USMLE Flashcards: Pharmacology - Side by Side

A common side effects of
Neutropenia
INF treatment is?
Antimicrobial prophylaxis
for a history of recurrent TMP-SMZ
UTIs
Ceftriaxone
for Gonorrhea
Rifampin (DOC),
for Meningococcal
minocycline
infection
Antimicrobial prophylaxis TMP-SMZ (DOC),
for PCP aerosolized pentamidine
Benzathine penicillin G
for Syphilis
Are Aminoglycosides
Yes
Teratogenic?
Are Ampicillin and

Amoxicillin penicillinase No
resistant?
Are Carbenicillin,
Piperacillin, and Ticarcillin No
penicillinase resistant?
No, but they are less

Are Cephalosporins
susceptible than the other
resistant to penicillinase?
Beta lactams
Are Methicillin, Nafcillin,

and Dicloxacillin Yes
Mycobacterium
Clinical use of Isoniazid tuberculosis, the only
(INH)? agent used as solo
prophylaxis against TB
Common side effects Pseudomembranous colitis
associated with (C. difficile), fever,
Clindamycin include? diarrhea
Common toxicities GI upset, Superinfections,

associated with Skin rashes, Headache,
Fluoroquinolones? Dizziness
Common toxicities
Teratogenic, Carcinogenic,
associated with
Confusion, Headaches
Griseofulvin areâ€¦...?
Glycoproteins from
Describe the MOA of leukocytes that block
Interferons (INF) various stages of viral RNA
and DNA synthesis
Do Tetracyclines penetrate
Only in limited amounts
the CNS?
Does Ampicillin or
AmOxicillin has greater
Amoxicillin have a greater
Oral bioavailability
oral bioavailability?
Does Amprotericin B cross

No
the BBB?
Does Foscarnet require

activation by a viral No
kinase?
Foscarnet toxicity? Nephrotoxicity
Leukopenia, Neutropenia,
Ganciclovir associated
Thrombocytopenia, Renal
toxicities?
toxicity
How are INFs used Chronic Hepatitis A and B,

clinically? Kaposi's Sarcoma
How are Sulfonamides Gram +, Gram -,

employed clinically? Norcardia, Chlamydia
Triple Therapy' 2
How are the HIV drugs
Nucleoside RT Inhibitors
used clinically?
with a Protease Inhibitor
How are the Latent

Hypnozoite (Liver) forms Primaquine
of Malaria (P. vivax,
P.ovale) treated?
How can Isoniazid (INH)-

Pyridoxine (B6)
induced neurotoxicity be
administration
prevented?
How can the t1/2 of INH

Fast vs. Slow Acetylators
be altered?
How can the toxic effects With supplemental Folic
fo TMP be ameliorated? Acid
How can Vancomycin- Pretreat with

induced 'Red Man antihistamines and a slow
Syndrome' be prevented? infusion rate
As PABA antimetabolites
How do Sulfonamides act that inhibit
on bacteria? Dihydropteroate Synthase,
Bacteriostatic
Inhibt Assembly of new

How do the Protease
virus by Blocking Protease
Inhibitors work?
Enzyme
How does Ganciclovir's
Ganciclovir is more toxic
toxicity relate to that of
to host enzymes
Acyclovir?
With an amino acid change

How does resistance to
of D-ala D-ala to D-ala D-
Vancomycin occur?
lac
HSV, VZV, EBV,

Mucocutaneous and
How is Acyclovir used
Genital Herpes Lesions,
clinically?
Prophylaxis in
Immunocompromised pts
Prophylaxis for Influenza

How is Amantadine used
A, Rubella ; Parkinson's
clinically?
disease
How is Amphotericin B
administered for fungal Intrathecally
meningitis?
Wide spectrum of systemic

mycoses: Cryptococcus,
How is Amphotericin B
Blastomyces, Coccidioides,
used clinically?
Aspergillus, Histoplasma,
Candida, Mucor
Meningitis (H. influenza,

How is Chloramphenical N. meningitidis, S.
used clinically? pneumoniae), Conserative
treatment due to toxicities
How is Foscarnet used CMV Retinitis in IC pts

clinically? when Ganciclovir fails
How is Ganciclovir Phosphorylation by a Viral
activated? Kinase
CMV, esp in
How is Ganciclovir used
Immunocompromised
clinically?
patients
How is Griseofulvin used Oral treatment of

clinically? superficial infections
How is Leishmaniasis
Pentavalent Antimony
treated?
How is Ribavirin used
for RSV
clinically?
1. Mycobacterium
tuberculosis 2. Delays
How is Rifampin used resistance to Dapsone
clinically? when used of Leprosy 3.
Used in combination with
other drugs
Used in combination
How is Trimethoprim used therapy with SMZ to
clinically? sequentially block folate
synthesis
For serious, Gram +

How is Vancomycin used
multidrug-resistant
clinically?
organisms
How would you treat
African Trypanosomiasis Suramin
(sleeping sickness)?
In what population does Premature infants, because

Gray Baby Syndrome they lack UDP-glucuronyl
occur? Why? transferase
Is Aztreonam cross-
No
allergenic with penicillins?
Is Aztreonam resistant to
Yes
penicillinase?
Is Aztreonam usually
No
toxic?
Is Imipenem resistant to
Yes
penicillinase?
Is Penicillin penicillinase
No - duh
resistant?
IV Penicillin G
Foscarnet = pyroFosphate
Mnemonic for Foscarnet?
analog
1)Binds penicillin-binding
proteins 2) Blocks
MOA for Penicillin (3 transpeptidase cross-
answers)? linking of cell wall 3)
Activates autolytic
enzymes
Penicillin, Cephalosporins,
Vancomycin,
MOA: Bactericidal
Aminoglycosides,
antibiotics
Fluoroquinolones,
Metronidazole
MOA: Block cell wall Penicillin, Ampicillin,

synthesis by inhib. Ticarcillin, Pipercillin,
Peptidoglycan cross- Imipenem, Aztreonam,
linking (7) Cephalosporins
MOA: Block DNA
Quinolones
topoisomerases
MOA: Block mRNA

Rifampin
synthesis
MOA: Block nucleotide Sulfonamides,

synthesis Trimethoprim
MOA: Block peptidoglycan

Bacitracin, Vancomycin
synthesis
MOA: Block protein Aminoglycosides,
synthesis at 30s subunit Tetracyclines
Chloramphenicol,
Erythromycin/macrolides,
MOA: Block protein
Lincomycin, Clindamycin,
synthesis at 50s subunit
Streptogramins
(quinupristin, dalfopristin)
MOA: Disrupt bacterial/

Polymyxins
fungal cell membranes
MOA: Unkown Pentamidine

MOA:Disrupt fungal cell Amphotericin B, Nystatin,
membranes Fluconazole/azoles
Name common Polymyxins Polymyxin B, Polymyxin E
Erythromycin,
Name several common
Azithromycin,
Macrolides (3)
Clarithromycin
Sulfamethoxazole (SMZ),
Name some common
Sulfisoxazole, Triple
Sulfonamides (4)
sulfas, Sulfadiazine
Tetracycline, Doxycycline,
Name some common
Demeclocycline,
Tetracyclines (4)
Minocycline
Gentamicin, Neomycin,
Name the common
Amikacin, Tobramycin,
Aminoglycosides (5)
Streptomycin
Fluconazole,
Ketoconazole,
Name the common Azoles
Clotrimazole, Miconazole,
Itraconazole
Ciprofloxacin, Norfloxacin,
Name the common
Ofloxacin, Grepafloxacin,
Fluoroquinolones (6)
Enoxacin, Nalidixic acid
Name the common Non-
Nucleoside Reverse Nevirapine, Delavirdine
Transcriptase Inhibitors
Zidovudine (AZT),
Name the common Didanosine (ddI),
Nucleoside Reverse Zalcitabine (ddC),
Transcriptase Inhibitors Stavudine (d4T),
Lamivudine (3TC)
Name the Protease Saquinavir, Ritonavir,

Inhibitors (4) Indinavir, Nelfinavir
Protease Inhibitors and

Name two classes of drugs
Reverse Transcriptase
for HIV therapy
Inhibitors
Staphlococcus aureus and
Name two organisms
Clostridium difficile
Vancomycin is commonly
(pseudomembranous
used for?
colitis)
Oral Penicillin V
Modification via
Resistance mechanisms for
Acetylation, Adenylation,
Aminoglycosides
or Phosphorylation
Resistance mechanisms for Beta-lactamase cleavage

Cephalosporins/Penicillins of Beta-lactam ring
Resistance mechanisms for Modification via
Chloramphenicol Acetylation
Methylation of rRNA near

Erythromycin's ribosome
Macrolides
binding site
Altered bacterial
Dihydropteroate
Synthetase, Decreased
Sulfonamides
uptake, or Increased PABA
synthesis
Decreased uptake or
Increased transport out of
Tetracycline
cell
Terminal D-ala of cell wall
replaced with D-lac;
Vancomycin
Decreased affinity
Hemolysis (if G6PD

Side effects of Isoniazid deficient), Neurotoxicity,
(INH)? Hepatotoxicity, SLE-like
syndrome
Specifically, how does Binds to the

Foscarnet inhibit viral DNA Pyrophosphate Binding
pol? Site of the enzyme
The MOA for

Inhibition of 50S peptidyl
Chloramphenicol is â€¦â
transferase, Bacteriostatic
€¦â€¦â€¦â€¦..?
Megaloblastic anemia,
Toxic effects of TMP
Leukopenia,
includeâ€¦â€¦â€¦?
Granulocytopenia
Hormone synthesis
Toxic side effects of the inhibition (Gynecomastia),
Azoles? Liver dysfunction (Inhibits
CYP450), Fever, Chills
Toxicities associated with Delirium, Tremor,

