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450 Cards in this Set

  • Front
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What drugs are effective in treating Pseudomonas?
FAT CAP = Ticercillin/Carbenacillin/Piperacillin, Cefipime, Aztreonam, Aminoglycosides, Fluoroquinolones, Polymyxins (topical agent)
Ceftazadime good for...
Pseudomonas
Ceftriaxone good for...
Neisseria
Drugs that cause a disulfuram-like rxn?
Metronidazole, Cephalosporins, Procarbazine, 1st gen Sulfonylureas (MCPS)
Drugs that cause photosensitivity?
SAT for photo (Sulfonamides, Amiodarone, Tetracycline)
Drugs that cause Stevens-Johnson syndrome?
PASS to Steve Johnson (Penicillins, Allopurinol, anti-Seizure drugs, Sulfonamides)
gray man syndrome?
amiodarone
red man syndrome?
vancomycin
linezolid
bind 23s rRNA; USE = MRSA, VRE
Aminoglycosides
bind 30s on initiation complex --> misreading; USE = Gram- rods; AE = Nephrotoxic (w/ cephs), Ototoxic (w/ loop diuretics), Teratogen
Which drugs have oto-/nephrotoxicity as side effects?
CLAV (Cisplatin, Loop diuretics, Aminoglycosides, Vancomycin)
What important side effects do patients on tetracycline experience?
discoloration of teeth/bone growth halting (children), photosensitivity, GI upset
Tetracycline
bind to 30S (prevent aa-tRNA attach); USE = VACUUM THe BedRoom
Macrolides
Bind 23s rRNA (of 50S); USE = PUS (atypical Pneumonia, URIs, STDs); AE = GI upset, QT prolongation, eosinophilia
Chloramphenicol
Binds 50S peptidyltransferase; USE = meningitis; AE = gray-baby, anemia (dose-dep), aplastic anemia (dose-ind)
Clindamycin
Binds 50S; USE = anaerobic ABOVE diaphragm; AE = C. diff overgrowth, fever, diarrhea
TMP-SMX
Inhibit dihydropteroate synthetase & DHFR; USE = UTI, PCP, Salmonella, Shigella; AE = leukopenia, megaloblastic anemia
Which drugs elicit sulfa allergy?
celecoxib, probenicid, thiazide diuretics, sulfa drugs, acetazolamide, furosemide
Fluoroquinolones
inhibit DNA gyrase; USE = Pseudomonas, Neisseria, Gram- rod UTIs/GI infections; AE = tendonitis, tendon rupture, damages cartilage (children/fetus), GI upset, superinfection
Which antibiotics should you not take with milk or antacids?
fluoroquinolones & tetracyclines
Metronidazole
creates free radicals; USE = GET GAP; AE = disulfuram-like, metallic taste
Polymyxins
disrupt osmotic properties of membrane; USE = Gram- resistant (topical only); AE = neurotoxic/nephrotoxic
Nitrofurantoin
reduced by bacteria to toxic intermediates; USE = UTIs (E. coli, S. saprophyticus); AE = nausea, flatulence (safe in pregnancy)
Streptogramins
A binds 50S & B prevents protein extension (premature termination); USE = MRSA, VRE; AE = hepatotoxic, C. diff overgrowth
What drugs affect anaerobes?
MIC (metronidazole, Imipenem/cilistatin, Clindamycin)
What drug increases nephrotoxicity of aminoglycosides? how about ototoxicity?
cephalosporins; loop diuretics
Penicillin G
[IV] binds PBP and inhibit transpeptidase; USE = Gram+, syphilis; AE = hypersensitivity
Methicillin
binds PBP --> weakens wall; USE = S. aureus; AE = interstitial nephritis
Ampicillin
binds PBP --> weakens wall; USE = HELPS (H. flu, E. coli/Enterococci, Listeria, Proteus, Salmonella); AE = ampicillin rash (w/ EBV), C. diff overgrowth
Amoxicillin
[greater ORAL] binds PBP --> weakens wall; USE = HELPS (H. flu, E. coli/Enterococci, Listeria, Proteus, Salmonella); AE = ampicillin rash (w/ EBV), C. diff overgrowth
Ticarcillin
binds PBP --> weakens wall; USE = Pseudomonas; AE = hypersensitivity rxn
What drug do you use with antipseudomonals?
Clavulonate/sulbactam/tazobactam (B-lactamase inhibitor) --> w/ ticarcillin, carbenicillin, piperacillin
How might you treat syphilis?
Penicillin G (IV)
Toxicity caused by cephalosporins?
