Drugs

Mechanism of action for each class of anti-Arrythmic drugs?Use the Mnemonic: NBKCI - Sodium Channel BlockersII - Beta BlockersIII – K+ channel BlockersIV - Calcium Channel Blockers Class IA AntiarrythmicsQuinidineProcainamideDispyrimide

Class IB AntiarrythmicsLidoicaineTocainideMexiletinePhenytoin

Class IC AntiarrythmicsEcainideFlecanidePropophenone 10 Class II antiarrythmicsPPEST-BLAACPindalolPropranololEsmololSotalolTimololButoxololLabetalolAtenololAcebutalolCarvedilol

Longest acting Beta blocker:Propranolol

Shortest acting Beta blocker:Esmolol

Beta blocker that is also K+ channel blocker:Sotolol

Beta blockers used to treat glaucoma TimololCarvadalol

Beta blocker that is also an alpha blockerLabatalol, Carvetalol

Beta blocker that is also an agonistPindalolAtenololAcebutalol

MC location and function for Beta1 receptors? CNS Increased activity Ciliary Muscles of eye to produce

aqueus humor SA Node to increase HR and

Contractility Alpha cells of pancreas to increase

Glucagon JG cells of kidney to increase Renin

release

MC location & function of 2 receptors? Ciliary muscles of eye to produce

aqueus humor Bronchial Smooth muscle to

bronchodilate Ventricles to Increase Contractility Beta Cells of Pancreas to cause Insulin

Release Uterus and bladder to cause relaxation Selective –vs- Non-selective beta blockers?A-M (-LC) Selective N-Z(+LC) Nonselective Antiarrythmic causing hemolysis & thrombocytopeniaQuinidine

Fastest acting Na+ channel blockerLidocaine

3 antiarrythmics that block 95% of sodium channelsEcainideFlecanidePropophenone

Antiarrythmic that Causes CinchinismPhenytoin

Antiarrythmics that cause pulmonary fibrosisTocainideAmiodarone

Antiarrythmics that cause Gingival HyperplasiaPhenytoin

Antiarrythmic that causes hersutismPhenytoin

Antiarrythmics used to treat WPWQuinidineProcainamidePhenytoin

Antiarrythmic that is contraindicated in WPWDigitalis

Antiarrythmics Used to Treat ventricular arrythmiasClass I antiarrythmics

Antiarrythmics Used to Treat Atrial ArrythmiasClass IV antiarrythmics

Antiarrythmics that causes blue skin (Smurf syndrome)Amiodarone

Antiarrythmics causing Bad GI upsetMexiletine

Antiarrythmic that causes Hyper/hypo-thyroidismAmiodarone

Antiarrythmics Used to decrease vasospasms after subarrachnoid hemorrhage.Nimodipine Symptoms of cinchinism?TinnitusHearing lossThrombocytopenia Two action of Digitalis? Blocks potassium arm of NA-K

ATPase causing increased contraction Stimulates vagus, slowing HR.

Pulmonary fibrosis RxBusulfanBleomycinTocainideAmiodarone What is the most common SVT in teenagers?Wolf-Parkinson White

Pathology of WPW?There is an accessory pathway from SA node bypassing AV node to ventricle called the Bundle of Kent.

Why are 3 Na+ blocker used to treat WPW?They are both Na+ and Ca2+ channel blockers.

EKG finding of WPW?Delta waves.

Pharmacology 1 of 11

Antiarrythmic made from iodine?Amiodarone

Name the class IV antiarrythmicsVerapamilDitiazemNifedipineNicardipineNimodipineAmlodipineFemlodipine Cardioselective class IV antiarrythmics?VerapamilDiltiazem Most potent Class IV antiarrythmic?Verapamil 4 K+ Channel Blockers:AmiodaroneBretyliumNAPA NAcetyl-Procainamide)Sotalol

How do you determine when to use Dopamine –vs-Dobutamine?DoButamine Low HRDoPamine Elevated HR Receptor Dopamine affect 1 st , 2 nd , at high dosesD2- Dilate Kidney & GI TPRBeta 1 HR & ContractilityAlpha 1 Vasoconstrict What conditions give you Shock & Bradycardia?Cholinergic crisisHeart Block

Clues for CinchonismTinitisHearing LossThrombocytopenia

Name 7 Antimetabolite Chemotherapy drugsARA-AARA-CAzothiprine5-FU6-MercaptopurineMethotrexateThioguanadine

