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PASS Pharm Drills

What is the MOA of Aztreonam?


What is the c/u for Imipenem/Cilastatin?
What is the MOA of Vancomycin?
What are the peptidoglycan synthesis Inhibitors?
What is the c/u for Vancomycin?
Vancomycin is the TX for Pseudomembranous Colitis secondary
to what?
Why is Vancomycin used for nosocomial infections?
What is the TX for VRSA?
What are the Streptogramins?
What is the MOA of Linezolid?
What is the MOA of Streptogramins?
What is the TX for linezolid-Resistent Staph Aureus?
What is the toxicity of Vancomycin?
What are the Ototoxic-causing drugs?
What is the MOA of AMG's?
What is the toxicity of AMG's?
What is the c/u of AMG's?
For what are AMG's used 1st line?
What is the order of TX for Pseudomonas?

What is the c/u of Aztreonam?


Why is Aztreonam used in pt's with Renal Failure?
MOA of Tetracyclines?
What is the function of amino acyl tRNA?
Why does tRNA need to be charged?
What is the c/u for Tetracyclines?

What are the anti-Staph Penicillins?


What are the anti-Pseudomonas Penicillins?

What is the order of TX for Pseudomonas?

What is the c/u of Ampicillin/Amoxicillin?

AzTHREEonam*Binds to PBP #3
DOC for Enterobacter
Inhibition of D-ala D-ala*t/f it can't make peptidoglycan
Bacitracin*Vancomycin*Cycloserine
MRSA*Pseudomembranous Colitis (Vanco & Metro)*Any
nosocomial infection
C. Difficile
Nosocomial is defined as any infection that is picked up while
hospitalized; it is t/f assumed that it is probably drug-resistent
Linezolid*Streptogramins
Dalfopristin*Quinopristin
Inhibition of 50s
Inhibition of 50s
Call the clergyman to pray for the pt b/c there is nothing else
There is NOT toxicity*Neurotoxic*Ototoxic*Thrombophlebitis
AMG's*Loops
(Furosemide)*Vancomycin*Quinidine*Chloroquine
Inhibits initiation complex of N-acetyl formation causing
misreading of mRNA
There is NNO toxicity*Neurotoxic
(teratogenic)*Nephrotoxic*Ototoxic
G- Rods
Pseudomonas infections
1. AMG's (1st line for any G- rod)*2. 3rd Gen Cephalosporins
(i.e. Ceftazidime)*3 4th Gen Pen's (i.e. Anti-Pseudomona
Penicillins)
G- rods in pt's who cannot tolerate AMG's*OR*Pt's allergic to
Penicillin*OR*Pt's with Renal Failure
AMG's are Nephrotoxic
Protein synthesis inhibition by preventing amino acyl tRNA
attachment
It charges the tRNA molecule
Charging provides energy to pick up the next nucleotide
VACUuM The BR*Vibrio Cholerea*Acne (Propionibacterium
Acnes)*Chlamydia*Ureaplasma
Urealyticum*Mycoplasm*Tularemia*H.
Pylori*Borrelia *Rickettsia
CONDM*Cloxacillin*Oxacillin*Nafcillin*Dicloxacillin*Methicilli
n*(Anti-Staph Pen's = 2nd Gen Pen's)
PTC of Pseudomonas in the
AM*Piperacillin*Ticarcillin*Carbenicillin*Azlocillin*Mezlocillin*(
Anti-Pseudomonas = 4th Gen Pen's)
1) AMG's (1st line for any G- rod)*2) 3rd Gen Cephalosporins
(i.e. Ceftazidime)*3) 4th Gen Pen's (i.e. Anti-Pseudomona
Penicillins)
HELPS Enterococci*H. Influenza*E.
Coli*Listeria*Proteus*Salmonella*Enterococci*(Ampicillin/Amo
xicillin = 3rd Gen Pen's)

What is co-administered with Ampicillin/Amoxicillin?


What is the MOA of clavulonic acid?
What are the anti-Penicillinase's?

What are the Penicillinase/B-Lactamase inhibitors?


What is the c/u for the Penicillinase/B-Lactamase inhibitiors?
What does Ampicillin/Amoxicillin toxicity cause?
Which antibiotics cause Pseudomembranous Colitis?
What is the TX for Pseudomembranous Colitis?
What are the 50s Inhibitors?

What are some 1st Gen Cephalosporins?

What is the c/u for 1st Gen Cephalosporins?


What are the G+ cocci?
What are some 2nd Gen Cephalosporins?

What is the c/u for 2nd Gen Cephalosporins?

What are some 3rd Gen Cephalosporins?


What is a 3rd Gen Ceph used to TX Pseudomona?
What is a 3rd Gen Cephs used to TX Gonorrhea?
What are the Cephalosporins that TX Gonorrhea?
What is the one-dose TX for Chlamydia?
What are the Cephalosporins that cause a Disulfram-like reaction
with Etoh?
What are some 4th Gen Cephalosporins?
What are the peptidoglycan synthesis Inhibitors?
What are the 50s Inhibitors?

What are the Macrolides?


What are the Streptogramins?
What are the 30s Inhibitors?
What are the AMG's?
What are the Nucleotide Synthesis Inhibitors?
What is the MOA of Sulfonamides?
What is the MOA of Trimethoprim?
What is the MOA of Pyrimethamine?
What drugs inhibit DHF Reductase?

Clavulonic Acid
Inhibition of Penicillinase
1) 2nd Gen Pen's (Anti-Staph Pen's):
*CONDM*Cloxacillin*Oxacilllin*Nafcillin*Dicloxacillin*Methici
llin**2) 3rd Gen Pen's: Ampicillin/Amoxicillin w/Clavulonic
Acid**3) All Cephalosporin
AIM*Aztreonam*Imipenem/Cilastatin*Meropenem
G- Rods
Hypersensitivity*Ampicillin rash*Pseudomembranous colitis
Ampicillin/Amoxicillin*Clindamycin
Metronidazole*Vancomycin
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin (i.e.
Macrolides)*Lincomycin*Linezolid*Streptogramins
Cephalosporin that begin with Cefa- or Cephaprefixes*Cefazolin*Cephalexin**Exception: Only a few 1st Gen
Cephs do not start w/one of these 2 prefixes*Exception:
Cefaclor & Cefamandole are 2nd Gen Cephalosporins
PEcK (c = cocci)*Proteus*E. Coli*Klebsiella*G+ cocci
Staphyloccoci*Streptococci
A FAMily of FOXes has FURry TETs*Cefamandole (exception
to 1st Gen Cephalosporins
rule)*Cefoxitin*Cefuroxime*Cefotetan*Cefaclor (exception to
1st Gen Cephalosporins rule)
HEN PEcKS (c = cocci)*H.
Influenza*Enterobacter*Neisseria*Proteus*E.
Coli*Klebsiella*Serratia*G+ cocci
Cefixime*Ceftriaxone*Ceftazidime*Cefotaxime*Cefeparazone
Ceftazidime
Ceftriaxone & Cefixime
TRI to FIX a FOX*Ceftriaxone (3rd Gen)*Cefixime (3rd
Gen)*Cefoxitin (2nd Gen)
Azithromycin
PAIR of FAMily TETS (tits)*Cefeparazone (3rd
gen)*Cefamandole (2nd gen)*Cefotetan (2nd gen)
Cefipime
Bacitracin*Vancomycin*Cycloserine
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin (i.e.
Macrolides)*Lincomycin*Linezolid*Streptogramins
ACE*Azithromycin*Clarithromycin*Erythromycin
Dalfopristin*Quinopristin
AT (Buys AT 30 CCELLS at 50)*AMG's*Tetracyclines
STANG*Streptomycin*Tobramycin*Amikacin*Neomycin*Gent
amicin
Sulfonamides*Trimethoprim*Pyrimethamine*Methotrexate
Inhibition of Dihydropterate Synthase
Inhibition of Dihydrofolate Reductase
Inhibition of Dihydrofolate Reductase
Trimethoprim*Pyrimethamine*Methotrexate

What blocks DNA Topoisomerase II?


What blocks DNA Gyrase?
What blocks mRNA Synthesis
Rifampin
How does Rifampin's MOA work?
What drugs bind bacterial & fungal membranes?

What drugs destroy fungal membranes?


What is the MOA of Penicillins?

What is the end-result of transpeptidase cross-linking?


What are the peptidoglycan synthesis Inhibitors?
What is the c/u of Penicillins?
What does Penicillin toxicity cause?
What does Methicillin toxicity cause?
What is the c/u for Methicillin?
What is used for MRSA?
If 75% of the drug is eliminated from the body, how many halflifes have occured?
How is half-life calculated?
How is Loading Dose calculated?
How is Maintenance Dose calculated?
What is the function of a Maintenance Dose?
3 Drugs that undergo 1st order elimination:
What direction does a noncompetitive antagonist shift the
potency curve (right, left, up, or down)?

What question is answered by Phase II drug development?


Which phase do we calculate Therapeutic Index?
How do we calculate Therapeutic Index?
What are the peptidoglycan synthesis inhibitor?
What are the 50s Inhibitors?

What are the Macrolides?


What are the Streptogramins?
What are the 30s Inhibitors?
What are the AMG's?
What are the Nucleotide Synthesis Inhibitors?
What is the MOA of Sulfonamides?
What is the MOA of Trimethoprim?
What is the MOA of Methotrexate?
What is the MOA of Pyromethamine?

Quinolones
Quinolones*(DNA Topoisomerase II & DNA Gyrase are the
same)

Inhibition of DNA-dependent RNA polymerase, thereby


blocking mRNA synthesis
Polymixins (Polymixin B & Polymixin E)**FA: Polymixins bind
to membranes and disrupt their osmotic properties; they mix up
membranes like a detergent.
Amphotericin B*Nystatin
1) Bind PBP's*2) Activate autolytic enzymes*3) Inhibits
transpeptidase cross-linking (does NOT block PG synthesis -->
Q #1)
Formation of peptide bonds between nucleotides
Bacitracin*Vancomycin*Cycloserine
G+ rods & cocci*G- cocci*Spirochetes*(Penicillins = 1st Gen
Pen's)
Hypersensitivity*Hemolytic anemia
Interstitial nephritis
Staph Aureus
Vancomycin
2 half-lifes
T1/2 = (Vd/Cl) x .7
LD = (Css x Vd) / f
MD = (Css x Cl) / f
To replace the amount of drug that has been eliminated
All drugs except:**EPA*Ethanol*Phenytoin*Asparin (high dose)
It doesn't: potency (Km) is not affected (the drug is just as potent
as before, but some receptors are turned off)*However, efficacy
(Vmax) is decreased and therefore the EFFICACY curve is
shifted downward
Does it work?
Phase II
TILE*TI = LD50 / ED50
Bacitracin*Vancomycin*Cycloserine
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin*Lincomycin*li
nezolid*Streptogramins
ACE*Azithromycin*Clarithromycin*Erythromycin
Dalfopristin*Quinopristin
AT (Buys AT 30 CCELLS at 50)*AMG's*Tetracyclines
STANG*Streptomycin*Tobramycin*Amikacin*Neomycin*Gent
amicin
Sulfonamides*Trimethoprim*Methotrexate*pyrimethamine
Inhibition of Dihydropterate Synthase
Inhibition of DHF Reductase
Inhibition of DHF Reductase
Inhibition of DHF Reductase

What Blocks Topoisomerase II?


What Blocks DNA Gyrase?
What inhibits mRNA synthesis?
How does Rifampin inhibit mRNA synthesis?
What is the c/u for Penicillins?
What is the toxicity of Penicillins?
What is the toxicity of Methicillin?
What is the c/u for Methicillin?
What are the anti-Staph Penicillins?
What are the anti-Pseudomonas Penicillins?

What is the c/u of Ampicillin/Amoxicillin?


What is the toxicitiy of Ampicillin/Amoxicillin?
What drugs cause Pseudomembranous Colitis?
What is the MOA of Clindamycin?
What is the c/u of Clindamycin?
What is the TX for Pseudomembranous Colitis secondary to C.
Difficile?
What is the MOA of Vancomycin?
What is the c/u for Vancomycin?
What is the c/u for 2nd Gen Cephalosporins?

What is a 3rd Gen Ceph used for the TX of Pseudomona?


What is a 3rd Gen Ceph used for the TX of Gonorrhea?
What are the Cephalosporins that TX Gonorrhea?
What is the one-dose TX for Chlamydia?
What are the Cephalosporins that cause a Disulfram-like reaction
with Etoh?
What are the anti-Penicillinase's?

What are the Penicillinase/B-Lactamase inhibitors?


How can any drug be altered to become Penicillinase-Resistent?
What is the MOA of Aztreonam?
What is the c/u of Aztreonam?
What pt's is Aztreonam used to TX?
With what is imipenem co-administered? Why?
What is the c/u of imipenem/cilistatin?
What are the Ototoxicity-causing drugs?

Quinilones
Quinilones
Rifampin
Inhibition of DNA-Dependent RNA Polymerase
G+ cocci & rods*G- cocci*Spirochetes
Hypersensitivity*Hemolytic anemia
Interstitial Nephritis
S. Aureus
CONDM*Cloxacillin*Oxacilllin*Nafcillin*Dicloxacillin*Methicill
in
PTC of Pseudomonas in the
AM*Piperacillin*Ticarcillin*Carbenicillin*Azlocillin*Mezlocillin*(
Anti-Pseudomonal Pen's = 4th Gen Pen's)
HELPS Enterococci*H. Influenza*E.
Coli*Listeria*Proteus*Salmonella*Enterococci
Hypersensitiity*Ampicillin rash*Pseudomembranous colitis
Ampicillin/Amoxicilin & Clindamycin
Inhibits peptide bond formation b/w nucleotides at the P site
Anaerobes above the diaphram
Vancomycin*Metronidazole
Inhibits D-ala D-ala (t/f can't make peptidoglycan)
MRSA*C. Difficile (Pseudomembranous Colitis)*Nosocomial
infections (presumeably drug-resistent infections)
HEN PEcKS (c = cocci)*H.
Influenza*Enterobacter*Neisseria*Proteus*E.
Coli*Klebsiella*Serratia*G+ cocci
Ceftazidime
Ceftriaxone & Cefixime
TRI to FIX a FOX*Ceftriaxone (3rd Gen)*Cefixime (3rd
Gen)*Cefoxitin (2nd Gen)
Azithromycin
PAIR of FAMily TETS (tits)*Cefeparazone (3rd
gen)*Cefamandole (2nd gen)*Cefotetan (2nd gen)
1) 2nd Gen Pen's (Anti-Staph Pen's):
*CONDM*Cloxacillin*Oxacilllin*Nafcillin*Dicloxacillin*Methici
llin**2) 3rd Gen Pen's: Ampicillin/Amoxicillin w/Clavulonic
Acid**3) All Cephalosporin
AIM*Aztreonam*Imipenem/Cilastatin*Meropenem
Add Clavulonic Acid
AzTHREEonam*Binds to PBP #3
G- Rods
Pt's who cannot tolerate AMG's (1st line for any G-)*OR*Pt's
who are allergic to Penicillin*OR*Pt's in Renal Failure
Cilistatin*Prevents breakdown of imipenem by inhibiting renal
dihydropeptidase-1
Enterobacter (DOC)
AMG's*Loops
(Furosemide)*Vancomycin*Quinidine*Chloroquine

What is the MOA of AMG's?


What is the MOA of Tetracyclines?
What is the MOA of Macrolides?
What is the MOA of Chloramphenicol?
What is the MOA of Clindamycin?
What is the c/u for Macrolides?

What is the clinical use for AMG's?


What drug is used if a pt cannot tolerate AMG's?
What is the c/u for Tetracyclines?

What is the toxicity of Tetracyclines?

What is the toxicity of Macrolides?


What is the MOA of Macrolides?
What are the Macrolides?
What is an alternative MOA of Erythromycin?
What class of drug is Demeclocycline?
What is the MOA of Tetracyclines?
What is the primary MOA of Demeclocycline?
What is an alternative MOA of Demeclocycline?
What drugs block ADH receptors?
What is the c/u for Chloramphenicol?
What is the MOA of Sulfonamides?
What else is Lamuvidine AKA? What class of drug is it?
What is the SE of any NRTI
Lactic Acidosis
What is the c/u of INF-beta?
What is the c/u of INF-gamma?
Summarize the functions of INF-a, INF-B, INF-gamma.
What is the MOA of Acyclovir?
What is the c/u of Acyclovir?
What are HSV I thru HSV VIII?

What is HSV III? What is the TX for HSV III?