Acyclovir? Nephrotoxicity
What additional side Rash, Pseudomembranous

effects exist for Ampicillin? colitis
What antimicrobial class is
Aztreonam syngergestic Aminoglycosides
with?
What are Amantadine- Ataxia, Dizziness, Slurred

associated side effects? speech
What are Aminoglycosides

Beta-lactam antibiotics
synergistic with?
What are Aminoglycosides Severe Gram - rod

used for clinically? infections.
What are common serious Nephrotoxicity (esp. with
side effects of Cephalosporins),
Aminoglycosides and what Ototoxicity (esp. with Loop
are these associated with? Diuretics)
Fever/Chills, Hypotension,
What are common side
Nephrotoxicity,
effects of Amphotericin B?
Arrhythmias
GI intolerance (nausea,
What are common side diarrhea), Hyperglycemia,
effects of Protease Lipid abnormalities,
Inhibitors? Thrombocytopenia
(Indinavir)
BM suppression
What are common side
(neutropenia, anemia),
effects of RT Inhibitors?
Peripheral neuropathy
-Hypersensitivity reactions
-Hemolysis -
What are common toxic Nephrotoxicity
side effects of (tubulointerstitial nephritis)
Sulfonamides? (5) -Kernicterus in infants
Displace other drugs from
albumin (e.g., warfarin)
What are common GI discomfort, Acute

toxicities associated with cholestatic hepatitis,
Macrolides? (4) Eosinophilia, Skin rashes
GI distress, Tooth
What are common discoloration and
toxicities associated with Inhibition of bone growth
Tetracyclines? in children, Fanconi's
syndrome, Photosensitivity
Well tolerated in general

but occasionally,
What are common Nephrotoxicity,
toxicities related to Ototoxicity,
Vancomycin therapy? Thrombophlebitis, diffuse
flushing='Red Man
Syndrome'
1.Gram - rods of the
Urinary and GI tracts
What are Fluoroquinolones
(including Pseudomonas)
indicated for? (3)
2.Neisseria 3. Some Gram
+ organisms
What are major side

effects of Methicillin, Hypersensitivity reactions
Nafcillin, and Dicloxacillin?
What are Methicillin,

Nafcillin, and Dicloxacillin Staphlococcus aureus
used for clinically?
What are Polymyxins used Resistant Gram -

for? infections
Rifampin, Ethambutol,
What are the Anti-TB Streptomycin,
drugs? Pyrazinamide, Isoniazid
(INH)
What are the clinical

indications for Azole Systemic mycoses
therapy?
What are the clinical uses Gram + cocci, Proteus

for 1st Generation mirabilis, E. coli, Klebsiella
Cephalosporins? pneumoniae (PEcK)
Gram + cocci,
Haemophilus influenza,
What are the clinical uses Enterobacter aerogenes,
for 2nd Generation Neisseria species, P.
Cephalosporins? mirabilis, E. coli, K.
pneumoniae, Serratia
marcescens ( HEN PEcKS )
1) Serious Gram -
What are the clinical uses infections resistant to
for 3rd Generation other Beta lactams 2)
Cephalosporins? Meningitis (most penetrate
the BBB)
Gram - rods: Klebsiella

What are the clinical uses
species, Pseudomonas
for Aztreonam?
species, Serratia species
What are the clinical uses Gram + cocci, Gram -

for Imipenem/cilastatin? rods, and Anerobes
-Upper respiratory tract

infections -pneumonias -
STDs: Gram+ cocci
What are the Macrolides (streptococcal infect in pts
used for clinically? allergic to penicillin) -
Mycoplasma,
Legionella,Chlamydia,
Neisseria
Cephalosporin: 1) has a 6
member ring attached to
What are the major
the Beta lactam instead of
structural differences
a 5 member ring 2)has an
between Penicillin and
extra functional group
Cephalosporin?
( attached to the 6
member ring)
What are the major toxic GI distress, Skin rash, and

side effects of Imipenem/ Seizures at high plasma
cilastatin? levels
1) Hypersensitivity reactions
2) Increased nephrotoxicity
What are the major toxic of Aminoglycosides 3)
side effects of the Disulfiram-like reaction
Cephalosporins? with ethanol (those with a
methylthiotetrazole group,
e.g., cefamandole)
What are the side effects Neurotoxicity, Acute renal

of Polymyxins? tubular necrosis
Minor hepatotoxicity, Drug
What are the side effects
interactions (activates
of Rifampin?
P450)
What are toxic side effects Disulfiram-like reaction

for Metronidazole? with EtOH, Headache
What are toxicities Aplastic anemia (dose

associated with independent), Gray Baby
Chloramphenicol? Syndrome
Giardiasis, Amoebic
What conditions are dysentery (E. histolytica),
treated with Bacterial vaginitis
Metronidazole? (Gardnerella vaginalis),
Trichomonas
What do Aminoglycosides
Oxygen
require for uptake?
What do you treat

Mebendazole/
Nematode/roundworm
Thiabendazole, Pyrantel
(pinworm, whipworm)
Pamoate
infections with?
What drug is given for

Pneumocystis carinii Pentamidine
prophylaxis?
What drug is used during

AZT, to reduce risk of Fetal
the pregnancy of an HIV +
Transmission
mother?, Why?
What drug is used to treat
Trematode/fluke (e.g.,
Schistosomes, Praziquantel
Paragonimus, Clonorchis)
or Cysticercosis
What is a common drug

Increases coumadin
interaction associated with
metabolism
Griseofulvin?
What is a mnemonic to Blocks Influenza A and

remember Amantadine's RubellA; causes problems
function? with the cerebellA
What is a prerequisite for It must be Phosphorylated

Acyclovir activation? by Viral Thymidine Kinase
What is a Ribavirin
Hemolytic anemia
toxicity?
What is an acronym to
RESPIre
remember Anti-TB drugs?
What is an additional side

Interstitial nephritis
effect of Methicillin?
What is an occasional side

GI upset
effect of Aztreonam?
What is Clindamycin used Anaerobic infections (e.g.,
for clinically? B. fragilis, C. perfringens)
What is clinical use for

Pseudomonas species and
Carbenicillin, Piperacillin,
Gram - rods
and Ticarcillin?
Recurrent UTIs, Shigella,

What is combination TMP-
Salmonella, Pneumocystis
SMZ used to treat?
carinii pneumonia
What is combined with

Ampicillin, Amoxicillin,
Carbenicillin, Piperacillin, Clavulanic acid
and Ticarcillin to enhance
their spectrum?
Cryptococcal meningitis in
What is Fluconazole
AIDS patients and Candidal
specifically used for?
infections of all types
What is Imipenem always

Cilastatin
administered with?
Blastomyces, Coccidioides,
What is Ketoconazole
Histoplasma, C. albicans;
specifically used for?
Hypercortisolism
What is Metronidazole
Bismuth and Amoxicillin or
combined with for 'triple
Tetracycline; against
therapy'? Against what
Helobacter pylori
organism?
Antiprotozoal: Giardia,
Entamoeba, Trichomonas,
What is Metronidazole
Gardnerella vaginalis
used for clinically?
Anaerobes: Bacteroides,
Clostridium
Cestode/tapeworm (e.g.,
What is Niclosamide used
D. latum, Taenia species
for?
Except Cysticercosis
Chagas' disease, American

What is Nifurtimox
Trypanosomiasis
administered for?
(Trypanosoma cruzi)
What is the chemical name DHPG (dihydroxy-2-

for Ganciclovir? propoxymethyl guanine)
Extended spectrum
What is the clinical use for
penicillin: certain Gram +
Ampicillin and Amoxicillin?
bacteria and Gram - rods
What is the clinical use for Topical and Oral, for Oral
Nystatin? Candidiasis (Thrush)
Bactericidal for: Gram +

rod and cocci, Gram -
Penicillin?
cocci, and Spirochetes
What is the major side

effect for Ampicillin and Hypersensitivity reactions
Amoxicillin?
What is the major side
effect for Carbenicillin, Hypersensitivity reactions
Piperacillin, and Ticarcillin?
What is the major toxic

Hypersensitivity reactions
side effect of Penicillin?
What is the memory aid for

subunit distribution of Buy AT 30, CELL at 50'
ribosomal inhibitors?
What is the memory key INH: Injures Neurons and

for Isoniazid (INH) toxicity? Hepatocytes
What is the memory key
for Metronidazole's clinical GET on the Metro
uses?

for organisms treated with VACUUM your Bed Room'
Tetracyclines?
1. RNA pol inhibitor 2.

What is the memory key Revs up P450 3. Red/
involving the '4 R's of orange body fluids 4.
Rifampin?' Rapid resistance if used
alone
What is the MOA for Inhibit viral DNA

Acyclovir? polymerase
Binds Ergosterol, forms
What is the MOA for
Membrane Pores that
Amphotericin B?
Disrupt Homeostatis
Same as penicillin.
What is the MOA for
Extended spectrum
Ampicillin and Amoxicillin?
antibiotics
What is the MOA for Same as penicillin.

Carbenicillin, Piperacillin, Extended spectrum
and Ticarcillin? antibiotics
Blocks Peptide Bond

What is the MOA for
formation at the 50S
Clindamycin?
subunit, Bacteriostatic
What is the MOA for Same as penicillin. Act as
Methicillin, Nafcillin, and narrow spectrum
Dicloxacillin? antibiotics
Forms toxic metabolites in

What is the MOA for
the bacterial cell,
Metronidazole?
Bactericidal
What is the MOA for Binds ergosterol, Disrupts

Nystatin? fungal membranes
What is the MOA for Inhibits DNA dependent

Rifampin? RNA polymerase
Inhibits formation of
What is the MOA for the Initiation Complex, causes
Aminoglycosides? misreading of mRNA,
Bactericidal
What is the MOA for the

Inhibit Ergosterol synthesis
Azoles?
What is the MOA for the Beta lactams - inhibit cell

Cephalosporins? wall synthesis, Bactericidal
Inhibit DNA Gyrase

(topoisomerase II),
Fluoroquinolones?
Bactericidal
Blocks translocation, binds
to the 23S rRNA of the 50S
Macrolides?
subunit, Bacteriostatic
Binds 30S subunit and

What is the MOA for the prevents attachment of
Tetracyclines? aminoacyl-tRNA,
Bacteriostatic
Inhibits bacterial
What is the MOA for
Dihydrofolate Reductase,
Trimethoprim (TMP)?
Bacteriostatic
Inhibits cell wall

What is the MOA for
mucopeptide formation,
Vancomycin?
Bactericidal
Blocks viral penetration/
What is the MOA of uncoating; may act to
Amantadine? buffer the pH of the
endosome
Inhibits cell wall synthesis

What is the MOA of
( binds to PBP3). A
Aztreonam?
monobactam
What is the MOA of Inhibits Viral DNA

Foscarnet? polymerase
What is the MOA of Inhibits CMV DNA

Ganciclovir? polymerase
Interferes with microtubule
What is the MOA of
function, disrupts mitosis,
Griseofulvin?
inhibits growth
What is the MOA of Acts as a wide spectrum

Imipenem? carbapenem
What is the MOA of Decreases synthesis of

Isoniazid (INH)? Mycolic Acid
Bind cell membrane,

disrupt osmotic
What is the MOA of
properties, Are Cationc,
Polymyxins?
Basic and act as
detergents
Inhibits IMP
Dehydrogenase
What is the MOA of
(competitively), and
Ribavirin?
therefore blocks Guanine
Nucleotide synthesis
Inhibit RT of HIV and

What is the MOA of the RT prevent the incorporation
Inhibitors? of viral genome into the
host DNA
What is the most common

cause of Pt noncompliance GI discomfort
with Macrolides?
What is treated with

Chloroquine, Quinine, Malaria (P. falciparum)
Mefloquine?
What microorganisms are
Aminoglycosides Anaerobes
ineffective against?
Vibrio cholerae Acne

