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129 Cards in this Set

  • Front
  • Back
Primaquine
anti-malarial (tissue schizonticide)
works against hypnozoites (liver)
P.vivax, P.ovale
can cause acute hemolytic anemia
(G6PD)
Chloroquine
anti-malarial (blood schizonticide)
effective, inexpensive, but....
high resistance
prevents polymerization to hemezoin
pruritis, AHA
Mefloquine
anti-malarial (blood schizonticide)
treatment AND prophylaxis

MENTAL effects (M=M)
CV effects
Quinine
anti-malarial (blood schizonticide)
ORAL- uncomplicated Pfalciparum
more toxic effects- "cinchonism"
neuromuscular, CV, oxytocic,
hypoglycemia, Blackwater fever
Quinidine
anti-malarial (blood schizonticide)
IV - severe, complicated Pfalciparum
more toxic effects-"cinchonism"
neuromuscular, CV, oxytocic,
hypoglycemia, Blackwater fever
Pyrimethamine /
Sulfadoxine
anti-malarial (blood schizonticide)
slow-acting
Tx and presumptive self-treatment
FOLATE chain inhibitors, 1- blocks DHFR, 2- blocks DHPS
AHA, sulfa allergies
Atovaquone /
ProGuanil

(Malarone)
anti-malarial (tissue & blood schizonticide) slow-acting
Tx and presumptive self-treatment
1- blocks mitochondrial electron transport, 2- blocks DHFR
AHA, sulfa allergies
Doxycycline

(in children- clindamycin)
anti-malarial
Tx and prophylaxis
adlunctive with quinine

