Pharmacology Onco + Renal + Dermato

1. Vincristine causes neurotoxic effects such as peripheral neuropathy

due to failure of microtubule polymerization in neuronal axons. It is a
chemotherapy agent.
2. Amphotericin B is the most toxic antifungal and is nephrotoxic (renal
tubular dysfunction) causing both anemia and electrolyte abnormalities
(hypokalemia and hypomagnesia)
3. Cladribrine is a purine analog that is resistant to degradation by
adenosine deaminase. Drug of choice for hairy cell leukemia.
4. Methotrexate (similar to folic acid) given to pregnant women for
ectopic pregnancy causes dihydrofolate polyglutamate to accumulate
in embryonic tissue. Methotrexate inhibits dihydrofolate reductase,
which catalyzes the synthesis of tetrahydrofolate. Failure of
dihydrofolate reductase causes the intermediate dihydrofolic acid
polyglutamate to accumulate in treated cells.
5. Acetazolamide treats acute angle-closure glaucoma. It is a diuretic that
inhibits carbonic anhydrase, which is found in the proximal tubule.
6. Para-aminobenzoic acid containing sunscreens protect skin from UVB
rays.
7. Methotrexate and 5-FU inhibit thymidylate formation, but methotrexate
is overcome by Leucovorin (N^5-formyl-tetrahydrofolate)
8. Acyclovir Is nephrotoxic and symptoms can be prevented by adequate
hydration
9. Etoposide targets topoisomerase II (blocks it from sealing strand
breaks it causes leading to chromosomal breaks
10. Nafcillin is a penicillinase-resistant penicillin that treats skin and
soft tissue infections
11. Tumor cells resist anticancer agents via MDR1 gene which
produces a P-glycoprotein, a transmembrane protein that functions as
an ATP-dependent efflux pump (removes chemotherapeutic agents)
12. Calcineurin activates IL-2, which promotes the growth and
differentiation of T cells. Cyclosporine and tacrolimus work by inhibiting
calcineurin activation.
13. Corticosteroids decrease the production of ECM collagen and
GAG causing dermal atrophy
14. Thiazides prevent calcium stone formation by decreasing urine
Ca2+ excretion (increase Ca2+ reabsorption by inhibiting the Na/Cl
cotransporter and by hypovolemia induced by thiazides.
15. Loop diuretics are used to treat volume overload due to CHF.
Work in thick ascending loop of Henle
16. Thiazide diuretics cause hyponatremia, hypokalemia, and
hypercalcemia
17. ACE-inhibitor (prevents efferent arteriole from constricting more
than afferent) side effects include decreased glomerular filtration rate,
cough and angioedema
18. Spironolactone is an aldosterone antagonist and is similar to
steroids it causes endocrine effects such as gynecomastia, decreased
libido, and impotence.
19. Finasteride (5a-reductase inhibitor) treats BPH (decreases
prostate volume)
20. Vincristine is a vinca alkaloid that inhibit microtubule formation
during the M phase of the cell cycle (replicated chromosomes unable
to align and separate)
21. Mannitol an osmotic diuretic side effects include headache,
nausea and vomiting. High doses can cause excessive volume
depletion and hypernatremia and pulmonary edema.
22. Thiazides cause hypercalcemia and work in the distal convoluted
tubule
23. Mesna (2-mercaptoethanesulfonate) prevents the hemorrhagic
cystitis associated with nitrogen mustard-based chemotherapy.
Cyclophosphamide causes hemorrhagic cystitis
24. Cidofovir is a nucleoside monophosphate that requires only
cellular kinases for activation. Treats varicella zoster virus in HIV
infected patients also foscarnet
25. Baldness in males is due to 5a-reductase activity. Finasteride
inhibits these effects
26. Lithium induced diabetes insipidus (treatment for bipolar
disorder) causes low urine specific gravity with trace ketones. ADH
(vasopressin) is antagonized in collecting duct
27. Isotretinoin (Accutane) is teratogenic so must test for pregnancy
(serum b-HCG levels) before prescribing to female
28. Ondansetron (5-HT3) receptor antagonist prevent chemo-induced
vomiting
29. Calcipotriene used to treat psoriasis activates a nuclear
transcription factor (vitamin D receptor)
30. Terbinafine is used to treat dermatophytosis by inhibiting
synthesis of ergosterol of the fungal membrane by inhibiting the
enzyme squalene epoxidase
31. Furosemide is ototoxic
32. Addition of low dose spironolactone to standard therapy reduces
morbidity and mortality in CHF patients
33. Leucovorin (folinic acid) can reverse methotrexate toxicity
34. Visual impairment in HIV infected patient caused by CMV induced
retinitis. Foscarnet, ganciclovir and cidofovir used to treat this, but
foscarnet can cause seizures due to hypomagnesemia and
hypocalcemia
35. Digoxin is cleared by the kidneys and causes renal insufficiency
in older patients
36. Amphotericin B is used to treat mucormycosis and causes renal
toxicity so serum potassium and magnesium should be monitored
37. The pathophysiology of EML4-ALK NSCLC is similar to the
pathophysiology of CML
38. 6-mercaptopurine is degraded in the liver by xanthine oxidase
39. Amifostine is a thiol-based cytoprotective free-radical scavenging
agent that decreases nephrotoxicity due to platinum containing agents
(cisplatin).

