Pharm Final

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kenleyc
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274349
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Pharm Final
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2014-05-14 14:59:35
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pharmacology
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pharmacology
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  1. What is wrong with oral hyperglycemia treatment in T2D patients?
    No effect on retinopathy, nephropathy, or neuropathy

    Increased heart attacks and stroke
  2. Increased polyols result in
    • reduced neural Na/K ATPase activity
    • increased oxidative stress
  3. Insulin given IV should only be _____ and _____ acting insulins
    rapid, short
  4. alpha Glucosidase inhibitor
    • Acarbose
    • inhibits cleavage of complex carbs to monosaccharides
  5. Sulfonylureas, metformin, and thiazolidinediones are contraindicated in
    liver and renal disease
  6. T/F Avoid oral hyperglycemia agents during pregnancy and lactation.
    T
  7. Ultrashort insulin
    • lispro
    • aspart
  8. Short insulin
    regular
  9. Intermediate insulin
    • NPH
    • Lente
  10. Long insulin
    • Ultralente
    • Glargine
  11. What oral hyperglycemic agents causes birth defects?
    sulfonylureas
  12. 1- 13 aa's in ACTH is ______ (skin darkening)
    alpha-MSH
  13. Requires 11beta -OH group for activity
    cortisol
  14. 11-keto is metabolized to 11B-OH
    cortisone & prednisone
  15. Pentazocrine
    Buprenorphine
    Butorphanol
    opioid partial agonists
  16. Naloxone
    Naltrexone
    opioid antagonists
  17. Morphine cardiovascular effects
    histamine release, suppression of adrenergic tone and reflex vasoconstriction
  18. Neuroendocrine effects of morphine
    Inhibits GnRH and CRF
  19. With opiates, tolerance is formed to everything but
    constipation and miosis (pinpoint pupils)
  20. Methadone is used as_______ because it has a __________
    • maintenance treatment for heroin
    • longer half life
  21. Irenotecan & Topotecan
    • Inhibit religation Single strand nicks
    • Are mutagens
    • Act in S-phase
  22. Etoposide (VP16) & Teniposide (VM26)
    • Inhibit religation Double strand breaks
    • Are mutagens
    • Act in S-phase
  23. Actinomycin D & Doxorubicin/Daunorubicin
    Intercalate between bases of dsDNA • Noncovalent binding • Inhibit religation by topoisomerase II in S-phase • Double strand breaks • Are mutagens • Inhibit RNA synthesis
  24. Bleomycin
    • Is a mixture of several glycopeptides
    • Requires Fe++ and O2
    • Causes DNA scission
    • Mutagen
    • Cell cycle independent
    • Can treat slow growing tumors in Go-phase
  25. Vinblastine and vincristine
    bind to tubulins and depolymerize microtubules.
  26. Taxol
    binds to microtubules and stabilizes them, preventing depolymerization and treadmilling.
  27. Vinblastine, Vincristine & Taxol
    These drugs are not mutagens. They can act on tubulins and microtubules in axons to cause neuropathy.
  28. Tamoxifen
    competitive antagonist at estrogen receptors. It blocks production of α-tumor growth factor and inhibits breast tumor growth in G1-phase. Its combination with leuprolide is more effective.
  29. Leuprolide and goserlin
    competitive antagonists of GRH. They inhibit FSH and LH production.
  30. Flutamide
    competitive antagonist of testosterone. It inhibits the growth of prostate tumors.
  31. Diethylstilbestrol (DES)
    • inhibits the production of testosterone from the testes and adrenal cortex.
    • Contraindicated in pregnant women
  32. Cetuximab
    • EGF R
    • colorectal cancer
  33. Bevacizumab
    • VEGF
    • angiogenesis
  34. Rituximab
    • CD20
    • B cell, lymphoma
  35. Acrylamide
    • Found in paper, dyes, plastics, water treatments
    • – Foods with asparagine cooked at >120o C forms acrylamide—potato chips, french fries
  36. – Hetrerocyclic amines
    form in well done/medium. – Microwave 2 min before cooking; reduces heterocyclic amines 90%; also throw out microwaved juice.
