Dumbdrugcards

Front 1

Side effects include cycloplegia, flushing, confusion, increased body temperature, dry mouth, tachycardia, and constipation.

Back 1

Atropine
(The side effects of this competitive muscarinic antagonist, as well as for all anticholinergics, are remembered as blind as a bat, red as a beet, mad as a hatter, hot as a hare, and dry as a bone.

Hint 1

1

Front 2

Muscarinic agonist used to treat postoperative urinary retention and atonic ileus.

Back 2

Bethanechol
( a related drug, carbachol, has both muscarinic and nicotinic agonist properties and is primarily used in the management of glaucoma. Both drugs are resistant to metabolism by acetylcholinesterases.)

Hint 2

2

Front 3

Short acting anticholinesterase used to confirm the diagnosis of masthenia gravis.

Back 3

Edrophonium
(Intervenous injection of this rapidly absorbed drug results in an appreciable increase in muscle strength)

Hint 3

3

Front 4

Indirect-acting sympathomimetic used in over-the-counter nasal decongestants.

Back 4

Ephedrine
(It has many of the same actions as amphetamines, with less central nervous system [CNS] stimulation; it is found in Chinese herbs such as ma-huang; one enantiomer, pseudoephedrine is found in many cold-relief medications)

Hint 4

4

Front 5

Adrenergic agonist used for acute asthma, anaphylactic shock, open-angle glaucoma, and cardiac resuscitation.

Back 5

Epinephrine
(Adrenergic anonist with affinity for a1, a2, b1 and b2 receptors. At low concentrations the effects of the b receptors predominate. b2 receptors cause vasodilation with dereased total peripheral resistance [TPR] and decreased diastolic pressure. At higher concentrations, b1 receptors lead to increased cardiac contractility and increased heart rate)

Hint 5

5

Front 6

Prototypic b agonist used for the treatment of both acute heart failure and acute asthma.

Back 6

Isoproterenol
(This agent has equivalent affinities for b1 and b2 receptors; the b1 activity causes an increase in cardiac contractility and increased heart rate, resulting in increased stroke volumen and cardiac output; the b2 activity induces bronchodilation)

Hint 6

6

Front 7

Adrenergic antagonist used in the treatment of benign prostatic hyperplasia (BPH) and in the management of hypertension caused by pheochromocytoma

Back 7

Phenoxybenzamine
(An irreversible a1 and a2 antagonist; a similar short-acting reversible antagonist, phentolamine, is used in the diagnosis of pheochromocytoma)

Hint 7

7

Front 8

Used in emergency situations for the treatment of both open and narrow angle glaucoma

Back 8

Pilocarpine
(Activation of muscarinic cholinergic receptors causes contraction of the ciliary muscles with opening of Schlemm's canal, allowing drainage of aqueous humor and a subsequent decrease in intraocular pressure)

Hint 8

8

Front 9

Used to treat hypertension and urinary retention; first-dose syncope is a significant side effect with this drug

Back 9

Prazosin
(A competitive a1 antagonist. The use of this drug can lead to postural hypotension, inhibition of ejaculation, reflex tachycardia, nasal congestion, and miosis)

Hint 9

9

Front 10

Prototypical b antagonist used in the treatment of hypertension, glaucoma, migraines, and angina; as prophylaxis, for myocardial infarction; and at low doses to prevent performance anxiety

Back 10

Propranolol
(Nonselective b1 and b2 blocker, not to be used in patients with chronic obstructive pulmonary disease [COPD] and asthma, due to significant bronchoconstriction)

Hint 10

10

Front 11

Long-acting anticholinesterase used in the chronic treatment of myasthenia gravis

Back 11

Pyrodostigmine
(Also used as an antidoet to tubocurarine toxcity; neostigmine is a similar substance, although it has a shorter duration of action)

Hint 11

11

Front 12

Used to prevent motion sickness and delivered by a transdermal patch

Back 12

Scopolamine
(Competitive cholinergic antagonist with sedating and amnestic effects)

Hint 12

12

Front 13

Depolarizing neuromuscular bocker used to facilitate intubation, and as a skeletal muscle relaxant for general anesthesia

Back 13

Succinylcholine
(Functions as a cholinergic nicotinic agonist, facilitating the opening of sodium channels. A rare but significant side effect, malignant hyperthermia, can occur in some patients when used in halothane.)

Hint 13

13

Front 14

Nondepolarizing neuromuscular ganglionic blockers used in surgical anesthesia

Back 14

Tubocurarine
Pancuronium
Mivacurium
(Neostigmine, physostigmine, and edrophonium can reverse the paralysis caused by these drugs. Tubocurarine is the most likely of htis class to cause the release of histamine, leading to vasodilation and hypertension)

Hint 14

14

Front 15

Diuretic used in the management of chronic glaucoma and actute mountain sickness; also used to alkalinize the urine in aspirin toxicity

Back 15

Acetazolamide
(Inhibits carbonic anhydrase in the proximal convoluted tubule; metabolic acidosis is a potential side effect)

Hint 15

15

Front 16

Potasium-sparing diuretics that do not have anti-androgenic effects

Back 16

Amiloride
Triamterene
(Block sodium channels in the cortical collecting tubules; may cause hyperkalemic metabolic acidosis)

Hint 16

16

Front 17

Caugh is a major side effect of this group of antihypertensive drugs

Back 17

ACE inhibitors
Captopril/Enalapril/Lisinopril
(Inhibit the conversion of angiotensin I to angiotensin II; inhibit breakdown of bradykinin, resulting in cough and potent vasodilation)

Hint 17

17

Front 18

Most potent class of diuretics that inhibit the Na+/K+/Cl- cotransporter in the thick ascending loop of Henle

Back 18

Loop Diuretics
Furosemide/Butamide
(These sulfa drugs can cause hypercalcemia, ototoxcity, hyperuricemia, hypokalemia, and metabolic alkalosis; Ethacrynic Acid is a non-sulfa drug with similar effects)

Hint 18

18

Front 19

Diuretic that functions early in the distal convoluted tubule by inhibiting NaCl reabsorption

Back 19

Hydrochlorothiazide
(Major side effects include hypokalemia, alkalosis, hyperuricemia, and hyperlipidemia)

Hint 19

19

Front 20

Angiotensin II receptor antagonist used as an antihypertensive drug

Back 20

Losartan
(Functions at the collecting tubules, like ACE inhibitors, but no cough, as a side effect. Again, like ACE inhibitors, this drug is teratogenic and, therefore, contraindicated during pregnancy.)

Hint 20

20

Front 21

Osmotic diuretic that works by extracting water from tissues into the blood; used in the treatment of hydrocephalus and increased intracranial pressure.

Back 21

Mannitol
(This diuretic functions primarily within the proximal convoluted tubules and is used to maintain high urine output in cases of severe hemolysis or rhabdomyolysis)

Hint 21

21

Front 22

Originally developed as an antihypertensive agent, it is used topically because of beneficial side effects of hypertrichosis

Back 22

Minoxidil
(Functions as a direct-acting vasodilator, as do nitroprusside and hydralazine)

Hint 22

22

Front 23

This potent vasodilator, used in the treatment of malignant hypertension, can cause significant postural hypotension

Back 23

Nitroprusside
(Functiosn to stimulate guanyl cyclase with an increase in cGMP within smooth muscle of vasculature. Prolonged infusion can result in cyanide poisoning due to release of CN-)

Hint 23

23

Front 24

This potasium-sparing diuretic is an aldosterone antagonist that functions at the collecting tubule

Back 24

Spironolactone
(Increases P450 activity that causes gynecomastia and other antiandrogenic effects)

Hint 24

24

Front 25

Extremely short-acting agent (15-20 seconds) administered IV for the control of atrioventricular (AV) nodal arrhythmias

Back 25

Adenosine
(The side effects of flushing and hypotension are short-lived as well, and do not limit the use of this agent

Hint 25

25

Front 26

Long-acting class III antiarrhythmic associated with pulmonary fibrosis, thyroid dysfunction, and corneal microdeposits

Back 26

Amiodarone
(This agent also blocks sodium channels, such as the class IA antiarrhythmics)

Hint 26

26

Front 27

Used for the treatment of congestive heart failure, this agent contains two isomers, one with nonselective b blocking activity and one with a1 blocking activity

Back 27

Carvedilol
(Labetalol has similar properties and has four diasteromers; the RR enantiomer is a nonselective b blocker, and the SR enantiomer is an a1 blocker)

Hint 27

27

Front 28

Bile acid-binding resins used in the management of hyperlipidemia

Back 28

Cholestyramine
Colestipol
(Bind bile acids, preventing enterohepatic recycling, thus diverting hepatic efforts to renew bile acids, instead of producing plasma lipids)

Hint 28

28

Front 29

These agents function to slow conduction velocity by slowing the rate and rise of the action potential

Back 29

Class IA Antiarrhythmics
Quinidine/Proainamide/Disopyramide
(These agents help maintain sinoatrial [SA] rhythm after cardioconversion for atrial fibrillation, and may cause torsade de pointes arrhythmias. Quinidine may cuase cinchonism, a type of poisoning that causes headache, vertigo, and tinnitus)

Hint 29

29

Front 30

Function to decrease the action potential duration by shortening the repolarization phase

Back 30

Class IB Antiarrhythmics
Lidocaine/Mexiletine/Tocainide/Phenytoin
(These agents are used for the treatment of ventricular arrhythmias, as well as for digitoxin-induced arrhythmias)

Hint 30

30

Front 31

Used for the treatment of refractory ventricular arrhythmias,as well as for rapid atrila arrhythmias associated with Wolff-Parkinson-White syndrome

Back 31

Class IC Antiarrhythmics
Flecainide/Propafenone
(Function to slow conduction velocity in the atrial and ventricular cells but do not affect the action potential. They typically are used as a last resolt, as their use is associated with drug-induced arrhythmias)

Hint 31

31

Front 32

These agents decrease the automaticity of the pacemaker tissue of the heart, resulting in prolonged atrioventricular (AV) conduction and slower heart rate

Back 32

Class II Antiarrhythmics
Propranonol/Esmolol
(These b blockers decrese cAMP levels, resulting in reduced sodium and calcium currents. These agents are not to be used in cases of congestive heart failure)