NO children, pregnant
warfarin
anti-coagulant
blocks vitamin K metabolism of 2,7,9,10,C,S
ORAL, monitor via PT
NARROW THERAPUTIC INDEX, needs frequent monitoring
TERATOGENIC
heparin
(UFH) (un-fractionated heparin)
anti-coagulant
interacts with AT3 to inhibit 2a, 10a
IV- unpredictable response
hospital dosing, monitor via aPTT
1-4% risk of HITT
enoxaparin
anti-coagulant
LMWH- low molecular weight heparin
interacts with AT3 to inhibit 10a only
SubQ- predictable effect, less need to monitor
home dosing, more expensive, but not clinically delivered
1 - 4% risk of HITT
dalteparin
anti-coagulant
LMWH- low molecular weight heparin
interacts with AT3 to inhibit 10a only
SubQ- predictable effect, less need to monitor
home dosing, more expensive, but not clinically delivered
1 - 4% risk of HITT
ardeparin
anti-coagulant
LMWH- low molecular weight heparin
interacts with AT3 to inhibit 10a only
SubQ- predictable effect, less need to monitor
home dosing, more expensive, but not clinically delivered
1 - 4% risk of HITT
tinzeparin
anti-coagulant
LMWH- low molecular weight heparin
interacts with AT3 to inhibit 10a only
SubQ- predictable effect, less need to monitor
home dosing, more expensive, but not clinically delivered
1 - 4% risk of HITT
fondaparinux
anti-coagulant
5-sugar selective factor Xa inhibitor
SubQ, longer half-life, no monitoring
DVT, PE, UA, STEMI, NSTEMI
hirudin
anticoagulant
Direct Thrombin inhibitor
leech saliva
dissolves soluble/fibrin-bound thrombin
lepirudin
anticoagulant
Direct Thrombin inhibitor
Recombinant derivative of hirudin, but allergy risk
dissolves soluble/fibrin-bound thrombin
alternative in HITT cases
bivalirudin
anticoagulant
Direct Thrombin inhibitor
Bivalent analog of hirudin
dissolves soluble/fibrin-bound thrombin
for PCI during HITT
argotraban
anticoagulant
Direct Thrombin inhibitor
Bivalent analog of hirudin
dissolves soluble/fibrin-bound thrombin
alternative in HITT cases
ASA- acetylsalicylic acid
(low dose)
anti-platelet
IRreversibly blocks COX-1 (in low dose), synthesis of TxA2 (thromoxane A2)
vaso-dilator, anti-aggregator
for thrombus, PCI, UA, STEMI, NSTEMI
clopidogrel
anti-platelet
ADP receptor blocker (irreversible)
prevents platelet aggregation
ORAL
for thrombus, PCI, UA, STEMI, NSTEMI
prasugrel
anti-platelet
ADP receptor blocker (irreversible)
prevents platelet aggregation
ORAL
for thrombus, PCI, UA, STEMI, NSTEMI
ticlopidine
anti-platelet
ADP receptor blocker (irreversible)
prevents platelet aggregation
ORAL
for thrombus, PCI, UA, STEMI, NSTEMI
abciximab
anti-platelet
glycoprotein IIb/IIIa receptor blocker
prevents platelet aggregation
“tight’ binding to GP IIb/IIIa receptor, 36 hrs
eftifibitide
anti-platelet
glycoprotein IIb/IIIa receptor blocker
prevents platelet aggregation
“loose" binding to GP IIb/IIIa receptor, 4 hrs
tibrofan
anti-platelet
glycoprotein IIb/IIIa receptor blocker
prevents platelet aggregation
“loose" binding to GP IIb/IIIa receptor, 4 hrs
streptokinase
THROMBOLYTIC
derived from B-strep
Catalyze plasminogen to plasmin, degrades fibrin
risk of allergic rxn
STEMI, DVT, PE, stroke
urokinase
THROMBOLYTIC
derived from kidney
Catalyze plasminogen to plasmin, degrades fibrin
STEMI, DVT, PE, stroke
anistreplase
THROMBOLYTIC
complex of bacterial & plasminogen
Catalyze plasminogen to plasmin, degrades fibrin
STEMI, DVT, PE, stroke
reteplase
THROMBOLYTIC
recombinant tPA
Catalyze plasminogen to plasmin, degrades fibrin
STEMI, DVT, PE, stroke
alteplase
THROMBOLYTIC
recombinant tPA
Catalyze plasminogen to plasmin, degrades fibrin
STEMI, DVT, PE, stroke
tenecteplase
THROMBOLYTIC
recombinant tPA
Catalyze plasminogen to plasmin, degrades fibrin
STEMI, DVT, PE, stroke
ferrous fumerate
iron supplement, ORAL
25% absorption
causes GI irritation, toxic, corrosive
acute iron toxicity
ferrous sulfate
iron supplement, ORAL
25% absorption
causes GI irritation, toxic, corrosive
acute iron toxicity
ferrous gluconate
iron supplement, ORAL
25% absorption
causes GI irritation, toxic, corrosive
acute iron toxicity
iron dextran
iron supplement, parental (one dose)
for malabsorption, intolerance
causes skin discoloration, pain
poss hypersensitivity rxns (I or IV)
iron sucrose
iron supplement, parental (one dose)
for malabsorption, intolerance
causes skin discoloration, pain
poss hypersensitivity rxns (I or IV)
sodium ferric gluconate complex in sucrose
iron supplement, parental (one dose)
for malabsorption, intolerance
causes skin discoloration, pain
poss hypersensitivity rxns (I or IV)
vitamin B12
deficiency causes macrocytic anemia & demyelination
can take years to manifest
diet, drugs, GI disease, lack of intrinsic factor
given subQ
folic acid
deficiency causes macrocytic anemia
a few weeks to manifest
diet, drugs, malabsorption, pregnancy
given ORALLY
epoetin alfa
Hematopoietic Growth Factor
stimulates RBC production
darbepoetin alfa
Hematopoietic Growth Factor
longer half-life
stimulates RBC production
sargramostim
GM-CSF
stimulates netrophil, macrophage production
filgastim
G-CSF
stimulates neutrophil, production
peg-filgastim
G-CSF
stimulates neutrophil, production
longer half-life
oprelvekin
IL-11
stimulates platelet production
Nystatin
anti-fungal, topical or oral use only
acts on fungal cell membrane, binds to ergosterol
Amphotericin B
anti-fungal, IV
acts on fungal cell membrane, binds to ergosterol
DOC for many severe, invasive fungal infections
severe renal toxocity, "cytokine storm"
Flucytosine
anti-fungal, ORAL
pro-drug of 5-fluorouracil, an anti-metabolite
always used in combination with Amphotericin B
NVD, BMD (bone marrow depression)
Griseofulvin
anti-fungal
anti-mitotic, ORAL
Tinea infections, but 2nd-line drug
Hepato-toxicity, p450 INducer
Terbinafine
anti-fungal
DOC for skin, nail infections
inhibits squalene metabolism
liver tox, neutropenia, CYP2D6 blocker
faster, more effective than azoles
Ketoconazole
anti-fungal, ORAL, topical
blocks ergosterol metabolism, and human p450
Tineas, steroid dysfunctions
older drug with more problems
May see hormonal deficiency side effects
oral absorption very acid-dependent
Fluconazole
anti-fungal, ORAL, IV
blocks ergosterol metabolism
DOC for several systemic and CNS fungal infections
kidney elimination
Itraconazole
anti-fungal, ORAL, IV
blocks ergosterol metabolism
first-line for systemic fungal infections
Voriconazole
anti-fungal, ORAL, IV
blocks ergosterol metabolism
systemic fungal infections
esp. ASPERGILLOSIS
visual disturbances
Caspofungin
anti-fungal, IV
impairs cell wall, by glucan monomers
Salvage therapy for Candida, Aspergillus
Clotrimazole
anti-fungal, topical, oral, OTC
Tinea, thrush, vaginal yeast infections
Micanazole
anti-fungal, topical, oral, OTC
Tinea, thrush, vaginal yeast infections
Amifostine
rescue drug- cancer chemo
during chemotherapy, for cis-Platin, alkylating agents
reduces nephrotoxicity
Mesna
rescue drug- cancer chemo
during chemotherapy, for alkylating agents
reacts with acrolein
reduces bladder toxicity
N-acetyl cysteine
(MucoMyst)
rescue drug- cancer chemo
during chemotherapy, for alkylating agents
reacts with acrolein
reduces bladder toxicity
Cyclophosphamide
anti-cancer, alkylating agent, nitrogen mustard
DNA cross-linking
most types of cancer - commonly used
pro-drug, needs liver metabolism
BMD, bloody bladder (use mesna, NAC)
Carmustine
anti-cancer, alkylating agent, nitroso-urea
DNA cross-linking, alkylator
brain cancer (crosses BBB)
profound BMD, 4 other tox= kidney, liver, CNS, lung
Lomustine
anti-cancer, alkylating agent, nitroso-urea
DNA cross-linking, alkylator
brain cancer (crosses BBB)
profound BMD, 4 other tox= kidney, liver, CNS, lung
cis-Platin
anti-cancer, alkylating agent, platinum complex
DNA cross-linking
tesicles, ovary, bladder, head/neck
severe NVD, anaphylaxis
Neuro, renal tox (use amifostine)
Leucovorin
Rescue drug- cancer chemo