Inhibits initiation complex of N-Acetyl formation causing


misreading of mRNA
Inhibition of tRNA charging by preventing attachement of
amino acyl tRNA, thereby inhibiting protein synthesis
Blocking translocation from the A --> P site by binding the 23s
subunit of the 50s ribosome
Inhibits Peptidyltransferase, the enzyme responsible for
transferring nucleotides from A --> P site
Inhibits peptide bond formation b/w nucleotides at the P site
UPS Lost My Brand New Car*URI's (caused by G+
cocci)*Pneumonia (caused by G+ cocci)*STD's (caused by G+
cocci)*Legionella*Mycoplasma*Bordatella*Neisseria*Chlamydia
Any G- rod
Aztreonam
VACUuM THe BR*Vibrio*Acne (Propionibacterium
Acnes)*Chlamydia*Ureaplasm
Urealytica*Mycoplasm*Tularemia*H. Pylori*Borrelia*Rickettsia
Discoloratio of teeth (kids)*Abnormal bone growth (kids) -->
teratogenic*Photosensitivity*Drug-induced pancreatitis*Fanconi
syndrome (old Tetracyclines)
Acute cholestatic hepetatis*Eosinophilia
Blocking translocation from the A --> P site by binding the 23s
subunit of the 50s ribosome
ACE*Azithromycin*Clarithromycin*Erythromycin
Binds to motilin receptors, causing hypermotility motility --> GI
upset
Tetracycline
Inhibition of tRNA charging by preventing attachement of
amino acyl tRNA
Prevents attachment of amino acyl tRNA
Blocks ADH receptors
Demeclocycline*Lithium
Bacterial meningitis
Inhibition of Dihydropterate Synthase
Lamivudine or 3CT is an NRTI

MS
CGD (NADPH oxidase deficiency)
INF-alpha: Hep B & Hep C (ABC --> aBC or alpha B C)*INFB: MS*INF-gamma: CGD
Inhibition of viral DNA polymerase when phosporylated by the
VIRAL thymidine kinase
Any HSV except HSV III and HSV V
HSV I = Oral herpes*HSV II = Genital herpes*HSV III =
VZV*HSV IV = EBV*HSV V = CMV*HSV VI =
Roseola*HSV VII = Pyteriasis Rosie*HSV VIII = Kaposi's
Sarcoma
HSV III = VZV**Little VALerie and the whole FAMily*Chicken
Pox Tx = Valcyclovir*Herpes Zoster Tx = Famciclovir

What is HSV V? What is the TX for HSV V?


What is the MOA of Ganciclovir?
What is the MOA of Foscarnet?
What is the DOC for CMV Retinitis?
What are the viral protease inhibitors?

What is the specific MOA of the viral protease inhibitors?


What is the SE of Indinavir?
What are the NNRTI's?
What is the toxicity of NNRTI's?
What is the SE of Nevirapine?
What are all of the NRTI's and their 3-letter acronyms?

What are the SE's of the NRTI's?

What is the MOA of Enfurvitide?


What is the TX for African Trypanosomiasis (aka African
Sleeping Sickness)?
What is the TX for Chagas?
What is the TX for PCP?

What is the MOA of Clindamycin?


What drugs INHIBIT Fungal DNA SYNTHESIS?
What drugs INHIBIT Fungal MEMBRANE SYNTHESIS?

What drugs DESTROY fungal MEMBRANES?


What is the c/u for Amphotericin B? Under what conditions?
What is the c/u for Azoles? Under what conditions?
What is the c/u for Nystatin?
What is the specific MOA for Flucytosine?
What is the c/u for Flucytosine?
What is the MOA of Caspofungin?
What is the c/u for Caspofungin?
What is the MOA of Terbinafine?
What is the c/u of Terbinafine?

HSV V = CMV**CMV is sooo large it takes a GANG to fight


it*Tx with Ganciclovir or Foscarnet
Inhibits CMV viral DNA polymerase when phosphorylated by
VIRAL thymidine kinase
Binds to pyrophosphate binding site;*Does NOT REQUIRE
phosphorylation by VIRAL thymidine kinase
Ganciclovir followed by Foscarnet
SIR AN (NAVIR separate a
protease)*Saquinavir*Indinavir*Rotinavir*Amprenavir*Nelfinavi
r
NAVIR separate a protease*Inhibition of aspartate protease
Crystal-induced Nephropathy*Thrombocytopenia
Nevada/Deleware/E-Fuck Virus or NEVIR Efir (ever) DELiver
nucleosides*Nevirapine*Delavirdine*Efavirenz
SJS
SJS*Hepatotoxicity
AZT/ZDV --> Ziduvidine*DDI --> Didanosine*DDC -->
Zalcytobine*3TC --> Lamuvidine*D4T --> Stavudine*ABC -->
Abacavir
All NRTI's: Lactic acidosis**Ziduvidine (AZT/ZDV)*--Aplastic
anemia*--Megaloblastic anemia*Didanosine (DDI)*--Druginduced pancreatitis*Zalcytobine (DDC):*--SJS*--Peripheral
neuropathy*Lamuvidine (3TC)*--only lactic acidosis*Stavudine
(D4T)*--Peripheral neuropathy*Abacavir (ABC)*-Hypersensitivity syndrome
Binds to GP41 & prevents VIRAL & CELLULAR membrane
fusion
Suramin
Nifurtimox
PCP is one BAD-ass bug*1st: B = Bactrim (TMP/SMX)*2nd: A
= Aerosolized Pentamidine*3rd: D = Dapsone**NOTE: PCP =
PneumoCystis Pneumonia *BUG: Pneumocystis Jiroveci
(formerly Pneumocystis Carinii)
Inhibits peptide bond formation
Flucytosine*Griseofulvin (interfers with microtubule formation
thereby inhibiting mitosis)
CAT*Caspofungin (inhibits synthesis of Beta-13-DeltaGlucan)*Azoles (inhibit the final step in ergosterol
synthesis)*Terbinafine (inhibits ergosterol synthesis by blocking
the enzyme squalene epoxidase)
Amphotericin B*Nystatin
Systemic fungal infections*Severe sepsis ( > 103 F)
Systemic fungal infections that are neither severe nor septic*All
topical fungal infections
Oral Candidiasis*Topical
Changes uracil to fluro-uracil
Any systemic fungal infection
Inhibits Beta-13 Delta-Glucan
CASPofungin*ASPergillosis (invasive)*Systemic Candidiasis
Inhibits cell wall synthesis by blocking squaline epoxidase
Superficial fungal infections*Dermatophytes

What is another drug that has the same c/u's as Terbinafine?


What is the MOA of Griseofulvin?
What is the general division of fungal drugs by c/u? Which drugs
fall under each division?

What is the MOA of Amantidine?


What is the c/u for Amantidine?
What is the TX for Influenza B?
What is the MOA of Oseltamivir/Zanamivir?
What is the TX for Influenza C?

What is the MOA of Ribavirin?


What is the c/u of Ribavirin?
What is the TX for chronic Hepatitis C?
What is the TX for Hepatitis B?
If 75% of a drug remains in the body, how many half-lifes have
occurred?
If 90% of the drug is eliminated from the body, how many halflifes have occured?
How is half-life calculated?
How is Maintenance Dose calculated?
3 Drugs that undergo 1st order elimination:
Which phase do we calculate Therapeutic Index?
How do we calculate Therapeutic Index?
What direction does a competitive antagonist shift the efficacy
curve (right, left, up, or down)?
What direction does a noncompetitive antagonist shift the
potency curve (right, left, up, or down)?

What are the 50s Inhibitors?

What are the Nucleotide Synthesis Inhibitors?


What is drug inhibits Topoisomerase II/DNA Gyrase?
What is the c/u for 2nd Gen Cephalosporins?

Griseofulvin
Binds microtubules, arresting the cell in mitosis
Severe &/or septic SYSTEMIC fungal infections:*-Amphotericin B*SYSTEMIC fungal infections:*--Azoles*-Flucytosine*--Caspofungin*TOPICAL fungal infections --> *
Topical TANG*--Terbinafine*--Azoles*--Nystatin*-Griseofulvin
Prevents viral uncoating*Prevents viral penetration*Increases
DA
Influenza A, RubellA & the CerebellA*Influenza
A*RubellA*Parkinson's (the CerebellA)
Oseltamivir*Zanamivir
Inhibits viral influenza neuraminidase, decreasing the release of
viral progeny
Acetaminophen**Full Name: N-Acetyl-Para-Aminophenol
(APAP)*Other Names: Tylenol (U.S.)*Paracetamol (outside
North America)
Inhibits Guanine nucleotide synthesis by competitively inhibiting
IMP Dehydrogenase
Chronic Hepatitis C*RSV
Ribavirin*INF-alpha
INF-alpha*Lamuvidine
< 1 half-life
3.3 half-lifes
T1/2 = (Vd/Cl) x .7
MD = (Css x Cl) / f
All drugs except:**EPA*Ethanol*Phenytoin*Asparin (high dose)
Phase II
TILE*TI = LD50 / ED50
It doesn't: efficacy (Vmax) is not affected*However, potency is
decreased (Km is increased) and therefore the POTENCY curve
is shifted to the right
It doesn't: potency (Km) is not affected (the drug is just as potent
as before, but some receptors are turned off)*However, efficacy
(Vmax) is decreased and therefore the EFFICACY curve is
shifted downward
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin (i.e.
Macrolides)*Lincomycin*Linezolid*Streptogramins
Sulfonamides*Trimethoprim*Methotrexate*Pyrimethamine
Quinolones
HEN PEcKS (c = cocci)*H.
Influenza*Enterobacter*Neisseria*Proteus*E.
Coli*Klebsiella*Serratia*G+ cocci

What is a 3rd Gen Ceph used for the TX of Pseudomona?


What is the c/u of imipenem/cilistatin?
What pt's is Azitreonam used to TX?

Ceftazidime
Enterobacter
Pt's who cannot tolerate AMG's*OR*Pt's who are allergic to
Penicillin*OR*Pt's in Renal Failure

What is the c/u for AMG's?

Any G- rod

What is the c/u for Tetracyclines?

What is the c/u for Macrolides?

What is the c/u of Chloramphenicol?


What is the c/u of Clindamycin?
What is the MOA of AMG's?
What is the MOA of Tetracyclines?
What is an alternative MOA of Demeclocycline?
What is the MOA of Aztreonam?
What is the MOA of Chloramphenicol?
What are the peptidoglycan synthesis Inhibitors?
What are the 50s Inhibitors?

What are the Streptogramins?


What are the 30s Inhibitors?
What drug blocks Topoisomerase II/DNA Gyrase?
What are the Nucleotide Synthesis Inhibitors?
What drug inhibits mRNA synthesis?
What is the MOA of Rifampin
Blocking mRNA synthesis by inhibiting DNA-Dependent RNA
Polymerase
What is the MOA of Penicillins?
What is the c/u of Ampicillin/Amoxicillin?
What is the c/u of methicillin?
What are the anti-Staph Penicillins?
What are the anti-Pseudomonas Penicillins?
What is the TX for local impetigo?
What is the c/u for 2nd Gen Cephalosporins?

What is a 3rd Gen Cephs used to TX Gonorrhea?


What are the Cephalosporins that TX Gonorrhea?
What is the one-dose TX for Chlamydia?
What is the MOA of Azithromycin?
What is the c/u for Azithromycin?

What is the toxicity of Azithromycin?


What is an alternative MOA for Erythromycin?

VACUuM THe BR*Vibrio*Acne (Propionibacterium


Acnes)*Chlamydia*Ureaplasm
Urealytica*Mycoplasm*Tularemia*H. Pylori*Borrelia*Rickettsia
UPS Lost My Brand New Car*URI's (caused by G+
cocci)*Pneumonia (caused by G+ cocci)*STD's (caused by G+
cocci)*Legionella*Mycoplasma*Bordatella*Neisseria*Chlamydia
Bacterial Meningitis
Anaerobes above the diaphram
Inhibits initiation complex at 30S causing misreading of mRNA
Inhibition of tRNA charging by preventing attachement of
amino acyl tRNA
Blocks ADH receptors
AzTHREEonam*Binds to PBP #3
Inhibits Peptidyltransferase, the enzyme responsible for
transferring nucleotides from A --> P site
Bacitracin*Vancomycin*Cycloserine
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin (i.e.
Macrolides)*Lincomycin*Linezolid*Streptogramins
Dalfopristin*Quinopristin
AT (Buys AT 30 CCELLS at 50)*AMG's*Tetracyclines
Fluoroquinolones
Sulfonamides*Trimethoprim*Methotrexate*Pyrimethamine
Rifampin

1. Bind PBP's*2. Activate autolytic enzymes*3. Inhibits


transpeptidase cross-linking
HELPS Enterococci*H. Influenza*E.
Coli*Listeria*Proteus*Salmonella*Enterococci
Staph Aureus
CONDM*Cloxacillin*Oxacillin*Nafcillin*Dicloxacillin*Methicilli
n
PTC of Pseudomonas in the
AM*Piperacillin*Ticarcillin*Carbenicillin*Azlocillin*Mezlocillin
Topical Mupirocin*Oral Erythromycin
HEN PEcKS (c = cocci)*H.
Influenza*Enterobacter*Neisseria*Proteus*E.
Coli*Klebsiella*Serratia*G+ cocci
Ceftriaxone & Cefixime
TRI to FIX a FOX*Ceftriaxone (3rd Gen)*Cefixime (3rd
Gen)*Cefoxitin (2nd Gen)
Azithromycin
Blocking translocation from the A --> P site by binding the 23s
subunit of the 50s ribosome
UPS Lost My Brand New Car*URI's (caused by G+
cocci)*Pneumonia (caused by G+ cocci)*STD's (caused by G+
cocci)*Legionella*Mycoplasma*Bordatella*Neisseria*Chlamydia
Acute cholestatic hepetatis*Eosinophilia
Binds motilin receptors, causing hypermotility of the gut

What is the primary and alternative MOA of Demeclocycline?


What drugs block ADH receptors?
What is the c/u for Demeclocycline?

What is the toxicity of Demeclocycline?

What are all of the NRTI's, their 3-letter acronyms, and SE's?

What is the SE of Neveripine?


What HIV drug causes Thrombocytopenia?
What is the Toxicity of Indinavir?
What is the MOA of Indinavir?
Name all aspartate protease inhibitors?

What is the MOA of Enfurvitide?


What is the TX for African Trypanosomiasis (aka African
Sleeping Sickness)?
What is the TX for Chagas?
What is the TX for PCP?

What is the c/u of Metronidazole?

What is the toxicity of Metronidazole?


What is the TX for bacterial vaginosis for pregnant pt's?
What is the TX for latent Hypnozytes (ovale & vivax) ?
How do you TX a patient with Malaria who has just returned
from Libya?
What is meant by Indian Subcontinent?

What is meant by Subsahara?

Inhibition of protein sysnthesis by preventing amino acyl tRNA


attachment*Inhibition of ADH receptors
Demeclocycline*Lithium
VACUuM THe BR (Demeclocycline =
Tetracycline)*Vibrio*Acne (Propionibacterium
Acnes)*Chlamydia*Ureaplasm
Urealytica*Mycoplasm*Tularemia*H. Pylori*Borrelia*Rickettsia
Discoloratio of teeth (kids)*Abnormal bone growth (kids) -->
teratogenic*Photosensitivity*Drug-induced pancreatitis*Fanconi
syndrome (old Tetracyclines)
All NRTI's: Lactic acidosis**Ziduvidine (AZT/ZDV)*--Aplastic
anemia*--Megaloblastic anemia*Didanosine (DDI)*--Druginduced pancreatitis*Zalcytobine (DDC):*--SJS*--Peripheral
neuropathy*Lamuvidine (3TC)*--only lactic acidosis*Stavudine
(D4T)*--Peripheral neuropathy*Abacavir (ABC)*-Hypersensitivity syndrome
Hepatotoxicity
Indinavir
Crystal-induced nephropathy*Thrombocytopenia
Inhibiton of aspartate protease
SIR AN (NAVIR separate a
protease)*Saquinavir*Indinavir*Rotinavir*Amprenavir*Nelfinavi
r
Binds to GP41 & prevents VIRAL & CELLULAR membrane
fusion
Suramin
Nifurtimox
PCP is one BAD-ass bug*1st: B = Bactrim (TMP/SMX)*2nd: A
= Aerosolized Pentamidine*3rd: D = Dapsone**NOTE: PCP =
PneumoCystis Pneumonia *BUG: Pneumocystis Jiroveci
(formerly Pneumocystis Carinii)
GET
GAP*Giardia*Entamoeba*Trichamona*Gardnerella*Anaerobes*
H. Pylori
Disulfram-like reaction with alcohol*Dysguzia*Drug-induced
pancreatitis*Teratogenic
Metro cream*Clindamycin cream
Primaquine for latent vivax & ovale (otherwise TX =
Chloroquine)
Chloraquine (Libya is above the Sahara Desert)**Note: Malaria
from the indian subcontinent/subsahara is assumed to be
resistent to Chloraquine & therefore, Methloquin is used instead
Source = Wikipedia*Indian Subcontinent aka South
Asia*Typically includes: Sometimes Includes:*India*
Afganastan*Pakistan Myanmur (formerly Burma)*Bangladesh
Tibet*Sri Lanka*Nepal*Bhutan*Maldives***New Dehli is the
capital of the Republic of India
Source = Wikipedia*Subsahara or Southern Africa aka Black
Africa includes:*Nubia (formerly Sudan and
Ethiopia)*Zimbabwe*Mozambique*Botswana*Kenya*Uganda*T
anzania*Sahul* ***Sahul runs from the west coast to the east
coast, forming the transition from N. Africa to Subsaharan
Africa; Sahul includes: Mali, Niger, Chad, & Sudan

What is the TX for Leishmaniasis ?


