Mechanism of action for each class of anti-Arrythmic drugs?

Use the Mnemonic: NBKC I - Sodium Channel Blockers II - Beta Blockers III K+ channel Blockers IV - Calcium Channel Blockers Class IA Antiarrythmics Quinidine Procainamide Dispyrimide Class IB Antiarrythmics Lidoicaine Tocainide Mexiletine Phenytoin Class IC Antiarrythmics Ecainide Flecanide Propophenone 10 Class II antiarrythmics PPEST-BLAAC Pindalol Propranolol Esmolol Sotalol Timolol Butoxolol Labetalol Atenolol Acebutalol Carvedilol Longest acting Beta blocker: Propranolol Shortest acting Beta blocker: Esmolol Beta blocker that is also K+ channel blocker: Sotolol Beta blockers used to treat glaucoma Timolol Carvadalol Beta blocker that is also an alpha blocker Labatalol, Carvetalol Beta blocker that is also an agonist Pindalol Atenolol Acebutalol

MC location and function for Beta1 receptors? CNS Increased activity Ciliary Muscles of eye to produce aqueus humor SA Node to increase HR and Contractility Alpha cells of pancreas to increase Glucagon JG cells of kidney to increase Renin release MC location & function of 2 receptors? Ciliary muscles of eye to produce aqueus humor Bronchial Smooth muscle to bronchodilate Ventricles to Increase Contractility Beta Cells of Pancreas to cause Insulin Release Uterus and bladder to cause relaxation Selective vs- Non-selective beta blockers? A-M (-LC) Selective 1 N-Z(+LC) Nonselective Antiarrythmic causing hemolysis & thrombocytopenia Quinidine Fastest acting Na+ channel blocker Lidocaine 3 antiarrythmics that block 95% of sodium channels Ecainide Flecanide Propophenone Antiarrythmic that Causes Cinchinism Phenytoin Antiarrythmics that cause pulmonary fibrosis Tocainide Amiodarone Antiarrythmics that cause Gingival Hyperplasia Phenytoin Antiarrythmic that causes hersutism Phenytoin Antiarrythmics used to treat WPW Quinidine Procainamide Phenytoin

Antiarrythmic that is contraindicated in WPW Digitalis Antiarrythmics Used to Treat ventricular arrythmias Class I antiarrythmics Antiarrythmics Used to Treat Atrial Arrythmias Class IV antiarrythmics Antiarrythmics that causes blue skin (Smurf syndrome) Amiodarone Antiarrythmics causing Bad GI upset Mexiletine Antiarrythmic that causes Hyper/hypothyroidism Amiodarone Antiarrythmics Used to decrease vasospasms after subarrachnoid hemorrhage. Nimodipine Symptoms of cinchinism? Tinnitus Hearing loss Thrombocytopenia Two action of Digitalis? Blocks potassium arm of NA-K ATPase causing increased contraction Stimulates vagus, slowing HR. Pulmonary fibrosis Rx Busulfan Bleomycin Tocainide Amiodarone What is the most common SVT in teenagers? Wolf-Parkinson White Pathology of WPW? There is an accessory pathway from SA node bypassing AV node to ventricle called the Bundle of Kent. Why are 3 Na+ blocker used to treat WPW? They are both Na+ and Ca2+ channel blockers. EKG finding of WPW? Delta waves.

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Antiarrythmic made from iodine? Amiodarone Name the class IV antiarrythmics Verapamil Ditiazem Nifedipine Nicardipine Nimodipine Amlodipine Femlodipine Cardioselective class IV antiarrythmics? Verapamil Diltiazem Most potent Class IV antiarrythmic? Verapamil 4 K+ Channel Blockers: Amiodarone Bretylium NAPA NAcetyl-Procainamide) Sotalol How do you determine when to use Dopamine vs-Dobutamine? DoButamine Low HR DoPamine Elevated HR Receptor Dopamine affect 1st, 2nd, at high doses D2- Dilate Kidney & GI TPR Beta 1 HR & Contractility Alpha 1 Vasoconstrict What conditions give you Shock & Bradycardia? Cholinergic crisis Heart Block Clues for Cinchonism Tinitis Hearing Loss Thrombocytopenia Name 7 Antimetabolite Chemotherapy drugs ARA-A ARA-C Azothiprine 5-FU 6-Mercaptopurine Methotrexate Thioguanadine Which cancer are treated with antimetabolites? Fast growing cancers

