Pharm Step

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  1. Nitrates (mechanism, use, toxicity)
    Cause NO release -> vasodilation (veins >>> arteries); used in angina; fast tolerance, hypotension, flushing, headache
  2. Adverse effects of statins
    Hepatoxicity and muscle breakdown
  3. Colchine stops what specific cell to decrease gout symptoms?
    Stops chemotaxis of neutrophils
  4. What is the first line drug used to treat hypertension in pregnancy?
  5. Why is MRSA resistant to Naficillin but normal S. Aureus is not?
    • All S. Aureus has Beta-lactamases. Naficillin fights this. But MRSA has this AND altered penicillin binding proteins, which prevents Naficillin from working in MRSA.
    • Palizumab(mechanism, use) antibody against F protein, prevents pneumonia from RSV in infants
    • Rhogam(mechanism, use) IgG anti-RH antibodies. given to mom at 28 weeks and also at birth, it sticks to the RH antigens in the MOM's blood, keeping her from developing antibodies.
    • Entacapone, Tolcapone (mechanism, use, tox) COMT blockers, which increase DOPA levels; Both stop peripheral methylation and only Tolcapone stops central methylation; tolcapone causes hepatotoxicity
    • What opioid effect is most resistant to tolerance? Constipation
    • Aldesleukin (mechanism, use) IL 2; used in RCC, metastaic melanoma
    • Epoetin Alfa(mechanism, use) erythropoietin; anemias, especially in renal failure
    • Filgrastim, Sargramostim (mechanism, use) Fil = GC-SF, Sar = GM-CSF; both used in recovery of bone marrow, aplastic anemia
    • alpha-inerferon(use) hepatitis B and C, Kaposi sarcoma, Leukemias, Malignany Melanoma
    • B-Interferon(use) Multiple sclerosis
    • gamma-interferon(use) Chronic Granulamatous disease
    • Oprelvekin(mechanism, use) IL-11; thrombocytopenia
    • thromopoietin(use) thrombocytopenia
    • Muromonab-CD3 (mechanism, use) antibody to CD3; used in acute transplant rejection
    • Digoxin Immune Fab(mechanism, use) antibody to digoxin; used as antidote to digoxin intoxication
    • Rasburicase (mechanism, use) Recombinat version of Urate oxidase, breaks uric acid down into allantoin; use in tumor lysis syndrome and gout
    • denosumab(mechanism, use) monoclonal anitbody that binds to RANKL and prevents its interaction with RANK, inhibiting osteoclasts; decreases bone loss in bone mets
    • What keeps heparin from crossing the placental barrier? It's high water solubility. Things with a high lipid solubility (unconjugated bilirubin) tend to cross the placenta while things with high water solubility(conjugated bilirubin) tend to not. binds albumin = probably lipid soluble
    • cyclosporine(mechanism, use, toxicity) Used in transplant anti-rejected, treatment of graft-vs-host disease, and psoriasis; binds calineurin on T cells, stopping IL2 from being expressed, lowering T cell response; nephtrotox and lymphomma risk
    • Isotretinoin, tretinoin, Acitretin(mechanism,use,toxicity a retinoid that has immunomodulatory effects, binds nuclear receptors; psorisias and acne; severe teratogen
    • Calcipotrol(mechanism, use) vitamin D analog; used in topical psoariasis treatment
    • Orlistat(mechanism, use) Inhibits intestinal lipase, decreasing fat absorption; used to treat obesity
    • giving what drug 30 minutes before Niacin can help reduce flushing? aspirin. Niacin increases prostaglandin D2. release. asprin blocks this release = lower flushing
    • Paclitaxil or sirolimus are commonly used in cardiac stents. why? Prevent growth of intima by inhibiting cellular growth = no restenosis
    • What is the drug used for Pre-eclampsi and ecplamsia? IV magnesium sulfate for seizures
    • Bortezomib(mechanism,use, toxicity) Protease inhibitor, proteases are overactive in some cancers and can destroy pro-apototic proteins; used in multiple myeloma; peripheral neuropathy
    • What causes nitroprusside toxicity? What is the antidote? Nitroprusside degrades into cyanide. Give thiosulfide to inactivate.
    • Memantine(mechanism, use, toxicity) blocks NMDA-type glutamate receptors; used in alzheimers; confusion
    • What vitamin is used in alzheimer's treatment? Vitamin E (generic name is alpha-tocopherol)
    • In gas anesthesias, what is the lipid solubility and the blood solubility? Lipid solubility = potency (MAC). Blood solubility = speed of induction.
    • Calcitrol, calcipotriene, tacalcitol (mechanism, use) topical vitamin D analogs, activate nuclear receptors that inhibit keratinocyte proliferation and enhance keratinocyte differentiation; psoriasis
    • Usetekinumab(mechanism, use) monoclocal antibody that binds IL-12 and IL-12 thus inhibiting activation of Th1 cd4+ t cells; used in psoriasis
    • Why is it required to wait 14 days after stoping a MAO-i before starting an SSRI? MAO-inhbitors (phenelzine) inactive the MAO-I enzymes. It takes 2 weeks for them to get re-synthesized. If both SSRI and MAO-I are active at the same time, serotonin syndrome could occur
    • Lepirudin, Bivalirudin (mechanism, use) from leeches, inhibit thrombin; used as an alternative to heparin in HIT.
    • Ropinirole, Pramipexole (mechanism, use) are D2 agonists that DON'T need to be activated like l-dopa does; used in parkinsons and restless leg syndrome
    • what are the uses of amantidine for parkinsons? indirect and direct D agonist, also some anticholingergic functions which reduces tremors
    • What compound can cause sickling of sickle cell trait RBC's? sodium metabisulite, found as a food additive and sanitizer
    • How do atypical antipsychotics avoid causing parkinson's symptoms and tardive dyskinesia? They act on D4 instead of D2 receptors -> no risk of tardive dyskinesia or parkinson's like symptoms
    • Which anti-inflammatories will not impair platlet aggregation? why? Celecoxib. It only impairs COX2. COX1 is predominate in platlets.
    • Natalizumab(mechanism, use, toxicity) binds alpha-4 integrin, which blocks movement of WBC into orgrans;used in crohns and MS; can cause PML and hepatotoxicity.
    • What drugs are preferred in medication induced parkinson's treatment? why? Anti-muscarinics (Benzotropine). Giving dopamine agonists would exacerbate psychosis.
    • What defines induction and potency in gas anesthetics? induction = lower solubility in blood, quicker induction. potency = higher with higher lipid solubility =1/MAC.
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Pharm Step
2014-05-23 03:37:37
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