What is the TX for Diphyllobothrium Latum?
What is the TX for Schistosoma Mansoni?
What is the TX for Ascaris Lumbricoides?
What is the TX for Necator Americanis?
What is the TX for Nematodes?
What is the TX for Onchocerca (River Blindness)?
What is the drug that inhibits the conversion of Acetyl CoA to
ACh?
What drug inhibits the release of ACh?
What drug inhibits the uptake of choline?
What drug inhibits the conversion of DA to NE?
What drug inhibits the release of NE?
What drug stimulates the release of NE?

Pentavir Antimony*Na+ Stipigluconate


Niclosemide
Praziquental
Pyrantal Pamoate
Pyrantal Pamoate followed by Mebendazole
Mebendazole
Ivermectin
Vesimicol

What drug inhibits the re-uptake of NE?


What receptor stimulates NE release?
What receptor inhibits NE release?
What is the MOA of Epinephrine?
What is the MOA of NE?

Cocaine*TCA's
Angiotensin II
M1 & a2
B1 > B2 > a1 > a2
a1/a2 > B1**Note: on day 4 he said a1/a2 > B2, however, on
days 10 & 11 he said a1/a2 > B1
B1 = B2
Dobutamine has a B*B1 > B2
DA has a D*D1 = D2 > B > a
Stimulates release of stored Catecholamines (i.e. NE)
a1 > a2
B2 > B1
Centrally acting a-agonist decreases central adrenergic outflow
D1 agonist
Phenoxybenzamine*Phentolamine
Phenoxybenzine is irreversible (both words have more
letters)*Phentolamine is reversible (both words have less letters)
Pheochromacytoma
Orthostatic Hypotension*Reflex Tachycardia
Prazosin*Terazosin*Doxazosin
Tamsulosin (less SE's than a1-blockers)
Does it work?
TILE*TI = LD50 / ED50
GAS (you get flatualance when you have to go
#2)*Glucoronidation*Acetylation*Sulfonation
It doesn't: potency (Km) is not affected (the drug is just as potent
as before, but some receptors are turned off)*However, efficacy
(Vmax) is decreased and therefore the EFFICACY curve is
shifted downward
All NRTI's: Lactic acidosis**Ziduvidine (AZT/ZDV)*--Aplastic
anemia*--Megaloblastic anemia*Didanosine (DDI)*--Druginduced pancreatitis*Zalcytobine (DDC):*--SJS*--Peripheral
neuropathy*Lamuvidine (3TC)*--only lactic acidosis*Stavudine
(D4T)*--Peripheral neuropathy*Abacavir (ABC)*-Hypersensitivity syndrome

What is the MOA of Isoproterenol?


What is the MOA of Dobutamine?
What is the MOA of DA?
What is the MOA of Methylphenidate?
What is the MOA of Phenylephrine (PE)?
What is the MOA of Terbutaline?
What is the MOA of a-Methyldopa?
What is the MOA of Fenooldepam?
What are the non-selective a-blockers?
How do you tell the non-selective a-blockers apart?
What is the c/u of the non-selective a-blockers?
What is the SE's of the non-selective a-blockers?
What are the a1-blockers?
What are the a1-A-blockers?
What question is answered by Phase II drug development?
How do we calculate Therapeutic Index?
What are the Phase II elimination reactions?
What direction does a noncompetitive antagonist shift the
potency curve (right, left, up, or down)?

What are all of the NRTI's, their 3-letter acronyms, and SE's?

Botulinum Toxin
Hemicholinium
Reserpine
Guanethidine
Amphetamine

10

What is the MOA of AMG's?


What is the MOA of Tetracyclines?
What is the MOA of Macrolides?
What is the MOA of Chloramphenicol?
What is the MOA of Clindamycin?
What are the general categories of MOA for all the anti-fungal
drugs & which drugs fall under each category?

What does Neuroleptic mean?


What are the Neuroleptics?
What is the MOA of the Neuroleptics?
What is the c/u for Neuroleptics?
What are the 2 main SE's of the Neuroleptics?
What are 4 features of EPS and the timeline involved for each
feature?

Inhibits initiation complex causing inhibition of mRNA


Inhibition of tRNA charging by preventing attachement of
amino acyl tRNA
Blocking translocation from the A --> P site by binding the 23s
subunit of the 50s ribosome
Inhibits Peptidyltransferase, the enzyme responsible for
transferring nucleotides from A --> P site
Inhibits peptide bond formation b/w nucleotides at the P site
Inhibit DNA Synthesis*--Flucytosine*--Griseofulvin (interfers
w/micro-T formation thereby inhibiting mitosis)*Inhibits
Membrane Synthesis***CAT*--Caspofungin*--Azoles*-Terbinifine*Destroys Fungal Membranes*--Amphotericin B*-Nystatin
TYPICAL Antipsychotics = 1st Gen Antipsychotics
Fluphenazine*Thioridazine*Haloperidol*Chlorpromazine*Proma
zine
Inhibition of D2 receptors
Psychosis*Schizophrenia
EPS Sx's*Neuroleptic Malignant Syndrome
4 Hrs: Dystonia (sustained muscle contractions causing twisting
& repetitive *movements or abnormal postures)*4 Days:
Akinesia (inability to initiate movement due to difficulty
selecting *&/or activating the movement pathway)*4 Wks:
Akathisia (unpleasant sensations of inner restlessness
that *manifests itself with an inability to sit still or remain
motionless)*4 Mos: Tardive Dyskinesia (disorder resulting in
involuntary, repetitive body *movements having a slow or
belated onset)
Diphenhydramine*Benztropine*Trihexyphenidyl
Autonomic Instability*Hyperthermia*Muscle Rigidity
CV Collapse*Hyperparexia*Muscle Rigidity

What is the TX for Dystonia?


What are 3 features of Neuroleptic Malignant Syndrome?
What are 3 features of Serotonin Syndrome?
Compare & Constrast Neuroleptic Malignant Syndrome (NMS)
with Serotonin Syndrome (SS).
Neuroleptic Malignant Syndrome Serotonin
Syndrome*Autonomic Instability CV
Collapse*HYPERTHERMIA HYPERPYREXIA*Muscle rigidity
Muslce rigidity
What is the difference between Hyperthermia and Hyperpyrexia? Hyperthermia: body temperature rises above its set
point*Hyperpyrexia: the body's temperature regulation
mechanism changes the body's set point above normal and then
generates heat to achieve this increased temperature
What is the Tx for Neuroleptic Syndrome?
Dantrolene (TX sx's) AND Dopamine Agonist (neuroleptic
reversal)
What are the DA agonists?
CPR
LAB*Cabergoline*Promipexole*Ropinerole*Levadopa/Carbidop
a*Amantidine*Bromocriptine
What is the toxicity of Fluphenazine?
Hyperthermia due to disruption of the thermo-regulatory center
What is the toxicity of Thioridazine?
Pigmented Retinopathy
What is the MOA of Dantrolene?
Inhibition of Ca2+ release by blocking Rhanidodine receptors at
the cytoplasmic reticulum

11

What are the Atypical Anti-Psychotics?

What is the MOA of the Atypical Anti-Psychotics?


What is the c/u for Atypical Anti-Psychotics?
What is/are an additional(s) c/u(s) for Olanzapine?
What is the TX for Tourette's?
What is the TX for OCD?
What is the MOA of Chlormipramine?
What is the MOA of Lithium?
What is an alternative MOA of Lithium?
What is the c/u for Lithium?
What are the mood stabilizer drugs?
What is the toxicity of Lithium?

What are the SSRI's?


What is the c/u of SSRI's?

What are the TCA's?

What is the MOA of the TCA's?


Which TCA is LEAST sedating?
Which TCA has the most anti-cholinergic SE's?
Which TCA has the LEAST anti-cholinergic SE's?
What is the TX for enuresis (bedwetting)?
What is the DOC for bedwetting in a pt < 5 y/o?
What is the toxicity of TCA's?
What type of Cardiotoxicity develops with TCA toxicity?
What is Torsades De Pointes?
What is the TX for Desipramine toxicity?
What is the MOA of TCA's?
What are the heterocyclic Anti-Depressants (5) & what class of
drug do they fall under?

What is the MOA of Maprotiline?


What is the MOA of Trazodone?
What is the MOA of Venlafaxine?
What is the DOC for generalized anxiety?
What is the indication for Benzodiazepines over Buspirone?
What Heterocyclic is used for generalized anxiety?

Its ATIPical for OLd CLOZets to Risper QUiETly *(they usually


squeak
loudly!)*ATIPamezole*OLanzapine*CLOZapine*RISPERidone*
QUETiapine*Ziprasidone
Block 5-HT-2 & D2 receptors*Olanzapine also blocks D4
receptors
Psychosis*Schizophrenia
TOAD*Tourettes*OCD*Anxiety*Depression
Olanzapine*Promazine
Paroxetine (DOC)*Chlormipramine*Olanzapine
Block the reuptake of NE & 5-HT (TCA's)
Inhibition of Phosphoinositol Cascade
ADH receptor antagonist
Mood Stabilizer
Lithium*Valproic Acid*Carbamazepine
LMNOP*L = Lithium*M = Muscle rigidity = tremors*N =
Nephrogenic Diabetes Insipidus (b/c it antagonizes ADH
rec's)*O = HyOthyroidism*P = Pregnancy = Ebstein's
Anomaly*P = Psoriasis Exacerbation (added day 9)
Sertraline*Fluoxetine*Citalopram*Paroxetine
P-LOAD*Premature Ejactulation*Long-term TX of Panic
Attacks*OCD (DOC = Paroxetine)*Anxiety*Depression (SSRI's
MC drug Rx'd)
CANDID (PASS Program uses DD
CAIN)*Clomipramine*Amitriptyline*Nortriptyline*Desipramine
*Imipramine*Doxepin
Block the reuptake of NE & 5-HT
Desipramine
Amitriptyline
Nortriptyline
DOC = Desmopressin (similar to ADH --> H2O
Retention)*TCA = Imipramine
NONE! It is expected at 5 years of age!
The 4 C's*Cardiotoxicity*Confusion*Convulsion*Coma
Torsades De Pointes
Ventricular Tachycardia associated with Prolonged QT
Syndrome
Na+ Bicarbonate (Tx for toxicity of all TCA's)
Block the reuptake of NE & 5-HT
The Very Big Med's*Trazodone (atypical antidepressant)*Venlafaxine (SNRI)*Bupropion (atypical antidepressant)*Mirtazapine (atypical anti-depressant)*Maprotiline
(atypical anti-depressant)
Block the reuptake of NE
Block the reuptake of 5-HT
Block the reuptake of NE, 5-HT, & DA
Buspirone*Benzodiazapines
Generalized anxiety in a pt with a hx of Etoh addiction
Venlafaxine

12

What are 2 anti-depressants used to TX a pt w/sleep


disturbances?
What is the DOC for a pt w/depression & sexual dysfunction?
What are the indications for Bupropion?
When is Bupropion contraindicated & why?
What is the MOA of Mirtazapine?
What other drugs are a2-antagonists?
What is the toxicity of Mirtazapine?
What is the MOA of Tranylcypromine?
What are the MAO-I's?
What is the difference in selectivity between the MAO-I's?

What is the c/u for the Non-selective MAO-I's?


What is the c/u for the selective MAO-I?
What is Atypical Depression?
With which drugs are MAO-I's contraindicated?
What is the toxicity of Vancomycin?
What are the Ototoxicity-causing drugs?
What is the toxicity of AMG's?
What is the toxicity of Tetracyclines?

What are the SE's of Macrolides?


What is the toxicity of Chloramphenicol?
What is the toxicity of Clindamycin?
What is the TX for Pseudomembranous Colitis secondary to C.
Difficile?
What is the toxicity of Sulfonamides?

What is the toxicity of Trimethoprim?


What is the toxicity of Quinolones?
What is an additional SE of Moxifloxicin?
What is the toxicity of Metronidazole?
What is the toxicity of Polymyxins?
What is the toxicity of INH?

Trazodone*Mirtazapine
Bupropion
Smoking Cessation*Depression (DOC if pt also has sexual
dysfunction)
Bulemia hx (bulemia causes electrolyte imbalance = incr'd risk of
seizures)*Epileptic pt's*Bupropion lowers the seizure threshhold
a2-antagonist*5-HT-2 & 5-HT-3 antagonist
Mirtazapine*Yohimbine
1 causes 2 causes 3 causes 4 (not literally; just a mnemonic)*1.
Incr'd appetite*2. Wt gain*3. Incr'd Cholesterol*4. Sedation
Non-selective MAO-I
PITS*P = Phenelzine*I = Isocarboxazid*T =
Tranylcypromine*S = Selegiline
Non-selective = MAO-IA (A for
Anywhere)*Phenelzine*Isocarboxazid*Tranylcypromine**Selecti
ve = MAO-IB (B for Brain)*Selegiline
Atypical Depression*Anxiety*Hypochondriasis*(Non-selective
MAO-I's = Phenelzine , Isocarboxazid, & Tranylcypromine)
Selective MAO-I = Selegiline*c/u = Anti-Parkinsonian
Depression with mood disorders and/or wt gain
SSRI's*Meperidine
There is NOT
toxicity*Nephrotoxic*Ototoxic*Thrombophlebitis
AMG's*Loops
(Furosemide)*Vancomycin*Quinidine*Chloroquine
There is NNO toxicity*Neurotoxic
(teratogenic)*Nephrotoxic*Ototoxic
Discoloration of teeth (children)*Abnormal bone growth
(children)*Photosensitivity*Drug-induced Pancreatitis*Fanconi
Syndrome (old Tetracyclines)
Acute Cholestatic Hepatitis*Eosinophilia
Dose-dependent Anemia*Dose-independent Aplastic
anemia*Grey Baby Syndrome (premature infants)
Pseudomembranous Colitis
Vancomycin*Metronidazole
Displaces drugs from albumin (e.g. Warfarin)*Hemolytic Anemia
(G6PD Def Pt's)*Kernicteris
(children)*Hypersensitivity*Photosensitivity*Tubulointerstitial
Nephritis
Megaloblastic Anemia
Tendonitis (adults)*Cartilage rupture (children)
Screws with K+ leading to Torsades de Pointes (aka Prolonged
QT Syndrome)
Disulfram-like reaction with alcohol*Dysguzia*Drug-induced
pancreatitis*Teratogenic
ATN (acute tubular necrosis)*Neurotoxicity
INHH*Induces SLE*Neurotoxicity (that's why we give
concomittant Vit B6)*Hepatotoxicity*Hemolytic anemia (G6PD
Pt's)

13

What is the toxicity of Ethambutol?


What is the toxicity of Dapsone?
What are the drugs that cause Agranulocytosis?
What is/are the SE(s) of Amphotericin B?
What is/are the SE(s) of Fluconazole?
What is/are the SE(s) of Flucytosine?
What is/are the SE(s) of Griseofulvin?
What is/are the SE(s) of Amantidine?
What is/are the SE(s) of Foscarnet?
What is/are the SE(s) of Indinavir?
What is/are the SE(s) of all of the NRTI's (& 3-letter acronyms)?

What is/are the SE(s) of Efavirenz?


What is/are the SE(s) of Nevirapine?
What is/are the SE(s) of Atropine?

What is/are the SE(s) of Phentolamine?


What is/are the SE(s) of Prazosin?
What is/are the SE(s) of Mirtazapine?
What is/are the SE(s) of Pindalol?

What is/are the SE(s) of L-Dopa?


When & Why is Sumatriptan contraindicated?

What is/are the SE(s) of Topiramate?


What is/are the SE(s) of Gabapentin?
What is/are the SE(s) of Lamotrigine?
What is/are the SE(s) of Ethosuxamide?
What is/are the SE(s) of Phenobarbital?
What is/are the SE(s) of Benzodiazepine?
What are the SE's of Valproic Acid (one of the top 10 drugs
tested on USMLE)?

