1.
3 Important points about Cefoperozone?: Disulfram like
Lipid soluble
DOESNT cross BBB for use in meningitis
2.
A good use of Tetracyclines are against..: Atypicals like chlamydia and mycoplasma
Part of the H. pylori regimin too
3.
Acyclovir is an analog of...: Guanosine
4.
ADHD is treated with...: Methylphenidate
or
Amphetamines like Dexedrine
5.
Advantages of Aztreonam?: Resistant to beta lactamases
NO CROSS ALLERGENICITY with penicillins and cephalosporins.. Can be used as a substitute if the bug is a GRAM (-) ROD, aerobe
6.
Adverse effects of Ganciclovir?: Dose limiting hematotoxicity and mucosal ulcerations
Renal toxicity with the potential to cause crystals
Seizures in OD
7.
Ag sulfadiazine is used to treat...: Burns...and it is the silver, Ag that is effective, not the sulfa drug
8.
Alcohol withdrawal is treated with: Benzodiazepines
9.
Alcoholics are at increased risk for which two cancers?: Esophageal cancer
and
Signet ring cancer of the stomach
10.
All antibiotics that inhibit bacterial protein synthesis are bacteriostatic except...: Aminoglycosides!
11.
Alternative drugs to use if allergy to cephs or penicillins?: Macrolides if Gram (+)
Aztreonam ONLY if Gram (-) ROD
12.
Alternative for treating CMV retinitis in pts with severe bone marrow suppression?: Foscarnet
13.
Amp B is synergistic with...: Flucytosine in candidiasis and cryptococcal infections
14.
Anorexia/Bulemia is treated with...: SSRIs
15.
Atypical depression is treated with...: MAO inhibitors
or
SSRIs
16.
Basically all Penicillins are excreted by the kidney except for...: Oxacillin and Nafcillin...These are excreted via the liver in the bile
17.
Benefits of Propofol on anesthesia protocol?: Used for induction and maintenance anesthesia PLUS
Is a strong Antiemetic**
18.
Besides effect on thermostat, what other role does DA play in the hypothalamus?: In the Medial/Lateral Nuclei...DA will cause wt loss and DA antagonists will cause wt Gain.
19.
Besides movement problems, what are some side effects of Antipsychotic medication?: Dysphoria, due to decreased dopamine...makes the negative symptoms of Schizophrenia worse.
Endocrine dysfunction! Can lead to disregulation of the thermostat by the Hypothalamus, leading to Neuroleptic Malignant Syndrome (and muscle rigidity increases heat)
WEIGHT GAIN***and thus DM, dyslipidemia
20.
Besides prolactin, what hormone does Dopamine inhibit?: Growth Hormone... Dopamine agonists can therefore be used to treat acromegaly or gigantism
21.
Bipolar disorders are treated with...: Lithium
Valproic acid
Carbamazepine
22.
Bonus point about Ketamine?: Can be used when we need to set compound fractures or dressing burns in Children, as the patient does not need to be fully put out.
23.
Cautions for Succinylcholine?: Prolonged paralysis if slow metabolizer
Hyperkalemia can worsen depolarization
Malignant Hyperthermia
24.
Cell wall synthesis inhibitors are all Bacteriocidal... They are all also Lactam antibiotics except...: Vancomycin!
25.
Chloramphenicol is commonly used in ...: Sepsis/meningitis, as it is highly lipid soluble
26.
Common clinical problems that occur in people after use of PCP?: Rhabdomyolysis due to their increased use of muscles when flipping cars or kicking thru walls... and lead to ATN
27.
Do not take Fluoroquinolones with...: Dairy... Ca++ binding occurs
28.
DOC for atypical bacteria?: Macrolides... good treatment for
Mycoplasma
Chlamydia
Ureaplasma
29.
DOC for Bipolar disorder?: Lithium
30.
DOC for Blastomycosis or Aspergillosis?: Vorconazole or Itraconazole
31.
DOC for bubonic plague?: Streptomycin
32.
DOC for chlamydia?: Probably doxycycline
33.
DOC for Coccidioidomycosis?: Fluconazole
34.
DOC for esophageal and invasive candidiasis?: Fluconazole
35.
DOC for legionella?: Erythromycin
36.
DOC for Lyme disease: Doxycycline
37.
DOC for Mycobacterium avium intracellulare?: Erythromycin
38.
DOC for Nocardia infection?: TMP-SMX
39.
DOC for Paracoccidiodes?: Ketoconazole
40.
DOC for prophylaxis against: endocarditis with dental procedures?: Penicillins
41.
DOC for prophylaxis against: Gonorrhea: Ceftriaxone
42.
DOC for prophylaxis against: Meningococcal infection?: Rifampin
43.
DOC for prophylaxis against: PCP pneumonia: TMP-SMX is DOC
or
Pentamidine if not available
44.
DOC for prophylaxis against: Syphilis: Penicillin G, Benzathinee
45.
DOC for prophylaxis against: UTI when there is a history of recurrence?: TMP-SMX
46.
DOC for Ricketsial infection, RMSF?: Doxycycline
47.
DOC for Tularemia?: Streptomycin
48.
Fluoroquinolones are commonly used to treat...: UTIs
STDs like chlamydia or gonorrhea...Lots of Gram (-) infections
Drug resistant pneumococci
Travellers Diarrhea
49.
Foscarnet is primarily used for: CMV retinitis
and
Acyclovir resistant HSV
50.
Foscarnet should not be used with...: PENTAMIDINE! This drug also causes nephrotoxicity and combine with foscarnet can cause life threatening hypocalcemia
51.
Ganciclovir is an analog of...: Guanosine
52.
Ganciclovir is primarily used for...: Prophylaxis and treatment of CMV retinitis
53.
Gonorrhea is primarily treated with...: Ceftriaxone
54.
How do you tell which Local Anesthetics are Esters or Amides?: If the name has an extra 'I" in it before the 'CAINE' it is an amIde... Like LIdocaine, BupIvacaine, MepIvicaine...
Esters do not have this... procaine, cocaine, benzocaine
55.
How do you treat the Acute EPS from antipsychotic drugs, those that occur from hours to weeks after taking the drug?: Antimuscarinic drugs! If you gave dopaminergic drugs you would exacerbate the problem u are fixing with the antipsychotic in the first place.
56.
How is nondepolarizing neuromuscular blockade reversed?: AChE Inhibitors to increase the ACh levels enough to displace the blocker.
57.
How is the first phophate put on Ganciclovir?: Via a Thymidine Kinase in HSV or VZV or vvia UL97 in CMV
58.
How many 'Curare' or Tubucurare molecules are needed at any one time to prevent the opening of an acetylcholine channel in the NMJ?: JUST 1! Stupid Board question...since 2 ACh molecules must bind to open the channel, just 1 curare molecule can prevent this.
59.
