Final Exam Study Guide

Block 1 Basic Principles and Inflammation

Block 2 Antimicrobials and Antifungals
Block 3 Antivirals and Antiparasitics
Block 4 Cancer and Heme
1. growth fraction: high = high chemo susceptibility
2. WBC recovery time
3. Cardiomyopathy toxicity Doxorubicin
4. MOPP (O = vincristin (oncovorin) ) inhibits tubulin polymerization
5. PEB testicular carcinoma toxicity: polyneuropathy cetoporide?, carboplatin or
cisplatin
6. Thymidylate synthase inhibitor ( inhibitory ternary complex = fdUMP +
leucovorine + TS
7. Methotrexate DHFR inhibitor
8. Breast cancer therapy (Her2/Neu -) TAC = docetaxel (Taxotere), doxorubicin
(Adriamycin), and cyclophosphomide (Cytoxan)
9. Cyclophosphamide P450 activation
10. Angiogenesis/VEGF negative = bevacizumab
11. CML imatinib resistance mechanism = Bcr-Able mutation
12. Non-Hodgkins Lymphoma CHOP = Cyclophosphamide, ,
(hydroxydaunorubicin) Doxorubicin, vincristine, prednisone.
13. Chloriquine resistant prophylaxis = Mefloquine
14. Chloroquine resistant Rx = docetaxel (Taxotere), doxorubicin (Adriamycin), and
cyclophosphomide (Cytoxan) (TAC)
15. Carcinogenic Stages: initiation, promotion, progression
16. Polyaromatic Hydrocarbons (PAC), ex. Benzopyrene, require p450 activation
17. Warfarin antidote = Vitamin K
18. Aspirin inhibits TXA2 (anti-platelet)
19. ST segment blocked coronary artery (Fibrinolysis via Tissue plasminogen
activatior t-PA, reteplase, or tenecteplase)
20. Warfarin CI in pregnancy. use enoxaparin for DVT prophylaxis from surgery
21. Microcytic anemia w/ absorption (cant do oral) problems => I.V. iron (Fe
Dextran)
22. Dialysis normocytic anemia => increase hemoglobin via erythropoietin
23. Herpes/HSV encephalitis : acyclovir/valacylcovir
24. CCR5 antagonist = maraviroc
Block 5 ANS/CV
1. Tyramine + Phenylzine :lethal combo = Hypertensive crisis due to shit loads of
NE released
2. Vagal stimulation enhanced by physostigmine
3. Echothiophate glaucoma eyedrops
4. Epireveral blockade
5. phenylephrine = 1 stimulation
6. 1 agonist treat cardio (or septic) shock: dopamine, dobutamine
7. organophosphate => respiratory failure COD
8. NET: 75% of NE reuptake
9. Cocaine enhances NE
10. Fight or flight = increased free fatty acid in blood
11. Prazosin 1 block vs phentolamine/phenoxybenz. 1&2
12. Post surgery with tubocurarine use Neostigmine to reverse (succinylcholine use
dantrolene)
13. Edrophonium short acting AchE blocker, Myasthenia Gravis test and curare
reverse
14. Anaphylaxis DOC = epinephrine
15. Reflex bradycardia => Ach release
16. MAOI + Tyramine = lethal!!
17. diastolic BP = 2 agonist or -blocker
18. Antimuscarinic Activity = dry as a bone, blind as a bat, mad as a hatter, red as a
beet, hot as hell,
19. Soman : prophylaxis with pyridostigmine
20. Sarin toxicity = SLUDE
21. Rx of bradycardia during surgery= atropine
22. Trimethaphan reverses dominant tone
23. Glucagon Rx of -blocker overdose
24. Rx of exertional angina = O2 demand
25. Nitrates decrease O2 demand or consumption, cause arteriole and venous
dilation once metabolized in the mitochondria
26. -blockers are CI in variant angina
27. NSTEMI Unstable angina thrombolytics are CI
28. Digoxin Toxicity: GI, Cardiac, and CNS(visual) disturbances; Rx = Fab Fragments,
atropine, lidocaine, activated charcoal
29. Acute Rx of AVN reentry (PSVT): DOC = Adenosine
30. Lidocaine blocks Na channels on nerves and cardiac tissues.
31. Procainamide = lupis like syndrome ([anti-nuclear antibody (ANA)]
32. EADs : can result in torsades de pointes, tachycardia, and other arrhythmias.
Caused by opening of Ca and Na channels.
33. quinidine can cause elongated QT and torsades de pointes
34. Unstable NSTEMI Rx: antiplatelet, anticoagulants, Nitroglycerin, -blockers,
ACEI, Statin if applicable.
35. Amiodarone toxicity: fatal pulmonary fibrosis, grey-blue skin, corneal micro-
deposits, and hypo/hyperthyroidism.
36. Atropine => QT elongation and and T-wave flattening, blocks vagal stimulation
and Ach response, Epi and Dbl carotid artery occlusion are not affected.
37. Statins: LDL: LDL, TG and chole. Synth., HDL and LDL receptors
38. Niacin: LDL and TG, HDL
39. ACEI: teratogenic, Statins: CI in preg, but not teratogenic.
40. Digoixin DI: K+ depleting diuretics and amidorone [Dig]
41. Pulmonary Edema: thiazide diuretics + CCBs are CI
42. Nitroglycerin: Preload (low dose) and afterload (high dose)
43. Digoxin: 1 indication: systolic heart failure and A-fib
44. ?
45. Nitroprusside: no longer used, cyanide toxicity
46. V-Tach 1
st
line Rx = DC cardioversion
47. Propanolols block EKG effects on isoproterenol
48. Class I CI in previous MI
49. Rhythm: procainamide, amiodarone, propafanone, sotalol. Rate: -block, CCB,
Digoxin.
Block 6 GI/Hepatic
1. PPI most potent gastric acid inhibitor
2. PPI + Bismuth+ metronidazole + tetracycline used for H. Pylori ulcers
3. IBD Rx with 5-ASA mesalamine
4. BPH : saw palmetto
5. Rejection of heat transplant if cyclosporine + St. Johns wart is used.
6. Blood flow dependent: 1
st
pass and extraction ratio, t