Optic Neuritis*Central Scotoma


HAMbone from Dapsone*Hemolytic
Anemia*Agranulocytosis*Methemoglobinemia
Clozapine*Colchicine*Carbamazepine*PTU*Dapsone*Ticlopidi
ne*Methimazole
Fever/Chills*Hypotension*Phlebitis*Arrhythmias*Nephrotoxicit
y
Torsades de Pointe (aka Prolonged QT Syndrome)
Bone marrow suppression
Incr'd metabolism of Warfarin*Teratogenic*Carcinogenic
Ataxia*Dizziness*Slurred speech*(SE's due to skrewed up
cerebellum)
Nephrotoxicity
Crystal-induced Nephropathy*Thrombocytopenia
All NRTI's: Lactic acidosis**Ziduvidine (AZT/ZDV)*--Aplastic
anemia*--Megaloblastic anemia*Didanosine (DDI)*--Druginduced pancreatitis*Zalcytobine (DDC):*--SJS*--Peripheral
neuropathy*Lamuvidine (3TC)*--only lactic acidosis*Stavudine
(D4T)*--Peripheral neuropathy*Abacavir (ABC)*-Hypersensitivity syndrome
SJS
SJS*Hepatotoxicity
Dry as a Bone: Dry eyes/skin (dec'd lacrimation/dec'd
sweat)*Hot as a Hare: Warm skin (dec'd sweat --> reflex
vasodilation)*Red as a Beet: Flushing (dec'd sweat --> reflex
vasodilation)*Blind as a Bat: Mydriasis/Cycloplegia (dec'd
PS's)*Mad as a Hatter: Confusion/Disorientation (CNS effects
on M4/M5 rec's)
Orthostatic Hypotension*Reflex Tachycardia
1st-dose Orthostatic Hypotension*Priapism
1 causes 2 causes 3 causes 4 (not literally; just a mnemonic)*1.
Incr'd appetite*2. wt gain*3. Incr'd Cholesterol*4. Sedation
Impotence*Exacerbates asthma*Masks hypoglycemia in
DM*Cardiovascular efffects (bradycardia, AV block, CHF)*CNS
effects (sedation, sleep alteration)
Arrythmia*Dyskinesia
Due to risk of vasospasm, Sumatriptan is contraindicated
in:*Prinzmetal angina*CAD*Pregnancy (must order pregnacy test
first)
Mental dulling*Renal stones*Wt loss
Movement disorders*Nystagmus*Wt loss
SJS
SJS*SLE*Urticaria = mild form of SJS
Sedation*Tolerance*Dependence*Induces P-450
Sedation*Tolerance*Dependence
Fetal Hepatotoxicity*Neural Tube Defects*Drug-Induced
Pancreatitis

14

What are the SE's of Phenytoin (one of the top 10 drugs tested
on USMLE)?

Indian men want a wife who is LIGHT-skinned AND


MMPSS*Lymphadenopathy*Induces P450*Gingival
Hyperplasia*Hirsutism*Teratogenic (Fetal Hydantoin
Syndrome)*Ataxia*Nystagmus*Diplopia*Megaloblastic
anemia*Malignant Hyperthermia*Peripheral
Neuropathy*SLE*Sedation

What are the contraindications of Barbiturates?


What is the TX for Benzodiazepine overdose?
What can abrupt cessation of Olprazelam cause?
What is the TX for alcohol withdrawal?
What is/are the SE(s) of Chlorpromazine?
What are 3 features of Neuroleptic Malignant Syndrome?
What is the TX for Neuroleptic Malignant Syndrome?
What are 4 features of EPS and the timeline involved for each
feature?

If Halothane is highly soluble in lipids & therefore goes into


tissues quickly, is the induction time fast or slow?
If Nitrous Oxide is poorly soluble in blood & therefore must go
into tissues, is potency high or low?
What is/are the SE(s) of Halothane?

Porphyrias
Flumazenil
Generalized seizures
Chlordiazepoxide
EPS SE's*NMS
Autonomic Instability*Hyperthermia*Muscle Rigidity
Dantrolene (TX sx's) + DA Agonist (NMS reversal)
4 Hrs: Dystonia (sustained muscle contractions causing twisting
and repetitive *movements or abnormal postures)*4 Days:
Akinesia (inability to initiate movement due to difficulty
selecting *and/or activating the movement pathway)*4 Wks:
Akathisia (unpleasant sensations of inner restlessness that
manifests *itself with an inability to sit still or remain
motionless)*4 Mos: Tardive Dyskinesia (disorder resulting in
involuntary, repetitive body *movements having a slow or
belated onset)
Diphenhydramine*Benztropine*Trihexyphenidyl
Pigmented Retinopathy
Hyperthermia due to disruption of the thermo-regulatory center
Agranulocytosis
Weight gain
Cataracts
LMNOP*L = Lithium*M = Muscle rigidity = tremors*N =
Nephrogenic Diabetes Insipidus*O = HyOthyroidism*P =
Pregnancy = Ebstein's Anomaly*P = Psoriasis Exacerbation
(added day 9)
Sexual retardation
Premature ejaculation
Concomittant use with MAOI's will cause Serotonin Syndrome
The 4 C's*Confusion*Cardiotoxicity*Convulsion*Coma
Concomittant use with SSRI's or Meperidine
1) Solubility in BLOOD tells me:*a. Induction time*b. Recovery
time*(directly related)*2) Solubility in LIPIDS tells me:*a.
Potency*b. Minimum Alveolar Concentration (MAC)*(inversely
related)
Cannot be determined; LIPID solubility indicates Potency &
MAC
Cannot be determined; BLOOD solubility indicates Induction &
Recovery time
Hepatotoxic

What is/are the SE(s) of Enflurane?


What is/are the SE(s) of Methoxyflurane?
What is/are the SE(s) of Sevoflurane?
If Thiopental is highly soluble in lipids & therefore goes into
tissues quickly, is the induction time fast or slow?

Convulsions (lowers seizure threshhold)


Nephrotoxic
Malignant Hyperthermia
Cannot be determined; LIPID solubility indicates Potency &
MAC

What is the TX for Acute Dystonia?


What is the toxicity of Thioridazine?
What is the toxicity of Fluphenazine?
What is/are the SE(s) of Clozapine?
What is/are the SE(s) of Olanzapine?
What is/are the SE(s) of Quetiapine?
What is/are the SE(s) of Lithium?

What is/are the SE(s) of Fluoxetine?


What is the c/u for Fluoxetine?
What are the contraindications of Fluoxetine?
What is/are the SE(s) of Doxepin?
What are the contraindications of Fenalzine?
What are the 2 rules of Anesthetics?

15

What is the c/u for Midazolam? Why?


With anesthetics, is the goal to increase or decrease cerebral
blood flow? Why?
What are the significant CV features of Ketamine that makes it
indicated in certain pt's?
What is the c/u for Ketamine? Why?
What is the TX for African Trypanosomiasis (aka African
Sleeping Sickness)?
What is the TX for Chagas?
What is the TX for PCP?

What is the SE of Aerosolized Pentamidine?


What is the TX for Entamoeba Histolytica?
What is the TX for P. vivax?
How do you TX a patient with Malaria who has just returned
from New Dehli?
What is the TX for Kala-azar?

What is the TX for Taenia Solium?


What is the TX for Clonorchis Sinensis?
What is the TX for Enterobius Vermacularis?
What is the TX for Onchocerca (River Blindness)?
What are the Neuroleptics?
What is the TX for Tourette's?
What is the MOA of Quetiapine?
What drug blocks 5-HT-1D receptors?
What drug blocks 5-HT-2, 5-HT-3, & a2 receptors?
What drug blocks 5-HT-3 receptors only?
What is/are the SE(s) of Quetiapine?
What drug has a SE profile of Pigmented Retinopathy?
What is/are the SE(s) of Fluphenazine?
What is the DOC for OCD?
What is the MOA of Clomipramine?
What drugs block NE re-uptake?

Endoscopic anesthesia b/c it causes anterograde amnesia


Decrease b/c we want them to sleep
Increased cerebral blood flow*Stimulates the heart --> increased
cardiac output
Anesthesia for pt's in heart trouble b/c it increases cardiac outpu
Suramin
Nifurtimox
PCP is one BAD-ass bug*1st: B = Bactrim (TMP/SMX)*2nd: A
= Aerosolized Pentamidine*3rd: D = Dapsone**NOTE: PCP =
PneumoCystis Pneumonia *BUG: Pneumocystis Jiroveci
(formerly Pneumocystis Carinii)
Drug-induced pancreatitis
Metronidazole
Primaquine for latent P. vivax & P. ovale to prevent relapse
(otherwise TX = Chloroquine)
Methloquine; Malaria from the indian subcontinent/subsahara is
assumed to be resistent to Chloraquine**NOTE: New Dehli is
the capital of the Republic of India
Pentavir Antimony*Na+ Stipigluconate**NOTE: Kala-azar (aka
Dumdum Fever) is Visceral Leishmaniasis, the most severe form
of Leishmaniasis
Niclosamide
Praziquental
Praziquental & Mebendazole (on day 11 he says Pyrantal
Pamoate & Mebendazole)
Ivermectin
Fluphenazine*Thioridazine*Haloperidol*Chlorpromazine*Proma
zine
Olanzapine*Promazine
Quetiapine = Atypical Neuroleptic*Block 5-HT-2 & D2
receptors
Nothing, h/w Sumitriptan is a 5-HT-1D AGONIST
Mirtazipine
Ondansetron
Cataracts
Thioridazine
Hyperthermia due to disruption of the thermo-regulatory center
Paroxetine
TCA's: Block 5-HT & NE re-uptake
Cocaine*TCA's*Maprotiline

What heterocyclic inhibits only 5-HT re-uptake?


What is the DOC for Generalized Anxiety in a pt who is an
alcoholic?
What is the MOA of Phenalzine?

Trazadone
Busparone

What is/are the SE(s) of Chlortalidone?

HyperGLUC:*HyperGlycemia*HyperLipidemia*HyperUricemia*Hyper
Calcemia
Hydrochlorothiazide*Indapamide*Metolazone*Chlortalidone

What are the 4 main Thiazide Diuretics?

Non-selective MAO inhibitor

16

What is/are the SE(s) of Quinidine?


What is/are the SE(s) of Methyldopa?
What is/are the SE(s) of Hexamethonium?
What is/are the SE(s) of Reserpine?
What is/are the SE(s) of Guanethidine?
What is/are the SE(s) of Prazosin?
What is/are the SE(s) of B-Blockers?

What is/are the SE(s) of Hydralazine?


What is/are the SE(s) of Minoxidil (OTC Rogaine)?
What is/are the SE(s) of Verapimil?
What is/are the SE(s) of Captopril?

What happens to EDV when Nitrates are given?


What happens to BP when Nitrates are given?
What happens to Contractility when Nitrates are given?
What happens to HR when Nitrates are given?
What happens to Ejection time when Nitrates are given?
What happens to MVO2 when Nitrates are given?
What happens to EDV when B-Blockers are given?
What happens to BP when B-Blockers are given?
What happens to Contractility when B-Blockers are given?
What happens to HR when B-Blockers are given?
What happens to Ejection Time when B-Blockers are given?
What happens to MVO2 when B-Blockers are given?
What happens to EDV when Nitrates AND B-Blockers are
given?
What happens to BP when Nitrates AND B-Blockers are given?
What happens to Contractility when Nitrates AND B-Blockers
are given?
What happens to HR when Nitrates AND B-Blockers are given?
What happens to Ejection Time when Nitrates AND B-Blockers
are given?
What happens to MVO2 when Nitrates AND B-Blockers are
given?
What is the 1st line TX for Cocaine-related MI?
What is the TX for symptomatic premature atrial contraction?
What is the Na+, K+, & Ca2+ ion normal physiology of the
heart?

Severe rebound HTN


Positive Coomb's Test
Sympatholytic *Severe orthostatic Hypotension*Sexual
Dysfunction*Parasympatholytic*Constipation*Blurred Vision
Depression*Diarrhea
Sexual Dysfunction*Diarrhea
1st-dose Orthostatic Hypotension*Priapism
Impotence*Exacerbates asthma*Masks hypoglycemia in
DM*Cardiovascular efffects (bradycardia, AV block, CHF)*CNS
effects (sedation, sleep alteration)
SARS*SLE-like sx's*Angina*Reflex tachycardia*Salt retention
SHARP*Salt retention*Hypertrichosis (too much
hair)*Angina*Reflex tachycardia*Pericardial effusion
Constipation
CHAPTOPRIL where H = Hyperkalemia*C = Cough*H =
Hyperkalemia (b/c decr'd aldosterone)*A = Angioedema*P =
Proteinuria*T = Taste change*O = HypOtension*P =
Pregnancy problems (fetal renal damage)*R = Rash*I = Incr'd
renin*L = Lowers Ang II & Aldosterone
Decreased
Decreased
Reflexively Increased
Reflexively Increased (reflex tachycardia)
Decreased
Decreased
Increased (incr'd time in diastole = incr'd filling time)
Decreased
Decreased
Decreased
Increased
Decreased
No change
Decreased
Decreased
Decreased (b/c B-Blockers = direct response, while Nitrates =
reflexive response)
No change
Decreased
Benzodiazepines to TX HTN*Nitrates to TX
VC/Vasospasm*Aspirin to decrease thrombus formation
B-Blockers
1) The Na+/K+ pump exchanges 2K+ (moves inward) & 3Na+
(moves outward)*2) The Na+/Ca2+ antiporter exchanges 3 Na+
(moves inward) & 1 Ca2+ (moves outward)*3) K+ leak channels
slowly allow K+ to diffuse (moves outward) to be used again by
the Na+/K+ pump (exchanger)*4) If the resting membrane
potential reaches threshhold (approx +90mv) an AP occurs

17

What is the MOA and physiology leading to the effects of


Digoxin?

What is the c/u and rationale for Digoxin?

What is the toxicity of Digoxin?


What is the TX for Digoxin toxicity?

What effects does Digoxin have on the EKG?

What are the Class III anti-arrhythmics?


What is the MOA and effects of Class III Anti-arrhythmics?

What is the break-down metabolite of Amiodarone?


What class of Anti-Arrhythmic is Procainamide?
Why is Amiodarone listed as a Class IA AND Class III antiarrhythmic?
What is the MOA & effects of Class IA Anti-arrhythmics?

What are the Class IB Anti-arrhythmics?


What is the c/u for Phenytoin?
What is the MOA of Phenytoin?
What direction does a competitive antagonist shift the efficacy
curve (right, left, up, or down)?
What direction does a noncompetitive antagonist shift the
potency curve (right, left, up, or down)?

MOA 1:*a) Digoxin binds the K+ on the Na+/K+ pump


preventing Na+/K+ exchange; K+ therefore stays outside the
cell while Na+ stays inside the cell;*b) Na+ is then no longer
exchanged with Ca2+; Ca2+ accumulates inside the cell;*c) Once
threshhold is finally reached and an action potential does occur,
the accumulated Ca2+ is released; release of an increased amount
of Ca2+ results in an increased ionotropic effect (i.e. increased
contractility due to increased ions, Ca2+ in this case)*MOA
2:*Stimulates CN X in the Medulla
Digoxin has 2 diff't c/u's b/c it has 2 diff't MOA's:*1)
CHF*MOA = Inhibition Na+/K+ ATPase --> incr'd
intracellular Ca2+ -->*incr'd contractility*2) Atrial
Fibrillation*MOA = Stimulation of CN X in the medulla -->
decr'd AV node stimulation --> *decr'd HR**NOTE: *I used
Dr. Francis's explanation (Physio notes p. 60) b/c Shahzad's
explanation is clearly wrong!*1) He said that ventricular
contraction is due to Na+ h/w ALL muscle contractions is due
to Ca2+ while ventricular DEPOLARIZATION (not
contraction) is due to Na+.*2) He also said that the reason
slowed conduction through the AV-node is helpful for A-fib is
that it gives time for Na+ accumulation that leads to incr'd
ventricular contractility h/w changing ventricular contractility will
have no affect on the atrium or A-Fib.
Torsades De Pointes Arrhythmia (i.e. prolonged QT) b/c of its
effects on K+*Yellow vision
1) STOP DIGOXIN ADMINISTRATION!*2) Slowly normalize
K+*3) Lidocaine*4) Mg2+*5) Digifab/Digibind*6) Pacemaker
once stable (~2wks later)
Decr'd Na+/K+ Pump action --> Incr'd intracellular CA2+
accumulation:*PR Interval: Increased*QT Interval: Decreased
(i.e shorter/faster) *b/c repolarization requires K+*ST segment:
Depression*T wave: Inversion (i.e. U wave)
Ibutilide*Sotalol*Bretylium*Amiodarone*Dofetilide
Blocks K+ leading to:*AP duration: Increased*QT interval:
Increased (i.e longer/slower) *b/c intracellular K+ is incr'd &
repolarization requires K+*ERP: Increased (b/c blocked K+)
Procainamide
Class IA
Class IA: Amiodarone's metabolite, Procainamide, is a Class
IA*Class III: Amiodarone's MOA is to block K+
Blocks Na+ AND K+ [leak] Channels leading to:*AP duration:
Increased*QT interval: Increased (i.e longer/slower) *b/c
repolarization requires K+*ERP: Increased (b/c blocked K+)
Lidicaine*Mexlotine*Tocanimide*Phenytoin
Treatment: Tonic-clonic seizures*Phrophylaxis: Status-epilepticus
seizures
Blocks Na+ channels
It doesn't: efficacy (Vmax) is not affected*However, potency is
decreased (Km is increased) and therefore the POTENCY curve
is shifted to the right
It doesn't: potency (Km) is not affected (the drug is just as potent
as before, but some receptors are turned off)*However, efficacy
(Vmax) is decreased and therefore the EFFICACY curve is
shifted downward

18

What is the c/u of Ampicillin/Amoxicillin?