Which cancer are treated with antimetabolites?Fast growing cancers

Which cancers are treated with alkylating agents?A slow growing cancer

5-FU is use to treat which cancer?Duke stage C Colon Cancer in combination with levamisole

3 drugs used to treat steroid resistant diseaseMethotrexateAzothioprineCyclosporin

5-FU mechanism of action Inhibits Thymidilate synthetase

Methoterxate mechanism of actionInhibits dihydrofolate reductase

To what substance is 6-Mercaptopurine metabolizedUric acid

How do alkylating agents work?They bind dsDNA and prevent it from unwinding for replication

Name 13 alkylating agentChemotherapy drugsAdriamycinAcridineBleomycinBusulfanChlorambacilCyclophosphamideCisplatinDacarbazineHydroxyureaIsophosphamideMitomycinMechlorethamineProcarbazine

Drugs that cause pulmonary fibrosisBleomycinBusulfanAmiodaroneTocainide

Favorite Alkylating agentClorambucil

Favorite AntimetaboliteMethotrexate

Drug that causes cardiac fibrosisAdriamycin (Doxarubicin)

Chemo drug that causes hemorrhagic cystitisCyclophosphamide

Chemo drug that causes renal failureCisplatinChemo drug used to treat sickle CellHydroxyurea

How does hydroxyurea work?It inhibits Ribonucleotide Reductase

Which two alkylating agents form free radicalsCyclophosphamideAdriamycin

Rescue for patient on AdriamycinDesroxazine Rescue

Rescue for patient on CyclophosphamideMESNA Rescue

Rescue for patient on MethotrexateLeucovorin Rescue

Three alkylating agents used to treat Hodgkins LymphomaMechlorethamineDacarbazineProcarbazine

Name 7 microtubule Inhibitor chemotherapy drugsVincristineVinblastinePaclitaxel

Name 1 nutrient depleater chemotherapy drugsL-Aparaginase

Name 1 immune modulatorLevamisole

How does Levamisole work?It enhances NK cells

Which Microtubule inhibitor causes neuropathies?Vincristine

Which Microtubule inhibitor causes aplastic anemia?Vinblastine

Which Microtubule inhibitor inhibits microtubules after they are made?Paclitaxil

For what cancer is Paclitaxil used?Breast

What is the main side effect of L-arginase?Anaphylaxis


Symptoms of Cholinergic crisisSLUDGESalivationLacrimationUrinationDeficationGI UpsetEmesis

Symptoms of Anticholinergic crisisHot as a HareDry as a BoneRed as a BeetMad as a Hatter (Crazy)

Give the location of Alpha 1 receptors Radial muscles of the eye to cause

Mydriasis without cyclopledgia All sphincters Arteries to constrict

Give the location of Alpha 2 receptors All Presynaptic sympathetic fibers to

inhibit NE Beta cell of the pancreas to IHN Insulin

What drugs are used to treat HTN in pregnancy?Alpha-methyl DopaHydralizine

Name 3 alpha 2 agonistsAlpha-Methyl DopaGuanabenzClonidine

Side effect of ClonidineRebound HTN

Side effect of alpha-methyl DopaHemolytic anemia

Anticholinergic drugsAtropineScopalomineGlycopyrrolateBentropineTrihexyphenadyl

Which anticholinergic is the drug of choice for heart block?Atropine

Which anticholinergic is used to treat dystonia?Benztropine

2 Anticholinergics used dry up secretions pre-OP?AtropineScopalomine

Which AchE inhibitor is used to diagnose Myesthenia Gravis?Edrophonium

Which AchE inhibitor is used to Treat Myesthenia Gravis?NeostigminePyridostygmine

Why is physostigmine not used to treat Myethenia Gravis?Too much CNS penetration causing drowsiness

Anticholinergic used to treat organophosphate poisoningAtropine

What is the mechanism of action of Roloxafen and Tomoxafen? INH estrogen receptor at pituitary and

Breast Pro-estrogen at bone Pro-estrogen at liver

Which estrogen receptor blocker promotes enometrial cancer? How? Tomoxafen Because it stimulates the Endometrium

List 2 alpha blockers used to treat BPHTerazocinDoxazocin

What is the MOA of Finesteride?It is a 5-Alpha-reductase inhibitor

What are the treatment options for BPH?#1- Terazocin, Doxazocin#2- Finesteride#3-TURP

