Repeated USMLE Questions Step 1- Pharmacology- 225

B- Cefotetan- It is a cephalosporin antibiotic, and it can cause a disulfiram-like reaction when combined with alcohol. Disulfiram is used to treat alcohol dependence, and it works by inhibiting the enzyme aldehyde dehydrogenase, leading to an accumulation of acetaldehyde when alcohol is consumed. This causes unpleasant symptoms such as flushing, nausea, vomiting, and headache, discouraging the person from drinking alcohol.

A- Aminocaproic acid- It works by preventing the activation of plasminogen to plasmin, an enzyme that degrades fibrin, a key component of blood clots. By inhibiting fibrinolysis, aminocaproic acid helps stabilize blood clots and can be used in various medical conditions, such as to control bleeding in certain surgical procedures or to treat conditions associated with excessive fibrinolysis.

Heparin works by enhancing the activity of antithrombin III. This, in turn, inhibits the enzymes thrombin and factor Xa, which are crucial for blood clot formation. Lepirudin is a direct thrombin inhibitor used as an anticoagulant. Rifampin does not have an antifibrinolytic effect.

D- Warfarin- Warfarin is an anticoagulant that works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver. These factors are II, VII, IX and X.  Clopidogrel is an antiplatelet agent, Heparin is an anticoagulant that works by enhancing antithrombin III, and Tirofiban is a platelet aggregation inhibitor.