Hint 32

32

Front 33

Used for the treatment of recurrent ventricular arrhythmias; many of these agents can precipitate torsade depointe arrhythmias

Back 33

Class III Antiarrhythmics
Sotalol/Ibutilide/Bretylium/Amiodarone
(These agents prolong the action potential by blocking potassium channels)

Hint 33

33

Front 34

Used for atrial arrhythmias and nodal re-entry, as well as hypertension and angina, these agents inhibit Ca2+ voltage channels

Back 34

Class IV Antiarrhythmics
Verapamil/Diltiazem
(Note: nifedipine has a similar mechanism of action, but it is used only for hypertension and angina; as it has no effects on heart tissue, it is not a class IV agent)

Hint 34

34

Front 35

Centrally-acting a2 agonist that reduces sympathetic autonomic nervous system outflow, resulting in decreased blood pressure

Back 35

Clonindine
(A major side effect of this drug is rebound hypertension, in the event of abrupt discontinuation)

Hint 35

35

Front 36

Used in the management of congestive heart failure, these drugs are reversible inhibitors of Na/K ATPase

Back 36

Digitoxin
Digoxin
(Unlike digitoxin, digoxin is shorter-acting and excreted by the kidneys; patients with low K, low Mg, high Na or high Ca can experience arrhythmias with either agent)

Hint 36

36

Front 37

Agents that decrease triglycerides dramatically by stimulating lipoprotein lipase

Back 37

Gemfibrozil
Fenofibrate
Clofibrate
(Clofibrate has been associated with gallstones and hepatobiliary neoplasms)

Hint 37

37

Front 38

Antihypertensive drug that blocks the release of norepinephrine by displacing it from intracellular vesicles

Back 38

Guanethinide
(Side effects include serious orthostatic hypotension; the effects of the drug are antagonized by tricyclic antidepressants

Hint 38

38

Front 39

Used for the treatment of ventricular arrhythmias, especially following myocardial infarction, because it works only on ischemic tissue

Back 39

Lidocaine
(This class IB antiarrhythmic has little effect on the ECG of normal [nonischemic] heart tissue, it is given intravenously, although similar agents [mexiletine and tocainide] are given orally)

Hint 39

39

Front 40

This a2 agonist decrease adrenergic outflow from the CNS, resulting in decreased peripheral resistance and decreased blood pressure

Back 40

Methyldopa
(This drug can haptenate red blood cell proteins, resulting in autoimmune hemolytic anemia

Hint 40

40

Front 41

Lipid-lowering agent that causes cutaneous flushing, which can be avoided by administration concurrently with aspirin

Back 41

Niacin
(Directly reduces the secretion of VLDLs from the apolipoprotein synthesis by the liver, while increasing HDLs)

Hint 41

41

Front 42

Causes an increase in cGMP within vascular smooth muscle, resulting in decreased preload to the heart and decreased blood pressure

Back 42

Nitroglycerin
(Administered as a sublingual patch to decrease first-pass metabolism; potential side effects include cyanide poisoning, postural hypotension, headache, and flushing)

Hint 42

42

Front 43

Antihyperlipidemic agent that may prevent atherosclerosis by acting as an antioxidant

Back 43

Probucol
(Rarely used for the treatment of hyperlipidemia because it decrease HDLs as well as LDLs; may be efficacious in preventing restenonis after angioplasty)

Hint 43

43

Front 44

This rarely used antihypertensive agent blocks the storage and release of catecholamines and serotonin from neurons

Back 44

Reserpine
(The drug readily enters the CNS and can cause suicidal dpression and Parkinsonian symptoms)

Hint 44

44

Front 45

Inhibits the rate-limiting enzymes of cholesterol synthesis, HMG-CoA reductase, resulting in dramatically decreased LDL levels

Back 45

Statins
Lovastatin/Pravastatin/Simvastatin/Atorvastatin
(May cause elevated liver enzymes, myositis with increased creatine kinase from skeletal muscle, and rarely, rhabdomyolysis)

Hint 45

45

Front 46

Intermediate-acting benzodiazepine used for the treatment of panic disorder and phobias

Back 46

Alprazolam
(Both alprazolam and clonazepam have sedative effects and can cause physiologic dependence; buspirone is an alternative drug that binds 5-HT1a receptors with minimal abuse potential)

Hint 46

46

Front 47

Used in the management of depression, it inhibits the reabsorption of both norepinephrine and serotonin within the synapse

Back 47

Amitriptyline
(Other tricyclic antidepressents include nortriptyline, imipramine, and desipramine. Major side effects of this class include sedation, orthostatic hypotension, and cardiac arrhythmias.

Hint 47

47

Front 48

Orally active antispamolytic agent

Back 48

Baclofen
(GABAb receptor agonist that functions on inhibitory pathways in the spinal cord)

Hint 48

48

Front 49

Because of its low toxicity, this local anesthitic can be used on large surface arease and is available over the counter as an ointment

Back 49

Benzocaine
(This ester-type compound, like cocaine, has surface activity or the ability to work on superficial nerves when applied to mucous membranes. Other ester-type compounds include short-acting procaine and the long-acting tetracaine)

Hint 49

49

Front 50

This antimuscarinic is used in the management of Parkinson disease, improving tremors and rigidity, but does little for bradykinesia

Back 50

Benztropine
(As for all antimuscarinics, contraindications include prostatic hyperplasia, GI obstruction, and closed angle glaucoma, and are more common in older patients)

Hint 50

50

Front 51

Drug used in the treatment of Parkinson disease as well as in the treatment of prolactinoma

Back 51

Bromocriptine
(This ergot derivative acts as a D2 agonist, improving extrapyramidal function, and also inhibits the release of prolactin from the pituitary gland. Unlike a similar agent, pergolide, bromocriptine maintains its effectiveness over time)

Hint 51

51

Front 52

This long-acting amide-type local anesthetic can cause severe hypotension and arrhythmias if inadvertently given intravenously

Back 52

Bupivacaine
(Local anesthetics bind to sodium channels in the open and inactive state, slowing recovery from depolarization 10 to 1000 fold)

Hint 52

52

Front 53

Antidepressant used in the managment of nicotine withdrawal in patients seeking to stop cigarette smoking with minimal sedation

Back 53

Bupropion
(This second-generation heterocyclic antidepressant inhibits the reuptake of norepinephrine. Newer third-generation agents used for depression, such as venlafaxine inhibit the reuptake of serotonin as well)

Hint 53

53

Front 54

This agent is used in the treatment of patial and generalized seizures, and is the primary agent used in the treatment of trigeminal neuralgia

Back 54

Carbamazepine
(Inhibits sodium channels on neurons; its use may result in idiosyncratic blood disorders such as aplastic anemia and agranulocytosis)

Hint 54

54

Front 55

Second-line treament for schizophrenia that is better for the negative symptoms of the disease

Back 55

Clozapine
(Atypical antipsychotic, associated with agranulocytosis, that blocks D4 receptor)

Hint 55

55

Front 56

The only local anesthetic with vasoconstricor activity

Back 56

Cocaine
(Other local anesthetics are administered with epinephrine to increase the duration of action and lower the effective dose)

Hint 56

56

Front 57

Used for the treatment of anxiety and ethanol dependence; also a primary agent in the treatment of status epilepticus

Back 57

Diazepam
(This long-acting, prototypic benzodiazepine binds to the GABAa receptor, increasing the frequency of chloride channel opening)

Hint 57

57

Front 58

Used in the treatment of Parkinson disease, it inhibits the enzyme catechol-O-methyltransferase (COMT)

Back 58

Entacapone
(This agent inhibits the conversion of levodopa to 3-O-methyldopa in the periphery. A similar agent, tolcapone has been associated with acute liver failure)

Hint 58

58

Front 59

Preferred agent in the treatment of absence seizures

Back 59

Ethosuximide
(Postulated to function by inhibiting T-type Calcium channels in thalamic neurons. Use has been associated wiht the development of Stevens-Johnson syndrome)

Hint 59

59

Front 60

Opioid used in the induction of anesthesia, and also for postoperative analgesia

Back 60

Fentanyl
(If used in conjunction with droperidol and nitrous oxide, it can produce a state of neuroleptanesthesia, resulting in both analgesia and amnesia)

Hint 60

60

Front 61

Popular drug used for the treatment of depression, it is the prototype of the selective serotonin reuptake inhibitiors (SSRIs)

Back 61

Fluoxetine
(Common side effects of this other SSRIs, such as sertraline, paroxetine, and citalopram, include headache, insomnia, nausea, and sexual dysfunction; these agents also are used in the management of obsessive compulsive disorder [OCD], social phobias, bulimia, and alcohol dependence)

Hint 61

61

Front 62

This analog of GABA used in the treatment of partial seizures, as well as in the management of peripheral neuropathy

Back 62

Gabapentin
(Other available agents for seizures include lamotrigine, which may cause life-threatening Stevens-Johnson syndrome and epidermal necrolysis, and vigabartin, which inhibits GABA transaminases)

Hint 62

62

Front 63

The most potent inhaled halogenated anesthetic, with the lowest minimal alveolar concentration (MAC), used for surgical anesthesia in children and asthmatics

Back 63

Halothane
(Rare but significant side effects include the development of malignant hyperthermia and fulminant hepatitis)

Hint 63

63

Front 64

Dissociated anesthetic that causes hallucinations and disorientation on recovery

Back 64

Ketamine
(Side effectws are due to an increase in cerebral blood flow, and can be reduced by preoperative use of benzodiazepines

Hint 64

64

Front 65

Used in the treatment of Parkinson disease, this precursor crosses the blood-brain barrier adn is converted to dopamine

Back 65

L-dopa (Levodopa)
(Administered with decarboxylase inhibitor carbidopa [which does not cross the blood-brain barrier] to increase bioavailability and to limite peripheral side effects)

Hint 65

65

Front 66

Mood stabilizer that is a first-like drug for the treatment of bipolar affective disorder

Back 66

Lithium
(Inhibits the secondary messengers inositol triphosphage [IP3] and diacylglycerol [DAG] and causes tremor, hypothyroidism, polydipsia, and polyuria)