Important point to remember about Nitrous Oxide?: Rapid onset and recovery
it is NOT metabolized! Inhaled and exhaled...
This unfortunately can lead to diffusional hypoxia as it replaces part of the partial pressure of O2
60.
In what pt population is Nitrous oxide contraindicated?: Pregnancy, can cause spontaneous abortions.
61.
Is there an antidote for Thiopental OD?: NO
62.
Ketoconazole absorption is decreased by..: Antacids! Because they are weak acids themselves, alkalinization of the stomach is not helpful.
EATING with them, will increase acid. Good for absorption.
63.
List the Bacterial cell wall synthesis inhibitors.: Penicillins
Cephalosporins
Imipenem/Meropenim
Aztreonam
Vancomycin (this one block PG synthesis, not crosslinking)
64.
List the bacterial protein synthesis inhibitors!: Aminoglycosides
Macrolides
Tetracyclines
Chloramphenicol
Clindamycin
Streptogramins
Linezolid
65.
Local anesthetics are weak bases! What type of environment must be present in order for them to be absorbed by the body?: High pH so they are not protonated...
Sometimes need to alkalinize the environment.
66.
Main side effect of Foscarnet?: Nephrotoxicity and can cause ATN and hypocalcemia
67.
Main side effect of the drug Buproprion?: Can cause Seizures (esp in bulimic pts)
68.
MAIN toxic effect of AMp B?: Nephrotoxic in every way imaginable, and can even lead to normochromic normocytic anemia due to lack of EPO release.
69.
Mechanism of resistance to Flucytosine?: This drug must be activated to 5-FU via a fungal deaminase...Absence or mutation of this will cause resistance.
70.
MOA of Amphotericin B?: Binds to ergosterol itself and causes artificial pores to be formed in the cell membranes...Resistance occurs when fungi have low ergosterol content to their cell walls
71.
MOA of AZOLE antifungals?: Inhibit the enzyme 14-alpha-demethylase which catalyzes the last step of ergosterol synthesis from Lanosterol
72.
MOA of bacitracin?: Blocks peptidoglycan synthesis
73.
MOA of Ethambutol?: Prevents the synthesis of Arabinogalactan synthesis
74.
MOA of Ethosuximide?: Blocks-T-type Ca++ channels and is used in absence seizures
75.
MOA of Flucytosine?: It is a precursor of 5-FU which is an antimetabolite! After phophorylation it gets incorporated into fungal RNA and blocks gene expression...
Also forms 5-Fd-UMP thus inhibiting DNA synthesis and thiamine cannot be formed
76.
MOA of Griseofulvin?: Blockes polymerization of microtubules, F-ing with the mitotic spindle
77.
MOA of Metronidazole?: Unknown..say it causes free radicals
78.
MOA of Polymyxins?: Disrupts bacterial cell MEMBRANES not the cell wall... membrane is internal to the wall.
79.
MOA of resistance to Chloramphenicol?: Acetylation which inactivates the drug.
80.
MOA of Rifampin?: Inhibits DNA dependent RNA polymerase
81.
MOA of sulfa drugs?: Inhibit Dihydropteroate reductase...
Then act synergistically when used with dihydrofolate reductase inhibitors like trimethoprim or pyrimethamine
82.
MOA of TCAs?: Block reuptake of NE and 5HT
83.
MOA of trimethoprim?: Inhibits bacterial dihydrofolate reductase!
84.
Morphine should be avoided in patients with head trauma because....: It can cause histamine release, and this would lead to vasodilation and can make a intracranial bleed worse!
85.
Most common cause of noncompliance for Macrolide antibiotics?: GI probs...this drug stimulates MOTILIN, which increases gut peristalsis and can cause diarrhea like no other
Also causes Acute cholestatic hepatitis.
86.
Most common COD in pts on MDMA?: Ecstacy! Dehydration or renal failure
87.
Most TB drugs will cause as a side effect?: Hepatoxicities
88.
Most USMLE relevant use of TMP-SMX?: Prophylaxis against PCP pneumonia when CD4 count is below 200
89.
Name 3 macrolide antibiotics...: Erythromycin
Azithromycin
Clarithromycin
90.
Name 4 SSRIs: Paroxetine
Citalopram
Escitalopram
Sertraline
91.
Name several aminoglycoside antibiotics: Gentamycin
Streptomycin
Neomycin
Amikacin
Tobramycin
92.
OCD can be treated with ...: SSRIs
93.
Outline the process of Maliganant Hyperthermia?: Depolarization of muscles in the body from Succinylcholine leads to increased contraction and need for ATP
This leads to an increase in the ETC, leading to increased acidosis and HEAT!
When the heat gets high enough, the SANS kicks in to increase sweating an decrease heat but leads to increased HR, Palpitations, arrhythmias and HTN
94.
Phenytoin is teratogenic...what does it cause?: Cleft lip and Palate commonly
95.
Primary use of Flucytosine?: Systemic cryptococcal and candidial infections, to be used in conjunction with Amp B.
96.
Primary use of Methadone??: Maintenance of opiate addiction, as it acts slower.
97.
Prophylactic DOC for cryptococcal meningitis?: Fluconazole--only azole that crosses the BBB
98.
Prophylaxis against toxoplasmosis is...: Pyrimethamine/ sulfadiazine...used in HIV when CD4 count is below 100
99.
PTSD is treated with: SSRIs
100.
Renal toxicity associated with Sulfonamides?: The ONLY drugs board tested where the metabolite of a drug is MORE lipid soluble than the parent compound...Leads to crystals in the urine and can cause tubulointerstitial nephritis
101.
Resistance occurs to Fluoroquinolones when ...: The DNA gyrase gets mutated
102.
Resistance to AZOLES comes about from..: Increased efflux from cellular pumps
103.
Safest anticonvulsant to use in Pregnancy?: Phenobarbitol
104.
Safest macrolide antibiotic to use in pregnancy?: Azithromycin! Does not inhibit cytochrome P450 as it is more water soluble, as as such does not cross the placenta as well.
105.
Several BOARD relevant drugs associated with causing acute pancreatitis?: Valproic acid
Alcohol
Didanosine
Zalcitabine
Asparaginase (treatment for Leukemias)
106.
Side effect of Ethambutol?: Red-Green colorblindness... TB drug
107.
Side effect of Tolcapone?: Severely hepatotoxic
108.
Side effects of Amantadine?: Atropine like due to its antimuscarinic nature but also
LIVEDO RETICULARIS!**
109.
Side effects of Amp B?: When given IV too fast it can cause 'shake and bake' fever and chills and hypotension, as well as anemia
110.
Side effects of Felbamate?: Hepatotoxicity and aplastic anemia
111.
Side effects of Flucytosine?: Bone marrow suppression
112.
Side effects of Griseofulvin?: Disulfram like reaction
Terato and carcinogenic
Increases P450
113.
Side effects of Imipenem?: Seizures
114.