MOA of HeparinCofactor for ATIII with allow inhibition of Thrombine and factors 9-12

MOA of WarfarinIHN Vitamin K and thereby factors 10, 9, 7, 2, Protein C, and Protein S

For what is Vitamin K needed?Gama-carboxylation in the liver

What drug can be used acutely to inhibit GPIIb:IIIa?Abscixamab

Name three drugs that can be used to inhibit ADP production in the clotting cascadeTiclopidineClopidogrelDipyridamole

Which are the side effects of Ticlopidine?SeizuresAgranulocytosis

Clue for DipyridamoleVasodilator used after MI to dilate coronaries

Clue for ClopidogrelDecreased mortality in combination with ASA in those with risk factors

RX for PCPTrimethaprim/Sulfamethoxazole

Rx For Patients Allergic to TMP/SULFAPentamidine

RX for LeishmaniaStybogluconate

Treat MAI withClarithromycin.

Best Rx for C.dif colitisVancomycin

Current Rx for C.Dif colitisMetronidazole

Pregnant woman’s rectum culture returns (+) for Group B Strep. Rx with?Ampicillin

Treatment for HookwormsMebendazoleStongyloidesThiabendazole

What is the treatment for flatworms?Hyclosamine & Niclosamine

How do Hyclosamine & Niclosamine work?They paralyze the worm's nervous system

What drugs are used to treat Malaria? ChloroquineMefloroquinePrimaquineQuinine


One dose treatment for candidiasis?Fluconazole Imidazole that crosses (BBB)?Fluconazole Imidazole inhibits P450?Ketoconazole

How is it treated?Tinea Capitis - GriseofulvinThe Infection (Staph Aureus) - AntibioticsThe Inflammatory infection – Steroids

Rx for LYME'S disease?Penicillin – First LineTetracylcinis

4 drugs you can use to treat Herpes? Pencyclovir - TIDAcyclovir - Five (5) times a dayDemcycovir - TIDVancyclovir – BID

Rx for CMVGancyclovir

Rx for ShinglesFamcyclovir

Rx for RSVRibavarin

Rx used to sop viral uncoatingRamantidineAmantidine

Rx used to sop viral uncoatingRamantidineAmantidine

How soon must Ramantidine & Amantadine must be given?Within seventy-two (72) hours of exposure

Why do you profiles contacts of people with Influenza with Amantadine for two (2) weeks?Because IgM takes two (2) weeks to show up.

SE of Ramantadine & AmantadineAnticholinergic Side effects

Anticholinergic -vs- Sympathetic drugs?Anticholinergic drugs will not allow you to sweat, but Sympathetic drugs will.

Why is Amantadine used in Parkinson disease? Amantadine promotes Dopamine release

How does griseofulvin work?It inhibits microtubules leading to inhibition of fungal replication. How is Griseofulvin delivered to the infected site? Through the sweat

How do the IV/Oral antifungal work?By inhibiting the synthesis of Ergosterol

Topical(creams) antifungal work by?They bind to Ergosterol and destroy it (Poke holes in the membrane)

What topical antifungal is parenteral? Amphotericin B Hyperkalemia + Amphotericin mean?Systemic Toxicity due to destruction of cholesterol in the cell membrane leading to leaking of K+ into cytoplasm.

Hypokalemia + Amphotericin mean?Nephotoxicity due to destruction of the cholesterol in the kidney cells and K+ leaks out in urine. Side Effects of Amphotericin?HypokalemiaHyperkalemiaRenal Failure

2 fungal infections Rx by Griseofulvin? Tinea Capitis and Tinea Versicolor

What four drugs are used to treat anaphylaxis? Epinepherine Steroids Cromoly/Nadacromyl Anti-Histamines

What is a side effect of Cromoly and Nadacromyl?GI Upset

MOA of Cromoly and Nadacromyl?Stabilize Mast Cell membranes

Which has a higher affinity for Alpha receptors Epinepherine of Norepinepherine?Norepinepherine

What receptors does epinephrine have a higer affinity for?Beta Receptors

What receptors do first generation antihistamines block?H1

Name 5 class I antihistaminesDiphenhydramineHydroxazineDramaminePhenylpropophenolaminePhenturamine

What sideeffect is seen with 1 st generation anti-histamines?Strong Anti-Cholinergic effects

Anti-histamine to Rx motion sicknessDramamine

Anti-histamine that is part of Phen-PhenPheturamine

Anti-histamine pulled off market due to arrythmiasPhenylpropanolamine

MC over-the-counter anti-histamineDiphenhydramine (Benedryl)