disulfuram-like rxn, vit K deficiency, hypersensitivity rxn
1st gen cephs
cefazolin, cephalexin; USE = Gram+ cocci, PEcK
2nd gen cephs
cefoxitin, cefuroxime; USE = Gram+ cocci, HEN PEcKS
3rd gen cephs
ceftazadime, ceftriaxone, cefdinir; USE = Pseudomonas, Neisseria, otitis media (cefdinir)
4th gen cephs
cefipime; USE = Pseudomonas, Gram+
Aztreonam
binds PBP3 (inhibits cell wall); USE = Gram- rods; good for penicillin allergy or renal-insufficiency
Imipenem
binds PBP; USE = Gram+ cocci, Gram- rods, anaerobes; AE = seizures, GI upset, skin rash
Vancomycin
binds D-ala D-ala; USE = Gram+ only; AE = Nephro-/Ototoxic, Thrombophlebitis, red-man syndrome
30S inhibitors
buy AT 30 (aminoglycosides, tetracyclines)
50S inhibitors
CCELL at 50 (clindamycin, chloramphenical, erythromycin, linezolid, lincomycin)
Neurotransmitter changes in Alzhemiers
dec ACh
bacteriostatic
ECSTaTiC (erythromycin, clindamycin, SMX, TMP, tetracyclines, Chloramphenicol)
Neurotransmitter changes in Huntingtons
dec ACh & GABA
bactericidal
Very Fucking Proficient At Cell Murder (Vanc, Fluoroquinolones, Penicillins, Aminoglycosides, Cephs, Metronidazole)
Neurotransmitter changes in mania
inc NE, dopamine, 5HT
How do you reduce red-man syndrome?
pretreat with antihistamines or slow infusion rate
Neurotransmitter changes in depression
dec NE, dopamine, 5HT
Neurotransmitter changes in Parksinons
dec dopamine, inc ACh & 5HT
Neurotransmitter changes in anxiety
inc NE, dec GABA, 5HT
Neurotransmitter changes in Schizophrenia
inc dopamine
high potency typical antipsychotics
haloperidol, fluphenazine, thiothixene (extrapyramidal SEs)
low potency typical antipsychotics
chlorpromazine, thoridazone (anticholinergic/antihistamine/a blockade SEs)
Typical antipsychotics
block D2; USE = schizophrenia (+), Tourettes, psychosis; AE = hyperprolactinemia, EPS (high potency), anticholinergic/antihistamine/a-blockade (low potency), NMS, tardive dyskinesia
What is Neuroleptic Malignant Syndrome?
FEVER: Fever, Encephalopathy, Vitals unstable (autonomic), Elevated enzymes (myoglobinuria), Rigidity (-->hyperpyrexia)
How do you treat NMS?
dantrolene, bromocriptine
Atypical antipsychotics
blocks 5HT2/D2/a/H1; USE = schizophrenia (+/-), Tourettes, OCD, depression, anxiety disorder, mania; AE = agranulocytosis (clozapine)
Rx: prostate cancer
leuprolide (continuous), flutamide
What drugs cause agranulocytosis?
Carbamazepine, Clozapine, Colchicine, PTU, Methimazole, Dapsone
Lithium
USE = mood stabilizer (bipolar)
What are the potential SEs from lithium?
LMNOP: Lithium use, Movement (tremor), Nephrogenic DI, hypOthyroid, Pregnancy (ebsteins anomaly)
Finasteride
5a-reductase inhibitor; USE = BPH, baldness
TCAs
block NE reuptake; USE = depression, bedwetting (imipramine), OCD (clomipramine), fibromyalgia
Flutamide
androgen receptor inhibitor; USE = prostate cancer
What are the side effects of TCAs?
anticholinergic, a-blockade, sedation; Tri-Cs (cardiotoxic, coma, convulsion) & hyperpyrexia
What non-traditional drugs can be used to treat PCOS?
ketoconazole & spironolactone
Buspirone
5HT1A agonist; USE = GAD
Tamsulosin
a1(A,D) antagonist; USE = BPH
SSRIs
5HT reuptake inhibitor; USE = depression, OCD, bulimia, social phobias
sildenafil
inhibits cGMP-phosphodiesterase; USE = erectile dysfunction, primary pulmonary HTN; AE = flushing, headache, dyspepsia, blue-green color blindness
What are the side effects of SSRIs?
GI upset, sexual dysfunction, serotonin syndrome (w/ MAOIs, cocaine, amphetamines)
What do you NOT want to take with sildenafil?
nitrates (cause hypotension!)
What is serotonin syndrome?
muscle rigidity, hyperthermia, flushing, seizures
Cyroheptadine
5HT2 receptor antagonist; USE = serotonin syndrome
If someone shows signs of serotonin syndrome, what would you give them?
cyproheptadine
SNRIs
5HT/NE reuptake inhibitors; USE = depression, GAD (venlafaxine), diabetic peripheral neuropathy (duloxetine)
MAOIs
inc neurotransmitter levels; USE = atypical depression, anxiety, hypochondriacs
What is contraindicated in MAOI use?
tyramine or B-agonist (both cause HTN crisis)
Buproprion
NDRI; USE = smoking cessation; AE = decrease seizure threshold in bulemics, tachycardia, insomnia
Mirtazapine
a2/5HT2/5HT3 antagonist; USE = depression; AE = sedation, inc appetite, dry mouth
Maprotiline
NE reuptake inhibitor; USE = depression; AE = orthostasis
Trazodone
SSRI (of sorts); USE = insomnia; AE = priapism, postural hypotension
fluoxetine
SSRI
citalopram
SSRI
sertraline
SSRI
paroxetine
SSRI
nortriptyline
TCA
clomipramine
TCA
imipramine
TCA
amitriptyline
TCA
desipramine
TCA
doxepin
TCA
selegiline
MAOI
phenylzine
MAOI
tranylcypromine
MAOI
venlafaxin
SNRI
duloxetine
SNRI
milnacipran
SNRI
nefazodone
SNRI
desvenlafaxine
SNRI
Treatment for leprosy
dapsone; rifampin/dapsone/clofazimine
Prophylaxis for MAC
azithromycin
How would you treat a chlamydia reaction?
azithromycin or doxycycline
How do you treat neonatal chlamydia?
azithromycin
Prophylaxis for TB?
