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292 Cards in this Set
- Front
- Back
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Bethanechol
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Direct Acting Cholinergic Agonist
Postoperative and neurogenic ileus and urinary retention Activates Bowel and Bladder smooth muscle Beth Anne call me to activate your bowels and bladder |
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Carbachol
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Direct Acting Cholinergic Agonist
Glaucoma, Pupillary Contraction, Release of intraocular pressure |
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Pilocarpine
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Direct Acting Cholinergic Agonist
Stimulates Sweat, Tears, and Saliva Contracts ciliary muscle of the eye (open angle), pupillary schincter (closed angle) Resistant to AChE PILE on the sweat and tears |
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Methacholine
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Direct Acting Cholinergic Agonist
Challenge test for diagnosis of asthma Stimulates muscarinic receptors in airway when inhaled |
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Neostigmine
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Indirect Acting Cholinergic Agonist
Postoperative and neurogenic ileus and urinary retention Myathenia Gravis Reversal of NMJ blockade post-operative Increases endogenous ACh No CNS penetration NEO CNS = NO CNS |
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Pyridostigmine
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Indirect Acting Cholinergic Agonist
Myasthenia Gravis (long-acting) Increases endogenous ACh No CNS |
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Edrophonium
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Indirect Acting Cholinergic Agonist
Diagnosis of Myasthenia Gravis (very short-acting) Increases endogenous ACh |
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Physostigmine
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Glaucoma
Atropine overdose Increases endogenous ACh PHYS is for EYES |
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Ectothiophate
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Glaucoma
Increases endogenous ACh |
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Atropine
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Muscarinic Antagonist
Eye Produce mydriasis and cycloplegia |
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Homatropine
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Muscarinic Antagonist
Eye Produce mydriasis and cycloplegia |
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Tropicamide
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Muscarinic Antagonist
Eye Produce mydriasis and cycloplegia |
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Benztropine
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Muscarinic Antagonist
CNS Parkinson's Disease PARK my BENZ |
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Scopolamine
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Muscarinic Antagonist
CNS Motion Sickness |
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Ipratropium
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Muscarinic Antagonist
Respiratory Asthma, COPD I PRAY I can breathe soon |
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Oxybutynin
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Muscarinic Antagonist
Genitourinary Reduce urgency in mild Cystitis |
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Glycopyrrolate
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Muscarinic Antagonist
Genitourinary Reduce urgency in mild Cystitis |
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Methscopolamine
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Muscarinic Antagonist
Gastrointestinal Peptic Ulcer treatment |
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Pirenzepine
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Muscarinic Antagonist
Gastrointestinal Peptic Ulcer treatment |
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Propantheline
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Muscarinic Antagonist
Gastrointestinal Peptic Ulcer treatment |
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Hexamethonium
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Nicotinic Antagonist
Ganglionic blocker Used in experiments to prevent vagal reflex responses to changes in blood pressure Prevents Reflex Bradycardia caused by NE Put a HEX on smokers (nicotine) ---------------------------------------------- Severe Orthostatic Hypertension Blurred Vision Constipation Sexual Dysfunction |
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Epinephrine
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Alpha 1 and 2
Beta 1 and 2 Low dose selective for Beta 1 (Blow) Anaphylaxis Glaucoma (open angle) Asthma Hypotension |
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Norepinephrine
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Alpha 1 and 2
Hypotension (but DECREASES renal perfusion) |
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Isoproterenol
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Beta 1 and 2
AV Block |
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Dopamine
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D1 and D2 > Beta > Alpha
Inotropic and Chronotropic Heart Failure Shock (INCREASES renal perfusion) |
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Dobutamine
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Beta 1 > Beta 2
Inotropic (NOT Chronotropic) Heart Failure Shock Cardiac Stress Testing |
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Phenylephrine
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Alpha 1 > Alpha 2
Pupillary Dilation Vasoconstriction Nasal Decongestion |
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Albuterol
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Beta 2 > Beta 1
Acute Asthma |
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Terbutaline
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Beta 2 > Beta 1
Reduces Premature Uterine Contractions |
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Ritrodine
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Beta 2
Reduces Premature Uterine Contractions |
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Ampthetamine
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Releases stores catecholamines
Narcolepsy Obesity Attention Deficit Disorder (ADD) |
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Ephedrine
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Releases stored catecholamines
Nasal Decongestion Urinary Incontinence Hypotension |
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Cocaine
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Uptake Inhibitor
Vasoconstriction Local Anesthesia |
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Clonidine
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Centrally acting Alpha 2 Agonist
DECREASES Central adrenergic outflow Hypertension (NO decrease in renal perfusion) ------------------------------------------------ Dry Mouth Sedation Severe Rebound Hypertension |
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ά-Methyldopa
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Centrally acting Alpha 2 Agonist
DECREASES Central adregergic outflow Hypertension (NO decrease in renal perfusion) --------------------------------------------- Sedation + Coomb's test |
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Selective Beta 2 Agonists
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MAST:
Metaproterenol Albuterol Salmeterol Terbutaline |
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Phenoxybenzamine
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Non-Selective Alpha Blocker
(IRREVERSIBLE) Pheochromocytoma (before removing tumor) --------------------------------------------- Orthostatic Hypotension Reflex Tachycardia |
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Phentolamine
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Non-Selective Alpha Blocker
(REVERSIBLE) Pheochromocytoma (before removing tumor) ---------------------------------------------------- Orthostatic Hypotension Reflex Tachycardia |
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Prazosin
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Alpha-1 Selective Blocker
Hypertension Urinary Retention in BPH -------------------------------------------- 1st dose Orthostatic Hypotension Dizziness Headache |
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Terazosin
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Alpha-1 Selective Blocker
Hypertension Urinary Retention in BPH -------------------------------------------- 1st dose Orthostatic Hypotension Dizziness Headache |
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Doxazosin
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Alpha-1 Selective Blocker
Hypertension Urinary Retention in BPH -------------------------------------------- 1st dose Orthostatic Hypotension Dizziness Headache |
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Mirtazapine
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Alpha-2 Selective Blocker
Depression --------------------------------------------------- Sedation Increase Serum Cholesterol Increase Appetite |
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Non-Selective Beta Blockers