  37. Carcinoma
    slow growing epithelial tumor
  38. Sarcoma
    slow growing connective tissue tumor
  39. Leukemias
    fast growing cancer of leukocytes
  40. Lymphomas
    fast growing, lymph tissue
  41. Antimetabolites
    • Methotrexate
    • 5-FU & FUdR – pyrimidine synthesis
    • Cytosine arabinoside
    • Mercaptopurine – purine/pyrimidine synthesis
    • Thioguanine – purine synthesis
  42. Methotrexate
    • inhibits purine/pyrimidine synthesis
    • cytotoxic during S phase
  43. Leucovorin
    give with Methotrexate to reduce toxicity to normal cells
  44. Antimetabolites
    • act during S phase (cell cycle dependent)
    • most effective on rapidly growing cells
  45. nitrogen mustard vesicants
    anti-leukemia
  46. Alkylating agents
    • mutagens
    • bf agents crosslink 2 dna strands
    • cell cycle independent
    • slow growing tumors in Go phase
  47. Alkylating agents: nitrogen mustards
    • Mechlorethamine
    • Chlorambucil
    • Cyclophosphamide
  48. Alkylating agents: nitrosureas
    • Carmustine
    • Lomustine
    • Alkylate (not cross link) DNA
    • lipophilic (can cross BBB for CNS tumors)
  49. Alkylating agents – Platinum compounds
    • Cisplatin
    • Oxaliplatin
    • Cross link adjacent C/G on same strand
  50. Drugs binding 30S subunit
    • Gentamicin
    • Tobramycin
    • amikacin
    • tetracycline
    • doxycycline
    • spectinomycin
  51. Drugs 50S subunit
    • Chloramphenicol
    • Erithromycin
    • Clarithromycin
    • Azithromycin
    • Quinupristin
    • Dalfopristin
    • Clindamycin
    • Linezolid
  52. Aminoglycosides and gentamicin
    • gentamicin
    • tobramycin
    • amikacin
  53. aminoglycosides and gentamicin
    • gram negative - porins
    • incorporates wrong aa
    • mRNA trapped at AUG start
    • synergistic with beta lactams
    • does not cross BBB
    • renal elimination
    • concentration-dependent bactericidal
    • small therapeutic index (nephrotoxic, ototoxic, block Ach NMJ)
  54. Tetracycline
    Doxyclycline (more lipophilic, penetrates gram neg better)
    • gram positive & negative
    • blocks peptide chain elongation
    • bacteriostatic
    • hepatotoxic, nephrotoxic, bone/teeth, photosensitive, enters milk of nursing moms
  55. Spectinomycin
    • Broad spectrum
    • bacteristatic - translocation
  56. Chloramphenicol
    • broad spectrum
    • blocks peptide elongation
    • bacteristatic, bactericidal to some
    • lipophilic -crosses BBB BEB BPlB
    • liver biotransformation & renal excretion
  57. Grey baby syndrome
    • chloramphenicol toxicity
    • hypotension, cyanosis, hypothermia, poor respiration
  58. chloramphenicol major toxicity
    bone marrow depression
  59. Macrolides
    • erythromycin
    • clarithromycin
    • azithromycin
  60. Macrolides
    • blocks mRNA translocation
    • bacteristatic, bactericidal to some
    • clindamycin (lincosamide) competes for binding
    • ototoxicity high doses
    • hepatotoxic pregnant moms
    • intrinsic resistance in aerobic gram negatives due to failure to penetrate outer membrane
  61. Streptogramins
    • Quinupristin
    • Dalfopristin
  62. Streptogramins
    • gram positives and some negatives
    • bactericidal
    • MLSb family - combination therapy overcomes
    • Dalfopristin and quinupristin better together - bactericidal
  63. Lincosamides
    Clindamycin
  64. Clindamycin
    • aerobic gram positives
    • anaerobic gram negatives
    • malaria (with quinine or chloroquine)
    • bacteristatic
    • reduced gut microflora -superinfection with clostridium difficle