used with methotrexate to reduce damage to bone marrow, GI tract
Allopurinol

(used during chemotherapy)
rescue drug during chemo
inhibits xanthine oxidase in purine metabolism
prevents urate overload when treating blood cancers
NOTE: need to reduce dose of 6-MP, 6-TP when using allopurinol
Methotrexate
anti-cancer, anti-folate, anti-purine
inhibits DHFR, blocks DNA synthesis
Leukemias, lymphomas, breast ca
also- for psoriasis, rheumatoid arthritis
resistance by change in DHFR, decreased uptake
BMD, ulcers in GI, ulcers in oral
5-fluorouracil
(5-FU)
anti-cancer, anti-pyrimadine
blocks DNA synthesis by blocking thymine synth.
breast, colo-rectal, basal cell carcinoma
resistance by change in enzymes
BMD, GI mucositis
NOTE: leucovorin INCREASES tox
Capecitabine
anti-cancer, anti-pyrimadine
oral version of 5-fluorouracil
breast, colo-rectal, basal cell carcinoma
BMD, GI mucositis
NOTE: leucovorin INCREASES tox
Gemcitabine
anticancer, anti pyrimadine
inhibits DNA poly, chain termination
Breast, NSCLC, pancreatic, ovary
causes neutropenia
Cytarabine
anticancer, anti pyrimadine
inhibits DNA poly, chain termination
ALL, non-HL
causes BMD, ataxia
6-mercaptopurine