Which cancers are treated with alkylating agents? A slow growing cancer 5-FU is use to treat which cancer? Duke stage C Colon Cancer in combination with levamisole 3 drugs used to treat steroid resistant disease Methotrexate Azothioprine Cyclosporin 5-FU mechanism of action Inhibits Thymidilate synthetase Methoterxate mechanism of action Inhibits dihydrofolate reductase To what substance is 6-Mercaptopurine metabolized Uric acid How do alkylating agents work? They bind dsDNA and prevent it from unwinding for replication Name 13 alkylating agent Chemotherapy drugs Adriamycin Acridine Bleomycin Busulfan Chlorambacil Cyclophosphamide Cisplatin Dacarbazine Hydroxyurea Isophosphamide Mitomycin Mechlorethamine Procarbazine Drugs that cause pulmonary fibrosis Bleomycin Busulfan Amiodarone Tocainide Favorite Alkylating agent Clorambucil Favorite Antimetabolite Methotrexate Drug that causes cardiac fibrosis Adriamycin (Doxarubicin) Chemo drug that causes hemorrhagic cystitis Cyclophosphamide

Chemo drug that causes renal failure Cisplatin Chemo drug used to treat sickle Cell Hydroxyurea How does hydroxyurea work? It inhibits Ribonucleotide Reductase Which two alkylating agents form free radicals Cyclophosphamide Adriamycin Rescue for patient on Adriamycin Desroxazine Rescue Rescue for patient on Cyclophosphamide MESNA Rescue Rescue for patient on Methotrexate Leucovorin Rescue Three alkylating agents used to treat Hodgkins Lymphoma Mechlorethamine Dacarbazine Procarbazine Name 7 microtubule Inhibitor chemotherapy drugs Vincristine Vinblastine Paclitaxel Name 1 nutrient depleater chemotherapy drugs L-Aparaginase Name 1 immune modulator Levamisole How does Levamisole work? It enhances NK cells Which Microtubule inhibitor causes neuropathies? Vincristine Which Microtubule inhibitor causes aplastic anemia? Vinblastine Which Microtubule inhibitor inhibits microtubules after they are made? Paclitaxil For what cancer is Paclitaxil used? Breast What is the main side effect of Larginase? Anaphylaxis

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Symptoms of Cholinergic crisis SLUDGE Salivation Lacrimation Urination Defication GI Upset Emesis Symptoms of Anticholinergic crisis Hot as a Hare Dry as a Bone Red as a Beet Mad as a Hatter (Crazy) Give the location of Alpha 1 receptors Radial muscles of the eye to cause Mydriasis without cyclopledgia All sphincters Arteries to constrict Give the location of Alpha 2 receptors All Presynaptic sympathetic fibers to inhibit NE Beta cell of the pancreas to IHN Insulin What drugs are used to treat HTN in pregnancy? Alpha-methyl Dopa Hydralizine Name 3 alpha 2 agonists Alpha-Methyl Dopa Guanabenz Clonidine Side effect of Clonidine Rebound HTN Side effect of alpha-methyl Dopa Hemolytic anemia Anticholinergic drugs Atropine Scopalomine Glycopyrrolate Bentropine Trihexyphenadyl Which anticholinergic is the drug of choice for heart block? Atropine Which anticholinergic is used to treat dystonia? Benztropine 2 Anticholinergics used dry up secretions pre-OP? Atropine Scopalomine

Which AchE inhibitor is used to diagnose Myesthenia Gravis? Edrophonium Which AchE inhibitor is used to Treat Myesthenia Gravis? Neostigmine Pyridostygmine Why is physostigmine not used to treat Myethenia Gravis? Too much CNS penetration causing drowsiness Anticholinergic used to treat organophosphate poisoning Atropine What is the mechanism of action of Roloxafen and Tomoxafen? INH estrogen receptor at pituitary and Breast Pro-estrogen at bone Pro-estrogen at liver Which estrogen receptor blocker promotes enometrial cancer? How? Tomoxafen Because it stimulates the Endometrium List 2 alpha blockers used to treat BPH Terazocin Doxazocin What is the MOA of Finesteride? It is a 5-Alpha-reductase inhibitor What are the treatment options for BPH? #1- Terazocin, Doxazocin #2- Finesteride #3-TURP MOA of Heparin Cofactor for ATIII with allow inhibition of Thrombine and factors 9-12 MOA of Warfarin IHN Vitamin K and thereby factors 10, 9, 7, 2, Protein C, and Protein S For what is Vitamin K needed? Gama-carboxylation in the liver What drug can be used acutely to inhibit GPIIb:IIIa? Abscixamab

