act that inhibit
on bacteria? Dihydropteroate Synthase,
Bacteriostatic

Inhibt Assembly of new


How do the Protease
virus by Blocking Protease
Inhibitors work?
Enzyme
How does Ganciclovir's
Ganciclovir is more toxic
toxicity relate to that of
to host enzymes
Acyclovir?

With an amino acid change


How does resistance to
of D-ala D-ala to D-ala D-
Vancomycin occur?
lac

HSV, VZV, EBV,


Mucocutaneous and
How is Acyclovir used
Genital Herpes Lesions,
clinically?
Prophylaxis in
Immunocompromised pts

Prophylaxis for Influenza


How is Amantadine used
A, Rubella ; Parkinson's
clinically?
disease
How is Amphotericin B
administered for fungal Intrathecally
meningitis?

Wide spectrum of systemic


mycoses: Cryptococcus,
How is Amphotericin B
Blastomyces, Coccidioides,
used clinically?
Aspergillus, Histoplasma,
Candida, Mucor

Meningitis (H. influenza,


How is Chloramphenical N. meningitidis, S.
used clinically? pneumoniae), Conserative
treatment due to toxicities

How is Foscarnet used CMV Retinitis in IC pts


clinically? when Ganciclovir fails
How is Ganciclovir Phosphorylation by a Viral
activated? Kinase

CMV, esp in
How is Ganciclovir used
Immunocompromised
clinically?
patients

How is Griseofulvin used Oral treatment of


clinically? superficial infections

How is Leishmaniasis
Pentavalent Antimony
treated?
How is Ribavirin used
for RSV
clinically?

1. Mycobacterium
tuberculosis 2. Delays
How is Rifampin used resistance to Dapsone
clinically? when used of Leprosy 3.
Used in combination with
other drugs

Used in combination
How is Trimethoprim used therapy with SMZ to
clinically? sequentially block folate
synthesis

For serious, Gram +


How is Vancomycin used
multidrug-resistant
clinically?
organisms
How would you treat
African Trypanosomiasis Suramin
(sleeping sickness)?

In what population does Premature infants, because


Gray Baby Syndrome they lack UDP-glucuronyl
occur? Why? transferase

Is Aztreonam cross-
No
allergenic with penicillins?

Is Aztreonam resistant to
Yes
penicillinase?
Is Aztreonam usually
No
toxic?

Is Imipenem resistant to
Yes
penicillinase?

Is Penicillin penicillinase
No - duh
resistant?

IV Penicillin G
Foscarnet = pyroFosphate
Mnemonic for Foscarnet?
analog

1)Binds penicillin-binding
proteins 2) Blocks
MOA for Penicillin (3 transpeptidase cross-
answers)? linking of cell wall 3)
Activates autolytic
enzymes

Penicillin, Cephalosporins,
Vancomycin,
MOA: Bactericidal
Aminoglycosides,
antibiotics
Fluoroquinolones,
Metronidazole

MOA: Block cell wall Penicillin, Ampicillin,


synthesis by inhib. Ticarcillin, Pipercillin,
Peptidoglycan cross- Imipenem, Aztreonam,
linking (7) Cephalosporins
MOA: Block DNA
Quinolones
topoisomerases

MOA: Block mRNA


Rifampin
synthesis

MOA: Block nucleotide Sulfonamides,


synthesis Trimethoprim

MOA: Block peptidoglycan


Bacitracin, Vancomycin
synthesis
MOA: Block protein Aminoglycosides,
synthesis at 30s subunit Tetracyclines

Chloramphenicol,
Erythromycin/macrolides,
MOA: Block protein
Lincomycin, Clindamycin,
synthesis at 50s subunit
Streptogramins
(quinupristin, dalfopristin)

MOA: Disrupt bacterial/


Polymyxins
fungal cell membranes

MOA: Unkown Pentamidine


MOA:Disrupt fungal cell Amphotericin B, Nystatin,
membranes Fluconazole/azoles

Name common Polymyxins Polymyxin B, Polymyxin E

Erythromycin,
Name several common
Azithromycin,
Macrolides (3)
Clarithromycin

Sulfamethoxazole (SMZ),
Name some common
Sulfisoxazole, Triple
Sulfonamides (4)
sulfas, Sulfadiazine
Tetracycline, Doxycycline,
Name some common
Demeclocycline,
Tetracyclines (4)
Minocycline

Gentamicin, Neomycin,
Name the common
Amikacin, Tobramycin,
Aminoglycosides (5)
Streptomycin

Fluconazole,
Ketoconazole,
Name the common Azoles
Clotrimazole, Miconazole,
Itraconazole

Ciprofloxacin, Norfloxacin,
Name the common
Ofloxacin, Grepafloxacin,
Fluoroquinolones (6)
Enoxacin, Nalidixic acid
Name the common Non-
Nucleoside Reverse Nevirapine, Delavirdine
Transcriptase Inhibitors

Zidovudine (AZT),
Name the common Didanosine (ddI),
Nucleoside Reverse Zalcitabine (ddC),
Transcriptase Inhibitors Stavudine (d4T),
Lamivudine (3TC)

Name the Protease Saquinavir, Ritonavir,


Inhibitors (4) Indinavir, Nelfinavir

Protease Inhibitors and


Name two classes of drugs
Reverse Transcriptase
for HIV therapy
Inhibitors
Staphlococcus aureus and
Name two organisms
Clostridium difficile
Vancomycin is commonly
(pseudomembranous
used for?
colitis)

Oral Penicillin V

Modification via
Resistance mechanisms for
Acetylation, Adenylation,
Aminoglycosides
or Phosphorylation

Resistance mechanisms for Beta-lactamase cleavage


Cephalosporins/Penicillins of Beta-lactam ring
Resistance mechanisms for Modification via
Chloramphenicol Acetylation

Methylation of rRNA near


Resistance mechanisms for
Erythromycin's ribosome
Macrolides
binding site

Altered bacterial
Dihydropteroate
Resistance mechanisms for
Synthetase, Decreased
Sulfonamides
uptake, or Increased PABA
synthesis

Decreased uptake or
Resistance mechanisms for
Increased transport out of
Tetracycline
cell
Terminal D-ala of cell wall
Resistance mechanisms for
replaced with D-lac;
Vancomycin
Decreased affinity

Hemolysis (if G6PD


Side effects of Isoniazid deficient), Neurotoxicity,
(INH)? Hepatotoxicity, SLE-like
syndrome

Specifically, how does Binds to the


Foscarnet inhibit viral DNA Pyrophosphate Binding
pol? Site of the enzyme

The MOA for


Inhibition of 50S peptidyl
Chloramphenicol is …â
transferase, Bacteriostatic
€¦â€¦â€¦â€¦..?
Megaloblastic anemia,
Toxic effects of TMP
Leukopenia,
include………?
Granulocytopenia

Hormone synthesis
Toxic side effects of the inhibition (Gynecomastia),
Azoles? Liver dysfunction (Inhibits
CYP450), Fever, Chills

Toxicities associated with Delirium, Tremor,


Acyclovir? Nephrotoxicity

What additional side Rash, Pseudomembranous


effects exist for Ampicillin? colitis
What antimicrobial class is
Aztreonam syngergestic Aminoglycosides
with?

What are Amantadine- Ataxia, Dizziness, Slurred


associated side effects? speech

What are Aminoglycosides


Beta-lactam antibiotics
synergistic with?

What are Aminoglycosides Severe Gram - rod


used for clinically? infections.
What are common serious Nephrotoxicity (esp. with
side effects of Cephalosporins),
Aminoglycosides and what Ototoxicity (esp. with Loop
are these associated with? Diuretics)

Fever/Chills, Hypotension,
What are common side
Nephrotoxicity,
effects of Amphotericin B?
Arrhythmias

GI intolerance (nausea,
What are common side diarrhea), Hyperglycemia,
effects of Protease Lipid abnormalities,
Inhibitors? Thrombocytopenia
(Indinavir)

BM suppression
What are common side
(neutropenia, anemia),
effects of RT Inhibitors?
Peripheral neuropathy
-Hypersensitivity reactions
-Hemolysis -
What are common toxic Nephrotoxicity
side effects of (tubulointerstitial nephritis)
Sulfonamides? (5) -Kernicterus in infants
Displace other drugs from
albumin (e.g., warfarin)

What are common GI discomfort, Acute


toxicities associated with cholestatic hepatitis,
Macrolides? (4) Eosinophilia, Skin rashes

GI distress, Tooth
What are common discoloration and
toxicities associated with Inhibition of bone growth
Tetracyclines? in children, Fanconi's
syndrome, Photosensitivity

Well tolerated in general


but occasionally,
What are common Nephrotoxicity,
toxicities related to Ototoxicity,
Vancomycin therapy? Thrombophlebitis, diffuse
flushing='Red Man
Syndrome'
1.Gram - rods of the
Urinary and GI tracts
What are Fluoroquinolones
(including Pseudomonas)
indicated for? (3)
2.Neisseria 3. Some Gram
+ organisms

What are major side


effects of Methicillin, Hypersensitivity reactions
Nafcillin, and Dicloxacillin?

What are Methicillin,


Nafcillin, and Dicloxacillin Staphlococcus aureus
used for clinically?

What are Polymyxins used Resistant Gram -


for? infections
Rifampin, Ethambutol,
What are the Anti-TB Streptomycin,
drugs? Pyrazinamide, Isoniazid
(INH)

What are the clinical


indications for Azole Systemic mycoses
therapy?