Hint 66

66

Front 67

Amphetamine used in the management of attention deficit disorder (ADD) and narcolepsy

Back 67

Methylphenidate
(Increases alertness and decreases appetite by stimulating the release of catecholamines; it is a controlled substance with abuse potential)

Hint 67

67

Front 68

Inhaled anesthetic that never reaches the level of surgical anesthesia without additon of another agent, it is safe and the induction and recovery are extremely rapid

Back 68

Nitrous Oxide
(This agent has a high minimal alveolar concentration [MAC] and a low blood/gas partition. It usually is administered with an intravenous anesthetic such as thiopental, and is commonly used in dental procedures)

Hint 68

68

Front 69

This older agent used in the treatment of depression increases levels of amine neurotransmitters by inhibiting their breakdown

Back 69

Monoamine oxidase inhibitors (MAOI)
Phenelzine/Tranylcypromine/Isocarboxazid
(Consumption of food such as cheese, which contain tyramine (an indirect-acting sympathomimetic) while on MAOIs can result in hypertensive crisis. If taken with selective serotonin reuptake inhibitors [SSRIs], life threatening serotonin syndrome can result)

Hint 69

69

Front 70

Used as a sedative; also is a first-line drug for tonic-clonic seizures in children and in the treatment of patients with Crigler-Najjar syndrome type II

Back 70

Phenobarbital
(As a long-acting, prototypic barbiturate, it binds to GABA receptors, increasing the duration of chloride channel opening with neuronal inhibition)

Hint 70

70

Front 71

Drug used for the treatment of partial and tonic-clonic seizures and status epilepticus, as well as being a class IB antiarrhythmic

Back 71

Phenytoin
(Side effects include gingival hyperplasia, hirsutism, anemia, and birth defects, because it interferes with folate absorption)

Hint 71

71

Front 72

This agent has the largest number of extrapyramidal side effects of all atypical antipsychotics

Back 72

Resperidone
(Atypical antipsychotics block the D2 and 5-HT2 receptors, contributing to high sedation. More recently introduced agents such as olanzapine have no extrapyramidal effects)

Hint 72

72

Front 73

Newly available agent used in the treatment of Parkinson disease that forstalls the used of levodopa

Back 73

Ropinirole
(This agent has a lower incidence of postural hypotension, dyskinesia, vomiting, and hallucination, unlike most dopamine agonists. It is not an ergot derivative; a similar agent, pramipexole, also is used)

Hint 73

73

Front 74

Inhibits the degeneration of dopamine in the central nervous system and is used as an adjuvant to levodopa in the treatment of Parkinson disease

Back 74

Selegiline
(Inhibits monoamine oxidase B, which selectively degrades dopamine)

Hint 74

74

Front 75

Ultra-short-acting barbiturate used intravenously for the induction of surgical anesthesia

Back 75

Thiopental
(Due to its high lipid solubility, this agent enters the CNS within 1 minute; it can be used only for short surgical procedures, because it rapidly redistributs to other tissues)

Hint 75

75

Front 76

Side effects of this antipsychotic include torsade de pointes arrhythmias and retinal deposits

Back 76

Thioridazine
(This low-potency antipsychotic blocks most dopamine receptors in the CNS, and can cause postural hypotension, sedation, and CNS depression)

Hint 76

76

Front 77

Used in the treatment of most forms of epilepsy, incuding generalized tonic-clonic, partial, absence, and myoclonic seizures, and in the treatment of bipolar disorder

Back 77

Valproid Acid
(This agent has been associated with the development of neural tube defects when administered to pregnant women)

Hint 77

77

Front 78

Although not a benzodiazepine, it has similar effects and is used as a hypnotic with less dependence liability

Back 78

Zolpidem
(Functions by binding to benzodiazepine [BDZ] receptors and thus results in similar actions with less amnesia and less muscle relaxation; also like benzodiazepines, its actions are antagonized by flumazenil)

Hint 78

78

Front 79

Causes feelings of euphoria and self-confidence, and at chronic high doses, delusions and paranoia

Back 79

Amphetamines
(Function as an indirect sympathomimetic by releasing stored catecholamines)

Hint 79

79

Front 80

Overdose often results in fatalities from arrhythmias, myocardial infarctions, or seizures

Back 80

Cocaine
(Inhibits catecholamine reuptake, resulting in cardiotoxicity and hypertensive episodes)

Hint 80

80

Front 81

Used in the treatment of alcoholism in compliant patients, causing flusing, vomiting, and hypertension when alcohol is consumed

Back 81

Disulfiram
(Inhibits aldehyde dehydrogenase, resulting in toxic accumulation of acetaldehyde. Drugs with similar side effects are said to cause a disulfiram-like reaction)

Hint 81

81

Front 82

Congener of amphetamins that results in increased intrapersonal communications and increased sexual drive

Back 82

Ecstasy
(Methylene dioxymethamphetamine [MDMA] use is on the rise in teenagers of higher socioeconomic status and often associated with "rave" parties)

Hint 82

82

Front 83

Rapidly acting benzodiazepine used as a "date-rape" drug

Back 83

Flunitrazepam
(Due to its amnestic properties, this drug often is added to alcohol, making the victim incapable of resisting or remembering being raped)

Hint 83

83

Front 84

Hallucinogenic agent that causes "psychedelic" perceptual effects and can lead to a "bad trip" or panic attack

Back 84

Lysergic Acid Diethylamide (LSD)
("Highs" also are associated with somatic effects, such as nausea, parasthesia, and weakness; such effects are also seen with the use of mescaline and psilocybin)

Hint 84

84

Front 85

"High" is associated with euphoria, disinhibtion, laughter, changes in perception and hunger

Back 85

Marijuana
(The active ingredient, tetrahydrocannabinol [THC], can be used medially to lower intraocular pressure in glaucoma)

Hint 85

85

Front 86

Used in the management of opioid withdrawal and maintenance programs for addicts

Back 86

Methadone
(Used to treat nausea, chills, sweats, lacrimation, cramps, rhinorrhea, yawning, piloerection, diarrhea, and tremor due to opioid withdrawal)

Hint 86

86

Front 87

A by-product of incorrectly synthesized illicit street opioids, this contaminant can cause irreversible parkinsonism

Back 87

MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine)
(Causes the destruction of dopaminergic neurons of the nigrostriatal tract)

Hint 87

87

Front 88

Overdose causes constricted pupils, clammy skin, nausea, drowsiness, and respiratory depression with possible coma and death

Back 88

Opiods
Heroin/Morphine/Meperidine/Fentanyl
(Modulate synaptic transmission by binding mu (morphine) delta (enkephalin), and kappa (dynorphin) receptors)

Hint 88

88

Front 89

Hallucinogen that often causes psychotic reactions and impaired judgement leading to reckless behavior

Back 89

Phencyclidine (PCP)
(Also known as "angel dust"; overdose leads to nystagmus, life-threatening hypertension, and seizures)

Hint 89

89

Front 90

Commonly used analgesic and antipyretic, but unlike NSAIDs, has no anti-inflammatory properties

Back 90

Acetaminophen
(Weak inhibitor of cyclooxygenase (COX), it inhibits prostaglandin synthesis in the central nervous system; a related prodrug, phenacetin, is no longer available due to nephrotoxicity)

Hint 90

90

Front 91

Used in the management of chronic gout and as an adjunct to cancer chemotheraphy, to slow the production of uric acid

Back 91

Allopurinol
(Results in suicide inhibition of xanthine oxidase with resultant increase of xanthine and hypoxanthine, both of which are more soluble and less likely to form crystals than uric acid)

Hint 91

91

Front 92

Nonsteroidal anti-inflammatory drug (NSAID) with analgesic, antipyreic, antiplatelet, and anti-inflammatory properties that irreversibly inhibits cyclooxygenase

Back 92

Aspirin (acetylsalicylic acid)
(Inhibits the formation of prostaglandin E (PGE), decreases pain and fever, and decreases the synthesis of PGE in the stomach, predisposing to acute gastritis)

Hint 92

92

Front 93

Used topically for the treatment of rheumatoid arthritis it depletes substance P

Back 93

Capsaicin
(Component of chili peppers that impairs the release of substance P, the potent neurotransmitter for pain sensation)

Hint 93

93

Front 94

Newly available NSAID, used in the treatment of rheumatoid arthritis and other chronic conditions, with a decreased risk of ulcers and other GI bleeds

Back 94

Celecoxib
(Celecoxib and a similar drug, rofexocib, selectively inhibit cyclooxygenase-2 (COX-2) present only in leukocytes; these agents do not inhibit COX-1 that produces protective prostaglandins in the stomach; as sulfa drugs, they both can cause hypersensitivity in some patients)

Hint 94

94

Front 95

Used for the treatment of actute attacks of gouty arthritis, because it impairs leukocyte function

Back 95

Colchicine
(Inhibits microtubule assembly, and, therefore, leukocyte migration and phagocytosis of uric acid cyrstals0

Hint 95

95

Front 96

Used in the treatment of transplant patients and patients with autoimmune diseases, as it impairs T cell production of interleukin-2 (IL-2)

Back 96

Cyclosporin
(Binds to cyclophilins and inhibits the transcription of cytokine genes; a similar agent, tacrolimus, binds to the immunophilin FK-binding protein (FKBP) and functions similarly; both display dose-limiting nephrotoxicity)

Hint 96

96

Front 97

Monoclonal antibody used in the management of patients with renal allografts

Back 97

Daclizumab
(Binds to the high affinity interleukin-2 [IL-2] receptor expressed on activated T cells; the side effects are minimal compared to agents such as cyclosporin or tacrolimus)

Hint 97

97

Front 98

Used in the treatment of rheumatoid arthritis and inflammatory bowel disease, a recombinant protien product that inhibits the effects of tumor necrosis factor alpha (TNF-a)

Back 98

Etanercept
(Administered IV, this drug is a fusion between the extracellular domain of the TNF-a receptor and the Fc portion of an antibody; a similar monoclonal antibody infliximab, aslo binds and inhibits TNF-a)

Hint 98

98

Front 99

Drug used in the treatmetn of severe rheumatoid arthritis, because it decreases lysosomal and macrophage function

Back 99

Gold salts
(Side effects include dermatitis, hematotoxicity, and nephrotoxicity)