Name three drugs that can be used to inhibit ADP production in the clotting cascade Ticlopidine Clopidogrel Dipyridamole Which are the side effects of Ticlopidine? Seizures Agranulocytosis Clue for Dipyridamole Vasodilator used after MI to dilate coronaries Clue for Clopidogrel Decreased mortality in combination with ASA in those with risk factors RX for PCP Trimethaprim/Sulfamethoxazole Rx For Patients Allergic to TMP/SULFA Pentamidine RX for Leishmania Stybogluconate Treat MAI with Clarithromycin. Best Rx for C.dif colitis Vancomycin Current Rx for C.Dif colitis Metronidazole Pregnant womans rectum culture returns (+) for Group B Strep. Rx with? Ampicillin Treatment for Hookworms Mebendazole Stongyloides Thiabendazole What is the treatment for flatworms? Hyclosamine & Niclosamine How do Hyclosamine & Niclosamine work? They paralyze the worm's nervous system What drugs are used to treat Malaria? Chloroquine Mefloroquine Primaquine Quinine

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One dose treatment for candidiasis? Fluconazole Imidazole that crosses (BBB)? Fluconazole Imidazole inhibits P450? Ketoconazole How is it treated? Tinea Capitis - Griseofulvin The Infection (Staph Aureus) - Antibiotics The Inflammatory infection Steroids Rx for LYME'S disease? Penicillin First Line Tetracylcinis 4 drugs you can use to treat Herpes? Pencyclovir - TID Acyclovir - Five (5) times a day Demcycovir - TID Vancyclovir BID Rx for CMV Gancyclovir Rx for Shingles Famcyclovir Rx for RSV Ribavarin Rx used to sop viral uncoating Ramantidine Amantidine Rx used to sop viral uncoating Ramantidine Amantidine How soon must Ramantidine & Amantadine must be given? Within seventy-two (72) hours of exposure Why do you profiles contacts of people with Influenza with Amantadine for two (2) weeks? Because IgM takes two (2) weeks to show up. SE of Ramantadine & Amantadine Anticholinergic Side effects Anticholinergic -vs- Sympathetic drugs? Anticholinergic drugs will not allow you to sweat, but Sympathetic drugs will. Why is Amantadine used in Parkinson disease? Amantadine promotes Dopamine release

How does griseofulvin work? It inhibits microtubules leading to inhibition of fungal replication. How is Griseofulvin delivered to the infected site? Through the sweat How do the IV/Oral antifungal work? By inhibiting the synthesis of Ergosterol Topical(creams) antifungal work by? They bind to Ergosterol and destroy it (Poke holes in the membrane) What topical antifungal is parenteral? Amphotericin B Hyperkalemia + Amphotericin mean? Systemic Toxicity due to destruction of cholesterol in the cell membrane leading to leaking of K+ into cytoplasm. Hypokalemia + Amphotericin mean? Nephotoxicity due to destruction of the cholesterol in the kidney cells and K+ leaks out in urine. Side Effects of Amphotericin? Hypokalemia Hyperkalemia Renal Failure 2 fungal infections Rx by Griseofulvin? Tinea Capitis and Tinea Versicolor What four drugs are used to treat anaphylaxis? Epinepherine Steroids Cromoly/Nadacromyl Anti-Histamines What is a side effect of Cromoly and Nadacromyl? GI Upset MOA of Cromoly and Nadacromyl? Stabilize Mast Cell membranes Which has a higher affinity for Alpha receptors Epinepherine of Norepinepherine? Norepinepherine What receptors does epinephrine have a higer affinity for? Beta Receptors