Side effects of Lamotrigine?: Hepatotoxicity and aplastic anemia
Stevens Johnson syndrome
115.
Side effects of Linezolid?: Bone marrow suppression, esp on platelets
116.
Side effects of metronidazole?: METALLIC TASTE
Disulfram like reaction
117.
Side effects of Selegiline use?: Dyskinesias, psychosis etc...
but
INSOMNIA! It is metabolized to an amphetamine, which keeps you agitated.
(Can also lead to a POSITIVE amphetamine test on a drug screen)
118.
Side effects of SSRIs?: Bruxism (grinding of teeth)
Anorgasmia...can be used offlabel for PE
Wt Loss
119.
Side effects of Terbinafine?: Possible hepatotoxicity
120.
Side effects of tetracycline?: Photosensitivity and discoloration of teeth, as they chelate Mg++ and Ca++
Do NOT give to children for this reason, or pregnant women.
121.
Side effects of Third generation antibiotics?: Ampicillin RASH
Both can cause Pseudomenbranous colitis
122.
Side effects of Trazodone?: It has a strong alpha 1 blockade ability...
Leads to CARDIAC ARRHYTHMIAS AND PRIAPRISM***
123.
Side effects of Valproic acid?: Hepatotoxicity
Thrombocytopenia
PANCREATITIS***
ALOPECIA ** (opposite effect of Phenytoin)
124.
Side effects of Vancomycin?: NOT!
Nephrotoxicity
Ototoxicity
Thrombophlebitis
Red Man due to histamine release...use antihistamines and slow infusion to fix.
125.
Side effects of Varenicline?: People kill themselves.
126.
Special K is...: Ketamine
127.
Sulfa drugs are not used alone because..: Of high drug resistance.
128.
Teratogenicity of Valproic acid?: Spina Bifida
129.
Tetracycline to be used in patients with renal failure?: Doxycycline, it is cleared by the liver
130.
The best answer for treating TB on the USMLE is...: The greatest combination of anti TB drugs possible
131.
The Nm receptor at the neuromuscular junction has 5 subunits, 2 alpha, 1 beta, 1 gamma and 1 delta... Where does ACh normally bind?: The Alpha subunits! Two molecules of Ach are needed to open the channel.
132.
The targets of Fluoroquinolones are...: Topoisomerase II and IV***
133.
Three classes of Antibiotics that cause photosensitivity??: Sulfonamides
Fluoroquinolones
Tetracyclines
(and Amiodarone)
134.
Tourette's is treated with...: Antipsychotics
135.
Toxicities associated with Azole antifungals?: Ketoconazole can lead to gynecomastia due to decreased steroid synthesis and decreased libido
Fever and Chills
Inhibit P450
136.
Toxicities associated with Fluoroquinolones?: Can increase the QT interval and cause Torsade rhythm (probably by binding Ca++)
Seizures
TENDONITIS AND TENDON RUPTURE!
Do not give to pregnant women or children
137.
Toxicities associated with INH?: INH! Injures Neurons and Hepatocytes
Hepatotoxic, will increase AST and ALT.. This depletes B6...Leads to peripheral neuritis and Sideroblastic anemia as B6 is needed for Heme synthesis as well.
Can precipitate G6PD hemolysis
SLE in slow acetylators
138.
Toxicity associated with Pyrazinamide?: Hepatitis and Hyperuricemia as it is a weak acid... (Anti TB drug)
139.
Toxicity associated with Rifampin?: Minor hepatotoxicity compounded by use with INH
140.
Toxicity associated with Trimethprim and Pyrimethamine?: Bone marrow suppression
Megaloblastic anemia, leukopenia etc...
Can be treated with folinic acid supplementation.
141.
Toxicity of 1st generation penicillins?: Hemolytic anemia
142.
Toxicity of 2nd generation penicillins?: Methcillin causes interstitial nephritis
143.
Toxicity of Clindamycin?: C-diff infection.
144.
Treatement of DI caused by Lithium?: Use Channel blockers as far down stream as possible to prevent rebound reabsorption of Lithium! Amiloride or Triamterene
145.
Treatment for neurotoxicity in INH use?: B6
146.
Treatment of a bipolar pregnant chick?: Gabapentin
Or
Clonazepam...
147.
Treatment of status epilepticus if Lorazepam or Diazepam don't work?: Phenytoin or Fosphenytoin
148.
Triad of Opiate use?: Pinpoint pupils
Respiratory depression
Coma
149.
Two treatment regimins for H. Pylori?: BMT
Bismuth
Metronidazole
Tetracycline
OR COM
Clarithamycin
Omeprazole
Amoxacillin
150.
Typical azoles used for dermatophytic infections?: Clotrimazole or Miconazole
151.
Use of AMP B?: Most any systemic mycosis...THO is does not cross the BBB so for meningitis it must be administered intrathecally.
152.
Use of Caspofungin?: Invasive candidiasis and ASPERGILLOSIS
153.
Uses of imipenem and Meropenem?: Lots of stuff, empirical use in severe life threatening conditions in hospital..
DOC for enterobacter
154.
Uses of Lithium besides Bipolar?: SIADH as it causes DI...
155.
Uses of Metronidazole?: GET GAP on the METRO!
Giardia
Entamoeba
Trichomonas
Gardnerella
Anaerobes like Clostridium (C-diff)
Pylori
156.
Uses of Terbinafine?: Treatment of Dermatophyte infection
157.
Uses of Valproic acid?: Any seizure
Mania of bipolar
Migraine headaches
158.
Venlafaxine is primarily used for...: GAD and depression
159.
Ways to prevent AMP B side effects?: Slow infusion
Hydration
Liposomal forms of Amp B
160.
What 3 drugs are found in the triple antibiotic ointment Neosporin and what component of it is associated with CONTACT DERMATITIS??: Neomycin***
Bacitracin
Polymyxin
161.
What Antipsychotic drug requires weekly blood tests due to potential agranulocytosis?: Clozapine
162.
What Antipsychotic is associated with Increased salivation to the point of being called a Wet Pillow Syndrome??: Clozapine
163.
What are common side effects of Phenytoin?: CNS depression
Ca+ and Phosphate changes in blood
Megaloblastic anemia from decreased folate absorption
Aplastic anemia from high protein binding
164.
What are important points to rememebr about Phenytoin use?: It follows Zero order kinetics
and
Is an inducer of P450, contraindicated in porphyrias
165.
What are some common uses of SSRIs?: MDD
OCD
Bulemia
Anxiety disorders
Premenstrual dysphoric Disorder
166.
What are some of the Atypical antipsychotic drugs?: It's not ATYPICAL for OLd CLOsets to RISPER!
Olanzapine
Clozapine
Risperidone
167.
What are the 4 R's of Rifampin?: RNA polymerase inhibitor
Rev's up P450 (inducer)
Red Orange body fluids
Rapid resistance develops if used alone
168.