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Propanolol
Pindolol Nadolol Timolol Labetalol |
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Beta-1 Selective Blockers
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Acebutolol (partial agonist)
Betaxolol Esmolol (short acting) Atenolol Metoprolol A BEAM of beta-1 blockers |
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Non-Selective Alpha and Beta Blockers
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Carvedilol
Labetolol |
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Partial Beta Agonists
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Pindolol
Acebutolol |
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Sulfa Drugs
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Celecoxib
Furosemide Probenecid Thiazides TMP-SMX Sulfasalazine Sulfonylureas Sumatriptan |
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Hydrochlorothiazide
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Diuretic
----------------------------------------------- Hypokalemia Mild Hyperlipidemia Hyperuricemia Lassitude Hypercalcemia Hyperglycemia |
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Loop Diuretics
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Diuretic
--------------------------------------------------- K+ Wasting Metabolic Alkalosis Hypotension Ototoxicity |
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Reserpine
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Sympatholytic
----------------------------------------------- Sedation Depression Nasal stuffiness Diarrhea |
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Guanethidine
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Sympatholytic
----------------------------------------------- Orthostatic and Exercise Hypotension Sexual Dysfunction Diarrhea |
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Hydralazine
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Vasodilator
Increases cGMP -> smooth muscle relaxation Vasodilates arterioles > veins Afterload reduction Severe Hypertension, CHF 1st line in pregnancy, with Methyldopa ------------------------------------------ Nausea Headache Lupus-like Syndrome Reflex Tachycardia (use w/ beta blocker to block) (contraindicated in angina/CAD) Angina Water / Salt Retention (use w/ diuretic to block) |
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Minoxidil
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Vasodilator
K+ Channel opener -> Hyperpolarizes and relaxes vascular smooth muscle Severe Hypertension ------------------------------------------ Hypertrichosis Pericardial Effusion Reflex Tachycardia (use w/ beta blocker to block) Angina Salt Retention (use w/ diuretic to block) |
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Nifedipine
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Vasodilator
Block voltage-dependent L-type Ca2+ channels of cardiac and smooth muscle and so reduce contractility Vascular smooth muscle: Nifedipine > Diltiazem > Verapamil Heart: Verapamil > Diltiazem > Nifedipine Hypertension Angina Prinzmetal's Angina Raynaud's Phenomenon ------------------------------------------------ Cardiac Depression Dizziness Flushing Nausea Edema Constipation |
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Verapamil
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Vasodilator
Block voltage-dependent L-type Ca2+ channels of cardiac and smooth muscle and so reduce contractility Vascular smooth muscle: Nifedipine > Diltiazem > Verapamil Heart: Verapamil > Diltiazem > Nifedipine Arrhythmias Hypertension Angina Prinzmetal's Angina Raynaud's Phenomenon ------------------------------------------------ Cardiac Depression Dizziness Flushing Nausea Edema Constipation |
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Diazoxide
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Vasodilator
K+ Channel opener -> hyperpolarizes and relaxes vascular smooth muscle Malignant Hypertension ------------------------------------------ Hyperglycemia (reduces insulin release, hypotension) |
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Captopril
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ACE Inhibitor
-------------------------------------------- Hyperkalemia Cough Angioedema Taste Changes Hypotension Pregnancy Problem (fetal renal problems) Rash Renin |
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Enalapril
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ACE Inhibitor
----------------------------------------------- Hyperkalemia Cough Angioedema Taste Changes Hypotension Pregnancy Problem (fetal renal problems) Rash Renin |
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Fosinopril
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ACE Inhibitor
-------------------------------------------- Hyperkalemia Cough Angioedema Taste Changes Hypotension Pregnancy Problem (fetal renal problems) Rash Renin |
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Losartan
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Angiotensin II Receptor Blocker (ARB)
-------------------------------------------- Fetal Renal Toxicity Hyperkalemia |
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Diltiazem
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Vasodilator
Block voltage-dependent L-type Ca2+ channels of cardiac and smooth muscle and so reduce contractility Vascular smooth muscle: Nifedipine > Diltiazem > Verapamil Heart: Verapamil > Diltiazem > Nifedipine Arrhythmias Hypertension Angina Prinzmetal's Angina Raynaud's Phenomenon ------------------------------------------------ Cardiac Depression Dizziness Flushing Nausea Edema Constipation |
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Nitroglycerin
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Vasodilate by releasing NO in smooth muscle, causing increased cGMP and smooth muscle relaxation
veins >> arteries Decreases preload Angina Pulmoary Edema Aphrodisiac Erection Enhancer ----------------------------------------------- Tachycardia Hypotension Flushing Headache "Monday Disease" |
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Isosorbide Dinitrate
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Vasodilate by releasing NO in smooth muscle, causing increased cGMP and smooth muscle relaxation
veins >> arteries Decreases preload Angina Pulmonary Edema Aphrodisiac Erection Enhancer ----------------------------------------------- Tachycardia Hypotension Flushing Headache "Monday Disease" |
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Nitroprusside
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Short acting
Increases cGMP via direct release of NO Malignant Hypertension ------------------------------------------ Cyanide Toxicity (releases CN) |
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Fenolodpam
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Dopamine D1 receptor agonist -> relaxes renal vascular smooth muscle
Malignant Hypertension |
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Lovastatin
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HMG-CoA Reductase Inhibitor
(decreases mevalonate) Decreases LDL ----------------------------------------------- Reversible INCREASED LFTs Rhabdomyolysis |
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Pravastatin
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HMG-CoA Reductase Inhibitor
(decreases mevalonate) Decreases LDL ----------------------------------------------- Reversible INCREASES LFTs Rhabdomyolysis |
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Simvustatin
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HMG-CoA Reductase Inhibitor
(decreases mevalonate) Decreases LDL ----------------------------------------------- Reversible INCREASES LFTs Rhabdomyolysis |
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Atorvastatin
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HMG-CoA Reductase Inhibitor
(decreases mevalonate) Decreases LDL ----------------------------------------------- Reversible INCREASES LFTs Rhabdomyolysis |
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Rosuvastatin
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HMG-CoA Reductase Inhibitor
(decreases mevalonate) Decreases LDL ----------------------------------------------- Reversible INCREASES LFTs Rhabdomyolysis |
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Niacin
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Inhibits lipolysis in adipose tissue
Reduces hepatic VLDL secretion into circulation Increases HDL --------------------------------------------- Red, Flushed face (decrease with aspirin or long-term use) |
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Cholestyramine
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Bile Acid Sequestrant
Prevents intestinal reabsorption of bile acids Liver must use cholesterol to make Decreases LDL ------------------------------------------------ Patients hate it Tastes bad GI discomfort Decrease absorption of ADEK Contraindicated in Gallstones |
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Colestipol
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Bile Acid Sequestrant
Prevents intestinal reabsorption of bile acids Liver must use cholesterol to make Decreases LDL ------------------------------------------------ Patients hate it Tastes bad GI discomfort Decrease absorption of ADEK Contraindicated in Gallstones |
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Colesevelam
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Bile Acid Sequestrant