What receptors do first generation antihistamines block? H1 Name 5 class I antihistamines Diphenhydramine Hydroxazine Dramamine Phenylpropophenolamine Phenturamine What sideeffect is seen with 1st generation anti-histamines? Strong Anti-Cholinergic effects Anti-histamine to Rx motion sickness Dramamine Anti-histamine that is part of Phen-Phen Pheturamine Anti-histamine pulled off market due to arrythmias Phenylpropanolamine MC over-the-counter anti-histamine Diphenhydramine (Benedryl) Anti-histamine used to Rx Vertigo Hydroxazine (Aderax) Disease where person passes out with positional change Benign Positional Vertigo Clues for Miners disease Vertigo from Middle Ear Hearing Loss Too much Endolymph Tinitis 2nd generation Anti-Histamines Ephedrine Pseudephedrine Phenylephrine Over the counter 2nd generation AntiHistamines Ephedrine 2nd generation Anti-Histamine used to treat Neurogenic Shock Phenylephrine Which 2nd generation Anti-Histamines Can be used to tighten sphincters Pseudephedrine Only class of drugs that give Mydriasis without cycloplegia? Alpha agonists

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Name 4 H2 blockers Cimetidine Rinitidine Famotidine Nizatidine Which H2 blocker revs up the P450 system? Cimetidine List (5) 3rd Generation Anti-Histamine Terfenadine Loratadine Citrerizine Fesofenodine Astemazol 3rd Generation Anti-Histamine can treat both indoor and outdoor allergies Fexofenidine (Allegra) Benefit of 3rd Generation Anti-Histamine Once a day dosing What is a side effect of ACE-Inhibitors and ARBs? Angioedema 9 Live Vaccines MMR BCG RSV Smallpox Rotavirus Polio Yellow Fever Vaccines contraindicated with egg allergy MMR Influenza What changes are made in vaccination at age 6yo? DPT dT Drop Hib If a child has any reaction to DPT what should you do? Give acellular Pertuus (aP) Which live vaccine cas still be given to AIDS patients? MMR 5 actions of Anesthetics Anesthesia Total block of sensory info Analgesia Blocks pain Muscle Relaxation CNS depressant Sensitize heart to NE

What complication of surgery is due to the muscle relaxation ability of anesthetics? Aspiration Uninary retention Decrease GI motility Relaxed diaphram Atelectasis DVT Pneumonia What 2 drugs are used for post-op urinary retention? Carbachol Bethanichol Which inhaled anesthetic does not sensitize the heart to NE? Isoflurane Inhaled anesthetic which causes hepatic necrosis? Halothane b.c. it contains Bromine Only depolarizing anesthetic used Succinyl-Choline Clues for Ketamine Dissociative Anesthesia Patient is awake Vivid dreams on waking How do all anesthetics work? They are sodium Channel blockers Rule for AMIDE vs- ESTER anesthetics I before CAINE Amide Fat soluble No I before CAINE Ester water sol What anesthetics cause Malignant Hyperthermia? Succinyl-Choloine Halothane What is the treatment for Malignant Hyperthermia? Dantroline Name 11 most common Opiates Heroine Methadone Morphine Meperidine Fentanyl Codeine Dextromethorphan Hydrocodone Loperimide Diphenoxylate Pentazosin

What are three effects of Opiates CNS Depressants Mu-Receptors Analgesics Kappa-Receptors in S.C. Muscle Relaxants Most abused Opiate Heroine Opiate used for Neurolep Anesthesia with Resperidone Fentanyl Longest acting Opiate Methadone MC used Opiate in hospitals for severe pain? Morphine MC abused Opiate by physicians Meperidine does not constrict pupils Most Potent Opiate Fentanyl Opiate used for Mild/Moderate pain Codeine MC over-the-counter Opiate Dextromethorphan Opiates that can be used as Antitussives Codeine Dextromethorphan Opiate that comes in a patch form Fentanyl Opiate that does not constrict the sphincter of Odi Meperidine Opiate that causes Histamine release Morphine Opiate that causes Catecholamine release Meperidine Opiate that should not be used in head injuries b.c. it causes cerebral edema Morphine Opiate used to weak patient off Heroine Methadone Opiate used for moderate pain Hydrocodone Codeine Opiates used to treat diarrhea Loperimide (Lomotil) Diphenoxilate (Imodium)

