usmle: pharm
Terms
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-
t or f
hyperkalemia inc effect of digoxin - f
- dantrolene moa
- blocks Ca release from SR -> used for malignant hyperthermia
- overdose w/ highest mortality: benzo's or barbi's
- barbi
- antiviral agent used in tx of drug induced Parkinson's
- amantadine
-
H1 of H2 receptor activation:
1. edema
2. gastric acid secretion
3. SA nodal activity
4. pain and pruritis
5. bronchial sm mm activity
6. inotropic action and automaticity -
1. H1
2. H2
3. H2
4. H1
5. H1
6. H2 -
t or f
the lack of DA production in the substantia nigra leads to the extrapyramidal dysfunction characteristically seen ion patients w/ Parkinson's -
true
lack of DA -> excess of ACh -> extrapyramidal dysf - which PG maintains patency of the ductus arteriosus and is used in the tx of primary pulmonary HTN
- PGI2
-
which CNS Ach receptor(s) are excitatory?
inhibitory? -
M1 and nicotinic are excitiatory
M2 inhibitory -
t or f
b2 adrenergic agents are used in management of acute asthma attack - t
- do local anesthetics bind to the activated or inactivated sodium channels
- inactivated
-
what is the DOC for Tourette
s - pimozide
- what mosquito is responsible for the transmission of malaria
- anopheles
- what enzyme is inhibited by disulfiram
- aldehyde dehydrogenase
- which diuretic is used as an adrenal steroid antagonist
- spironolactone
- what drugs is given transdermally for chronic pain but can cause chest wall rigidity if given IV
- fentanyl
- what is the DOC for penicillin-resistant GC
- spectinomycin
- is heparin contraindicated in pregnancy
- no
- what oral antifungal agent is used to tx dermatophyte infections by disrupting microtubule structure and depositing keratin
- griseofulvin
- which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida
- carbamazapine
- what are the three beta lactamase inhibitors
-
clavulanic acid
sulbactam
tazobactam - which anticonvulsant used in the tx of bipolar disorder is refractory to lithium
- carbamazepine
- are antineoplastic agents that work on actively proliferating cells schedule or dose dependent
- schedule
- which class of diuretics is used to tx metabolic acidosis, acute mountain sickness, and glaucoma and to aid in the elimination of acidic drug overdose
-
carbonic anhydrase inhibitors
(acetazolamide, dorzolamide) - what estrogen receptor agonist in bone is used in the tx and prevention of osteoporosis
- raloxifene
- which tetracycline is used in the tx of SIADH
- demeclocycline
- how is the eye effected by opiods
- pinpoint pupils
- grey baby syndrome
- chloramphenicol
- CN VIII damage
- aminoglycosides
- teratogenicity
- metronidazole
- cholestatic hepatitis
- erythromycin
- hemolytic anemia
- nitrofurantoin
- dental staining in kids
- tetracycline
- altered folate metabolism
- trimethoprim
- auditory toxicity
- vancomycin
- cartilage abnormalities
- fluoroquinolones
- gynecomastia
-
spironolactone
digitalis
cimetidine
Alcohol
ketoconazole - photosensitivity
-
Sulfonamides
Amiodarone
Tetracycline - SLE
-
hydralazine
INH
procainamide
phenytoin - torsades de poites
- class III and Class Ia antiarrhythmics
- gingival hyperplasia
- phenytoin
- fanconi's
- tetracycline
- which anticonvulsant is also used in the tx of bipolar disorder and for migraine headaches
- valproic acid
- what antitubercular agent causes loss of red green visual discrimination
- ethambutol
-
name the insulin prep
1. peak 8 hrs, lasts 24 hrs
2. peak .5 hrs, lasts 5 hrs
3. peak 8 hrs, lasts 18 hrs
4. peak in .3 hrs, lasts 3 hrs -
1. ultralente
2. insulin
3. lente or NPH insulin
4. lispro - is digoxin or digitoxin renally eliminated
-
digoxin
(digiToxin is hepaTically eliminated) - what is the DOC for steroid induced osteoporosis
- alendronate
- what are the first signs of overdose from phenobarbitals
- nystagmus and ataxia
- how are lipid solubility and potency related for inhaled anesthetics? how do they affect onset and recovery?
-
directly
high lipid solubility -> high potency -> slow onset -> slow recovery - what a1 agonist, not inactivated by COMT, is used as a decongestant and for tx of paroxysmal atrial tachycardia
- phenylephrine
- which laxative is used in the tx of hepatic encephalopathy
- lactulose
- are hydrolyis, oxidation, and reduction p hase I or II
- phase I
- what beta blocker is also an alpha blocker
- labetalol
- what agent is used IM to tx acute dystonias
- diphenhydramine
-
t or f
anaerobes are resistant to aminoglycosides -
t
aminoglycosides use O2 dep uptake - what two beta blockers dec serum lipids
-
pindolol
acebutolol - if a drug is ionized, is it water or lipid soluble? can it cross a membrane?