Hint 99

99

Front 100

Reversible inhibitors of cyclooxygenase widely used as over-the-counter pain relievers

Back 100

Ibuprofen
Naproxen
Piroxicam
(These agents share many of the same side effects as aspirin, but are more efficacious analgesics and anti-inflammatories; however, they lack aspirin's long duration and antiplatelet effects)

Hint 100

100

Front 101

High-potency NSAID used in the treatment of gout and arthritis, adn for closure of a patent ductus arteriousus

Back 101

Indomethacin
(Conversely, prostaglandin E(PGE) can be used to maintain a patent ductus arteriosus in congenital cyanonitic heart disease)

Hint 101

101

Front 102

The only parenteral NSAID, used primarily for its analgesic (rather than inflammatory) properties

Back 102

Ketorolac
(Its systemic route of delivery substantially decreases GI irritation)

Hint 102

102

Front 103

Unlike most opioid agonists, this derivative does not cause biliary spasms, and is preferred, therefore, as an analgesic for pancreatitis and cholecystitis

Back 103

Meperidine
(Causes relaxation of the sphincter of Oddi; all opioids are contraindicated in cases of head injury, because they cause increased intracranial pressure)

Hint 103

103

Front 104

Used in the prevention of migraine headaches, this ergot derivative has no value in the treatment of acute migraine attacks

Back 104

Methylsergide
(Because this agent blocks serotonin [5-HT] receptors, it can be used in the treatment of carcinoid tumors; notable side effects include retroperitoneal and subendocardial fibroplasia)

Hint 104

104

Front 105

Uricosuric agent used in the treatment of chronic gout, and also in to increase the effective concentration of weakly acidic drugs such as penicillins

Back 105

Probenecid
(Both probenecid adn sulfinpyrazone compete with uric acid for reabsorption in the proximal tubules of the kidney, and also inhibit the secretion of weak acids)

Hint 105

105

Front 106

Given to Rh-negative mothers within 72 hours of giving birth to an Rh-positive child, to prevent the development of hemolytic disease of the newborn (erythroblastosis fatalis) in subsequent Rh-positive pregnancies

Back 106

RhoGAM
(Fetal Rh-positive red blood cells that enter the maternal circulation are opsonized by these antibodies against the Rh (D) antigen, preventing the mother from producing anti-Rh antibodies)

Hint 106

106

Front 107

Serotonin agonist used in the treatment of acute migraines adn cluster headaches

Back 107

Sumatriptan
(Binds to the HT1d receptor, causing vasoconstriction of the cerebral vasculature)

Hint 107

107

Front 108

Notorious for causing teratogenic effects, such as phocomelia ("flipper limbs"); has gained attention as a potent immunosuppressant

Back 108

Thalidomide
(Used in the treatment o fsystemic lupus erythematosus [SLE], multiple myeloma, and leprosy, its effects are due to its ability to suppress the production of tumor necrosis factor alpha [TNF-a])

Hint 108

108

Front 109

Monoclonal antibody used as an anticoagulant, preventing restenosis after coronary angioplasty

Back 109

Abciximab
(Antibodies against the glycoprotein IIb/IIIa receptor on platelets, preventing platelet aggregation)

Hint 109

109

Front 110

Used in the treatment of acute bleeding in patientes with hemophilia and other coagulopathies

Back 110

Aminocaproic Acid
(An orally active inhibitor of plasminogen activation, thereby inhibiting the fibrinolysis; tranexamic acid is a similar agent)

Hint 110

110

Front 111

Recombinant product used in the treatment of anemia associated with renal failure

Back 111

Erythropoietin (Epoetin Alfa)
(Also used to treat anemia associated with bone marrow transplants or toxic drug reactions)

Hint 111

111

Front 112

Will correct the anemia, but not the neurologic deficits causd by vitamin B12 deficiency

Back 112

Folic Acid
(Vitamin B12 deficiency must be ruled out before treating megaloblastic anemia with folic acid)

Hint 112

112

Front 113

Rapid-acting, intravenously administered anticoagulant, used for acute myocardial infarction and prevention of deep vein thrombosis (DVT) following prolonged immobilization

Back 113

Heparin
(Binds to and activates antithrombin III, resulting in the inactivation of thrombin and other clotting factors; unlike warfarin, it does not across the placenta and thus may be used during pregnancy. Protamine sulfate is used to reverse the effects of heparin.)

Hint 113

113

Front 114

Used in the management of sickle cell anemia, as well as for various myeloid neoplasms

Back 114

Hydroxyurea
(May decrease the incidence of sickle cell crisis, by increasing levels of fetal hemoglobin [HbF]; it also inhibits DNA synthesis by blocking the conversion of ribonucleotides to deoxyribonucleotide)

Hint 114

114

Front 115

Recombinantly produced granulocyte-macrophage colony-stimulating factor (GM-CSF), used in the managment of patients undergoing chemotherapy

Back 115

Sargramostim
(A smilar agent, G-CSF (e.g., filgrastim), is also used for similar applications, but affects only granulocytes)

Hint 115

115

Front 116

A bacterial product of Streptococcus pyogenes, used in the treatment of coronary artery thrombosis

Back 116

Steptokinase
(Complexes with and catalyzes the conversion of plasminogen to plasmin; it is significantly cheaper, although debatably equivalent, agent to tissue plasminogen activator [tPA])

Hint 116

116

Front 117

Platelet antiaggregant, used for the prevention of transient ischemic attacks (TIA) in patients with aspirin sensitivity

Back 117

Ticlopidine
(Interferes with the binding of fibrin to the glycoprotein IIb/IIIa receptor on platelets)

Hint 117

117

Front 118

Created through the use of recombinant DNA technology, this agent is used for coronary artery thrombosis and ischemic stroke

Back 118

Tissue Plasminogen Activator (t-PA)
Alteplase/Reteplase
(Converts fibrin-bound plasminogen to plasmin, resulting in dissolution of thrombi)

Hint 118

118

Front 119

Orally administered anticoagulant, used in the management and prophylaxis of venous thrombosis, myocardial infarction, and stroke

Back 119

Warfarin
(Coumadin compound that interferes with vitamin K-dependent carboxylation of clotting factors II, VII, IX, and X)

Hint 119

119

Front 120

Used for the treatment of traveler's diarrhea

Back 120

Bismuth Subsalicylate
(Helps decrease fluid secretion by the bowel; also used with metronidazole and tetracycline for the treatment of Helicobacter pylori-associated peptic ulcer disease)

Hint 120

120

Front 121

Chronic ingestion of this antacid with milk can induce the milk-alkali syndrome

Back 121

Calcium Carbonate
(Can result in hypercalcemic alkalosis with the development of renal calculi)

Hint 121

121

Front 122

Used in the treatment of gastrointestinal reflux disease (GERD), this histamine blocker is associated with gynecomastia and glactorrhea

Back 122

Cimetidine
(The stronger H2 blocker, ranitidine and famotidine, do not inhibit the hepatic P450 system and, therefore, do not cause antiandrogenic effects)

Hint 122

122

Front 123

Prokinetic agent used in the treatment of upper gastrointestinal dysfunction, such as gastroesophageal reflux disease (GERD) or gastroparesis with delayed gastric emptying

Back 123

Cisapride
(Stimulates peristalsis by promoting the release of acetylcholine from postganglionic nerves of the myenteric plexus. High doses have not been associated with long QT syndrome)

Hint 123

123

Front 124

Opioid derivatives used in the treatmetn of diarrhea, because they suppress gastrointestinal motility

Back 124

Diphenoxylate
Loperamide
(Whereas diphenoxylate is formulated with antimuscarinic alkaloids; both preparations have minimal abuse potential)

Hint 124

124

Front 125

This preparation is used to treat emesis and nausea associated with chemotherapy, and contains the active ingredient in marijuana

Back 125

Dronabinol
(This schedule III drug, which contains tetrahydrocannabinol [THC], is a controlled substance with approved medical used and moderate potential for dependence)

Hint 125

125

Front 126

Commonly used proemetic agent used in cases of ingestion of caustic substances or mineral oils

Back 126

Ipecac Syrup
(Orally administered substance that acts directly on the chemoreceptor trigger zone in the medulla)

Hint 126

126

Front 127

Among the most popular antacids used in the United States, neither is absorbed and, therefore, neither causes systemic effects

Back 127

Magnesium Hydroxide
Aluminum Hydroxide
(Magnesium hydroxide also has a strong laxitive effect, whereas aluminum hydroxide causes constipation)

Hint 127

127

Front 128

This prokinetic agent is used to prevent emesis (e.g., post anesthesia or due to cancer chemotherapy), because it blocks D2 receptors in the area postrema that trigger vomiting)

Back 128

Metoclopramide
(Functions to facilitate acetylcholine, while antagonizing the action of dopamine on the enteric nervous system. Side effects include sedation, diarrhea, and extrapyramidal symptoms)

Hint 128

128

Front 129

Eicosanoid preparation used to prevent peptic ulcers in patients taking high doses of NSAIDs for conditions such as rheumatoid arthritis

Back 129

Misoprostol
(This prostaglandin E (PGE) analog decreases gastric acid production and increases mucus production, protecting the lining of the stomach)

Hint 129

129

Front 130

Proton pump inhibitor used in the treatment of gastroesophageal reflux disease (GERD), gastric and duodenal ulcers, Helicobacter pylori gastritis, and Zollinger-Ellison syndrome (gastrinoma)

Back 130

Omeprazole
(Irreversibly inhibits the H+/K+ ATPase on the luminal side of parietal cells)

Hint 130

130

Front 131

Central-acting antiemetic used to control postoperativ vomiting and vomiting in chemotherapy patients

Back 131

Ondansetron
(5-HT3 inhibitor that functions at the chemoreceptive area of the area postrema)

Hint 131

131

Front 132

Used in the treatment of peptic ulcers, because it polymerizes and selectively coats necrotic ulcerated tissue

Back 132

Sucralfate
(Requires an acidic environment to polymerize, and, therefore cannot be used in the presence of antacids or H2 blockers)

Hint 132

132

Front 133

B-adrenergic antagonists used in the treatment of hypertension for patients with asthma or chronic obstructive pulmonary disease (COPD), and smokers