INH
What drug causes red-green blindness?
Ethambutol
Anti-TB drugs
Streptomycin, Pyrazinamde, INH, Rifampin, Ethambutol
INH
INHibit mycolic acid synthesis; USE = TB (solo prophylaxis); AE = neuro/hepatotoxic, drug-induced lupus
How can you reduce the side-effects of INH?
B6
drug-induced lupus
SHIPP (sulfonamides, Hydralazine, INH, procainamide, phenytoin)
Rifampin
inhibits DDRP; USE = TB, leprosy (w/ dapsone), meningococcal & HiB prophylaxis; AE = inc P450, orange body fluids
meningococcal prophylaxis
rifampin, minocycline
gonorrhea prophylaxis
ceftriaxone
syphilis prophylaxis
penicillin G
recurrent UTI prophylaxis
TMP-SMX
PCP prophylaxis
TMP-SMX, pentamide, dapsone
MRSA Rx
vancomycin
VRE Rx
linezolid, streptogramins
How do you treat Toxoplasmosis?
Sulfadiazine & pyrimethamine
Rx for Leishmaniasis
Sodium stibogluconate
Rx for T. cruzi?
Nifurtimox
How would you treat ringworms, hookworms, and pinworms?
-bendazoles or pyrantel pamoate
How do you treat Strongyloides?
-bendazole or ivermectin
Rx for tapeworms?
Praziquantel
How do you treat onchocerca?
Ivermectin
Rx for W. bancrofti?
Diethylcarbamazine
Amphotericin B
bind ergosterol (pores); USE = serious, systemic mycoses; AE = nephrotoxic, IV phlebitis, fevers, chills
Nystatin
binds ergosterol (pores); USE = "swish and swallow" for oral candidiasis, topical for vaginal/diaper rash candida
Fluconazole
inhibits formation of ergosterol; USE = cryptococcal meningitis & candidiasis; AE = gynecomastia, liver dysfunction, inhibits P450
Itraconazole
inhibits formation of ergosterol; USE = Sporothrix; AE = gynecomastia, liver dysfunction, inhibits P450
Ketoconazole
inhibits formation of ergosterol; USE = blasto, histo, coccidioides, candida; AE = gynecomastia, liver dysfunction, inhibits P450
Flucytosine
inhibits DNA synthesis; USE = candida, cryptococcus; AE = NVD, BM suppression
Caspofungin
inhibits B-glucan synthesis; USE = invasive aspergillus; AE = flushing, GI upset
Terbinafine
inhibit squalene epoxidase; USE = dermatophytes (nail especially)
Griseofulvin
interfere with microtubule formation; USE = dermatophytes; AE = carcinogenic, teratogenic, inc P450
TERATOGEN: lithium
ebstein's anomaly (atrialization of RV)
TERATOGEN: iodide
congenital hypothyroidism
TERATOGEN: maternal diabetes
transposition of great vessels, caudal regression syndrome
TERATOGEN: vitamin A
spontaneous abortion, cleft palate, cardiac abnormalities
TERATOGEN: tetracycline
discolored teeth
TERATOGEN: thalidomide
limb defects
TERATOGEN: aminoglycosides
CN VIII toxicity
TERATOGEN: DES
vaginal adenocarcinoma & abnormalities
TERATOGEN: alkylating agents
absence of digits
TERATOGEN: ACE-Is
renal damage
TERATOGEN: valproate
inhibit folate --> NTDs
Rx: torsades de pointes
Mg+2
Rx: A-fib
B-blockers, CCBs
Rx: Prinzmetals angina?
dihydropyridine CCBs (nifedipine)
Digoxin
inhibit Na+K+ ATPase --> indirect inhibition of Na/Ca exchanger (inc intracellular Ca); USE = CHF, A-fib; AE = blurry yellow vision, NVD, hyperkalemia, bradycardia, inc PR, dec QT, T-wave inversion
What factors increase digoxin toxicity?
quinidine, hypokalemia, renal failure
Class I antiarrhythmics (name them)
A = quinidine, procainamide, disopyramide; B = lidocaine, Mexiletine, Tocainide; C = flecainide, encainide, propafenone
Class IA antiarrhythmic
block Na+ channels (active); USE = reentry/ectopic SVT and V-tach; AE = cinchonism (quinidine), SLE-like (procainamide), torsades
How do the class I antiarrhythmics affect the conduction of the cells?