-
water
no - what are the longest acting and shortest acting benzo's
-
diazepam is the longest
(Die after a long life)
midazolam is the shortest
(MIDgets are short)
also (Triazolam Oxazepam and Midazolam -> TOM thumb) - what is the DOC for infections w/ sporothrix, mucor, histo, crypto, candida and aspergillus
- amphotericin B
- what neurotransmitter is presynaptically inhibited by reserpine and quanethidine
- NE
- which 2 cephalosporins cross the BBB
-
cefuroxime
cefaclor -
t or f
cocaine induced coronary ischemia shouldn't be tx w/ beta blockers -
true
go with Ca channel blockers - what antimuscarinic is used as an inhalant for asthma
- ipratropium
- what two forms of insulin, if mixed together , precipitate zinc
- lente and NPH or protamine zinc insulin (PZI)
- what androgen receptor blocker is used to tx prostatic cancer
- flutamide
- which virus is tx with palivizumab
- RSV
- name the classes of antiarrhythmics
-
I: Na channel blockers
II: beta blockers
III: K channel blockers
IV: calcium channel blockers - which muscarinic receptor uses a dec in adenyl cyclase as its second messenger
- M2
- what antiepileptic agent has SIADH as a side effect
- carbamazepine
- what is the only anesthetic that causes CV stimulation
- ketamine
- which bacteriostatic drug whose major side effect is the lepra reax inhibits folic acid synthesis
-
dapsone
(one of the acute episodes of chills and fever, malaise, and skin eruption occurring in the chronic course of leprosy) - what form of antimicrobial therapy is best for an immunocompromised patient
- bactericidal
- which class of heparin is active against factor Xa and has no effect on Pt
- LMWH
- what is the DOC for coccidio
- fluconazole
- what three cephalosporons have good penetration against B frag
-
cefotetan
cefoxitin
fetizoxime - which immunosuppressive agent is converted to 6-mercaptopurine
- azathioprine
- which size nerve fibers are mores sensitive to local anesthetic block
- small myelinated > small unmyelinated > lg myelinated > lg unmyelinated
- what enzyme is inhibited by TMP
- DHF reductase
- what are the two absolute requirements for the P450 enzyme system
- NADPH and O2
- a depressive patients on paroxetine goes to the ER w/ pain and is given meperidine. shortly afterword she develops diaphoresis, mycolonus, mm rigidity, hyperthermia, and seizures
-
sertonin crisis
SSRI mixed with MAOI, TCADS, detromethorphan and meperidine
tx w/ cyproheptadine - tx demineralization of bone
- bisphosphonates
- what is the only class of diuretics to retain Cl used in the short term tx of glaucoma and of acute mountain sickness
- acetazolamide
-
t or f
all aluminum containing anatacids can cause hypophophatemia - true
- what TCA causes sudden cardiac death in children
- desipramine
- what two beta2 agonists are used to produce bronchodilation
-
albuterol
metaproterenol - what IV only agent inhibits water reabsorption in the PCT and is used to tx inc intracranial press, inc intraoccular press, and acute renal failure
- mannitol
- what cell type do cromolyn and nedocromil affect for prophylactic management of astham
- mast cell degranulation
- what two beta2 agonists cause myometrial relaxation
-
ritodrine
terbutaline - where in the spinal cord are the presynaptic opiod receptors
- dorsal horn on the primary afferent neurons
- what thrombolytic agent is derived from beta hemolytic strep, is antigenic, and produces depletion of ciculating fibrinogen, plasminogen, and factors V and VII
- streptokinase
- what antifungal agent is used to tx dermatophyte infections by inhibiting squalene epoxidase
- terbinafine
- which class of antihypertensives produces angioedema, hyperkalemia, and dry cough
- ACEI
- which medication req an acidic gastric pH for activation to form a protective gel like coating over ulcers and GI epi
- sucralfate
- of what serotonin receptors is sumatriptan an agonist
- 5HT-1D
-
a pt w/ hx of epilepsy goes to ER w/ sedation, gait ataxia, diplopia, vertical nystagmus.