What are the clinical uses Gram + cocci, Proteus


for 1st Generation mirabilis, E. coli, Klebsiella
Cephalosporins? pneumoniae (PEcK)

Gram + cocci,
Haemophilus influenza,
What are the clinical uses Enterobacter aerogenes,
for 2nd Generation Neisseria species, P.
Cephalosporins? mirabilis, E. coli, K.
pneumoniae, Serratia
marcescens ( HEN PEcKS )
1) Serious Gram -
What are the clinical uses infections resistant to
for 3rd Generation other Beta lactams 2)
Cephalosporins? Meningitis (most penetrate
the BBB)

Gram - rods: Klebsiella


What are the clinical uses
species, Pseudomonas
for Aztreonam?
species, Serratia species

What are the clinical uses Gram + cocci, Gram -


for Imipenem/cilastatin? rods, and Anerobes

-Upper respiratory tract


infections -pneumonias -
STDs: Gram+ cocci
What are the Macrolides (streptococcal infect in pts
used for clinically? allergic to penicillin) -
Mycoplasma,
Legionella,Chlamydia,
Neisseria
Cephalosporin: 1) has a 6
member ring attached to
What are the major
the Beta lactam instead of
structural differences
a 5 member ring 2)has an
between Penicillin and
extra functional group
Cephalosporin?
( attached to the 6
member ring)

What are the major toxic GI distress, Skin rash, and


side effects of Imipenem/ Seizures at high plasma
cilastatin? levels

1) Hypersensitivity reactions
2) Increased nephrotoxicity
What are the major toxic of Aminoglycosides 3)
side effects of the Disulfiram-like reaction
Cephalosporins? with ethanol (those with a
methylthiotetrazole group,
e.g., cefamandole)

What are the side effects Neurotoxicity, Acute renal


of Polymyxins? tubular necrosis
Minor hepatotoxicity, Drug
What are the side effects
interactions (activates
of Rifampin?
P450)

What are toxic side effects Disulfiram-like reaction


for Metronidazole? with EtOH, Headache

What are toxicities Aplastic anemia (dose


associated with independent), Gray Baby
Chloramphenicol? Syndrome

Giardiasis, Amoebic
What conditions are dysentery (E. histolytica),
treated with Bacterial vaginitis
Metronidazole? (Gardnerella vaginalis),
Trichomonas
What do Aminoglycosides
Oxygen
require for uptake?

What do you treat


Mebendazole/
Nematode/roundworm
Thiabendazole, Pyrantel
(pinworm, whipworm)
Pamoate
infections with?

What drug is given for


Pneumocystis carinii Pentamidine
prophylaxis?

What drug is used during


AZT, to reduce risk of Fetal
the pregnancy of an HIV +
Transmission
mother?, Why?
What drug is used to treat
Trematode/fluke (e.g.,
Schistosomes, Praziquantel
Paragonimus, Clonorchis)
or Cysticercosis

What is a common drug


Increases coumadin
interaction associated with
metabolism
Griseofulvin?

What is a mnemonic to Blocks Influenza A and


remember Amantadine's RubellA; causes problems
function? with the cerebellA

What is a prerequisite for It must be Phosphorylated


Acyclovir activation? by Viral Thymidine Kinase
What is a Ribavirin
Hemolytic anemia
toxicity?

What is an acronym to
RESPIre
remember Anti-TB drugs?

What is an additional side


Interstitial nephritis
effect of Methicillin?

What is an occasional side


GI upset
effect of Aztreonam?
What is Clindamycin used Anaerobic infections (e.g.,
for clinically? B. fragilis, C. perfringens)

What is clinical use for


Pseudomonas species and
Carbenicillin, Piperacillin,
Gram - rods
and Ticarcillin?

Recurrent UTIs, Shigella,


What is combination TMP-
Salmonella, Pneumocystis
SMZ used to treat?
carinii pneumonia

What is combined with


Ampicillin, Amoxicillin,
Carbenicillin, Piperacillin, Clavulanic acid
and Ticarcillin to enhance
their spectrum?
Cryptococcal meningitis in
What is Fluconazole
AIDS patients and Candidal
specifically used for?
infections of all types

What is Imipenem always


Cilastatin
administered with?

Blastomyces, Coccidioides,
What is Ketoconazole
Histoplasma, C. albicans;
specifically used for?
Hypercortisolism

What is Metronidazole
Bismuth and Amoxicillin or
combined with for 'triple
Tetracycline; against
therapy'? Against what
Helobacter pylori
organism?
Antiprotozoal: Giardia,
Entamoeba, Trichomonas,
What is Metronidazole
Gardnerella vaginalis
used for clinically?
Anaerobes: Bacteroides,
Clostridium

Cestode/tapeworm (e.g.,
What is Niclosamide used
D. latum, Taenia species
for?
Except Cysticercosis

Chagas' disease, American


What is Nifurtimox
Trypanosomiasis
administered for?
(Trypanosoma cruzi)

What is the chemical name DHPG (dihydroxy-2-


for Ganciclovir? propoxymethyl guanine)
Extended spectrum
What is the clinical use for
penicillin: certain Gram +
Ampicillin and Amoxicillin?
bacteria and Gram - rods

What is the clinical use for Topical and Oral, for Oral
Nystatin? Candidiasis (Thrush)

Bactericidal for: Gram +


What is the clinical use for
rod and cocci, Gram -
Penicillin?
cocci, and Spirochetes

What is the major side


effect for Ampicillin and Hypersensitivity reactions
Amoxicillin?
What is the major side
effect for Carbenicillin, Hypersensitivity reactions
Piperacillin, and Ticarcillin?

What is the major toxic


Hypersensitivity reactions
side effect of Penicillin?

What is the memory aid for


subunit distribution of Buy AT 30, CELL at 50'
ribosomal inhibitors?

What is the memory key INH: Injures Neurons and


for Isoniazid (INH) toxicity? Hepatocytes
What is the memory key
for Metronidazole's clinical GET on the Metro
uses?

What is the memory key


for organisms treated with VACUUM your Bed Room'
Tetracyclines?

1. RNA pol inhibitor 2.


What is the memory key Revs up P450 3. Red/
involving the '4 R's of orange body fluids 4.
Rifampin?' Rapid resistance if used
alone

What is the MOA for Inhibit viral DNA


Acyclovir? polymerase
Binds Ergosterol, forms
What is the MOA for
Membrane Pores that
Amphotericin B?
Disrupt Homeostatis

Same as penicillin.
What is the MOA for
Extended spectrum
Ampicillin and Amoxicillin?
antibiotics

What is the MOA for Same as penicillin.


Carbenicillin, Piperacillin, Extended spectrum
and Ticarcillin? antibiotics

Blocks Peptide Bond


What is the MOA for
formation at the 50S
Clindamycin?
subunit, Bacteriostatic
What is the MOA for Same as penicillin. Act as
Methicillin, Nafcillin, and narrow spectrum
Dicloxacillin? antibiotics

Forms toxic metabolites in


What is the MOA for
the bacterial cell,
Metronidazole?
Bactericidal

What is the MOA for Binds ergosterol, Disrupts


Nystatin? fungal membranes

What is the MOA for Inhibits DNA dependent


Rifampin? RNA polymerase
Inhibits formation of
What is the MOA for the Initiation Complex, causes
Aminoglycosides? misreading of mRNA,
Bactericidal

What is the MOA for the


Inhibit Ergosterol synthesis
Azoles?

What is the MOA for the Beta lactams - inhibit cell


Cephalosporins? wall synthesis, Bactericidal

Inhibit DNA Gyrase


What is the MOA for the
(topoisomerase II),
Fluoroquinolones?
Bactericidal
Blocks translocation, binds
What is the MOA for the
to the 23S rRNA of the 50S
Macrolides?
subunit, Bacteriostatic

Binds 30S subunit and


What is the MOA for the prevents attachment of
Tetracyclines? aminoacyl-tRNA,
Bacteriostatic

Inhibits bacterial
What is the MOA for
Dihydrofolate Reductase,
Trimethoprim (TMP)?
Bacteriostatic

Inhibits cell wall


What is the MOA for
mucopeptide formation,
Vancomycin?
Bactericidal
Blocks viral penetration/
What is the MOA of uncoating; may act to
Amantadine? buffer the pH of the
endosome

Inhibits cell wall synthesis


What is the MOA of
( binds to PBP3). A
Aztreonam?
monobactam

What is the MOA of Inhibits Viral DNA


Foscarnet? polymerase

What is the MOA of Inhibits CMV DNA


Ganciclovir? polymerase
Interferes with microtubule
What is the MOA of
function, disrupts mitosis,
Griseofulvin?
inhibits growth

What is the MOA of Acts as a wide spectrum


Imipenem? carbapenem

What is the MOA of Decreases synthesis of


Isoniazid (INH)? Mycolic Acid

Bind cell membrane,


disrupt osmotic
What is the MOA of
properties, Are Cationc,
Polymyxins?
Basic and act as
detergents
Inhibits IMP
Dehydrogenase
What is the MOA of
(competitively), and
Ribavirin?
therefore blocks Guanine
Nucleotide synthesis

Inhibit RT of HIV and


What is the MOA of the RT prevent the incorporation
Inhibitors? of viral genome into the
host DNA

What is the most common


cause of Pt noncompliance GI discomfort
with Macrolides?

What is treated with


Chloroquine, Quinine, Malaria (P. falciparum)
Mefloquine?
What microorganisms are
Aminoglycosides Anaerobes
ineffective against?

Vibrio cholerae Acne


Chlamydia Ureaplasma
What microorganisms are
Urealyticum Mycoplasma
clinical indications for
pneumoniae Borrelia
Tetracycline therapy?
burgdorferi (Lyme's)
Rickettsia Tularemia

What microorganisms is
Aztreonam not effective Gram + and Anerobes
against?

What musculo-skeletal
side effects in Adults are Tendonitis and Tendon
associated with rupture
Floroquinolones?
What neurotransmitter
Dopamine; causes its
does Amantadine affect?
release from intact nerve
How does it influence this
terminals
NT?

What organism is
Imipenem/cilastatin the Enterobacter
Drug of Choice for?

What organisms does Dermatophytes (tinea,


Griseofulvin target? ringworm)

Giant Roundworm
What parasites are treated
(Ascaris), Hookworm
with Pyrantel Pamoate
(Necator/Ancylostoma),
(more specific)?
Pinworm (Enterobius)
What parasitic condition is Onchocerciasis ('river
treated with Ivermectin? blindness'--rIVER-mectin)

What populations are Pregnant women, Children;


Floroquinolones because animal studies
contraindicated in? Why? show Damage to Cartilage

Milk or Antacids, because


What should not be taken divalent cations inhibit
with Tetracyclines? / Why? Tetracycline absorption in
the gut

What Sulfonamides are


Triple sulfas or SMZ
used for simple UTIs?
When pts have Low CD4+
When is HIV therapy
(< 500 cells/cubic mm)
initiated?
or a High Viral Load

1. Meningococcal carrier
When is Rifampin not used
state 2. Chemoprophylaxis
in combination with other
in contacts of children
drugs?
with H. influenzae type B

Where does Griseofulvin Keratin containing tissues,


deposit? e.g., nails

Which Aminoglycoside is
Neomycin
used for Bowel Surgery ?
Which antimicrobial 1) Aminoglycosides =
classes inhibit protein bactericidal 2)
synthesis at the 30S Tetracyclines =
subunit? (2) bacteriostatic

1) Chloramphenical =
bacteriostatic 2)
Which antimicrobials Erythromycin =
inhibit protein synthesis at bacteriostatic 3)
the 50S subunit? (4) Lincomycin = bacteriostatic
4)cLindamycin =
bacteriostatic

Which individuals are


predisposed to G6PD deficient individuals
Sulfonamide-induced
hemolysis?