What are the drugs Famciclovir and Valacyclovir?: Newer drugs similar to acyclovir but with a longer halflife... May be beneficial in acyclovir resistant strains
169.
What are the drugs Tolcapone and Entcapone?: Inhibitors of COMT, which leads to enhanced L-DOPA uptake and efficacy.
COMT normally converts dopa to 3-O-methyldopa, a partial agonist which could interfere with Dopamine levels if not regulated. (and competes for entry into the CNS across the BBB)
170.
What are the EPS effects of antipsychotic drugs that can be seen within hours of taking them?: Pseudoparkinsonism...
171.
What are the EPS effects of antipsychotics that can be seen within days of taking them?: Dystonias, like spastic torticullis...
172.
What are the EPS effects of antipsychotics that can be seen within weeks of taking them?: Akathesia...The unsuppressable need to move, stand up , sit down, stand up, or move from one foot to the other and back..
173.
What are the extended spectrum 4th generation penicillins?: Ticarcillin
Carbenicillin
Piperacillin...ANTIPSEUDOMONAL
174.
What are the Fluoroquinolones?? Name some...: End in Oxacin! Ciprofloxacin, moxifloxacin, gemfloxacin.. Naladixic acid too.
175.
What are the general toxicities associated with Cephalosporins and what are the exceptions to this?: Nephrotoxicity, esp when used in conjunction with aminoglycosides.
Cefoperazone and ceftriaxone are eliminated in the liver thru bile
176.
What are the High Potency typical antipsychotics?: Fluphenazine
Haloperidol
Trifluoperizine
177.
What are the Lower Potency typical antipsychotics?: Thioridazine
Chlorpromazine... Less likely to cause neurologic side effects.
178.
What are the MOAs of Penicillins?: They Bind PBPs...This inhibits crosslinking of the peptidoglycan later, inhibits transpeptidation
179.
What are the second generation Penicilins and what are they used on?: Methcillin
Oxacillin
DiCloxacillin
Nafcillin etc... Only used on Staph Aureus unless MRSA.
These were supposed to be beta lactamase resistant
180.
What are the side effects of Aminoglycosides??: Nephrotoxicity, esp if used in conjunction with a cephalosporin
Ototoxicity, esp if used in conjunction with loop diuretics
NEUROMUSCULAR BLOCKADE!! Acts like Botulinism in preventing release of ACh from presynaptic terminals
181.
What are the side effects of Carbamazepine that set it apart from Phenytoin?: EXFOLIATIVE DERMATITIS, aka Stevens Johnson syndrome
and
Increased ADH secretion, leading to dilutional hyponatremia and brain edema, increased IOP
182.
What are the side effects of Ethylene glycol ingestion (Antifreeze): CNS depression
Metabolic Acidosis!! (Oxalic Acid)
Nephrotoxicity from formation of Ca++ oxylate crystals... can lead to ATN
183.
What are the side effects of L-DOPA use?: Vomiting via CTZ stimulation of DA
On-OFF effects, which are hyperkinetic dyskinesias when the drug is present, followed by movement difficulty as it is metabolized...Difficult to control.
Psychosis if too much DA
Hypotension, as D1 receptor stimulation can cause vasodilation.
184.
What are the side effects of Lithium?: LMNOP!
Lithium Side effects!
Movement problems, SEIZURES**
Nephrogenic Diabetes insipidus!
HypOthyroidism! (TSH receptors use Gs AND it prevents conversion of T4 to T3 in the periphery.
Pregnancy Problems...Ebsteins anomaly with a downward displaced Tricuspid valve, small RV, enlarged RA with regurg and hypoxia
185.
What are the side effects of Local Anesthetics?: Can cause Neurotoxicity and CV toxicity if not properly 'localized' esp with vasoconstrictors.
186.
What are the side effects of Methanol, AKA wood alcohol ingestion?: Respiratory failure
Metabolic acidosis
Ocular damage*** with permanent blindness
187.
What are the SS of neuroleptic malignant syndrome?: FEVER!
Fever
Encephalopathy
Vitals unstable
Elevated Enzymes
Rigidity of Muscles
188.
What are the symptoms of Serotonin Syndrome?: Profuse sweating
Rigidity
Myoclonus
Hyperthermia
Seizures
189.
What are the TB Drugs?: INH-SPIRE
INH, isoniazid
Streptomycin
Pyrazinamide
INH
Rifampin
Ethambutol
190.
What are the teratogenic effects of Carbamazepine?: Cleft lip and Palate
Spina Bifida
191.
What are the top 3 DOCs for partial seizures of general tonic-clonic seizures?: Valproic acid
Phenytoin
Carbamazepine
192.
What are the toxicities associated with All TCAs?: Convulsions, Coma and Cardiotoxicity
They block Muscarinic and Alpha receptors
193.
What are the two phases of Succinylcholine effects?: Phase I the depolarization phase leading to fasciculations and contraction...Eventually leads to flaccid paralysis.
Phase II the desensitization phase! Constant stimulation leads to lack of response...causes paralysis.
194.
What are the two side effects of Opiates that patients to not become tolerant to?: Miosis and Constipation
195.
What are the used of Trazodone?: Sedative for insomnia
and
Antidepressant
196.
What are the uses of Acyclovir and why is it limited to these viruses?: HSV 1 and 2 and VZV...Acyclovir needs a viral thymidine kinase to make the first phosphorylation step and only these viruses have that enzyme
Can ONLY be turned on in viral cells therefore, not our body cells
197.
What are the uses of Dalfopristin and Quinupristin?: VRE and VRSA
198.
What are the uses of Linezolid?: VRSA and VRE
199.
What are the uses of Mirtazapine?: It is marketed as an antidepressant but is used heavily in ANOREXICS because it increases appetite and causes Wt. gain.
200.
What are two 1st generation cephalosporins?: Cefazolin and and drug starting with a Ceph, like Cephalexin
201.
What are two antibacterial drugs that inhibit nucleic acid synthesis?: Fluoroquinolones
and
Rifampin
202.
What are two general rules about the MAC value for Inhaled Anesthetics?: The more lipid soluble the anesthetic, the lower the MAC and the Greater the Potency
MAC values are additive
MAC values are lower in the elderly and in the present of sedative hypnotics
203.
What are two important BOARD points to remember about Atracurium?: It is safe to use in hepatic or renal impairment as it is not metabolized by these organs
AND
It is spontaneously inactivated to LAUDANOSINE, which is known to cause seizures?
Any pt coming off of skeletal muscle relaxants that experiences seizures, think of this.
204.
What bugs are commonly treated with 1st generation cephalosporins?: PEcK!
Proteus
E. coli
Klebsiella
205.
What bugs are commonly treated with 2nd gen cephs?: HEN PEcKS
H. influenza
Enterobacter aerogenes
Neisseria species
PEcK
Serratia marcescens
206.