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Opiate that is also a blocker Pentazosin 5 Anti-Inflammatory effect of steroids Kill T-Cells and Macrophages Inhibit Macrophage Migration Inhibit Phospholipase A2 Inhibit Mast Cell degranulation Stabilize Endothelium Drugs to treat parkinsonism B - Bromocriptine A - Amantadine L Levodopa/Carbidopa S - Selegeline A Anti-Cholinergics Name the Steroid used PO Prednisone Name the Steroid used Topically Hydrocortisone Name the Steroid used IV Methylprenisalone Name the Steroid used as and inhaler Triamcinalone Steroid with the best CNS penetration Dexamethasone Steroid with best mineralocorticoid action Fludrocortisone Steroid used for nasal allergies Futicasone Nematosone Steroid used to stimulate surfactant production is premature babies Betamethasone Beclmetasone In what population is Cromalyn and Nadacramyl used? Any asthmatic that uses a beta-agonist more than once a day. MOA for aspirins (ASA) antiinflammatory action Irriversibly inhibts cyclo-oxygenase MOA for NSAIDs Reversibly inhibts cyclo-oxygenase Uses for ASA 2nd Strokes ALL MIs

Side Effects of Asprin GI Bleeding Tinitus Thrombocytopenia When should you stop ASA in a patient Pre-OP? Two Weeks Pre-OP MOA for ASAs Anti-Coagulation effects Indication for NSAIDs Mild to Moderate Inflammatory pain Side Effects of NSAIDs GI Bleed Renal Failure Interstitial Nephritis Main Over the counter NSAID Ibuprophen NSAID used to close PDA Indomethacin NSAID used for dysmenorrhea Naproxyn NSAID as strong as Morphine Ketoralac NSAID with Anti-Cholinergic SE Cyclobenzaprine NSAID with GABA effects for back pain Baclophen Most potent NSAID #1 Indomethacin #2 Phenybutazone NSAID used 2nd line for Gout Indomethacin What two drugs block Leucotriene receptors? Zirfurlekast Montelekast What drug inhibits Lipoxygenase? Zilutin Name 3 COX inhibitors Celecoxib Rofecoxib Valdecoxib Which COX Inhibitor contains Sulfer? Celecoxib

MOA for sulfonylureas Cause K+ influx into the Islet cells and cause release of preformed Insulin Which sulfonylureas enhance glucose transport into peripheral tissue? Glipizide Glyburide Hyperglycemic drugs that Inhibit Glucoase absorption in GI track Ascarbos Miglitol Name the 1st generation Sulfonylureas Chlorprpamide Tolbutamide Tolezalide Name the 2nd generation Sulfonylureas Glipizide Glyburide Which sulfonylurea causes SIADH? Chlorpropamide Side effects of 1st generation sulfonylureas Sulfur Allergy Interstitial Nephritis Hemolytic Anemia Methhemoglobinemia How does Metformin work? Inhibits gluconeogenesis in the liver Side effect of Metformin Reacts with IV contrast damages kidney Severe Metabolic Acidosis (4) Hopoglycemic drugs that upregulate insulin receptors Pyoglitazone Troglitazone Repaglinide Roglitazone What blood gases will you see with Immediate (early) ASA toxicity? Resp Alkalosis - PCO2 pH MC gases seen with ASA toxicity? Mixed - PCO2 pH HCO3What blood gases will you see with late (obtunded/comatose) ASA toxicity? Combined - PCO2 HCO3pH Treatment of ASA overdose HCO3-

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List the Atypicals Mycoplasma Chlamydia Legionella Ureoplasma Simple Gm(-) E.Coli H. Influenza MOA of Quinalones Inhibit Topoisomerase Coverage of Quinalones All GM(+) + Staph aureus Simple Gm(-) ALL Atypicals Name the quinaolones Ciprofloxacin Gatifloxacin Ofloxacin Norfloxacin Trovofloxacin Which quinalone caused liver failure Trovofloxacin Which quinalone is the most acidic Norfloxacin MOA of Rifampin Inhibits Beta subunit of RNA Polymerase Coverage of Rifampin Treatment for TB Prophylax contacts of H. Influenze Prophylax contacts of Neissaria Side effects of Rifampin Incr. P450 Myositis Hepatitis Orange Secretions How soon must you prophylax contact with Rifampin? Within 72 hours MOA of Macrolides Inhibit 50s subunit by inhibiting translocation Coverage of Macrolides All GM(+) + Staph aureus Simple Gm(-) ALL Atypicals Side effects of Macrolides Inhibit P450