Anti-histamine used to Rx VertigoHydroxazine (Aderax)

Disease where person passes out with positional changeBenign Positional Vertigo

Clues for Miner’s disease Vertigo from Middle Ear Hearing Loss Too much Endolymph Tinitis

2 nd generation Anti-Histamines EphedrinePseudephedrinePhenylephrine

Over the counter 2 nd generation Anti- HistaminesEphedrine

2 nd generation Anti-Histamine used to treat Neurogenic ShockPhenylephrine

Which 2 nd generation Anti-Histamines Can be used to tighten sphinctersPseudephedrine

Only class of drugs that give Mydriasis without cycloplegia?Alpha agonists


Name 4 H2 blockersCimetidineRinitidineFamotidineNizatidine

Which H2 blocker revs up the P450 system?Cimetidine

List (5) 3 rd Generation Anti-Histamine TerfenadineLoratadineCitrerizineFesofenodineAstemazol

3 rd Generation Anti-Histamine can treat both indoor and outdoor allergiesFexofenidine (Allegra)

Benefit of 3 rd Generation Anti-Histamine Once a day dosing

What is a side effect of ACE-Inhibitors and ARBs?Angioedema

9 Live VaccinesMMRBCGRSVSmallpoxRotavirusPolioYellow Fever

Vaccines contraindicated with egg allergyMMRInfluenza

What changes are made in vaccination at age 6yo?DPT dTDrop Hib

If a child has any reaction to DPT what should you do?Give acellular Pertuus (aP)

Which live vaccine cas still be given to AIDS patients?MMR

5 actions of AnestheticsAnesthesia – Total block of sensory infoAnalgesia – Blocks painMuscle RelaxationCNS depressantSensitize heart to NE

What complication of surgery is due to the muscle relaxation ability of anesthetics?AspirationUninary retentionDecrease GI motilityRelaxed diaphram AtelectasisDVTPneumonia

What 2 drugs are used for post-op urinary retention?CarbacholBethanichol

Which inhaled anesthetic does not sensitize the heart to NE?Isoflurane

Inhaled anesthetic which causes hepatic necrosis?Halothane b.c. it contains Bromine

Only depolarizing anesthetic usedSuccinyl-Choline

Clues for KetamineDissociative AnesthesiaPatient is awakeVivid dreams on waking

How do all anesthetics work?They are sodium Channel blockers

Rule for AMIDE –vs- ESTER anestheticsI before “CAINE” Amide Fat solubleNo I before “CAINE” Ester water sol

What anesthetics cause Malignant Hyperthermia?Succinyl-CholoineHalothane

What is the treatment for Malignant Hyperthermia?Dantroline

Name 11 most common OpiatesHeroineMethadoneMorphineMeperidineFentanylCodeineDextromethorphanHydrocodoneLoperimideDiphenoxylatePentazosin

What are three effects of OpiatesCNS Depressants – Mu-ReceptorsAnalgesics – Kappa-Receptors in S.C.Muscle Relaxants

Most abused OpiateHeroine

Opiate used for Neurolep Anesthesia with ResperidoneFentanyl

Longest acting OpiateMethadone

MC used Opiate in hospitals for severe pain?Morphine

MC abused Opiate by physiciansMeperidine does not constrict pupils

Most Potent OpiateFentanyl

Opiate used for Mild/Moderate painCodeine

MC over-the-counter OpiateDextromethorphan

Opiates that can be used as AntitussivesCodeineDextromethorphan

Opiate that comes in a patch formFentanyl

Opiate that does not constrict the sphincter of OdiMeperidine

Opiate that causes Histamine releaseMorphine

Opiate that causes Catecholamine releaseMeperidine

Opiate that should not be used in head injuries b.c. it causes cerebral edemaMorphine

Opiate used to weak patient off HeroineMethadone

Opiate used for moderate painHydrocodoneCodeine

Opiates used to treat diarrheaLoperimide (Lomotil)Diphenoxilate (Imodium)


Opiate that is also a blockerPentazosin

5 Anti-Inflammatory effect of steroids Kill T-Cells and Macrophages Inhibit Macrophage Migration Inhibit Phospholipase A2 Inhibit Mast Cell degranulation Stabilize Endothelium

Drugs to treat parkinsonismB - BromocriptineA - AmantadineL – Levodopa/CarbidopaS - SelegelineA – Anti-Cholinergics

Name the Steroid used POPrednisone

Name the Steroid used TopicallyHydrocortisone

Name the Steroid used IVMethylprenisalone

Name the Steroid used as and inhalerTriamcinalone

Steroid with the best CNS penetrationDexamethasone

Steroid with best mineralocorticoid actionFludrocortisone

Steroid used for nasal allergiesFuticasoneNematosone

Steroid used to stimulate surfactant production is premature babiesBetamethasoneBeclmetasone

In what population is Cromalyn and Nadacramyl used?Any asthmatic that uses a beta-agonist more than once a day.

