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98 Cards in this Set
- Front
- Back
- 3rd side (hint)
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H2 Blockers
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cimetidine, ranitidine, famotidine, nizatidine. Competitive antagonist for histamine at H2 receptor => dec parietal cell acid secretion. Use: peptic ulcer, gastritis, mild esophageal refulx. Tox: just cimetidine: inhibit p450, anti-androgen (gynecomastia), renal
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PPI
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Omeprazole, Lansoprazole. Inhibit parietal cell H/K ATPase. Use: peptic ulcer, gastris, esophageal refulx, Zollinger-Ellison
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Bismuth
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Physically protect ucler. Use: ulcer healing, traveler's diarrhea, H. pylori infection (T-BAM: tetracycline, bismuth, amoxicillin, metronidazole)
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Sucralfate
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Physically protect ucler. Use: ulcer healing, traveler's diarrhea, H. pylori infection (T-BAM: tetracycline, bismuth, amoxicillin, metronidazole)
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Misoprostol
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PGE1 analog. Inc gastric mucous production, dec acid secretion. Use: w/ NSAIDS, maintain PDA, induce labor. Tox: diarrhea, abortifacient.
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Pirenzepine
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muscarinic antagonists: M1 on ECL, M3 on parietal cells. Use: peptic ulcer. Tox: tachycardia, dry mouth, blurry vision
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Propantheline
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muscarinic antagonist: M1 on ECL, M3 on parietal cells. Use; peptic ulcer. Tox: tachycardia, dry mouth, burry vision.
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Infliximab
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anti-TNF-alpha mAb. Use: IBD, RA, akylosising spondylitis. Tox: respiratory infection, fever, hypotension
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Sulfasalazine
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sulfapyradine (abio) + mesalamine (anti-inflam). Use: IBD. Tox: reversible oligospermia.
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Ondansetron
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competitively block 5HT3 in CNS (chemoreceptor trigger zone).
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Al(OH)3 overuse
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antacid. overuse: constipation ("alu-minimum feces"), ∆ drug availability
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Mg(OH)2 overuse
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antacid. overuse: diarrhea (Mg = "must go"), ∆ drug availability
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Calcium carbonate overuse
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antacid. overuse: hypercalcemia (bones, stones, groans, moans), rebound acidity, ∆ drug availability
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Insulins
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1) liver: glucose => glycogen. 2) muscle: uptake K, glucose. glucose => glycogen. 3) fa => lipids. Use: DM1, DM2. Tox: hypoglycemia; rare hypersensitivity
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Insulin length
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short acting
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Lispro
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short acting insulin
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NPH
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intermediate length insulin
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lente
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long acting insuline. ultra-lente = ultra slow.
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Sulfonylureas
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block K channels => inc membrane V => open Ca2+ channeles => insulin release. 1st gen: tolbutamide, chlorproamide. 2nd gen: glipizide, glyburide, glimepiride. Use: DM1. Tox: hypoglycemia. (first gen: disulfiram-like)
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tolbutamide
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1st gen sulfonylurea
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clorproamide
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1st gen sulfonylurea
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glipizde
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2nd gen sulfonylurea
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glyburide
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2nd gen sulfonylurea
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glimepiride
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2nd gen sulfonylurea
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Biguanides
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Metformin. inc glycolysis, dec gluconeogenesis => dec blood glucose. Use: DM1, DM2. Tox: lactic acidosis. Avoid if heart, liver, renal disease
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Metformin
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Biguanides
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Thiazolidinediones
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Glitizones. Rosiglitizone, Pioglitizone. bind PPAR-gamma => dec insulin insensitivity. Dec: glucose, CRP, triglycerides. Inc: HDL. (statins + dec glucose!) Use: DM2. Tox: weight gain.
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Alpha-glucosidase inhibitor
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inhibit intestinal alpha-glucosidase => dec carb hydrolysis => dec glucose abs. Use: DM2. Tox: GI sx. Acarbose, miglitol
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None
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Acarbose
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alpha-glucosidase inhibitor
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Miglitol
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alpha-glucosidase inhibitor
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Orlistat
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inh pancreatic lipase. Use: obesity. Tox: steatorrhea, ADEK
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Sibutramine
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SNRI. Use: obesity. Tox: hypertension, tachycardia.
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Propylthiouracil
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inh TPO (thyroid peroxidase): oxidation, organification, coupling. *inh 5'iodinase (peripheral conversion T4=>T3)*. Use: hyperthyroidism. Tox: rahs, agranulocytosis, aplastic anemia
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Methimazole
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inh TPO (thyroid peroxidase): oxidation, organification, coupling. hyperthyroidism. Tox: rash, agranulocytosis, aplastic anemia
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GH
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GH defiency, Turner's syndrome
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Octreotide
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acromegaly, carcinoid, gastrinoma, glucagonoma, decrease portal flow (bleeding esophageal varicies)
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Oxytocin
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milk let down, uterine contraction (labor, dec uterine bleeding)
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Desmopressin
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Central diabetes insipidis
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Finasteride
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5 alpha reductase inhibitor => dec DHT. Use: BPH, male pattern baldness (propecia).