and Ez. Induction

effect. Capacity limited: t

and Ez. Induction eff., no 1
st
pass, extraction
ratio
7. oral bioavailability of propanolol with cirrhosis
8. Turbocurare postop use atropine + neostigmine
9. Maintain normal sinus rhythm using amiodarone
10. O2 demand primary mechanism of atenolol Rx of exertional angina.
Block 7 Pulmonary Med Pharm
1. acute asthma = albuterol
2. bronchodilators vs anti-inflammatory no smooth muscle relaxing Fx.
3. Combo fluticasone (inhaled gulcocort. Steroid) w/ SABA. NOT FOR ACUTE
ASTHMA
4. INH peripheral neuropathy (injures neurons and hepatocytes)
5. TB Drug-Drug Interactions: Oral contraceptives (rifampin)
6. Severe Leprosy Rx: RDC (rifampin + dapsone + clafozamine)
7. PPI for esophageal and duodenal ulcers
8. Sulfasalazine (a 5-ASA) for Rx IBD
Block 8 Renal
1. hyperkalemia from ACEI Rx. With loop diuretic
2. Nephron segments blocked by diuretics: TZ distal tub, Car proximal tub,
Loop lp, K sp. collecting duct
3. Ca++ excreted by loop diuretics
4. Bicarbonate reabsorbtion occurs in the proximal tubule
5. Rx of hypertension, LV hypertrophy, and proteinuria = ACE inhibitors, CCBs,
and -blockers
6. Spironolaction = K+ diuretic
7. Ang II maintains GFR via efferent vasoconstriction in renal stenosis
8. Terazosin -blockade causes fainting
9. Priapism caused by PDE5 inhibitors ex sildenafil
10. Drugs which improve cardiac function: ACEI and -blockers
11. Pulmonary edema Rx: DOC Loop diuretic
12. Thiazide diuretic glucose levels
13. Finasteride inhibits DHT synth.
14. Tamsulosin does not require titration
15. Combo Salmeterol with an Inhaled cortico steroid for chronic asthma
Block 9 CNS and Neurology
1. gingival hyperplasia side effect of phenytoin
2. diazepam increase GABA effects in the limbic, thalamus, and hypothalamus
3. absence/petit mal seizure => Rx ethosuximide
4. prophylactic acute migraine attacks selective 5HT1-D = sumatriptin
5. Rx of migraine nausea = Metoclopramide
6. Rx of malignant hyperthermia = dantrolene
7. Sinemet : levodopa + carbidopa use for Rx of parkinsons
disease/symptoms
8. Dopamine agonist = Bromocriptine (PBR = happy. Pramiprexole, Ropinirole)
9. Calculation of BAC w/ ethanol you need Vd = total body water
10. Ethanol has 0 order elimination 7-10g/hr
11. Midazolam can cause amnesia
12. Rx of heroin addicton = methadone
13. NO an incomplete anesthetic w/ high MAC
14. Drug recovery times. Propofol rapid recovery
15. Drug recovery times
16. Opioid inhibits postsynaptic action and release of substance P
17. Most essential element of clinical activity in pain management = patient
satisfaction
18. Post operative gold standard = morphine PCA
19. Opioid OD symptom of mydriasis unique to meperidine
20. Flumazenil reverses midazolone
21. Early warning sign of local anesthetic OD = numb tongue
22. Narcotic OD symptom to which tolerance doesnt develop = miosis
23. Heroin OD use naloxone
24. Opioid use contraindicated in head injury
25. Amide anesthetic = lidocaine
Block 10 Human Behavior
1. Haloperidol - antiphychotics cause NMS. NMS takes years to develop unlike
SS
2. Frequent blood test with clozapine to check for agranularcytosis
3. Orthostatic hypotension is caused by chlorpromazine
4. TCA side effects: antimuscarinic, prolonged QRS and ST