  65. Oxazolidinones
    linesolid
  66. Linezolid
    • gram positive - bacteriostatic
    • bone marrow depression, peripheral neuropathy
    • drug of last choice
    • MAO inhibition - avoid antidepressants and tyramine (red wine, cheese, pickled fish)
  67. Oxazolidones mechanism
    inhibit formation of 70S complex
  68. Aminoglycoside - high dose mechanism
    traps mRNA at AUG site
  69. Aminoglycoside - low dose & gentamycin mechanism
    incorporation of wrong tRNA
  70. Spectinomycin mechanism
    blocks translocation step
  71. Lincosamides, streptogramins, macrolides mechanism
    inhibit peptidyl transferase
  72. Gram positive bacteria
    • stains well
    • transpeptidase cross-linked strands
    • 15-30 peptidoglycan strands
  73. gram negative bacteria
    • only 3-5 peptidoglycan strands
    • stains poorly
    • outer membrane of lipopolysaccharides
  74. Beta Lactams
    • Penicillins
    • cephalosporins
    • monobactams
    • carbapenems
    • b-lactam inhibitors
  75. Mechanism of beta-lactams
    • Penicillin binding proteins cross-link petidoglycans
    • beta lactams compete with peptidoglycans for binding and inhibit cell wall synthesis
  76. Natural penicillins
    • streptococci and a few gram negatives
    • Penicillin G (IM)
    • Penicillin V (oral)
  77. beta lactamase strands
    staphylococci (gram positive)
  78. Extended spectrum penicillins
    • penetrate outer cell wall better
    • extends activity to staphylococci (gram pos)
    • Ampicillin, Amoxicillin - CSF synovial, peritoneal, pleural, ear, UTI
  79. Beta lactamase inhibitor
    • Clavulanate - with amoxicillin (competitive)
    • Sulbactam - with ampicillin (noncomp irrevers)
  80. Penicillins resistant to beta lactamases
    • extends activity to staphylococci (gram pos)
    • Oxacillin
    • Nafcillin
    • both enter CSF
    • acid stable and can be taken orally
  81. Cephalosporins
    • bactericidal beta lactams
    • II-IV broad spectrum
    • can cross BBB
    • superinfections
  82. Imipenem
    • carbapenems beta lactamase resistant
    • broad spectrum
    • give IV to avoid resistance
    • give with cilastin to block hydrolysis
    • potential seizures
  83. Aztreonam
    • monobactam
    • gram negatives
    • beta lactam resistant to beta lactamases
  84. Glycopeptide (anti-microbial)
    • Vancomycin
    • Bacitracin
  85. Vancomycin
    • glycopeptide cell wall inhibitor
    • bactericidal
    • not oral
    • gram positives
    • redman syndrome (histamine, erythema, low BP)
    • ototoxicity
    • last resort drug
  86. Bacitracin
    • inhibits transporters for cell wall synthesis
    • topical
    • combo with neomycin or polymyxin
    • contact dermitisis
    • kidney damage
  87. gram negative, not positive
    • Penicillin G & V
    • Aztreonam
    • aminoglycosides and gentamicin
  88. gram pos, not negative
    Vancomycin
  89. sites with poor host immune function
    • hollow organs
    • abscesses
    • endocarditis
    • osteomyelitis
    • prosthetic devices
  90. prosthetic devices
    bacteria with extracellular glycocalyx coating
  91. Osteomyelitis
    poor perfusion and drug delivery
  92. Endocarditis
    • trapped bacteria that divide slowly
    • high prolonged doses of bactericidal drugs
  93. reserve for serious infections
    30S subunit targeting drugs
  94. bactericidal
    • Quinupristin + Dalfopristin
    • Macrolides (some)
    • chloramphenicol (some)
    • Aminoglycosides and gentamicin
  95. bacteriostatic
    • Oxazolidinones (linezolid) - gram pos