Which RT inhibitor causes


AZT
Megaloblastic Anemia?
Which RT inhibitors cause
Non-Nucleosides
a Rash?

Which RT inhibitors cause


Nucleosides
Lactic Acidosis?

Which Tetracycline is used


Doxycycline, because it is
in patients with renal
fecally eliminated
failure? / Why?

B.W. !!!, Ha. Good Luck on


Who's your daddy?
Boards
Why are Methicillin,
Due to the presence of a
Nafcillin, and Dicloxacillin
bulkier R group
penicillinase resistant?

To inhibit renal
Why is Cilastatin Dihydropeptidase I and
administered with decrease Imipenem
Imipenem? inactivation in the renal
tubules

-S-phase anti-metabolite
List the mechanism, Pyr analogue -Colon, solid
clinical use, & toxicity tumors, & BCC/ -
of 5 FU. Irreversible
myelosuppression

List the mechanism,


-inhibits HGPRT (pur. Syn.)
clinical use, & toxicity
- Luk, Lymph,
of 6 MP.
-DNA intercalator -
List the mechanism, testicular &
clinical use, & toxicity lymphomas -Pulmonary
of Bleomycin. fibrosis mild
myelosuppression.

List the mechanism, -Alkalates DNA -CML -


clinical use, & toxicity Pulmonary fibrosis
of Busulfan. hyperpigmentation

-Alkalating agent -
List the mechanism,
testicular,bladder,ovary,&a
clinical use, & toxicity
mp;lung -Nephrotoxicity
of Cisplatin.
& CN VIII damage.

-Alkalating agent -NHL,


List the mechanism, Breast, ovary, & lung.
clinical use, & toxicity - Myelosuppression,
of Cyclophosphamide. & hemorrhagic
cystitis.
-DNA intercalator -
List the mechanism, Hodgkin's, myeloma,
clinical use, & toxicity sarcoma, and solid tumors
of Doxorubicin. -Cardiotoxicity &
alopecia

-Topo II inhibitor(GII
specific) -Oat cell of Lung
List the mechanism,
& prostate, &
clinical use, & toxicity
testicular -
of Etoposide.
Myelosuppression &
GI irritation.

-S-phase anti-metabolite
folate analogue -Luk,
List the mechanism,
Lymp, sarc, RA,
clinical use, & toxicity
&psoriasis / -
of Methotrexate.
Reversible
myelosuppression

List the mechanism,


-Alkalate DNA -Brain
clinical use, & toxicity
tumors -CNS toxicity
of Nitrosureas.
-MT polymerization
List the mechanism, stabilizer -Ovarian &
clinical use, & toxicity breast CA -
of Paclitaxel. Myelosupperession &
hypersensitivity.

List the mechanism, -Triggers apoptosis -CLL,


clinical use, & toxicity Hodgkin's in MOPP -
of Prednisone. Cushing-like syndrome

-Estrogen receptor
List the mechanism,
antagonist -Breast CA -
clinical use, & toxicity
increased endometrial CA
of Tamoxifen.
risk

-MT polymerization
inhibitor(M phase) -MOPP,
List the mechanism,
clinical use, & toxicity lymphoma, Willm's &
choriocarcinoma -
of Vincristine.
neurotoxicity and
myelosuppression
-Alkalating agents
Which cancer drugs effect +cisplatin -Doxorubicin
nuclear DNA (4)? +Dactinomycin -Bleomycin
-Etoposide

Which cancer drugs inhibit - Methotrexate - 5 FU - 6


nucleotide synthesis(3)? mercaptopurine

Which cancer drugs work


-Steroids -Tamoxifen
at the level of mRNA(2)?

Which cancer drugs work -Vinca alkaloids(inhibit


at the level of proteins(2)? MT) -Paclitaxel
ACE inhibitors- clinical hypertension, CHF,
use? diabetic renal disease

reduce levels of
Angiotensin II, thereby
ACE inhibitors- preventing the inactivation
mechanism? of bradykinin (a potent
vasodilator); renin level is
increased

fetal renal damage,


hyperkalemia, Cough,
Angioedema, Proteinuria,
ACE inhibitors- toxicity? Taste changes, hypOtension,
Pregnancy problems, Rash,
Increased renin, Lower
Angiotensin II (CAPTOPRIL)

glaucoma, urinary
Acetazolamide- clinical
alkalinization, metabolic
uses?
alkalosis, altitude sickness
acts at the proximal
convoluted tubule to
inhibit carbonic anhydrase.
Acetazolamide-
Causes self-limited
mechanism?
sodium bicarb diuresis and
reduction of total body
bicarb stores.

acetazolamide- site of proximal convoluted


action? tubule

hyperchloremic metabolic
Acetazolamide- toxicity? acidosis, neuropathy, NH3
toxicity, sulfa allergy

ACIDazolamide' causes
Acetazolamide causesÉ?
acidosis
DOC in diagnosing and
Adenosine- clinical use? abolishing AV nodal
arrhythmias

ADH antagonists- site of


collecting ducts
action?

adverse effect of cyanide toxicity (releases


Nitroprusside? CN)

impotence, asthma, CV
effects (bradycardia, CHF,
adverse effects of beta-
AV block), CNS effects
blockers?
(sedation, sleep
alterations)
fetal renal toxicity,
hyperkalemia, Cough,
adverse effects of Angioedema, Proteinuria,
Captopril? Taste changes, hypOtension,
Pregnancy problems, Rash,
Increased renin, Lower
Angiotensin II (CAPTOPRIL)

dry mouth, sedation,


adverse effects of
severe rebound
Clonidine?
hypertension

severe orthostatic
adverse effects of hypotension, blurred
ganglionic blockers? vision, constipation,
sexual dysfunction

orthostatic and exercise


adverse effects of
hypotension, sexual
Guanethidine?
dysfunction, diarrhea
nausea, headache, lupus-
adverse effects of like syndrome, reflex
Hydralazine? tachycardia, angina, salt
retention

hypokalemia, slight
hyperlipidemia,
adverse effects of
hyperuricemia, lassitude,
Hydrochlorothiazide?
hypercalcemia,
hyperglycemia

K+ wasting, metabolic
adverse effects of Loop
alkalosis, hypotension,
Diuretics?
ototoxicity

adverse effects of fetal renal toxicity,


Losartan? hyperkalemia
adverse effects of sedation, positive Coombs'
Methyldopa? test

hypertrichosis, pericardial
adverse effects of effusion, reflex
Minoxidil? tachycardia, angina, salt
retention

dizziness, flushing,
adverse effects of
constipation (verapamil),
Nifedipine, verapamil?
nausea

first dose orthostatic


adverse effects of
hypotension, dizziness,
Prazosin?
headache
adverse effects of sedation, depression,
Reserpine? nasal stuffiness, diarrhea

pulmonary fibrosis, corneal


deposits, hepatotoxicity, skin
deposits resulting in
Amiodarone- toxicity? photodermatitis, neurologic
effects, consitpation, CV
(bradycardia, heart block,
CHF), and hypo- or
hyperthyroidism.

slowly normalize K+,


lidocaine, cardiac pacer,
antidote?
and anti-Dig Fab
fragments

Beta Blockers- CNS


sedation, sleep alterations
toxicity?
bradycardia, AV block,
Beta Blockers- CV toxicity?
CHF

Beta adrenergic receptors


Beta Blockers- site of
and Ca2+ channels
action?
(stimulatory)

BP? decrease

BP? decrease
new arrhythmias,
Bretyllium- toxicity?
hypotension

Ca2+ channel blockers- hypertension, angina,


clinical use? arrhythmias

block voltage dependent


L-type Ca2+ channels of
Ca2+ channel blockers-
cardiac and smooth
mechanism?
muscle- decreasing
contractility

Cell membrane Ca2+


Ca2+ channel blockers-
channels of cardiac
site of action?
sarcomere
cardiac depression,
Ca2+ channel blockers- peripheral edema,
toxicity? flushing, dizziness,
constipation

Ca2+ sensitizers'- site of troponin-tropomyosin


action? system

Cautions when using check PFTs, LFTs, and


Amiodarone? TFTs

increased AP duration,
increased ERP increased
class IA effects?
QT interval. Atrial and
ventricular.
post MI and digitalis
class IB- clinical uses?
induced arrhythmias

decrease AP duration,
affects ischemic or
class IB- effects?
depolarized Purkinje and
ventricular system

local anesthetic. CNS


class IB- toxicity? stimulation or depression.
CV depression.

NO AP duration effect.
useful in V-tach that
class IC- effects? progresses to V-fib and in
intractable SVT LAST
RESORT
class IC- toxicity? proarrhythmic

decrease the slope of


phase 4, increase PR
class II- effects?
interval (the AV node is
particularly sensitive)

blocking the beta


adrenergic receptor leads
class II- mechanism?
to decreased cAMP, and
decreased Ca2+ flux

impotence, exacerbation
of asthma, CV effects, CNS
class II- toxicity?
effects, may mask
hypoclycemia
increase AP duration,
increase ERP, increase QT
Class III- effects?
interval, for use when
other arrhythmics fail

prevention of nodal
class IV- clinical use?
arrhythmias (SVT)

decrease conduction
class IV- effects? velocity, increase ERP,
increase PR interval

class IV- primary site of


AV nodal cells
action?
constipation, flushing,
edema, CV effects (CHF,
class IV- toxicity? AV block, sinus node
depression), and torsade
de pointes (Bepridil)

diuretics,
sympathoplegics,
classes of antihypertensive
vasodilators, ACE
drugs?
inhibitors, Angiotensin II
receptor inhibitors

angina, pulmonary edema


clinical use?
(also, erection enhancer)

clinical use? CHF, atrial fibrillation


contractility? increase (reflex response)

contractility? decrease

renal failure, hypokalemia,


contraindications?
pt on quinidine

decrease Digitoxin dose in


NO
renal failure?
decrease Digoxin dose in
YES
renal failure?