Prevents intestinal reabsorption of bile acids Liver must use cholesterol to make Decreases LDL ------------------------------------------------ Patients hate it Tastes bad GI discomfort Decrease absorption of ADEK Contraindicated in Gallstones |
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Ezetimibe
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Cholesterol Absorption Blockers
Prevents cholesterol reabsorption at small intestinal brush border Decreases LDL ------------------------------------------------- Rare Increased LFTs |
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Gemfibrozil
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Upregulates LPL to increase Triglyceride clearance
Decreases TG -------------------------------------------------- Myositis Increases LFTs |
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Clofibrate
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Upregulates LPL to increase Triglyceride clearance
Decreases TG -------------------------------------------------- Myositis Increases LFTs |
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Fenofibrate
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Upregulates LPL to increase Triglyceride clearance
Decreases TG -------------------------------------------------- Myositis Increases LFTs |
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Digoxin
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Direct inhibition of Na/K ATPase leads to indirect inhibition of Na/Ca exchanger to increase intracellular Ca
CHF Atrial Fibrillation -------------------------------------------Blurry Yellow Vision Arrhythmia Toxicity increased by hypokalemia Antidote is K+, Lidocaine, Digi-bind Fab fragments, Mg2+ |
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Quinidine
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Class IA Antiarrhythmic
Na+ channel blocker Atrial and Ventricular Arrhythmias Reentrant and Ectopic Supraventricular and Ventricular Arrhythmias ------------------------------------------ Cinchonism (headache, tinnitus, thrombocytopenia, torsades de pointes |
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Procainamide
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Class IA Antiarrhythmic
Na+ channel blocker Atrial and Ventricular Arrhythmias Reentrant and Ectopic Supraventricular and Ventricular Arrhythmias ------------------------------------------------------ Reversible SLE-like Syndrome |
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Disopyramide
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Class IA Antiarrhythmic
Na+ channel blocker Atrial and Ventricular Arrhythmias Reentrant and Ectopic Supraventricular and Ventricular Arrhythmias |
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Lidocaine
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Class IB Antiarrhythmic
Na+ channel blocker Acute Ventricular Arrhythmia Digitalis-induced Arrhythmia ---------------------------------------- Local Anesthetic CNS stimulation/depression Cardiovascular Depression |
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Mexiletine
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Class IB Antiarrhythmic
Na+ channel blocker Acute Ventricular Arrhythmia Digitalis-induced Arrhythmia ---------------------------------------- Local Anesthetic CNS stimulation/depression Cardiovascular Depression |
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Tocainide
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Class IB Antiarrhythmic
Na+ channel blocker Acute Ventricular Arrhythmia Digitalis-induced Arrhythmia ---------------------------------------- Local Anesthetic CNS stimulation/depression Cardiovascular Depression |
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Flecanide
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Class IC Antiarrhythmic
Ventricular Tachycardia that progresses to Ventricular Fibrillation Intractable Supraventricular Tachycardia Last resort in refractory tachyarrythmias ------------------------------------------ For patients without structural abnormalities Proarrhythmic, especially post-MI Prolongs refractory period in AV node |
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Encainide
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Class IC Antiarrhythmic
Ventricular Tachycardia that progresses to Ventricular Fibrillation Intractable Supraventricular Tachycardia Last resort in refractory tachyarrythmias ------------------------------------------ For patients without structural abnormalities Proarrhythmic, especially post-MI Prolongs refractory period in AV node |
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Propafenone
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Class IC Antiarrhythmic
Ventricular Tachycardia that progresses to Ventricular Fibrillation Intractable Supraventricular Tachycardia Last resort in refractory tachyarrythmias ------------------------------------------ For patients without structural abnormalities Proarrhythmic, especially post-MI Prolongs refractory period in AV node |
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Propanolol
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Class II Antiarrythmic
Beta-blocker Ventricular Tachycardia Supraventricular Tachycardia Atrial Fibrillation/Flutter ----------------------------------------- Impotence Asthma Bradycardia, AV Block, CHF Sedation, Sleep disturbance May mask hypoglycemia |
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Esmolol
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Class II Antiarrythmic
Beta-blocker Ventricular Tachycardia Supraventricular Tachycardia Atrial Fibrillation/Flutter ----------------------------------------- Impotence Asthma Bradycardia, AV Block, CHF Sedation, Sleep disturbance May mask hypoglycemia |
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Metoprolol
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Class II Antiarrythmic
Beta-blocker Ventricular Tachycardia Supraventricular Tachycardia Atrial Fibrillation/Flutter ----------------------------------------- Impotence Asthma Bradycardia, AV Block, CHF Sedation, Sleep disturbance May mask hypoglycemia DYSLIPIDEMIA |
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Atenolol
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Class II Antiarrythmic
Beta-blocker Ventricular Tachycardia Supraventricular Tachycardia Atrial Fibrillation/Flutter ----------------------------------------- Impotence Asthma Bradycardia, AV Block, CHF Sedation, Sleep disturbance May mask hypoglycemia |
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Timolol
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Class II Antiarrythmic
Beta-blocker Ventricular Tachycardia Supraventricular Tachycardia Atrial Fibrillation/Flutter ----------------------------------------- Impotence Asthma Bradycardia, AV Block, CHF Sedation, Sleep disturbance May mask hypoglycemia |
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Sotalol
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Class III Antiarrhythmic
K+ channel blocker Use when other anti-arrhythmics fail ----------------------------------------------- Torsades de Pointes Excessive Beta-block |
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Ibutilide
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Class III Antiarrhythmic
K+ channel blocker Use when other anti-arrhythmics fail ---------------------------------------------- Torsades de Pointes |
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Bretylium
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Class III Antiarrhythmic
K+ channel blocker Use when other anti-arrhythmics fail --------------------------------------------- New arrhythmias Hypotension |
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Amiodarone
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Class III Antiarrhythmic
K+ channel blocker Use when other anti-arrhythmics fail ------------------------------------------ Pulmonary Fibrosis Hepatotoxicity Hypo/Hyperthyroidism Corneal deposits Skin deposits, photodermatitis Neurologic effects Check PFTs, LFTs, TFTs |
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Verapamil
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Class IV Antiarrhythmic
Ca2+ channel blockers Prevent Nodal Arrythmias (SVT) --------------------------------------------- Constipation Flushing Edema AV Block, CHF, Sinus node depression |
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Diltiazem
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Class IV Antiarrhythmic
Ca2+ channel blockers Prevent Nodal Arrythmias (SVT) --------------------------------------------- Constipation Flushing Edema AV Block, CHF, Sinus node depression |
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Adenosine
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Increases K+ out of cells to hyperpolarize them and decreases inward Ca2+ current
Drug of choice in diagnosing/abolishing AV nodal arrhythmias ------------------------------------------Hypotension Flushing Chest pain |
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K+
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Depresses ectopic pacemakers in hypokalemia (digoxin toxicity)
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Mg2+
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Effective in Torsades de Pointes and Digoxin toxicity
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Lispro
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Insulin