Chlamydia Ureaplasma
What microorganisms are
Urealyticum Mycoplasma
clinical indications for
pneumoniae Borrelia
Tetracycline therapy?
burgdorferi (Lyme's)
Rickettsia Tularemia
What microorganisms is
Aztreonam not effective Gram + and Anerobes
against?
What musculo-skeletal
side effects in Adults are Tendonitis and Tendon
associated with rupture
Floroquinolones?
What neurotransmitter
Dopamine; causes its
does Amantadine affect?
release from intact nerve
How does it influence this
terminals
NT?
What organism is
Imipenem/cilastatin the Enterobacter
Drug of Choice for?
What organisms does Dermatophytes (tinea,

Griseofulvin target? ringworm)
Giant Roundworm
What parasites are treated
(Ascaris), Hookworm
with Pyrantel Pamoate
(Necator/Ancylostoma),
(more specific)?
Pinworm (Enterobius)
What parasitic condition is Onchocerciasis ('river
treated with Ivermectin? blindness'--rIVER-mectin)
What populations are Pregnant women, Children;

Floroquinolones because animal studies
contraindicated in? Why? show Damage to Cartilage
Milk or Antacids, because

What should not be taken divalent cations inhibit
with Tetracyclines? / Why? Tetracycline absorption in
the gut
What Sulfonamides are

Triple sulfas or SMZ
used for simple UTIs?
When pts have Low CD4+
When is HIV therapy
(< 500 cells/cubic mm)
initiated?
or a High Viral Load
1. Meningococcal carrier
When is Rifampin not used
state 2. Chemoprophylaxis
in combination with other
in contacts of children
drugs?
with H. influenzae type B
Where does Griseofulvin Keratin containing tissues,

deposit? e.g., nails
Which Aminoglycoside is
Neomycin
used for Bowel Surgery ?
Which antimicrobial 1) Aminoglycosides =
classes inhibit protein bactericidal 2)
synthesis at the 30S Tetracyclines =
subunit? (2) bacteriostatic
1) Chloramphenical =
bacteriostatic 2)
Which antimicrobials Erythromycin =
inhibit protein synthesis at bacteriostatic 3)
the 50S subunit? (4) Lincomycin = bacteriostatic
4)cLindamycin =
bacteriostatic
Which individuals are

predisposed to G6PD deficient individuals
Sulfonamide-induced
hemolysis?
Which RT inhibitor causes

AZT
Megaloblastic Anemia?
Which RT inhibitors cause
Non-Nucleosides
a Rash?
Which RT inhibitors cause

Nucleosides
Lactic Acidosis?
Which Tetracycline is used

Doxycycline, because it is
in patients with renal
fecally eliminated
failure? / Why?
B.W. !!!, Ha. Good Luck on

Who's your daddy?
Boards
Why are Methicillin,
Due to the presence of a
Nafcillin, and Dicloxacillin
bulkier R group
To inhibit renal
Why is Cilastatin Dihydropeptidase I and
administered with decrease Imipenem
Imipenem? inactivation in the renal
tubules
-S-phase anti-metabolite
List the mechanism, Pyr analogue -Colon, solid
clinical use, & toxicity tumors, & BCC/ -
of 5 FU. Irreversible
myelosuppression
List the mechanism,

-inhibits HGPRT (pur. Syn.)
clinical use, & toxicity
- Luk, Lymph,
of 6 MP.
-DNA intercalator -
List the mechanism, testicular &
clinical use, & toxicity lymphomas -Pulmonary
of Bleomycin. fibrosis mild
myelosuppression.
List the mechanism, -Alkalates DNA -CML -

clinical use, & toxicity Pulmonary fibrosis
of Busulfan. hyperpigmentation
-Alkalating agent -
List the mechanism,
testicular,bladder,ovary,&a
mp;lung -Nephrotoxicity
of Cisplatin.
& CN VIII damage.
-Alkalating agent -NHL,

List the mechanism, Breast, ovary, & lung.
clinical use, & toxicity - Myelosuppression,
of Cyclophosphamide. & hemorrhagic
cystitis.
-DNA intercalator -
List the mechanism, Hodgkin's, myeloma,
clinical use, & toxicity sarcoma, and solid tumors
of Doxorubicin. -Cardiotoxicity &
alopecia
-Topo II inhibitor(GII
specific) -Oat cell of Lung
List the mechanism,
& prostate, &
testicular -
of Etoposide.
Myelosuppression &
GI irritation.
-S-phase anti-metabolite
folate analogue -Luk,
List the mechanism,
Lymp, sarc, RA,
&psoriasis / -
of Methotrexate.
Reversible
myelosuppression
List the mechanism,

-Alkalate DNA -Brain
tumors -CNS toxicity
of Nitrosureas.
-MT polymerization
List the mechanism, stabilizer -Ovarian &
clinical use, & toxicity breast CA -
of Paclitaxel. Myelosupperession &
hypersensitivity.
List the mechanism, -Triggers apoptosis -CLL,

clinical use, & toxicity Hodgkin's in MOPP -
of Prednisone. Cushing-like syndrome
-Estrogen receptor
List the mechanism,
antagonist -Breast CA -
increased endometrial CA
of Tamoxifen.
risk
-MT polymerization
inhibitor(M phase) -MOPP,
List the mechanism,
clinical use, & toxicity lymphoma, Willm's &
choriocarcinoma -
of Vincristine.
neurotoxicity and
myelosuppression
-Alkalating agents
Which cancer drugs effect +cisplatin -Doxorubicin
nuclear DNA (4)? +Dactinomycin -Bleomycin
-Etoposide
Which cancer drugs inhibit - Methotrexate - 5 FU - 6

nucleotide synthesis(3)? mercaptopurine
Which cancer drugs work

-Steroids -Tamoxifen
at the level of mRNA(2)?
Which cancer drugs work -Vinca alkaloids(inhibit

at the level of proteins(2)? MT) -Paclitaxel
ACE inhibitors- clinical hypertension, CHF,
use? diabetic renal disease
reduce levels of
Angiotensin II, thereby
ACE inhibitors- preventing the inactivation
mechanism? of bradykinin (a potent
vasodilator); renin level is
increased
fetal renal damage,

hyperkalemia, Cough,
Angioedema, Proteinuria,
ACE inhibitors- toxicity? Taste changes, hypOtension,
Pregnancy problems, Rash,
Increased renin, Lower
Angiotensin II (CAPTOPRIL)
glaucoma, urinary
Acetazolamide- clinical
alkalinization, metabolic
uses?
alkalosis, altitude sickness
acts at the proximal
convoluted tubule to
inhibit carbonic anhydrase.
Acetazolamide-
Causes self-limited
mechanism?
sodium bicarb diuresis and
reduction of total body
bicarb stores.
acetazolamide- site of proximal convoluted

action? tubule
hyperchloremic metabolic
Acetazolamide- toxicity? acidosis, neuropathy, NH3
toxicity, sulfa allergy
ACIDazolamide' causes
Acetazolamide causesÃ‰?
acidosis
DOC in diagnosing and
Adenosine- clinical use? abolishing AV nodal
arrhythmias
ADH antagonists- site of

collecting ducts
action?
adverse effect of cyanide toxicity (releases

Nitroprusside? CN)
impotence, asthma, CV
effects (bradycardia, CHF,
adverse effects of beta-
AV block), CNS effects
blockers?
(sedation, sleep
alterations)
fetal renal toxicity,
hyperkalemia, Cough,
adverse effects of Angioedema, Proteinuria,
Captopril? Taste changes, hypOtension,
Pregnancy problems, Rash,
Increased renin, Lower
Angiotensin II (CAPTOPRIL)
dry mouth, sedation,

adverse effects of
severe rebound
Clonidine?
hypertension
severe orthostatic
adverse effects of hypotension, blurred
ganglionic blockers? vision, constipation,
sexual dysfunction
orthostatic and exercise

adverse effects of
hypotension, sexual
Guanethidine?
dysfunction, diarrhea
nausea, headache, lupus-
adverse effects of like syndrome, reflex
Hydralazine? tachycardia, angina, salt
retention
hypokalemia, slight
hyperlipidemia,
adverse effects of
hyperuricemia, lassitude,
Hydrochlorothiazide?
hypercalcemia,
hyperglycemia
K+ wasting, metabolic
adverse effects of Loop
alkalosis, hypotension,
Diuretics?
ototoxicity
adverse effects of fetal renal toxicity,

Losartan? hyperkalemia
adverse effects of sedation, positive Coombs'
Methyldopa? test
hypertrichosis, pericardial
adverse effects of effusion, reflex
Minoxidil? tachycardia, angina, salt
retention
dizziness, flushing,
adverse effects of
constipation (verapamil),
Nifedipine, verapamil?
nausea
first dose orthostatic

adverse effects of
hypotension, dizziness,
Prazosin?
headache
adverse effects of sedation, depression,
Reserpine? nasal stuffiness, diarrhea
pulmonary fibrosis, corneal

deposits, hepatotoxicity, skin
deposits resulting in
Amiodarone- toxicity? photodermatitis, neurologic
effects, consitpation, CV
(bradycardia, heart block,
CHF), and hypo- or
hyperthyroidism.
slowly normalize K+,

lidocaine, cardiac pacer,
antidote?
and anti-Dig Fab
fragments
Beta Blockers- CNS

sedation, sleep alterations
toxicity?
bradycardia, AV block,
Beta Blockers- CV toxicity?
CHF
Beta adrenergic receptors

Beta Blockers- site of
and Ca2+ channels
action?
(stimulatory)
BP? decrease
BP? decrease
new arrhythmias,
Bretyllium- toxicity?
hypotension
Ca2+ channel blockers- hypertension, angina,

clinical use? arrhythmias
block voltage dependent

L-type Ca2+ channels of
Ca2+ channel blockers-
cardiac and smooth
mechanism?
muscle- decreasing
contractility
Cell membrane Ca2+

Ca2+ channel blockers-
channels of cardiac
site of action?
sarcomere
cardiac depression,
Ca2+ channel blockers- peripheral edema,
toxicity? flushing, dizziness,
constipation
Ca2+ sensitizers'- site of troponin-tropomyosin

action? system
Cautions when using check PFTs, LFTs, and

Amiodarone? TFTs
increased AP duration,
increased ERP increased
class IA effects?
QT interval. Atrial and
ventricular.
post MI and digitalis
class IB- clinical uses?
induced arrhythmias
decrease AP duration,
affects ischemic or
class IB- effects?
depolarized Purkinje and
ventricular system
local anesthetic. CNS

class IB- toxicity? stimulation or depression.
CV depression.
NO AP duration effect.
useful in V-tach that
class IC- effects? progresses to V-fib and in
intractable SVT LAST
RESORT
class IC- toxicity? proarrhythmic
decrease the slope of

phase 4, increase PR
class II- effects?
interval (the AV node is
particularly sensitive)
blocking the beta

adrenergic receptor leads
class II- mechanism?
to decreased cAMP, and
decreased Ca2+ flux
impotence, exacerbation
of asthma, CV effects, CNS
class II- toxicity?
effects, may mask
hypoclycemia
increase AP duration,
increase ERP, increase QT
Class III- effects?
interval, for use when
other arrhythmics fail
prevention of nodal
class IV- clinical use?
arrhythmias (SVT)
decrease conduction
class IV- effects? velocity, increase ERP,
increase PR interval
class IV- primary site of