which anticonvulsant overdose resulted in these sx - phenytoin
- what are the five penicillinase resistant penicillins
-
Cloxacillin
Oxacillin
Nafcillin
Dicloxacillin
Methicillin
(CONDM) - which aminoglycoside is the DOC for tularemia and bubonic plague
- streptomycin
-
t or f
progestins are used in combo w/ estrogens to dec the risk of endometrial cancer - t
- what neuroleptic agent causes agranulocytosis but does no induce tardive dyskinesia
- clozapine
- what two factors influence low oral bioavailability
-
first pass metabolism
acid lability - what is the only site in the body that uses M1 receptors
- stomach
- what vitamin is a cofactor of aromatic AACD and dec the efficacy of L-dopa if used concomitantly
- vit B6 (pyridoxine)
-
t or f
acetaminophen has analgesic and antipyretic activites but lack antiinflammatory effects - t
- what happens to plasma conc of a drug if there is a lg vol of dist
- dec
- why should opiod analgesics be avoided for pt's with head trauma
- can cause cerebral vasodilation and can result in inc intracranial press
- what is the DOC for tx of lepra reax
- clofazimine
- what two drugs, when mixed, can lead to malignant hyperthermia
- succinyl choline and halothane
- what three beta blockers are used in the tx of glaucoma
-
timolol
carteolol
propranolol - what is the neurotransmitter at the k-receptor
- dynorphin
-
t or f
succinyl choline is a nicotinic receptor agonist - t
- what is the drug of choice for patients w/ hypertension and dec renal funciton
-
alpha-methyldopa
or clonidine - what is the vol of dist when a drug is highly protein bound
- dec
- what antihistamine is used in the tx of serotonergic crisis
- cyproheptadine
- what is the drug of choice for early Parkinson's
- selegiline
-
where is the site of the following
1. osmotic diuretics
2. loop diuretics
3. thiazide diuretics
4. k sparing
5. aldosterone antagonists -
1. entire tubule except thick ascending limb
2. ascending limb
3. early distal tubule
4. early collecting duct
5. distal convoluted tubule - what hematoligic malignancy is tx with rituximab
- non-hodgkin's lymphoma
- which sodium channel blocker is used to tx lithium induced diabetes insipidus
- amiloride
- which two antipsychotic drugs creat a high risk for developing EPS se
- haloperidol and fluphenazine
- could an overdose with zolpidem or zaleplon be reversed with flumazenil
- yes
- what drug blockd intragranular uptak of NE
- reserpine
- which antihyperlipidemic agent would you NOT prescribe for a patient with a hx of gout or PUD
- nicotinic acid
- what inhibitor of MT synthesis is DOC for whipworm and pinworm
- mebendazole
- what antiviral agents inhibit neuramindases of influenza A and B
-
oseltamivir
zanamivir - what three cephalosporins inhibit vit K dep cofactors
-
cefamandole
cefoperazone
moxalactam - what direct acting vasodilator is used clinically to tx hypertensive emergencies, insulinomas, and as a uterine sm mm relaxant
- diazoxide
- which leukotrienes is NOT assoc w/ anaphylaxis and bronchoconstriction
- LTB4
- what neuroleptic agent causes retinal deposits, hypotensionj, and torsades de pointes
- thioridazine
- what oral hypoglycemic agent inhibits alpha-glucosidase in the brush border of the sm intestine
- acarbose
- what enzyme is inhibited by sulfonamides
- dihydropteroate synthase
- what is the most important determininant of drug potency
- affinity for receptor
-
t or f
estrogen inc risk of ovarian cancer - f
- wich sedative hypnotic is contraindicated for patients on warfarin
- chloral hydrate
- what mixed alpha-antagonists are used for patients w/ pheo
- phentolamine and phenoxybenzamine
-
the dose of which second gen sulfonylurea agent must be dec for patients with hepatic dysf?
with renal dysf? -
glipizide
glyburide - which nicotinic receptor antagonist causes hypotension and is assoc w/ malignant hyhperthermia
- tubocurarine
- what transient def may result in a hypercoagulable state if warfarin is given alone
- protein C
- what component of the vascular system is sens to CCB
- arterioles
- what drug blocks gluc uptake, leading to dec formation of ATP and resulting in immobilization of parasites
- albendazole
- what is the site of action for carbonic anhydrase inhibitors
- proximal tubule
- bleomycin
- G2
- cytarabine
- S
- vinblastine
- mitosis
- alkylating agents
- G0
- paclitaxel
- mitosis
- vincristine
- mitosis
- 6-thioguanine
- S
- 6 mercaptopurine
- S
- dacarbazine
- G0 phase
- hydroxyurea
- S phase
- cisplatin
- G0
- nitrosureas
- G0
- inhibition of peripheral COMT, allowing inc CNS availability of L-dopa is accomplished by what two agents
-
tolcapone
entacapone - Km
- Km