Short-acting Binds insulin receptor (tyrosine kinase activity) Type I DM Type II DM Life-threatening Hyperkalemia Stress-induced Hyperglycemia ------------------------------------------- Hypoglycemia Hypersensitivity Reaction |
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Aspart
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Insulin
Short-acting Binds insulin receptor (tyrosine kinase activity) Type I DM Type II DM Life-threatening Hyperkalemia Stress-induced Hyperglycemia ------------------------------------------- Hypoglycemia Hypersensitivity Reaction |
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Regular Insulin
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Insulin
Short-acting Binds insulin receptor (tyrosine kinase activity) Type I DM Type II DM Life-threatening Hyperkalemia Stress-induced Hyperglycemia ------------------------------------------- Hypoglycemia Hypersensitivity Reaction |
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NPH
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Insulin
Intermediate-acting Binds insulin receptor (tyrosine kinase activity) Type I DM Type II DM Life-threatening Hyperkalemia Stress-induced Hyperglycemia ------------------------------------------- Hypoglycemia Hypersensitivity Reaction |
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Glargine
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Insulin
Long-acting Binds insulin receptor (tyrosine kinase activity) Type I DM Type II DM Life-threatening Hyperkalemia Stress-induced Hyperglycemia ------------------------------------------- Hypoglycemia Hypersensitivity Reaction |
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Detemir
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Insulin
Long-acting Binds insulin receptor (tyrosine kinase activity) Type I DM Type II DM Life-threatening Hyperkalemia Stress-induced Hyperglycemia ------------------------------------------- Hypoglycemia Hypersensitivity Reaction |
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Tolbutamide
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Sulfonylurea
Closes K+ channel in beta-cell membrane so cell depolarizes triggering release of insulin via Ca2+ influx Stimulates release of endogenous insulin in Type II DM Requires some islet function so useless in Type I DM ---------------------------------------------- Disulfiram-like effects |
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Chlorpropamide
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Sulfonylurea
Closes K+ channel in beta-cell membrane so cell depolarizes triggering release of insulin via Ca2+ influx Stimulates release of endogenous insulin in Type II DM Requires some islet function so useless in Type I DM ---------------------------------------------- Disulfiram-like effects |
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Glyburide
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Sulfonylurea
Closes K+ channel in beta-cell membrane so cell depolarizes trigerring release of insulin via Ca2+ influx Stimulates release of endogenous insulin in Type II DM Requires some islet function so useless in Type I DM ---------------------------------------------- Hypoglycemia |
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Glimepiride
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Sulfonylurea
Closes K+ channel in beta-cell membrane so cell depolarizes trigerring release of insulin via Ca2+ influx Stimulates release of endogenous insulin in Type II DM Requires some islet function so useless in Type I DM ---------------------------------------------- Hypoglycemia |
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Glipizide
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Sulfonylurea
Closes K+ channel in beta-cell membrane so cell depolarizes trigerring release of insulin via Ca2+ influx Stimulates release of endogenous insulin in Type II DM Requires some islet function so useless in Type I DM ---------------------------------------------- Hypoglycemia |
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Metformin
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Biguanide
Possibly decreases gluconeogenesis, increases glycolysis, decreases serum glucose levels Overall acts as glucose sensitizer Oral hypoglycemic Can be used in patients without islet function ----------------------------------------- Lactic acidosis |
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Pioglitazone
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Glitazone
Inreases target cell response to insulin Used as monotherapy in Type II DM or combined ------------------------------------------------- Weight gain Hepatotoxicity Cardiovascular toxicity |
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Rosiglitazone
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Glitazone
Inreases target cell response to insulin Used as monotherapy in Type II DM or combined ------------------------------------------------- Weight gain Hepatotoxicity Cardiovascular toxicity |
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Acarbose
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alpha-glucosidase Inhibitor
Inhibits intestinal brush border alpha-glucosidases Delayed sugar hydrolysis and glucose absorption leads to decreased postprandial hyperglycemia Used as monotherapy in Type II DM or in combination ------------------------------------------- GI disturbances |
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Miglitol
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alpha-glucosidase Inhibitor
Inhibits intestinal brush border alpha-glucosidases Delayed sugar hydrolysis and glucose absorption leads to decreased postprandial hyperglycemia Used as monotherapy in Type II DM or in combination ------------------------------------------- GI disturbances |
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Pramlintide
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Mimetic
Decreases Glucagon Type II DM ------------------------------------------- Hypoglycemia Nausea Diarrhea |
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Exenatide
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GLP-1 Mimetic
Increases Insulin Decreases Glucagon release Type II DM -------------------------------------------- Pancreatitis? Nausea Vomiting |
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Orlistat
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Alters fat metabolism by inhibiting pancreatic lipases
Long-term obesity management (with modified diet) Orlistat gets rid of FAT ------------------------------------------- Steatorrhea GI discomfort Reduced ADEK absorption Headache |
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Sibutramine
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Sympathomimetic Serotonin and NE reuptake inhibitor
Short-term and long-term obesity management ------------------------------------------- Hypertension Tachycardia |
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Propylthiouracil
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Inhibit organification and coupling of thyroid hormone synthesis
Decreases peripheral conversion of T4 to T3 Hyperthyroidism ------------------------------------------- Skin rash Agranulocytosis Aplastic anemia |
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Methimazole
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Inhibit organification and coupling of thyroid hormone synthesis
Hyperthyroidism ------------------------------------------- Skin rash Agranulocytosis Aplastic anemia |
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GH
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GH Deficiency
Turner's Syndrome |
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Somatostatin (Octreotide)
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Acromegaly
Carcinoid Gastrinoma Glucagonoma |
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Oxytocin
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Stimulates labor, uterine contractions, milk let-down
Controls uterine hemorrhage |
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ADH (desmopressin)
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Pituitary CENTRAL diabetes insipidus
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Levothyroxine
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Thyroxine replacement
Hypothyroidism Myxedema ----------------------------------------------- Tachycardia Heat intolerance Tremors Arrhythmias |
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Triiodothyronine
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Thyroxine replacement
Hypothyroidism Myxedema ----------------------------------------------- Tachycardia Heat intolerance Tremors Arrhythmias |
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Hydrocortisone
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Decreases production of leukotrienes and prostaglandins by inhibiting Phospholipase A2 and expression of COX-2
Addison's Disease Inflammation Immune Suppression Asthma ------------------------------------------- Cushings Syndrome Peptic ulcers Diabetes if chronic |
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Prednisone
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Decreases production of leukotrienes and prostaglandins by inhibiting Phospholipase A2 and expression of COX-2
Addison's Disease Inflammation Immune Suppression Asthma ------------------------------------------- Cushings Syndrome Peptic ulcers Diabetes if chronic |
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Triamcinolone