Back 133

Acebutolol
Atenolol
Metoprolol
(Selective b1 blockers that decrease blood pressure, with no bronchoconstriction at low doses)

Hint 133

133

Front 134

Prototypic adrenergic agonist, available as an inhaler, used for the management of bronchospasm in asthmatics

Back 134

Albuterol
(Other selective b2 agonists include metaproterenol, terbutaline, and salmeterol)

Hint 134

134

Front 135

Synthetic glucocorticoid that readily penetrates the airway mucosa; used in the management of asthma

Back 135

Beclomethasone
(Beclomethasone and a related agent, budesonide, have very short half-lives in the blood stream, and, therefore, cause less systemic effects than other glucocorticoids)

Hint 135

135

Front 136

Stabilizes mast cell and basophil membranes, preventing the release of histamine in asthmatics

Back 136

Cromolyn Sodium
(Used for prophylaxis only, not for the treatment of acute asthma attacks)

Hint 136

136

Front 137

Opioid agonist available in many over-the-counter cough syrups

Back 137

Dextromethorphan
(Antitussive agent that depresses the cough center in the medulla; unlike dextromethorphan, codeine provides analgesia and has a higher abuse potential)

Hint 137

137

Front 138

Antihistaminics used for the treatment of allergic conditions (e.g., hay fever, urticaria, atopy), as well as for the treatment of motion sickness

Back 138

Diphenhydramine
Chlorpheniramine
(Inhibit the binding of histamine to H1 receptors; such as older agents have anticholinergic effects, contributing to sedative side effects)

Hint 138

138

Front 139

Nonsedating antihistaminics used for the treatment of allergy

Back 139

Fexofenadine
Loratadine
(These second-generation antihistamines do not really enter the CNS, preventing sedation)

Hint 139

139

Front 140

Aerosolized antimuscarinic agent, used in the treatment of chronic obstructive pulmonary disease (COPD) and asthma

Back 140

Ipratropium
(Not as effective as b2 agonists; dry mouth is a major side effect)

Hint 140

140

Front 141

Long-acting b2 agonist used for the prophylaxis of asthma

Back 141

Salmeterol
(This agent works for 12 hours or more; it may cause tremors and arrhythmias)

Hint 141

141

Front 142

A methylxanthine used in the treatment of asthma for its bronchodilatory effects

Back 142

Theophylline
(Inhibits phosphodiesterase, thereby inhibiting the degradation of cAMP to AMP; other methylxanthines include caffeine and theobromine found in cocoa)

Hint 142

142

Front 143

Used in the treatment of asthma, selectively inhibiting leukotriene synthesis

Back 143

Zileutin
(Leukotrienes can also be inhibited by the LTD4 and LTE4 antagonists zafirlukast and montelukast)

Hint 143

143

Front 144

Oral hypoglycemic agent that functions within the intestinal lumen, decreasing postprandial hyperglycemia, although there are no effects on fasting sugar

Back 144

Acarbose
(Inhibits a-galactosidase, an enzyme required for rapid absorption of most dietary sugars)

Hint 144

144

Front 145

These compounds reduce bone resoprtion and formation, and are used in the treatment of osteoporosis (postmenopausal, senile, or glucocorticoid-induced) and Paget disease

Back 145

Bisphosphonates
Alendronate/Etidronate/Pamidronate/Risedronate
(Characterized by poor oral availablility and cannot be taken with food; may cause esophageal ulcerations, so must be taken with large amounts of water, adn the patient must remain upright for at least 30 minutes afterward)

Hint 145

145

Front 146

Used in the treatment of hyperprolactinemia, e.g., due to a pituitary adenoma

Back 146

Bromocriptine
(Ergot alkaloid with dopaminergic activity, inhibiting the release of prolactin)

Hint 146

146

Front 147

Used for the treatment of osteoporosis, this hormone produced by the thyroid decreases bone breakdown, and decreases serum calcium and phosphate levels

Back 147

Calcitonin
(Also used in the treatment of acute hypercalcemia and Paget disease; salmon calcitonin is used because it is more potent and has a longer half-life; it is administered intranasally or by injection)

Hint 147

147

Front 148

Fertility drug used to induce ovulation in anovulatory women, although its use may be associated with multiple birth

Back 148

Clomiphene
(Blocks negative feedback to the pituitary, increasing the release of follicle-stimulating hormone [FSH] and luteinizing hormone [LH] to stimulate ovulation)

Hint 148

148

Front 149

A synthetic analog of adrenocorticotropin (ACTH) used to diagnose patients with abnormalities of cortisol production, e.g., Addison's disease

Back 149

Cosyntropin
(Proteolytic cleavage of preproopiomelanocortin [POMC] forms ACTH and melanocyte-stimulating hormone [MSH], as well as beta-endrophin and metenkephalin)

Hint 149

149

Front 150

Used in the treatment of endometriosis and fibrocystic disease of the breast

Back 150

Danazol
(Inhibits several P450 enzymes involved in gonadal steroid synthesis)

Hint 150

150

Front 151

An antidiuretic hormone (ADH) receptor agonist used for the treatment of diabetes insipidus

Back 151

Desmopressin
Vasopressin
(Desmopressin is a V2-selective agonist that facilitates water reabsorption form the collecting tubules. Vasopressin is both a V1 and V2 agonist; its V1 activity increases vascular smooth muscle tone and, therefore, is used for the treatment of esophageal varices)

Hint 151

151

Front 152

Use of this estrogen compound by pregnant women has been associated with development of clear cell adenocarcinoma of the vagina in their daughters

Back 152

Diethylstibestrol (DES)
(May be used as a postcoital ["morning after"] birth control, and for the treatment of testicular tumors)

Hint 152

152

Front 153

Synthetic estrogen with high oral availability, used in contraceptive pills as well as in hormone replacement therapy (HRT)

Back 153

Ethinyl Estradiol
Mestranol
(Increasingly controversial, HRT has been shown to deacrease the risk of artery disease, slow the progression of osteoporosis, and to ameliorate hot flashes in postmenopausal women; it does, however, carry a risk of breast and ovarian cancer)

Hint 153

153

Front 154

Antiandrogenic compound used in the treatment of benign prostatic hyperplasia and alopecia

Back 154

Finasteride
(Inhibits 5a-reductase, and thus the conversion of testosterone to dihydrotestosterone [DHT])

Hint 154

154

Front 155

Used for mineralocorticoid deficiency, this agent has a long duration of action, adn is a naturally occuring precursor to aldosterone

Back 155

Fludrocortisone
(Used in conjunction with glucocorticoids in postadrenalectomy therapy)

Hint 155

155

Front 156

This ultra-rapid-acting human insulin is administered immediately before meals

Back 156

Insulin Lispro
(An altered from of insulin that enters the circulation more rapidly than crystalline zinc [regular] insulin)

Hint 156

156

Front 157

A synthetic thyroid hormone used in the treatment of hypothyroidism, as seen in Hashimoto thyroiditis, myxedema, and patients on lithium

Back 157

Levothyroxine (T4)
(T4 is converted in the periphery to T3, the active form of thyroid hormone. Liothyronine, synthetic T3, is faster-acting, but more expensive and, therefore, is used less frequently)

Hint 157

157

Front 158

Oral hypoglycemic agent that does nto rquire functional pancreatic islet cells adn decreases postprandial glucose levels without resultant hypoglycemia or weight gain

Back 158

Metformin
(Biguanide compound that functions by increasing peripheral glycolysis and, therefore, hepatic gluconeogenesis, resulting in a decrease in serum glucose levels)

Hint 158

158

Front 159

Abortifacient steroid receptor agonist known as the "morning after" pill

Back 159

Mifepristone (RU486)
(Blocks the binding of progesterone to cycloplasmic receptors, preventing successful implantation)

Hint 159

159

Front 160

Synthetic progesterone analog used in oral contraceptives and implantable contraceptive devices

Back 160

Norgestrel
(Norgestrel and similar agents, such as norethindrone adn medroxyprogesterone, may be used in hormone replacement therapy, and to prevent abnormal uterine bleeding)

Hint 160

160

Front 161

A synthetic analog of somatostatin, used in the treatment of many endocrine tumors, including carcinoid gastrinoma, and somatropic pituitary adenoma

Back 161

Octreotide
(This octapeptide is used instead of somatostatin, because it has a higher half-life)

Hint 161

161

Front 162

Normally produced in the posterior pituitary, this hormone is used to stimulate and reinforce labor, as well as stimulate milk ejection from nursing mothers

Back 162

Oxytocin
(Stimulates contraction of uterine smooth muscle for labor; stimulates contraction of myoepithelial cells of the mammary glands to eject milk)

Hint 162

162

Front 163

Oral agent used in the treatment of hyperthyroidism

Back 163

Propylthiouracil
(Inhibits the iodination and coupling reactions in thyroid hormone synthesis. Methimazole also used, although it can cross the placenta and enter breast milk)

Hint 163

163

Front 164

This estrogen partial agonist is used to prevent osteoporosis in postmenopausal women

Back 164

Raloxifene
(It also increases serum high-density lipoprotein [HDL], protecting against atherosclerosis and heart disease; unlike another selective estrogen receptor modulator [SERM], tamoxifen, it does nto increase the risk of endometrial carcinoma)

Hint 164

164

Front 165

This insulin secretagogue has a rapid onset, but shorter duration of action, than sulfonylureas

Back 165

Repaglinide
(Belongs to a class of drugs known as meglinitides, with facilitate insulin release from pancreatic b cells by binding to potassium channels)

Hint 165

165

Front 166

These agents increase cell sensitivity to insulin, by stimulating the peroxismal proliferation gamma (PPARg) nuclear receptor

Back 166

Rosiglitazone
Pioglitazone
(PPARg regulates a number of genes involved in carbohydrate metabolism. The first memeber of this class, troglitazone, was removed from teh market because it caused hepatotoxicity)

Hint 166

166

Front 167

Oral hypoglycemic agents used to stimulate the release of endogenous insulin from b cells

Back 167

Sulfonylurease
Glyburide/Glipizide
(Stimulates the closure of potassium channels, resulting in depolarization of b cells and the release of preformed insulin in vesicles)