AV nodal cells
action?
constipation, flushing,
edema, CV effects (CHF,
class IV- toxicity? AV block, sinus node
depression), and torsade
de pointes (Bepridil)
diuretics,
sympathoplegics,
classes of antihypertensive
vasodilators, ACE
drugs?
inhibitors, Angiotensin II
receptor inhibitors
angina, pulmonary edema

clinical use?
(also, erection enhancer)
clinical use? CHF, atrial fibrillation

contractility? increase (reflex response)
contractility? decrease
renal failure, hypokalemia,

contraindications?
pt on quinidine
decrease Digitoxin dose in

NO
renal failure?
decrease Digoxin dose in
YES
renal failure?
Digitalis- site of action? Na/K ATPase
Digoxin v. Digitoxin: Digitoxin>95% Digoxin

bioavailability? 75%
Digoxin v. Digitoxin: Digoxin=urinary

excretion? Digitoxin=biliary
Digoxin v. Digitoxin: half Digitoxin 168hrs Digoxin
life? 40 hrs
Digoxin v. Digitoxin: Digitoxin 70% Digoxin

protein binding? 20-40%
ejection time? decrease
ejection time? increase

inc PR, dec QT, scooping
EKG results? of ST, and T wave
inversion
end diastolic volume? decrease
end diastolic volume? increase
Esmolol- short or long

very short acting
acting?
Ethacrynic Acid- clinical Diuresis in pateints with
use? sulfa allergy
not a sulfonamide, but

Ethacrynic Acid-
action is the same as
mechanism?
furosemide
NO HYPERURICEMIA, NO
Ethacrynic Acid- toxicity? SULFA ALLERGY; same as
furosemide otherwise
Sulfonamide Loop Diuretic.

Inhibits ion co-transport
system of thick ascending
Furosemide- class and
loop. Abolishes
mechanism?
hypertonicity of the
medulla, thereby preventing
concentration of the urine.
edematous states (CHF,
cirrhosis, nephrotic
Furosemide- clinical use?
syndrome, pulm edema),
HTN, hypercalcemia
Ototoxicity, Hypokalemia,
Furosemide- toxicity? (OH Dehydration, Allergy
DANG) (sulfa), Nephritis
(interstitial), Gout
Furosemide increases the

Ca2+ (Loops Lose calcium)
excretion of what ion?
HDL effect? no effect

HDL effect? increase
HDL effect? moderate increase
HDL effect? increase
HDL effect? DECREASE

decrease myocardial O2
consumption by: 1-
decreasing end diastolic
how do we stop angina? volume 2- decreasing BP
3- decreasing HR 4-
decreasing contractility 5-
decreasing ejection time
HR? increase (reflex response)
HR? decrease
vasodilator- increases
cGMP to induce smooth
Hydralazine- class and
muscle relaxation
mechanism?
(arterioles>veins;
afterload reduction)
Hydralazine- clinical use? severe hypertension, CHF
compensatory tachycardia,
Hydralazine- toxicity? fluid retention, lupus-like
syndrome
Hydrochlorothiazide- HTN, CHF, calcium stone

clinical use? formation, nephrogenic DI.
Inhibits NaCl reabsorption

Hydrochlorothiazide-
in the early distal tubule.
mechanism?
Decreases Ca2+ excretion.
Hypokalemic metabolic
alkalosis, hyponatremia,
Hydrochlorothiazide- hyperGlycemia,
toxicity? (hyperGLUC, plus hyperLipidemia,
others) hyperUricemia,
hyperCalcemia, sulfa
allergy.
Ibutilide- toxicity? torsade de pointes
depresses ectopic
K+- clinical use? pacemakers, especially in
digoxin toxicity
K+ sparing diuretics- hyperaldosteronism, K+

clinical use? depletion, CHF
K+ sparing diuretics- site
cortical collecting tubule
of action?
hyperkalemia, endocrine
K+ sparing diuretics-
effects (gynecomastia,
toxicity?
anti-androgen)
LDL effect? moderate decrease
LDL effect? large decrease

LDL effect? moderate decrease
LDL effect? decrease
LDL effect? decrease
loop diuretics
(furosemide)- site of thick ascending limb
action?
ARF, shock, drug
overdose, decrease
Mannitol- clinical use?
intracranial/intraocular
pressure
Mannitol-
anuria, CHF
contraindications?
osmotic diuretic- increase

tubular fluid osmolarity,
Mannitol- mechanism?
thereby increasing urine
flow
proximal convoluted
mannitol- site of action? tubule, thin descending
limb, and collecting duct
pulmonary edema,
Mannitol- toxicity?
dehydration
vasodilate by releasing NO
in smooth muscle, causing
mechanism? and increase in cGMP and
smooth muscle relaxation
(veins>>arteries)
inhibits the Na/K ATPase,

increasing intracellular Na
mechanism? + decreasing the function
of the Na/Ca antiport
causing an increase in
intracellular Ca2+
Na+ channel blockers.

Slow or block conduction.
mechanism? Decreased slope in phase
4 and increased threshold
for firing in abnormal
pacemaker cells.
effective in torsade de
Mg+- clinical use? pointes and digoxin
toxicity
MVO2? decrease
MVO2? decrease
propanolol, esmolol,
name five in class II? metoprolol, atenolol,
timolol
name four HMG-CoA Lovastatin, Pravastatin,
reductase inhibitors. Simvastatin, Atorvastatin
Quinidine, Amiodarone,
name four in class IA. Procainamide,
Disopyramide
Sotalol, Ibutilide,
name four in class III.
Bretylium, Amiodarone
Captopril, Enalapril,
name three ACE inhibitors?
Lisinopril
name three calcium Nifedipine, Verapamil,
channel blockers? Diltiazem
Lidocaine, Mexiletine,
name three in class IB.
Tocainide
Flecainide, Encainide,
name three in class IC.
Propafenone
Verapamil, Diltiazem,
name three in class IV.
Bepridil
Spironolactone,
name three K+ sparing
Triamterene, Amiloride
diuretics?
(the K+ STAys)
name two bile acid resins. cholestyramine, colestipol
name two LPL stimulators. Gemfibrozil, Clofibrate
Nifedipine has similar

Nitrates
action to?
preferential action of the cardiac muscle:
Ca2+ channel blockers at Verapamil>Diltiazem&gt
cardiac muscle? ;Nifedipine
preferential action of the vascular sm. Mus.:

Ca2+ channel blockers at Nifedipine>Diltiazem&g
vascular smooth muscle? t;Verapamil
reversible SLE-like
Procainamide- toxicity?
syndrome
cinchonism: HA, tinnitus,

thrombocytopenia, torsade
Quinidine- toxicity?
de pointes due to
increased QT interval
Ryanodine- stie of action? blocks SR Ca2+ channels
slectively depress tissue

that is frequently
selectivity?
depolarized (fast
tachycardia)
tastes bad and causes GI

side effects/problems?
discomfort
expensive, reversible
side effects/problems? increase in LFTs, and
myositis
red, flushed face which is
side effects/problems? decreased by ASA or long
term use
side effects/problems? myositis, increased LFTs
side effects/problems? DECREASED HDL
torsade de pointes,
Sotalol- toxicity?
excessive Beta block
competitive inhibirot of
Spironolactone-
aldosterone in the cortical
mechanism?
collecting tubule
TG effect? slight increase
TG effect? decrease
TG effect? decrease
TG effect? large decrease
TG effect? no effect
distal convoluted tubule

thiazides- site of action?
(early)
tachycardia, hypotension,
toxicity? headache - 'Monday
disease'
nausea, vomiting,
toxicity? diarrhea, blurred vision,
arrhythmia
Triamterene and block Na+ channels in the

amiloride- mechanism? cortical collecting tubule
Verapamil has similar

Beta Blockers
action to?
what two vasodilators

require simultaneous
treatment with beta Hydralazine and Minoxidil
blockers to prevent reflex
tachycardia and diuretics
to prevent salt retention?
carbonic anhydrase
which diuretics cause
inhibitors, K+ sparing
acidosis?
diuretics
which diuretics cause

loop diuretics, thiazides
alkalosis?
which diuretics decrease

thiazides, amiloride
urine Ca2+?
which diuretics increase loop diuretics,

urine Ca2+? spironolactone
all except the K+ sparing
which diuretics increase
diuretics Spironolactone,
urine K+?
Triamterene, Amiloride
which diuretics increase

all of them
urine NaCl?
Acetaminophen has what Acetaminophen has

two clinical uses and lacks antipyretic and analgesic
what one clinical use of properties, but lacks anti-
the NSAIDs? inflammatory properties.
Can Heparin be used Yes, it does not cross the

during pregnancy? placenta.
No, warfarin, unlike
Can Warfarin be used
heparin, can cross the
during pregnancy?
placenta.
Does Heparin have a long,

Short.
medium, or short half life?
Does Warfarin have a long,

Long.
medium, or short half life?
For Heparin what is the 1. Heparin 1. Structure - Large anionic

Structure 2. Route of polymer, acidic 2. Route of administration
- Paranteral (IV, SC) 3. Onset of action -
administration 3. Onset of action Rapid (seconds) 4. Mechanism of action -
4. Mechanism of action 5. Activates antithrombin III 5. Duration of
Duration of action 6. Ability to action - Acute (hours) 6. Ability to inhibit
inhibit coagulation in vitro 7. coagulation in vitro - Yes 7. Treatment for
overdose - Protamine sulfate 8. Lab value
Treatment for overdose 8. Lab to monitor-aPTT (intrinsic pathway) 9.
value to monitor 9. Site of action Site of action - Blood
For Warfarin what is the 1. Warfarin 1. Structure - Small lipid-
soluble molecule 2. Route of
Structure 2. Route of
administration -Oral 3. Onset of action
administration 3. Onset of action - Slow, limited by half lives of clotting
4. Mechanism of action 5. factors 4. Mechanism of action -
Duration of action 6. Ability to Impairs the synthesis of vitamin K-
inhibit coagulation in vitro 7. dependent clotting factors 5. Duration
Treatment for overdose 8. Lab of action - Chronic (weeks or months)
6. Ability to inhibit coagulation in vitro
value to monitor 9. Site of action - No
7. Treatment for overdose

- IV vitamin K and fresh
For Warfarin what is the
frozen plasma 8. Lab value
(continued):
to monitor - PT 9. Site of
action - Liver
Is toxicity rare or common

whith Cromolyn used in Rare.
Asthma prevention?
1. Hydrocortisone 2.
Predisone 3.
List five common
Triamcinolone 4.
glucocorticoids.
Dexamethasone 5.
Beclomethasone
Secretion of what drug is
inhibited by Probenacid Penicillin.
used to treat chronic gout?
The COX-2 inhibitors The COX-2 inhibitors

(celecoxib, rofecoxib) have should not have the
similar side effects to the corrosive effects of other
NSAIDs with what one NSAIDs on the
exception? gastrointestinal lining.
Sulfonylureas are oral

What are are the
hypoglycemic agents, they
Sulfonylureas (general
are used to stimulate
description) and what is
release of endogenous
their use?
insulin in NIDDM (type-2).
1. Reliable (<1% failure) 2.