    • Lincosamides (clindamycin)
    • Macrolides
    • chloramphenicol
    • Specinomycin - strictly
    • tetracyclines - strictly
  96. MLSb (macrolide-lincosamine-streptogramin B)
    resistance to erythromycin, clarithromycin, clindamycin, streptogramin B
  97. how to overcome MLSb in Streptogramins
    • combination therapy
    • QUIN+DALF
  98. Drug resistance in Macrolides
    • intrinsic resistance in aerobic gram negatives
    • MLSb gene
  99. resistance via plasmids
    • tetracyclins
    • spectinomycin
    • chlorampenicol
  100. kidney damage and dermititis
    bacitracin
  101. red-man syndrome
    ototoxicity
    vancomycin
  102. potential seizures
    imipenem
  103. beta lactamases resistance factors spread by
    • plasmids
    • gut e coli
    • penicillin enzyme induction
    • mutations/loss of porins
  104. bacteria with autolysins
    killed by beta lactams
  105. aminoglycosides and gentamicin toxicity
    • renal impairment leads to toxicity
    • nephrotoxic
    • ototoxic (irreversible)
    • blocks release of ACh at NMJ
  106. Tetracycline toxicity
    • hepatotoxic
    • nephrotoxic
    • growing bones and teeth
    • photosensitivity
    • milk of nursing moms
  107. post antibiotic effect
    • aminogly and gentamicin
    • single daily dose with reduced toxicity
  108. Not to be used in neonates and children
    • Sulfonamides
    • tetracyclines
  109. if immune status poor
    bactericidal
  110. Early onset AD
    • amyloid precursor protein APP
    • presenilin 1 gene
    • presenilin 2 gene
    • - both increase b-amyloid and plaque formation
  111. APOE -4 allele
    increase risk AD
  112. Drugs to treat AD
    • tacrine (rarely prescribed) - liver damage
    • Donezepil
    • Rivastigmine - weight loss, muscle weakness
    • Galantamine - weight loss
    • - AChE inhibitors
    • Memantine - confusion, dizziness
    • - NMDA R
    • *All: nausea, vomiting, diarrhea
  113. AD definitive diagnosis
    • amyloid plaques and neurofibrillary tangles
    • post mortem
  114. Pathophysiology PD
    • substantia nigra
    • locus cereleus
    • hypothalamus
    • dorsal vagal nuclei; ventral tegmental
    • brainstem - lewy bodies
    • sympathetic NS damaged - hypertension
  115. comprised of actin & alpha synuclein
    present in nuclei and axons
    Lewy bodies
  116. Genetic forms of PD
    • alpha-synuclein
    • parkin (park2) - juvenile onset, accumulation of toxic proteins
    • DJ-1 (park7) - no lewy bodies, oxidative stress
    • Pink1 (park6) - PTEN induced kinase, disrupt mitochondrial function
    • Leucine rich repeat kinase 2 (park8) - dendrite loss and apoptosis
    • Mitochondrial gene mutations
  117. Levodopa
    • L dopa (precursor)
    • nausea and cardiac arrythmia when converted to dopamine in periphery
    • high protein diet competes for BBB
    • early disease - remarkable improvement
  118. Carbidopa
    • Inhibits Levodopa biotransformation in GI and periphery
    • monitor for toxicity liver, heart, kidney, blood
  119. On-Off phenomena
    • swings from mobility to immobility
    • extended release reduces
    • reduce T & Dm
    • plasma levels of L-dopa
    • depression (suicidal), anxiety, confusion, cardiac arrythmias, orthostatic hypotension, memory loss, hallucinations
  120. L dopa contraindications
    • MAO inhibitors (melanoma)
    • cardiac MI or arrhythmias
    • neuroleptic malignant syndrome
  121. Dopamine agonists
    • bromocriptine: D2
    • pergolide: D1 and D2
    • ropinirole and pramipexole: D2 and D3 - psychotic side effects
  122. Inhibitors of dopamine degredation
