PMD 705 Therapeutics NAPLEX-Style Exam Prep

Practice flashcards covering therapeutics for Asthma, COPD, Hypertension, Dyslipidemia, Anticoagulation, Chronic Coronary Disease, and Heart Failure.

Allergic Asthma Primary Drivers

The immune cells primarily responsible for airway inflammation in allergic asthma are mast cells, eosinophils, and $TH2$ lymphocytes.

Early-phase Asthmatic Reaction Mediators

The mediators released immediately upon allergen binding to $IgE$ on mast cells include histamine, leukotrienes ($LTC4$, $LTD4$, $LTE4$), and prostaglandin $D2$.

Chronic Bronchitis (COPD subtype)

A condition characterized by a chronic productive cough for more than 3 months per year for at least 2 consecutive years.

Emphysema

A pathological finding of permanent enlargement of airspaces distal to terminal bronchioles accompanied by alveolar wall destruction.

Beta-2 Agonist Mechanism

Activation of $G\text{α}s$ protein, which increases adenylyl cyclase, leading to increased $cAMP$ and subsequent airway smooth muscle relaxation.

Theophylline Dosing Range

A methylxanthine with a narrow therapeutic index and a target therapeutic range of $5 – 15\text{ mcg/mL}$.

Omalizumab (Xolair)

An anti-$IgE$ monoclonal antibody that binds free serum $IgE$ to prevent it from binding to mast cells and basophils.

Dupilumab (Dupixent) Mechanism

Blocks the $IL–4R\text{α}$ subunit shared by $IL–4$ and $IL–13$ receptors to inhibit $TH2$-driven inflammation, mucus production, and $IgE$ synthesis.

Aspirin-exacerbated Respiratory Disease (AERD) Triad

The clinical triad of asthma, nasal polyposis, and hypersensitivity to aspirin or $NSAIDs$.

GOLD 3 (Severe COPD) Criteria

A COPD classification where the post-bronchodilator $FEV1/FVC < 0.70$ and the $FEV1$ is between 30–49\text{%} predicted.

Roflumilast (Daliresp) Mechanism

A selective $PDE–4$ inhibitor that increases $cAMP$ to reduce neutrophilic inflammation in severe COPD.

Ivacaftor (Kalydeco)

A $CFTR$ potentiator that increases the probability of the $CFTR$ channel gate being open.

Aqueous Humor Drainage Path

Primary drainage occurs via the trabecular meshwork into Schlemm's canal (conventional pathway), with minor drainage through the uveoscleral (unconventional) pathway.

Ocular Hypertension

Defined as an intraocular pressure ($IOP$) greater than $21\text{ mmHg}$ in the absence of optic nerve damage.

Prostaglandin Analog Mechanism

$PF2\text{α}$ receptor agonists that lower $IOP$ by increasing the uveoscleral (unconventional) outflow of aqueous humor.

Carbonic Anhydrase Inhibitor (CAI) Mechanism

Direct inhibition of the carbonic anhydrase enzyme to reduce the formation of bicarbonate ($HCO\text{3}^{-}$) ions, thereby decreasing aqueous humor secretion.

Netarsudil (Rhopressa)

A $ROCK$ inhibitor that reduces trabecular meshwork contractility and increases conventional aqueous humor outflow.

Blood Pressure ($BP$) Equation

$BP = \text{Cardiac Output (CO)} \times \text{Peripheral Vascular Resistance (PVR)}$.

Stage 1 Hypertension (2025 AHA/ACC)

A blood pressure reading of $130 – 139\text{ mmHg}$ systolic or $80 – 89\text{ mmHg}$ diastolic.

DASH Diet

A dietary pattern high in fruits, vegetables, whole grains, and low-fat dairy, while low in saturated fat and sodium, used to treat hypertension.

ACE Inhibitor Side Effects

Common adverse effects include a dry nonproductive cough, hyperkalemia, and the potentially life-threatening risk of angioedema.

ARNI Washout Period

A mandatory $36\text{-hour}$ period between the last dose of an ACE inhibitor and the initiation of sacubitril/valsartan to prevent angioedema.

Hypertensive Emergency

Blood pressure $> 180 / 120\text{ mmHg}$ with evidence of acute target organ damage, requiring hospitalization and IV therapy.

High-Intensity Statin Therapy

Regimens such as atorvastatin $40 – 80\text{ mg}$ or rosuvastatin $20 – 40\text{ mg}$ that typically reduce $LDL–C$ by \text{≥} 50\text{%}.

Ezetimibe (Zetia) Mechanism

Selective inhibition of the $NPC1L1$ transporter in the small intestine to block cholesterol absorption.

Coagulation Intrinsic Pathway Monitoring

The intrinsic pathway of the coagulation cascade is monitored using the activated partial thromboplastin time ($aPTT$).

Warfarin (Coumadin) Mechanism

Inhibition of vitamin K epoxide reductase, preventing the activation of clotting factors $II$, $VII$, $IX$, and $X$.

Aspirin Antiplatelet Mechanism

Irreversible acetylation of $COX–1$ and $COX–2$, which prevents the synthesis of thromboxane $A2$ ($TXA2$).

HFrEF Classification

Heart Failure with reduced Ejection Fraction, defined as a clinical diagnosis of heart failure with an LVEF \text{≤} 40\text{%}.

Sacubitril Mechanism

A neprilysin inhibitor that increases levels of natriuretic peptides ($BNP$ and $ANP$).

Milrinone Mechanism

A phosphodiesterase-3 inhibitor that increases $cAMP$, leading to positive inotropic effects and systemic vasodilation.