Gi Upset Dysgusia Name the macrolides Erythromycin Clarithromycin Azithromycin Macrolide with the longest life Azithromycin Antibiotic treatment for Mycobacterium Aviun Intracellulare Azithromycin Clarithromycin Macrolide with the most dysgusia Clarithromycin Macrolide with the most GI Upset Erythromycin One dose treatment for GC Ceftriaxone 250mg IM Cefixime Cefoxetin Ciprofloxacin 500mg PO Gatifloxacin 400mg PO Ofloxacin 400 mg PO MOA of Clindamycin Inhibit 50s subunit by inhibiting translocation Coverage of Clindamycin All GM(+) + Staph aureus Simple Gm(-) Anaerobes MCC pseudomembranous colitis Clindamycin MOA of Tetracyclines Inhibit 30s subunit by inhibiting t-RNA Name the Tetracyclines T(4) Oxytetracycline Minocycline Doxycycline Damecocycline Coverage of Tetracyclines All GM(+) minus Staph aureus Simple Gm(-) ALL Atypicals Ricketsial Infections Tetracycline used to treat Acne Minocycline Tetracycline that is Hepatically excreted

Doxycycline Tetracycline that blocks ADA receptors in kidney and causes nephrogenic DI Domicocycline Side Effects of Tetracyclines GI Upset Pill Esophagitis Photosensitivity Fanconi syndrome Binds Ca2+ in GI Incr. P450 Turns teeth Gray MOA of Pyramycin Inhibits the A site of the 50s subunit MOA of Chloramphenicol Inbibits the 50s subunit by inhibiting Peptidyl-Transferace Coverage of Chloramphenicol Gm(+) + Staph Aureus Ricketsial Infections Side Effects of Chloramphenicol Gray baby Syndrome Aplastic Anemia How does Chloramphenicol Cause gray baby syndrome? They Inhibit ETC Complex IV MOA of Aminoglycosides Inhibits the 30s subunit by inhibiting EF2 Coverage for Aminoglycosides ALL Gram negatives How do Aminoglycosides cause neurotoxicity? They Inhibit the presynaptic influx of Calcium Name the Aminoglycosides GASS Toll No Kash G Gentamycin A Amikacin S Streptomycin S - Spectinomycin T Tobramycin N Neomycin K Kentamycin Aminoglycoside that is hepaticaaly excreted Amikacin Aminoglycosides used in triple antibiotic Neomycin

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Polymixin B Bacitracin

Aminoglycoside with the most side effects Gentamycin Aminoglycoside used to treat TB Streptomycin Side effects of Aminoglycosides Ototoxicity Nephrotoxicity Neurotoxicity How do Aminoglycosides cause neurotoxicity? They Inhibit the presynaptic influx of Calcium Causes of dysgusia Zn2+ deficiency Metronidazole Macrolides Which drugs cause Nephrogenic DI Lithium Damicocycline Which part of the triple anti-biotic ointment is responsible for a rash? Neomycin MOA of Vancomycin Inhibits cell wall synthesis by inhibiting the Phospholipid carrier Coverage for Vancomycin GM(+) + Staph Aureus Enterococcus Staph epidermidis Side Effects of Vancomycin Ototoxic Nephrotoxic Red man Syndrome Why does Vancomycin cause Redman syndrome? Infusion is too fast and causes histamine release MOA of Metronidazole (Flagyl) Causes release of free radicals Coverage for Metronidazole All Anaerobes Gardnerella Protozoa Side effects of Metronidazole Dysgusia Disulfram Reaction

G6PD Methemoglobinemia Hemolytic Anemia Big mama drugs for anaerobes Metronidazole Clindamycin Cefoxatin How do sulfa drugs work? They inhibit PABA 5 Sulfa drugs Sulfamethoxazole Sulfadiazine Sulfapyrizone Sulfaqsalazine Sulfacetmide (2) drug used with Sulfa drugs that block Dihydrofolate reductase? Trimethaprim Pyrimethamine Coverage of sulfadrugs Gm(+) + Staph aureus Simple Gm(-) Treatment for PCP and UTIs Sulfamethoxazole/Trimethoprim Sulfa drugs used to treat burn patients Sulfadiazine (silvadine) Sulfa drugs used to treat Toxoplasmosis Sulfadiazine/Pyrimethamine Sulfa drug that comes in an eye drop Sulfacetamide 3 Sulfa drug used to treat ulcerative colitis Sulfapyrizone Sulfasalazine Silfacetamide MOA of Penecillins Cell Wall inhibitors by inhibiting transpeptidation Coverae for ALL Penecillins Gm(+) not Staph Aureus ALL Simple Anaerobes Side effects of Penecillins Anaphylaxis Drug rash Interstitial Nephritis Hemolytic Anemia Differentiate between the 2 simple Penecillins