Renal Physiology

40. Constriction of efferent arteriole causes increase of GFR and FF

41. Diabetic ketoacidosis triad: polydipsia, polyuria and fruity odor to
the breath and/or urine. DKA yields a low pH, low serum bicarbonate
and a low PaCO2.
42. Potassium levels in bowmans capsule is 100%. In collecting duct
it is 110%. In proximal tubule 65% of K is filtered out leaving 35% in
the proximal tubule. In thick ascending loop of Henle there is 10 % of
K.
43. End-stage renal disease causes hypocalcemia via renal retention
of phosphate and decreased renal synthesis of 1,25-
dihydroxycholecalciferol vitamin D. Both hypocalcemia and the
resultant hyperparathyroidism contribute to renal osteodystrophy.
44. PCT reabsorption of glucose occurs via Na+/glucose co-
transporter. Inulin is a substance that is not filtered so it is used to
calculate GFR.
45. Serum creatinine rise as GFR declines to less than 60 ml/min
46. Increase to capillary hydrostatic pressure will increase GFR due
to constriction of efferent arteriole
47. Rate of dialysis with semipermeable membrane is increased by
increasing surface area of the membrane
48. Filtration fraction of healthy individual is 20%. Creatine estimates
GFR and PAH estimates RPF
49. In aspirin overdose, blood pH is acidic (METABOLIC ACIDOSIS) or
results in respiratory alkalosis
50. PAH is not reabsorbed and has lowest concentration in Bowmans
capsule. Concentration increases as it moves through tubules
51. Elevated aldosterone causes HTN, hypokalemia, and muscle
weakness. Increased levels of aldosterone and renin caused by renin-
secreting tumors (juxtaglomerular tumor)
52. Water is impermeable to the ascending limb of the loop of Henle
regardless of serum vasopressin levels
53. Chronic renal failure causes secondary hyperparathyroidism. PTH
and phosphate are high and calcium and calcitriol are low.
54. In DKA, metabolic acidosis is compensated by respiratory
alkalosis. When PaCO2 levels are above range from Winters formula,
the patient has respiratory acidosis and failure.
55. Fluid filtered in the glomerulus is reabsorbed in the proximal
tubules
56. Spironolactone is an aldosterone receptor inhibitor. Na is
removed from the tubular fluid. Also, K and H ions are lost in the
tubular fluid.
57. ADH is released during dehydration and acts on collecting ducts.
In presence of ADH, the collecting ducts contain concentrated fluid,
while thick ascending limp of loop of Henle and distal convoluted
tubule contain most dilute fluid
58. In DKA, pH, HCO3, and CO2 are low. Titratable acids like H2PO4
are high.
59. PAH, creatinine, inulin, and urea increase as fluids flows along
proximal tubule. Bicarb., glucose and amino acids decrease
60. Dehydration leads to decrease in RPF and GFR and FF increases.
61. Urea concentration increases ADH concentrating urine in the
medullary segment of the collecting duct
62. Ureteral constriction or obstruction acutely decrease the GFR and
glomerular filtration fraction
63. PAH secretion can be saturated at high blood concentrations
64. ADH acts on the collecting ducts increasing their permeability to
water. When ADH is absent, the tubular fluid is most concentrated
between the descending and ascending limps of the loop of Henle and
most dilute in the collecting ducts.
65. FF calculated by GFR/ (1-Hct)(RBF).
66. ADH injection reduces urea
67. Loop diuretics stimulate prostaglandin release and NSAIDs inhibit
prostaglandin
68. Net excretion= (inulin clearance)(plasma conc. of A) (tubular
reabsorption of A)
69. RBF= PAH clearance= (urine PAH x urine flow rate)/plasma PAH /
1 hematocrit
70. Glucose is completely reabsorbed at low concentrations and high
fractional excretion is observed at high plasma concentrations
Anatomy CVS
71. Left atrium is anterior to esophagus
72. Descending aorta is posterior to the esophagus
73. Left ventricular leads course through the coronary sinus which
resides in the AV groove
74. IVC is formed by right and left common iliac veins
75. Staph affects tricuspid valve
76. Inferior wall of left ventricle forms diaphragmatic surface of
heart. Posterior descending artery supplies this area and derives from
the right coronary artery
77. Coronary sinus dilation due to HTN
78. Left heart failure shows pulmonary edema, pleural effusions,
Kerley B lines and vascular shadowing
79. Saphenous vein harvested at inferolateral area to the pubic
tubercle
80. Right ventricle at LSB 4th intercostal space
81. Aortic rupture common in motor vehicle accidents and aortic
isthmus (connects ascending and descending aorta) is usually injured
82. IVC filter used to prevent DVT from traveling to lungs
83. Pathology Reproductive