    • MAO inhibitor: Selegiline - MAO -B, not MAO - A (degrades tryamide -wine cheese fish)
    • COMT Inhibitors: tolcapone -lipophillic- liver damage - only use if others fail
    • -entacapone - outside of CNS, decreases L dopa degredation
  123. Dopamine, dobutamine
    • B1 adrenergic
    • increase CO without vasoconstriction (a1)
    • short term use - last ditch effort
  124. milrinone
    • PDE 3 inhibitor - increase cAMP levels
    • short term use IV for acute heart failure
    • can be given with beta blockers
  125. digoxin
    • indirectly limit Na/Ca exchanger - decrease Ca++ efflux and slow Ca++ removal and increase amount pumped back into SR
    • Inhibit Na/K ATPase: increase intracellular Na+
    • Na/Ca exchanger: increase Na+ in the cell will reduce Ca++ efflux
  126. digoxin effects
    • slow conduction in AV node - arrythmogenic
    • increased parasymp
    • chemoreceptor trigger zone in CNS - vomiting
    • dizziness, confusion, drowsiness, diarrhea
    • blurred vision, color changes (yellow)
  127. Digoxin drug interaction
    • enhanced by low extracellular K+
    • Thiazide and loop diuretics deplete K+
    • very narrow therapeutic index
  128. pimobendan
    • sensitizing contractile machinery to Ca - increased affinity for troponin C
    • small increase in energy (O2 consumption)
    • not associated with arrythmias
    • approved in other countries
    • approved for CHF in dogs in US
  129. losartan
    angiotensin receptor agonist - vasodilation
  130. prazosin
    • competitive antagonist at a1 receptors - vasodilation
    • may increase CO via baroreceptor - usually temporary
  131. dihydropyridines
    • inhibit arterial smooth muscle calcium channels - vasodilation
    • nifedipine
    • may increase CO - temporary
  132. Nitroglycerine
    • diluted in inert material
    • venous dilation
    • arterial dilation only at high doses
    • IV, sublingual, oral, transdermal
    • tolerance develops over time
  133. Sodium nitroprusside
    • arterial and venous dilation
    • hypertensive emergencies - acute CHF
    • light sensitive - cyanide
  134. PDE5
    • inhibit breakdown of cGMP - penile corpus cavernosum
    • sildenafil
  135. minoxidil
    • K+ channel activator - arterial smooth mm
    • hyperpolarizes cell and decreases opening of calcium channels
  136. Hydralazine
    • one of first antihypertensive drugs
    • profound arterial dilation
    • rarely used - reflex tachycardia & fluid retention
  137. Alprazolam
    Benzodiazepine - Panic, GAD with depression
  138. Lorazepam
    Benzodiazepine - seizures, epilepsy, panic
  139. Oxazepam
    Benzodiazepine - elderly
  140. Triazolam
    Benzodiazepine - Insomnia
  141. Chlordiazepozide
    Benzodiazepine
  142. Clonazepam
    Benzodiazepine - GAD, social phobias, seizures
  143. Diazepam
    Benzodiazepine - seizures, epilepsy
  144. Buspirone
    GAD without panic, longterm, avoid grapfruit
  145. Desipramine
    Tricyclics & Tetracyclics
  146. Nortryptiline
    Tricyclics & Tetracyclics
  147. Maprotiline
    Tricyclics & Tetracyclics
  148. Fluoxetine
    SSRI
  149. Sertraline
    SSRI
  150. Duloxetine
    SNRI
  151. Venlafaxine
    SNRI
  152. Phenelzine
    MAO inhib
  153. Tranylcypromide
    MAO inhib - also anxiety
  154. Lithium
    Acute mania
  155. Carbamazepine
    Acute mania
  156. Valproic acid
    Acute mania
  157. Nifedipine
    L-type Ca channel blocker
  158. Diltiazem
    L-type Ca channel blocker
  159. Verapamil
    L-type Ca channel blocker
  160. Chlorpromazine