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Decreases production of leukotrienes and prostaglandins by inhibiting Phospholipase A2 and expression of COX-2
Addison's Disease Inflammation Immune Suppression Asthma ------------------------------------------- Cushings Syndrome Peptic ulcers Diabetes if chronic |
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Dexamethasone
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Decreases production of leukotrienes and prostaglandins by inhibiting Phospholipase A2 and expression of COX-2
Addison's Disease Inflammation Immune Suppression Asthma ------------------------------------------- Cushings Syndrome Peptic ulcers Diabetes if chronic |
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Beclomethasone
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Decreases production of leukotrienes and prostaglandins by inhibiting Phospholipase A2 and expression of COX-2
Addison's Disease Inflammation Immune Suppression Asthma ------------------------------------------- Cushings Syndrome Peptic ulcers Diabetes if chronic |
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Demeclocycline
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ADH antagonist
Member of tetracycline family SIADH ---------------------------------------------- Photosensitivity Abnormal bone and teeth Nephrogenic Diabetes Insipidus |
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Cimetidine
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H2 Blocker
Reversible block of histamine H2 receptors decreases H+ secretion by parietal cells Peptic ulcer Gastritis Esophageal Reflux -------------------------------------------- Inhibits CYP450 Prolactin release Gynecomastia Impotence Decreased libido Can cross BBB (confusion, dizziness, headache) Can cross placenta Decrease renal excretion of creatinine |
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Ranitidine
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H2 Blocker
Reversible block of histamine H2 receptors decreases H+ secretion by parietal cells Peptic ulcer Gastritis Esophageal Reflux ----------------------------------------------- Decrease renal excretion of creatinine |
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Famotidine
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H2 Blocker
Reversible block of histamine H2 receptors decreases H+ secretion by parietal cells Peptic ulcer Gastritis Esophageal Reflux |
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Nizatidine
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H2 Blocker
Reversible block of histamine H2 receptors decreases H+ secretion by parietal cells Peptic ulcer Gastritis Esophageal Reflux |
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Omeprazole
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Proton Pump Inhibitor
Irreversibly inhibits H/K ATPase in stomach parietal cells Peptic ulcers Gastritis Esophageal reflux Zollinger-Ellison Syndrome |
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Lansoprazole
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Proton Pump Inhibitor
Irreversibly inhibits H/K ATPase in stomach parietal cells Peptic ulcers Gastritis Esophageal reflux Zollinger-Ellison Syndrome |
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Bismuth
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Binds to ulcer base providing physical protection and allows HCO3- secretion to reestablish pH gradient in mucous layer
Increase ulcer healing Traveler's diarrhea |
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Sucralfate
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Binds to ulcer base providing physical protection and allows HCO3- secretion to reestablish pH gradient in mucous layer
Increase ulcer healing Traveler's diarrhea |
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Misoprostol
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A PGE1 analog that increases production and secretion of gastric mucous barrier
Decreases acid production Prevention of NSAID-induced peptic ulcers Maintenane of patent ductus arteriosus Induces labor -------------------------------------------- Diarrhea Contraindicated in women of child-bearing age (abortifacient) |
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Pirenzepine
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Blocks M1 receptors on ECL cells to decrease Histamine secretion and M3 receptors on parietal cells to decrease H+ secretion
Peptic ulcers -------------------------------------------- Tachycardia Dry mouth Difficulty focusing eyes |
|
|
Propantheline
|
Blocks M1 receptors on ECL cells to decrease Histamine secretion and M3 receptors on parietal cells to decrease H+ secretion
Peptic ulcers -------------------------------------------- Tachycardia Dry mouth Difficulty focusing eyes |
|
|
Aluminum Hydroxide
|
Antacids
------------------------------------------- Constipation Hypophosphatemia Proximal muscle weakness Osteodystrophy Seizures Hypokalemia |
|
|
Magnesium Hydroxide
|
Antacids
-------------------------------------------- Diarrhea Hyporeflexia Hypotension Cardiac arrest Hypokalemia |
|
|
Calcium Carbonate
|
Antacids
--------------------------------------------- Hypercalcemia Rebound acid secretion Hypokalemia |
|
|
Infliximab
|
Monoclonal antibody of TNF, proinflammatory cytokine
Crohn's Disease Rheumatoid arthritis -------------------------------------------- Respiratory infection (reactivation of latent TB) Fever Hypotension |
|
|
Sulfasalazine
|
Combination of sulfapyridine (antibacterial) and mesalamine (anti-inflammatory)
Activated by colonic bacteria Ulcerative colitis Crohn's Disease ------------------------------------------ Malaise Nausea Sulfonamide toxicity Reversible oligospermia |
|
|
Odansetron
|
5-HT3 antagonist
Powerful central-acting antiemetic Control vomiting post-op and in patients undergoing chemotherapy -------------------------------------------- Headache Constipation |
|
|
Metoclopramide
|
D2 receptor antagonist
Increases resting tone, contractility, LES tone, motility Does NOT influence colon transport time Diabetic and post-surgery gastroparesis ---------------------------------------------- Parkinson Effects Restlessness Drowsiness Fatigue Depression Nausea Diarrhea Drug interaction with Digoxin and Diabetic agents Contraindicated in patients with small bowel obstruction |
|
|
Heparin
|
Catalyzes the activation of Antithrombin III and decreases thrombin and Xa
Immediate anticoagulation for pulmonary embolism, stroke, MI Used during pregnancy Newer LMWH act more on Xa, more bioavailability, longer half-life ----------------------------------------------- Bleeding Osteoporosis Heparin Induce Thrombocytopenia (HIT) = heparin binds to platelets causing antibody production that destroys platelets and overactivates remaining ones, thrombocytopenic hypercoagulable state Protamine sulfate to reverse |
|
|
Lepirudin
|
Hirudin derivative
Directly inhibits thrombin Alternative to Heparin for anticoagulating patients with HIT |
|
|
Bivalirudin
|
Hirudin derivative
Directly inhibits thrombin Alternative to Heparin for anticoagulating patients with HIT |
|
|
Warfarin
|
Interferes with normal synthesis and gamma-carboxylation of Vit. K-dependent clotting factors
Metabolized by CYP450 Increases PT (Extrinsic pathway) Chronic anticoagulation Not used in pregnancy ------------------------------------------- Bleeding Teratogen Skin/Tissue Necrosis Drug-Drug Interactions |
|
|
Streptokinase
|
Converts plasminogen to plasmin which cleaves thrombin and fibrin clots
Increases PT and PTT Early MI, Ischemic stroke --------------------------------------------- Bleeding Aminocaproic acid is antidote (inhibits fibrinolysis) |
|
|
Urokinase
|
Converts plasminogen to plasmin which cleaves thrombin and fibrin clots
Increases PT and PTT Early MI, Ischemic stroke --------------------------------------------- Bleeding Aminocaproic acid is antidote (inhibits fibrinolysis) |
|
|
t-PA (Alteplase)
|
Converts plasminogen to plasmin which cleaves thrombin and fibrin clots
Increases PT and PTT Early MI, Ischemic stroke --------------------------------------------- Bleeding Aminocaproic acid is antidote (inhibits fibrinolysis) |
|
|
APSAC (Anistreplase)
|
Converts plasminogen to plasmin which cleaves thrombin and fibrin clots
Increases PT and PTT Early MI, Ischemic stroke --------------------------------------------- Bleeding Aminocaproic acid is antidote (inhibits fibrinolysis) |
|
|
Aspirin
|
Acetylates and irreversibly inhibits COX-1 and COX-2 to prevent conversion of arachidonic acid to TXA2
No effect on PT or PTT Increases Bleeding Time Antipyretic, Analgesic, Anti-inflammatory, anti-platelet ------------------------------------------------ Gastric ulcers Bleeding Hyperventilation Reye's Syndrome Tinnitus (CN VIII) |
|
|
Clopidogrel
|
Inhibits platelet aggregation by irreversibly blocking ADP receptors
Inhibits fibrinogen by preventing glycoprotein IIb/IIIa expresion Acute Coronary Syndrome, Coronary Stenting Decrease incidence/recurrence of thrombotic stroke ---------------------------------------------- Neutropenia |
|
|
Ticlopidine
|
Inhibits platelet aggregation by irreversibly blocking ADP receptors
Inhibits fibrinogen by preventing glycoprotein IIb/IIIa expresion Acute Coronary Syndrome, Coronary Stenting Decrease incidence/recurrence of thrombotic stroke ---------------------------------------------- Neutropenia |
|
|
Abciximab
|
Monoclonal antibody that binds to the glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation
Acuta Coronary Syndrome, Percutaneous transluminal coronary angioplasty ------------------------------------------- Bleeding Thrombocytopenia |
