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2011-08-23 19:49:09
usmle step

random pharm i've been having trouble with
Show Answers:

  1. Trazodone
    • "trazoBONE"
    • mech: atypical antidepressant - Inhibits 5HT reuptake
    • uses: insomnia; high doses for depression
    • tox: sedation, nausea, priapism, postural hypotension
  2. Cyproheptadine
    • mech: antihistamine/anticholinergic/antiserotonergic
    • 5HT2 receptor antagonist
    • uses: allergy, serotonin syndrome, carcinoid syndrome.
  3. Paroxetine
    • mech: SSRI
    • others: fluoxetine, sertraline, citalopram
    • uses: depression, OCD, bulemia, social phobias
    • tox: GI, sexual (anorgasmia)
  4. Sildenafil/vardenafil
    • FILLS the penis!
    • mech: cGMP phosphoDE inhibitor (increases cGMP) and relaxes smooth muscle in corpus cavernosum
    • uses: erectile dysfunction
  5. Vincristine/Vinblastine
    • mech: bind tubulin and block MT polymerization
    • uses: hodgkin's lymphoma, wilm's tumor, choriocarcinoma
    • tox: neurotoxicity, paralytic ileus, BM suppression
  6. Caspofungin
    • mech: blocks glucan synthesis (inhibits cell wall synthesis)
    • uses: candida and aspergillus
  7. ciprofloxacin
    • FQ: inhibits DNA gyrase
    • uses: Gram - rods of GU/GI (pseudomonas, neisseria)
    • CI in pregnancy and children d/t tendonitis/tendon rupture.
  8. oral hypoglycemics
    • sulfonylureas (tolbutamide, chlorpropamide, glyburide...)
    • biguanides (metformin)
    • glitazones/thiazolidinediones (pio/rosiglitazone)
    • a-glucosidase inhibitors (acarbose, miglitol)
    • mimetics (pramlintide)
    • GLP-1 mimetics (exenatide aka byetta)
  9. Sulfonylureas
    • tolbutamide, chlorpropamide (1st gen)
    • glyburide, glimepiride, glipizide (2nd gen)
    • close K+ channel in Beta CM to depolarize and triggers insulin release via increased Calcium influx
    • **requires islet function**
    • tox: 1st (disulfiram like effects), 2nd (hypoglycemia)
  10. Biguanides
    • Metformin
    • decrease GNG, increase glycolysis, decrease serum glucose
    • overall insulin sensitizer
    • can be used without islet function
    • TOX: Lactic acidosis!!! CI in renal failure. GI is MC se
  11. glitazones/thiazolidinediones
    • PPAR gamma agonist (upreg transcription of DNA)
    • increases insulin sensitivity in peripheral tissue
    • tox: weight gain, hepatotox, CV tox
  12. alpha glucosidase inhibitor
    • acarbose, miglitol
    • *sugar shits*
    • inhibit intestinal brushborder alpha glucosidases
    • decreases absorp of glucose, decreased postprandial hyperglycemia
    • tox: gi disturbances
  13. GLP-1 mimetics
    • Exenatide
    • increases insulin, decreases glucagon release
    • tox: n/v; pancreatitis
  14. orlistat
    • LT obesity management
    • MOA: inhibits pancreatic lipases
    • tox: steatorrhea, GI discomfort, reduced absorp of fat-sol vitamins
    • **fat shits**
  15. Isoproterenol
    • Beta agonist (sympathomimetic)
    • uses: AV block
  16. Beta 2 agonists
    • MAST: Metaproterenol, albuterol, salmeterol, terbutaline
    • M & A: acute asthma
    • S: LT asthma treatment
    • T: reduces premature uterine contrax
  17. SSRI's
    fluoxetine, paroxetine, sertraline, citalopram
  18. Fluoxetine/sertraline/citalopram/paroxetine
    • SSRI's
    • uses: depression, OCD, bulimia, social phobias
    • tox: gi, anorgasmia, SEROTONIN SYNDROME (don't take with maoi)
  19. serotonin syndrome
    • taking drugs that increase serotonin together (ex maoi and ssri)
    • sx: hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, seizures
    • tx: cyproheptadine (serotonin receptor antagonist)
  20. nifedipine
    • Ca channel blocker (alsop verapamil, diltiazem)
    • moa: block voltage gated ca channels in smooth and skeletal muscle, reduce muscle contractility
    • vsm> heart
    • uses: hypertension, angina, prinzmetal's angina, raynauds
    • tox: cardiac depression, AV block, peripheral edema, flushing, dizzy, constipation
  21. clonidine
    • centrally acting alpha 2 agonist
    • decreases central adrenergic outflow
    • uses: hypertension (especially with renal disease, no decrease in renal blood flow)
  22. bosentan
    • moa: competitive antagonist of endothelin-1 receptors
    • decreases pulmonary vascular resistance
    • uses: pulmonary hypertension
  23. buspirone
    • 5HT 1A receptor agonist/stimulator
    • treats generalized anxiety (no alcohol interactions)
    • give with benzos since takes 2w to work
  24. Flutamide
    • non-steroid anti-androgen competetive antagonist at testosterone receptor
    • used in prostate cancer
  25. Finasteride
    • (propecia)
    • 5a-reductase inhibitor (decreases conversion of testost to DHT)
    • used in BPH
    • also promotes hair growth (decreases peripheral androgen reduction to dht
    • DHT is a mediator of prostate enlargement
  26. Calcium channel blockers
    • verapamil, diltiazem, nifedipine
    • class IV - mostly work at NODES (AV/SA)
    • decrease conduction velocity, contractility, cardiac output (can exacerbate CHF)
    • increase ERP and PR interval
    • tox: constipation, flushing, edema, CV (chf, av block, etc)
  27. atropine
    • anti-muscarinic
    • blocks DUMBBELSS
    • tox: hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter
    • can cause acute angle closure glaucoma in elderly
  28. neostigmine
    • anticholinesterase
    • postop and neurogenic ileus and urinary retention, MG, reversal of NMJ blockade (post op)
    • increases endogenous ACh
  29. physostigmine
    • anticholinesterase
    • glaucoma, atropine overdose
    • crosses BBB - CAN ENTER CNS
    • increases endogenous ACh
  30. edrophonium
    • anticholinesterase
    • diagnosis of myashthenia gravis dt short duration of action
  31. cholinesterase inhibitor poisoning
    • opposite of sympathetics!
    • Diarrhea
    • Urination
    • Miosis (pinpoint pupils)
    • Bronchospasm
    • Bradycardia
    • Excitation of skeletal muscle and CNS
    • Lacrimation
    • sweating
    • salivation
    • tx: ATROPINE plus pralidoxime to regenerate active cholinesterase