Lowers risk of endometrial
What are five advantages
and ovarian cancer 3.
of Oral Contraceptives
Decreased incidence of
(synthetic progestins,
ectopic pregnancy 4. Lower
estrogen)?
risk of pelvic infections 5.
Regulation of menses
1. Taken daily 2. No
What are five protection against STDs 3.
disadvantages of Oral Raises triglycerides 4.
Contraceptives (synthetic Depression, weight gain,
progestins, estrogen)? nausea, HTN 5.
Hypercoagulable state
1. Gastric ulceration 2.
What are five possible Bleeding 3.
toxic effects of Aspirin Hyperventilation 4. Reye's
therapy? syndrome 5. Tinnitus (CN
VIII)
1. Significant:
What are five toxicities nephrotoxicity 2.
associated with Tacrolimus Peripheral neuropathy 3.
(FK506)? Hypertension 4. Pleural
effusion 5. Hyperglycemia.
1. Better bioavailability 2.
What are four advantages 2 to 4 times longer half
of newer low-molecular- life 3. Can be administered
weight heparins subcutaneously 4. Does
(Enoxaparin)? not require laboratory
monitoring
1. Antipyretic 2. Analgesic
What are four clinical
3. Anti-inflammatory 4.
activities of Aspirin?
Antiplatelet drug.
1. Addison's disease 2.
What are four clinical uses
Inflammation 3. Immune
of glucocorticoids?
suppression 4. Asthma
What are four conditions in 1. Peptic ulcer 2. Gastritis

which H2 Blockers are 3. Esophageal reflux 4.
used clinically? Zollinger-Ellison syndrome
1. Cimetadine 2. Ranitidine
What are four H2 Blockers?
3. Famotidine 4. Nizatidine
1. Tolbutamide 2.
What are four
Chlorpropamide 3.
Sulfonylureas?
Glyburide 4. Glipizide
1. Streptokinase 2.
What are four Urokinase 3. tPA
thrombolytics? (alteplase), APSAC
(anistreplase)
1. Hot flashes 2. Ovarian

What are four unwanted enlargement 3. Multiple
effects of Clomiphene use? simultaneous pregnancies
4. Visual disturbances
1. Buffalo hump 2. Moon

facies 3. Truncal obesity 4.
What are nine findings of
Muscle wasting 5. Thin
Iatrogenic Cushing's
skin 6. Easy bruisability 7.
syndrome caused by
Osteoporosis 8.
glucocorticoid therapy?
Adrenocortical atrophy 9.
Peptic ulcers
Headache, flushing ,
What are signs of Sildenafil
dyspepsia, blue-green
(Viagra) toxicity?
color vision.
Acute coronary syndrome;

What are the clinical uses coronary stenting.
for Ticlopidine, Decreases the incidence or
Clopidogrel? recurrence of thrombotic
stroke.
What are the four

1. Peptic ulcer 2. Gastritis
conditions in which
3. Esophageal reflux 4.
Omeprazole, Lansoprazole
Zollinger-Ellison syndrome
is used?
1. Infertility (pulsatile) 2.
Prostate cancer
What are three clinical
(continuous: use with
uses of the Leuprolide?
flutamide) 3. Uterine
fibroids
What are three clinical 1. Antipyretic 2. Analgesic
uses of the NSAIDs? 3. Anti-inflammatory
What are three common Ibuprofen, Naproxen, and

NSAIDS other than Aspirin? Indomethacin
What are three 1. Bleeding 2.

complications of Warfarin Teratogenicity 3. Drug-
usage? drug interactions
What are three possible 1. Bleeding 2.

complications of Heparin Thrombocytopenia 3.
therapy? Drug-drug interactions
1. Renal damage 2.
What are three possible
Aplastic anemia 3. GI
toxicities of NSAID usage?
distress
What are three toxicities of 1. Antiandrogen 2. Nausea

Leuprolied? 3. Vomiting
1. Skin rash 2.
What are three toxicities of
Agranulocytosis (rare) 3.
Propylthiouracil?
Aplastic anemia
1. Aluminum hydroxide:
constipation and
What are three types of hypophosphatemia 2.
antacids and the problems Magnesium hydroxide:
that can result from their diarrhea 3. Calcium
overuse? carbonate: Hypercalcemia,
rebound acid increase - All
may cause hypokalemia
1. Heavy bleeding 2. GI
What are three unwanted
effects (n/v, anorexia) 3.
effects of Mifepristone?
Abdominal pain
What are two Alpha-

1. Acarbose 2. Miglitol
glucosidase inhibitors?
1. Kidney transplantation
2. Autoimmune disorders
What are two clinical uses
(including
of Azathioprine?
glomerulonephritis and
hemolytic anemia)
What are two conditions in

Rheumatoid and
which COX-2 inhibitors
osteoarthritis.
might be used?
1. Pioglitazone 2.
What are two Glitazones?
Rosiglitazone.
Inhibits organification and

What are two mechanisms coupling of thyroid
of action of hormone synthesis. Also
Propythiouracil? decreases peripheral
conversion of T4 to T3.
1. Phospholipase A2 is
prevented from releasing
What are two processes
arachidonic acid 2.
Corticosteroids inhibit
Decreases protein
leading to decreased
synthesis thus lowering
inflammation?
amount of Cyclooxygenase
enzymes
1. Predisposes to viral
What are two toxicities infections and lymphoma
associated with 2. Nephrotoxic
Cyclosporine? (preventable with mannitol
diuresis)
1. Weight gain 2.
What are two toxicities of
Hepatotoxicity
the Glitazones?
(troglitazone)
1. Hypoglycemia (more
common with 2nd-
generation drugs:
What are two toxicities of
glyburide, glipizide) 2.
the Sulfonylureas?
Disulfiram-like effects (not
seen with 2nd-generation
drugs).
Sucralfate cannot work in

What are two types of the presence of antacids
drugs that interfere with or H2 blockers because it
the action of Sucralfate requires an acidic
and why? environment to
polymerize.
Can affect absorption,

bioavailability, or urinary
What can result due to excretion of other drugs
antacid overuse? by altering gastric and
urinary pH or by delaying
gastric emptying.
What enzyme does
Lipoxygenase
Zileuton inhibit?
What enzymes are

inhibited by NSAIDs, Cyclooxygenases (COX I,
acetaminophen and COX II COX II).
inhibitors?
What is a common side

effect of Colchicine used GI side effects. (Note:
to treat acute gout, Indomethacin is less toxic,
especially when given more commonly used.)
orally?
What is a common side

Diarrhea
effect of Misoprostol?
Overdose produces
hepatic necrosis;
What is a possible result of acetaminophen
overdose of metablolite depletes
Acetaminophen? glutathione and forms
toxic tissue adducts in
liver.
What is a possible toxicity

of Alpha-glucosidase GI disturbances.
inhibitors used in type-2
diabetes?
What is a possible toxicity Neutropenia (ticlopidine);

of Ticlopidine, Clopidogrel reserved for those who
usage? cannot tolerate aspirin.
What is a sign of toxicity

with the use of Bleeding.
thrombolytics?
1. In liver, increases storage
of glucose as glycogen. 2. In
What is action of insulin in muscle, stimulates glycogen
the liver, in muscle, and in and protein synthesis, and K
adipose tissue? + uptake. 3. In adipose
tissue, facilitates
triglyceride storage.
1. Suppresses organ
What is are two clinical rejection after
uses of Cyclosporine? transplantation 2. Selected
autoimmune disorders.
What is the category and

mechanism of action of Antileukotriene; blocks
Zafirlukast in Asthma leukotriene receptors.
treatment?
What is the category and

mechanism of action of Antileukotriene; blocks
Zileuton in Asthma synthesis by lipoxygenase.
treatment?
What is the category of
Inhalational general
drug names ending in -
anesthetic.
ane (e.g. Halothane)

drug names ending in - Benzodiazepine.
azepam (e.g. Diazepam)

drug names ending in - Phenothiazine
azine (e.g. (neuroleptic, antiemetic).
Chlorpromazine)

drug names ending in - Antifungal.
azol (e.g. Ketoconazole)
drug names ending in - Babiturate.
barbital (e.g.
Phenobarbital)

drug names ending in - Local anesthetic.
caine (e.g. Lidocaine)

drug names ending in - Penicillin.
cillin (e.g. Methicillin)

Antibiotic, protein
synthesis inhibitor.
cycline (e.g. Tetracycline)
drug names ending in - Tricyclic antidepressant.
ipramine (e.g. Imipramine)

drug names ending in - Protease inhibitor.
navir (e.g. Saquinavir)

drug names ending in - Beta antagonist.
olol (e.g. Propranolol)

Butyrophenone
(neuroleptic).
operidol (e.g. Haloperidol)
Cardiac glycoside
(inotropic agent).
oxin (e.g. Digoxin)

drug names ending in - Methylxanthine.
phylline (e.g. Theophylline)

drug names ending in -pril ACE inhibitor.
(e.g. Captopril)

drug names ending in - Beta-2 agonist.
terol (e.g. Albuterol)
drug names ending in - H2 antagonist
tidine (e.g. Cimetidine)

drug names ending in - Tricyclic antidepressant.
triptyline (e.g.
Amitriptyline)

drug names ending in - Pituitary hormone.
tropin (e.g. Somatotropin)

drug names ending in - Alpha-1 antagonist
zosin (e.g. Prazosin)
Nonspecific beta-agonist;
What is the category, desired effect is the
desired effect, and adverse relaxation of bronchial
effect of Isoproterenol in smooth muscle (Beta 2).
the treatment of Asthma? Adverse effect is
tachycardia (Beta 1).
Beta 2 agonist; desired

What is the category,
effect is the relaxation of
desired effect, and period
bronchial smooth muscle
of use of albuterol in the
(Beta 2). Use during acute
treatment of Asthma?
exacerbation.
Methylzanthine; desired
What is the category, effect is bronchodilation,
desired effect, and may cause bronchodilation
possible mechanism of by inhibiting
Theophylline in treating phosphodiesterase, enzyme
Asthma? involved in degrading cAMP
(controversial).
Muscarinic antagonist;
competatively blocks
mechanism of action, and
muscarinic receptors,
effect of Ipratroprium in
preventing
Asthma treatment?
bronchoconstriction.
Corticosteroids; prevent
production of leukotrienes
mechanism of action, and
from arachodonic acid by
particular use of
blocking phospholipase A2.
beclomethasone and
Drugs of choice in a patient
prednisone in Asthma
with status asthmaticus (in
treatment?
combination with albuterol.)
What is the category, Beta 2 agonist; used as a

method of use, and long-acting agent for
adverse effects of prophylaxis. Adverse
Salmeterol in Asthma effects are tremor and
treatment? arrhythmia.
Prevention of NSAID-
What is the clincial use for
induced peptic ulcers,
Misoprostol?
maintains a PDA.