PEN V - PO PENG - IV Two Extended spectrum Penecillins Amoxacillin Ampicillin What coverage do the extended spectrum PCNs add? Simple Gm(-) coverage What is added to the simple PCNs to cover Staph Aureus? Amoxacillin/Clauvulinic Acid Ampicillin/Sulbactam Extended spectrum Penecillins which causes Jarisch-Herxeheimer reaction? Ampicillin What infections are the most common causes of Jarisch-Herxeheimer reaction? EBV CMV Syphilis Drug of choice for UTI inpregnant women Ampicillin/sulbactam MC used in pediactrics Amoxacillin (pink stuff) 5 Anti-Staph PCNs (Beta Lactamase resistant) Metahcillin Nafcillin Oxacillin Cloxacillin Dicloxacillin MCC of Interstitial Nephritis #1 Methacillin #2 Ampicillin 3 PO Anti-Staph PCNs Oxacillin Cloxacillin Dicloxacillin IV Anti-Staph PCN Nafcillin Anti-Staph PCN with a high Sodium load Nafcillin 5 Anti-Pseudomonal PCNs Pipercillin Ticarcillin Azocillin

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Mezocillin Carbenicillin

Cefalosporin with the best CNS penetration Ceftriaxone Hepatically excreted Cefalosporin Ceftriaxone First line for Meningitis > 2 month old Ceftriaxone First line for Meningitis < 2 month old Cefotaxime First line for Pseudomonas Ceftazidine Four Cefalosporins with MTT side chains Cefotetan Cefomandol Cefaperazone Moxalactam What does the MTT chain do? Inhibits Vitamin K Only oral 3rd generation Cefalosporin Cefixeme Drugs that cause a disulfram reaction Cefotetan Cefomandol Metronidazole Cefalosporin with the highest allergic reaction in Pediatrics Cefaclor MOA Of Benzodiazapines Increase GABA channel Frequency Indication for Benzodiazepines Anxiety Insomnia Seizure Muscle Cramps What is the cause of death for Benzos and Barbituates? Respiratory Failure Which Anxiolytinc is used for people who cannot be sedated? Bupropion Name (10) Benzodiazepines Floureapam Zolpiden Oxazepam Triazelam Tomazepam Diazepam

Anti-Pseudomonal PCN with a high sodium load Carbenicillin What drug are added to the AntiPseudomonal PCNs to cover staph Pipercillin/Tazobactam Ticarcillin/Clauvulnic Acid MOA of Cefalosporins Cell Wall inhibitors by inhibiting transpeptidation Coverage of Cefalosporins Gm(+) + Staph Aureus Simple Gm(-) 1st generation Cephalosporin that is parenteral Cefazolin 1st generation Cephalosporin that is the #1 cause of Interstitial Nephritis Cephalotin Name 5 1st generation Cephalospoirins Cefazolin Cefalotin Cefalexin Cefadoxil Cefadroxil Name 5 2 generation Cephalospoirins Cefaclor Cefotetan Cefomandol Cefuroxime Cefoxatin Name 6 3rd generation Cephalospoirins Ceftriaxone Cefixime Cefotaxime Ceftazidine Cefperazome Maxalactam Most commonly used Cefalosporin in children Cefaclor Cefalosporin used to treat H. Influenza B Cefuroxime Cefalosporin used to treat Anaerobes Cefoxatin
nd

