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87 Cards in this Set
- Front
- Back
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What is metoclopramide used for and what is its mechanism of action?
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improves gastric emtpying
anti-emetic peripheral cholinergic stimulant peripheral dopamine antagonist central dopamine antagonist |
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What kind of drugs can not be used with litium?
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anti-emetics
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Sulfasalazine, mesalamine, olsalazine, and balsalazide are all used for ?
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inflammatory bowel disease
COX inhibitors |
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What is infliximab?
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monoclonal Ab against TNF alpha
It is anti inflammatory and can be used for Crohns or Rheumatoid arthritis May activate latent TB |
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Bisacodyl, castor oil and Mg all stimulate?
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PAF and NO
tissue destructive |
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mineral oil + docusate could result in?
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lymph node inflammation (increased absorption of mineral oil)
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What is apomorphine?
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dopamine agonist that stimulates chemorecptor trigger zone
induces vomiting |
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Mechanism of action for Aprepitant.
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substance P/ neurokinin-1 receptor antagonist
used for emesis related to cancer chemotherapy |
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What are amrinone (-rinones) mechanism of action and use?
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phosphodiesterase inhibitors (III)
inotropic dilators increase contractility of the heart increase rate of contraction/ relaxation decrease peripheral resistance myocardial oxygen consumption is unchanged thrombocytopenia |
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What are the side effects of loop diuretics? (Furosemide, Bumetanide, Ethracrynic acid, Torsemide)
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Hypovolemia
Hypokalemia Metabolic Alkalosis Hypocalcemia and Hypomagnesemia Increased lipids and glucose renal stone formation hyperuricemia Reversible ototoxicity |
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Which drugs are more likely to cause hyponatremia thiazides or loop diuretics?
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thiazides
because they inhibit kidneys to produce dilute urine but not concentrated urine |
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What effect do thiazide diuretics have on calcium?
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hypercalcemia (increase resorption) good for osteoporosis
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What are the three thiazide-like diuretics?
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chlorthalidone
indapamide metolazone |
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What is amiloride?
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Na channel inhibitor in collecting tubule
K sparing diuretic |
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What is triamterene
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Na channel inhibitor in collecting tubule
K sparing diuretic poorly soluble and may precipitate causing stones |
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What are the osmotic diuretics?
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mannitol and urea - IV
isosorbide and glycerin - oral |
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Hydralazine, minoxidil, diazoxide, fenoldopam are all?
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Selective arterial dilators
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Fenoldopam mechanism of action
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dopamine 1 receptor agonist which causes direct relaxation of arteriolar smooth muscle
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Heart block may be caused by using Beta blockers with?
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non-DHP CCBs
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Trimepthaphan and Mecamylamine mechanism of action
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autonomic ganglionic blockers
compete with ACh for ganglionic cholinergic receptor sites blocking both PSNS and SNS resulting in decreased TPR and Preload |
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Mechanism of alpha-methyl dopa
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replaces NE in nerves and when released is a potent agonst at alpha 2 receptors
this is an indirect mechanismd which reduces the incidence of rebound HTN |
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Drugs that cause retrograde ejaculation
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guanethidine, guanadrel, metyrosine
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What is used to treat heparin induced thrombocytopenia?
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Direct thrombin inhibitors (lepirudin, bivalirubin, argatroban)
DO NOT use warfarin because it decreases protein C |
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What are 3 of the direct thrombin inhibitors?
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lepirudin
bivalirubin argatroban |
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What is the mechanism and use of Dipyridamole?
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adenosine/ adenosine diphosphate receptors
causes an accumulation of adenosine indrectly stimulating platelet cAMP accumulation anti-platelet and vasodilation REQUIRES warfarin for therapeutic effect use in patients with artificial heart valves |
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Glycoprotein IIB/ IIIA inhibition
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Abciximab
Ticofiban Eptifibatide |
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Inhibitor of plasminogen (competitive inhibtion of plasminogen activation to plasmin)
PROMOTES clotting |
Aminocapronic acid
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Drug that causes dry ejaculate
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aminocapronic acid
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Contraindications for bile acid sequestrants (Chole-)
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Diabetes
Triglycerides > 400 (they will increase triglycerides) |
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An advantage to mefloquine
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long half life (15-33 days) so it has flexible dosing
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If a drug contains "quine" what problems are usually associated?
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liver, blood, brain, heart
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What is the Mazzotti reaction and what drug(s) cause it?
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large amount of parasitic contents released into circulation after "kill" with Ivermectin
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Drug to treat nematodes (round worms)
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ivermectin
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Drug to treat trematodes (flukes)
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praziquantal
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Mechanism of action of phenoxybenzamine
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non specific alpha blocker
binds irreversibly |
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What are the three non selective alpha antagonists
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phenoxybenzamine, phentolamine, tolazoline
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Propothiouracil mechanism of action
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inhibits thyroid peroxidase enzyme and peripheral conversion of T4 to T3
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methimazole?
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inhibits thyroid peroxidase enzyme
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Tolbutamide and Chlorpropamide
also acetohexamide and tolazamide |
1st generation sulfonylureas
directly stimulate insulin secretion by depolarizing beta cell (block ATP sensitive K channel) |
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miglitol and acarbose mechanism of action
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alpha-glucosidase inhibitors
delay carbohydrate digestion and absorption |
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fludrocortisone is a?