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Flutamide
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nonsteroidal androgen R antagonist. Use: prostate ca.
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Ketoconazole
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inhibit steroid synthesis. Use: hirsutism in PCOS.
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Spironolactone
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steroidal aldosterone and androgen R antagonist. Use: hirsutism in PCOS
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Sildenafil
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"fill the penis". PDE inh => cGMP. Use: erectile dysfunction. Tox: *fatal hypotension w/ nitrates*, blue-green color blindness ("inc amount of red!")
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Verdenafil
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"fill the penis". PDE inh => cGMP. Use: erectile dysfunction. Tox: *fatal hypotension w/ nitrates*, blue-green color blindness ("inc amount of red!")
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Leuprolide
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GnRH analog. Pulsatile = agonist: infertility. Constant = antagonist: uterine fibroids, prostate ca (w/ flutamide). Tox: antiandrogen
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Clomiphene
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SERM. Partial agonist at pituitary => inc LH, FSH => ovulation. Use: e.g. PCOS. Tox: hot flashes, visual distrubances, ovarian enlargment, multiple prego.
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Buserelin
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GnRH analog.
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Mifepristone
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Progesterone R antag. Use: abortifacient. Tox: bleed, GI.
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Fludrocortisol
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mineralocorticoid. Use: CAH, adrenal insufficiency. Tox: glucocorticoid activity.
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oral contraceptives
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progesterone inh GnRH, LH, FSH => no LH spike, no ovulation. + low dose estrogen => some endometrial growth => less breakthrough bleeding.
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Heparin
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bind ATIII => inh 12, 11, 9, 10, 2 (esp 10, 2). Large anionic polymer. Short half life. Use: acute anti-coag (stroke, PE, MI, angina, DVT). Tox: bleeding, HIT (give argatroban or bivalirudin instead). Follow PTT. does NOT cross placenta. Rev w/: protamine sulfate.
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LMWH
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enoxaparin. bind ATII => inh 10. Use: acute anti-caog (stroke, PE, MI, angina, DVT). Tox; bleeding, hit. Can't reverse. Follow PTT. Doesn't cross placenta
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Warfarin
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inhibit vit K epoxide reductase (liver) => inh gamma glutamyl carboxylation of 9, 7, 10, 2. Long lasting effect. Use: chronic anticoag. Tox: bleeding, CROSSES THE PLACENTA => TERATOGEN. Follow PT.
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Bivalirudin
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Direct thrombin inhibitor. Instead of Heparin if HIT.
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Argatroban
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Direct thrombin inhibitor. Instead of Heparin if HIT.
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HIT
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antibodies to PF4-heparin complex => Fc binds platelets, activates => platelet aggregation => thrombocytopenia
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Aspirin
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irreversibly inhibits (acetylates) COX1, 2 => dec prostaglandin and thromboxane production. (platelet's can't produce new cox => antiplatelet). inc bleeding t. no ∆(PT, PTT). Use: anti-pyretics, analgesic, anti-inflammatory, anti-platelet. Tox: GI bleed, Reye's syndrome, tinnitus, hyperventilation, bleeding.
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Clopidogrel
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irreverisbly block ADP R => dec GP2b3a expression. Use: acute coronary syndromes, stent placement
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Ticlopidine
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irreversibly block ADP R => dec GP2b3a expression => dec aggregation. Use; acute coronary snydromes, stenting. Tox: neutropenia.
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Abciximab
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mAb vs. GP2b3a => dec aggregation. Use: ACS, angioplasty. Tox: thrombocytopenia, bleeding.
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Anti-clotting factor meds
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Heparin, Warfarin, Argatroban, Bivalirudin
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Anti-platelet meds
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ASA, clopidogrel, ticlopidine, abciximab, eptifibatide
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None
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Thrombolytics
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urokinase, tPA (anteplase), streokinase, APSAC (anistreplase)
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Methotrexate
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S-phase antimetabolite. inh dihydrofolate reductase => inhibit dAMP, dGMP, dTMP synth. Use: leukemia/lymphoma, choriocarcinoma, sarcoma, abortion/ectopic pregnancy, RA, psorasis. Tox: myelosuppression (rev w/ leucovorin=folinic acid), fatty ∆s liver
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5FU
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S-phase antimetabolite. met to 5dUMP, binds irreversibly to folate => inh nuc acid synthesis. Use: colon cancer + other solids, topical for BCC, synergy w/ MTX. Tox: myelosuppression (not rev w/ leukovorin), photosensitivity
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6MP
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S-phase antimetabolite. activated by HGPRTase. (Azathioprine => 6MP). Use: leukemia/lymphoma, !CLL, !hodgkins. Tox: GI, bone, liver. Met by xanthine oxidase (tox inc by allopurinol)
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Toxicity inc by allopurinol
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6MP, azathioprine.