(6-MP)
anticancer, anti purine
needs to be activated by HGPRT
ALL, AML, CML
resisted by lowering HGPRT
causes BMD, hyperuricemia
allopurinol reduces metabolism (lower the dose)
6-thioguanine

(6-TG)
anticancer, anti purine
needs to be activated by HGPRT
ALL, AML, CML
resisted by lowering HGPRT
causes BMD, hyperuricemia
allopurinol reduces metabolism (lower the dose)
Prednisone

(chemotherapy)
anti-cancer, glucocorticoid (hormone)
suppresses lymphocyte production, induces apoptosis
for ALL, acute lymphomas
causes "Steroid Man" effects
Tamoxifen
anti-cancer, hormone blocker
competitively blocks estrogen receptor
good for ER+ Breast cancer
can be outcompeted by endogenous estrogen
mild side effects, can raise risk of uterine cancer
Anastrozole
anti-cancer, hormone synthesis blocker
blocks estrogen synthesis
good for ER+ Breast cancer
SALVAGE therapy beyond tamoxifen
Bortezomib
anti-cancer, signal pathway blocker
blocks NF-kappa-B, inhibits 26s proteosome (stops cell cycle)
for multiple myeloma
causes BMD
Hydroxyurea
anti-cancer, (anti ribonucleotide reductase)
blocks ribose to deoxyribose sugar synthesis
for melanoma, CML, ovarian cancer
causes myelosuppression (low RBCs, platelets, PMNs)
Imatinib
anti-cancer, (aka Gleevac)
monoclonal antibody
blocks signaling pathway of bcr-abl tyrosine kinase
for CML (philadelphia chromosome)
Trastuzumab
anti-cancer, (aka Herceptin)
monoclonal antibody
blocks signaling pathway at HER2 receptor (EGFR)
for aggressive ER- Breast cancers
some cardiotox
Bevacizumab
anti-cancer, monoclonal antibody
binds VEGF, prevents receptor activation
blocks angiogenesis, prevents tumor expansion thru increased blood supply
for metastatic colo-rectal cancer
causes GI tox - ulcers & perforations
vinCristine
anti-cancer / "natural"
anti-mitotic - binds to G-tubulin
for Leukemias, Non-Hodgkins lymphomas
resistance by p-glycoprotein
causes neurotoxicity- sensory, autonomic, muscular
FATAL if given intrathecally
vinBlastine
anti-cancer / "natural"
anti-mitotic - binds to G-tubulin
for Leukemias, all lymphomas, breast, testicles
resistance by p-glycoprotein
causes myelosuppression (remember B =B, vinBlastine, Blood, Bone)
Paclitaxel
anti-cancer / "natural"
anti-mitotic - hyperstabilizes tubulin
for breast, ovarian cancers
causes BMD, neuropathy (sensory)
Docetaxel
anti-cancer / "natural"
anti-mitotic - hyperstabilizes tubulin
for breast, prostate, NonSCLC
causes BMD, neurotox (sensory & motor), and fluid retention
Etoposide

("e-TOPO-side")
anti-cancer / "natural"
inhibits TOPO 2- causes DNA strand breaks
resistance by p-glycoprotein, other mechanisms
for testicular, SCLC (small cell)
causes BMD
Irinotecan
anti-cancer / "natural"
inhibits TOPO 1- causes DNA strand breaks
for metastatic COLON cancer
causes BMD, diarrhea (poss FATAL!)
Topotecan

"TOPO-tecan"
anti-cancer / "natural"
inhibits TOPO 1- causes DNA strand breaks
for ovarian, SCLC (small cell)
causes BMD
Dactinomycin
anti-cancer / "natural"
intercalates into DNA, stops polymerase
resistance by p-glycoprotein
for pediatric tumors (Wilms, Ewings, etc), germcell tumors
causes BMD, stomatitis, proctitis (inflammation at both ends)
Doxorubicin

-rubicin = ruby red = blood, heart
anti-cancer / "natural"
intercalates into DNA, stops TOPO 2
forms damaging free radicals
resistance by p-glycoprotein
broad-spectrum chemo (incl blood)
causes CARDIO-TOX, BMD, and is a tissue vesicant
Daunorubicin