|
|
Methotrexate
|
S-phase specific antimetabolite
Folic acid analog that inhibits Dihydrofolate reductase causing decreased dTMP and thus decreased DNA and protein synthesis Leukemias / Lymphomas Choriocarcinoma Sarcoma Abortion Ectopic Pregnancy Rheumatoid Arthritis Psoriasis -------------------------------------------- Myelosuppression (reversible with Leucovorin or folinic acid Macrovesicular fatty change in liver Mucositis |
|
|
5-Fluorouracil
|
S-phase specific antimetabolite
Pyrimidine analog bioactivated to 5F-dUMP which covalently complexes folic acid Complex inhibits thymidylate synthase causing decreased dTMP and decreased DNA and protein synthesis Colon cancer and solid tumors Basal cell carcinoma (topical) Synergy with Methotrexate -------------------------------------------- Myelosuppression (NOT reversible with Leucovorin) Photosensitivity Rescue with Thymidine |
|
|
6-Mercaptopurine
|
Blocks de novo purine synthesis
Activated by HGPRTase Leukemia / Lymphoma (NOT CLL or Hodgkin's) -------------------------------------------- Bone marrow GI Liver Metabolized by Xanthine Oxidase so increased toxicity with Allopurinol |
|
|
Cytarabine
|
Inhibits DNA polymerase
AML, ALL High-grade non-Hodgkin's Lymphoma ------------------------------------------- Leukopenia Thrombocytopenia Megaloblastic anemia |
|
|
Cyclophosphamide
|
Alkylating agents
Covalently cross-links (interstrand) DNA at guanine N-7 Requires bioactivation by Liver Non-Hodgkin's Lymphoma Breast / Ovarian Carcinomas Immunosuppressant ------------------------------------------ Myelosuppression Hemorrhagic Cystitis (prevent with Mesna) |
|
|
Ifosfamide
|
Alkylating agents
Covalently cross-links (interstrand) DNA at guanine N-7 Requires bioactivation by Liver Non-Hodgkin's Lymphoma Breast / Ovarian Carcinomas Immunosuppressant ------------------------------------------ Myelosuppression Hemorrhagic Cystitis (prevent with Mesna) |
|
|
Carmustine
|
Nitrosourea
Alkylate DNA Require bioactivation Cross BBB to CNS Brain tumors (including glioblastoma multiforme) --------------------------------------------- CNS Toxicity (dizziness, ataxia) |
|
|
Lomustine
|
Nitrosourea
Alkylate DNA Require bioactivation Cross BBB to CNS Brain tumors (including glioblastoma multiforme) --------------------------------------------- CNS Toxicity (dizziness, ataxia) |
|
|
Semustine
|
Nitrosourea
Alkylate DNA Require bioactivation Cross BBB to CNS Brain tumors (including glioblastoma multiforme) --------------------------------------------- CNS Toxicity (dizziness, ataxia) |
|
|
Streptozocin
|
Nitrosourea
Alkylate DNA Require bioactivation Cross BBB to CNS Brain tumors (including glioblastoma multiforme) --------------------------------------------- CNS Toxicity (dizziness, ataxia) |
|
|
Cisplatin
|
Cross-links DNA
Testicular Carcinoma Bladder Carcinoma Ovarian Carcinoma Lung Carcinoma -------------------------------------------- Nephrotoxicity Acoustic nerve damage |
|
|
Carboplatin
|
Cross-links DNA
Testicular Carcinoma Bladder Carcinoma Ovarian Carcinoma Lung Carcinoma -------------------------------------------- Nephrotoxicity Acoustic nerve damage |
|
|
Busulfan
|
Alkylates DNA
CML Ablating bone marrow in hematopoietic stem cell transplants ------------------------------------------- Pulmonary fibrosis Hyperpigmentation |
|
|
Doxorubicin (Adriamycin)
|
Generates free radicals and noncovalently intercalates in DNA (creating breaks in DNA strand to decrease replication)
ABVD Regimen for Hodgkin's Lymphoma Myeloma Sarcoma Breast / Ovary / Lung tumors -------------------------------------------- Cardiotoxicity Myelosuppression Marked alopecia Toxic extravasation |
|
|
Daunorubicin
|
Generates free radicals and noncovalently intercalates in DNA (creating breaks in DNA strand to decrease replication)
ABVD Regimen for Hodgkin's Lymphoma Myeloma Sarcoma Breast / Ovary / Lung tumors -------------------------------------------- Cardiotoxicity Myelosuppression Marked alopecia Toxic extravasation |
|
|
Dactinomycin (Actinomycin D)
|
Intercalates in DNA
Wilm's Tumor Ewing's Sarcoma Rhabdomyosarcoma ACTinomycin since kids ACT out ------------------------------------------- Myelosuppression |
|
|
Bleomycin
|
Induces formation of free radicals, which cause breaks in DNA strands
Testicular cancer Hodgkin's Lymphoma (ABVD Regimen) --------------------------------------------- Pulmonary fibrosis Skin changes Minimal myelosuppression |
|
|
Hydroxyurea
|
Inhibits Ribonucleotide reductase
and so decreases DNA synthesis (S-phase specific) Melanoma CML Sickle Cell Disease (increases HbF) --------------------------------------------- Bone marrow suppression GI Upset |
|
|
Etoposide (VP-16)
|
G2-phase specific agent that inhibits Topoisomerase II and increases DNA degradation
Small Cell Lung Cancer Small Cell Prostate Cancer Testicular Carcinoma ------------------------------------------- Myelosuppression GI Irritation Alopecia |
|
|
Prednisone
|
May trigger apoptosis, may even work on non-dividing cells
Cancer chemotherapy CLL Hodgkin's Lymphoma (MOPP Regimen) Immunosupression in autoimmune diseases ------------------------------------------ Cushing-like Symptoms Immunosuppression Cataracts Acne Osteoporosis Hypertension Peptic ulcers Hyperglycemia Psychosis |
|
|
Tamoxifen
|
SERMs
receptor antagonists in breast receptor agonist in bone Block the binding of estrogen to estrogen receptor + cells Breast cancer Prevent Osteoporosis ----------------------------------------------- Increase Endometrial carcinoma via partial agonist effects Hot flashes |
|
|
Raloxifene
|
SERMs
receptor antagonists in breast receptor agonist in bone Block the binding of estrogen to estrogen receptor + cells Breast cancer Prevent Osteoporosis ----------------------------------------------- Hot flashes |
|
|
Trastuzumab (Herceptin)
|
Monoclonal antibody against HER-2 (erb-B2)
Helps kill breast cancer cells that overexpress HER-2 possibly through antibody-dependent cytotoxicity (ADCC) Metastatic breast cancer ----------------------------------------- Cardiotoxicity |
|
|
Imatinib (Gleevac)
|
Philadelpia chromosome bcr-abl tyrosine kinase inhibitor
CML GI stromal tumors ------------------------------------------ Fluid retention |
|
|
Vincristine
|
M-phase specific alkaloids that bind to tubulin and block polymerization of microtubules so that mitotic spindle cannot form
Part of MOPP Regimen for Hodgkin's Lymphoma Wilm's Tumor Choriocarcinoma ------------------------------------------- Neurotoxicity (areflexia, peripheral neuritis) Paralytic ileus |
|
|
Vinblastine
|
M-phase specific alkaloids that bind to tubulin and block polymerization of microtubules so that mitotic spindle cannot form
Part of MOPP Regimen for Hodgkin's Lymphoma Wilm's Tumor Choriocarcinoma ------------------------------------------- Bone marrow suppression |
|
|
Paclitaxel
|
Taxol
M-phase specific agent that binds to tubulin and hyperstabilize polymerized microtubules so the mitotic spindle cannot break down (anaphase cannot occur) Ovarian / Breast carcinomas -------------------------------------------- Myelosuppression Hypersensitivity |
|
|
Aspirin
|
Irreversibly inhibits COX by covalent binding which decreases synthesis of both Thromboxane and Prostaglandins
Low dose to decrease platelet aggregation (<300mg-2400gm) ---------------------------------------------- Gastric upset Acute renal failure Interstitial nephritis Upper GI bleeding Reye's Syndrome in children with viral infection |
|
|
Ibuprofen
|
NSAID
Reversibly inhibits COX-1 and COX-2 Blocks Prostaglandin synthesis Antipyretic Analgesic Anti-inflammatory ------------------------------------------ Renal damage Aplastic anemia GI distress Ulcers |
|
|
Naproxen
|
NSAID
Reversibly inhibits COX-1 and COX-2 Blocks Prostaglandin synthesis Antipyretic Analgesic Anti-inflammatory ------------------------------------------ Renal damage Aplastic anemia GI distress Ulcers |
|
|
Indomethacin
|
NSAID
Reversibly inhibits COX-1 and COX-2 Blocks Prostaglandin synthesis Close patent ductus arteriosus Antipyretic Analgesic Anti-inflammatory ------------------------------------------ Renal damage Aplastic anemia GI distress Ulcers |
|
|
Ketorolac
|
NSAID
Reversibly inhibits COX-1 and COX-2 Blocks Prostaglandin synthesis Antipyretic Analgesic Anti-inflammatory ------------------------------------------ Renal damage Aplastic anemia GI distress Ulcers |
|
|
Celecoxib
|
COX-2 Inhibitor
Reversibly inhibits COX-2 found in inflammatory cells and vascular endothelium and mediates inflammation and pain Spares COX-1 so maintains gastric mucosa Rheumatoid arthritis Osteoarthritis ------------------------------------------ Increased thrombosis Sulfa allergy Less ulcers and bleeding than NSAIDs |
|
|
Acetaminophen
|
Reversibly inhibits COX, mostly in CNS
Inactivated peripherally Antipyretic, Analgesic NO anti-inflammatory Used in children to prevent Reye's Syndrome in viral infection ------------------------------------------- Hepatic necrosis in overdose Metabolite depletes Glutathione and forms toxic tissue adducts in liver N-acetylcysteine is antidote (regenerates glutathione) |
|
|
Etridronate
|
Bisphosphonate
Inhibits osteoclastic activity Reduces formation and resorption of hydroxyapatite Malignancy-associated hypercalcemia Paget's Disease of bone Postmenopausal osteoporosis ------------------------------------------- Corrosive esophagitis Nausea Diarrhea |
|
|
Pamidronate
|
Bisphosphonate