A = increase AP duration, QT interval, and ERP; B = dec AP duration; C = no effect
Class IB antiarrhythmics
block Na+ channels (ischemic/depolarized); USE = acute ventricular arrhythmias & digoxin toxicity (lidocaine); AE = CV depression
Class IC antiarrhythmics
blocks Na+ channel; USE = V-tachs, SVT; AE = pro-arrhythmic
Class II antiarrhythmics
B-blockers; USE = V-tach, SVT, A-fib, atrial flutter; AE = impotence, exacerbate asthma/CHF, sedation, mask hypoglycemia in diabetics
What effects do class II antiarrhythmics have on the nodal phases?
inc PR interval, decrease slope of phase 4
Class III antiarrhythmics
block K+ channels; USE = when others fail; AE = sotalol (torsades), amiodarone (LFT, TFT, PFT, skin deposits, photosensitive), bretylium (hypotension)
What effects do class III antiarrhythmics have on the nodal phases?
inc AP duration, ERP, & QT interval (just like Class IA)
Class IV antiarrhythmics
non-dihydropyridine CCBs; USE = nodal arrhythmias; AE = constipation, flushing, edema, AV block, sinus node depression
What effects do class IV antiarrhythmics have on the nodal phases?
dec conduction velocity; inc ERP & PR interval
Adenosine
Increase K+ efflux; USE = SVT; AE = flushing, hypotension, chest pain
Potassium use
USE = ectopic pacemakers
Magnesium use
USE = digitoxin toxicity, torsades de pointes
Hydralazine
inc cGMP --> vasodilate arterioles; USE = severe HTN, CHF; AE = compensatory tachy, fluid retention, SLE-like, headache
Nifedipine
dihydropyridine CCB; USE = HTN, angina, arrhythmias, Prinzmetals angina, Raynauds; AE = flushing, dizziness, constipation, peripheral edema
Nitroglycerin
release NO from endothelia --> vasodilate veins; USE = angina, pulm edema; AE = reflex tachy, hypotension, flushing, headache
What typically happens with constant use of nitrates?
tolerance is built up...space out use
Nitroprusside
release of NO; USE = malignant HTN; AE = CN toxicity
Fenoldopam
D1 agonist (inc renal blood flow & natriuresis); USE = malignant HTN
Diazoxide
K+ opener; USE = malignant HTN
Minoxidil
K+ channel opener; USE = HTN; AE = hypertrichosis, salt retention, pericardial effusion
Statins
HMG-CoA reductase inhibitors; USE = decrease LDL mainly; AE = hepatotoxic, rhabdomyolysis, myositis
Niacin
inhibits adipose lipolysis & reduces VLDL secretion; USE = increase HDL; AE = flushing, hyperglycemia, hyperuricemia
Bile acid resins
inhibits bile acid reabsorption (need to use more cholesterol); USE = lipid-lowering; AE = tastes bad, GI discomfort, cholesterol gallstones, fat-vitamin decreased
Which cardiac drug binds up C. difficile toxin?
cholestyramine
Ezetimibe
prevent cholesterol absorption; USE = lipid-lowering; AE = LFTs
Fibrates
upregulate LPL; USE = hypertriglyceridemia; AE = myositis, hepatotoxicity, cholesterol gallstones
SE: myositis, elevated LFTs
statins, fibrates
SE: flushing
niacin
SE: bad taste, GI discomfort
bile acid resins
antihypertensives that cause reflex tachycardia?
nitrates, hydralazine, nifedipine
antihypertensives that cause dry mouth, sedation, rebound HTN
clonidine
Which diuretic is contraindicated in kidney stones?
loop diuretics (loops LOSE calcium)
Short acting Benzos
OAT (Oxazepam, Alprazolam, Triazolam) --> increased risk of addiction
Medium acting Benzos
LET (lorazepam, Estazolam, Temazepam)
Long acting Benzos
Chlordiazepoxide, Clorazepate, Diazepam, Flurazepam
Amantadine
block viral penetration/uncoating (M2 protein) & causes dopamine release; USE = influenza A, Parkinsons
Zanamivir
block neuroaminidase function; USE = influenza A & B
Oseltamivir
block neuroaminidase function; USE = influenza A & B
Ribavirin
inhibits IMP DH (no guanine nucleotides made); USE = RSV (adults only), HCV; AE = teratogenic
What would you use to treat HCV?
ribavirin & IFN-a
Acyclovir
phosphorylated by (HSV/VZV) thymidine kinase --> inhibit viral DNA pol; USE = HSV, VZV, EBV
Ganciclovir
phosphorylated by (HSV/VZV) thymidine kinase & (CMV) viral kinase --> inhibit viral DNA pol; USE = CMV; AE = leukopenia, thrombocytopenia
Foscarnet
don't require activation --> inhibit viral DNA pol; USE = CMV retinitis & when ganciclovir fails; AE = nephrotoxic
protease inhibitors
end in -navir
NRTIs
zidovudine, didanosine, zalcitabine, stavudine, lamivudine, abacavir
NNRTIs
nevirapine, efavirenz, declaviridine
Fusion inhibitors
Enfuvirtide
Maraviroc
gp120 inhibitor; USE = only for R5 phenotype of HIV
Raltegravir
HIV-1 integrase inhibitor; USE = HIV; AE = unfavorable lipid profile
[ANTIRETROVIRAL/CLASS] SE: lactic acidosis
NRTIs
[ANTIRETROVIRAL/CLASS] SE: GI intolerance
protease inhibitors
[ANTIRETROVIRAL/CLASS] SE: pancreatitis
ritonavir, didanosine, stavudine, zalcitabine
[ANTIRETROVIRAL/CLASS] SE: peripheral neuropathy
didanosine, stavudine
[ANTIRETROVIRAL/CLASS] SE: megaloblastic anemia
zidovudine
[ANTIRETROVIRAL/CLASS] SE: rash
NNRTIs (declavirdine, efavirenz, nevirapine)
[ANTIRETROVIRAL/CLASS] SE: hyperglycemia & lipdystrophy
saquinavir, indinavir, amprenavir
[ANTIRETROVIRAL/CLASS] SE: BM suppression
zidovudine
If a health care worker was stuck with a high-risk HIV needle, what would he be put on?