-rubicin = ruby red = blood, heart
anti-cancer / "natural"
intercalates into DNA, stops TOPO 2
forms damaging free radicals
resistance by p-glycoprotein
blood cancers- ALL, non-lymphocytic leukemias
causes CARDIO-TOX, BMD, and is a tissue vesicant
Bleomycin
anti-cancer / "natural"
causes DNA strand breaks by chelating Fe, free radicals
for lymphomas, squamous cell, testicular, head/neck ca.
causes lung fibrosis, skin toxicity
LOW BMD!
L-asparaginase
anti-cancer / "natural"
enzyme, hydrolyzes circulating L-asparagine, blocks tumor cells of amino acid
for lymphocytic leukemias, ALL
resistance by increased asparagine synthesis
ACUTE cause = anaphylaxis
causes- clotting problems (+/-), glucose intolerance, CNS, pancreatitis
Prednisone
immunosuppressant- glucocorticoid
used in prevention AND treatment of transplants and autoimmune
inhibits some T-cell populations
inhibits IL-2 production (macs & PMNs)
causes "Steroid Man" effects- skin, lipids, eyes, GI tract, osteoporosis, infections
Cyclosporine
immunosuppressant- calcineurin inhibitor
used in prevention only in transplants and autoimmune
binds to 'cyclophilin', inhibits IL-2 gene transcription
causes renal tox, liver tox, BP increase, hyperkalemia
ZEBRAS- gingival hyperplasia, hirsuitism
Tacrolimus
immunosuppressant- calcineurin inhibitor
used in prevention only in transplants and autoimmune
binds to 'FKBP', inhibits IL-2 gene transcription
causes renal tox, diabetes
Sirolimus
immunosuppressant- anti-proliferative agent
used in prevention only in transplants and autoimmune
inhibits signal downstream of IL-2 - mTOR
causes hyperlipidemia, myelodepression, NO renal tox
Azathioprine
immunosuppressant- anti-proliferative
pro-drug- metabolized to 6-MP (6-mercatopurine)
blocks DNA synthesis in stimulated T-cells
used in prevention, maintenance only in transplants and autoimmune
Depresses both cell mediated and antibody mediated reactions
** INACTIVATED by xanthine oxidase- must reduce dose when using with allopurinol **
BMD, GI tox, mutagenic
Mycophenolate mofetil
immunosuppressant- anti-proliferative
Selective, noncompetitive inhibitor of IMPDH
blocks B & T-cell proliferation
used in prevention, maintenance only in transplants and autoimmune
Depresses both cell mediated and antibody mediated reactions
less tox than other anti-metabolites = BMD, GI tox
ALG

(anti-lymphocyte globulin)
immunosuppressant- anti-bodies
Used as ‘adjuvants’ to ↓ # circulating T-cells, leaves humoral fxn
ANTISERA produced by large animals
Primarily used in kidney transplants
Used to treat steroid resistant rejections
AE- mainly allergic effects- rash, local pain
ATG

(anti-thymocyte glogulin)
immunosuppressant- anti-bodies
Used as ‘adjuvants’ to ↓ # circulating T-cells, leaves humoral fxn
ANTISERA produced by large animals
Used during acute rejection episodes
Used to treat steroid resistant rejections
AE- mainly allergic effects- rash, local pain
Muromonab-CD3