Lorazepam Clonezapam Chlordiazepoxide Midazolam Shortest Acting Benzo Florezepam Longest Acting Benzo Zolpidem Medium duration Benzo Oxazepam Triazelam Benzo used for elderly who have trouble initiating sleep Triazelam Benzo used with 20 minutes antegrade amnesia Triazelam Benzo used for people who have difficulty maintaining sleep Tomazepam (4) Benzos MC used for Seizures Diazepam Lorazepam Clonazepam Chlordiazepoxide (2) Benzos MC used for Status Epilepticus Diazepam Lorazepam Benzo MC used for Absance Seizures in children Clonazepam Benzo MC used for restless leg syndrome Clonazepam Benzo that comes in sopository Diazepam Benzo that is best for anxiety in middle aged females Lorazepam Benzo MC used for Alcoholic withdrawal Chlordiazepoxide Benzo used for short procedures Midazelam Benzo with 45min antegrade amnesia Midazelam Antedote for Benzo Overdose Flumazenil

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MOA of Barbituates Increase GABA channel Duration Indication for Barbituates Insomnia Seizure Muscle Cramps Why are Barbituates not indicated for Anxiety Because they are too sedating Longest acting barbituate Phenobarbital Shortest acting Barbituate Thiopental Barbituate most commonly abused on the street Secobarbital Treatment for Barbituate Overdose HCO3- + Doxapram Barbituate most commonly used for generalized seizures on children Phenobarbital 3 drugs used to treat Bipolar #1 Lithium #2 Valproic Acid #3 Carbamazapine MOA of lithium Looks like Sodium and stabilizes cell membranes Side effects of Lithium Hyponatremia Hypothyroidism Hyperthyroidism Hypercalcemia Hypophosphatemia Nephrogenic DI Epsteins Anomoly How does Lithium cause Nephrogenic DI? It inhibits ADH receptors are the kidney How does Lithium cause Hyponatremia? Because it looks like Sodium, the kidney hold onto it instead of Sodium How does Lithium cause hypothyroidism? How does Lithium cause How does Lithium cause hypercalcemia? It binds to PTH receptors

MOA of Carbamazapine Sodium Channel Blocker Side effects of Carbamazepine Agranulocytosis SIADH Indication for Carbamazepine Temporal Lobe Seizures 3rd Line for Bipolar Disorber Shooting Neuropthy How does Carbamazapine cause SIADH It stimulates the ADH receptors in kidney MOA of Valproic Acid Indication for Valproic Acid 2nd Line for Bipolar 1st Line for Myotonic Seizures 1st Line for Mixed Seizures Side Effects of Valproic Acid BM Suppression What is the main cause of depression Serotonin Norepinepherine MOA of Tri-Cyclic Anti-depressants Blocks reuptake of ALL Catecholamines Strong Anti-Cholinergic affects Block 1 receptors by accident Block A-V conduction in heart Clue for Anti-Cholinergic effects Sympathetic with Hot Dry Skin Name (5) TCAs C - Clomipramine A - Amitryptaline N - Nortryptaline D - Desipramine I - Imipramine TCA used for bedwetting in children Imipramine TCA used for Chronic Pain or neuropathy Amitryptaline TCA used for OCD Clomipramine Shortest acting TACs Nortryptaline Desipramine

MOA of SSRIs Inhibit the reuptake of Serotonin

Name (4) SSRIs F - Fluoxetine L Luvoxatine i P - Paroxatine S Sertraline Side effects of SSRIs Anorgasmia Name (4) MAOIs P - Phenylzine I - Isocarboxazid T - Tranylcypramine S - Selegeline Foods avoided when on MAOIs Wine and Cheese Wine & cheese contraindicated with MAOIs because The interaction can cause Seratonin Syndrome When switching from SSRI to MAOI, how long is the washout period? One Month Name the MAOBI Selegeline MOA of Bupropion Blocks reuptake of Seratonin Indication for Bupropion Used if sexual dysfunction occurs with other antidepressants Help stop smoking Side effects of Bupropion Decreased Seizure threshold Indications for Electroconvulsive Therapy Person who is actively suicidal or with intractable depression #1 Side effect of ECT Amnesia Treatment for Methemoglobinemia Methyline Blue Rx for Acute intermittent Porphorya Sugar Fluids Hematin

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How does Hematin Work? It inhibits D-ALA Synthase Treatment for Cyanide Poisoning Amylnitrate Sodium Thiosulphate Methyline Blue Transfusion Rx for Carbon Monoxide Poisoning Hyperbaric Oxygen Rx used for the Used for the Cystic Fibrosis sweat test & to Treat glaucoma Pilocarpine For what was Methacholine Previously used? To diagnose Asthma because is Causes Broncho spasm How do Amphetamines work? They cause the release of preformed catecholamines.

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