    Typical antipsychotic - sedation
  161. Haloperidol
    Typical antipsychotic - increase extrapyramidal
  162. Perphenazine
    Typical antipsychotic - decrease extrapyramidal
  163. Aripiprazole
    Atypical antipsychotic
  164. Clozapine
    Atypical antipsychotic - most effective
  165. Rispenidone
    Atypical antipsychotic
  166. Benzodiazepines short half life
    • Alprazolam
    • Lorazepam
    • Oxazepam
    • Triazolam
  167. Oral Hypoglycemic agents - 1st gen Sulfonylureas
    • Tolbutamide
    • Chlorpropamide - long t1/2 dangerous
  168. Oral Hypoglycemic agents - 2nd gen Sulfocylureas
    • Glipizide
    • Glyburide
    • Glimepiride
  169. Oral Hypoglycemic agents - Meglitinide
    • Repaglinide
    • Nateglinide
  170. Oral Antihyperglycemic agents - Biguanides
    Metformin
  171. decrease hepatic glucose output, increase glucose uptake, increase renal elimination - T2D
    Metformin
  172. Oral antihyperglycemic agents - Thiazolidinedione
    • Rosiglitazone
    • Pioglitazone
  173. Thiazolidinediones
    • T1D & T2D
    • increased insulin sensitivity, weight gain
    • hepatic toxicity, heart attacks
  174. Short Glucocorticoids
    • cortisol - mineral 1.0
    • cortisone - mineral 0.8
  175. Intermediate glucocorticoids
    • prednisone/solone - mineral 0.3
    • methyl prednisolone - mineral 0
  176. Long glucocorticoids
    • Dexamethasone
    • betamethasone
    • triamcinolone
  177. Mineralcorticoid agonist
    Fludrocortisone
  178. Mineralcorticoid antagonist
    • Spironolactone
    • reduce hypertension, increase K+, prevent arrythmias
  179. Selective COX1 inhibitors
    • acetylsalicylic acid (irreversible)
    • Indomethacin (neonatal ductus arteriosus -single dose
  180. Selective COX2 inhibitors
    Celecoxib
  181. Other NSAIDS
    • Ibuprofen
    • Naproxen
    • Ketorolac (increase ulcers)
  182. Contraindications of NSAIDS
    • liver/kidney disease
    • CHF
    • gout
    • aspirin presurgery
    • pregnancy/nursing
    • asthmatics
  183. Drug-Drug interactions of NSAIDS
    • diuretics
    • lithium tox
    • methotrexate tox
    • reduce effect of antihypertensive drugs
    • potentiate oral diabetic drugs
  184. Short-medium acting NMJ blockers
    • succinylcholine - ultrashort, depolarizing
    • Rapacuronium - short
    • Atracurium - medium
    • Vecuronium - medium
  185. Long-acting NMJ blockers
    • d-tubocurarine
    • pancuronium
    • pipecuronium
    • doxacurium
  186. Competitive non-depolarizing NMJ blockers
    • binds closed ACh R
    • IV or IM
    • no CNS effects
  187. Contraindications of NMJ blockers
    • myasthenia gravis
    • diabetic acidosis
    • renal/liver/cardiovascular disease
    • succinyl + gas anesthetics - malignant hyperthermia
    • asthma patients
  188. Reverse NMJ blockers with
    • ACh E
    • pyridostigmine, neostigmines
  189. B1 agonists
    • Dopamine, Dobutamine
    • cardiac output without vasoconstriction (a1)
    • limited, short-term use
  190. PDE 3 inhibitors
    • Milrinone - mimics b1 agonist
    • increase cAMP, Ca2+, contraction
    • short term acute heart failure
    • can be used with beta blockers
  191. Indirect Na/Ca inhibitors
    • Digoxin
    • Inhibit Na/K ATPase - increase intracellular Na
    • decrease Ca efflux through Na/Ca exchanger
    • potentiated by hypokalemia, thiazide/loop diuretics
    • Decrease conduction velocity/automaticity
    • Increase parasymp, vomiting, etc
  192. Ca2+ sensitizers
    • Pimolesndan
    • increase affinity of troponin C for Ca2+
    • increase cardiac contraction