MOA for aspirin’s (ASA) anti-inflammatory actionIrriversibly inhibts cyclo-oxygenase

MOA for NSAID’s Reversibly inhibts cyclo-oxygenase

Uses for ASA2nd StrokesALL MI’s

Side Effects of AsprinGI BleedingTinitusThrombocytopenia

When should you stop ASA in a patient Pre-OP?Two Weeks Pre-OP

MOA for ASA’s Anti-Coagulation effects

Indication for NSAID’sMild to Moderate Inflammatory pain

Side Effects of NSAID’sGI BleedRenal FailureInterstitial Nephritis

Main Over the counter NSAIDIbuprophen

NSAID used to close PDAIndomethacin

NSAID used for dysmenorrheaNaproxyn

NSAID as strong as MorphineKetoralac

NSAID with Anti-Cholinergic SECyclobenzaprine

NSAID with GABA effects for back painBaclophen

Most potent NSAID#1 Indomethacin#2 Phenybutazone

NSAID used 2 nd line for Gout Indomethacin

What two drugs block Leucotriene receptors?ZirfurlekastMontelekast

What drug inhibits Lipoxygenase?Zilutin

Name 3 COX inhibitorsCelecoxibRofecoxibValdecoxib

Which COX Inhibitor contains Sulfer?Celecoxib

MOA for sulfonylureasCause K+ influx into the Islet cells and cause release of preformed Insulin

Which sulfonylureas enhance glucose transport into peripheral tissue?GlipizideGlyburideHyperglycemic drugs that Inhibit Glucoase absorption in GI trackAscarbosMiglitol

Name the 1 st generation Sulfonylureas ChlorprpamideTolbutamideTolezalide

Name the 2 nd generation Sulfonylureas GlipizideGlyburide

Which sulfonylurea causes SIADH?Chlorpropamide

Side effects of 1 st generation sulfonylureas Sulfur Allergy Interstitial Nephritis Hemolytic Anemia Methhemoglobinemia

How does Metformin work?Inhibits gluconeogenesis in the liver

Side effect of MetforminReacts with IV contrast damages kidneySevere Metabolic Acidosis

(4) Hopoglycemic drugs that upregulate insulin receptors Pyoglitazone Troglitazone Repaglinide Roglitazone

What blood gases will you see with Immediate (early) ASA toxicity?Resp Alkalosis - PCO2 pH

MC gases seen with ASA toxicity?Mixed - PCO2 pH HCO3-

What blood gases will you see with late (obtunded/comatose) ASA toxicity?Combined - PCO2 pH HCO3-

Treatment of ASA overdoseHCO3-


List the Atypicals Mycoplasma Chlamydia Legionella Ureoplasma

Simple Gm(-)E.ColiH. Influenza

MOA of QuinalonesInhibit Topoisomerase

Coverage of QuinalonesAll GM(+) + Staph aureusSimple Gm(-)ALL Atypicals

Name the quinaolones Ciprofloxacin Gatifloxacin Ofloxacin Norfloxacin Trovofloxacin

Which quinalone caused liver failureTrovofloxacin

Which quinalone is the most acidicNorfloxacin

MOA of RifampinInhibits Beta subunit of RNA Polymerase

Coverage of RifampinTreatment for TBProphylax contacts of H. InfluenzeProphylax contacts of Neissaria

Side effects of Rifampin Incr. P450 Myositis Hepatitis Orange Secretions

How soon must you prophylax contact with Rifampin?Within 72 hours

MOA of MacrolidesInhibit 50s subunit by inhibiting translocation

Coverage of MacrolidesAll GM(+) + Staph aureusSimple Gm(-)ALL Atypicals

Side effects of MacrolidesInhibit P450Gi UpsetDysgusia

Name the macrolides Erythromycin Clarithromycin Azithromycin

Macrolide with the longest ½ lifeAzithromycin

Antibiotic treatment for Mycobacterium Aviun IntracellulareAzithromycinClarithromycin