A patient who was in a bar fight and was bit in the hand comes
into the ER, what is the proper TX?
A patient presents to your office with an infection in which labs
show G+ aerobic rods in long, branching filaments.what is
TX?
What is the profile for Norcardia?
What is initial TX for infective endocarditis?
What is the TX for infective endocarditis that is culture positive
for S. Viridans?
A patient comes to you office; has a fever of 102 F; CBC shows
WBC of 500; negative U/A; neg CXR; pt is on chemotherapy,
denies cough & diarrhea; what is the next step in the
management of this pt?
A patient comes to you office; has a fever of 102 F and is
hypertensive; CBC shows WBC of 500; negative U/A; neg CXR;
pt is on chemotherapy, denies cough & diarrhea; what is the next
step in the management of this pt?
A patient comes to you office; has a fever of 102 F and is
hypertensive; CBC shows WBC of 500; negative U/A; neg CXR;
pt is on chemotherapy, denies cough & diarrhea; The pt is TX'd
with IV Cefipime plus Vancomycin, but the fever persists; what
is the next step in the managment of this pt?
After taking a hiking vacation to the upper NEern US, a pt
comes to your office with autoimmune polyarthiritis chronica
migrans; what is the TX?
With what sx's does a pt with primary Lyme's Disease present?
What is the TX for primary Lyme's Disease?
With what sx's does a pt with secondary Lyme's Disease present?

What is the TX for secondary Lyme's Disease?


What is the initial TX for a pregnant woman with Lyme's
Disease?
What is the DOC of a 7 y/o male with severe acute exacerbation
of Cystic Fibrosis lung disease?

What are the causes of community-aquired pneumonia (CAP)?


How does this effect medical management?
What is the in-house TX for community-aquired pneumonia
(CAP)?
What is the c/u for Quinolones?
What is out-pt TX for community-aquired pneumonia?

What is the c/u of Macrolides?

HELPS Enterococci*H. Influenza*E.


Coli*Listeria*Proteus*Salmonella*Enterococci
Amoxicillin/Clavulonic Acid*(there are no dogs in the bar; he
got bit by a person)
Bug = Actinomyces*Tx = 6-12 wks IV Penicillin

G+ rods in long branching filaments, anaerobic, partially acid fast


Emperical TX = Vancomycin + Gentomycin
Iv Penicillin G*Ceftriaxone
Dx = Febrile Neutropenia*Pt @ risk of Pseudomonas*Tx for
G+'s = IV Ceftazidime or IV Cefipime

Dx = Febrile Neutropenia with HTN*Pt @ risk of


Pseudomonas*Tx for G+'s = IV Ceftazidime or IV
Cefipime *PLUS *Tx for G-'s = Vancomycin
Dx = Febrile Neutropenia with HTN*Pt @ risk of
Pseudomonas*Tx for G+'s = IV Ceftazidime or IV
Cefipime *PLUS *Tx for G-'s = Vancomycin*PLUS*Tx for
Fungi = Flucytosine
Dx = Tertiary Lyme Ds*Tx = IV Ceftriaxone

Flu-like sx's*Erythema chronicum migrans (bull's eye rash)


Doxycycline
Migrating pain in muscles, joint, and tendons*Changes in
heartbeat --> cardiac manifestations:*Heart
palpitations*Dizziness*Neurological manifestations*Bell's
Palsy*Meningitis*Encephalitis*Chorea
Doxycycline
Ampicillin/Amoxicillin b/c Doxycycline is Teratogenic
1 AMG (DOC for any G- rod)*AND 1 Other Drug:*AntiPseudomonal Penicillin (e.g. Piperacillin, Ticarcillin)*3rd Gen
Cephalosporins (e.g. Ceftazidime)**NOTE: MC infection in CF
is Pseudomonas (G- rod); you always cover for Pseudomonas
with 2 drugs
Causes of CAP include bacteria, viruses, fungi, and parasites,
therefore, broad-spectrim antiboitics (covers G+ AND G-) is
used to TX CAP
Fluoroquinolones (aka Quinolones): broad-spectrum (i.e. G+
AND G-)*Levofloxacin*Gatifloxicin
G- rods in GI/GU track*CAP
Azithromycin (Macrolides)*Intracellular organisms*G+
cocci*Doxycycline (Tetracyclines)*Intracellular
orgnaisms*Mycoplasm --> walking pneumonia
UPS Lost My Brand New Car*URI's (caused by G+
cocci)*Pneumonia (caused by G+ cocci)*STD's (caused by G+
cocci)*Legionella*Mycoplasma*Bordatella*Neisseria*Chlamydia

19

What is the c/u of Tetracyclines?

What is the DOC for bacterial vaginosis in a non-pregnant


woman?
A diabetic pt comes to your office with a rhinocerebral
infectionwhat is the next step in management?
An HIV pt comes to your office with dysphagia, what is the next
step in management?
An HIV pt comes to your office with dysphagia; the initial TX
with Fluconazole doesn't work; what is the next step in
management?
An HIV pt comes to your office with dysphagia; the initial TX
with Fluconazole doesn't work so you do an endoscopy; biopsy
reveals large, shallow ulcers; what is the next step in
management?
An HIV pt comes to your office with dysphagia; the initial TX
with Fluconazole doesn't work so you do an endoscopy; biopsy
reveals multiple small vesiculated ulcers; what is the next step in
management?
What is the MOA and target of Statins?
What is the MOA and target of Niacin?
What is the MOA and target of Cholestepol?
What is the MOA and target of Izentamide?
What is the MOA and target of Fibrates?
What are the Fibrates?
What effect do Statins have on LDL, HDL, & TG's?
What effect does Niacin have on LDL, HDL, & TG's?
What effect does Cholestepol have on LDL, HDL, & TG's?

What effect does Izentamide have on LDL, HDL, & TG's?


What effect do Fibrates have on LDL, HDL, & TG's?
What effect do Probucol have on LDL, HDL, & TG's?
In a pt with CAD, what should his/her LDL be less than?
In a pt with 3 RF's for CAD, what should his/her LDL be less
than?
In a pt with 2 RF's for CAD, what should his/her LDL be less
than?
In a pt with 1 RF's for CAD, what should his/her LDL be less
than?
In a pt with CAD or 3 or more RF's for CAD, when do I begin
medical management?
In a pt with 2 RF's for CAD, when do I begin medical
management?

VACUuM The BR*Vibrio Cholerea*Acne (Propionibacterium


Acnes)*Chlamydia*Ureaplasma
Urealyticum*Mycoplasm*Tularemia*H.
Pylori*Borrelia*Rickettsia
DOC = Tinidazole*2nd = Metronidazole (more SE's than
Tinidazole)
Dx'd bug = Mucor Rhizopus = HIGHLY FATAL
DISEASE!!!*Treatment:*1) Debridement of necrotic tissue*2)
Amphotericin B (direct injection)
Fluconazole (b/c in HIV pt's, dysphagia has 90% correlation
w/Candida)
Endoscopy

Dx = CMV (b/c lg shallow ulcers)*Tx = Ganciclovir

Dx = HSV (b/c multiple small vesiculated ulcers)*Tx =


Acyclovir

Inhibition of HMG CoA reductase in liver


Inhibits the uptake of Ch'ol as VLDL from hepatocytes into
circulation
It is a bile acid resin that inhibits the uptake of everything in the
gut into the liver (works in the gut)
Ch'ol absorption blocker in the gut
Stimulates LPL in the circulation on the endothelial cells
Bezafibrate*Ciprofibrate *Clofibrate (largely obsolete due to sideeffect profile, e.g. gallstones) *Gemfibrozil*Fenofibrate
LDL: Decreased*HDL: Increased*TG's: Decreased
LDL: Decreased*HDL: Increased*TG's: Decreased
LDL: Decreased*HDL: No effect (b/c works in gut)*TG's:
Slightly incr'd (indirect action: b/c decr'd GI absorption = LES -> incr'd lipolysis --> incr'd vLDL --> incr'd TG's)
LDL: Decreased*HDL: No effect (b/c works in gut)*TG's: No
effect (b/c still absorb proteins, carbohydrates, and fats)
LDL: Decreased*HDL: Increased (1st line drug)*TG's:
Decreased
LDL: Decreased (increases LDL metabolism in last step of ch'ol
elimination)*HDL: No effect*TG's: No effect
<100 (CAD or 3+ RF's)
<100 (CAD or 3+ RF's)
<130 (2 RF's)
<160 (0 - 1 RF's)
When their LDL is >130 (TX starts when LDL reaches 1 level
higher than target, 100)
When their LDL is >160 (TX starts when LDL reaches 1 level
higher than target, 130)

20

In a pt with 0 - 1 RF's for CAD, when do I begin medical


management?
What is the drug of choice for high LDL?

What is the MOA of Doxylamine?


What is the c/u for Doxylamine?
What is the difference between Hyperemesis Gravidarum and
morning sickness?
What is Hyperemesis Gravidarum?
With what drug is Doxylamine co-administered?
What is the MOA of Dimenhydrinate?
What type of histamine receptors are present on gastric parietal
cells?
What do gastric parietal cells secrete?
How are gastric parietal cells involved in allergies?
What is the MOA of Fexofenadine?
Why do we use 2nd Gen H1 blockers instead of 1st Gen H1
blockers?
A pt comes to your office has mild intermittent asthma; what is
the 1st step in management?
What is the MOA of Albuterol?
A pt comes to your office has moderate persistent asthma; pt is
currently taking asthma but is having night time flare-ups more
than 3 times a week; what is the 1st step in management?
What are the 6 actions of steroids?

Where does TNF-a come from?


What are all the things that Macrophages secrete?
What do Th-1 cells secrete?
What do Th-2 cells secrete?
What do Cytotoxic T-cells secrete?
A pt comes to your office with severe persistent asthma; the pt is
currently taking Albuterol and low-dose prednisone; he is
currently having an acute exacerbation; what is the next step in
management?
A pt comes to your office with severe persistent asthma; the pt is
currently taking Albuterol and low-dose prednisone; he is
currently having an acute exacerbation & he has already rec'd
ONE dose of Abluterol; what is the next step in management?
A pt comes to your office with severe persistent asthma; the pt is
currently taking Albuterol and low-dose prednisone; he is
currently having an acute exacerbation & he has already rec'd
TWO doses of Abluterol; what is the next step in management?

When their LDL is >190 (TX starts when LDL reaches 1 level
higher than target, 160)
Lifestyle Management until they reach 1 level higher than their
target LDL*Medical Management once they reach 1 level higher
than their target LDL
H1 receptor blocker
Hyperemesis Gravidarum*Morning sickness
Morning sickness occurs in the 1st trimester*Hyperemesis
Gravidarum can occur in 1st, 2nd, or 3rd trimester
Can be a severe form of morning sickness*Can be due to a
gestational mole
B6
REVERSIBLY inhibits H1 receptors in tissues
H2 receptors
Intrinsic Factor*Hydrochloric Acid (HCl)
Though they have histaminic receptors, they are NOT involved
in allergies
2nd Generation H1 Blocker
Because it has fewer SE's
Albuterol
B2 agonist leading to bronchidilation
Low-dose steroids

KIIISS*1) Kills T-cells & eosinophils*2) Inhibit macrophage


migration*3) Inhibit phospholipase A*4) Inhibit mast cell
degranulation*5) Stabalizes endothelium*6) Stiumulates protein
synthesis**Also according to FA: activates NF-B therefore
don't make any TNF-a
Macrophages
IL-1, IL-6, IL-12, TNF-a
IL-2 & IF-gamma
IL-4, IL-5, and IL-10
IL-3 and TNF-B
Give a dose of Albuterol

Give a 2nd dose of Albuterol

Give a 3rd dose of Albuterol

21

A pt comes to your office with severe persistent asthma; the pt is


currently taking Albuterol and low-dose prednisone; he is
currently having an acute exacerbation & he has already rec'd
THREE doses of Abluterol; what is the next step in
management?
An asthmatic pt currently on Albuterol, comes to your office
complaining that everytime he work out, he become short of
breath; what is the next step in management?
What is the c/u for drugs that block transpeptidase crosslinking?
What is/are the SE(s) for drugs that block transpeptidase
crosslinking?
What does Methicillin toxicity cause?
What is the c/u for Methicillin?
What are the anti-Staph Penicillins?
What are the anti-Pseudomonas Penicillins?

What is the c/u of Ampicillin/Amoxicillin?

What does Ampicillin/Amoxicillin toxicity cause?


What other antibiotic causes Pseudomembranous Colitis?
What is the MOA of Clindamycin?
What is the c/u of Clindamycin?
What is the TX for Pseudomembranous Colitis?
What is the MOA of Metronidazole?
What is the toxicity of Metronidazole?
What is the c/u for Metronidazole?

What is the TX for bacterial vaginosis for pregnant pt's?


What is the MOA of Vancomycin?
What are the peptidoglycan synthesis Inhibitors?
What is the c/u for Vancomycin?
What is the TX for VRSA?
What is the MOA of Linezolid?
What are the 50s Inhibitors?

What are the Streptogramins?


What blocks mRNA Synthesis
Rifampin
How does Rifampin's MOA work?
What is the c/u of Rifampin?
What are the Penicillinase/B-Lactamase inhibitors?

Give high-dose inhaled corticosteroids**NOTE: For acute


exacerbation of asthma you try 3 consecutive doses of Albuterol
& if that doesn't work you turn to high-dose corticosteroids?

Tx: Albuterol prior to working out

Drug = Penicillins*G+ cocci & rods*G- cocci*Spirochetes


Drug = Penicillins*Hypersensitivity*Hemolytic Anemia
Interstitial nephritis
S. Aureus
CONDM*Cloxacillin*Oxacillin*Nafcillin*Dicloxacillin*Methicilli
n*(Anti-Staph Pen's = 2nd Gen Pen's)
PTC of Pseudomonas in the
AM*Piperacillin*Ticarcillin*Carbenicillin*Azlocillin*Mezlocillin*(
Anti-Pseudomonas = 4th Gen Pen's)
HELPS Enterococci*H. Influenza*E.
Coli*Listeria*Proteus*Salmonella*Enterococci*(Ampicillin/Amo
xicillin = 3rd Gen Pen's)
Hypersensitivity*Ampicillin rash*Pseudomembranous colitis
Clindamycin
Inhibits peptide bond formation
Anaerobes above the diaphram
Metronidazole*Vancomycin
Form toxic metabolites in the bacterial cell wall that damage
DNA
Disulfram-like reaction with alcohol*Dysguzia*Drug-induced
pancreatitis*Teratogenic
GET
GAP*Giardia*Entomeba*Trichamonas*Gardnerella*Anaerobes*
H. Pylori
Metro cream*Clindamycin cream
Inhibits D-ala D-ala (t/f can't make peptidoglycan)
Bacitracin*Vancomycin*Cycloserine
MRSA*C. Difficile*Nosocomial infections (presumeably drugresistent infections)
Linezolid*Streptogramins
Inhibition of 50s
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin (i.e
Macrolides)*Lincomycin*Linezolid*Streptogramins
Dalfopristin*Quinopristin

Inhibition of DNA-dependent RNA polymerase, thereby


blocking mRNA synthesis
TB*Meningiococcal Prophylaxis*Close contacts of Pt's with
Hib*Delays Dapsone resistence in the TX of Leprosy
AIM*Aztreonam*Imipenem/Cilastatin*Meropenem

22

What is the MOA of Aztreonam?