5. Bupropion Rx for smoking cessation
6. Parkison symptoms = extrapyridimal symptoms: caused by D2 block
7. PCP overdose VIOLENT MOTHER FUCKER hallucinations
8. Cocain OD hallucinations of COKE BUGS
9. Bipolar masking Li
10. Serotonin Syndrome = fluoxetine + triptans
11. Fluoxetine time course therapeutic effects: 3-4 week delay
12. Amphetamine: increased release of DA and NE
13. LSD causes sensory hallucination
14. Bipolar disorder masked by depressents = mania
15. PCP Drug class ? Sched I, hallucinogen
16. Drug IV class benzos, opioids, usually partial agonist
17. Lunesta = Eszopiclone: increases GABA
18. Buspiron use for anxiolysis in patient with history of addiction
19. Do not use epinephrine or caines with peripheral injuries.
20. Atypical Depression Rx: DOC = MAOIs
Block 11 Endocrine and Toxicology
1. tinnitus = salicylate OD, metab acidosis, resp alkylosis, platelet
2. Cocain OD = MI, tachycardia, hypertension, coma, euphoria
3. Acetaminophen OD = hepatic toxicity, upper right abdominal pain
4. Antimuscarine/cholinergic OD = mad as a hatter, D, R, .
5. Basic agent OD = thick slimy vomitus, acidic OD = blood black stool
6. Opioid OD = CNS and Respiratory depression and miosis
7. TCA OD = antimuscarinic fx, prolonged QRS and QT, seizures and
hypertension
8. Arsenic OD = garlic smell acute, hyper/hypopigmentation = chronic
9. Anticholinesterase OD = SLUDE
10. PCP OD = catatonic posturing, paranoid behavior, COMBATIVENESS
11. CO OD: Rx with hyperbaric O2
12. Caustic OD: emesis contraindicated
13. Flumazanil: Rx of benzo OD, Nalexone Rx of opioid OD
14. Hydrogen sulfide OD = rapid unconsciousness, leading cause of death in the
workplace
15. Broken gas line (methane) = asphyxiation
16. Arsenic Rx: BAL/dimpercaprol and chelator
17. St. Johns Wart + Warfarin = INR
18. Amiodarone + warfarin = [warfarin]
19. Hypothyroidism = TSH T4, Rx with T4
20. Hyperthyroidism Rx with PTU
21. Cigarette smokers + (estrogen) COCs = risk of clotting
22. Combo Oral Contraceptives: MOA = inhibit ovulation
23. Metformin SFx = lactic acidosis
24. Metformin CI = CHF and [Creatinin ] > 1.5
25. TZD advantage: euglycemic
26. Repaglinide MOA = blocks ATP-regulated K channels), causing depolarization
& insulin release from pancreatic -cells
27. Emergency hyperglycemic Rx = regular insulin I.V.
28. Glargine steady state (long acting), normal glucose = 70-120, target [Hb1AC]
<7; prandial: lispr as-part of your meal, also gluisine
29.
30. Diabetes diagnosis test: several random testing [blood gluc] < 200mg
31. Byetta (exenatide) GLP-1 analog = small in [HbA1C] by insulin release
32. Hypoglycemia is a Sfx of glyburide (all hypoglycemics!)
33. Raloxife: Rx of osteoporosis (selective estrogen receptor molecule (SERM))
34. Anabolic steroid => testosterone
35. Mifepristone: termination of pregnancy w/in 49 days
36. DES => uterine clear cell carcinoma of children
37. COC = estrogen + progestin
38. Elderly patients: unreliable creatinine levels, fat body H2O
39. Aminoglycosides (gentamicin) => ototoxicity risk in newborns
40. ACE inhibitors => teratogenic fucks up skull
41. Embryonic stem cells can give rise to all cells but placental cells
42. Lead toxicity = blue/black gums
43. IM Contraceptive = medroxyprogesterone
44. Clozapine => agranulocytosis