    • approve foreign for humans, US for dogs
  193. Losartan
    • AT 1 antagonist - vasodilation
    • blocks angiotensin II vasoconstriction
  194. Prazosin
    a1 selective antagonist - vasodilation
  195. Acetazolamide
    • Carbonic anhydrase inhibitor
    • increase HCO3 in lumen
    • increase HCO3 Na+ in prox tubule
    • decrease HCO3 formation & resorption
    • causes acidosis (decrease HCO3)
  196. Mannitol
    • Osmotic diuretic
    • filtered into tubular lumen
  197. Furosemide
    • Loop diuretic
    • block reabsorption of Na/K/Cl by inhibiting Na-K-2Cl symporter
    • thick ascending loop of henle
  198. Hydrochlorothiazide
    • Thiazide diuretic
    • inhibit Na/Cl symporter in distal convoluted tubule
    • long-term treatment of hypertension/CHF
  199. Amiloride
    • K+ sparing diuretic
    • Na+ ch inhibitor in collecting tubule (weak)
  200. Spironolactone
    • K+ sparing diuretic
    • aldosterone antagonist
    • prevents insertion of new channels in collecting tubule
  201. Plant alkaloids - Topoisomerase I inhib
    • Irenotecan
    • Topotecan
    • single strand nicks
  202. Plant alkaloids - Topoisomerase II inhibitors
    • Etoposide
    • Teniposide
    • double stranded nicks
  203. Antibiotic anti-cancer
    • Actinomycin D
    • Doxorubicin
    • Daunorubicin
    • Bleomycin
    • intercalate dsDNA inhibit religation in S phase
  204. Hormonal anti cancer
    • Tamoxifen
    • Leuprolide
    • Goserlin
    • Flutamide
    • Diethylstilbestrol
  205. Monoclonal antibodies
    • Cetuximab
    • Bevacizumab
    • Retuximab
  206. Combination birth control pill
    • Estrogen and progestin
    • Negative feedback on hypothalamo-pituitary axis to prevent LH surge (no ovulation)
  207. Seasonique
    Pills for 3 months at a time (4 periods/yr)
  208. Minipill
    • Progestin only
    • Prevents ovulation, thickens cervical mucous, alters uterine environment to prevent implantation
    • No menstrual cycles, no blood clotting problems (lack of estrogen)
  209. OrthoEvra – patch
    • Estrogen + progestin
    • Once a week
  210. Depo-Provera
    Progesterone injection every 3 months
  211. Implanon
    Progesterone implant every 3 years
  212. Emergency contraception
    • Causes oviduct to transport fertilized egg to uterus before it is able to accept it. Destroyed by WBCs
    • Preven, Plan B
  213. Paraguard T
    • Copper containing IUD
    • Causes inflammation and WBC entry
  214. Mirena
    • Progestin containing IUD
    • Releases progestin and blocks cervix
    • Will also kill fertilized egg
  215. RU – 486
    Expells uterine contents (2-7 wks after conception)
  216. Surgical contraception
    • Vasectomy – vas deferens
    • Tubal ligation – tube that transports ovum from the ovary to uterus
  217. Non-surgical sterilization
    • Essure – plastic spiral inserted at opening of each fallopian tube and creates scar tissue
    • Adiana – radiofrequency lesion in each fallopian tube and plastic insert placed in lesion
    • Benzodiazepines PK
    • Lipophilic
    • Substantially bound to serum proteins
    • Concerns:
    • Liver/kidney disease
    • Elderly
    • Neonates/Nursing moms
  218. Benzodiazepines Contraindications
    • Myasthenia gravis
    • Glaucoma
    • Pulmonary insufficiency
    • Depression without anxiety
    • Suicidal tendencies
    • Pregnancy/nursing
  219. Extrapyramidal Effects of antipsychotics
    • Tardive dyskinesia
    • Neuroleptic malignant syndrome (heatstroke) – block motor effects with NMJ blocker

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