Digitalis- site of action? Na/K ATPase

Digoxin v. Digitoxin: Digitoxin>95% Digoxin


bioavailability? 75%

Digoxin v. Digitoxin: Digoxin=urinary


excretion? Digitoxin=biliary
Digoxin v. Digitoxin: half Digitoxin 168hrs Digoxin
life? 40 hrs

Digoxin v. Digitoxin: Digitoxin 70% Digoxin


protein binding? 20-40%

ejection time? decrease

ejection time? increase


inc PR, dec QT, scooping
EKG results? of ST, and T wave
inversion

end diastolic volume? decrease

end diastolic volume? increase

Esmolol- short or long


very short acting
acting?
Ethacrynic Acid- clinical Diuresis in pateints with
use? sulfa allergy

not a sulfonamide, but


Ethacrynic Acid-
action is the same as
mechanism?
furosemide

NO HYPERURICEMIA, NO
Ethacrynic Acid- toxicity? SULFA ALLERGY; same as
furosemide otherwise

Sulfonamide Loop Diuretic.


Inhibits ion co-transport
system of thick ascending
Furosemide- class and
loop. Abolishes
mechanism?
hypertonicity of the
medulla, thereby preventing
concentration of the urine.
edematous states (CHF,
cirrhosis, nephrotic
Furosemide- clinical use?
syndrome, pulm edema),
HTN, hypercalcemia

Ototoxicity, Hypokalemia,
Furosemide- toxicity? (OH Dehydration, Allergy
DANG) (sulfa), Nephritis
(interstitial), Gout

Furosemide increases the


Ca2+ (Loops Lose calcium)
excretion of what ion?

HDL effect? no effect


HDL effect? increase

HDL effect? moderate increase

HDL effect? increase

HDL effect? DECREASE


decrease myocardial O2
consumption by: 1-
decreasing end diastolic
how do we stop angina? volume 2- decreasing BP
3- decreasing HR 4-
decreasing contractility 5-
decreasing ejection time

HR? increase (reflex response)

HR? decrease

vasodilator- increases
cGMP to induce smooth
Hydralazine- class and
muscle relaxation
mechanism?
(arterioles>veins;
afterload reduction)
Hydralazine- clinical use? severe hypertension, CHF

compensatory tachycardia,
Hydralazine- toxicity? fluid retention, lupus-like
syndrome

Hydrochlorothiazide- HTN, CHF, calcium stone


clinical use? formation, nephrogenic DI.

Inhibits NaCl reabsorption


Hydrochlorothiazide-
in the early distal tubule.
mechanism?
Decreases Ca2+ excretion.
Hypokalemic metabolic
alkalosis, hyponatremia,
Hydrochlorothiazide- hyperGlycemia,
toxicity? (hyperGLUC, plus hyperLipidemia,
others) hyperUricemia,
hyperCalcemia, sulfa
allergy.

Ibutilide- toxicity? torsade de pointes

depresses ectopic
K+- clinical use? pacemakers, especially in
digoxin toxicity

K+ sparing diuretics- hyperaldosteronism, K+


clinical use? depletion, CHF
K+ sparing diuretics- site
cortical collecting tubule
of action?

hyperkalemia, endocrine
K+ sparing diuretics-
effects (gynecomastia,
toxicity?
anti-androgen)

LDL effect? moderate decrease

LDL effect? large decrease


LDL effect? moderate decrease

LDL effect? decrease

LDL effect? decrease

loop diuretics
(furosemide)- site of thick ascending limb
action?
ARF, shock, drug
overdose, decrease
Mannitol- clinical use?
intracranial/intraocular
pressure

Mannitol-
anuria, CHF
contraindications?

osmotic diuretic- increase


tubular fluid osmolarity,
Mannitol- mechanism?
thereby increasing urine
flow

proximal convoluted
mannitol- site of action? tubule, thin descending
limb, and collecting duct
pulmonary edema,
Mannitol- toxicity?
dehydration

vasodilate by releasing NO
in smooth muscle, causing
mechanism? and increase in cGMP and
smooth muscle relaxation
(veins>>arteries)

inhibits the Na/K ATPase,


increasing intracellular Na
mechanism? + decreasing the function
of the Na/Ca antiport
causing an increase in
intracellular Ca2+

Na+ channel blockers.


Slow or block conduction.
mechanism? Decreased slope in phase
4 and increased threshold
for firing in abnormal
pacemaker cells.
effective in torsade de
Mg+- clinical use? pointes and digoxin
toxicity

MVO2? decrease

MVO2? decrease

propanolol, esmolol,
name five in class II? metoprolol, atenolol,
timolol
name four HMG-CoA Lovastatin, Pravastatin,
reductase inhibitors. Simvastatin, Atorvastatin

Quinidine, Amiodarone,
name four in class IA. Procainamide,
Disopyramide

Sotalol, Ibutilide,
name four in class III.
Bretylium, Amiodarone

Captopril, Enalapril,
name three ACE inhibitors?
Lisinopril
name three calcium Nifedipine, Verapamil,
channel blockers? Diltiazem

Lidocaine, Mexiletine,
name three in class IB.
Tocainide

Flecainide, Encainide,
name three in class IC.
Propafenone

Verapamil, Diltiazem,
name three in class IV.
Bepridil
Spironolactone,
name three K+ sparing
Triamterene, Amiloride
diuretics?
(the K+ STAys)

name two bile acid resins. cholestyramine, colestipol

name two LPL stimulators. Gemfibrozil, Clofibrate

Nifedipine has similar


Nitrates
action to?
preferential action of the cardiac muscle:
Ca2+ channel blockers at Verapamil>Diltiazem&gt
cardiac muscle? ;Nifedipine

preferential action of the vascular sm. Mus.:


Ca2+ channel blockers at Nifedipine>Diltiazem&g
vascular smooth muscle? t;Verapamil

reversible SLE-like
Procainamide- toxicity?
syndrome

cinchonism: HA, tinnitus,


thrombocytopenia, torsade
Quinidine- toxicity?
de pointes due to
increased QT interval
Ryanodine- stie of action? blocks SR Ca2+ channels

slectively depress tissue


that is frequently
selectivity?
depolarized (fast
tachycardia)

tastes bad and causes GI


side effects/problems?
discomfort

expensive, reversible
side effects/problems? increase in LFTs, and
myositis
red, flushed face which is
side effects/problems? decreased by ASA or long
term use

side effects/problems? myositis, increased LFTs

side effects/problems? DECREASED HDL

torsade de pointes,
Sotalol- toxicity?
excessive Beta block
competitive inhibirot of
Spironolactone-
aldosterone in the cortical
mechanism?
collecting tubule

TG effect? slight increase

TG effect? decrease

TG effect? decrease
TG effect? large decrease

TG effect? no effect

distal convoluted tubule


thiazides- site of action?
(early)

tachycardia, hypotension,
toxicity? headache - 'Monday
disease'
nausea, vomiting,
toxicity? diarrhea, blurred vision,
arrhythmia

Triamterene and block Na+ channels in the


amiloride- mechanism? cortical collecting tubule

Verapamil has similar


Beta Blockers
action to?

what two vasodilators


require simultaneous
treatment with beta Hydralazine and Minoxidil
blockers to prevent reflex
tachycardia and diuretics
to prevent salt retention?
carbonic anhydrase
which diuretics cause
inhibitors, K+ sparing
acidosis?
diuretics

which diuretics cause


loop diuretics, thiazides
alkalosis?

which diuretics decrease


thiazides, amiloride
urine Ca2+?

which diuretics increase loop diuretics,


urine Ca2+? spironolactone
all except the K+ sparing
which diuretics increase
diuretics Spironolactone,
urine K+?
Triamterene, Amiloride

which diuretics increase


all of them
urine NaCl?

Acetaminophen has what Acetaminophen has


two clinical uses and lacks antipyretic and analgesic
what one clinical use of properties, but lacks anti-
the NSAIDs? inflammatory properties.

Can Heparin be used Yes, it does not cross the


during pregnancy? placenta.
No, warfarin, unlike
Can Warfarin be used
heparin, can cross the
during pregnancy?
placenta.

Does Heparin have a long,


Short.
medium, or short half life?

Does Warfarin have a long,


Long.
medium, or short half life?

For Heparin what is the 1. Heparin 1. Structure - Large anionic


Structure 2. Route of polymer, acidic 2. Route of administration
- Paranteral (IV, SC) 3. Onset of action -
administration 3. Onset of action Rapid (seconds) 4. Mechanism of action -
4. Mechanism of action 5. Activates antithrombin III 5. Duration of
Duration of action 6. Ability to action - Acute (hours) 6. Ability to inhibit
inhibit coagulation in vitro 7. coagulation in vitro - Yes 7. Treatment for
overdose - Protamine sulfate 8. Lab value
Treatment for overdose 8. Lab to monitor-aPTT (intrinsic pathway) 9.
value to monitor 9. Site of action Site of action - Blood
For Warfarin what is the 1. Warfarin 1. Structure - Small lipid-
soluble molecule 2. Route of
Structure 2. Route of
administration -Oral 3. Onset of action
administration 3. Onset of action - Slow, limited by half lives of clotting
4. Mechanism of action 5. factors 4. Mechanism of action -
Duration of action 6. Ability to Impairs the synthesis of vitamin K-
inhibit coagulation in vitro 7. dependent clotting factors 5. Duration
Treatment for overdose 8. Lab of action - Chronic (weeks or months)
6. Ability to inhibit coagulation in vitro
value to monitor 9. Site of action - No

7. Treatment for overdose


- IV vitamin K and fresh
For Warfarin what is the
frozen plasma 8. Lab value
(continued):
to monitor - PT 9. Site of
action - Liver

Is toxicity rare or common


whith Cromolyn used in Rare.
Asthma prevention?

1. Hydrocortisone 2.
Predisone 3.
List five common
Triamcinolone 4.
glucocorticoids.
Dexamethasone 5.
Beclomethasone
Secretion of what drug is
inhibited by Probenacid Penicillin.
used to treat chronic gout?

The COX-2 inhibitors The COX-2 inhibitors


(celecoxib, rofecoxib) have should not have the
similar side effects to the corrosive effects of other
NSAIDs with what one NSAIDs on the
exception? gastrointestinal lining.

Sulfonylureas are oral


What are are the
hypoglycemic agents, they
Sulfonylureas (general
are used to stimulate
description) and what is
release of endogenous
their use?
insulin in NIDDM (type-2).