What is the c/u of Aztreonam?
What pt's is Aztreonam used to TX?
With what is Imipenem co-administered? Why?
What is the c/u of Imipenem/cilistatin?
What is the c/u for 2nd Gen Cephalosporins?

What is a 3rd Gen Ceph used for the TX of Pseudomona?


What is a 3rd Gen Ceph used for the TX of Gonorrhea?
What are the Cephalosporins used for the TX of Gonorrhea?
What is the one-dose TX for Chlamydia?
What is the MOA of Azithromycin?

What is the c/u of Macrolides?

What is an alternative MOA of Erythromycin?


What is the toxicity of Macrolides?
MOA of Tetracyclines?
What is the c/u for Tetracyclines?

What is the toxicity of Tetracyclines?

What is an alternative MOA of Demeclocycline?


What drugs block ADH receptors?
What is the MOA of Lithium?
What is the c/u for Lithium?
What is the toxicity of Lithium?

What is the MOA of Chloramphenicol?


What is the c/u for Chloramphenicol?
What is the toxicity of Chloramphenicol?

What drugs inhibit Fungal DNA Synthesis?

AzTHREEonam*Binds to PBP #3
G- Rods
Pt's who cannot tolerate AMG's*OR*Pt's who are allergic to
Penicillin*OR*Pt's in Renal Failure
Cilistatin*Prevents breakdown of Imipenem by inhibiting renal
dihydropeptidase-1
Enterobacter
HEN PEcKS (c = cocci)*H.
Influenza*Enterobacter*Neisseria*Proteus*E.
Coli*Klebsiella*Serratia*G+ cocci
Ceftazidime
Ceftriaxone & Cefixime
TRI to FIX a FOX*Ceftriaxone (3rd Gen)*Cefixime (3rd
Gen)*Cefoxitin (2nd Gen)
Azithromycin
Inhibits Macroslide (macro = 50s; slide = translocation)*Blocks
translocation from the A --> P site by binding the 23s subunit of
the 50s ribosome
UPS Lost My Brand New Car*URI's (caused by G+
cocci)*Pneumonia (caused by G+ cocci)*STD's (caused by G+
cocci)*Legionella*Mycoplasma*Bordatella*Neisseria*Chlamydia
Binds to motilin receptors, causing hypermotility motility --> GI
upset
Acute cholestatic hepetatis*Eosinophilia
Protein synthesis inhibition by preventing amino acyl tRNA
attachment
VACUuM The BR*Vibrio Cholerea*Acne (Propionibacterium
Acnes)*Chlamydia*Ureaplasma
Urealyticum*Mycoplasm*Tularemia*H.
Pylori*Borrelia*Rickettsia
Discoloration of teeth (children)*Abnormal bone growth
(children)*Photosensitivity*Drug-induced Hepatitis*Fanconi
Syndrome (old Tetracyclines)
Blocks ADH receptors
Demeclocycline*Lithium
Inhibition of Phosphoinositol Cascade
Mood Stabilizer
LMNOP*L = Lithium*M = Muscle rigidity = tremors*N =
Nephrogenic Diabetes Insipidus*O = HyOthyroidism*P =
Pregnancy = Ebstein's Anomaly*P = Psoriasis Exacerbation
Inhibits Peptidyltransferase, the enzyme responsible for
transferring nucleotides from A --> P site
Bacterial meningitis
Dose-dependent Anemia*Dose-independent Aplastic
anemia*Grey Baby Syndrome (premature infants who lack UDPglucuronyl transferase)

What drugs INHIBIT Fungal Membrane Synthesis?


What drugs DESTROY fungal Membranes?

Flucytosine*Griseofulvin (interfers with microtubule formation


thereby inhibiting mitosis)
CAT*Caspofungin*Azoles*Terbinafine
Amphotericin B*Nystatin

What is the MOA of Caspofungin?

Inhibits Beta-13-Delta-Glucan

23

What is the c/u for Caspofungin?


What is the MOA of Terbinafine?
What is the c/u of Terbinafine?
What drugs can be used for Dermatophytes?
What is the MOA of Griseofulvin?
What is the MOA of Amantidine?
What is the c/u for Amantidine?
What is the MOA of Oseltamivir and Zanamivir?
What is the c/u of Oseltamivir and Zanamivir?
What is the TX for Influenza C?

What is the MOA of Acetaminophen?

What is the TX for acetaminophen toxicity?


What is the MOA of N-Acetylcysteine?
What is the MOA of Ribavirin?
What is the c/u of Ribavirin?
What is the TX for chronic Hepatitis C?
What is the TX for Hepatitis B?
What are the SE's of the Lamuvidine?
What is the c/u of INF-beta?
What is the drug that inhibits Acetyl CoA to ACh?
What drug inhibits the uptake of choline?
What drug inhibits the release of ACh?
What drug inhibits the conversion of DA to NE?
What drug inhibits the release of NE?
What drug stimulates the release of NE?
What drug inhibits the re-uptake of NE?
What receptor stimulates NE release?
What receptor inhibits NE release?
What are the direct-acting cholinomimetics?
What are the indirect-acting cholinomimetics?
What are the indirect cholinomimetics used in the TX of
Glaucoma?
What indirect cholinomimetic crosses the BBB?
What indirect cholinomimetic is used to reverse NMJ blockade?
What drug caused the NMJ blockade?
What drug reverses Phase I of SuccinlyCholine?
Why can't Phase I of depolaring muscular blockade be reversed?
What drug reverses Phase II of SuccinlyCholine?

CASPofungin*ASPergillosis (invasive)*Systemic Candidiasis


Inhibits cell wall synthesis by blocking squaline epoxidase
Dermatophytes*Superficial fungal infections
Terbinafine*Griseofulvin
Binds microtubules, arresting the cell in mitosis
Prevents viral uncoating*Prevents viral penetration*Increases
DA
Influenza A, RubellA & the CerebellA*Influenza
A*RubellA*Parkinson's (the CerebellA)
Inhibits viral influenza neuraminidase, decreasing the release of
viral progeny
Influenza A and B
Acetaminophen**Full Name: N-Acetyl-Para-Aminophenol
(APAP)*Other Names: Tylenol (U.S.)*Paracetamol (outside
North America)
Tylenol = Acetaminophen*MOA: REVERSIBLY blocks Cox I
& Cox II**Full Name: N-Acetyl-Para-Aminophenol
(APAP)*Other Names: Tylenol (U.S.)*Paracetamol (outside
North America)
Tylenol = Acetaminophen*N-Acetylcysteine
Regenerates glutithione & binds toxic metabolite NAPQI
Inhibits Guanine nucleotide synthesis by competitively inhibiting
IMP Dehydrogenase
Chronic Hepatitis C*RSV
Ribavirin*INF-alpha
INF-alpha*Lamuvidine
Lactic acidosis
MS
Vesimicol
Hemicholinium
Botulinum Toxin
Reserpine
Guanethidine
Amphetamine
Cocaine*TCA's
Angiotensin II
M1 & a2
Methanacol*Bethanacol*Carbichol*Pilocarpine
Neostigmine*Pyridostigmine*Physostigmine*Edrophonium*Ech
othiophate*Rivastigmine*Galantamine*Tacrine*Donepezil
Physostigmine*Echothiophate
Physostigmine
Neostigmine
SuccinylCholine
None; Phase I is IRREVERSIBLE
It CAN'T be reversed b/c post synaptic membranes are stuck in
depolarization
Neostigmine

24

For what is N-Acetylcysteine used to reverse?


How does AChE-I poisoning present?

What is the TX for AChE-I poisoning?


What is the MOA of Atropine?
What are the affects of Atropine?
What is toxicity of Atropine?

What is the MOA of Fenoldopam


D1 Agonist
What is the TX for Type II Heart Block?
What is the MOA of Epinephrine?
What is the MOA of Isoproterenol?
What is the MOA of NE?
What is the MOA of Dobutamine?
What is the MOA of DA?
What is the MOA of PE?
What is the MOA of Terbutaline?
What is the MOA of Cocaine?
What is the MOA of TCA's?
What is a heterocyclic that inhibits the reuptake of 5-HT?
What is a heterocyclic that inhibits the reuptake of NE?
What is the MOA of Mirtazapine?
What drug blocks 5-HT-3 receptors only?

Acetaminophen toxicity
ADDUMBBELSS*Abdominal
cramping*Diaphoresis*Diarrhea*Urination*Miosis*Bradycardia*
Bronchospasm*Excitation of skeletal
muscle*Lacrimation*Secretion*Salvation
Atropine followed by...*Pralidoxime (2-PAM)
AChE-Inhibitor
Blocks SLUD (antiPS):*Salivation*Lacrimation*Urination*Defication
Dry as a Bone: Dry eyes/skin (dec'd lacrimation/dec'd
sweat)*Hot as a Hare: Warm skin (dec'd sweat --> reflex
vasodilation)*Red as a Beet: Flushing (reflex vasodilation
secondary to dec'd sweat)*Blind as a Bat: Mydriasis/Cycloplegia
(dec'd PS's)*Mad as a Hatter: Confusion/Disorientation (CNS
effects on M4/M5 rec's)**NOTE: Decr'd sweating (SS response
under PS control) --> *incr'd body temp --> compensatory
cutaneous vasodilatory response --> *REFLEX
VASODILATION

Atropine followed by*Pacemaker


B1 > B2 > a1 > a2
B1 = B2
a1/a2 > B1
Dobutamine has a B*B1 > B2
DA has a D*D1 = D2 > B > a
a1 > a2
B2 > B1
Inhibits reuptake of NE
Block the reuptake of NE & 5-HT
Trazadone
Maprotiline
a2-antagonist*5-HT-2 & 5-HT-3 antagonist
Ondansetron

What drug blocks 5-HT-1D receptors?


What is the MOA of Venlafaxine?
What are 2 anti-depressants used to TX a pt w/sleep
disturbances?

Nothing, h/w Sumitriptan is a 5-HT-1D AGONIST


Block the reuptake of NE, 5-HT, & DA
Trazodone*Mirtazapine

What is the DOC for a pt w/depression & sexual dysfunction?


What is the TX for generalized anxiety in a pt with a hx of Etoh
addiction?
What is the TX for generalized anxiety in a pt with no hx of Etoh
addiction?
What is the MOA of Tranylcypromine?
What are the MAO-I's?

Bupropion
Buspirone

What is the difference in selectivity between the MAO-I's?

What is the c/u for the Non-selective MAO-I's?

Benzodiazapines
Non-selective MAO-I
PITS*P = Phenelzine*I = Isocarboxazid*T =
Tranylcypromine*S = Selegiline
Non-selective = MAO-IA (A for
Anywhere)*Phenelzine*Isocarboxazid*Tranylcypromine**Selecti
ve = MAO-IB (B for Brain)*Selegiline
Atypical Depression*Anxiety*Hypochondriasis*(Non-selective
MAO-I's = Tranylcypromine & Phenelzine)

25

What is the c/u for the selective MAO-I?


What is the DOC for OCD?
What is the 2nd line TX for OCD?
What is the MOA of Chlormipramine?
What are the TCA's?

Selective MAO-I = Selegiline*c/u = Anti-Parkinsonian


Paroxetine
Chlormipramine
Block the reuptake of NE & 5-HT (TCA's)
CANDID (PASS Program uses DD
CAIN)*Clomipramine*Amitriptyline*Nortriptyline*Desipramine
*Imipramine*Doxepin
Which TCA is LEAST sedating?
Desipramine
Which TCA has the MOST anti-cholinergic SE's?
Amitriptyline
Which TCA has the LEAST anti-cholinergic SE's?
Nortriptyline
What is the TX for enuresis (bedwetting)?
DOC = Desmopressin (similar to ADH --> H2O
Retention)*TCA = Imipramine
What is the DOC for diabetic neuropathy?
Any TCA
What is 2nd line TX for diabetic neuropathy?
Gabapentin
What is the MOA of Gabapentin?
GABA Agonist
What are the GABA-Agonists?
GBP
TV*Gabapentin*Benzodiazepines*Phenobarbital*Topiramate*V
alproic Acid
What NT's &/or ions does Topiramate and Valproic Acid affect? Inrease GABA*Decrease Na+
What direction?
What drugs decrease Na+ & is used for the TX of epilepsy?
Long-Term
CPA*Lamotrigine*Topiramate*Carbamazepine*Phenytoin*Valpr
oic Acid (A = Acid)
What is the DOC for a pt with upper limb spasticity and lower
Riluzole
limb flaccidity?
What is the MOA of Riluzole?
Glutamate Inhibitor
What are the drugs that cause Agranulocytosis?
Clozapine*Colchicine*Carbamazepine*PTU*Dapsone*Ticlopidi
ne*Methimazole
What is the TX for Restless Leg Syndrome?
DA Agonist
What are the DA Agonists?
CPR
LAB*Cabergoline*Promipexole*Ropinerole*Levadopa/Carbidop
a*Amantidine*Bromocriptine
What are the D2 Antagonists?
D2 Antagonists =
Neuroleptics:*Fluphenazine*Thioridazine*Haloperidol*Chlorpro
mazine*Promazine
What are the SE(s) of D2 Antagonists?
EPS Sx's*Neuroleptic Malignant Syndrome
What are 3 features of Neuroleptic Malignant Syndrome?
Autonomic Instability*Hyperthermia*Muscle Rigidity
What are 3 features of Serotonin Syndrome?
CV Collapse*Hyperparexia*Muscle Rigidity
What is the Tx for Neuroleptic Syndrome?
Dantrolene AND Dopamine Agonist
What are 4 features of EPS and the timeline involved for each
4 Hrs: Dystonia (sustained muscle contractions causing twisting
feature?
and repetitive *movements or abnormal postures)*4 Days:
Akinesia (inability to initiate movement due to difficulty
selecting *&/or activating the movement pathway)*4 Wks:
Akathisia (unpleasant sensations of inner restlessness that
manifests *itself with an inability to sit still or remain
motionless)*4 Mos: Tardive Dyskinesia (disorder resulting in
involuntary, repetitive body *movements having a slow or
belated onset)
If 87.5% of a drug has been eliminated from the body, how many 3 half-lifes
half-lifes have occurred?
If 50% of a drug remains in the body, how many half-lifes have
1 half-life
occurred?

26

How is half-life calculated?


How is Loading Dose calculated?
How is Maintenance Dose calculated?
How is Clearance calculated?
What are 3 drugs that undergo zero-order elimination?
What are the Phase II elimination reactions?
What are the Phase I elimination reactions?
Which elimination phase (I or II) is lost first?
What question is answered by Phase I drug development?
What question is answered by Phase II drug development?
What question is answered by Phase III drug development?
What question is answered by Phase IV drug development?
How do we calculate Therapeutic Index?
What direction does a noncompetitive antagonist shift the
potency curve (right, left, up, or down)?
What direction does a competitive antagonist shift the efficacy
curve (right, left, up, or down)?
What are the peptidoglycan synthesis Inhibitors?
What are the 50s Inhibitors?

What are the Macrolides?


What are the Streptogramins?
What are the 30s Inhibitors?
What are the AMG's?
What are the Nucleotide Synthesis Inhibitors?
What blocks mRNA Synthesis
Rifampin
What blocks DNA Topoisomerase II?
What drugs destroy fungal AND bacterial membranes?
What is the toxicity of Polymyxins?
What is the MOA of Penicillins?

What is the c/u of Penicillins?


What does Penicillin toxicity cause?
What does Methicillin toxicity cause?
What is the c/u for Methicillin?
What are the anti-Staph Penicillins?
What are the anti-Pseudomonas Penicillins?
What is the c/u of Ampicillin/Amoxicillin?
What does Ampicillin/Amoxicillin toxicity cause?
Which antibiotics cause Pseudomembranous Colitis?
What is the MOA of Clindamycin?