Treatment of infertility.
Clomiphene?
Immediate anticoagulation
for PE, stroke, angina, MI,
Heparin?
DVT.

Erectile dysfunction.
Sildenafil (Viagra)?

Peptic ulcer disease.
Sucralfate?

Chronic anticoagulation.
Warfarin?
What is the clinical use of
Abortifacient.
Mifepristone (RU486)?
Potent immunosuppressive
What is the clinical use of
used in organ transplant
Tacrolimus (FK506)?
recipients.
What is the effect of the

Increase target cell
Glitazones in diabetes
response to insulin.
treatment?
Finasteride inhibits 5
What is the enzyme
Alpha-reductase, this
inhibited, the effect of this
decreases the conversion
inhibition, and the clinical
of testosterone to
use of the antiandrogren
dihydrotestosterone,
Finasteride?
useful in BPH
What is the lab value used
to monitor the The PTT.
effectiveness of Heparin
therapy?
What is the lab value used

to monitor the The PT.
effectiveness of Warfarin
therapy?
What is the main clinical Early myocardial

use for the thrombolytics? infarction.
Aluminum sucrose sulfate

polymerizes in the acid
environment of the
What is the mecanism of
stomach and selectively
action of Sucralfate?
binds necrotic peptic ulcer
tissue. Acts as a barrier to
acid, pepsin, and bile.
Selectively inhibit
cyclooxygenase (COX)
What is the mecanism of isoform 2, which is found in
action of the COX-2 inflammatory cells nad
inhibitors (celecoxib, mediates inflammation and
rofecoxib)? pain; spares COX-1 which
helps maintain the gastric
mucosa.
Prevents release of
What is the mecanism of
mediators from mast cells.
action, effective period,
Effective only for the
and ineffective period of
prophylaxis of asthma. Not
use for Cromolyn in
effective during an acute
treating Asthma?
attack.
Flutamide is a nonsteroidal
What is the mechanism of competitive inhibitor of
action and clinical use of androgens at the
the antiandrogen testosterone receptor,
Flutamide? used in prostate
carcinoma.
What is the mechanism of Inhibit steroid synthesis,

action and clinical use of used in the treatment of
the antiandrogens polycystic ovarian
Ketoconazole and syndrome to prevent
Spironolactone? hirsutism.
Reversibly inhibits
What is the mechanism of cyclooxygenase, mostly in
action of Acetaminophen? CNS. Inactivated
peripherally.
What is the mechanism of Inhibits xanthine oxidase,

action of Allopurinol used decresing conversion of
to treat chronic gout? xanthine to uric acid.
Acetylates and irreversibly

inhibits cyclooxygenase
What is the mechanism of (COX I and COX II) to
action of Aspirin? prevent the conversion of
arachidonic acid to
prostaglandins.
Clomiphene is a partial
agonist at estrogen receptors
in the pituitary gland.
What is the mechanism of Prevents normal feedback
action of Clomiphene? inhibition and increses
release of LH and FSHfrom
the pituitary, which
stimulates ovulation.
Depolymerizes
What is the mechanism of
microtubules, impairing
action of Colchicine used
leukocyte chemotaxis and
to treat acute gout?
degranulation.
Binds to cyclophilins
(peptidyl proline cis-trans
isomerase), blocking the
differentiation and
action of Cyclosporine?
activation of T cells mainly
by inhibiting the production
of IL-2 and its receptor.
Heparin catalyzes the

activation of antithrombin
action of Heparin?
III.
What is the mechanism of Competitive inibitor of

action of Mifepristone progestins at progesterone
(RU486)? receptors.
Misoprostol is a PGE1
analog that increases the
production and secretion
action of Misoprostol?
of the gastic mucous
barrier.
Reversibly inhibit
cyclooxygenase (COX I and
action of NSAIDs other
COX II). Block
than Aspirin?
prostaglandin synthesis.
What is the mechanism of Irreversibly inhibits H+/K+

action of Omeprazole, ATPase in stomach parietal
Lansoprazole? cells.

Inhibits reabsorption of
action of Probenacid used
uric acid.
to treat chronic gout?
Inhibits cGMP
phosphodiesterase,
What is the mechanism of casuing increased cGMP,
action of Sildenafil smooth muscle relaxation
(Viagra)? in the corpus cavernosum,
increased blood flow, and
penile erection.
Inhibit intestinal bursh
border Alpha-glucosidases;
What is the mechanism of delayed hydrolysis of
action of the Alpha- sugars and absorption of
glucosidase inhibitors? sugars leading to decresed
postprandial
hyperglycemia.
Decrease the production of

What is the mechanism of leukotrienes and
action of the protaglandins by inhibiting
glucocorticoids? phospholipase A2 and
expression of COX-2.
What is the mechanism of Reversible block of

action of the H2 Blockers? histamine H2 receptors
Close K+ channels in
Beta-cell membrane
What is the mechanism of leading to cell
action of the depolarization causing
Sulfonylureas? insulin release triggered
by increase in Calcium ion
influx.
Directly of indirectly aid
conversion of plasminogen to
What is the mechanism of plasmin which cleaves
action of the thrombin and fibrin clots. (It
is claimed that tPA
thrombolytics?
specifically converts fibrin-
bound plasminogen to
plasmin.)
Inhibits platelet
What is the mechanism of aggregation by irreversibly
action of Ticlopidine, inhibiting the ADP pathway
Clopidogrel involved in the binding of
fibrinogen.
Warfarin interferes with

the normal synthesis and
What is the mechanism of gamma-carboxylation of
action of Warfarin vitamin K-dependent
(Coumadin)? clotting factors II, VII, IX,
and X, Protein C and S via
vitamin K antagonism.
Antimetabolite derivative
of 6-mercaptopurine that
interferes with the
Azathioprine?
metablolism and synthesis
of nucleic acid.
GnRH analog with agonist

properties when used in
pulsatile fashion and
antagonist properties when
Leuprolide?
used in continuous fashion,
causing a transient initial
burst of LH and FSH
Similar to cyclosporine;
binds to FK-binding
protein, inhibiting
Tacrolimus (FK506)?
secretion of IL-2 and other
cytokines.

for the action of Sildenafil Sildenafil fills the penis
(Viagra)?
AluMINIMUM amount of
for the effect of aluminum
feces.
hydroxide overuse?

for the effect of Mg = Must go to the
magnesium hydroxide bathroom.
overuse?
What is the memory key to

remember which pathway WEPT: Warfarin affects the
(extrinsic vs. intrinsic) and Extrinsic pathway and
which lab value Warfarin prolongs the PT.
affects?
Mechanism unknown;
What is the possible possibly inhibits
mechanism and effect of gluconeogenesis and
Metformin in treating increases glycolysis; effect
diabetes? is to decrease serum
glucose levels
What is the specific clinical Indomethacin is used to
use of Indomethacin in close a patent ductus
neonates? arteriosus.
Protamine Sulfate is used

for rapid reversal of
What is used to reverse the heparinization (positively
action of Heparin? charged molecule that
binds to negatively
charged heparin).
What patients are at risk

for life threatening Those patients who are
hypotension when taking taking nitrates.
Sildenafil (Viagra)?
What process does Leukotrienes increasing

Zafirlukast interfere with? bronchial tone.
What type of gout is
Chronic gout.
treated with Allopurinol?

Acute gout.
treated with Colchicine?

Chronic gout.
treated with Probenacid?
Misoprostol is
What type of patient contraindicated in women
should not take of childbearing potential
Misoprostol and why? because it is an
abortifacient.
Cimetidine is a potent
inhibitor of P450; it also has
Which H2 Blocker has the an antiandrogenic effect and
most toxic effects and decreases renal excretion of
what are they? creatinine. Other H2
blockers are relatively free
of these effects.
Why are the Sulfonylureas Because they require some

inactive in IDDM (type-1)? residual islet function.
Acetaldehyde is
metabolized by -Disulfram & also
Acetaldehyde sulfonylureas,
dehydrogenase, which metronidazole
drug inhibs this enzyme?
-Weak Acids>Alkinalize
urine(CO3) to remove
Explain pH dependent
more -Weak
urinary drug elimination?
bases>acidify urine to
remove more
-Airway -Breathing -
How do you treat coma in Circulation -Dextrose
the ER (4)? (thiamine &narcan) -
ABCD
-Infections -Trauma -
In coma situations you rule Seizures -CO -Overdose -
out what (7)? Metabolic -Alcohol (IT'S
COMA)
-A57Blue lines in
gingiva& long bones
List some specifics of lead -Encephalopathy &
poisoning(4)? Foot drop -Abdominal
colic / -Sideroblastic
anemia
List the specific antidote

for this toxin: -N-acetylcystine
Acetaminophen
for this toxin: -Ammonium Chloride
Amphetamine

for this toxin: -Atropine &
Anticholinesterases pralidoxime
(organophosphate.)

for this toxin: -Physostigmine salicylate
Antimuscarinic
(anticholinergic)

for this toxin: Arsenic (all -Dimercaprol, succimer
heavy metals)
for this toxin: -Flumazenil
Benzodiazepines

for this toxin: Beta -Glucagon
Blockers

for this toxin: Carbon -100% oxygen, hyperbaric
monoxide

-Penicillamine
for this toxin: Copper
-Nitrate,
hydroxocobalamin
for this toxin: Cyanide
thiosulfate
List the specific antidote -Normalize K+, Lidocaine,

for this toxin: Digitalis & Anti-dig Mab

-Protamine
for this toxin: Heparin

-Deferoxamine
for this toxin: Iron
-EDTA, dimercaprol,
succimer, &
for this toxin: Lead
penicillamine

-Ethanol, dialysis, &
for this toxin: Methanol
fomepizole
& Ethylene glycol

for this toxin: -Methylene blue
Methemoglobin
List the specific antidote -B51Naloxone /

for this toxin: Opioids naltrexone (Narcan)
List the specific antidote -Alkalinize urine &
for this toxin: Salicylates dialysis

for this toxin: TPA & -Aminocaproic acid
Streptokinase

for this toxin: Tricyclic -NaHCO3
antidepressants
List the specific antidote -Vitamin K & fresh

for this toxin: Warfarin frozen plasma
What are the products and
-Acetaldehyde -Nausea,
their toxicities of the
vomiting, headache,
metabolism of ethanol by
& hypotension
/ alcohol dehydrogenase?

