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35 Cards in this Set

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Amlodipine

Ca+ channel blocker (reduce muscle contractility)


Dihydropyridine


Vascular SM >>> heart


HTN, angina

Nifedipine

Ca+ channel blocker (reduce muscle contractility)Dihydropyridine


Vascular SM >>> heart


HTN, angina

Diltiazam

Ca+ channel blocker (reduce muscle contractility) Non-dihydropyridine


Heart approx = Vascular SM effects


HTN, angina, afib/flutter

Verapamil

Ca+ channel blocker (reduce muscle contractility) Non-dihydropyridine


Heart >>> Vascular SM effects


HTN, angina, afib/flutter

Hydralazine

Increases cGMP causing SM relaxation --> vasodilates arterioles>>veins (reduces afterload)


Severe HTN, CHF, (also, pregnancy w/methyldopa)

Hypertensive emergency

Nitroprusside (direct NO release --> increased cGMP)


Fenoldopam (D1 agonist)

Nitrates (nitroglycerin, isosorbide, dinitrate)

Vasodilation veins >> arteries


Increase NO --> increase in cGMP and SM relaxation

HMG-CoA reductase inhibitors

- Lovastatin, pravastatin, simvastatin, atorvastatin, rovustatin


- Inhibits conversion of HMG-CoA to mevalonate (cholesterol precursor)


- SE: heptatotoxicity (LFTs), rhabdo (espw/fibrates and niacin; CrKinase)

Niacin

- Vit B3


- Inhibits lipolysis in adipose; reduces hepatic VLDL synthesis


- SE: Red flushed face (decreased w/aspirin or long-term use); hyperglycaemia (acanthuses nigricans); hyperuricemia (gout)

Bile acid resins

- Cholestyramine, colestipol, colesevelam


- Prevents intestinal reabsorption of bile acids, so liver must use cholesterol to make more


- SE: bad taste, GI discomfort, decr absorption of fat-soluble vitamins, cholesterol gallstones

Cholesterol absorption blockers

- Prevents cholesterol absorption at SI brush border


- SE: diarrhea

Fibrates

- Gemfibrozil, clofibrate, bezafibrate, fenofibrate


-Upregulates LPL to increase TG clearance; activates PPAR-alpha to induce HDL synthesis


- SE: myositis (incr risk w/statins), hepatotoxicity, cholesterol gallstones

Cardiac glycosides/digoxin

- Direct inhibition of Na+/K+ ATPase causing direct inhibition of Na+/Ca2+ exchanger. Increased [Ca] inside cell = + ionotropy


- Increased [Ca] in cell also stimulates VAGUS nerve --> decreased HR


- CHF (incr contractility), afib (decr conduction at AV node and depression of SA node)


Many SE!: cholinergic (nausea, dizzy, diarrhea), hyperK+, arrhythmia, AV block

Na+ channel blockers

- Quinidine, procainamide, lidocaine, flecainide


- Slow/block conduction --> decrease the slope of phase 0 depolarization and increase threshold for firing in abnormal pacemaker cells


- State-dependent (selectively depress tissue that is frequently polarized)


-Use: Arrhythmias (atrial or ventricular depend on class A, B or C)

Beta-blockers

- Metoprolol, propanolol, atenolol, timolol, carvedilol


- decrease SA and AV nodal activity by decr cAMP, decr Ca2+ currents--> suppress abnormal pacemaker cells by decreasing slope of phase 4 (prolonged depolarization). Esp effective at AV node


- Use: SVT, slowing ventricular rate during afib/aflutter


- SE: may mask signs of hypoglycemia!!!

K+ channel blockers

- Amiodarone, ibutilide, sotalol


- Increase AP duration. Used when others fail


- Use: afib, aflutter, vtach


- SE: Sotalol and ibutilide = torsade des pointes; amiodatone = pulm fibrosis, hepatotoxicity, hyper/hypothyriodism, etc.

Ca2+ channel blockers (as antiarrhythmics)

- Verapamil, diltiazam (non-dohydropyramidines)

- Decrease conduction velocity


- Use: prevention of nodal arrhythmias, rate control in afib


Adenosine

- increased K+ out of cells --> hyper polarized cells and decreased internal Ca2+.