Inhibits osteoclastic activity Reduces formation and resorption of hydroxyapatite Malignancy-associated hypercalcemia Paget's Disease of bone Postmenopausal osteoporosis ------------------------------------------- Corrosive esophagitis Nausea Diarrhea |
|
|
Alendronate
|
Bisphosphonate
Inhibits osteoclastic activity Reduces formation and resorption of hydroxyapatite Malignancy-associated hypercalcemia Paget's Disease of bone Postmenopausal osteoporosis ------------------------------------------- Corrosive esophagitis Nausea Diarrhea |
|
|
Risedronate
|
Bisphosphonate
Inhibits osteoclastic activity Reduces formation and resorption of hydroxyapatite Malignancy-associated hypercalcemia Paget's Disease of bone Postmenopausal osteoporosis ------------------------------------------- Corrosive esophagitis Nausea Diarrhea |
|
|
Colchicine
|
Chronic gout
Depolymerizes microtubules impairing leukocyte chemotaxis and degranulation ------------------------------------------- GI side effects (especially if orally given) Indomethacin is less toxic for use in acute gout Salicylates depress uric acid clearance |
|
|
Probenecid
|
Chronic gout
Inhibits reabsorption or uric acid in PCT (also inhibits secretion of Penicillin) Salicylates depress uric acid clearance |
|
|
Allopurinol
|
Chronic gout
Inhibits Xanthine oxidase and decreases conversion of xanthine to uric acid Used in Leukemia and Lymphoma to prevent tumor-lysis syndrome-associated urate nephropathy Increases concentrations of Azathioprine and 6-MP (both normally metabolized by Xanthine oxidase) Salicylates depress uric acid clearance |
|
|
Etanercept
|
Recombinant form of human TNF receptor that binds TNF
Rheumatoid arthritis Psoriasis Ankylosing spondylitis |
|
|
Infliximab
|
Anti-TNF antibody
Crohn's Disease Rheumatoid arthritis Ankylosing spondylitis |
|
|
Mannitol
|
Osmotic diuretic
Increases tubular fluid osmolarity producing increased urine flow Shock Drug overdose Decrease intracranial/intraocular pressure ----------------------------------------- Pulmonary edema Dehydration Contraindicated in anuria, CHF |
|
|
Acetazolamide
|
Carbonic anhydrase inhibitor
Causes self-limited NAHCO3 diuresis and reduction in total body HCO3- Glaucoma Urinary alkalinization Metabolic alkalosis Altitude sickness ------------------------------------------- Hyperchloremic metabolic acidosis Neuropathy NH3 toxicity Sulfa allergy ACIDazolamid causes acidosis |
|
|
Furosemide
|
Sulfonamide loop diuretic
Inhibits cotransport system (Na/K/2Cl) of thick ascending limb Abolishes hypertonicity of medulla, prevents concentrating of urine Increases Ca2+ excretion (Loops lose calcium) Edematous states (CHF, cirrhosis, nephrotic syndrome, pulmonary edema) Hypertension Hypercalcemia ---------------------------------------------- Ototoxicity Hypokalemia Dehydration Sulfa allergy Interstitial nephritis Gout OH DANG |
|
|
Ethacrynic Acid
|
Phenoxyacetic acid derivative (NOT a sulfonamide)
Inhibits cotransport system (Na/K/2Cl) of thick ascending limb Abolishes hypertonicity of medulla, prevents concentrating of urine Increases Ca2+ excretion (Loops lose calcium) Diuresis in patient allergic to sulfa drugs ------------------------------------------------- Ototoxicity Hypokalemia Dehydration Interstitial nephritis Gout Can be used in hyperuricemia OH DANG |
|
|
Hydrochlorothiazide
|
Thiazide diuretic
Inhibits NaCl reabsorption in early distal tubule, reducing diluting capacity of the nephron Decreases Ca2+ excretion Hypertension CHF Idiopathic hypercalciuria Nephrogenic diabetes insipidus ---------------------------------------------- Hypokalemic metabolic acidosis Hyponatremia Hyperglycemia Hyperlipidemia Hyperuricemia Hypercalcemia HyperGLUC Sulfa allergy |
|
|
Spironolactone
|
Competitive adlosterone receptor antagonist on the cortical collecting tubule
Hyperaldosteronism K+ depletion CHF ------------------------------------------------- Hyperkalemia (can lead to arrhythmias) Endocrine effects (gynecomastia, antiandrogen effects) |
|
|
Triamterene
|
Blocks Na+ channels in cortical collecting tubule
Hyperaldsteronism K+ depletion CHF ------------------------------------------------- Hyperkalemia (can lead to arrhythmias) Endocrine effects (gynecomastia, antiandrogen effects) |
|
|
Amiloride
|
Blocks Na+ channels in cortical collecting tubule
Hyperaldsteronism K+ depletion CHF ------------------------------------------------- Hyperkalemia (can lead to arrhythmias) Endocrine effects (gynecomastia, antiandrogen effects) |
|
|
Eplerenone
|
Blocks Na+ channels in cortical collecting tubule
Hyperaldsteronism K+ depletion CHF ------------------------------------------------- Hyperkalemia (can lead to arrhythmias) Endocrine effects (gynecomastia, antiandrogen effects) |
|
|
Captopril
|
ACE Inhibitor
Inhibits ACE reducing levels of angiotensin II and preventing inactivation of bradykinin (a vasodilator) Increases renin due to loss of feeedback Hypertension CHF Diabetic renal disease ------------------------------------------------- Cough Angioedema Proteinuria Taste changes Hypotension Teratogen (fetal renal damage) Increased renin Hyperkalemia Avoid with bilateral renal artery stenosis because ACE inhibitors reduce GFR by preventing constriction of efferent arterioles CAPTOPRIL |
|
|
Enalapril
|
ACE Inhibitor
Inhibits ACE reducing levels of angiotensin II and preventing inactivation of bradykinin (a vasodilator) Increases renin due to loss of feeedback Hypertension CHF Diabetic renal disease ------------------------------------------------- Cough Angioedema Proteinuria Taste changes Hypotension Teratogen (fetal renal damage) Increased renin Hyperkalemia Avoid with bilateral renal artery stenosis because ACE inhibitors reduce GFR by preventing constriction of efferent arterioles CAPTOPRIL |
|
|
Lisinopril
|
ACE Inhibitor
Inhibits ACE reducing levels of angiotensin II and preventing inactivation of bradykinin (a vasodilator) Increases renin due to loss of feeedback Hypertension CHF Diabetic renal disease ------------------------------------------------- Cough Angioedema Proteinuria Taste changes Hypotension Teratogen (fetal renal damage) Increased renin Hyperkalemia Avoid with bilateral renal artery stenosis because ACE inhibitors reduce GFR by preventing constriction of efferent arterioles CAPTOPRIL |
|
|
Finasteride (Propecia)
|
5-alpha reductase inhibitor
Decreases conversion of testosterone to DHT BPH Promotes hair growth (used in male-pattern baldness) ------------------------------------------ To prevent baldness, give a drug that encourages female breast growth |
|
|
Flutamide
|
A nonsteroidal competitive inhibitor of androgens at the testosterone receptor
Prostate carcinoma |
|
|
Ketoconazole
|
Inhibits steroid synthesis
PCOS to prevent hirsutism ------------------------------------------- Gynecomastia Amenorrhea |
|
|
Spironolactone
|
Inhibits steroid binding
PCOS to prevent hirsutism ------------------------------------------- Gynecomastia Amenorrhea |
|
|
Leuprolide
|
GnRH analog with agonist properties when used in pusatile fashion; antagonist properties when used in continuous fashion
Infertility (pulsatile) Prostate cancer (continuous) Uterine fibroids ------------------------------------------- Antiandrogen Nausea Vomiting Leuprolide used in LIEU or GnRH |
|
|
Sildenafil
|
Inhibits cGMP phosphodiesterase causing increased smooth muscle relaxation in the corpus cavernosum
Increases blood flow Erectile dysfunction --------------------------------------------- Headache Flushing Dyspepsia Impaired blue-green vision Life-threatening hypotension with Nitrates |
|
|
Vardenafil
|
Inhibits cGMP phosphodiesterase causing increased smooth muscle relaxation in the corpus cavernosum
Increases blood flow Erectile dysfunction --------------------------------------------- Headache Flushing Dyspepsia Impaired blue-green vision Life-threatening hypotension with Nitrates |
|
|
Mifepristone (RU-486)
|
Competitive inhibitor of progestins at progesterone receptors
Termination of pregnancy (given with Misoprostol [PGE1]) ------------------------------------------------ Heavy bleeding GI effects (nausea, vomiting, anorexia) Abdominal pain |
|
|
Oral Contraceptives (synthetic progestins, estrogen)
|
Prevent estrogen surge and thus prevent LH surge so ovulation does not occur
Reliable Decreased risk of ovarian / endometrial cancer Decreased ectopic pregnancy Decreased pelvic infections Regulates menses ------------------------------------------- Taken daily No protection against STDs Increases TG Depression Weight gain Hypertension Nausea Hypercoagulable state |
|
|
Hormone Replacement Therapy
|
Used for relief or prevention of menopausal symptoms (hot flashes, vaginal atrophy) and osteoporosis (due to decreased E2)
----------------------------------------------- Unopposed estrogen therapy increases risk of endometrial carcinoma so progesterone is added Increased cardiovascular risk |
|
|
Dinoprostone
|
PGE2 analog causing cervical dilation and uterine contraction
Induces labor |
|
|
Ritrodine
|
Beta-2 agonist that relaxes the uterus
Reduces premature uterine contractions |
|
|
Terbutaline
|
Beta-2 agonist that relaxes the uterus
Reduces premature uterine contractions |
|
|
Testosterone (Methyltestosterone)
|
Agonist at androgen receptors
Treats hypogonadism and promotes development of 2º sex chraracteristics Stimulates anabolism to promote recovery after burn or injury Treats estrogen-receptor + breast cancer (exemestane) --------------------------------------------- Masculinization in females Reduces intratesticular testosterone in males by inhibiting Leydig cells (leads to gonadal atrophy) Premature closure of epiphyseal plates |
|
|
Anastrazole
|