What bugs do NOT react to 3rd generation cephalosporines?: LAME!
Listeria! (use amoxacillin)
Atypicals like mycoplasma (use Macrolides)
MRSA (use Vancomycin)
Enterococci (use Amox)
207.
What can cause hypertensive crisis while taking and MAOI?: Tyramine...
Amphetamines
Ephedrine derivatives... Can all cause RELEASE of NTs
TCAs...block reuptake...
208.
What cofactors are required by Acetaldehyde dehydrogenase to do its job?: Thiamine
and
Folate!! This is how alcoholics get deficient in these.
209.
What drug ' LOOKS LIKE MILK?': Propofol...
210.
What drug are contraindicated with concurrent use of MAO inhibitors?: SSRIs
TCAs
Meperidine (Normeperidine metabolite is an SSRI)
Dextrometorphan
St. Johns Wort...All can increase 5HT
211.
What drug can be given with 3rd and 4th generation penicillins in enhance their spectrum?: Clavulanic Acid
Tazobactam
Sulbactam...suicide inhibitors of
212.
What drug is commonly used as prophylactic antibiotic prior to surgery?: Cefazolin
213.
What drug must be given with Imipenem and why?: Cilistatin! This drug is a renal dihydropeptidase inhibitor that decreases the inactivation of Imipenem in the kidney.
214.
What drugs are third generation Penicillins and what are they used on?: Amoxicillin and Ampicillin
Used for Gram + cocci that aren't Staph
Gram negatives esp. H pylori
Borellia (spirochete)
HELPS kill enterococci
H. influenza
E. coli
Listeria monocytogenese
Proteus mirabilis
Salmonella
215.
What drugs should TCAs not be used in conjunction with?: MAOIs
Serotonin drugs
Guanethidine, as TCAs block its uptake into the nerve terminal
Alpha 2 agonists, which cause negative feedback at the nerve terminal to decrease NE release.
216.
What EPS occurs with chronic use of antipsychotics and show up after months of taking the drugs?: Tardive Dyskinesia! Often irreversible...Caused by dopamine receptor sensitization and upregulation.
217.
What form must local anesthetics be in in order to elicit their response?: The ionized form...needs a low pH which the metabolic activity of cells provides.
218.
What gen is Cefoperozone?: Third gen ceph---Disulfram like rxn
219.
What generation is Cefixime?: Third gen ceph
220.
What generation is cefotaxime?: Third gen ceph
221.
What generation is ceftriaxone?: Third gen ceph
222.
What generation of drug is Cefaclor?: 2nd gen ceph
223.
What generation of drug is Cefotetan?: 2nd gen ceph--disulfram like effect
224.
What generation of drug is Cefuroxime?: 2nd gen ceph
225.
What generation of what antibiotic is used in empirical management of sepsis and meningitis?: Third gen cephs except cefoperazone...
TOO lipid soluble, stays protein bound
226.
What is a shuffling Gait AKA?: Fenestrating Gait
227.
What is BOARD tested about Opiate tolerance?: The tolerance is NOT mediated by receptor downregulation or desensitization but that cells are managing to RAISE cAMP levels, the opposite of the action of the Mu receptors, which work using Gi receptors. Pharmacodynamic.
228.
What is Carbamazepine used for besides seizure treatment?: Bipolar disorder
229.
What is Carbidopa?: A peripheral inhibitor of Aromatic Amino Acid Decarboxylase to keep L-Dopa available to enter the brain
230.
What is extremely notable about Cefuroxine?: It is a second gen cephalosporin, the first antibiotic to cross the BBB because of its lipid solubility.
231.
What is important to remember about Codeine?: Weak Mu agonist that causes analgesia...
Also is a cough suppressant
232.
What is important to remember about Halothane WRT toxicity?: CUMULATIVE hepatotoxicity
233.
What is important to remember about Halothanes and other Halogenated hydrocarcons?: Can cause malignant hyperthermia!
Hepatitis!
Cardiac arrhythmias, as they sensitize the heart to catecholamines
234.
What is important to remember about Mivacurium?: It has a very short duration of action
EXCEPT
That it is metabolized by cholinesterases, of which we have slow and fast metabolizers. If someone is a slow metabolizer, this drug will NOT have a short duration of action.
235.
What is important to remember about the metabolism of Local Anesthetic Amidases?: They are metabolized by the liver...need a good liver function for this.
236.
What is important to remember about the metabolism of Local Anesthetic ESTERS?: They are degraded by tissue esterases, which are genetically determined and we can have slow and fast metabolizers... Slow metabolizers may suffer general anesthesia
237.
What is important to remember about the metabolism of Meperidine?!: It is metabolized to NORmeperidine, which is an SSRI! This can precipitate Serotonin Syndrome, leading to seizures.
238.
What is important to remember about Thioridazine WRT the BOARDS?: It is highly 'quinidine like' with its anti muscarinic and anti alpha receptor properties...
Highly likely to cause the 3 C's of Cardiotoxicity, Convulsions and Coma.
Also can cause retinal deposits
239.
What is important WRT MAO-B?: There are NO tyramine interactions, as MAO-B does not degrade tyramine so an inhibitor of MAO-B (Selegiline) cannot cause the cheese reaction.
240.
What is inhibited by both acyclovir and ganciclovir?: viral DNA polymerase
241.
What is Ketamine used for in the clinical setting?: It is a dissociative anesthetic used for induction... Pt may feel out of body experiences or have hallucinations
242.
What is meant by a Tetrodotoxin sensitive ion channel?: Means that it is a VOLTAGE gated ion channel.. Means the same thing to Physiologists
243.
What is Nystatin used for?: Swish and Swallow for oral and esophageal candidiasis as it is too toxic for systemic use.
Topical for diaper rash and vaginal candidiasis
244.
What is relevant about the effect of Valproic Acid on P450??: Unlike Phenytoin and Carbamazepine it is an INHIBITOR of P450
245.
What is sulfasalazine used to treat?: It is a prodrug converted to 5-ASA, aminosalisylic acid, and Sulfapyridine
5-ASA stays in the gut and is used in UC
Sulfapyridine is absorbed and treats RA
246.
What is the 'antidote' for malignant hyperthermia caused by Succinylcholine?: Dantrolene! Prevents release of Ca++ from the SR
247.
What is the actions of the drug Buproprion and what are its uses?: Increase NE and Dopamine via unknown mech.
Was used to treat depression (Wellbutrin) but has been remarketed to treat smoking addiction, since the DA boost gives smokers a good feeling and can treat their depression.
248.
What is the DOC for a generalized ABSENCE seizure?: Ethosuximide...
Can also use Valproic acid
249.
What is the DOC for trigeminal neuralgia?: Carbamazepine...
250.
What is the drug Buspirone used for clinically?: GAD
251.
What is the drug Clindamycin commonly used to treat?: Gram (+) organisms and anerobes, esp above the diaphragm..