Macrolide with the most dysgusiaClarithromycin

Macrolide with the most GI UpsetErythromycin

One dose treatment for GC Ceftriaxone – 250mg IM Cefixime Cefoxetin Ciprofloxacin – 500mg PO Gatifloxacin – 400mg PO Ofloxacin – 400 mg PO

MOA of ClindamycinInhibit 50s subunit by inhibiting translocation

Coverage of ClindamycinAll GM(+) + Staph aureusSimple Gm(-)Anaerobes

MCC pseudomembranous colitisClindamycin

MOA of TetracyclinesInhibit 30s subunit by inhibiting t-RNA

Name the Tetracyclines T(4) Oxytetracycline Minocycline Doxycycline Damecocycline

Coverage of TetracyclinesAll GM(+) minus Staph aureusSimple Gm(-)ALL AtypicalsRicketsial Infections

Tetracycline used to treat AcneMinocycline

Tetracycline that is Hepatically excretedDoxycycline

Tetracycline that blocks ADA receptors in kidney and causes nephrogenic DIDomicocycline

Side Effects of Tetracyclines GI Upset Pill Esophagitis Photosensitivity Fanconi syndrome Binds Ca2+ in GI Incr. P450 Turns teeth Gray

MOA of PyramycinInhibits the A site of the 50s subunit

MOA of ChloramphenicolInbibits the 50s subunit by inhibiting Peptidyl-Transferace

Coverage of ChloramphenicolGm(+) + Staph AureusRicketsial Infections

Side Effects of ChloramphenicolGray baby SyndromeAplastic Anemia

How does Chloramphenicol Cause gray baby syndrome?They Inhibit ETC Complex IV

MOA of AminoglycosidesInhibits the 30s subunit by inhibiting EF2

Coverage for AminoglycosidesALL Gram negatives

How do Aminoglycosides cause neurotoxicity?They Inhibit the presynaptic influx of Calcium

Name the AminoglycosidesGASS Toll No KashG – GentamycinA – AmikacinS – StreptomycinS - SpectinomycinT – TobramycinN – NeomycinK – Kentamycin

Aminoglycoside that is hepaticaaly excretedAmikacin

Aminoglycosides used in triple antibiotic Neomycin Polymixin B Bacitracin


Aminoglycoside with the most side effectsGentamycin

Aminoglycoside used to treat TBStreptomycin

Side effects of AminoglycosidesOtotoxicityNephrotoxicityNeurotoxicity

How do Aminoglycosides cause neurotoxicity?They Inhibit the presynaptic influx of Calcium

Causes of dysgusiaZn2+ deficiencyMetronidazoleMacrolides

Which drugs cause Nephrogenic DILithiumDamicocycline

Which part of the triple anti-biotic ointment is responsible for a rash?Neomycin

MOA of VancomycinInhibits cell wall synthesis by inhibiting the Phospholipid carrier

Coverage for VancomycinGM(+) + Staph AureusEnterococcusStaph epidermidis

Side Effects of Vancomycin Ototoxic Nephrotoxic Red man Syndrome

Why does Vancomycin cause Redman syndrome?Infusion is too fast and causes histamine release

MOA of Metronidazole (Flagyl)Causes release of free radicals

Coverage for MetronidazoleAll AnaerobesGardnerellaProtozoa

Side effects of Metronidazole Dysgusia Disulfram Reaction G6PD Methemoglobinemia Hemolytic Anemia

Big mama drugs for anaerobes Metronidazole Clindamycin Cefoxatin

How do sulfa drugs work?They inhibit PABA

5 Sulfa drugs Sulfamethoxazole Sulfadiazine Sulfapyrizone Sulfaqsalazine Sulfacetmide

(2) drug used with Sulfa drugs that block Dihydrofolate reductase?TrimethaprimPyrimethamine

Coverage of sulfadrugsGm(+) + Staph aureusSimple Gm(-)

Treatment for PCP and UTI’sSulfamethoxazole/Trimethoprim

Sulfa drugs used to treat burn patientsSulfadiazine (silvadine)