1. Reliable (<1% failure) 2.


Lowers risk of endometrial
What are five advantages
and ovarian cancer 3.
of Oral Contraceptives
Decreased incidence of
(synthetic progestins,
ectopic pregnancy 4. Lower
estrogen)?
risk of pelvic infections 5.
Regulation of menses
1. Taken daily 2. No
What are five protection against STDs 3.
disadvantages of Oral Raises triglycerides 4.
Contraceptives (synthetic Depression, weight gain,
progestins, estrogen)? nausea, HTN 5.
Hypercoagulable state

1. Gastric ulceration 2.
What are five possible Bleeding 3.
toxic effects of Aspirin Hyperventilation 4. Reye's
therapy? syndrome 5. Tinnitus (CN
VIII)

1. Significant:
What are five toxicities nephrotoxicity 2.
associated with Tacrolimus Peripheral neuropathy 3.
(FK506)? Hypertension 4. Pleural
effusion 5. Hyperglycemia.

1. Better bioavailability 2.
What are four advantages 2 to 4 times longer half
of newer low-molecular- life 3. Can be administered
weight heparins subcutaneously 4. Does
(Enoxaparin)? not require laboratory
monitoring
1. Antipyretic 2. Analgesic
What are four clinical
3. Anti-inflammatory 4.
activities of Aspirin?
Antiplatelet drug.

1. Addison's disease 2.
What are four clinical uses
Inflammation 3. Immune
of glucocorticoids?
suppression 4. Asthma

What are four conditions in 1. Peptic ulcer 2. Gastritis


which H2 Blockers are 3. Esophageal reflux 4.
used clinically? Zollinger-Ellison syndrome

1. Cimetadine 2. Ranitidine
What are four H2 Blockers?
3. Famotidine 4. Nizatidine
1. Tolbutamide 2.
What are four
Chlorpropamide 3.
Sulfonylureas?
Glyburide 4. Glipizide

1. Streptokinase 2.
What are four Urokinase 3. tPA
thrombolytics? (alteplase), APSAC
(anistreplase)

1. Hot flashes 2. Ovarian


What are four unwanted enlargement 3. Multiple
effects of Clomiphene use? simultaneous pregnancies
4. Visual disturbances

1. Buffalo hump 2. Moon


facies 3. Truncal obesity 4.
What are nine findings of
Muscle wasting 5. Thin
Iatrogenic Cushing's
skin 6. Easy bruisability 7.
syndrome caused by
Osteoporosis 8.
glucocorticoid therapy?
Adrenocortical atrophy 9.
Peptic ulcers
Headache, flushing ,
What are signs of Sildenafil
dyspepsia, blue-green
(Viagra) toxicity?
color vision.

Acute coronary syndrome;


What are the clinical uses coronary stenting.
for Ticlopidine, Decreases the incidence or
Clopidogrel? recurrence of thrombotic
stroke.

What are the four


1. Peptic ulcer 2. Gastritis
conditions in which
3. Esophageal reflux 4.
Omeprazole, Lansoprazole
Zollinger-Ellison syndrome
is used?

1. Infertility (pulsatile) 2.
Prostate cancer
What are three clinical
(continuous: use with
uses of the Leuprolide?
flutamide) 3. Uterine
fibroids
What are three clinical 1. Antipyretic 2. Analgesic
uses of the NSAIDs? 3. Anti-inflammatory

What are three common Ibuprofen, Naproxen, and


NSAIDS other than Aspirin? Indomethacin

What are three 1. Bleeding 2.


complications of Warfarin Teratogenicity 3. Drug-
usage? drug interactions

What are three possible 1. Bleeding 2.


complications of Heparin Thrombocytopenia 3.
therapy? Drug-drug interactions
1. Renal damage 2.
What are three possible
Aplastic anemia 3. GI
toxicities of NSAID usage?
distress

What are three toxicities of 1. Antiandrogen 2. Nausea


Leuprolied? 3. Vomiting

1. Skin rash 2.
What are three toxicities of
Agranulocytosis (rare) 3.
Propylthiouracil?
Aplastic anemia

1. Aluminum hydroxide:
constipation and
What are three types of hypophosphatemia 2.
antacids and the problems Magnesium hydroxide:
that can result from their diarrhea 3. Calcium
overuse? carbonate: Hypercalcemia,
rebound acid increase - All
may cause hypokalemia
1. Heavy bleeding 2. GI
What are three unwanted
effects (n/v, anorexia) 3.
effects of Mifepristone?
Abdominal pain

What are two Alpha-


1. Acarbose 2. Miglitol
glucosidase inhibitors?

1. Kidney transplantation
2. Autoimmune disorders
What are two clinical uses
(including
of Azathioprine?
glomerulonephritis and
hemolytic anemia)

What are two conditions in


Rheumatoid and
which COX-2 inhibitors
osteoarthritis.
might be used?
1. Pioglitazone 2.
What are two Glitazones?
Rosiglitazone.

Inhibits organification and


What are two mechanisms coupling of thyroid
of action of hormone synthesis. Also
Propythiouracil? decreases peripheral
conversion of T4 to T3.

1. Phospholipase A2 is
prevented from releasing
What are two processes
arachidonic acid 2.
Corticosteroids inhibit
Decreases protein
leading to decreased
synthesis thus lowering
inflammation?
amount of Cyclooxygenase
enzymes

1. Predisposes to viral
What are two toxicities infections and lymphoma
associated with 2. Nephrotoxic
Cyclosporine? (preventable with mannitol
diuresis)
1. Weight gain 2.
What are two toxicities of
Hepatotoxicity
the Glitazones?
(troglitazone)

1. Hypoglycemia (more
common with 2nd-
generation drugs:
What are two toxicities of
glyburide, glipizide) 2.
the Sulfonylureas?
Disulfiram-like effects (not
seen with 2nd-generation
drugs).

Sucralfate cannot work in


What are two types of the presence of antacids
drugs that interfere with or H2 blockers because it
the action of Sucralfate requires an acidic
and why? environment to
polymerize.

Can affect absorption,


bioavailability, or urinary
What can result due to excretion of other drugs
antacid overuse? by altering gastric and
urinary pH or by delaying
gastric emptying.
What enzyme does
Lipoxygenase
Zileuton inhibit?

What enzymes are


inhibited by NSAIDs, Cyclooxygenases (COX I,
acetaminophen and COX II COX II).
inhibitors?

What is a common side


effect of Colchicine used GI side effects. (Note:
to treat acute gout, Indomethacin is less toxic,
especially when given more commonly used.)
orally?

What is a common side


Diarrhea
effect of Misoprostol?
Overdose produces
hepatic necrosis;
What is a possible result of acetaminophen
overdose of metablolite depletes
Acetaminophen? glutathione and forms
toxic tissue adducts in
liver.

What is a possible toxicity


of Alpha-glucosidase GI disturbances.
inhibitors used in type-2
diabetes?

What is a possible toxicity Neutropenia (ticlopidine);


of Ticlopidine, Clopidogrel reserved for those who
usage? cannot tolerate aspirin.

What is a sign of toxicity


with the use of Bleeding.
thrombolytics?
1. In liver, increases storage
of glucose as glycogen. 2. In
What is action of insulin in muscle, stimulates glycogen
the liver, in muscle, and in and protein synthesis, and K
adipose tissue? + uptake. 3. In adipose
tissue, facilitates
triglyceride storage.

1. Suppresses organ
What is are two clinical rejection after
uses of Cyclosporine? transplantation 2. Selected
autoimmune disorders.

What is the category and


mechanism of action of Antileukotriene; blocks
Zafirlukast in Asthma leukotriene receptors.
treatment?

What is the category and


mechanism of action of Antileukotriene; blocks
Zileuton in Asthma synthesis by lipoxygenase.
treatment?
What is the category of
Inhalational general
drug names ending in -
anesthetic.
ane (e.g. Halothane)

What is the category of


drug names ending in - Benzodiazepine.
azepam (e.g. Diazepam)

What is the category of


drug names ending in - Phenothiazine
azine (e.g. (neuroleptic, antiemetic).
Chlorpromazine)

What is the category of


drug names ending in - Antifungal.
azol (e.g. Ketoconazole)
What is the category of
drug names ending in - Babiturate.
barbital (e.g.
Phenobarbital)

What is the category of


drug names ending in - Local anesthetic.
caine (e.g. Lidocaine)

What is the category of


drug names ending in - Penicillin.
cillin (e.g. Methicillin)

What is the category of


Antibiotic, protein
drug names ending in -
synthesis inhibitor.
cycline (e.g. Tetracycline)
What is the category of
drug names ending in - Tricyclic antidepressant.
ipramine (e.g. Imipramine)

What is the category of


drug names ending in - Protease inhibitor.
navir (e.g. Saquinavir)

What is the category of


drug names ending in - Beta antagonist.
olol (e.g. Propranolol)

What is the category of


Butyrophenone
drug names ending in -
(neuroleptic).
operidol (e.g. Haloperidol)
What is the category of
Cardiac glycoside
drug names ending in -
(inotropic agent).
oxin (e.g. Digoxin)

What is the category of


drug names ending in - Methylxanthine.
phylline (e.g. Theophylline)

What is the category of


drug names ending in -pril ACE inhibitor.
(e.g. Captopril)

What is the category of


drug names ending in - Beta-2 agonist.
terol (e.g. Albuterol)
What is the category of
drug names ending in - H2 antagonist
tidine (e.g. Cimetidine)

What is the category of


drug names ending in - Tricyclic antidepressant.
triptyline (e.g.
Amitriptyline)

What is the category of


drug names ending in - Pituitary hormone.
tropin (e.g. Somatotropin)

What is the category of


drug names ending in - Alpha-1 antagonist
zosin (e.g. Prazosin)
Nonspecific beta-agonist;
What is the category, desired effect is the
desired effect, and adverse relaxation of bronchial
effect of Isoproterenol in smooth muscle (Beta 2).
the treatment of Asthma? Adverse effect is
tachycardia (Beta 1).

Beta 2 agonist; desired


What is the category,
effect is the relaxation of
desired effect, and period
bronchial smooth muscle
of use of albuterol in the
(Beta 2). Use during acute
treatment of Asthma?
exacerbation.

Methylzanthine; desired
What is the category, effect is bronchodilation,
desired effect, and may cause bronchodilation
possible mechanism of by inhibiting
Theophylline in treating phosphodiesterase, enzyme
Asthma? involved in degrading cAMP
(controversial).