Hint 167

167

Front 168

This form of insulin is given in the morning and in the evening, to maintain basal levels of insulin for 12-24 hours

Back 168

Ultralente Insulin
(Supplemented throughout the day with Insulin Lispro; a modified version of human insluin; insulin glargine, has an een longer duration of action)

Hint 168

168

Front 169

Oral, topical, and intravenous preparatoins are available for this drug, used to reduce symptomatology of herpes simplex virus (HSV) infection, although it does nto inhibit the reactivation of herpes

Back 169

Acyclovir
(This guanosine analog is activated by the thymidine kinase of herpes viruses (including herpes simplex, varicella zoster, and Epstein-Barr) and functions as a chain terminator when incorporated into viral DNA during replication)

Hint 169

169

Front 170

Used for the prophylaxis of influenza A and rubella viral infection if given within 48 hours of exposure; also used in the treatment of Parkinson disease

Back 170

Amantadine
(A similare drug, Rimantadine, has similar antiviral effects with a longer half-life; both durgs inhibit the fusion of viral particles within an endosome in a cell. Amantadine is not effective against influenza B, which lacks the M2 protein to which amantadine binds)

Hint 170

170

Front 171

Ineffective against anaerobes, due to the requirement for oxygen to be taken up by the organism

Back 171

Aminoglycosides
Gentamicin/Streptomycin/Tobramycin/Amikacin/Neomycin
(Bacteriacidal inhibitor of mRNA transslation at the 30S ribosome; these agents are associated with significatn nephrotoxicity and ototoxicity)

Hint 171

171

Front 172

Polyene antifungal agent used for the treatment of systemic mycosis and intrathecally for the treatment of fungal meningitis

Back 172

Amphotericin B
(This drug disrupts fungal membranes by binding to ergosterol, which induces pore formation. Side effects include chills, fever, hypotension, and dose-limiting nephrotoxicity, all of which are less severe than using liposomal formulations)

Hint 172

172

Front 173

This extended-spectrum penicillin is used to treat infections with gram-negative organsims such as Haemophilus spp., E. coli, Listeria spp., Proteus spp., and Salmonella spp.

Back 173

Ampicillin
(Often administered with penicillinase inhibitors; a similar durg, amoxicillin, often is preferred because of its greater oral bioavailability and decreased gastrointestinal irritability0

Hint 173

173

Front 174

Although it works similarly to penicillins adn cephalosporins, this monobactam is resistant to b-lactamases, adn displays no cross-allergenicity to penicillins

Back 174

Aztreonam
(Although it is ineffective against gram-positive or anaerobic bacteria, it works synergistically with aminoglycosides against gram-negative rods)

Hint 174

174

Front 175

Inhibitor of bacterial cell wall synthesis, this agent is available as a topical preparation in many over-the-counter antibacterial ointments

Back 175

Bacitracin
(This peptide antibiotic inhibits cell wall synthesis in gram-positive organisms; causes severe nephrotoxicity if used systemically)

Hint 175

175

Front 176

These extended-spectrum penicillins are particularly useful against infections wiht Pseudomonas adn Enterobacter spp.

Back 176

Carbenicillin
Piperacillin
Ticaracillin
(These agents can be used with penicillinase inhibitors and work synergistically wiht aminoglycosides)

Hint 176

176

Front 177

Used for the treatment of septic meningitis, because this cephalosporin has good penetration into the central nervous system

Back 177

Ceftriaxone
(It demonstrates coverage against the leading causes of bacterial meningitis, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae; other third generation cephalosporins, such as cefixime, also are the drug of choice for treatment of Neisseria gonorrhoeae infection)

Hint 177

177

Front 178

Causes cyanosis and cardiovascular collapse in premature neonates deficient in hepatic gluconosyltranferase (gray baby syndrome)

Back 178

Chloramphenicol
(A bacteriostatic inhibitor of protein synthesis, blocking peptidyl transferase activity at the 50S ribosome)

Hint 178

178

Front 179

Associated with myelosuppression, and, rarely, an idiosyncratic irreversible aplastic anemia

Back 179

Chloramphenicol
(Because of its inhibition of red blood cell maturation, it is rearely used systemically; it is available as a topical preparation)

Hint 179

179

Front 180

Primary drug used for attacks and prophylaxis of malarial infection, although resistance is common

Back 180

Chloroquine
(This drug kills parasites within erythrocytes [schizonticidal]; it disrupts hemoglobin breakdown, within the accumulation of heme, wihc is toxic to the oranism)

Hint 180

180

Front 181

Administered with penicillins to enhance their antimicrobial effects

Back 181

Clavulanic Acid
Sulbactam
Tazobactam
(Inhibit b-lactamases, resulting in increased microbial coverage)

Hint 181

181

Front 182

Antibiotic associated with the development of pseudomembranous colitis, due to overgrowth of Clostridium difficile

Back 182

Clindamycin
(A bacteriostatic inhibitor of protein synthesis, methylating the 50S ribosomal subunit, used in the treatment of serious anaerobic infetions due to Bacteriodes spp.)

Hint 182

182

Front 183

Used in combination regimens for the treatment of HIV infection, this drug is associated with dose-limiting pancreatitis

Back 183

Didanosine (ddI)
(Other nucleoside reverse transcriptase inhibitors [NRTI] include zidovudine [ZDT], zalcitabine (ddC), lamivudine (3TC), and stavudine (d4T); lamivudine is unique in that it also inhibitss the reverse transcriptase of hepatitis B virus)

Hint 183

183

Front 184

Side effects of this widely used antibiotic include gastrointestinal irritation and hypersensitivity based actue cholestatic hepatitis

Back 184

Erythromycin
(Bacteriostatic inhibitor of protein synthesis, functioning on the 50S ribosome; erythromycin and other macrolides, azithromycin and clarithromycin show good coverage against Mycoplasma, Corynebacterium, Chlamydia, Legionella, and Bordetella ssp.)

Hint 184

184

Front 185

Can cause tendon damage in adults, and is contra indicated in children an dpregnant women because of damage to developing cartilage

Back 185

Fluoroquinolones
(Bactericidal inhibitor of DNA gyrase, used for gram-negative rods, Neisseria ssp., and some gram-positive organisms)

Hint 185

185

Front 186

Imidazole antifungal used for the treatment of fungal meningitis, because it can cross the blood-brain barrier

Back 186

Fluconazole
(The drug inhibits the formation of ergosterol, adn lacks the antiendocrine effects seen with ketoconazole. It also is used for prophylaxis against Cryptococcus neoformans, and is effective in the treatment of esophageal and oropharyngial candidiasis)

Hint 186

186

Front 187

Back-up drug used for the treatment of cytomegalovirus infection in immunocompromised patients, when resistance to ganciclovir develops

Back 187

Foscarnet
(The drug does not require phosphorylation by viral kinases and inhibits viral DNA polymerase at a different site than ganciclovir; it also is no tmetabolized by viral transferases, which render ganciclovir ineffective)

Hint 187

187

Front 188

Used for the treatment of retinitis and other infections associated with cytomegalovirus (CMV)

Back 188

Ganciclovir
(Guanosine analog converted by CMV to a triphosphorylated form which inhibits the viral polymerase; given IV, it has good penetration to the eye and CNS, but causes neutrophenia, leukopenia, and thrombocytopenia)

Hint 188

188

Front 189

Given orally, this antifungal accumulates in keratinized tissues and is effective against dermatophyte infections, such as ringwork (tinea)

Back 189

Griseofulvin
(This drug binds to tubulin, interfering with microtubule function, thus inhibiting mitosis

Hint 189

189

Front 190

Broad-spectrum b-lactamase-resistant carbapenem, administered in conjuction with cilastin

Back 190

Imipenem
(Used against gram-positive cocci, gram-negative rods, and anaerobes. It is metabolized by renal dihydropeptidase which is blocked by coadministration of cilastin)

Hint 190

190

Front 191

Protease inhibitors used in combined treatment regimens for HIV infection

Back 191

Indinavir
Ritonavir
Saquinavir
Nelfinavir
(These agents inhibit the protease encoded by the HIV pol gene and required for the production of infectious virions; these compounds are metabolized by the cytochrome P450 system)

Hint 191

191

Front 192

This agent is recommended for prophylaxis of tuberculossi in skin test convereters and in people who have close contact with patients with active disease. It is also the primary drug in most multidrug regimens for the treatment of active tuberculosis

Back 192

Isoniazid (INH)
(Inhibits the synthesis of mycolic acid in the mycobacterial cell wall; because it is acetylated by the liver, side effects include peripheral neuritis in slow acetylators and hepatitis in fast acetylators. Due to the emergence of multidrug-resistant strains of Mycobacterium tuberculosis, multidrug regimens also include ethambutol, pyrazinamide, rifampin, and streptomycin)

Hint 192

192

Front 193

Antihelminthic agent used for the treatment of river blindness (caused by Onchocerca volvulus) and threadworm infections (Strongyloides stercoralis)

Back 193

Ivermectin
(Increases GABA-mediated neurotransmission, but since it does not cross teh blood-brain barrier, it selectively effects the nematode, resulting in paralysis of the worm)

Hint 193

193

Front 194

Used for the treatment of mycotic infections, these agents inhibit hormone production and result in gynecomastia

Back 194

Azoles
Ketoconazole/Intraconazole/Fluconazole
(These drugs interfere with fungal cell wall synthesis by inhibiting the 14a-demethylation of lanosterol; the demethylation is catalyzed by the cytochrome P450 system)

Hint 194

194

Front 195

Used for the treatment of many helminth infections, it is the drug of choice for pinworms, the most common helminth infection in the United States

Back 195

Mebendazole
(Functions by inhibiting microtubule synthesis and glucose uptake in helminths; related drugs such as albendazole adn thiabendazole are alternatives)

Hint 195

195

Front 196

Narrow-spectrum, menicillinase-resistant b-lactam antibiotics, used to treat penicillin-resistant Staphylococcus aureus

Back 196

Methicillin
Nafcillin
Dicloxacillin
(Bulkier R-groups on the penicillin backbone prevent degradation of penicillinases

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196

Front 197

Antiprotozoal agent used in the treatment of amebiasis, trichomoniasis, and giardiasis, as well as for pseudomembranous colitis