Aromatase inhibitor used in postmenopausal women with breast cancer
|
|
|
Exemestane
|
Aromatase inhibitor used in postmenopausal women with breast cancer
|
|
|
Ethinyl estradiol
|
Binds estrogen receptors
Hypogonadism in ovarian failure Menstrual abnormalities HRT in postmenopausal women Used in men with androgen-dependent prostate cancer ------------------------------------------ Increases risk of endometrial cancer Increases bleeding in postmenopausal women Increases thrombi risk Contraindicated in estrogen receptor + breast cancer |
|
|
DES
|
Binds estrogen receptors
Hypogonadism in ovarian failure Menstrual abnormalities HRT in postmenopausal women Used in men with androgen-dependent prostate cancer ------------------------------------------ Increases risk of endometrial cancer Increases bleeding in postmenopausal women Increases thrombi risk Contraindicaed in estrogen receptor + breast cancer Clear cell adenocarcinoma of vagina in females exposed to DES in utero |
|
|
Mestranol
|
Binds estrogen receptors
Hypogonadism in ovarian failure Menstrual abnormalities HRT in postmenopausal women Used in men with androgen-dependent prostate cancer ------------------------------------------ Increases risk of endometrial cancer Increases bleeding in postmenpausal women Increases thrombi risk Contraindicaed in estrogen receptor + breast cancer |
|
|
Progestin
|
Binds progesterone receptors
Reduces growth Increases vascularization of endometrium Used in oral contraceptives Treats endometrial cancer Treats abnormal uterine bleeding |
|
|
Clomiphene
|
SERM
Partial agonist at estrogen receptors in pituitary gland Prevents feedback inhibition and increases release of LH and FSH from pituitary which stimulates ovulation Treats infertility and PCOS -------------------------------------------- Hot flashes Ovarian enlargement Multiple spontaneous pregnancies Visual disturbances |
|
|
Tamoxifen
|
Antagonist on breast tissue
Treats and Prevents recurrence of estrogen receptor + breast cancer |
|
|
Raloxifene
|
Agonist on bone
Reduces resorption of bone Used to treat osteoporosis |
|
|
Diphenhydramine
|
1st Generation H1 blocker
Allergy Motion sickness Sleep aid -------------------------------------------- Sedation Anti-muscarinic Anti-alpha adrenergic |
|
|
Dimenhydrinate
|
1st Generation H1 blocker
Allergy Motion sickness Sleep aid -------------------------------------------- Sedation Anti-muscarinic Anti-alpha adrenergic |
|
|
Chlorpheniramine
|
1st Generation H1 blocker
Allergy Motion sickness Sleep aid -------------------------------------------- Sedation Anti-muscarinic Anti-alpha adrenergic |
|
|
Loratadine
|
2nd Generation H1 Blocker
Allergy -------------------------------------------- Less sedation (decreased entry into CNS) |
|
|
Fexofenadine
|
2nd Generation H1 Blocker
Allergy -------------------------------------------- Less sedation (decreased entry into CNS) |
|
|
Desloratadine
|
2nd Generation H1 Blocker
Allergy -------------------------------------------- Less sedation (decreased entry into CNS) |
|
|
Cetirizine
|
2nd Generation H1 Blocker
Allergy -------------------------------------------- Less sedation (decreased entry into CNS) |
|
|
Isoproterenol
|
Relaxes bronchial smooth muscle (beta-2)
Asthma ------------------------------------------ Tachycardia (beta-1) |
|
|
Albuterol
|
Relaxes bronchial smooth muscle (beta-2)
Use during acute exacerbation Asthma |
|
|
Salmeterol
|
Relaxes bronchial smooth muscle (beta-2)
Long-acting agent for prophylaxis Asthma -------------------------------------------- Tremor Arrhythmia |
|
|
Theophylline
|
Methylxanthine
Bronchodilation by inhibiting phosphodiesterase and decreasing cAMP hydrolysis Asthma ------------------------------------------ Narrow therapeutic index Cardiotoxicity Neurotoxicity Metabolized by CYP450 |
|
|
Ipratropium
|
Muscarinic Antagonist
Competitive block of muscarinic receptors preventing bronchoconstriction Asthma, COPD |
|
|
Cromolyn
|
Prevents release of mediators from mast cells
Effective only for the prophylaxis of asthma Not effective during acute attack Toxicity is rare |
|
|
Beclomethasone
|
Inhibits the synthesis of all cytokines
Inactives NF-kB, the transcription factor that induces the production of TNF-alpha and others 1st line treatment for chronic asthma |
|
|
Prednisone
|
Inhibits the synthesis of all cytokines
Inactives NF-kB, the transcription factor that induces the production of TNF-alpha and others 1st line treatment for chronic asthma |
|
|
Zileuton
|
5-lipoxygenase pathway inhibitor
Blocks conversion or arachidonic acid to leukotrienes |
|
|
Zafirlukast
|
Blocks leukotriene receptors
Especially good for aspirin-induced asthma |
|
|
Montelukast
|
Blocks leukotriene receptors
Especially good for aspirin-induced asthma |
|
|
Guafenesin (Robitussin)
|
Removes excess sputum but large doses necessary
Does not suppress cough reflex |
|
|
N-acetylcysteine
|
Mucolytic
Loosens musous plugs in CF patients Used as antidote for acetaminophen overdose |
|
|
Hydroxyurea
|
Inhibits ribonucleotide reductase
|
|
|
6-Mercaptopurine
|
Blocks de novo purine synthesis
|
|
|
5-Fluorouracil
|
Inhibits thymidylate synthase
|
|
|
Methotrexate
|
Inhibits DHF reductase
|
|
|
Trimethoprim
|
Inhibits DHF reductase
|
|
|
Fluoroquinolones
|
Inhibit DNA gyrase (prokaryotic topoisomerase)
|
|
|
Tetracyclines
|
Bind 30S subunit and prevent aminoacyl-tRNA attachment
|
|
|
Aminoglycosides
|
Inhibit formation of initiation complex and cause misreading of mRNA
|
|
|
Cloramphenicol
|
Inhibits 50S peptidyltransferase
|
|
|
Macrolides
|
Bind 50S and blocks translocation
|
|
|
Clindamycin
|
Binds 50S and blocks translocation
|
|
|
Ouabain
|
Binds K+ site on Na/K ATPase to inhibit it
|
|
|
Cyclosporine
|
Binds to cycophilins
Complex blocks the differentiation and activation of T cells by inhibiting calcineurin and thus preventing production of IL-2 and its receptor Suppresses organ rejection after transplant Selected autoimmune disorders --------------------------------------------- Predisposes to viral infections and lymphoma Nephrotoxic (prevent with mannitol diuresis) |
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Tacrolimus (FK506)
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Binds to FK binding protein and inhibits secretion of IL-2 and other cytokines
Potent immunosuppressive for organ transplants --------------------------------------------- Nephrtoxicity Peripheral neuropathy Hypertension Pleural effusion Hyperglycemia |
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Azathioprine
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Antimetabolite precursor of 6-MP that interferes with the metabolism and synthesis of nucleic acids
Toxic to proliferating lymphocytes Kidney transplants Autoimmune disorders (glomerulonephritis and hemolytic anemia) --------------------------------------------- Bone marrow suppression 6-MP metabolized by Xanthine oxidase so toxic with Allopurinol |
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Muromonab-CD3 (OKT3)
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Monoclonal antibody that binds CD3 (epsilon chain) on the surface of T cells
Blocks cellular interaction with CD3 protein responsible for T-cell signal transduction Immunosuppression after kidney transplant -------------------------------------------- Cytokine release syndrome Hypersensitivity reaction |
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Sirolimus (Rapamycin)
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Binds to mTOR
Inhibits T cell proliferation in response to IL-2 Immunosuppression after kidney transplant in combo with Cyclosporine and Corticosteroids ------------------------------------------- Hyperlipidemia Thrombocytopenia Leukopenia |
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Mycophenolate Mofetil
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Inhibits de novo guanine synthesis and blocks lymphocyte production
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Daclizumab
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Monoclonal antibody with high affinity for IL-2 receptor on activated T cells
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Aldesleukin (IL-2)
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Recombinant IL-2
Renal cell carcinoma Metastatic Melanoma |
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Erythropoietin (Epoietin)
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Anemias (especially in renal failure)
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Filgastrim (G-CSF)
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Recovery of bone marrow
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Sargramostim (GM-CSF)
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Recovery of bone marrow
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alpha-Interferon
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Hepatitis B / C
Kaposi's Sarcoma Leukemias Malignant Melanoma |
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beta-Interferon
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Multiple Sclerosis
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gamma-Interferon
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Chronic granulomatous disease
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Oprelvekin (IL-11)
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Thrombocytopenia
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Thrombopoietin
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Thrombocytopenia
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