Muscarinic antagonist;
What is the category,
competatively blocks
mechanism of action, and
muscarinic receptors,
effect of Ipratroprium in
preventing
Asthma treatment?
bronchoconstriction.
Corticosteroids; prevent
What is the category,
production of leukotrienes
mechanism of action, and
from arachodonic acid by
particular use of
blocking phospholipase A2.
beclomethasone and
Drugs of choice in a patient
prednisone in Asthma
with status asthmaticus (in
treatment?
combination with albuterol.)

What is the category, Beta 2 agonist; used as a


method of use, and long-acting agent for
adverse effects of prophylaxis. Adverse
Salmeterol in Asthma effects are tremor and
treatment? arrhythmia.

Prevention of NSAID-
What is the clincial use for
induced peptic ulcers,
Misoprostol?
maintains a PDA.

What is the clinical use for


Treatment of infertility.
Clomiphene?
Immediate anticoagulation
What is the clinical use for
for PE, stroke, angina, MI,
Heparin?
DVT.

What is the clinical use for


Erectile dysfunction.
Sildenafil (Viagra)?

What is the clinical use for


Peptic ulcer disease.
Sucralfate?

What is the clinical use for


Chronic anticoagulation.
Warfarin?
What is the clinical use of
Abortifacient.
Mifepristone (RU486)?

Potent immunosuppressive
What is the clinical use of
used in organ transplant
Tacrolimus (FK506)?
recipients.

What is the effect of the


Increase target cell
Glitazones in diabetes
response to insulin.
treatment?

Finasteride inhibits 5
What is the enzyme
Alpha-reductase, this
inhibited, the effect of this
decreases the conversion
inhibition, and the clinical
of testosterone to
use of the antiandrogren
dihydrotestosterone,
Finasteride?
useful in BPH
What is the lab value used
to monitor the The PTT.
effectiveness of Heparin
therapy?

What is the lab value used


to monitor the The PT.
effectiveness of Warfarin
therapy?

What is the main clinical Early myocardial


use for the thrombolytics? infarction.

Aluminum sucrose sulfate


polymerizes in the acid
environment of the
What is the mecanism of
stomach and selectively
action of Sucralfate?
binds necrotic peptic ulcer
tissue. Acts as a barrier to
acid, pepsin, and bile.
Selectively inhibit
cyclooxygenase (COX)
What is the mecanism of isoform 2, which is found in
action of the COX-2 inflammatory cells nad
inhibitors (celecoxib, mediates inflammation and
rofecoxib)? pain; spares COX-1 which
helps maintain the gastric
mucosa.

Prevents release of
What is the mecanism of
mediators from mast cells.
action, effective period,
Effective only for the
and ineffective period of
prophylaxis of asthma. Not
use for Cromolyn in
effective during an acute
treating Asthma?
attack.

Flutamide is a nonsteroidal
What is the mechanism of competitive inhibitor of
action and clinical use of androgens at the
the antiandrogen testosterone receptor,
Flutamide? used in prostate
carcinoma.

What is the mechanism of Inhibit steroid synthesis,


action and clinical use of used in the treatment of
the antiandrogens polycystic ovarian
Ketoconazole and syndrome to prevent
Spironolactone? hirsutism.
Reversibly inhibits
What is the mechanism of cyclooxygenase, mostly in
action of Acetaminophen? CNS. Inactivated
peripherally.

What is the mechanism of Inhibits xanthine oxidase,


action of Allopurinol used decresing conversion of
to treat chronic gout? xanthine to uric acid.

Acetylates and irreversibly


inhibits cyclooxygenase
What is the mechanism of (COX I and COX II) to
action of Aspirin? prevent the conversion of
arachidonic acid to
prostaglandins.

Clomiphene is a partial
agonist at estrogen receptors
in the pituitary gland.
What is the mechanism of Prevents normal feedback
action of Clomiphene? inhibition and increses
release of LH and FSHfrom
the pituitary, which
stimulates ovulation.
Depolymerizes
What is the mechanism of
microtubules, impairing
action of Colchicine used
leukocyte chemotaxis and
to treat acute gout?
degranulation.

Binds to cyclophilins
(peptidyl proline cis-trans
isomerase), blocking the
What is the mechanism of
differentiation and
action of Cyclosporine?
activation of T cells mainly
by inhibiting the production
of IL-2 and its receptor.

Heparin catalyzes the


What is the mechanism of
activation of antithrombin
action of Heparin?
III.

What is the mechanism of Competitive inibitor of


action of Mifepristone progestins at progesterone
(RU486)? receptors.
Misoprostol is a PGE1
analog that increases the
What is the mechanism of
production and secretion
action of Misoprostol?
of the gastic mucous
barrier.

Reversibly inhibit
What is the mechanism of
cyclooxygenase (COX I and
action of NSAIDs other
COX II). Block
than Aspirin?
prostaglandin synthesis.

What is the mechanism of Irreversibly inhibits H+/K+


action of Omeprazole, ATPase in stomach parietal
Lansoprazole? cells.

What is the mechanism of


Inhibits reabsorption of
action of Probenacid used
uric acid.
to treat chronic gout?
Inhibits cGMP
phosphodiesterase,
What is the mechanism of casuing increased cGMP,
action of Sildenafil smooth muscle relaxation
(Viagra)? in the corpus cavernosum,
increased blood flow, and
penile erection.
Inhibit intestinal bursh
border Alpha-glucosidases;
What is the mechanism of delayed hydrolysis of
action of the Alpha- sugars and absorption of
glucosidase inhibitors? sugars leading to decresed
postprandial
hyperglycemia.

Decrease the production of


What is the mechanism of leukotrienes and
action of the protaglandins by inhibiting
glucocorticoids? phospholipase A2 and
expression of COX-2.

What is the mechanism of Reversible block of


action of the H2 Blockers? histamine H2 receptors
Close K+ channels in
Beta-cell membrane
What is the mechanism of leading to cell
action of the depolarization causing
Sulfonylureas? insulin release triggered
by increase in Calcium ion
influx.
Directly of indirectly aid
conversion of plasminogen to
What is the mechanism of plasmin which cleaves
action of the thrombin and fibrin clots. (It
is claimed that tPA
thrombolytics?
specifically converts fibrin-
bound plasminogen to
plasmin.)

Inhibits platelet
What is the mechanism of aggregation by irreversibly
action of Ticlopidine, inhibiting the ADP pathway
Clopidogrel involved in the binding of
fibrinogen.

Warfarin interferes with


the normal synthesis and
What is the mechanism of gamma-carboxylation of
action of Warfarin vitamin K-dependent
(Coumadin)? clotting factors II, VII, IX,
and X, Protein C and S via
vitamin K antagonism.
Antimetabolite derivative
of 6-mercaptopurine that
What is the mechanism of
interferes with the
Azathioprine?
metablolism and synthesis
of nucleic acid.

GnRH analog with agonist


properties when used in
pulsatile fashion and
What is the mechanism of
antagonist properties when
Leuprolide?
used in continuous fashion,
causing a transient initial
burst of LH and FSH

Similar to cyclosporine;
binds to FK-binding
What is the mechanism of
protein, inhibiting
Tacrolimus (FK506)?
secretion of IL-2 and other
cytokines.

What is the memory key


for the action of Sildenafil Sildenafil fills the penis
(Viagra)?
What is the memory key
AluMINIMUM amount of
for the effect of aluminum
feces.
hydroxide overuse?

What is the memory key


for the effect of Mg = Must go to the
magnesium hydroxide bathroom.
overuse?

What is the memory key to


remember which pathway WEPT: Warfarin affects the
(extrinsic vs. intrinsic) and Extrinsic pathway and
which lab value Warfarin prolongs the PT.
affects?

Mechanism unknown;
What is the possible possibly inhibits
mechanism and effect of gluconeogenesis and
Metformin in treating increases glycolysis; effect
diabetes? is to decrease serum
glucose levels
What is the specific clinical Indomethacin is used to
use of Indomethacin in close a patent ductus
neonates? arteriosus.

Protamine Sulfate is used


for rapid reversal of
What is used to reverse the heparinization (positively
action of Heparin? charged molecule that
binds to negatively
charged heparin).

What patients are at risk


for life threatening Those patients who are
hypotension when taking taking nitrates.
Sildenafil (Viagra)?

What process does Leukotrienes increasing


Zafirlukast interfere with? bronchial tone.
What type of gout is
Chronic gout.
treated with Allopurinol?

What type of gout is


Acute gout.
treated with Colchicine?

What type of gout is


Chronic gout.
treated with Probenacid?

Misoprostol is
What type of patient contraindicated in women
should not take of childbearing potential
Misoprostol and why? because it is an
abortifacient.
Cimetidine is a potent
inhibitor of P450; it also has
Which H2 Blocker has the an antiandrogenic effect and
most toxic effects and decreases renal excretion of
what are they? creatinine. Other H2
blockers are relatively free
of these effects.

Why are the Sulfonylureas Because they require some


inactive in IDDM (type-1)? residual islet function.

Acetaldehyde is
metabolized by -Disulfram & also
Acetaldehyde sulfonylureas,
dehydrogenase, which metronidazole
drug inhibs this enzyme?

-Weak Acids>Alkinalize
urine(CO3) to remove
Explain pH dependent
more -Weak
urinary drug elimination?
bases>acidify urine to
remove more
-Airway -Breathing -
How do you treat coma in Circulation -Dextrose
the ER (4)? (thiamine &narcan) -
ABCD

-Infections -Trauma -
In coma situations you rule Seizures -CO -Overdose -
out what (7)? Metabolic -Alcohol (IT'S
COMA)

-A57Blue lines in
gingiva& long bones
List some specifics of lead -Encephalopathy &
poisoning(4)? Foot drop -Abdominal
colic / -Sideroblastic
anemia

List the specific antidote


for this toxin: -N-acetylcystine
Acetaminophen
List the specific antidote
for this toxin: -Ammonium Chloride
Amphetamine

List the specific antidote


for this toxin: -Atropine &
Anticholinesterases pralidoxime
(organophosphate.)