-Oxalic acid -Acidosis
metabolism of Ethylene
& nephrotoxicity
Glycol by / alcohol
dehydrogenase?

-Formaldehyde &
formic acid -severe
metabolism of Methanol
acidosis & retinal
by / alcohol
damage
dehydrogenase?
Which drug(s) cause this

reaction: Adrenocortical -Glucocorticoid withdrawal
Insufficiency
Which drug(s) cause this -Cloazapine -
reaction: Agranulocytosis carbamazapine -colchicine
(3)? -PTU

-Penicillin
reaction: Anaphylaxis?
Which drug(s) cause this -Chloramphenicol -

reaction: Aplastic anemia benzene -NSAIDS -PTU -
(5)? phenytoin

reaction: Atropine-like -Tricyclic antidepressants
side effects?
Which drug(s) cause this -Daunorubicin &
reaction: Cardiac toxicity? Doxorubicin

-Quinidine -quinine
reaction: Cinchonism (2)?
Which drug(s) cause this -ACE inhibitors

reaction: Cough? (Losartan>no cough)
Which drug(s) cause this -Niacin -Ca++ channel

reaction: Cutaneous blockers -adenosine -
flushing (4)? vancomycin
reaction: Diabetes -Lithium
insipidus?
-Metronidazole -certain
cephalosporins -
reaction: Disulfram-like
procarbazine -
reaction (4) ?
sulfonylureas
Which drug(s) cause this -Haloperidol -

reaction: Drug induced chlorpromazine -reserpine
Parkinson's (4) ? -MPTP

-Chlorpromazine -
reaction: Extrapyramidal
thioridazine -haloperidol
side effects (3)?
reaction: Fanconi's -Tetracycline
syndrome?
Which drug(s) cause this -Halothane -Valproic acid

reaction: Focal to massive -acetaminophen -Amantia
hepatic necrosis (4)? phalloides
-Sulfonamides -INH -ASA

Which drug(s) cause this -Ibuprofen -primaquine -
reaction: G6PD hemolysis nitrofurantoin /-
(8)? pyrimethamine -
chloramphenicol

reaction: Gingival -Phenytoin
hyperplasia?
reaction: Gray baby -Chloramphenicol
syndrome?
Which drug(s) cause this -Cimetidine -ketoconazole

reaction: Gynecomastia (6) -spironolactone -digitalis
? -EtOH -estrogens

-Isoniazid
reaction: Hepatitis?

-Tamoxifen
reaction: Hot flashes?
reaction: Neuro and -polymyxins
Nephrotoxic?

-Corticosteroids -heparin
reaction: Osteoporosis (2)?

-aminoglycosides -loop
reaction: Oto and
diuretics -cisplatin
Nephrotoxicity (3)?
Which drug(s) cause this -Barbiturates -phenytoin -

reaction: P450 induction carbamazipine -rifampin -
(6)? griseofulvin -quinidine
-Cimetidine -ketoconazole
-grapefruit juice -
reaction: P450 inhibition
erythromycin -INH -
(6)?
sulfonamides

-Tetracycline -amiodarone
reaction: Photosensitivity
-sulfonamides
(3)?

reaction: -Clindamycin
Pseudomembranous
colitis?

-Bleomycin -amiodarone -
reaction: Pulmonary
busulfan
fibrosis(3)?
Which drug(s) cause this -Hydralazine -
reaction: SLE-like Procainamide -INH -
syndrome phenytoin

-Ethosuxamide -
reaction: Stevens-Johnson
sulfonamides -lamotrigine
syn. (3) ?

reaction: Tardive -Antipsychotics
dyskinesia?

reaction: Tendonitis and -Fluoroquinolones
rupture?
reaction: Thrombotic -Oral Contraceptives
complications?
Which drug(s) cause this -Class III antiarrhythmics

reaction: Torsade de (sotalol) -class IA
pointes (2) ? (quinidine)
-Sulfonamides -
furosemide -methicillin -
reaction: Tubulointerstitial
rifampin -NSAIDS (ex.
Nephritis (5)?
ASA)
Constant FRACTION
Describe first-order
eliminated per unit time.
kinetics?
(exponential)
-reduction, oxy, &
Describe Phase I
hydrolysis -H2O sol. Polar
metabolism in liver(3)?
product -P450
-acetylation,
Describe Phase II glucuron.,& sulfation
metabolism in liver(3)? -Conjugation -Polar
product
Explain differences
- Act on same receptor -
between full and partial
Full has greater efficacy
agonists(2).
- partial agonist can have

Explain potency in relation increased, decreased, /
to full and partial agonists A21or equal potency as
(2). full agonist. - Potency is
an independent factor.
- ED 50 is less than the
How do spare receptors
Km (less than 50% of
effect the Km?
receptors)
How do you calculate Md= (CpxCL)/F Cp= plas.

maintenance dose? Conc. CL=clear. F=bioaval.
How does a competitive

-Shifts the curve to the
antagonist effect an
right -increases Km
agonist?
How does a
- Shifts the curve down -
noncompetitive antagonist
reduces Vmax
effect an agonist?
-Phase I (clinical tests) -
Name the steps in drug
Phase II -Phase III -PhaseIV
approval(4)?
(surveillance)
Steady state concentration In 4 half-lifes= (94%) T1/2

is reached in __#half-lifes = (0.7x Vd)/CL
What is the definition of -Constant AMOUNT

zero-order kinetics? eliminated per unit time. -
Example? Etoh &ASA
What is the formula for CL= (rate of elimination of

Clearance (CL) drug/ Plasma drug conc.)
What is the formula for Vd= (Amt. of drug in
Volume of distribution (Vd) body/ Plasma drug conc.)
Ld= (CpxVd)/F
What is the loading dose
Cp=plasma conc. F=
formula?
Bioaval.
A 12yo patient was treated

for a reaction to a bee
sting, what drug provides Epinephirine(Alpha1,2 and
the best coverage of Beta 1,2)
sympathomimetic
receptors?
A 57 yo heart failure pt
develops cardiac
decompensation, what
drug will give you Dopamine
adequate perfusion of his
kidneys as well as tx for
his Hypotension
A fellow passenger on a
Carnival cruise ship looks
pale and diaphoretic, what scopolamine
antimuscarinic agent
would you give them?
A group of pts are rushed

into the ER complaining of Atropine pts are suffering
excessive sweating, tearing, from Cholinestrase
salivation, HA, N and V, inhibitor poisining(Nerve
muscle twitching, difficulty
gas/Organophosphate
breathing and diarrhea. What
poisining)
drug would be the most
effective immediate tx
As an Anes you want to

use a depolarizing
neuromuscular blocking Succinylcholine
drug on your pt, what do
you use
By what mechanism does Prevents the release of Ca

this drug help from SR of skeletal muscle
Centrally acting alpha
Clonidine is the preferred
agonist, thus causing a
sym pathomimetic tx of
decrease in central
HTN in pts with renal
adrenergic outflow,
disease, why??
spairing renal blood flow
Cocaine casues
vasoconstriction and local Indirect agonist, uptake
anesthesia by what inhibitor
mechanism
Cocaine shares is
mechanism of action with TCA
what antidepressant
Dobutamine used for the

tx of shock acts on which Beta1 more than B2
receptors
Guanethidine enhances the No, it inhibits the release
release of Norepi? of Nor Epi
How does angiotensin II It acts presynaptically to

affect NE release? increase NE release.
Prevents the release of

How does botulinum toxin
ACh, which results in
result in respiratory arrest?
muscle paralysis.
Prevents the release of

How does dantrolene calcium from the
work? sarcoplasmic reticulum of
skeletal muscle.
NE acts presynaptically on
alpha-2 receptors to
How does NE modulate its
inhibit its own release.
own release? What other
ACh also acts
neurotransmitter has this
presynaptically through
same effect?
M1 receptors to inhibit NE
release.
Hemicholinium inhibits the

How would hemicholinium
transport of choline into
treatment affect
the nerve, thus inhibiting
cholinergic neurons?
formation of ACh.
How would you reverse the Give an antichloinesterase

effect of a neuromuscular - neostigmine,
blocking agent? edrophonium, etc
It would increase to ~ 100

beats/min. Both sympathetic
If a patient is given and vagal stimulation would
hexamethonium, what be knocked out, but the SA
would happen to his/her node has an intrinsic pace of
heart rate? 100 beats/min, which is
normally checked by vagal
stimulation.
Isopoterenol was given to
Stimulates beta adrenergic
a patient with a developing
receptors
AV block, why?
Norepi feedbacks and

Binding to the presynaptic
inhibits the presynaptic
alpha 2 release
receptor by what
modulating receptors
mechanism
Reserpine will block the

Blocks Norepi, but not
syntheis of this drug and
Dopamine
but not its precursor.
These drugs acts indirectly

by releasing strored Amphetamine and
catecholamines in the Ephedrine
presynaptic terminal
What anticholinesterase
crosses the blood-brain- physostigmine
barrier?
What antimuscarinic agent

is used in asthma and Ipratropium
COPD?
What antimuscarinic drug

is useful for the tx of Ipratropium
asthma
Diarrhea, Urination,
What are the classic Miosis, Bronchospasm,
symptoms of Bradycardia, Excitation of
cholinesterase inhibitor skeletal muscle and CNS,
poisoning (parathion or Lacrimation, Sweating, and
other organophosphates)? Salivation = DUMBBELS;
also abdominal cramping
Activates cholinergic
receptors on bladder and
What are the clinical
bowel smooth muscle,
indications for
alleviating post-op and
bethanechol?
neurogenic ileus and
urinary retention.
Post-op and neurogenic

ileus and urinary retention,
What are the clinical myasthenia gravis, and
indications for reversal of neuromuscular
neostigmine? junction blockade (post-
op) through
anticholinesterase activity.
narcolepsy, obesity, and

What are the indications
attention deficit disorder (I
for using amphetamine?
wouldn't recommend this)
What are the