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mineralocorticoid
acts just like aldosterone |
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mechanism of metyrapone
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inhibitor of 11-hydroxylase
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What is abarelix?
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GnRH antagonist (decreases LH and FSH) used to treat prostate cancer
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Tamoxifen is estrogenic in... and anti-estrogenic in...
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estrogenic - endometrium, CV system, bone
anti estrogenic - breast |
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Raloxifene is estrogenic in...and anti-estrogenic in...
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estrogenic - bone
anti estrogenic - breast and endometrium |
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clomiphene is anti-estrogenic in...
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hypothalamus - it blocks the negative feedback of estradiol (increases GnRH ---> increases LH and FSH)
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fulvestrant
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estrogen receptor antagonist
used for metastatic breast cancer |
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What are three specific aromatase inhibitors and one non specific inhibitor?
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Specific = anastrozole, letrozole, exemestane
non-specific = aminoglutethimide blocks androgen - estrogen use for tamoxifen resistant breast cancer |
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Drugs that can be used to halt pre-term labor
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Beta 2 agonists (terbutaline, ritodrine)
Magnesium sulfate indomethacin |
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Nitrosoureas (-mustine) are primarily used for what time of cancer?
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cross the BBB so Brain cancer
alkylating agent G-G crosslinking |
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Streptozocin is used for what type of cancer?
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pancreatic cancer - toxic to B cells of pancreas patient becomes type I diabetic
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methotrexate mechanism of action and can overcome cancer resistance how?
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dihydrofolate reductase inhibitor give in BIG dose along with leucovorin
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Vincristine main toxicity and mechanism of action
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nerves (CNS)
interferes with mitotic spindle formation (antimitotic) |
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vinblastine toxicity and mechanism of action
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anti-mitotic
Bone marrow suppression ("blasts" are found in the bone marrow) |
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paclitaxel mechanism of action
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interferes with most tubular functions
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imatinib (gleevec) is used for?
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t(9;22) CML
inhibits tyrosine kinase |
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sulfonamides mechanism of action
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folate antagonist
competitive inhibitor of dihydropteroate sythetase preventing PABA incorporation into folic acid |
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trimethoprim/ pyrimethamine mechanism of action
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folate antagonist
inhibits bacterial dyhydrofolate reductase |
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nitrofuantoin mechanism of action
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reactive nitro group damages nucleic acids
secondary formation of superoxide free radicals (lung toxicity) |
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mechanism of action for fluoroquinolones
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inhibit topoisomerase II
lones hurt attachment to bones |
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Vancomycin mechanism of action
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binds D-ala-D-ala preventing polymerization of linear peptidoglycan
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methenamine mechanism of action
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converted to formaldehyde in acidic environment
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Mechanism of action for penicillins
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inhibits cell wall synthesis by preventing cross linking of peptidoglycan
also activates auto-lytic enzymes |
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What are the rules for cephalosporin generations
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First Generation
FA, PHA (except fac) Second Generation all the rest Third Generation CEFT, FIX, FOP Fourth Generation Cefepime increasing activity against gram - with later generations increasing beta-lactamase resistance increased distribution DECREASED activity against gram + except 3rd to 4th (increases) |
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Mechanism of action for cephalosporins
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beta-lactamase
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Drug of choice for enterobacter
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imipenem with cilastin
use meropenem if sensitive to penicillins |
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Drug of choice for gonorrhea
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ceftriaxone (ceft so 3rd)
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mechanism of action for daptomycin
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lipoprotein that binds membranes of gram + bacteria
major drug interaction with statins because causing depolarization (myopathy and peripheral neuropathy) |
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aminoglycoside mechanism of action
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binds 30S ribosome subunit
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tetracycline mechanism of action
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binds 30S ribosome and inhibits AA-tRNA complex binding
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vancomycin resistant enterococcus drug of choice
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linezolid
although I wonder why imipenem couldn't be used? |
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quinopristin-dalfopristin mechanism of action
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binds 50S ribosomal subunit and constricts exit channel
"ribosomal constipation" |
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linezolid mechanism of action
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50S ribosome subunit and block formation of functional tRNA ribosome mRNA complex
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Linezolid and Didanosine can't be used in someone with?
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PKU- both contain phenylalanine
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Isoniazid mechanism of action
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decreases synthesis of mycolic acid
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ethambutol mechanism of action
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inhibits synthesis of arabinogalactan
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rifampin mechanism of action
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inhibits DNA dependant RNA polymerase
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Drug of choice for absence seisures
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ethosuxamide
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drug of choice for status epilepticus
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diazepam
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Drug of choice for partial seizures
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carbamazepine
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drug of choice for atonic seizure
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clonazepam
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drug of chocie for myoclonic seizure
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clonazepam
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use barbiturates in head trauma because...
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they decrease ICP
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What blocks the benzodiazepine receptor?
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flumazenil
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What can be done to the urine to increase excretion of amphetamine in an overdose?
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acidify it
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A selective MAO B inhibitor
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selegiline
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Drug that chelates metals
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penicillamine
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