(OKT3)
immunosuppressant- anti-bodies
Used as ‘adjuvants’ to ↓ # circulating T-cells, leaves humoral fxn
T-cell specific murine monoclonal Ab
Used during acute rejection episodes
Shuts down activation of T-cell proliferation and impairs cytotoxic T-cell function
AE- fairly toxic, allergic effects- "cytokine storm"
Daclizumab
immunosuppressant- anti-bodies
Monoclonal antibodies to part of IL-2 receptor (CD25)
Probably prevents IL-2 from binding to activated lymphocytes
for prophylaxis against acute rejection of renal transplants
causes infections & allergic type symptoms
Acyclovir
anti-viral, against DNA viruses
a guanosine analog
activity against: HSV-1, HSV-2, VZV
MOA = Phosphorylated by viral thymidine kinase, inhibits viral DNA synthesis
AE- oral=few, IV= acute renal failure, neuro tox
Ganciclovir
anti-viral, against DNA viruses
a guanosine analog
activity against: CMV
MOA = Phosphorylated by CMV phosphotransferase , inhibits viral DNA synthesis
AE- BMD, neuro tox
Foscarnet
anti-viral, against DNA viruses
A pyrophosphate analog
Serious HSV and CMV infections
MOA = Inhibits viral DNA polymerase
AE- renal, hypocalcemia, electrolyte problems
Zanamivir
anti-viral, Neuraminidase Inhibitor
inhaled
Effective against both influenza A & B
MOA = prevents the release of progeny virions
AE- bronchospasm
Oseltamivir
anti-viral, Neuraminidase Inhibitor
ORAL
Effective against both influenza A & B
MOA = prevents the release of progeny virions
AE- NV, rare neuropsychiatric events in children
Amantidine
anti-viral, Viral Uncoating Inhibitor
Treatment of Influenza A
MOA = prophylaxis, if given BEFORE exposure, Pre-emptive treatment
AE- enters CNS, causes skittishness, GI problems
Rimantidine
anti-viral, Viral Uncoating Inhibitor
blocks M2 proton channel
Treatment of Influenza A only
MOA = prophylaxis, if given BEFORE exposure, Pre-emptive treatment
AE- GI problems, less CNS
Ribavarin
anti-viral, guanosine analog
treats Respiratory Syncytial Virus (RSV), hepatitis C
MOA = Interferes with cellular GTP production
AE = anemia, pulmonary deterioration
Pregnancy category X
Interferon-alfa
anti-viral, transcription factor
treats Chronic hepatitis B, C viral infections
MOA = Turn on gene expression of proteins with antiviral effects
AE = many toxicities, incl. myelosuppression, Flu-like symptoms, Marked CNS effects
Lamivudine
anti-viral, Nucleoside analog
treats Chronic hepatitis B viral infections
MOA = Antimetabolite, causes viral DNA chain termination
AE = Lactic acidosis with hepatic steatosis (rare but potentially fatal)
Lamivudine
anti-viral, Nucleoside analog
NRTIs (nuke)
anti-HIV
Zidovudine
anti-viral, Nucleoside analog
NRTIs (nuke)
anti-HIV
Stavudine
anti-viral, Nucleoside analog
NRTIs (nuke)
anti-HIV
Didanosine
anti-viral, Nucleoside analog
NRTIs (nuke)
anti-HIV
Zalcitabine
anti-viral, Nucleoside analog
NRTIs (nuke)
anti-HIV
Ritonavir (RTV)

co-drug
anti-viral, Protease inhibitor
anti-HIV
used mainly for pharmacologic enhancement of Protease Inhibitors.
prevents immature virions from becoming mature, infectious viruses
Indinavir
anti-viral,
Protease inhibitor
anti-HIV
prevents immature virions from becoming mature, infectious viruses
Amprenavir
anti-viral,
Protease inhibitor
anti-HIV
prevents immature virions from becoming mature, infectious viruses
Nelfinavir
anti-viral,
Protease inhibitor
anti-HIV
prevents immature virions from becoming mature, infectious viruses
Saquinavir
anti-viral,
Protease inhibitor
anti-HIV
prevents immature virions from becoming mature, infectious viruses
Efavirenz
anti-viral, (NNRTIs or non-nuke)
Nonnucleoside reverse transcriptase inhibitor
anti-HIV
Have potent antiviral activity
Nevirapine
anti-viral, (NNRTIs or non-nuke)
Nonnucleoside reverse transcriptase inhibitor
anti-HIV
Have potent antiviral activity
Enfuvirtide
anti-viral, Fusion inhibitor
anti-HIV
Blocks the entry of HIV-1 into CD4+ cells by inhibiting the fusion of viral and cellular components
Maraviroc
anti-viral, Entry Inhibitor
anti-HIV
CCR5 co-receptor antagonist
Raltegravir
anti-viral,
Integrase inhibitor
anti-HIV