- Drug of choice in diagnosing/abolishing SVT


- VERY short acting (15 sec) and make you feel like you want to die

Mg2+ (antiarrhythmics)

- Use: torsade des pointes and digoxin toxicity

Terbinafine

Antifungal


Inhibits squalene epoxidase


"Squatter" = Terbinafine blocks squalene oxydase


For ochychomycosis (fungal infection of skin/nail)

Azoles

Antifungal


Inhibits ergosterol synthesis by inhibiting the p450 enzyme that converts lanosterol to ergosterol


For local/less serious systemic mycoses


SE: Testosterone synthesis inhibition, liver dysfunction

5-Flucytosine (5-FU)

Antifungal


Inhibits nucleic acid synthesis


For systemic fungal infections w/amphoB (cryptococcal meningitis)


Also used for cancer

Echinocandins

Antifungal


E.g. caspofungin, micafingin, anidulafungin


Inhibits beta-gluten synthesis of cell wall (Glucan inhibitors = "-gin")


For invasive aspergillosis, candida


SE: GI upset, flushing (histamine release)

Polyenes

Antifungal


Amphotericin B, Nystatin (topical only, too toxic for systemic use)


Binds ergosterol and forms membrane pores allowing leakage of electrolytes


For serious systemic mycoses


TONS of SE (fevers/chills, hypotension, arrythmias, nephrotoxicity, anemia, etc)

Vancomycin (+ Bacitracin)

Inhibits cell wall peptidoglycan formation, binds D-ala D-ala portion


Bactericidal


For serious G+ infections


NOT - Nephrotoxicity, Ototoxicity, Thrombophlebitis


"You need D-ala's to buy a Van, NOT"

Penicillins + derivations (B-lactam)

Block cross linking of peptidoglycan


Penicillinase in bacteria (B-lactamase) cleaves B-lactam ring


Ampicillin (IV), amOxicillin (PO) - give clavulinic acid to protect against B-lactamase


Oxacillin, nafcillin, dicloxacillin ("naf for staph") - penicillinase-resistant, bulky group blocks access


Ticarcillin, piperacillin - pseudomonas, G- rods, use w/B-lactamase inhibitors


Cephalosporins, Gen1 = G+; Gen 2 = G+; Gen 3 = G-; Gen4 = G-, Gen 5 = G+/-


Carbapenems = big guns

Protein synthesis inhibitors

Block 50S subunit (all bacteriostatic)


- Macrolides (erythromycin, azithromycin, etc.)


- Chloramphenicol


- Clindamycin (anaerobe infections above diaphragm)


- Linezolid


Block 30S subunit


- Aminoglycosides (gentamycin, neomycin, tobramycin, streptomycin) (bacteriocidal)


- Tetracyclines (doxycycline, tetracycline, minocycline, tigecycline) (bacteriostatic)

Sulfonamides


Trimethoprim

Sulfamethoxazole (SMX), silfadiazine, etc.


- Inhibits folate synthesis by blocking DHP synthase (bacteriostatic)


Trimethoprim (TMP)


- Inhibits folate synthesis by blocking DHP reductase (bacteriostatic)

Fluoroquinolones

Ciprofloxacin, moxifloxacin, levofloxacin, etc.


Inhibits DNA gyrase (topoisomerase II) and topoisomerase IV


(Bacteriocidal)

Metronidazole

Damages DNA via free radical formation


(Bacteriocidal. Also antiprotozoal)


Anaerobe infections below the diaphragm ("metros underground, hookups 'clean' if above the diaphragm)

Rifampin

Inhibits DNA-dependant RNA polymerase


Orange body fluids


P450 stimulation

Izoniazid

↓ synthesis of mycolic acids


For TB

Class IA antiarrhythmics

Double Quarter Pounder


Discopyrimide, Quinidine, Procainamide


↑ AP duration, ↑ effective refractory period


For: ectopic and re-entrant SVT and VT


Torsade des Points possible (↑QT)

Class IB antiarrhythmics

Lettuce, Tomato, Mayo


Lidocaine, Tocainamide, Mexiletine


↓ AP duration, **preferentially affects ischemic/depolarized Purkinje and ventricular tissue = B is Best post MI


For: Vtach, post MI

Class IC antiarrhythmics

More Fries Please


Moricizine, Flecanide, Propafenone


No effect on AP duration


Significantly prolongs refractory period (AV node)


For: SVTs (afib), do NOT use pot MI!!