Back 197

Metronidazole
(Undergoes activation by anaerobes and parasites, to create productss that interfere with nucleic acid synthesis, resulting in cytotoxicity)

Hint 197

197

Front 198

Aminoglycoside given orally for prophylaxis in bowel surgery, and also used to treat hepatic encephalopathy

Back 198

Neomycin
(This drug prevents growth of GI flora adn teh accumulation of nitrogenous microbial metabolites, which contribute to the development of hepatic encephalopathy; too toxic to be administered IV, but often used topically in over-the-counter antibiotic ointments)

Hint 198

198

Front 199

Nonnucleoside reverse-transcriptase inhibitors (NNRTIs) used in the management of HIV infection

Back 199

Neviparine
Delavirdine
Efavirenz
(Because these drugs bind to a unique site on reverse transcriptase, there is no cross-resistance with the nucleoside reverse-transcriptase inhibitors [NRTIs]; the NNRTIs are all metabolized by the P450 system)

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Front 200

Trypanosomicidal drug used for the treatment of Chagas disease

Back 200

Nifurtimox
(Drug used to treat African trypanosomiasis include pentamidine, surafin, and melarsoprol)

Hint 200

200

Front 201

Urinary antiseptic that requires acidification and, therefore, is ineffective systemically, although toxic levels can accumulate in patients with renal failure

Back 201

Nitrofurantoin
(Can cause GI side effects, rash, and hemolysis in glucose-6-phosphate dehydrogenase deficiency patients)

Hint 201

201

Front 202

"Swish and swallow" treatment for oral candidiasis, or topically for the treatment of diaper rash

Back 202

Nystatin
(Disrupts fungal membrane permeability by binding to ergosterol)

Hint 202

202

Front 203

Orally active antifungal drug used to decrease the duration and symptoms of influenza A infection

Back 203

Oseltamivir
(Zanavimir is a similar drug, but is administered intranasally; both drugs function as neuraminidase inhibitors, preventing the spread of virus from cell to cell)

Hint 203

203

Front 204

This group of bactericidal antibiotics inhibits the transpeptidation step during cell wall synthesis, resulting in the activation of autolytic enzymes, which destroy the bacteria

Back 204

Penicillins
(The mechanism of cephalosphorins is nearly identical; major side effects include hypersensitivity wth urticaria and rarely, anaphylaxis leadin to life-threatening asphyxiation)

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Front 205

This antibiotic disrupts bacterial membranes adn is often too toxic to be administered systemically, although it is safe topically

Back 205

Polymyxin B
(This agent acts as a cationic detergent that disrupts the membrane; systemic use causes neurotoxcity and acute tubular necrosis)

Hint 205

205

Front 206

Primary drug used for the treatment of trematode (fluke) and cestode (tapeworm) infections

Back 206

Praziquantel
(Increases calcium permeability in the worm, resulting in paralysis; nicosamide, which functions by uncoupling oxidative phosphorylation (inhibiting ATP production) or by activating ATPases, often is used with praziquantel in cestode infections)

Hint 206

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Front 207

Antihelminthic agent, often used with mebendazole for the treatment of roundworm, pinworm, and hookworm infections

Back 207

Pyrantel Pamoate
(Stimulates nicotinic receptors in the nematode, resulting in a spastic paralysis)

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Front 208

Used for the treatment of chloroquine-resistant malarial infection due to Plasmodium falciparum

Back 208

Quinine
(Blocks DNA replication and RNA transcription in P. falciparum within erythrocytes; a common side effect is cinconism, a constellation of symptoms including headache, vertigo, blurred vision, and tinnitus; a related drug, mefloquine, has fewer side effects and is used as prophylaxis in chloroquine-resistant areas)

Hint 208

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Front 209

Administered as an aerosol, this drug is used for the treatment of respiratory syncytial virus (RSV) infection

Back 209

Ribavirin
(Guanosine analog that inhibits formation, the capping of viral mRNA-dependent RNA polymerase activity; also used for the management of viral hemorrhagic fevers and hepatitis C infection)

Hint 209

209

Front 210

Rarely used alone, except for the treatment of meningococcal carrier state, this drug imparts a red-orange color to secretions

Back 210

Rifampin
(Inhibits DNA-dependent RNA polymerase; often used in a combined drug regimen for Mycobacterium tuberculosis because of rapid resistance if used alone)

Hint 210

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Front 211

This class of antibiotics that inhibits protein synthesis and is effective in the treatment of methicillin-resistant Staphylococcus aureus (MSRA) and vancomycin-resistant enterococci (VRE)

Back 211

Streptogramins
(Synercid is a mixture of quinupristin and dalfopristin; use has been associated iwth arthralgias and myalgias, as well as inhibition of P450 enzymes)

Hint 211

211

Front 212

Contraindicatedin pregnant women and children, because it cuases bone dysplasia and defects in dental enamel

Back 212

Tetracycline
(Broad-spectrum bacteriostatic drug that inhibits the 30S ribosome and thus protein synthesis; provides good coverage against Mycoplasma, Chlamydia, Rickettsia, and Vibrio spp.)

Hint 212

212

Front 213

These two drugs create a block in successive reactions for folate synthesis; also often used to treat urinary tract infections

Back 213

Trimethoprim and
Sulfamethoxazole
(Trimethoprim blocks bacterial dihydrofolate reductase adn can cause megaloblastic anemia; sulfamethoxazole blocks diydropteroate synthase and can cause hypersensitivity reactions and hemolysis in patients with glucose-6-phosphate dehydrogenase [G6PDH] deficiency)

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213

Front 214

Rapid IV infusion is associated with diffuse flushing ("red man" syndrome)

Back 214

Vancomycin
(Used for the treatment of methicillin-resistant Staphylococcus aureus [MSRA], and psudomembranous colitis due to Clostridium defficile; side effects can be limited by infusion over a prolonged period and coadministration fo antihistamines)

Hint 214

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Front 215

Commonly used as part of highly active anti-viral retroviral theraphy (HAART), this HIV drug is used for prophylaxis of needlestick transmission and of transmission to neonates from infected mothers during birth

Back 215

Zidovudine (ZDT)
(Formerly known as AZT, phosphorlylation of this agent by host cell enzymes results in inhibiting viral reverse transcriptase, as well as functioning as a chain terminator

Hint 215

215

Front 216

Inhibits the enzyme aromatase and is used for the treatment of estrogen-dependent cancer

Back 216

Anastrozole
(An inhibitor of steroid synthesis, it hinhibits the conversion of androstenedione to estrone. Aminoglutethimide is a similar drug that inhibits the conversion of cholesterol to prednenolone, and is used for the same types of cancers)

Hint 216

216

Front 217

This antineoplastic agent is used for the treatment of testicular carcinome and squamous cell carcinoma; it can cause life-threatening pulmonary fibrosis

Back 217

Bleomycin
(This drug is a mixture of glycoprotiens that results in the production of free radicals after binding to DNA, creating singl adn double-stranded breaks. This G2 phase inhibitior is a parrt of the ABVD regimen [adriamycin, bleomycin, vinblastine, adn dacarbazine] for Hodgkin disease)

Hint 217

217

Front 218

Highly lipophilic nitrosoureas that readily corss the blood-brain barrier and are used for the treatment of many brain tumors

Back 218

Carmustine (BCNU)
Lomustine (CCNU)
(These alkylating agents result in DNA cross-linking and strand breaks)

Hint 218

218

Front 219

Platinum-containing compound used in the treatment of testicular and lung carcinomas

Back 219

Cisplatin
(Acts as an alkylating agent that causes nephrotoxicity and acoustic nerve damage; a smilar agent, carboplatin, has less nephrotoxicity and neurotoxicity, but greater myelosuppression)

Hint 219

219

Front 220

Alkylating agent used for the treatment of non-Hodgkin lymphoma and breast and ovarian carcinomas

Back 220

Cyclophosphamide
(The major side effect, hemorrhagic cystitis, may be decreased by vigorous hydration adn the use of mesna)

Hint 220

220

Front 221

Part of the AVBD regimen, an antibiotic-type compound used in the treatment of myelomas, sarcomas, and lymphomas

Back 221

Doxyrubicin (Adriamycin)
(Inercalates in DNA to decrease the replication and transcription; this drug is associated with significan tcardiotoxicity and dilated cardiomyopathy. Daunorubicin is a similar drug and is used primarily for the treatment of acute myelogenous leukemia [AML])

Hint 221

221

Front 222

Inhibitor of topoisomerase II used for the treatmen tof small cell carcinoma of the lung and prostate, and testicular cancers

Back 222

Etoposide
(G2 phase-specific inhibitior, resulting in double-stranded DNA breaks and degradation)

Hint 222

222

Front 223

Inhibits thymidylate synthase, resulting in thymineless death, and is used for the treatment of colon cancer and superficial tumors, such as basal cell carcinoma

Back 223

Flourouracil (5-FU)
(This S-phase antimetabolite causes myelosuppression)

Hint 223

223

Front 224

Androgen receptor antagonist, used for the treatment of carcinoma of the prostate

Back 224

Flutamide
(Used to antagonize residual androgens after orchiectomy; side effects include gynecomastia and libido changes)

Hint 224

224

Front 225

Recombinantly produced cytokine, used for the treatment of hairy cell leukemia

Back 225

Interferon Alpha
(Also used for the treatment of chronic myelogenous leukemia [CML], malignant melanoma, and Kaposi sarcoma; it normally is produced by virally infected cells to prevent infection of adjacent cells)

Hint 225

225

Front 226

Gonadotropin-releasing homrone (GnRH) agonists, used for the treatment of metastatic carcinoma of the prostate

Back 226

Leuprolide
Goserelin
Nafarelin
(May also be used for the treatmetn of endometriosis, benign prostatic hyperplasia, and precocious puberty; if administered in a pulsatile manner, they stimulate the release of follicle-stimulating hormone [FSH] and leuteinizing hormone [LH], and can thus be used in the management of infertility)

Hint 226

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Front 227

Purine metabolites, used for the management of leukemias and lymphomas

Back 227

Mercaptopurine (6-MP)
Thioguanine (6-TG)
(Requires activation by hypoxanthine-guanine phosphoribosyltransferase [HGPRT], and inhibits many enzymes involved in purine metabolism)

