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35 Cards in this Set
- Front
- Back
Amlodipine |
Ca+ channel blocker (reduce muscle contractility) Dihydropyridine Vascular SM >>> heart HTN, angina |
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Nifedipine |
Ca+ channel blocker (reduce muscle contractility)Dihydropyridine Vascular SM >>> heart HTN, angina |
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Diltiazam |
Ca+ channel blocker (reduce muscle contractility) Non-dihydropyridine Heart approx = Vascular SM effects HTN, angina, afib/flutter |
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Verapamil |
Ca+ channel blocker (reduce muscle contractility) Non-dihydropyridine Heart >>> Vascular SM effects HTN, angina, afib/flutter |
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Hydralazine |
Increases cGMP causing SM relaxation --> vasodilates arterioles>>veins (reduces afterload) Severe HTN, CHF, (also, pregnancy w/methyldopa) |
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Hypertensive emergency |
Nitroprusside (direct NO release --> increased cGMP) Fenoldopam (D1 agonist) |
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Nitrates (nitroglycerin, isosorbide, dinitrate) |
Vasodilation veins >> arteries Increase NO --> increase in cGMP and SM relaxation |
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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) |
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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) |
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Bile acid resins
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- 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 |
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Cholesterol absorption blockers |
- Prevents cholesterol absorption at SI brush border - SE: diarrhea |
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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 |
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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 |
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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) |
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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!!! |
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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. |
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Ca2+ channel blockers (as antiarrhythmics) |
- Verapamil, diltiazam (non-dohydropyramidines)
- Decrease conduction velocity - Use: prevention of nodal arrhythmias, rate control in afib |
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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 |
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Mg2+ (antiarrhythmics) |
- Use: torsade des pointes and digoxin toxicity |
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Terbinafine |
Antifungal Inhibits squalene epoxidase "Squatter" = Terbinafine blocks squalene oxydase For ochychomycosis (fungal infection of skin/nail) |
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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 |
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5-Flucytosine (5-FU) |
Antifungal Inhibits nucleic acid synthesis For systemic fungal infections w/amphoB (cryptococcal meningitis) Also used for cancer |
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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) |
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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) |
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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" |
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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 |
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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) |
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Sulfonamides Trimethoprim |
Sulfamethoxazole (SMX), silfadiazine, etc. - Inhibits folate synthesis by blocking DHP synthase (bacteriostatic) Trimethoprim (TMP) - Inhibits folate synthesis by blocking DHP reductase (bacteriostatic) |
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Fluoroquinolones |
Ciprofloxacin, moxifloxacin, levofloxacin, etc. Inhibits DNA gyrase (topoisomerase II) and topoisomerase IV (Bacteriocidal) |
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Metronidazole |
Damages DNA via free radical formation (Bacteriocidal. Also antiprotozoal) Anaerobe infections below the diaphragm ("metros underground, hookups 'clean' if above the diaphragm) |
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Rifampin |
Inhibits DNA-dependant RNA polymerase Orange body fluids P450 stimulation |
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Izoniazid |
↓ synthesis of mycolic acids For TB |
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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) |
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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 |
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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!! |