Works well in S. aureus osteomyelitis
C. perfringens and B fragilis infections as well (aspiration pneumonia
252.
What is the drug Demeclocycline and what is it used for?: It is a tetracycline, but not used as an antibiotic, it is an ADH receptor antagonist used to treat SIADH caused by Small cell lung cancer, Renal cell cancer or brain trauma
253.
What is the drug PIMOZIDE used for?: Tourette's Syndrome...
Anti Dopaminergic drug.
254.
What is the drug used to treat respiratory depression induced by Morphine?: NALOXONE!
Do NOT give O2 as the Mu receptors have knocked out the central respiratory control center in the Medulla that causes respiration in high CO2 states. Now the only reason the pt is breathing is because of the low O2 sensed by the carotid body
255.
What is the effect of DA stimulation of the Chemoreceptive Trigger Zone?: Causes vomiting
256.
What is the effect of Dopamine on the Mesolimbic-Mesocortical tracts?: (VTA) DA stimulation here leads to reinforcement and addiction, as it causes pleasure.
257.
What is the effect of Inducers of P450 on OC pills?: Decreased efficacy...Many pts on seizure meds are on OC pills to prevent pregnancy due to teratogenic risks...Use Valproic acid, an inhibitor of P450
258.
What is the function of the enzyme aromatic amino acid decarboxylase, AAAD?: Converts L-DOPA the prodrug of dopamine into dopamine in the CNS
259.
What is the Jarisch Herxheimer reaction?: Seen in treatment of syphillis with Penicillin...
Caused by release of cell components as the cells die..
Fever, Joint pain and swelling.
260.
What is the least sedating TCA?: Desipramine
261.
What is the MAC value WRT inhaled anesthetics?: The minimal alveolar anesthetic concentration needed such that 50% of pts do not respond to an assault, such as a scalpel. (like the ED50)
262.
What is the main mechanism of resistance to the antibiotics Aminoglycosides?: Formation of enzymes that inactivate the drugs via conjugation reactions...Acetyl, Phosphoryl or Adenylyl groups
263.
What is the main mechanism of resistance to the antibiotics Macrolides and clindamycin?: Formation of methyltransferases that alter the drug binding sites on the 50S ribosome
264.
What is the main mechanism of resistance to the antibiotics Penicillins and Cephalosporins?: Production of beta-lactamasees, which cleave the beta lactam ring.
OR
Changes in the penicillin binding protein
OR
Changes in the porin structure prevents the drug entry in Gram (-) bugs
265.
What is the main mechanism of resistance to the antibiotics Tetracyclines?: Increased activity of the transport pump to pump drugs out of the cell.
266.
What is the mechanism of resistance against vancomycin?: D-ALA D-ALA gets made into a D-ALA, D-Lactate
267.
What is the MOA o Vancomycin?: Binds at the D-ALA D-ALA portion of cell wall precursors and inhibits TRANSGLYCOSYLATION involved in elongatino of the Peptidoglycan Chains
268.
What is the MOA of aminoglycosides?: Block formation of the initiation complex of Ribosomes by binding to the 30 S subunit and also is so large, that it causes a frameshift and leads to the incorporation of the wrong AAs
269.
What is the MOA of Carbamazepine?: Blocks axonal Na+ channels in their inactive state, with the M-gate open and the H-gate closed so it prolongs the time before returning to an active conformation...Prevents seizure propogation, not the start of the seizure itself.
270.
What is the MOA of Caspofungin and Micafungin?: Block Beta glucan synthesis, inhibiting cell WALL synthesis
271.
What is the MOA of Clindamycin?: Inhibit translocation of the peptidyl-tRNA from acceptor site to the donor site, by binding at the 50S subunit
272.
What is the MOA of Dalfopristin and Quinupristin, the Streptogramins?: Block the attachment of the aminoacyl tRNA to the A site, the Acceptor site of the ribosome by binding the 50 S subunit
273.
What is the MOA of disulfram?: Inhibits Acetaldehyde Dehydrogenase, leading to a buildup of Acetaldyhyde and N/V, headache, hypotension, and bad feelings
274.
What is the MOA of felbamate?: Blocks Na+ channels and Glutamate receptors.
275.
What is the MOA of imipenem and meropenem?: Like penicillins, but resistant to beta lactamases! There are more potent!
276.
What is the MOA of Isoniazid?: Inhibitor of Mycolic acid synthesis
277.
What is the MOA of Lamotrigine?: Blocks Na+ channels and Glutamate receptors
278.
What is the MOA of lithium?: Prevents the recycling of inositol, so it decreases the PIP2 concentration and thus effects Gq coupled receptors...
Also it decreases the cAMP levels, so affects Gs/Gi receptors...basically hits everything... Dont stress.
279.
What is the MOA of Methylphenidate?: Increases presynaptic NE vesicular release, like amphetamines
280.
What is the MOA of Phenytoin?: Blocks axonal Na+ channels in their inactive state, with the M-gate open and the H-gate closed so it prolongs the time before returning to an active conformation...Prevents seizure propogation, not the start of the seizure itself.
281.
What is the MOA of Terbinafine?: Inhibits ergosterol synthesis by blocking Squaline epoxidase
282.
What is the MOA of Tetracyclines?: Block the attachment of the aminoacyl tRNA to the A site, the Acceptor site of the ribosome by binding the 30 S subunit
283.
What is the MOA of Tetrodotoxin and Saxitoxin?: Inhibit the entry of Na+ though an activated Na+ channel... Type 1A.
284.
What is the MOA of the drug Chlorarmphenicol?: Prevents peptide bond formation between AA's via inhibition of the peptidyltransferase enzyme.
Works on the 50 S subunit
285.
What is the MOA of the drug Duloxetine?: It inhibits NE and 5HT reuptake like Venlafaxine...More NE effect tho....
Useful for Neuropathic pain.
286.
What is the MOA of the drug Linezolid?: Interferes with formation of the ribosomal initiation complex by binding to the 50S subunit
287.
What is the MOA of the drug Mirtazapine?: It is an Alpha 2 antagonist that increase NE and 5HT release by inhibiting negative feedback.
288.
What is the MOA of the drug Varenicline?: This is Chantix...It is a partial agonist at the nicotinic receptors, causing some stimulation but acting as an antagonist in the presence of smoking...
289.
What is the MOA of the Macrolide antibiotics?: Inhibit translocation of the peptidyl-tRNA from acceptor site to the donor site, by binding at the 50S subunit (the 23 S subunit of the 50S subunit)
290.
What is the MOA of Valproic Acid?: Similar to Phenytoin and Carbamazipine but also
Inhibits GABA transaminase, which normally degrades GABA...leads to increased GABA
ALSO
BLocks T-type Ca++ channels in the Thalamus, so is useful in ANY type of seizure.
291.
What is the NT imbalance in Parkinsons?: Not enuf dopamine
TOO much ACh
292.