List the specific antidote


for this toxin: -Physostigmine salicylate
Antimuscarinic
(anticholinergic)

List the specific antidote


for this toxin: Arsenic (all -Dimercaprol, succimer
heavy metals)
List the specific antidote
for this toxin: -Flumazenil
Benzodiazepines

List the specific antidote


for this toxin: Beta -Glucagon
Blockers

List the specific antidote


for this toxin: Carbon -100% oxygen, hyperbaric
monoxide

List the specific antidote


-Penicillamine
for this toxin: Copper
-Nitrate,
List the specific antidote
hydroxocobalamin
for this toxin: Cyanide
thiosulfate

List the specific antidote -Normalize K+, Lidocaine,


for this toxin: Digitalis & Anti-dig Mab

List the specific antidote


-Protamine
for this toxin: Heparin

List the specific antidote


-Deferoxamine
for this toxin: Iron
-EDTA, dimercaprol,
List the specific antidote
succimer, &
for this toxin: Lead
penicillamine

List the specific antidote


-Ethanol, dialysis, &
for this toxin: Methanol
fomepizole
& Ethylene glycol

List the specific antidote


for this toxin: -Methylene blue
Methemoglobin

List the specific antidote -B51Naloxone /


for this toxin: Opioids naltrexone (Narcan)
List the specific antidote -Alkalinize urine &
for this toxin: Salicylates dialysis

List the specific antidote


for this toxin: TPA & -Aminocaproic acid
Streptokinase

List the specific antidote


for this toxin: Tricyclic -NaHCO3
antidepressants

List the specific antidote -Vitamin K & fresh


for this toxin: Warfarin frozen plasma
What are the products and
-Acetaldehyde -Nausea,
their toxicities of the
vomiting, headache,
metabolism of ethanol by
& hypotension
/ alcohol dehydrogenase?

What are the products and


their toxicities of the
-Oxalic acid -Acidosis
metabolism of Ethylene
& nephrotoxicity
Glycol by / alcohol
dehydrogenase?

What are the products and


-Formaldehyde &
their toxicities of the
formic acid -severe
metabolism of Methanol
acidosis & retinal
by / alcohol
damage
dehydrogenase?

Which drug(s) cause this


reaction: Adrenocortical -Glucocorticoid withdrawal
Insufficiency
Which drug(s) cause this -Cloazapine -
reaction: Agranulocytosis carbamazapine -colchicine
(3)? -PTU

Which drug(s) cause this


-Penicillin
reaction: Anaphylaxis?

Which drug(s) cause this -Chloramphenicol -


reaction: Aplastic anemia benzene -NSAIDS -PTU -
(5)? phenytoin

Which drug(s) cause this


reaction: Atropine-like -Tricyclic antidepressants
side effects?
Which drug(s) cause this -Daunorubicin &
reaction: Cardiac toxicity? Doxorubicin

Which drug(s) cause this


-Quinidine -quinine
reaction: Cinchonism (2)?

Which drug(s) cause this -ACE inhibitors


reaction: Cough? (Losartan>no cough)

Which drug(s) cause this -Niacin -Ca++ channel


reaction: Cutaneous blockers -adenosine -
flushing (4)? vancomycin
Which drug(s) cause this
reaction: Diabetes -Lithium
insipidus?

-Metronidazole -certain
Which drug(s) cause this
cephalosporins -
reaction: Disulfram-like
procarbazine -
reaction (4) ?
sulfonylureas

Which drug(s) cause this -Haloperidol -


reaction: Drug induced chlorpromazine -reserpine
Parkinson's (4) ? -MPTP

Which drug(s) cause this


-Chlorpromazine -
reaction: Extrapyramidal
thioridazine -haloperidol
side effects (3)?
Which drug(s) cause this
reaction: Fanconi's -Tetracycline
syndrome?

Which drug(s) cause this -Halothane -Valproic acid


reaction: Focal to massive -acetaminophen -Amantia
hepatic necrosis (4)? phalloides

-Sulfonamides -INH -ASA


Which drug(s) cause this -Ibuprofen -primaquine -
reaction: G6PD hemolysis nitrofurantoin /-
(8)? pyrimethamine -
chloramphenicol

Which drug(s) cause this


reaction: Gingival -Phenytoin
hyperplasia?
Which drug(s) cause this
reaction: Gray baby -Chloramphenicol
syndrome?

Which drug(s) cause this -Cimetidine -ketoconazole


reaction: Gynecomastia (6) -spironolactone -digitalis
? -EtOH -estrogens

Which drug(s) cause this


-Isoniazid
reaction: Hepatitis?

Which drug(s) cause this


-Tamoxifen
reaction: Hot flashes?
Which drug(s) cause this
reaction: Neuro and -polymyxins
Nephrotoxic?

Which drug(s) cause this


-Corticosteroids -heparin
reaction: Osteoporosis (2)?

Which drug(s) cause this


-aminoglycosides -loop
reaction: Oto and
diuretics -cisplatin
Nephrotoxicity (3)?

Which drug(s) cause this -Barbiturates -phenytoin -


reaction: P450 induction carbamazipine -rifampin -
(6)? griseofulvin -quinidine
-Cimetidine -ketoconazole
Which drug(s) cause this
-grapefruit juice -
reaction: P450 inhibition
erythromycin -INH -
(6)?
sulfonamides

Which drug(s) cause this


-Tetracycline -amiodarone
reaction: Photosensitivity
-sulfonamides
(3)?

Which drug(s) cause this


reaction: -Clindamycin
Pseudomembranous
colitis?

Which drug(s) cause this


-Bleomycin -amiodarone -
reaction: Pulmonary
busulfan
fibrosis(3)?
Which drug(s) cause this -Hydralazine -
reaction: SLE-like Procainamide -INH -
syndrome phenytoin

Which drug(s) cause this


-Ethosuxamide -
reaction: Stevens-Johnson
sulfonamides -lamotrigine
syn. (3) ?

Which drug(s) cause this


reaction: Tardive -Antipsychotics
dyskinesia?

Which drug(s) cause this


reaction: Tendonitis and -Fluoroquinolones
rupture?
Which drug(s) cause this
reaction: Thrombotic -Oral Contraceptives
complications?

Which drug(s) cause this -Class III antiarrhythmics


reaction: Torsade de (sotalol) -class IA
pointes (2) ? (quinidine)

-Sulfonamides -
Which drug(s) cause this
furosemide -methicillin -
reaction: Tubulointerstitial
rifampin -NSAIDS (ex.
Nephritis (5)?
ASA)

Constant FRACTION
Describe first-order
eliminated per unit time.
kinetics?
(exponential)
-reduction, oxy, &
Describe Phase I
hydrolysis -H2O sol. Polar
metabolism in liver(3)?
product -P450

-acetylation,
Describe Phase II glucuron.,& sulfation
metabolism in liver(3)? -Conjugation -Polar
product

Explain differences
- Act on same receptor -
between full and partial
Full has greater efficacy
agonists(2).

- partial agonist can have


Explain potency in relation increased, decreased, /
to full and partial agonists A21or equal potency as
(2). full agonist. - Potency is
an independent factor.
- ED 50 is less than the
How do spare receptors
Km (less than 50% of
effect the Km?
receptors)

How do you calculate Md= (CpxCL)/F Cp= plas.


maintenance dose? Conc. CL=clear. F=bioaval.

How does a competitive


-Shifts the curve to the
antagonist effect an
right -increases Km
agonist?

How does a
- Shifts the curve down -
noncompetitive antagonist
reduces Vmax
effect an agonist?
-Phase I (clinical tests) -
Name the steps in drug
Phase II -Phase III -PhaseIV
approval(4)?
(surveillance)

Steady state concentration In 4 half-lifes= (94%) T1/2


is reached in __#half-lifes = (0.7x Vd)/CL

What is the definition of -Constant AMOUNT


zero-order kinetics? eliminated per unit time. -
Example? Etoh &ASA

What is the formula for CL= (rate of elimination of


Clearance (CL) drug/ Plasma drug conc.)
What is the formula for Vd= (Amt. of drug in
Volume of distribution (Vd) body/ Plasma drug conc.)

Ld= (CpxVd)/F
What is the loading dose
Cp=plasma conc. F=
formula?
Bioaval.

A 12yo patient was treated


for a reaction to a bee
sting, what drug provides Epinephirine(Alpha1,2 and
the best coverage of Beta 1,2)
sympathomimetic
receptors?

A 57 yo heart failure pt
develops cardiac
decompensation, what
drug will give you Dopamine
adequate perfusion of his
kidneys as well as tx for
his Hypotension
A fellow passenger on a
Carnival cruise ship looks
pale and diaphoretic, what scopolamine
antimuscarinic agent
would you give them?

A group of pts are rushed


into the ER complaining of Atropine pts are suffering
excessive sweating, tearing, from Cholinestrase
salivation, HA, N and V, inhibitor poisining(Nerve
muscle twitching, difficulty
gas/Organophosphate
breathing and diarrhea. What
poisining)
drug would be the most
effective immediate tx

As an Anes you want to


use a depolarizing
neuromuscular blocking Succinylcholine
drug on your pt, what do
you use

By what mechanism does Prevents the release of Ca


this drug help from SR of skeletal muscle
Centrally acting alpha
Clonidine is the preferred
agonist, thus causing a
sym pathomimetic tx of
decrease in central
HTN in pts with renal
adrenergic outflow,
disease, why??
spairing renal blood flow

Cocaine casues
vasoconstriction and local Indirect agonist, uptake
anesthesia by what inhibitor
mechanism

Cocaine shares is
mechanism of action with TCA
what antidepressant

Dobutamine used for the


tx of shock acts on which Beta1 more than B2
receptors
Guanethidine enhances the No, it inhibits the release
release of Norepi? of Nor Epi

How does angiotensin II It acts presynaptically to


affect NE release? increase NE release.

Prevents the release of


How does botulinum toxin
ACh, which results in
result in respiratory arrest?
muscle paralysis.

Prevents the release of


How does dantrolene calcium from the
work? sarcoplasmic reticulum of
skeletal muscle.
NE acts presynaptically on
alpha-2 receptors to
How does NE modulate its
inhibit its own release.
own release? What other
ACh also acts
neurotransmitter has this
presynaptically through
same effect?
M1 receptors to inhibit NE
release.

Hemicholinium inhibits the


How would hemicholinium
transport of choline into
treatment affect
the nerve, thus inhibiting
cholinergic neurons?
formation of ACh.

How would you reverse the Give an antichloinesterase


effect of a neuromuscular - neostigmine,
blocking agent? edrophonium, etc

It would increase to ~ 100


beats/min. Both sympathetic
If a patient is given and vagal stimulation would
hexamethonium, what be knocked out, but the SA
would happen to his/her node has an intrinsic pace of
heart rate? 100 beats/min, which is
normally checked by vagal
stimulation.
Isopoterenol was given to
Stimulates beta adrenergic
a patient with a developing
receptors
AV block, why?