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cytarabine
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C-ara. "C-arAML". S phase antimetabolite. inhibit DNA polymerase. Tox: bone (leukopenia, thrombocytopenia, megaloblastic anemia)
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Cyclophosphamide
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and Ifosfamide. Alkylating agent => crosslink. Hepatic activation. Tx: non-hodgkin's lymphoma (CHOP), ovarian+breast, immunosuppressant. Tox: bone, hemorrhagic cystitis (prevent w/ mesna)
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Nitrosureas
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Streptozocin, carmustine, lomustine, semustine (MUSTang with NITRO). Alkylating agent. Cross BBB. Use: brain tumors. Toxicity: CNS.
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Cisplatin
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Alkylating agent. Use: lung, bladder, testicular, ovarian. Tox: nephro + CN8 (like AG)
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Carboplatin
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Alkylating agent. Use: lung, bladder, testicular, ovarian. Tox: nephro + CN8 (like AG)
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Busulfan
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Alkylating agent. Use: CML. Tox: pulmonary fibrosis.
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Procarbazine
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Alkylating agent. Hodgkins: MAPP. Tox: bone.
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Doxorubicin
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Adriamycin. Intercalates => DNA breaks. Use: ABVD for Hodgkins. CHOP for non-hodgkins. Tox: *Cardiotoxicity*, alopecia, bone.
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Daunorubicin
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Intercalates => DNA breaks. Use: ABVD for Hodgkins. CHOP for non-Hodgkins. Tox: bone
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Dactinomycin
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Actinomycin-D. "Kids ACT out. WERD". Kids tumors: Wilm's tumor, Ewing's sarcoma, Rhabdomyosarcoma. Tox: bone.
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Bleomycin
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G2. Bind Fe => ROS => DNA breaks. Use: testicular ca, lymphoma (ABVD for Hodgkins). Tox: *pulmonary fibrosis*, blisters, not much bone.
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Etoposide
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eTOPO-side. inhibit topoisomerase II. Use: small cell, testicular, prostate. Tox: bone, Gi, alopecia
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Prednisone (for cancer)
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Apoptosis (even if not dividing). Use: CLL, Hodkins (MOPP), immunosuppressant. Tox: Cushingoid (cataracts, ulcers, hypertension, hyperglycemia, acne, psychosis).
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Tamoxifen
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SERM: -breast, +bone, +endometrium. Use: breast cancer, osteoporosis. Tox: endometrial cancer.
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Raloxifene
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SERM: -breast, +bone, -endometrium. Use: breast cancer, osteoporosis. Unlike tamoxifen, does not cause endometrial ca.
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Trastuzumab
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mAb vs. HER2 (erb2b) => ADCC of tumor cells. Use: metastatic BC. Tox: cardiotoxicity.
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Imatinib
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small molec inh of bcr-abl tyrosine kinase (Ph chromosome t(9;22)). Use: CML, GI stromal tumors. Tox: fluid retention
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Vincristine
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M phase. Inhibit MT polymeriziation. MOPP. Tox: Christ=> neuropathy (areflexia, peripheral neuritis, paralytic ileus)
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Vinblastine
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M phase. Inhibit MT polymerization. ABVD. Tox: vinBLASTine: bone.
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Paclitaxel
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M phase. (Taxol) hyperstabilze MT. Use: ovarian + breast carcinomas. Tox: myelosuppression + hypersensitivity.
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Rituximab
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mAB vs CD20. NH lymphoma, CLL, RA (other autoimmune). Tox: viral inf, Progressive multifoal leukoencephalopathy (JC)
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Antimetabolites
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(s phase). Methotrexate, 5FU, 6MP/azathioprine, cytarabine
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Alkylating agents
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cyclophosphamide/ifosfomide, nitrosureas (carmustine, streptozocin), busulfan, procarbazine.
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Intercalating agents
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Doxorubicin (adriamycin), daunorubicin
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G2 specific
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Bleomycin (ROS), etoposide (topoisomerase II inhibitor)
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M phase specific
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Vincristine, Vinblastine, Paclitaxel/taxol (hyperstabilize)
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Misoprostol
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PGE1. Prevent NSAD gastric ulcers.
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Alprostadil
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PGE1. ED. "al prostethic dill"
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Latanoprost
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PGF2. Inc aqueous humor outflow
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Epoprostenol
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PGI2. Pulmonary hypertension. "epo => blood oxygenation => lungs"
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Dinoprostone
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PGE2. Dilate cervix, contract uterus. "dinosaur egg"
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