Hint 227

227

Front 228

Folic acid analog, used for the treatment of leukemias, non-Hodgkin lymphoma, rheumatoid arthritis, and therapeutic abortions

Back 228

Methotrexate
(S phase inhibitor of dihydrofolate reductase, leading to decreased DNA and protein synthesis; the accompanying myelosuppression can be treated with leucovorin)

Hint 228

228

Front 229

Microtubule stabilizing agent, used for the treatment of ovarian and breast carcinomas

Back 229

Paclitaxel
(Derived from the yew tree, this M phase agent prevents the mitotic spindle from breaking down and thus inhibits completion of anaphase)

Hint 229

229

Front 230

Glucocorticoud used for the treatment of leukemias and lymphomas, as well as for rheumatoid arthritis and asthma

Back 230

Prednisone
(Triggers apoptosis and can lead to hypercortisolism with Cushing-like symptoms. Drug must be tapered gradually to prevent life-threatening adrenal insufficiency)

Hint 230

230

Front 231

Monoclonal antibody used for the treatment of low-grade non-Hodgkin lymphoma

Back 231

Rituximab
(Binds to the CD20 antigen on B cells; adverse reactions are associated with infusion, and include fever, chills, headache, and nausea)

Hint 231

231

Front 232

Primary agent used in the treatment of estrogen receptor-positive breast cancer

Back 232

Tamoxifen
(An estrogen receptor partial agonist, which may increase the risk of endometrial carcinoma)

Hint 232

232

Front 233

Monoclonal antibody used for the treatment of metastatic breast cancer

Back 233

Transtuzumab
(Binds to the receptor tyrosine kinase Erb-B2 [HER-2], overexpressed on some breast cancers)

Hint 233

233

Front 234

Vinca alkaloid used as part of the MOPP regimen for lymphomas, Wilms tumor, and choriocarcinomas

Back 234

vincristine (Oncovin)
M phase inhibitor that blocks microtubule polymerization and spindle formation; a similar agent, vinblastine, is part of the ABVD recimen. The ABVD recimen includes the combined used of adriamyci, bleomycin, vinblastine, adn decarbazine whereas the MOPP regimen includes the use of mechlorethamine, Oncovin [vincristine], procarbazine, and prednisone)

Hint 234

234

Front 235

Used to treat the ingestion of suicidal doseas of acetaminophen

Back 235

N-Acetylcysteine
(Given early, it may protect from the development of fulminant hepatic failure)

Hint 235

235

Front 236

Antispasmodic used for the treatment of malignant hyperthermia and neuroleptic malignant syndrome

Back 236

Dantrolene
(Decreases the release of calcium from sarcoplasmic reticulum)

Hint 236

236

Front 237

Used for the treatment of acute iron toxicity

Back 237

Deferoxamine
(Rapid infusion has been associated with hypotensive shock)

Hint 237

237

Front 238

Fab fragment antibody used for the treatment of digitalis toxicity

Back 238

Digibind
(Treatment also includes the correction of Mg2+ adn K+, as well as lidocaine for induced arrhythmias)

Hint 238

238

Front 239

Agent used to treat heavy metal poisoning due to lead, arsenic, and mercury

Back 239

Dimercaprol
(Given perenterally, it chelates metals, preventing them from damaging proteins; succimer is an orraly available derivative used for similar applications)

Hint 239

239

Front 240

Ingestion, industrial inhalation, or absorption through the skin causes metabolic acidosis and precipitaiton of damaging oxalate crystals in the kidney

Back 240

Ethylene Glycol
(A major component of antifreeze, toxicity is managed by the administration of ethanol)

Hint 240

240

Front 241

Used in the event of benzodiazepine overdose

Back 241

Flumazenil
(This benzodiazepine derivative antagonizes the actions of benzodiazepines and zolpidem, although it does not block the actions of barbiturates)

Hint 241

241

Front 242

Intoxication can cause retinal damage and blindness along with metabolic acidosis and coma

Back 242

Methanol
(Damage is due to the conversion to formaldehyde by the liver; the treatment includes ethanol, which competes for alcohol dehydrogenase)

Hint 242

242

Front 243

Used to treat the symptoms of opioid overdose

Back 243

Naltrexone
Naloxone
(Pure antagonists, primarily of mu opioid receptors)

Hint 243

243

Front 244

Anticholinesterases used as insecticides and as possible agents of chemical warfare, inducing motor paralysis, respiratory depression, and convulsions

Back 244

Organophosphates
Isoflurophate/Echotiophate/Parathion
(Antidote includes the use of atropine and acetylcholineesterase regenerators, such as pralidoxime)

Hint 244

244

Front 245

Derivative of penicillin with the ability to chelate copper ions, used for the treatment of copper toxicity

Back 245

Penecillamine
(Also used for the treatment of Wilson disease, and an anjunct therapy for rheumatoid arthritis)

Hint 245

245

Front 246

Drugs that cause significant ototoxcity and nephrotoxicity

Back 246

Aminoglycosides (antibiotics)
Loop Diuretics
Cisplatin (Antineoplastic)
(Vancomycin rarely is associated with mild ototoxicity and nephrotoxicity, although both may become significant when used in conjunction with aminoglycosides)

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Front 247

Drugs that lead to pulmonary fibrosis and subsequent restrictive lung disease

Back 247

Bleomycin (antineoplastic)
Amiodarone (Class IA antiarrhythmic)
Busulfan (Antineoplastic)
(Patients may manifest with dyspnea, tachypnea, and eventual cyanosis, with a decreased forced expiratory volume at 1 second [FEV1] and a decreased forced vital capacity [FVC])

Hint 247

247

Front 248

Drugs that cause gynecomastia

Back 248

Cimetidine (Antiulcer)
Ketoconazole (Antifungal)
Spironolactone (Antihypertensive)
All compete for androgen receptors, leading to antiandrgenic effects)

Hint 248

248

Front 249

Common drugs that inhibit P450 system

Back 249

Cimetidine (Antiulcer)
Ketoconazole (Antifungal)
Erythromycin (Antibiotic)
(Such drugs potentiate the aciton of other drugs which are normally metabolized by the P450; often doses must be lowered when such drugs are used together)

Hint 249

249

Front 250

Drugs that can cause massive hepatic necrosis

Back 250

Halothane (Anesthetic)
Acetaminophen (Analgesic)
Valproic Acid (Anticonvulsant)
(Histologically, damage to the liver is indistinguishable from that caused by chronic viral hepatitis)

Hint 250

250

Front 251

Drugs that cause a systemic lupus erythematosus (SLE)-like syndrome

Back 251

Hydralazine (Vasodilator)
Procainamide (Class IA Antiarrhythmic)
Isoniazid (Antituberculoid)
Phenytoin (Anticonvulsant)
(Symptoms include arthralgias, myalgias, skin rashes, and fever)

Hint 251

251

Front 252

Drugs that inhibit microtubule function

Back 252

Mebendazole (Antihelminthic)
Thiabendazole (Antihelminthic)
Paclitaxel (Antineoplastic)
Vincristine (Antineoplastic)
Colchicine (Antigout)
Griseofulvin (Antifungal)
(These agents either block intracellular transport, interfere with locomotion, or disrupt the formation of the mitotic spindle)

Hint 252

252

Front 253

Drugs that cause a disulfiram-like reaction

Back 253

Metronidazole (Antibiotic)
Certain Cephalosporins (Antibiotic)
Procarbazine (Antineoplastic)
(Cause flushing, headache, nausea, sweats, hypotension, and confusion)

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Front 254

Drugs that cause cutaneous flushing on administration

Back 254

Niacin (Antihyperlipidemic)
Calcium Channel Blockers
Adenosine (Antiarrhythmic)
Vancomycin (Antibiotic)
(Often this side effect can be controlled by slow infusion or coadministration with histamine blockers)

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Front 255

Bactericidal antibiotics

Back 255

Penicillins
Cephalosporins
Vancomycin
Aminoglycosides
Fluoroquinolones
Metronidazole
(Most of the other antibiotics are bacteriostatic)

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255

Front 256

Drugs that induced the hepatic P450 system

Back 256

Phenytoin (Anticonfulsant)
Carbamazepine (Anticonvulsant)
Griseofulvin (Antifungal)
Rifampin (Antituberculoid)
Barbiturates
Chronic Ethanol Use
(The hepatic microsomal mixed funciton oxidase system is involved in phase I metabolism of many drugs)

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Front 257

Drugs that cause a Stevens-Johnson syndrome, a febrile, erosive hemorrhagic crusting on the lips and oral mucosa of children

Back 257

Sulfonamides (Antibiotic)
Ethosuximide (Anticonvulsant)
Lamotrigine (Anticonvulsant)
(Other agents such as penicillins, barbiturates, salicylates, hydantoins, and antimalarials may be associated with a less severe form of erythema multiforme, with macules, papules, vesicles, and bullae)

Hint 257

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Front 258

Drugs that cause hemolysis in glucose-6 phosphate dehydrogenase (G6PDH) deficiency

Back 258

Sulfonamides (Antibiotic)
Isoniazid (Antituberculoid)
Primaquine (Antimalarial)
(In patients with G6PDH deficiency, these agents cause oxidative stress in RBCs because of a deficid ot reducing equivalents of nicotimaide adenine dinucleotide phosphate [NADPH] normally generated by the hexose monophosphate shunt)

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Front 259

Drugs that cause photosensitivity

Back 259

Tetracycline (Antibiotics)
Amiodarone (Class IA Antiarrhythmic)
Sulfonamides (Antibiotics)
(Barbiturates can precipitate photosensitivity in patients with acute intermittent porphyria)

Hint 259

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Front 260

Table of Contents

Back 260

Section Card #
Autonomics 1-14
Diuretics 15-24
Cardiovascular 25-45
CNS 46-78
Drugs of Abuse 79-89
Anti-Inflammatory 90-108
Blood 109-119
Gastrointestinal 120-132
Respiratory 133-143
Endocrine 144-168
Antimicrobials 169-215
Cancer 216-234
Toxicology 235-245
Shared Effects 246-259

Hint 260

The End