T1/2 = Vd/Cl x 0.7


LD = (Css x Vd) / f
MD = (Css x Cl) / f
Cl = Amount eliminated / Css
EPA*Ethanol*Phenytoin*Aspirin (high dose)
GAS (you get flatualance when you have to go
#2)*Glucoronidation*Acetylation*Sulfonation
HOR*Hydrolysis*Oxidation*Reduction
Phase I
Is it safe?
Does it work?
FDA double-blind study
Post-market surveillance: What SE's exist?
TILE*TI = LD50 / ED50
It doesn't: potency (Km) is not affected
It doesn't: efficacy (Vmax) is not affected
Bacitracin*Vancomycin*Cycloserine
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin
(macrolides)*Lincomycin*Linezolid*Streptogramins
ACE*Azithromycin*Clarithromycin*Erythromycin
Dalfopristin*Quinopristin
AT (Buys AT 30 CCELLS at 50)*AMG's*Tetracyclines
STANG*Streptomycin*Tobramycin*Amikacin*Neomycin*Gent
amicin
Sulfonamides*Trimethoprim*Methotrexate*Pyrimethamine

Quinolones
Polymixins (Polymixin B & Polymixin E)
ATN (acute tubular necrosis)*Neurotoxicity
1) Bind PBP's*2) Activate autolytic enzymes*3) Inhibits
transpeptidase cross-linking (does NOT block PG synthesis -->
Q #1)
G+ rods & cocci*G- cocci*Spirochetes
Hypersensitivity*Hemolytic anemia
Interstitial nephritis
Staph Aureus
CONDM*Cloxacillin*Oxacillin*Nafcillin*Dicloxacillin*Methicilli
n
PTC of Pseudomonas in the
AM*Piperacillin*Ticarcillin*Carbenicillin*Azlocillin*Mezlocillin
HELPS Enterococci*H. Influenza*E.
Coli*Listeria*Proteus*Salmonella*Enterococci
Hypersensitivity*Ampicillin rash*Pseudomembranous Colitis
Ampicillin/Amoxicillin*Clindamycin
Inhibition of bond formation between nucleotides at the P site

27

What is the c/u of Clindamycin?


What is the TX for Pseudomembranous Colitis?
What is the MOA of Metronidazole?
What is the c/u for Metronidazole?

What is the toxicity of Metronidazole?


What is the TX for bacterial vaginosis for pregnant pt's?
What is the DOC for Gardnerella Vaginosis?
What is the MOA of Vancomycin?
What is the c/u for Vancomycin?
What is the toxicity of Vancomycin?
What is the TX for VRSA?
What is the TX for local impetigo?
What is the c/u for 2nd Gen Cephalosporins?

What is a 3rd Gen Ceph used for the TX of Pseudomona?


What is a 3rd Gen Ceph used for the TX of Gonorrhea?
What are the Cephalosporins used for the TX of Gonorrhea?
What is the one-dose TX for Chlamydia?
What is the MOA of Azithromycin?

What is the c/u of Azithromycin?

What are the SE's of Azithromycin?


What is a 3rd Gen Ceph that cause a Disulfram-like reaction with
Etoh?
What is the MOA of Aztreonam?
What is the c/u of Aztreonam?
What is the DOC for G- rods?
What is the MOA of AMG's?
What is the toxicity of AMG's?
With what is imipenem co-administered? Why?
What is the MOA of Cilistatin?
What is the c/u of imipenem/cilistatin?
What are the Ototoxicity-causing drugs?
MOA of Tetracyclines?

Anaerobes above the diaphram


Metronidazole*Vancomycin
Form toxic metabolites in the bacterial cell wall that damage
DNA
GET
GAP*Giardia*Entomeba*Trichamonas*Gardnerella*Anaerobes*
H. Pylori
Disulfram-like reaction with alcohol*Dysguzia*Drug-induced
pancreatitis*Teratogenic
Metro cream*Clindamycin cream
Tinidazole
Blocks peptidoglycan synthesis by inhibiting D-ala D-ala
MRSA*Pseudomembranous Colitis (C. Difficile)*Any
nosocomial infection
There is NOT toxicity*Neurotoxic*Ototoxic*Thrombophlebitis
Linezolid*Streptogramins
Topical Mupirocin*Oral Erythromycin
HEN PEcKS (c = cocci)*H.
Influenza*Enterobacter*Neisseria*Proteus*E.
Coli*Klebsiella*Serratia*G+ cocci
Ceftazidime
Ceftriaxone & Cefixime
TRI to FIX a FOX*Ceftriaxone (3rd Gen)*Cefixime (3rd
Gen)*Cefoxitin (2nd Gen)
Azithromycin
Inhibits Macroslide (macro = 50s; slide = translocation)*Blocks
translocation from the A --> P site by binding the 23s subunit of
the 50s ribosome
UPS Lost My Brand New Car*URI's (caused by G+
cocci)*Pneumonia (caused by G+ cocci)*STD's (caused by G+
cocci)*Legionella*Mycoplasma*Bordatella*Neisseria*Chlamydia
Acute Cholestatic Hepatitis*Eosinophilia
PAIR of FAMily TETS (tits)*Cefeparazone (3rd
gen)**Cefamandole (2nd gen)*Cefotetan (2nd gen)
AzTHREEonam*Binds to PBP #3
G- rods in pt's who cannot tolerate AMG's*OR*Pt's allergic to
Penicillin*OR*Pt's with Renal Failure
AMG's
Inhibits initiation complex of N-acetyl formation causing
misreading of mRNA
There is NNO toxicity*Neurotoxic
(teratogenic)*Nephrotoxic*Ototoxic
Cilistatin
Inhibits renal dihydropeptidase-1
Enterobacter (DOC)
AMG's*Loops
(Furosemide)*Vancomycin*Quinidine*Chloroquine
Protein synthesis inhibition by preventing amino acyl tRNA
attachment

28

What is the c/u for Tetracyclines?

What is the toxicity of Tetracyclines?

What is the TX of Cat-Scratch Fever?


What is an alternative MOA of Demeclocycline?
What drugs block ADH receptors?
What are the drug-induced SLE?
What are the TB Rx?
What drugs Induce p450?
What drugs Inhibit p450?

What drugs are P450 Dependent?


What is Plan F?

What drugs can cause a disulfiram reaction?


What pathway does Coumadin/Warfarin. affect?
WEPTeD
How is Coumadin/Warfarin. monitored?
WEPTeD
What does Coumadin/Warfarin. do to PT?
WEPTeD
What drug causes SIADH? What are 5 causes of SIADH?

What do you get with a decrease in thiamine?


What are the drug-induced SLE?
What are the drugs that Blast the BM?
What are the TB Rx?
What drugs Induce p450?
What drugs Inhibit p450?

What drugs are P450 Dependent?


What are the one dose treatments for Gonorrhea?
What is the one dose treatment for Chlamydia?
What are the Big Mama anaerobes?

VACUuM The BR*Vibrio Cholerea*Acne (Propionibacterium


Acnes)*Chlamydia*Ureaplasma
Urealyticum*Mycoplasm*Tularemia*H.
Pylori*Bordetella*Rickettsia
Discoloration of teeth (children)*Abnormal bone growth
(children)*Photosensitivity*Drug-induced Hepatitis*Fanconi
Syndrome (old Tetracyclines)
Bug = Bartonella Henselae*Tx = Azithromycin
Blocks ADH receptors
Demeclocycline*Lithium
Hydralazine, INH, Phenytoin, Procainamide, Penicillamine,
Ethosuximide*(HIPPPE)
Rifampin, Pyrazinamide, INH, Ethambutanol, Streptomycin*(R
ESPI)
Barbiturates, Alcohol, Griseofulvin, Carbamazapine, Rifampin,
Quinidine, Tetracycline, Sulfa drugs*(BAG 4 CPR QTS)
INH, Dapsone, Spirolactones, Macrolides, Amiodarone,
Cimetidine, Ketoconazole, Quinilones*(I Do SMACK
Quinolones)
Warfarin, Estrogen, Phenytoin, Theophylline,
Digoxin*(WEPTeD)
TPP = Thiamin = B1, Lipoic Acid = B4, CoA = Pantothenic
acid = B5, FAD = Riboflavin = B2, NAD = Niacin =
B3*(PLAN F)
Chloramphenicol, Lactams, Cefamandole, Cefoperazone,
Antabuse, disulfiram , Metronidazole*(CLAM)
Extrinsic pathway
PT
Prolongs it
Small cell Ca of lung, Increased intracranial pressure, Any Pain
(most common), Drugs (Carbamazepine), Hypoxic Lung
Disease/Restrictive Lung disease*(SIADH mnemonic)
Beri Beri*(B-er-1 B-er-1
Hydralazine, INH, Phenytoin, Procainamide, Penicillamine,
Ethosuximide (HIPPPE)
AZT, Benzene, Chloramphenicol, Vinblastine
Rifampin, Pyrazinamide, INH, Ethambutanol, Streptomycin (R E
SPI)
Barbiturates, Alcohol, Griseofulvin, Carbamazapine, Rifampin,
Quinidine, Tetracycline, Sulfa drugs (BAG 4 CPR QTS)
INH, Dapsone, Spirolactones, Macrolides, Amiodarone,
Cimetidine, Ketoconazole, Quinilones (I Do SMACK
Quinolones)
Warfarin, Estrogen, Phenytoin, Theophylline, Digoxin
(WEPTeD)
Ceftriaxone, Cefixime, Cefoxine, Ciprofloxin, Oflaxacin,
Gatifolxacin
Azithromycin
Strep bovis, Clostridium melanogosepticus, Bacteriodes fragilis

29

What big mama bugs are associated with colon cancer? What are
the Big Mama Rx?
What drugs cause Cardiac Fibrosis? What drug is used to TX
Cardiac Fibrosis?
What is the MCC of any ....-penia?
What are the Drugs that cause Autoimmune hemolytic anemia?

BUGS: Strep. Bovis, Clostridium melanogosepticus; DRUGS:


Clindamycin, Metranidazole, Cefoxitin
DRUG-MEDIATED: Adriamycin (Doxyrubicin), Phen-fen;
TREATMENT: Dozaroxsin
#1 = Virus, #2 = Drugs

What is the one dose TX for Vaginal Candidiasis?


What is the one dose TX for Trichomonas?
What is the one dose TX for Gardnerella?
What are the 3 cephalosporins & doses used as one dose
treatments for Gonorrhea?
What are the 3 Quinolones & doses used as one dose treatments
for Gonorrhea?
What does tPA, Streptokinase, Urokinase inhibit?

Difluccan, 1 pill
Metronidazole, 2 grams
Metronidazole, 2 grams
Ceftriaxone, 250 mg im, Cefixime, 400 mg po, Cefoxitin, 400 mg
po
Ciprofloxacin, 500 mg po, Ofloxacin, 400 mg po, Gatifloxacin,
400 mg im
Aminocaproic acid

What doe Warfarin inhibit?


What does Heparin inhibit?
What is the dosage of tPA?
What is the dosage for Streptokinase?
What is Urokinase used for?

Vitamin K
Protamine Sulfate
IV push = 20mg, Drip = 40mg
IV push = 750K, Drip = 750K
Used ONLY for such things as: Feeding tubes, Central lines,
Fistulas

PCN, -methyldopa, Cephalosporins, Sulfa, PTU, Anti-malarials,


Dapsone
What are the drugs that cause Autoimmune thrombocytopenia?
ASA, Heparin, Quinidine
What are the sulfa containing drugs?
Sulfonamides, Sulfonylurea, Celebrex
What is another name for celebrex?
Celecoxib
What type of inhibitor is Celebrex?
COX 2 specific
What COX-2 specific drug can you give to a pt with sulfa allergy? Vioxx (Rofecoxib)
What drugs inhibit dihydrofolate reductase?
Pyremethamin/Sulfadiazine, Trimethoprim/Sulfamethoxazole
What drugs cause Pulmonary Fibrosis?
Bleomycin, Bulsufan, Amiodarone, Tocainide
What are the SE of Loop diuretics?
Ototoxicity, Hypokalemia, Dehydration, Allergy, Nephritis
(interstitial), Gout, (OH DANG)
What are the inhibitors of Complex 1 of the ETC?
Amytal, Rotenone
What are the inhibitors of Complex 2 of the ETC?
Malonate
What are the inhibitors of Complex 3 of the ETC?
Antimycin D
What are the inhibitors of Complex 4 of the ETC?
CN-, CO, Chloramphenicol
What are the inhibitors of Complex 5 of the ETC?
Oligomycin
What are the ETC chemical uncouplers?
DNP, Free Fatty acids, Aspirin
What type of uncoupler is Aspirin?
Physical uncoupler
What is the one dose TX for Hemophilus ducreyi?
Azithromycin, 1 gram po, Ceftriazone,250 mg im
What is the one dose TX for Chlaymdia?
Azithromycin, 1 gram po
What is the one dose TX for Candidiasis?
Ketoconazole, 150mg

What is the special list for Penicillin?


What is the #1 cause of anaphylaxis?
What is Plan F?
What is dysgusia? What are 3 causes of dysgusia?
What are the risk factors for Esophageal/Gastric CA?
What are the risk factors for bladder CA?

Penicillin
TPP = Thiamin = B1, Lipoic Acid = B4, CoA = Pantothenic
acid = B5, FAD = Riboflavin = B2, NAD = Niacin = B3
Dysgusia is a problem with sense of taste , Metronidazole,
Clarithromycin, Zinc deficiency
Smoking, Alcohol, Nitrites, Japanese
Smoking , Aniline dyes, Benzene, Aflatoxin, Cyclophosphamide,
Schistosomiasis, 2 diseases: Von Hippel-Lindau, Tubular sclerosis

30

What is the NBT test? What is it used for?


Test used to detect CF? What does this test measure?
Definitive presence of CF disease has a Pilocarpine test value of
what? Normal person? Heterozygous person?
What drugs can cause a disulfiram reaction?
Which of the B-Blockers are B1-selective?
Which of the B-Blockers are non-selective?
What type of charge does heparin have?
What type of charge does protamine sulfate have?
What is Protamine Sulfate used for?
What is the MOA of Erythromycin?
What is the MOA of Chloramphenicol?
What is the MOA of Puromycin?
What is the MOA of Streptomycin?
What is the MOA of Tetracycline?
What is the MOA of Cyclohexamide?
What are the 5 bacteria causing Heart Block?

What bacteria cause Reiters Syndrome?


What are the Low Complement bugs causing Cryoglobuniemia?
What are the drugs induced SLE?
What are the drugs that Blast the BM?
What are the Comma Shaped bugs?
What is the cresent shaped protozoa?
What bacteria looks like Chinese letters?
What are the TB Rx?
What are the 6 Low Complement assocs. with Nephrotic
Syndrome?
What drugs Induce p450?

What drugs Inhibit p450?


What drugs are P450 Dependent?

What disease is a Neutophil Deficiency?

Nitro Blue Tetrazolium test, Screening CGD, What is the Tx for


Cytic Fibrosis?; What else is it used for?
Pilocarpine sweat test, Cl- ion levels in the sweat
CF Ds > 60; Normal < 20; Heterozygous: 30 60
Chloramphenicol, Lactams, Cefamandole, Cefoperazone,
Antabuse, disulfiram , Metronidazole (CLAM)
Drugs that end in -lol and begin with the letters A M
Drugs that end in -lol and begin with the letters N Z;
EXCEPTIONS: Carbetalol and Labetolol are non-selective
-ve charge
+ve charge
Reversing the effects of Heparin
Inhibits the translocation step of ribosomal protein synthesis
Inhibits ribosomal peptidyl transferase in prokaryotes
Inhibits elongation by binding to A site and prematurely
terminating chain growth in pro and eukaryotes
Causes misreading of code during initiation in prokaryotes
Prevents binding of aminoacyl-t-RNA to ribosome on
prokaryotes therefore inhibiting initiation
Inhibits ribosomal peptidyl transferase in eukaryotes , cell wall
inhibitor
Lyme Disease*Salmonella typhii (typhoid)*Chagas Disease
(Whipples)*Legionella*Diptheria**Lets Stop Doing Long
Contractions
Shigella*IBD*Crohns*Chlamydia*Yersina**Reiter & Crohn Saw
Yersina and got Chlamyia
Influenzae*Adenovirus*Mycoplasma*Hepatitis C*EBV**I AM
HE
Hydralazine*INH*Phenytoin*Procainamide*Penicillamine*Ethos
uximide**H I PPPE
AZT*Benzene*Chloramphenicol*Vinblastine**Vinblastine
Anilate Bone Cells
Vibrio*Campylobacter*Listeria*H. pylori**Campylobacter Has
Very Long Comma Genes
Giardia lamblia
Corynebacter
Rifampin*Pyrazinamide*INH*Ethambutanol*Streptomycin**R
ESPI
Serum Sickness*PSGN*SLE*SBE*Cryoglobinemia*MPGN II
Barbiturates*Alcohol*Griseofulvin*Carbamazapine*Rifampin*Q
uinidine*Tetracycline*Sulfa drugs**BAG 4 CPR QTS*Car Grabs
Queens Tets to Rev Up *Alcoholic doing drugs and stinking up
car
INH*Dapsone*Spirolactones*Macrolides*Amiodarone*Cimetidi
ne*Ketoconazole*Quinilones**I Do SMACK Quinolones
Warfarin*Estrogen*Phenytoin*Theophylline*Digoxin**Theo
came from war & dig inside WDEPT taking Estrogen & now is
Phenytoin
CGD

31

What is another name for CGD?


What are the Side effects of Statins?
What are the painful genital Lesions?
What is the painful chancroid lesion due to?
What are the 4 hormones with disulfide bonds?
What are the Hookworms?

