Step I Drugs for step 1
Started by MudPhud20XX
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IIRC it inhibits late phase inward sodium current.
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Name 3 GP IIb/IIIa inhibitors and 3 P2Y12 inhibitors. Which P2Y12 inhibitor is a prodrug? Which one is converted to active metabolite via CYP 2C19 (so, avoid combo with omeprazole and esomeprazole)?
I'm just curious as to how HY is distinguishing all of the pro-drugs vs. Non-prodrugs for step 1? Do they really ask questions like that?
I think so, but I thought that was when clomiphene failed?
Red man/red neck syndrome
Gray baby syndrome
Cefutetan and cefoxitin
Ceftazidime
.....Cefupime??
Disulfiram-like rxn with alcohol?
Speaking of disulfiram and metronidazole, what can result when a pt take both disulfiram and metronidazole together?
I'm not sure. Metformin is an insulin sensitizer, so I would think that giving someone metformin will help with hirsutism/acne, oligomenorrhea/amenorrhea, and insulin lowering in addition to ovulation induction. I guess if the pt isn't having other SXs besides infertility, clomiphene might be the DOC. Your thoughts?
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if there is hepatic enzyme inducer or hepatic enzyme inhibitor due to drugs like carbamazepine or ketoconazole
is that risk for any disease or complication
is that risk for any disease or complication
Thanks! So easy to mess up that 1 letter. Ha
Yup!
I don't know if/how often metformin is used alone for fertility in PCOS, but I remember reading something about how when used in combo with clomiphene, it can increase the chances of ovulation, but not necessarily the chances of having a baby. So, based off of that, my thoughts would be to use each drug "as intended" so to speak, and if the metformin ends up helping on the fertility side of things, then it's a bonus.
Thanks. 🙂 Yes, I also read about the combo of metformin and clomiphene.
Speaking of infertility, can you use aromatase inhibitors to induce ovulation?
Speaking of aromatase inhibitors, which one is a steroidal aromatase inhibitor?
What do you mean? Like drug-drug interaction?
i mean if there is increase or decrease in the hepatic enzyme is that can leads to complication like liver damage ?
No. The increase in enzymes, i.e., AST, ALT indicates liver disease. I see it as damaged cells releasing the enzymes into the circulation. It's not the other way around. Those enzymes are markers of injury to hepatocytes. So, those enzymes are only elevated when the cells are injured. Also, they don't measure liver function even though we call it LFTs (liver function tests). Does that make sense? Hope that helps. 🙂
You talked about enzyme inducers or inhibitors in your previous post, were you talking about CYP450? Those are enzymes involved in drug metabolism. Hope that helps.
Is that even FDA approved?
Probably not HY at all. Person asking is a pharmacist though, what do you expect?
It's a mechanism. Historical purposes.
Good because he/she was stressing me out lol
It was used (although I believe it only made it to clinical trials) before it was discovered that as an ATP uncoupler, it caused fatal hyperthermia. Obviously not used for obesity anymore! 🙂
Thanks! That's good to know. 🙂 I've never heard of it. I only know the ones that are FDA approved - Qsymia, Xenical, Phentermine, Lorcaserin, Contrave, Tenuate, and Bontril.
Thanks! Good to know! I learn something new every day. 🙂
I'm joining this forum to learn something from you guys. I'm sorry if I'm asking questions that are not quite relevant. My bad! 😳
Sorry! I didn't mean to stress you out. I was just trying to keep my brain cells active. My bad!😳
How about name me some GLP-1 agonists, amylin analog, and DPP-4 inhibitors (gliptins)? And their MOAs? The first class of drugs affects 4 things, second affects 3, and third affects 2. Just think of it as home run, triple and double.
Haha yeah same. I think some of the prodrugs might be worth knowing though. Can't think of many off the top of my head, but prednisone, azathioprine, and a bunch of other anticancers need to be activated (i.e. are prodrugs). In our classes we sometimes have questions like "which of the following medications should be prescribed to this patient?" and the answer is something like "a drug that must be activated in the liver before having efficacy".
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I don't know all the prodrugs and I don't think it's that important, but there are a few that you guys should probably know since it's been talked about a lot. Clopidogrel, a prodrug, that needs to be converted to an active metabolite via CYP2C19, so avoid omeprazole since it inhibits CYP2C19. You are right, azathioprine is a prodrug for 6-MP. Another one that's good to know is Valacyclovir, a prodrug for acyclovir. It has a better bioavailability vs acyclovir and it doesn't have to be dosed that often. Another one that's worth knowing is Valganciclovir, a prodrug for ganciclovir. It also has a better bioavailability and can be given by mouth.
How about something that you guys need to know.
Name a few beta-1 blockers.
Non-selective beta blockers.
Non-selective beta blockers and alpha-1 blockers.
Give me 3 beta-blockers that are indicated for heart failure.
Name 2 aldosterone receptor antagonists (they changed the name to mineralocorticoid receptor antagonist).
One way to remember beta blockers (ending with "olol"):
1. The one's starting with letters A to M are beta-1 selective.
2. The one's starting with letters N to Z are non-selective.
This , however, excludes the one's NOT ending with "olol" like Labetalol, Carvedilol ( both also block alpha-1) & Sotalol ( Class III antiarrhythmic properties by its inhibition of potassium channels.).
1. The one's starting with letters A to M are beta-1 selective.
2. The one's starting with letters N to Z are non-selective.
This , however, excludes the one's NOT ending with "olol" like Labetalol, Carvedilol ( both also block alpha-1) & Sotalol ( Class III antiarrhythmic properties by its inhibition of potassium channels.).
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zero yield. No question is going to list 5 drugs and ask you which one is the pro-drug. They could design a question in which you have to know what being a pro-drug means in terms of metabolism/target site/half-life.
what is the treatment of hypertension which specifically caused by pheochromocytoma ? and why ?
Surgery to take out the Pheo.
They might make it fun by asking about the effects of a prodrug in the presence of a P450 inducer or inhibitor.
The effect will be opposite as compared to other drugs since other drugs will have decreased levels of active compound with a P450 inducer.
For example, Codeine with a P450 inducer will lead to increased levels of Morphine since the prodrug (codeine) is increasingly being metabolized to the active compound (morphine).
So, you have to give a thought to prodrugs while doing a P450 inducer/inhibitor question.
What are modafanil/armodafanil, amphetamines, etc. ?
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