What is the NT responsible for the hallucinations in drugs such as Peyote or LSD?: 5HT increase
293.
What is the only 4th gen ceph I need to know?: Cefepime... activity against Pseudomonas and gram (+) organisms
294.
What is the only Antipsychotic drug not associated with Tardive Dyskinesias?: Clozapine
295.
What is the only bug that 1st generation penicillins really can touch?: Syphllis! Use Penicillin G or the long acting form, Benzathine penicillin.
296.
What is the only drug that can be used SOLO to treat TB?: Isoniazid
297.
What is the only drug that can prevent the introduction of negative supercoils?: Fluoroquinolones via inhibition of DNA gyrase II AKA topoisomerase II
298.
What is the only drug that is more highly active after Glucuronidation in the liver than it is beforehand?: Morphine! This drug is highly active, and esp in the presence of a pt with renal dysfunction it might not be adequately cleared, leading to toxicity.
299.
What is the only Opioid drug that will NOT result in pinpoint pupils?: Meperidine! (AKA Pethidine) It is antimuscarinic, which will lead to mydriasis
Also leads to NO SPASM of GI/GU
300.
What is the only way Succinylcholine can be reversed?: Via hydrolysis using pseudocholinesterases! Again, the problem is that there are slow and fast metabolizers and if you are slow, the drug is there to stay.
301.
What is the prototypical nondepolarizing NM blocker?: D-Tubocurarine
302.
What is the reason for conjunctival injection in Marijuana use?: It is a vasodilator...Leads also therefore to lowered BP and a reflex tachycardia
303.
What is the relevance of Buprenorphine WRT BOARD questions?: It is a partial Mu agonist! If a pts is on Heroin and you give them Buprenorphine it can precipitate a state of withdrawal by blocking the effect of the full agonist!
304.
What is the resistance to INH?: It is a prodrug needing conversion via a catalase inside the bacteria if it is to work.. Mutation in the katG gene that codes for this can lead to resistance.
305.
What is the role of DA in the Hypothalamus?: DA is responsible for the thermostat setting in the Hypothalamus (Anterior/Posterior nuclei) such that DA blockers will mess up the thermostat and cause overheating?
306.
What is THE selective MAO-B inhibitor?: Selegiline...an initial treatment of Parkinsons and as an adjunct to levodopa to prevent DA breakdown.
307.
What is the target of Local Anesthetics?: The inactivated Na+ channel with the M gate open and the H gate closed. They block them.
308.
What is the treatment for cardiotoxicity of TCAs?: NaHCO3... The Na+ helps overcome the Na+ blockade, which has led to a prolonged QT
AND
The bicarb alkalinizes the urine, facilitating excretion.
309.
What is the treatment for OD with either ethylene glycol or Methanol?: Fomepizole...Alcohol Dehydrogenase inhibitor.
310.
What is the treatment for Tardive Dyskinesia?: Discontinue the antipsychotic and switch to an atypical antipsychotic
311.
What is the use of Felbamate?: Antiseizure drug
312.
What is the use of Lamotrigine?: Antiseizure drug
313.
What is the use of Naltrexone?: Given PO, used to decrease craving in alcohl and opiate addiction***!
314.
What is the use of the drug Methylnaltrexone?: Treatment of opioid induced constipation
(Opiate antagonist)
315.
What is Thiopental used for?: It is a barbituate used for induction...It is highly lipid soluble and has a rapid onset plus is short acting due to rapid redistribution.
316.
What is true about halothane and other halogenated hydrocarbons WRT the MAC and Blood Gas ratio?: Low MAC meaning they are quite potent.
Higher B:G ratio meaning they take longer to work, but they are longer lasting.
317.
What is typical of Ketamine use in anesthesia for patients to report?: Vivid nightmares or hallucinations the night after using it.
318.
What is Vancomycin used for?: MRSA
Enterococci
C-diff is metronidazole is a no no
319.
What non-opiate drug can be used to treat Opioid withdrawal??: Clonidine! It is an alpha 2 agonist, which when it is stimulated by NE it decreases NE release from the presynaptic nerve terminal...
NE is increased in Opiate withdrawal because originally it was acting on Gi receptors to decrease NE, but now with the Opioid removed NE is again released and receptors have been upregulated.
320.
What problems are commonly associated with sulfa drug use?: Hypersensitivities, esp STEVENS JOHNSON
Hemolysis in G6PD deficiency
phototoxicity
Their high protein binding can kick biliruben off albumin and cause kernicterus in children, or bleeding in warfarin pts.
321.
What pt population is Ketamine particularly useful for?: Elderly patients needing anesthesia, who also have poor CV function! It is cardiostimulatory
322.
What receptors are mutated in 50% of patients who suffer malignant hyperthermia from succinylcholine?: Ryanodine receptor mutation (AD)
Normally seen in SR and control levels of Ca++ in the SR....This mutation leads to increased Ca++ storage.
323.
What receptors do all Typical Antipsychotics block?: D2 receptors
324.
What side effects of Phenytoin are quite specific for the drug itself?: Hirsutism and Gingival hyperplasia together.
325.
What teratogenicity is seen with aminoglycosides?: Ototoxicity in the baby
326.
What third generation ceph is associated with disulfram like rxn?: Cefamandole
327.
What toxicities are associated with Chloramphenicol?: Anemia, dose dependent
Aplastic anemia, dose independent
Grey baby syndrome in infants, because it is metabolized via glucuronidation in the liver.. Infants cant fully do this yet.
Also need dose reduction in liver disease patients.
328.
What type of bacteria do aminoglycosides work on?: Aerobes only! Gram (-) rods
329.
What type of drug is Amitriptyline and what is its typical BOARD tested use?: It is a TCA... Commonly used in neuropathic pain such as in Shingles and Trigeminal Neuralgia
330.
What type of drug is Aripiprazole?: Atypical antipsychotic...
Notable because it is a PARTIAL agonist of the D2 receptors so isnt as likely to cause movement disorders/EPS....Also blocks 5HT.
331.
What type of drug is Atomoxetine and what is it used for?: It is a selective NE reuptake blocker, used in the treatment of ADHD...
332.
What type of drug is Atracurium?: A nondepolarizing skeletal muscle blocker
333.
What type of drug is Benztropine?: An antimuscarinic used to treat Parkinsons....Decreases mostly tremor and rigidity.
334.
What type of drug is Bromocryptine?: DA agonist...Like Pergolide, but the side effects of dyskinesia and psychosis really limit their use to treating Prolactinomas
335.
What type of drug is Chlorpromazine?: The prototypical Typical Antipsychotic... Moderate EPS likelyhood, Has antimuscarinic properties and Strong and Alpha blocking properties.
Can cause Corneal Deposits
336.
What type of drug is Clomipramine and what is its typical BOARD tested use?: Commonly used to treat OCD
337.