What are the X-Linked enzyme Deficiencies?

What diseases do we screen for at birth?

HLA-Antigens

What are the actions of Steroids?

What are the causes of Monocytosis?


E. Coli is the most common cause of what?
What are the one dose treatments for Gonorrhea?
What is the one dose treatment for Chlamydia?
What are the Big Mama anaerobes?
What are the Big Mama Rx?
What big mama bugs are associated with colon cancer?
What are psammoma bodies?
In what diseases are Psammoa Bodies present?
What are the Urease (+) organism?

What types of stones are formed from Proteus?


What type of motility do Proteus have?
What are 5 indications of Surgery?
What drugs cause Cardiac Fibrosis?
What drug is used to TX cardiac fibrosis?

Chronic Granulomatous disease*NADPH Oxidase deficiency


Myositis*Hepatitis*Increased liver enzymes
Chancroid*Herpes*Lymphogranuloma inguinale
Hemophilus ducreyi
Prolactin *Insulin*Inhibin*GH**I PIG on BONDS
Necatur americanis*Enterobius vermicularis*Ankylostoma
duodenale*Trichuris trichurium*Ascaris
lumbercoides*Strongyloides**Hooks AS NEAT
Fabry's Tale: Duke the Muscular Hunter Brutally Lysed the
Albino Gopher without aWAre it was a Fragile
Hemophiliac**Fabry's*Duchenne MD*Hunters*Bruton's
agammaglobinemia*Lesch-nyhan*Ocular
albinism*G6DP*Wiskott Alridge syndrome*Fragile
X*Hemophilia A & B
PKU*CAH(Congential Adrenal
Hyperplasia)*Biotinidase*Galactosemia*Hypothyroidism***Pleas
e Check Before Going Home
HLA-DR2= Narcolepsy, Allergy, Goodpastures, MS*HLADR3= DM, Chronic Active Hepatitis, Sjogrens, SLE, Celiac
Sprue*HLA-DR3 & 4= IDDM(Type I)*HLA-DR4=
Rheumatoid Arthritis, Pemphigus Vulgaris*HLA-DR5= JRA,
Pernicious Anemia*HLA-DR7= Nephrotic Syndrome(Steroid
induced) HLA-DR 3 & B8=Celiac Disease*HLA-A3=
Hemochromatosis(chromo. 6, point mut.cysteine>tyrosine)*HLA-B8=MG*HLA-B13= Psoriasis*HLAB27= Psoriais(only if w/arthritis) Ankylosing Spondylitis, IBD,
Reiters, Postgonococcal Arthritis*HLA-BW 47= 21 alpha
Hydroxylas def.(Vit.D)
Kills helper T-cells & eosinophils*Inhibits Macrophage
migration*Inhibits Mast cell degranulation*Inhibits
Phospholipase A*Stimulates protein synthesis*Stablizes
endothelium
Salmonella (typhoid)*TB*EBV*Listeria*Syphillis
UTI*Spontaneous bacterial peritonitis *Abdominal
abscess*Cholecystitis*Ascending cholangitis*Appendicitis
Ceftriaxone*Cefixime*Cefoxine*Ciprofloxin*Oflaxacin*Gatifolx
acin
Azithromycin
Strep bovis*Clostridium melanogosepticus*Bacteriodes fragilis
Clindamycin*Metranidazole*Cefoxitin
Strep. Bovis*Clostridium melanogosepticus
Calcified CAs
Papillary carcinoma of the Thyroid*Serous cystadenocarcinoma
of the ovary*Meningioma*Mesothelioma
UREASE PUNCH**Proteus*Ureaplasma urealyticum*Nocardia
species*Cryptococcus neoformans*H. pylori**the first two: PU
makes struvite stones
Struvite (90%)
swarming
Intractable pain*Hemorrhage (massive)*Obstruction (from
scarring)*Perforation
Adriamycin (Doxyrubicin)*Phen-fen
Dozaroxsin

32

What is the MCC of any .penia?


What is seen in the Salmonella Triad?
What drugs cause Myositis?
What are the 7 Gram -encapsulated bacteria?

What is the Jones Criteria for Rheumatic Fever?


What are the causes of Eosinophilla?
What are the Risk Factors for Liver CA?

What are the live attenuated vaccines?

What are the Killed Vaccines?


What are the IgA Nephropathies?
What are the Drugs that cause Autoimmune hemolytic anemia?

#1 = Virus*#2 = Drugs
High Fever*Rose spots (rash)*Intestinal fire
Rifampin*INH*Predinsone*Statins
Salmonella*Strep. Pneumo (gr+)*Klebsiella*H.
influenza*Pseudomonas*Neisseria*Cryptococcus**Some Strange
Killers Have Pretty Nice Capsules
JHONES**Joints*Heart: pancarditis*Nodules (subq)*Erythema
marginatum*St. Vitus's horea
Neoplasms*Allergies/Asthma*Addisons Dz*Collagen Vascular
Dz*Parasites
Hep B,C,D*Aflatoxin*Vinyl chloride*Ethanol*Carbon
Tetrachloride*Anyline
Dyes*Smoking*Hemochromatosis*Benzene*Schistomiasis
live! one night only! Flu here and see SMALL YELLOW
CHICKENs get vaccinated with Sabin and MMR! Their eggs are
flu yellow (intranasal flu and yellow fever vaccine are eggbased)**intranasal influenza*smallpox*chickenpox (VZV)*polio
(sabin)*MMR
Salk (polio)*Influenza*Rubella*Hepatitis A**SIR Hep A
Henoch-Schoenlein P. (HSP)*Alports*Bergers

PCN*-methyldopa*Cephalosporins*Sulfa*PTU*Antimalarials*Dapsone
What are the drugs that cause Autoimmune thrombocytopenia?
ASA*Heparin*Quinidine
What are the enzymes that show after an MI?
Troponin I*CKMB*LDH
What is the first MI enzyme to appear?
Troponin I*Appears*Peaks*Gone****2 hrs*2 days*7 days
What is the 2nd MI enzyme to appear?
CK-MB*Appears*Peaks*Gone****6 hrs*12 hrs*24 hrs
What is the 3rd MI enzyme to appear?
LDH*Appears*Peaks*Gone****1 day*2 days*3 days
What bacteria have Silver Stains?
Legionella*Pneumocysitis carinii*H. pylori*Bartonella henseslae
(lymph node)*Candida (yeast)
What are the sulfa containing drugs?
Sulfonamides*Sulfonylurea*Celebrex
What is another name for celebrex?
Celecoxib
What type of inhibitor is Celebrex?
COX 2 specific
What COX-2 specific drug can you give to a pt with sulfa allergy? Vioxx (Rofecoxib)
What drugs inhibit dihydrofolate reductase?
Pyremethamin/Sulfadiazine*Trimethoprim/Sulfamethoxazole
What drugs cause Pulmonary Fibrosis?
What are the macrophage deficiency diseases?
What are the SE of Loops and Thiazides?
What are the SE of Loop diuretics?
What are the only 3 Pansystolic Murmurs and when are they
heard?
What are the 7 Rashes of the Palms & Soles?

What is seen in every restrictive lung dz and low volume state?


What are the different 2nd messenger systems?
What is the clue for cAMP?
What is the clue for cGMP?

Bleomycin*Bulsufan*Amiodarone*Tocainide
Chediak-Higashi*NADPH-oxidase deficiency
Hyperglycemia*Hyperuricemia*Hypovolemia*Hypokalemia
Ototoxicity*Hypokalemia*Dehydration*Allergy*Nephritis
(interstitial)*Gout**OH DANG
MR: Decrease on inspiration (^exp)*TR: Increase on
inspiration*VSD: Decrease on inspiration (^exp)
TSS*Rocky Mountain Spotted Fever*Coxsackie A (Hand/Foot
& mouth dz)*Kawasaki*Syphillis*Scarlet Fever*Staph Scalded
Skin Syndrome
Tachypnea*Decrease pCO2*Decrease pO2*Increase pH
cAMP*cGMP*IP3/DAG*Ca:Calmodulin*Ca+*Tyrosine
kinase*NO
It is the 90%*Sympathetic*CRH (cortisol)*Catabolic
Parasympathetic*Anabolic

33

What are the clues for IP3/DAG?


Used by what and for what?
What are the peptidoglycan synthesis Inhibitors?
What are the 50s Inhibitors?

What are the Macrolides?


What are the Streptogramins?
What are the 30s Inhibitors?
What are the AMG's?
What are the Nucleotide Synthesis Inhibitors?
What is the MOA of Sulfonamides?
What is the MOA of Trimethoprim?
What is the MOA of Pyrimethamine?
What drugs inhibit DHF Reductase?
What blocks DNA Topoisomerase II?
What blocks DNA Gyrase?
What blocks mRNA Synthesis
Rifampin
How does Rifampin's MOA work?
What drugs block bacterial & fungal membranes?
What drugs destroy fungal membranes?
What is the MOA of Penicillins?
What is the end-result of transpeptidase cross-linking?
What are the peptidoglycan synthesis Inhibitors?
What is the c/u of Penicillins? (1st generation) G+ rods &
cocci*G- cocci*Spriochetes
What does Penicillin toxicity cause?
What does Methicillin toxicity cause?
What is the c/u for Methicillin?
What is used for MRSA?
What are the anti-Staph Penicillins?
*CONDM*Cloxacillin*Oxacillin*Nafcillin*Dicloxacillin*Methicil
lin
What are the anti-Pseudomonas Penicillins?
*PTC of Pseudomonas in the
AM*Piperacillin*Ticarcillin*Carbenicillin*Azlocillin*Mezlocillin
What is the order of TX for Pseudomonas?
What is the c/u of Ampicillin/Amoxicillin?
*HELPS Enterococci*H. Influenza*E.
Coli*Listeria*Proteus*Salmonella*Enterococci
What is co-administered with Ampicillin/Amoxicillin?

Neurotransmitter*GHRH*All hypothalamic hormones xc


cortisol
Smooth muscle for contraction
Bacitracin*Vancomycin*Cycloserine
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin*Lincomycin*
Linezolid*Streptogramins
ACE*Azythromycin*Clarithromycin*Erythromycin
Dalfopristin*Quinopristin
AT (Buys AT 30 CCELLS at 50)*AMG's*Tetracyclines
(doxycycline, demecyocycline, minocycline, tetracycline)
STANG*Streptomycin*Tobramycin*Amikacin*Neomycin*Gent
amicin
Sulfonamides*Trimethroprim*Pyrimethamine*Methotrexate
Inhibition of Dihydropterate Synthase
Inhibition of Dihydrofolate Reductase
Inhibition of Dihydrofolate Reductase
Trimethoprim*Pyrimethamine*Methotrexate
Quinolones
Quinolones (DNA Topoisomerate II & DNA Gyrase are the
same)

Inhibition of DNA-dependent RNA polymerase, thereby


blocking mRNA synthesis
Polymixins (Polymixin B & Polymixin E)
Amphotericin B*Nystatin
1) Bind PBP's*2) Activates autolytic enzymes*3) Inhibits
transpeptidase cross-linking
Formation of peptide bonds between nucleotides
Bacitracin*Vancomycin*Cycloserine

Hypersensitivity*Hemolytic Anemia
Interstitial nephritis
Staph Aureus
Vancomycin
(Anti-Staph PCN's = 2nd Gen PCN)

(4th Gen PCN)

1. AMG's (1st for any G- rod)*2. 3rd Gen Cephalosporins*3.


Anti-Pseudomona PCN's
(3rd Gen PCN)

Clavulonic Acid

34

What is the MOA of clavulonic acid?


What are the anti-Penicillinase's?
What are the Penicillinase/B-Lactamase inhibitors?
*AIM*Aztreonam*Imipenem/Cilistatin*Meropenem
What is the c/u for the Penicillinase/B-Lactamase inhibitiors?
What does Ampicillin/Amoxicillin toxicity cause?
Which antibiotics cause Pseudomembranous Colitis?
What is the TX for Pseudomembranous Colitis?
What are the 50s Inhibitors?

What are some 1st Gen Cephalosporins?

What is the c/u for 1st Gen Cephalosporins?


What are the G+ cocci?
What are some 2nd Gen Cephalosporins?

What is the c/u for 2nd Gen Cephalosporins?

What are some 3rd Gen Cephalosporins?


What is a 3rd Gen Ceph used to TX Pseudomona?
What is a 3rd Gen Ceph used to TX Gonorrhea?
What are the Cephalosporins that TX Gonorrhea?

Inhibition of Penicillinase (Beta-Lactamase)


CONDM + Ampicillin/Amoxicillin w/Clavulonic Acid + all
Cephalosporins
(these drugs are resistant to B-Lactamases)
G- bugs
Hypersensitivity*Ampicillin rash*Pseudomembranous colitis
Ampicillin/Amoxicillin*Clindamycin
Metronidazole*Vancomycin
CCELLS (Buys AT 30 CCELLS at
50)*Chloramphenicol*Clindamycin*Erythromycin*Lincomycin*
Linezolid*Streptogramins
Cephalosporin that begin with Cefa- or Cephaprefixes*Cefazolin*Cephalexin**Exception: Cefaclor is a 2nd
Gen Ceph. Only a few 1st Gen Cephs don't start w/one of these
2 prefixes
PEcK (c = cocci)*Proteus*E. Coli*Klepsiella*G+ cocci
Staphyloccoci*Streptococci
A FAMily of FOXes has FURry
TETs*Cefamandole*Cefoitin*Cefuroxime*Cefotetan*Cefaclor
(exception to 1st Gen Cephalosporins rule)
HEN PEcKS (c = cocci)*H.
Influenza*Enterobacter*Neisseria*Proteus*E.
Coli*Klebsiella*Serratia (red pigment)*G+ cocci
Cefixime*Ceftriaxone*Ceftazidime*Cefotaxime*Cefeparazone
Ceftazidime

What is the one-dose TX for Chlymdia?

Ceftriaxone & Cefixime


TRI to FIX a FOX*Ceftriaxone (3rd)*Cefixime (3rd)*Cefoxitin
(2nd)
Azithromycin

What are the Cephalosporins that cause a Disulfram-like reaction


with Etoh?
What are some 4th Gen Cephalosporins?
What is the MOA of Aztreonam?

PAIR of FAMily TETS (tits)*Cefeparazone (3rd)*Cefamandole


(2nd)*Cefotetan (2nd)
Cefipime
AzTHREEonam*Binds to PBP #3

What is the c/u for Imipenem/Cilastatin?


What is the MOA of Vancomycin?
What are the peptidoglycan synthesis Inhibitors?
What is the c/u for Vancomycin?
Vancomycin is the TX for Pseudomembranous Colitis secondary
to what?
Why is Vancomycin used for nosocomial infections?

DOC for Enterobacter


Inhibition of D-ala D-ala*t/f it can't make peptidoglycan
Bacitracin*Vancomycin*Cycloserine
MRSA*Pseudomembranous Colitis*Any nosocomial infection
C. Difficile

What is the TX for VRSA?


What are the Streptogramins?
What is the MOA of Linezolid?
What is the MOA of Streptogramins?
What is the TX for linezolid-Resistent Staph Aureus?
What is the toxicity of Vancomycin?
What are the Ototoxic-causing drugs?

Linezolid*Streptogramins (-pristins)
Dalfopristin*Quinopristin
Inhibition of 50s
Inhibition of 50s
Call the clergyman to pray for the pt b/c there is nothing else
There is NOT toxicity*Neurotoxic*Ototoxic*Thrombophlebitis
AMG's*Loops (Furosemide)*Vancomycin*Quinidine (Na
channel blocker)*Chloroquine (malaria)

Nosocomial is defined as any infection that is picked up while


hospitalized; it is t/f assumed that it is probably drug-resistent

35

What is the MOA of AMG's?


What is the c/u of AMG's?
For what are AMG's used 1st line?
What is the TX of Pseudomonas infection in a pt who cannot
tolerate AMG's?
What is the c/u of Aztreonam?
Why is Aztreonam used in pt's with Renal Failure?
What is the toxicity of AMG's?
MOA of Tetracyclines?
What is the function of amino acyl tRNA?
Why does tRNA need to be charged?

Inhibits initiation complex of N-acetyl formation causing


misreading of mRNA
G- Rods
Pseudomonas infections
Aztreonam
G- rods in pt's who cannot tolerate AMG's*OR*Pt's allergic to
Penicillin*OR*Pt's with Renal Failure
AMG's are Nephrotoxic
There is NNO toxicity*Neurotoxic
(teratogenic)*Nephrotoxic*Ototoxic
Protein synthesis inhibition by preventing amino acyl tRNA
attachment
It charges the tRNA molecule
Charging provides energy to pick up the next nucleotide

36

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