Tubocurarine, atracurium,
nondepolarizing
mivacurium, pancuronium,
neuromuscular blocking
vecuronium, rapacuronium
drugs?
Phase 1 = prolonged
depolarization, no antidote,
What are the phases of effect potentiated by
succinylcholine anticholinesterase; Phase 2
neuromuscular blockade? = repolarized but blocked,
an anticholinesterase is the
antidote for this phase.
What are two indirect

amphetamine and
acting adrenergic
ephedrine
agonists?
What beta 2 agonist will

Albuterol, tertbutaline
help your 21yo Astma pt?
What cholinergic inhibitor

acts by directly inhibiting Botulinum
Ach release at the
presynaptic terminal
What cholinomimetic is
useful in the diagnosis of Edrophonium
Myasthenia Gravis
What cholinomimetics Carbachol, pilocarpine,

might your pt be taking physostigmine,
for his glaucoma echothiophate
What class of drug is

anticholinesterase
echothiophate? What is its
glaucoma
indication?
In treatment of malignant
hyperthermia, due to
What conditions would you concomitant use of halothane
use dantrolene? and succinylcholine. Also in
neuroleptic malignant
syndrome, a toxicity of
antipsychotic drugs.
What drug is used to edrophonium (extremely
diagnose myasthenia short acting
gravis? anticholinesterase)
Neostigmine,
pyridostigmine
What drugs target this
edrophonium
enzyme
physostigmine
echothiophate
Theoretically it could be
What effect would atropine
used to block the cephalic
have on a patient with
phase of acid secretion
peptic ulcer disease?
(vagal stimulation).
What effect would atropine None. No, because

have on the preganglionic atropine would block the
sympathetic activation of postganglionic muscarinic
sweat glands? Would this receptors involved in
person sweat? sweat gland stimulation.
What enzyme is
Acetylcholinesterase; ACh
responsible for the
is broken down into
breakdown of ACh in the
choline and acetate.
synaptic cleft?
What enzyme is
responsible for the Acetylcholine esterase
degredation of Ach
What enzyme is
responsible for the Choline acetyltransferase
production of Ach from
Acetyl CoA and Choline
Treatment of
hypertension, especially
What is the clinical utility
with renal disease (lowers
of clonidine?
bp centrally, so flow is
maintained to kidney).
The only local anesthetic
What is the clinical utility
with vasoconstrictive
of cocaine?
properties.
Dobutamine has more of an

What is the difference affintiy for beta-1 than
between the affinity for beta-2, and is used for
beta receptors between treating heart failure and
shock. Albuterol and
albuterol/terbutaline and
terbutaline is the reverse, and
dantroline? is used in treatment of acute
asthma.
What is the difference in Prefers beta's at low

receptor affinity of doses, but at higher doses
epinephrine at low doses? alpha agonist effects are
High doses? predominantly seen.
Increased systolic and

What is the effect of pulse pressure, decreased
epinephrine infusion on bp diastolic pressure, and
and pulse pressure? little change in mean
pressure.
What is the effect of
guanethidine on It inhibits release of NE.
adrenergic NE release?
Increases mean, systolic,

What is the effect of
and diastolic bp, while
norepinephrine on bp and
there is little change in
pulse pressure?
pulse pressure.
They inhibit reuptake of

What is the effect of TCA's
NE at the nerve terminal
on the adrenergic nerve?
(as does cocaine).
What is the only

depolarizing Succinylcholine
neuromuscular blocking
agent?
What is the receptor It affects beta receptors
affinity and clinical use of equally and is used in AV
isoproterenol? heart block (rare).
It antagonizes Ach M
What makes this drug
receptors and decreases
effective
parasym (GI) rxn
What nondepolorizing
Tubocurarine, atra-, miv-,
agents could you have
pan-,ve-, rapacuronium
used
What other substances

regulate the Norepi nerve Ach, AngiotensinII
ending
What other syndrome can Neuroleptic malignant
this drug tx syndrome
SLUD (salivation,
What physiological effects Lacrimation, urination,
was the Anes using Defecation)as well as
Atropine to tx airway secretion, GI
motility, acid secretions
What reversal agent could

Bethanechol, Neostigmine,
a Anes give to reverse the
physostigmine
effects of Atropine
Atropine would also block

What side effect of using the receptors in the ciliary
atropine to induce muscle, causing an
pupillary dilation would impairment in
you expect? accommodation
(cycloplegia).
What sympathomimetic
would you not prescribe Norepinephrine (Alpha1,2
for hypotension in a pt and beta 1)
with renal artery sclerosis.
Hexamethonium is a
What type of neurological
nicotinic antagonist, and
blockade would
thus is a ganglionic
hexamethonium create?
blocker.
Initially vasoconstriction
would increase bp, but
What would be the effect
then it acts on central
on blood pressure with
alpha-2 receptors to
infusion of the alpha -2
decrease adrenergic
agonist clonidine?
outflow resulting in
decreased bp.
What would be the next

Pralidoxime, regenerates
drug that you would give
active cholinestrase
and why
Which antimuscarinic
agents are used in atropine, homatropine,
producing mydriasis and tropicamide
cycloplegia?
Which drug increases Sys

BP w/o affecting Pulse Epinephrine
Pressure
Which of epi, norepi, or

isoproterenol results in Norepinephrine
bradycardia?
Dry flushed skin, due to

Which of the following
inhibition of sympathetic
would atropine
post-ganglionic blockade
administration cause?
on muscarinic receptors of
Hypothermia, bradycardia,
sweat glands. All others
excess salivation, dry
are opposite of what
flushed skin, or diarrhea
would be expected.
Which of these three drugs
will cause a reflex
bradycardia in your pt Norepinephrine
(Norepi, Epi, or
Isoporterenol)
alpha-1 > alpha-2;

Which receptors does used as a pupil dilator,
phenylephrine act upon? vasoconstrictor, and for
nasal decongestion
While at a tail gait party,

Epinephrine to treat
you bite into a sandwich
anaphylaxis. Also useful if
that a yellow jacket is also
you have open angle
enjoying. Knowing your
glaucoma, asthma, or
allergy to this creature,
hypotension.
what should you do?
Why are albuterol and These B-2 agonists cause

terbutaline effective in tx respiratory smooth muscle
of acute asthmatic attacks? to relax.
Blocking muscarinic
receptors in the circular
Why does atropine dilate
fibers of the eye, results in
the pupil?
unopposed action of radial
muscles to dilate.
NE increases bp, which

stimulates baroreceptors
Why does NE result in in the carotid sinus and
bradycardia? the aorta. The CNS signals
through vagal stimulation
to decrease heart rate.
They activate the ciliary

Why is carbachol and
muscle of the eye (open
pilocarpine useful in
angle) and pupillary
treatment of glaucoma?
sphincter (narrow angle).
As an anticholinesterase it
Why is pyridostigmine
increases endogenous ACh
effective in the treatment
and thus increases
of myasthenia gravis?
strength.
Reserpine inhibits
dopamine transport into
Why is reserpine effective vesicles, attenuating its
in treating HTN? conversion to NE by
dopamine beta-
hydroxylase.
Stimulating beta receptors

Why is there a drop in
stimulates heart rate, but
systolic, mean, and
beta receptor induced
diastolic bp with infusion
vasodilation reduces
of isoproterenol?
peripheral resistance.
Parkinson patients benefit

Why would a patient with
from antimuscarinic
cog-wheel rigidity and a
agents through its
shuffling gait be given
inhibitory action within the
benztropine?
indirect pathway.
Receptors =
D1=D2>beta>alpha,
Why would dopamine be thus increasing heart rate
useful in treating shock? (beta) and blood pressure
(alpha vasoconstriction) while
maintaining kidney perfusion
(dopamine receptors)
Why would you give a drug Useful in muscle paralysis
like pancuronium or during surgery or
succinylcholine? mechanical ventilation.
Why would you use

pralidoxime after Pralidoxime regenerates
exposure to an active cholinesterase.
organophosphate?
Will Hemicholinum affect

No, hemicholinum block
the release of stored Ach
the uptake of Choline and
during Cholinergic
thus Ach synthesis
Stimulation
No. Atropine is used to

Would blockade of
reduce urgency in mild
muscarininc receptors in
cystitis. So it would
the bladder be useful in
aggravate the urinary
treating urinary retention?
retention.
No, hexamethonium
targets Nicotinc receptors
Would Hexamethonium be
and will block Parasym,
an effective substitute
Sym, as well as Somatic
systems
You tx your pt with

halothane as well and he
has also developed Dantrolene
malignant hypothermia,
what drug can you give
Your patient develops a

No cholinesterase
marked arrythmia due to a
inhibitors will potentiate
prolonged depolarization,
the stimulating action of
can you tx this w/
Succinlycholine
Neostigmine
Your patient has acute

Yes, Scopolamine would
angle glaucoma, does this
antagonize his glaucoma
affect your tx
Your patient wants an
effective drug to treat his Scopolamine
motion sickness, what
would you prescribe

USMLE Flashcards: Pharmacology - Side by Side

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USMLE Flashcards: Pharmacology - Side by Side

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A common side effects of

Are Ampicillin and

No, but they are less

Are Methicillin, Nafcillin,

Common toxicities GI upset, Superinfections,

Does Amprotericin B cross

Does Foscarnet require

How are INFs used Chronic Hepatitis A and B,

How are Sulfonamides Gram +, Gram -,

How are the Latent

How can Isoniazid (INH)-

How can the t1/2 of INH

How can Vancomycin- Pretreat with

Inhibt Assembly of new

With an amino acid change

HSV, VZV, EBV,

Prophylaxis for Influenza

Wide spectrum of systemic

Meningitis (H. influenza,

How is Foscarnet used CMV Retinitis in IC pts

How is Griseofulvin used Oral treatment of

For serious, Gram +

In what population does Premature infants, because

MOA: Block cell wall Penicillin, Ampicillin,

MOA: Block mRNA

MOA: Block nucleotide Sulfonamides,

MOA: Block peptidoglycan

MOA: Disrupt bacterial/

MOA: Unkown Pentamidine

Name common Polymyxins Polymyxin B, Polymyxin E

Name the Protease Saquinavir, Ritonavir,

Protease Inhibitors and

Resistance mechanisms for Beta-lactamase cleavage

Methylation of rRNA near

Hemolysis (if G6PD

Specifically, how does Binds to the

The MOA for

Toxicities associated with Delirium, Tremor,

What additional side Rash, Pseudomembranous

What are Amantadine- Ataxia, Dizziness, Slurred

What are Aminoglycosides

What are Aminoglycosides Severe Gram - rod

What are common GI discomfort, Acute

Well tolerated in general

What are major side

What are Methicillin,

What are Polymyxins used Resistant Gram -

What are the clinical

What are the clinical uses Gram + cocci, Proteus

Gram - rods: Klebsiella

What are the clinical uses Gram + cocci, Gram -

-Upper respiratory tract

What are the major toxic GI distress, Skin rash, and

What are the side effects Neurotoxicity, Acute renal

What are toxic side effects Disulfiram-like reaction

What are toxicities Aplastic anemia (dose

What do you treat

What drug is given for

What drug is used during

What is a common drug

What is a mnemonic to Blocks Influenza A and

What is a prerequisite for It must be Phosphorylated

What is an additional side

What is an occasional side