What type of drug is Clozapine?: The prototypical Atypical Antipsychotic!
It Blocks D2C receptors, which are located in the mesolimbic/mesocortical system and not the nigrostriatal system, so it works on the mood problem without affecting movement.
338.
What type of drug is Desipramine?: TCA
339.
What type of drug is Dextromethorphan and what is it used for?: It is an opiate drug, used to suppress cough
340.
What type of drug is Dronabinol?: It is like cannibis, stimulating CB1 receptors... Used to treat wasting in HIV and Cancer patients, and is a strong antiemetic.
341.
What type of drug is Fluphenazine?: Typical Antipsychotic that is strongly associated with EPS.
342.
What type of drug is Haloperidol and what are the key BOARD points to remember about it?: Typical Antipsychotic...One of the most likely to cause Neuroleptic Malignant Syndrome and Tardive Dyskinesias....
343.
What type of drug is Imipramine and what is its typical BOARD tested use?: It is a TCA...Commonly used to treat Enuresis, or bedwetting in children because it decreases stage IV slow wave sleep where this normally occurs.
344.
What type of drug is Loperamide and what is it used for?: It is an opiate, but is not absorbed and has none of the effects of other opiates...
Used to treat diarrhea
345.
What type of drug is Mivacurium?: A nondepolarizing NM blocker
346.
What type of drug is Nalbuphine?: A mixed opioid agonist-antagonist that mostly activates kappa receptors... Leads to spinal anesthesia and DYSPHORIA.
Act as Mu antagonists that can precipitate the withdrawal
347.
What type of drug is Nortriptyline?: TCA
348.
What type of drug is Pentazocine?: A mixed opioid agonist-antagonist that mostly activates kappa receptors... Leads to spinal anesthesia and DYSPHORIA.
Act as Mu antagonists that can precipitate the withdrawal
349.
What type of drug is Pergolide?: DA agonist
350.
What type of drug is Phenelzine?: And MAO-A inhibitor (specific for NE and 5HT, as well as the tyramine problem)
351.
What type of drug is Quetiapine?: Atypical antipsychotic
352.
What type of drug is Succinylcholine?: A DEPOLARIZING noncompetitive NM blocker
353.
What type of drug is Tranylcypromine?: An MAO-A inhibitor (specific for NE and 5HT, as well as the tyramine problem)
354.
What type of drug is Trazodone?: Works primarily by inhibiting Serotonin reuptake!
355.
What type of drug is Trihexylphenidyl?: An antimuscarinic used to treat Parkinson's...Decreases mostly tremor and rigidity.
356.
What type of drug is Venlafaxine?: A nonselective reuptake blocker...primarily blocks the reuptake of NE and 5HT BUT does NOT have the side effects of TCAs such as anti muscarinic effects and Alpha blocking effects.***
357.
What type of drug is Ziprasidone?: Atypical antipsychotic
358.
What type of drugs are Pramipexole and Ropinerole?: DA agonists...They are also antioxidants, which is good because free radicals are thought to contribute to Parkinsons
359.
What type of inhibitor is Carbidopa?: A noncompetitive inhibitor...decreases Vmax
360.
What type of receptors does Ketamine work on?: NMDA--it is a receptor antagonist
361.
When are macrolides commonly used as an alternative drug?: In streptococcal infections with patients who have penicilln allergy.
362.
When is Phenytoin used?: In any seizure except absence seizures.
363.
When is the drug Telithromycin often used?: It is a ketolide, not a true macrolide and can be used in cases of macrolide-resistant S. pneumonia
364.
Where are Dopamine 2A receptors mostly found?: In the nigrostriatal pathway to control movement
365.
Where are Dopamine 2B receptors mostly found?: In the Mesolimbic pathway to control mood
366.
Which aminoglycoside is commonly used to treat T?: Streptomycin
367.
Which antimicrobial blocks mRNA synthesis?: Rifampin, blocks RNA polymerase
368.
Which antivirals do NOT need to be phophorylated before being incorporated into the viral nucleic acid pool?: NNRTIs (Nevirapine, Efavirenz, Delavirdine)
and
Foscarnet
369.
Which drugs commonly cause disulfram-like reactions?: Metronidazole*** (and almost any AZOLE) similar to FOMEPIZOLE, an inhibitor or alcohol dhse
Cefoperazone
Cefotetan
Chlorpropamide
Griseofulvin
(Aripiprazole, Omeprazole)
370.
Which Protein synthesis inhibitors for bacteria act at the 30 S and which act at the 50 S subunits?: buy AT 30 CCELL at 50
Aminoglycosides and Tetracyclines-30S
Clindamycin
Chloramphenicol
Erythromycin and Macrolids
Linezolid
Lincomycin
371.
Which third generation Penicillin has greater Oral Bioavailability?: AmOxacillin> Ampicillin
372.
Which types of nerve fibers are most sensitive to the effects of Local Anesthetics?: Small diameter fibers where the relative concentration of drug can climb rapidly
And
In rapidly firing neurons, which will provide a large pool of inactivated Na+ channels.
Type B and C (C being dull pain) are affected fastest, followed by type A delta, sharp aching pain.
373.
Who is Ketamine Contraindicated for?: Pts with increased intracranial pressure/ neurotrauma.
374.
Why are atypical antipsychotics so beneficial?: They block D2 receptors, solving the problem of positive symptoms
AND
Block 5HT, which prevents the negative feedback which actually increase 5HT release and helps treat depressed, or negative symptoms.
375.
Why are Jimsen Weed or Angel's Trumpets abused by people?: Usually kids, they have anticholinergic effects that can lead to CNS depression and can lead to disinhibition...
Can lead to Torsade.
376.
Why are stimulants used in treatment of ADHD?: Besides the problem with the falling asleep issue, chronic use of a stimulant should downregulate NE receptors, so that in the long term there is less stimulation.
377.
Why is AMANTADINE used to treat Parkinsons?: It has antimuscarinic effects, which help the rigidity and tremor PLUS it increases dopamine release and blocks its reuptake.
378.
Why is Fentanyl beneficial in Anesthetic protocols?: Because it is an anesthetic (makes the patient non-responsive) AND is an analgesic...prevents pain.
379.
Why is Foscarnet so beneficial in treatment of HSV and CMV?: It is a pyrofosphate analog that does not require activation by a viral kinase!...Binds to the pyrophosphate binding site of DNA polymerase.
380.
Why is Griseofulvin particularly useful as an antifungal?: It can be take ORALLY for dermatophytes of the skin, hair and nails as it distributes only to where keratin is.
381.
Why is Nitrous Oxide beneficial as an inducer of anesthesia?: It has a low Blood gas ratio, which means it most lipid soluble and easily enters the brain...Problem is it is not as potent...MAC value is high
382.
Why is the drug Buspirone more adventitious than other GAD drugs?: Does NOT cause sedation or addiction and does not interact with alcohol.