lamuvidine/zidovudine
TCAs - list drugs
imipramine, desipramine, nortriptyline, amitriptyline, climipramine, doxepin, amoxapine
SSRIs - list drugs
fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine
SNRIs - list drugs
venlafaxine, duloxetine, nefazodone, desvenlafaxine, milnacipram
MAOIs - list drugs
phenelzine, tranylcypromine, selegiline,
NDRIs - list drugs
buproprion
Tetracyclic antidepressants - list drugs
mirtazapine, trazodone
atypical antipsychotics - list drugs
olanzapine, quetiapine, aripiprazole, ziprasidone, clozapine, risperidone
Methotrexate
inhibits DHFR; USE = abortion, choriocarcinoma, leukemia/lymphomas & as anti-inflammatory; AE = teratogen (NTDs), stomatitis, hepatotoxic
What is leucovorin?
provides folinic acid rescue in MTX usage
What is a clinical use for thymidine?
rescue of 5-FU overdose?
5FU
inhibits thymidylate synthase; USE = colon cancer, basal cell carcinoma (topical); AE = photosensitivity
6MP
inhibit PRPP synthetase; USE = leukemia/lymphoma; AE = GI, liver toxicity
What is contraindicated with 6MP?
allopurinol --> because 6MP is metabolized by xanthine oxidase
6FP
inhibit PRPP synthetase; USE = ALL
Cytarabine
inhibit DNA pol; USE = AML, ALL; AE = megaloblastic anemia w/ pancytopenia
What drugs inhibit the S-phase of the cell cycle?
Etoposide, 5FU, MTX, 6MP, 6TG, cytarabine
What drugs are used to treat testicular cancer?
Eradicate Ball Cancer (Etoposide, Bleomycin, Cisplatin)
Dactinomycin
DNA intercalates; USE = childhood tumors
Doxorubicin/Daunorubisin
generate free radicals --> intercalates and makes breaks; USE = HL; AE = cardiotoxic
Bleomycin
introduced free radicals --> breaks; USE = testicular cancer, HL; AE = pulm fibrosis
Drugs that cause pulm fibrosis?
BLAB (BLeomycin, Amiodarone, Busulfan)
Etoposide
inhibit DNA topoisomerase II; USE = testicular cancer, small cell of lung; AE = alopecia
Cyclophosphamide
crosslink DNA @ guanine N-7; USE = Non-HL, breast, ovarian, Wegener's, PAN; AE = hemorrhagic cystitis
What is a particularly worrisome side-effect of cyclophosphamide? What can you do to help prevent it?
hemorrhagic cystitis (give MESNA)
Nitrosureas
cross BBB; USE = brain tumors
Busulfan
DNA alkylates; USE = CML; AE = hyperpigmentation, pulm fibrosis
Vincristine
blocks tubulin polymerization; USE = HL, Wilms, choriocarcinoma; AE = neurotoxic, ileus
What drugs can be used to treat Wilm's tumor?
Dactinomycin, Vincristine/Vinblastine
What drugs can be used for choriocarcinoma?
MTX, Vincristine/Vinblastine
Vinblastine
prevents tubulin polymerization; USE = HL, Wilms, choriocarcinoma; AE = BLASTS bone marrow
Taxols
hyperstabilizes tubulin polymers; USE = breast & ovarian carcinoma
Cisplatin
cross-link DNA; USE = testicular, bladder, ovary, lung cancer; AE = nephrotoxic & ototoxic
Hydroxyurea
inhibits ribonucleotide reductase; USE = sickle cell, melanoma, CML
Prednisone
triggers cell apoptosis; USE = CLL, HL, autoimmune
What are the side-effects of prednisone?
CHEAP COPS = Cushings, HTN, eyes (cataracts), acne, PUD, confusion, osteoporosis, psychosis, sugar (hyperglycemia)
tamoxifen
SERM; USE = ER+ breast cancer; AE = risk of endometrial carcinoma (antagonistic to endometrium)
raloxifene
SERM; USE = ER+ breast cancer & osteporosis (agonist @ bone)
Trastuzumab
antibody against HER-2; USE = metastatic breast cancer; AE = cardiotoxic
Imatinib
bcr-abl tyrosine kinase inhibitor; USE = CML, GIST
Rituximab
monoclonal ab against CD20; USE = RA
Bisphosphonates
inhibits osteoclastic activity; USE = postmenopausal osteoporosis, Pagets; AE = esophagitis, jaw osteonecrosis
Drugs used to treat gout:
acute = NSAIDs & colchicine; chronic = probenecid & allopurinol
Probenecid
inhibits uric acid reabsorption in PCT; USE = chronic gout
Colchicine
stabilizes tubulin --> inhibit polymerization; USE = acute gout
Allopurinol
inhibit xanthine oxidase; USE = chronic gout, prevent urate nephropathy (leukemia/lymphoma treatments)
Celecoxib
selective COX-2 inhibitor (only inflammation); USE = RA & osteoarthritis; AE = risk of thrombosis, sulfa allergy
Acetaminophen
reversibly inhibit COX; USE = antipyretic, analgesic; AE = hepatic necrosis (in overdose)
How do you treat acetaminophen overdose and what is the mechanism is uses?
