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98 Cards in this Set

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