Norepi feedbacks and


Binding to the presynaptic
inhibits the presynaptic
alpha 2 release
receptor by what
modulating receptors
mechanism

Reserpine will block the


Blocks Norepi, but not
syntheis of this drug and
Dopamine
but not its precursor.

These drugs acts indirectly


by releasing strored Amphetamine and
catecholamines in the Ephedrine
presynaptic terminal
What anticholinesterase
crosses the blood-brain- physostigmine
barrier?

What antimuscarinic agent


is used in asthma and Ipratropium
COPD?

What antimuscarinic drug


is useful for the tx of Ipratropium
asthma

Diarrhea, Urination,
What are the classic Miosis, Bronchospasm,
symptoms of Bradycardia, Excitation of
cholinesterase inhibitor skeletal muscle and CNS,
poisoning (parathion or Lacrimation, Sweating, and
other organophosphates)? Salivation = DUMBBELS;
also abdominal cramping
Activates cholinergic
receptors on bladder and
What are the clinical
bowel smooth muscle,
indications for
alleviating post-op and
bethanechol?
neurogenic ileus and
urinary retention.

Post-op and neurogenic


ileus and urinary retention,
What are the clinical myasthenia gravis, and
indications for reversal of neuromuscular
neostigmine? junction blockade (post-
op) through
anticholinesterase activity.

narcolepsy, obesity, and


What are the indications
attention deficit disorder (I
for using amphetamine?
wouldn't recommend this)

What are the


Tubocurarine, atracurium,
nondepolarizing
mivacurium, pancuronium,
neuromuscular blocking
vecuronium, rapacuronium
drugs?
Phase 1 = prolonged
depolarization, no antidote,
What are the phases of effect potentiated by
succinylcholine anticholinesterase; Phase 2
neuromuscular blockade? = repolarized but blocked,
an anticholinesterase is the
antidote for this phase.

What are two indirect


amphetamine and
acting adrenergic
ephedrine
agonists?

What beta 2 agonist will


Albuterol, tertbutaline
help your 21yo Astma pt?

What cholinergic inhibitor


acts by directly inhibiting Botulinum
Ach release at the
presynaptic terminal
What cholinomimetic is
useful in the diagnosis of Edrophonium
Myasthenia Gravis

What cholinomimetics Carbachol, pilocarpine,


might your pt be taking physostigmine,
for his glaucoma echothiophate

What class of drug is


anticholinesterase
echothiophate? What is its
glaucoma
indication?

In treatment of malignant
hyperthermia, due to
What conditions would you concomitant use of halothane
use dantrolene? and succinylcholine. Also in
neuroleptic malignant
syndrome, a toxicity of
antipsychotic drugs.
What drug is used to edrophonium (extremely
diagnose myasthenia short acting
gravis? anticholinesterase)

Neostigmine,
pyridostigmine
What drugs target this
edrophonium
enzyme
physostigmine
echothiophate

Theoretically it could be
What effect would atropine
used to block the cephalic
have on a patient with
phase of acid secretion
peptic ulcer disease?
(vagal stimulation).

What effect would atropine None. No, because


have on the preganglionic atropine would block the
sympathetic activation of postganglionic muscarinic
sweat glands? Would this receptors involved in
person sweat? sweat gland stimulation.
What enzyme is
Acetylcholinesterase; ACh
responsible for the
is broken down into
breakdown of ACh in the
choline and acetate.
synaptic cleft?

What enzyme is
responsible for the Acetylcholine esterase
degredation of Ach

What enzyme is
responsible for the Choline acetyltransferase
production of Ach from
Acetyl CoA and Choline

Treatment of
hypertension, especially
What is the clinical utility
with renal disease (lowers
of clonidine?
bp centrally, so flow is
maintained to kidney).
The only local anesthetic
What is the clinical utility
with vasoconstrictive
of cocaine?
properties.

Dobutamine has more of an


What is the difference affintiy for beta-1 than
between the affinity for beta-2, and is used for
beta receptors between treating heart failure and
shock. Albuterol and
albuterol/terbutaline and
terbutaline is the reverse, and
dantroline? is used in treatment of acute
asthma.

What is the difference in Prefers beta's at low


receptor affinity of doses, but at higher doses
epinephrine at low doses? alpha agonist effects are
High doses? predominantly seen.

Increased systolic and


What is the effect of pulse pressure, decreased
epinephrine infusion on bp diastolic pressure, and
and pulse pressure? little change in mean
pressure.
What is the effect of
guanethidine on It inhibits release of NE.
adrenergic NE release?

Increases mean, systolic,


What is the effect of
and diastolic bp, while
norepinephrine on bp and
there is little change in
pulse pressure?
pulse pressure.

They inhibit reuptake of


What is the effect of TCA's
NE at the nerve terminal
on the adrenergic nerve?
(as does cocaine).

What is the only


depolarizing Succinylcholine
neuromuscular blocking
agent?
What is the receptor It affects beta receptors
affinity and clinical use of equally and is used in AV
isoproterenol? heart block (rare).

It antagonizes Ach M
What makes this drug
receptors and decreases
effective
parasym (GI) rxn

What nondepolorizing
Tubocurarine, atra-, miv-,
agents could you have
pan-,ve-, rapacuronium
used

What other substances


regulate the Norepi nerve Ach, AngiotensinII
ending
What other syndrome can Neuroleptic malignant
this drug tx syndrome

SLUD (salivation,
What physiological effects Lacrimation, urination,
was the Anes using Defecation)as well as
Atropine to tx airway secretion, GI
motility, acid secretions

What reversal agent could


Bethanechol, Neostigmine,
a Anes give to reverse the
physostigmine
effects of Atropine

Atropine would also block


What side effect of using the receptors in the ciliary
atropine to induce muscle, causing an
pupillary dilation would impairment in
you expect? accommodation
(cycloplegia).
What sympathomimetic
would you not prescribe Norepinephrine (Alpha1,2
for hypotension in a pt and beta 1)
with renal artery sclerosis.

Hexamethonium is a
What type of neurological
nicotinic antagonist, and
blockade would
thus is a ganglionic
hexamethonium create?
blocker.

Initially vasoconstriction
would increase bp, but
What would be the effect
then it acts on central
on blood pressure with
alpha-2 receptors to
infusion of the alpha -2
decrease adrenergic
agonist clonidine?
outflow resulting in
decreased bp.

What would be the next


Pralidoxime, regenerates
drug that you would give
active cholinestrase
and why
Which antimuscarinic
agents are used in atropine, homatropine,
producing mydriasis and tropicamide
cycloplegia?

Which drug increases Sys


BP w/o affecting Pulse Epinephrine
Pressure

Which of epi, norepi, or


isoproterenol results in Norepinephrine
bradycardia?

Dry flushed skin, due to


Which of the following
inhibition of sympathetic
would atropine
post-ganglionic blockade
administration cause?
on muscarinic receptors of
Hypothermia, bradycardia,
sweat glands. All others
excess salivation, dry
are opposite of what
flushed skin, or diarrhea
would be expected.
Which of these three drugs
will cause a reflex
bradycardia in your pt Norepinephrine
(Norepi, Epi, or
Isoporterenol)

alpha-1 > alpha-2;


Which receptors does used as a pupil dilator,
phenylephrine act upon? vasoconstrictor, and for
nasal decongestion

While at a tail gait party,


Epinephrine to treat
you bite into a sandwich
anaphylaxis. Also useful if
that a yellow jacket is also
you have open angle
enjoying. Knowing your
glaucoma, asthma, or
allergy to this creature,
hypotension.
what should you do?

Why are albuterol and These B-2 agonists cause


terbutaline effective in tx respiratory smooth muscle
of acute asthmatic attacks? to relax.
Blocking muscarinic
receptors in the circular
Why does atropine dilate
fibers of the eye, results in
the pupil?
unopposed action of radial
muscles to dilate.

NE increases bp, which


stimulates baroreceptors
Why does NE result in in the carotid sinus and
bradycardia? the aorta. The CNS signals
through vagal stimulation
to decrease heart rate.

They activate the ciliary


Why is carbachol and
muscle of the eye (open
pilocarpine useful in
angle) and pupillary
treatment of glaucoma?
sphincter (narrow angle).

As an anticholinesterase it
Why is pyridostigmine
increases endogenous ACh
effective in the treatment
and thus increases
of myasthenia gravis?
strength.
Reserpine inhibits
dopamine transport into
Why is reserpine effective vesicles, attenuating its
in treating HTN? conversion to NE by
dopamine beta-
hydroxylase.

Stimulating beta receptors


Why is there a drop in
stimulates heart rate, but
systolic, mean, and
beta receptor induced
diastolic bp with infusion
vasodilation reduces
of isoproterenol?
peripheral resistance.

Parkinson patients benefit


Why would a patient with
from antimuscarinic
cog-wheel rigidity and a
agents through its
shuffling gait be given
inhibitory action within the
benztropine?
indirect pathway.

Receptors =
D1=D2>beta>alpha,
Why would dopamine be thus increasing heart rate
useful in treating shock? (beta) and blood pressure
(alpha vasoconstriction) while
maintaining kidney perfusion
(dopamine receptors)
Why would you give a drug Useful in muscle paralysis
like pancuronium or during surgery or
succinylcholine? mechanical ventilation.

Why would you use


pralidoxime after Pralidoxime regenerates
exposure to an active cholinesterase.
organophosphate?

Will Hemicholinum affect


No, hemicholinum block
the release of stored Ach
the uptake of Choline and
during Cholinergic
thus Ach synthesis
Stimulation

No. Atropine is used to


Would blockade of
reduce urgency in mild
muscarininc receptors in
cystitis. So it would
the bladder be useful in
aggravate the urinary
treating urinary retention?
retention.
No, hexamethonium
targets Nicotinc receptors
Would Hexamethonium be
and will block Parasym,
an effective substitute
Sym, as well as Somatic
systems

You tx your pt with


halothane as well and he
has also developed Dantrolene
malignant hypothermia,
what drug can you give

Your patient develops a


No cholinesterase
marked arrythmia due to a
inhibitors will potentiate
prolonged depolarization,
the stimulating action of
can you tx this w/
Succinlycholine
Neostigmine

Your patient has acute


Yes, Scopolamine would
angle glaucoma, does this
antagonize his glaucoma
affect your tx
Your patient wants an
effective drug to treat his Scopolamine
motion sickness, what
would you prescribe