N-acetylcysteine --> regenerates glutathione
Rx: central DI
desmopressin (intranasal)
Rx: nephrogenic DI
hydrochlorothiazide, indomethacin, amiloride
Rx: acromegaly
octreotide
Sitagliptin
inhibits dipeptidyl peptidase IV --> increases GLP-1 (increased insulin)
Exenatide
GLP-1 analog --> increases insulin; AE = acute pancreatitis
Pramlintide
amylin analog --> decreased glucagon
[Type II DM agents] SE = lactic acidosis
metformin
[Type II DM agents] SE = hypoglycemia
2nd gen sulfonylureas
[Type II DM agents] helps lower TG & LDL
metformin
[Type II DM agents] not safe in hepatic dysfunction or CHF
TZDs or metformin
[Type II DM agents] not used in renal failure
metformin
[Type II DM agents] not used in renal failure, cirrhosis, or IBD
acarbose or miglitol
[Type II DM agents] SE = hepatotoxic
TZDs or metformin
[Type II DM agents] excellent for renal dz
TZDs
[Type II DM agents] decreased postprandial hyperglycemia
acarbose or miglitol
[Type II DM agents] SE = lipodystrophy, weight gain, hypoglycemia
exogenous insulin
[Type II DM agents] SE = disulfuram-like rxn
1st gen sulfonylurea
1st gen sulfonylureas
Tolbutamide, Chlorpropamide
2nd gen sulfonylureas
glyburide, glimepiride, glipizide
sulfonylureas MOA
close K+ channels --> increase insulin release
Metform MOA
decrease gluconeogenesis, increase glycolysis & peripheral uptake
What are the TZDs? MOA?
rosiglitazone, pioglitazone --> bind PPAR-gamma and upregulate GLUT4 (increased insulin sensitivity)
[Type II DM agents] SE = cardiotoxic
TZDs
Acarbose
inhibit intestinal a-glucosidases (decrease absorption of glucose)
Miglitol
inhibit intestinal a-glucosidases (decrease absorption of glucose)
PTU
inhibit organification of iodide & decrease T4 --> T3; USE = hyperthyroidism; AE = agranulocytosis, aplastic anemia
Rx: Parkinsons
bromocriptin/ropinirole/pramipexole (dopamine receptor agonist), amantadine, L-dopa/carbidopa, selegiline (MAOI type B), entecapone (COMT-i), Benztropine (antimuscarinic)
Methimazole
inhibit organification of iodide; USE = hyperthyroidism; AE = agranulocytosis, aplastic anemia
L-dopa
crosses BBB --> converted to dopamine; USE = Parkinson's; AE = arrhythmia, dyskinesia, akinesia
Levothyroxine
thyroxine replacement; USE = hypothyroidism, myxedema; AE = heat intolerance, tachycardia, tremors
Carbidopa
inhibit peripheral decarboxylase; USE = Parksinons w/ L-dopa
Octreotide
somatostatin analog; USE = acromegaly, carcinoid, glucagonoma, VIPoma, gastrinoma
Memantine
NMDA receptor antagonist (prevents excitation); USE == Alzheimers; AE = hallucinations, confusion
Demeclocycline
ADH antagonist; USE = SIADH; AE = nephrogenic DI, photosensitivity
Donepezil/Galantamine/Rivastigmine
AChE inhibitors; USE = Alzheimers; AE = insomnia, dizziness
What happens when glucocorticoids are stopped suddenly?
tertiary adrenal insufficiency
Rx: Huntingtons
haloperidol (dopamine receptor antagonist)
Orlistat
inhibits pancreatic lipase; USE = obesity; AE = steatorrhea, GI upset, reduced absorption of fat-soluble vitamins
Sumatriptan
5HT(1B/D) agonist --> vasoconstriction; USE = acute migraine, cluster headaches; AE = coronary vasospasm, tingling
Sibutramine
SNRI (peripheral only); USE = obesity; AE = HTN, tachycardia
What is generally not recommended with sibutramine?
MAOIs or SSRIs
What medication inhibits PRPP synthetase?
6MP & 6TG
What medication inhibits IMP DH?
mycophenylate
clomiphene
partial agonist @ ER --> increase LH/FSH release; USE = infertility, PCOS; AE = ovarian enlargement, hot flashes, simultaneous pregnancies
Anastrozole
aromatase inhibitors; USE = postmenopausal breast cancer
Mifepristone
inhibits progestins; USE = pregnancy termination; AE = heavy bleding
Misprostol
PGE1 analog; USE = terminate pregnancy
Dinoprostone
PGE2 analog; USE = induce labor
Ritodrine
B2 agonist; USE = reduce premature uterine contractions
Terbutaline
B2 agonist; USE = reduce premature uterine contractions
What is the main function of OCPs?