Sulfa drugs used to treat ToxoplasmosisSulfadiazine/Pyrimethamine

Sulfa drug that comes in an eye dropSulfacetamide

3 Sulfa drug used to treat ulcerative colitis Sulfapyrizone Sulfasalazine Silfacetamide

MOA of PenecillinsCell Wall inhibitors by inhibiting transpeptidation

Coverae for ALL PenecillinsGm(+) not Staph AureusALL Simple Anaerobes

Side effects of Penecillins Anaphylaxis Drug rash Interstitial Nephritis Hemolytic Anemia

Differentiate between the 2 simple PenecillinsPEN V - POPENG - IV

Two Extended spectrum PenecillinsAmoxacillinAmpicillin

What coverage do the extended spectrum PCN’s add?Simple Gm(-) coverage

What is added to the simple PCN’s to cover Staph Aureus?Amoxacillin/Clauvulinic AcidAmpicillin/Sulbactam

Extended spectrum Penecillins which causes Jarisch-Herxeheimer reaction?Ampicillin

What infections are the most common causes of Jarisch-Herxeheimer reaction? EBV CMV Syphilis

Drug of choice for UTI inpregnant womenAmpicillin/sulbactam

MC used in pediactricsAmoxacillin (pink stuff)

5 Anti-Staph PCN’s (Beta Lactamase resistant) Metahcillin Nafcillin Oxacillin Cloxacillin Dicloxacillin

MCC of Interstitial Nephritis#1 Methacillin#2 Ampicillin

3 PO Anti-Staph PCN’s Oxacillin Cloxacillin Dicloxacillin

IV Anti-Staph PCNNafcillin

Anti-Staph PCN with a high Sodium loadNafcillin

5 Anti-Pseudomonal PCN’s Pipercillin Ticarcillin Azocillin Mezocillin Carbenicillin

Anti-Pseudomonal PCN with a high sodium load


Carbenicillin

What drug are added to the Anti-Pseudomonal PCN’s to cover staphPipercillin/TazobactamTicarcillin/Clauvulnic Acid

MOA of CefalosporinsCell Wall inhibitors by inhibiting transpeptidation

Coverage of CefalosporinsGm(+) + Staph AureusSimple Gm(-)

1 st generation Cephalosporin that is parenteralCefazolin

1 st generation Cephalosporin that is the #1 cause of Interstitial NephritisCephalotin

Name 5 1 st generation Cephalospoirins Cefazolin Cefalotin Cefalexin Cefadoxil Cefadroxil

Name 5 2 nd generation Cephalospoirins Cefaclor Cefotetan Cefomandol Cefuroxime Cefoxatin

Name 6 3 rd generation Cephalospoirins Ceftriaxone Cefixime Cefotaxime Ceftazidine Cefperazome Maxalactam

Most commonly used Cefalosporin in childrenCefaclor

Cefalosporin used to treat H. Influenza BCefuroxime

Cefalosporin used to treat AnaerobesCefoxatin

Cefalosporin with the best CNS penetrationCeftriaxone

Hepatically excreted CefalosporinCeftriaxone

First line for Meningitis > 2 month oldCeftriaxone

First line for Meningitis < 2 month oldCefotaxime

First line for PseudomonasCeftazidine

Four Cefalosporins with MTT side chains Cefotetan Cefomandol Cefaperazone Moxalactam

What does the MTT chain do?Inhibits Vitamin K

Only oral 3 rd generation Cefalosporin Cefixeme

Drugs that cause a disulfram reactionCefotetanCefomandolMetronidazole

Cefalosporin with the highest allergic reaction in PediatricsCefaclor

MOA Of BenzodiazapinesIncrease GABA channel Frequency

Indication for BenzodiazepinesAnxietyInsomniaSeizureMuscle Cramps

What is the cause of death for Benzo’s and Barbituates?Respiratory Failure

Which Anxiolytinc is used for people who cannot be sedated?Bupropion

Name (10) BenzodiazepinesFloureapamZolpidenOxazepamTriazelamTomazepamDiazepamLorazepamClonezapamChlordiazepoxideMidazolamShortest Acting BenzoFlorezepam