prevent estrogen surge --> no LH surge --> no ovulation
Rx: trigeminal neuralgia
carbamazepine
Rx: pyruvate DH deficiency
lysine & leucine
Rx: ALS
riluzole (decrease glutamate)
Rx: MS
IFN-B
Rx: absence seizures
Ethosuxomide
Rx: status epilepticus
lorazepam, diazepam, phenytoin
increase frequency Cl- opening --> inc GABAa
benzodiazepines
increases duration Cl- opening --> inc GABAa
barbituates
Rx: both clonic tonic & partial seizures
valproate, carbamazepine, phenytoin
SE: phenytoin
gingival hyperplasia, fetal hydantoin syndrome, hirsuitism, induce P450, SLE-like, megaloblastic anemia
SE: antiseizures
nystagmus, diplopia, dizziness, ataxia, sedation
Rx: ONLY partial seizures
lamotrigine, gabapentin, topiramate, phenobarbital
Rx: eclampsia
lorazepam, diazepam
Which antiepileptics are teratogenic?
valproate (NTDs), phenytoin (fetal hydantoin), carbamazepine (NTDs)
which antiepileptics cause SJS?
ethosuximide, phenytoin, phenobarbital, carbamazepine, lamotrigine
What drugs causes agranulocytosis?
PTU, methimazole, colchicine, carbamazepine, clozipine
antiepileptic SE: hepatoxicity
valproate, carbamazepine
antiepileptics that block Na+ channels?
carbamazepine, phenytoin, valproate, lamotrigine, topiramate
antiepileptics that potentiate GABA effects (inhibition)?
benzos & barbs, gabapentin, valproate, topiramate
antiepileptic SE: kidney stones
topiramate
a child "spaces out" during class while talking and moments later, continues the conversation from where she left off
absence seizure
Dantrolene
inhibit Ca+2 channels; USE = malignant hyperthermia (succinylcholine + inhaled anesthetics), NMS, serotonin syndrome
Rx: benzo overdose? barb overdose?
benzo = flumazenil; barb = supportive
zolpidem
BZ1 receptor agonist (potentiate GABA); USE = insomnia; AE = headache, confusion
Tramadol
weak opiate agonist & SNRI; USE = chronic pain; AE = decreased seizure threshold
What drugs decrease the seizure threshold?
bupropion & tramadol
butorphanol
opioid mu & kappa agonist; USE = pain; AE = withdrawal
dextromethorphan
opiate agonist; USE = cough suppressant
loperamide
opiate agonist; USE = anti-diarrheal
diphenoxylate
opiate agonist; USE = antidiarrheal
Rx: acute CHF
LMNOP: loops, morphine, nitrates, oxygen, pressors/position
methadone
opiate agonist; USE = maintenance program for addicts
Rx: opiate overdose
naloxone, naltrexone
inhalational anesthetics: what happens when you increase solubility? decrease solubility?
increase = increase potency; decrease = increase induction speed/recovery
What is MAC?
amount of anesthetic in alveoli to get 50% of population anesthetized
opiate cough suppressant
dextromethorphan
opiate used for diarrhea
loperamide, diphenoxylate
opiate used in acute CHF
morphine
non-addictive opiate
tramadol
which fibers are anesthetized first with local anesthetics?
pain (small, myelinated)
anesthetic SE: hallucinations & bad dreams
ketamine
anesthetic SE: nephrotoxic
methoxyflurane
most common anesthetic used for endoscopy?
midazolam
anesthetic SE: convulsions/seizures
Enflurane = epilepsy
anesthetic SE: hepatotoxic
Halothane
anesthetic used for rapid induction & short procedures
propofol
anesethetic used for induction of anesthesia
thiopental (& propofol)
anesthetic SE: risk of pancreatitis
propofol
inhalational anesthetic used for rapid anesthesia
methoxyflurane
anesthetic that decreases cerebral blood flow
thiopental
which anesthetic would you want to use in brain surgery?
thiopental
Prophylaxis for status epilepticus
phenytoin
treatment for chronic asthma
glucocorticoids (prednisone)
treatment of acute asthma exacerbations
albuterol
blocks conversion of arachidonic acid --> leukotrienes
zileuton
inhibits mast cell release of mediators
cromolyn
asthma treatment that blocks muscarinic receptors
ipratropium
inhaled long-active B2-agonist
salmeterol
blocks leukotriene receptors
zafirlukast, montelukast
Rx: appetite stimulant
cyproheptadine
Rx: vertigo
meclizine
1st gen H1 antagonists
Diphenhydramine, dimenhydrinate, chlorpheniramine; USE = motion sickness, sleep aid; AE = antimuscarinic, anti-adrenergic
2nd gen H1 antagonists
loratadine, fexofenadine, cetirizine; USE = allergy
asthma treatment that inhibits phosphodiesterase
theophylline
Narrow TI asthma treatment
theophylline
What are the expectorants?
NAc & guaifenesin
Bosentan
antagonize endothelin-1 receptors; USE = pulm HTN
Rx: pulm HTN
bosentan, nifedipine, sildenafil
asthma treatment that inactivates NF-kB
prednisone
AE of theophylline
cardiotoxicity & neurotoxicity
Rx: abetalipoproteinemia
Vit E
precursor of 6MP
azathioprine
mannitol diuresis prevents nephrotoxicity caused by this
cyclosporine
antibody that binds CD3 on T cels
muromonab
antibody that binds IL-2r of activated cells
daclizumab
inhibits IMP DH
mycophenylate
MOA of cyclosporine
binds cyclophilin --> inhibit calcineurin --> lack of IL-2r
MOA of tacrolimus
binds FK-BP --> inhibit calcineurin --> lack of IL-2r
MOA of sirolimus
binds FK-BP --> inhibit mTOR --> lack of IL-2r
Rx: lupus nephritis
mycophenylate
metabolized by xanthine oxidase
azathioprine, 6MP
Causes phocomelia
flipper arms --> thalidomide
Rx: acute rejection after organ transplant
cyclosporine or OKT3 (muromonab)
AE: tacrolimus
nephrotoxic, peripheral neuropathy, pleural effusion, hyperglycemia
AE: cyclosporine
nephrotoxic (prevent w/ mannitol), rise of lymphoma & viral infection
recombinant IL-2
aldesleukin
MAB to CD20
rituximab
MAB to Gp IIb/IIIa
abciximab
recombinant IL-11
oprelvekin
post exposure prophylaxis for N. meningitidis
Rifampin
Antacid SE: diarrhea
Magnesium-hydroxide
Antacid SE: constipation
aluminum hydroxide
Antacid SE: rebound hypercalcemia
calcium carbonate
Antacid SE: hypokalemia
ALL
What is the MOA of PPIs?
inhibit H+K+ ATPase (decrease gastric acid secretion)
Rx: NSAID-induced PUD
Misoprostol
Uses of misoprostol?
PGE1 analog = keep PDA open, induce labor, and NSAID-induced PUD
H2 blockers
-tidine; USE = peptic ulcers, gastritis, GERD
Cimetidine SEs:
inhibit P450, antiandrogenic, crosses BBB & placenta
PPIs
-prazole; irreversibly block H/K ATPase; USE = PUD, gastritis, GERD, Z-E syndrome
Bismuth
binds to ulcer base --> allow HCO3 to reestablish pH; USE = ulcer healing, traveler's diarrhea
Propantheline
M1 (ECL) & M3 (parietal) antagonist; USE = PUD; AE = anticholinergic
Octreotide
SST analog; USE = esophageal varices, acromegaly, VIPoma, carcinoid
Which antacid causes osteodystophy?
aluminum hydroxide
Sulfasalazine
antibacterial/anti-inflammatory --> activated by colon bacteria; USE = UC, Crohns
Ondansetron
5HT3 antagonist; USE = postop/chemo vomiting; AE = constipation
Metoclopramide
D2 antagonist; USE = postop/diabetic gastroparesis; AE = parkinsonian, restlessness, diarrhea, decrease seizure threshold
When would you not give someone metoclopramide?
Parksinson or bowel obstruction
What drugs decrease seizure threshold?
tramadol, buproprion, metoclopramide, enflurane
Rx: diabetic gastroparesis
metoclopramide
Rx: UC
sulfasalazine
Mannitol
osmotic diuresis (PCT); USE = shock, dec intracranial/intraocular pressure; AE = dehydration
Acetazolamide
carbonic anhydrase inhibitor (PCT); USE = altitude sickness, metabolic alkalosis, glaucoma; AE = hypochloremic metabolic acidosis, neuropathy
SE: hypochloremic metabolic acidosis
acetazolamide
Furosemide
inhibit Na/K/2Cl co-transporter (ascending LoH); USE = edematous states, hypercalcemia
SE: loop diuretics
OH DANG: ototoxicity, hypokalemia/-calcemia, dehydration, allergy (sulfa), nephrotoxic, gout
SE: thiazides
hypeGLUC (glycemia, lipidemia, uricemia, calcemia); hypokalemic metabolic alkalosis
SE: hypokalemic metabolic alkalosis
Thiazides
Thiazides
inhibit Na+/Cl+ reabsorption (DCT); USE = hypercalciuria, nephrogenic DI, HTN, CHF
Triamterene
inhibit Na+ channels in CCT; USE = Conn's syndrome, CHF; AE = hyperkalemia
Spironolactone
inhibit aldosterone receptor (CCD); USE = Conn's, CHF; AE = hyperkalemia, endocrine (gynecomastia, antiandrogenic)
Captopril
inhibit ACE-I (lung); USE = HTN, CHF, renal disease
Amiloride
inhibit Na+ channels in CCT; USE = Conn's syndrome, CHF; AE = hyperkalemia
Who do you avoid giving ACE-Is to?
bilateral renal artery stenosis
What are the side effects of ACE-Is?
CAPTOPRIL = Cough, Angioedema, Proteinuria, Taste change, hypOtension, Pregnancy prob, Rash, Increased Renin, Lower ATII & hyperkalemia
What diuretics cause acidemia?
Acetazolamide (inhibit HCO3- reabsorption) & K+sparing (prevent K+ & H+ secretion)
What diuretics cause alkalemia?
loops/thiazides
Rx: acute intermittent porphyria
glucose & heme
Rx: vWF disease
DDAVP (desmopressin) --> release vWF stores
Rx: M3 AML
ATRA (vit A)
Rx: CML
Imatinib
A patient is recently diagnosed w/ CHF and cancer. What should you avoid in your treatment modality?
Dauno-/Doxorubicin
SEs of Heparin
HIT, osteoporosis, bleeding
inhibits gamma-carboxylation
warfarin
Which anticoagulant can you use in pregnancy?
heparin --> less likely to cross placenta due to highly anionic charge
tPA
convert plaminogen --> plasmin; USE = early MI & stroke; AE = bleeding
irreversibly block ADP-receptors
clopidogral, ticlopidine
antibody that blocks GpIIb/IIIa
abciximab, tirofiban, eptifibatide