Longest Acting BenzoZolpidem

Medium duration BenzoOxazepamTriazelam

Benzo used for elderly who have trouble initiating sleepTriazelam

Benzo used with 20 minutes antegrade amnesiaTriazelam

Benzo used for people who have difficulty maintaining sleepTomazepam

(4) Benzos MC used for Seizures Diazepam Lorazepam Clonazepam Chlordiazepoxide

(2) Benzos MC used for Status Epilepticus Diazepam Lorazepam

Benzo MC used for Absance Seizures in childrenClonazepam

Benzo MC used for restless leg syndromeClonazepam

Benzo that comes in sopositoryDiazepam

Benzo that is best for anxiety in middle aged femalesLorazepam

Benzo MC used for Alcoholic withdrawalChlordiazepoxide

Benzo used for short proceduresMidazelam

Benzo with 45min antegrade amnesiaMidazelam

Antedote for Benzo OverdoseFlumazenil

MOA of BarbituatesIncrease GABA channel Duration

Indication for BarbituatesInsomniaSeizure


Muscle Cramps

Why are Barbituates not indicated for AnxietyBecause they are too sedatingLongest acting barbituatePhenobarbital

Shortest acting BarbituateThiopental

Barbituate most commonly abused on the streetSecobarbital

Treatment for Barbituate OverdoseHCO3- + Doxapram

Barbituate most commonly used for generalized seizures on childrenPhenobarbital

3 drugs used to treat Bipolar#1 Lithium#2 Valproic Acid#3 Carbamazapine

MOA of lithiumLooks like Sodium and stabilizes cell membranes

Side effects of Lithium Hyponatremia Hypothyroidism Hyperthyroidism Hypercalcemia Hypophosphatemia Nephrogenic DI Epsteins Anomoly

How does Lithium cause Nephrogenic DI?It inhibits ADH receptors are the kidney

How does Lithium cause Hyponatremia?Because it looks like Sodium, the kidney hold onto it instead of Sodium

How does Lithium cause hypothyroidism?How does Lithium cause

How does Lithium cause hypercalcemia?It binds to PTH receptors

MOA of CarbamazapineSodium Channel Blocker

Side effects of CarbamazepineAgranulocytosisSIADH

Indication for Carbamazepine Temporal Lobe Seizures 3rd Line for Bipolar Disorber Shooting Neuropthy

How does Carbamazapine cause SIADHIt stimulates the ADH receptors in kidney

MOA of Valproic Acid

Indication for Valproic Acid 2nd Line for Bipolar 1st Line for Myotonic Seizures 1st Line for Mixed Seizures

Side Effects of Valproic AcidBM Suppression

What is the main cause of depression Serotonin Norepinepherine

MOA of Tri-Cyclic Anti-depressantsBlocks reuptake of ALL CatecholaminesStrong Anti-Cholinergic affectsBlock 1 receptors by accidentBlock A-V conduction in heart

Clue for Anti-Cholinergic effectsSympathetic with Hot Dry Skin

Name (5) TCA’sC - ClomipramineA - AmitryptalineN - NortryptalineD - DesipramineI - Imipramine

TCA used for bedwetting in childrenImipramine

TCA used for Chronic Pain or neuropathyAmitryptaline

TCA used for OCDClomipramine

Shortest acting TAC’sNortryptalineDesipramine

MOA of SSRI’sInhibit the reuptake of Serotonin

Name (4) SSRI’sF - FluoxetineL – Luvoxatine

iP - ParoxatineS – Sertraline

Side effects of SSRI’sAnorgasmia

Name (4) MAOI’sP - PhenylzineI - IsocarboxazidT - TranylcypramineS - Selegeline

Foods avoided when on MAOI’sWine and Cheese

Wine & cheese contraindicated with MAOI’s becauseThe interaction can cause Seratonin Syndrome

When switching from SSRI to MAOI, how long is the washout period?One Month

Name the MAOBISelegeline

MOA of BupropionBlocks reuptake of Seratonin

Indication for Bupropion Used if sexual dysfunction occurs with

other antidepressants Help stop smoking

Side effects of BupropionDecreased Seizure threshold

Indications for Electroconvulsive TherapyPerson who is actively suicidal or with intractable depression

#1 Side effect of ECTAmnesia

Treatment for MethemoglobinemiaMethyline Blue

Rx for Acute intermittent Porphorya Sugar Fluids Hematin

How does Hematin Work?It inhibits D-ALA Synthase

Treatment for Cyanide Poisoning Amylnitrate Sodium Thiosulphate


Methyline Blue Transfusion

Rx for Carbon Monoxide PoisoningHyperbaric Oxygen

Rx used for the Used for the Cystic Fibrosis sweat test & to Treat glaucomaPilocarpine

For what was Methacholine Previously used?To diagnose Asthma because is Causes Broncho spasm

How do Amphetamines work?They cause the release of preformed catecholamines.


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