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40 Cards in this Set

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Monoclonal antibody (MAb) to fibrin receptor (glycoprotein IIb/IIIa) on platelets. Use to prevent clotting after coronary angioplasty and in acute coronary syndrome. Eptifibatide and tirofiban have a similar action on this receptor to inhibit platelet cross-linking.
Antipyretic analgesic: very weak cyclooxygenase inhibitor; not anti-inflammatory. Less GI distress than aspirin but dangerous in overdose. Tox: hepatic necrosis. Antidote: acetylcysteine.
Carbonic anhydrase-inhibiting diuretic acting in the proximal convoluted tubule: produces a NaHCO₃ diuresis, results in bicarbonate depletion and, therefore, has self-limited action. Used in glaucoma and mountain sickness. Tox: paresthesias, hepatic encephalopathy. Dorzolamide and brinzolamide are topical analogs for glaucoma.
Cholinomimetic prototype: transmitter in CNS, ENS, all ANS ganglia, parasympathetic postganglionic synapses, sympathetic postganglionic fibers to sweat glands, and skeletal muscle endplate synapses.
Antiviral: inhibits DNA synthesis in herpes simplex virus (HSV) and varicella-zoster virus (VZV). Requires activation by viral thymidine kinase (TK negative strains are resistant). Tox: behavioral effects and nephrotoxicity (crystalluria) but minimal myelosuppresion. Famciclovir, penciclovir, and valacyclovir are similar but with longer half-lives.
Antiarrhythmic: unclassified (miscellaneous group); parental only. Hyperpolarizes AV nodal tissue, blocks conduction for 10-15 sec. Used for nodal reentry arrhythmias. Tox: hypotension, flushing, chest pain.
Typical β₂ agonist; important use in asthma. Tox: tachycardia, arrhythmias, tremor. Other drugs with similar action: metaproterenol, salmeterol, terbutaline.
Bisphosphonate; stabilizes bone structure and increases bone mineral density. Used in postmenopausal and steroid-induced osteoporosis. Tox: esophageal ulceration. Other bisphosphonates (eg, etidronate, pamidronate) are used in Paget's disease
Antigout: suicide inhibitor of xanthine oxidase; reduces production of uric acid. Used in gout and adjunctively in cancer chemotherapy
Benzodiazepine sedative-hypnotic: used in anxiety states, selectivity for panic attacks and phobias; possible antidepressant actions. Tox: psychological and physiologic dependence, additive effects with other CNS depressants.
Thrombolytic: human recombinant tissue plaminogen activator. Used in acute MI (to recanalize the occluded coronary), pulmonary embolism, stroke. Tox: bleeding.
Alteplase (t-PA)
K-sparing diuretic: blocks Na channels in cortical collecting tubules. Tox: hyperkalemia.
Class III (and other classes) antiarrhythmic: broad spectrum; blocks sodium, potassium, calcium channels, β receptors. High efficacy and very long half-life (weeks to months). Tox: deposits in tissues; skin coloration; hypo- or hyperthyroidism; pulmonary fibrosis.
Penicillin: wider spectrum than penicillin G with activity similar to ampicillin but greater oral bioavailability; fewer adverse effects on GI tract than ampicillin. Susceptible to penicillinases unless used with clavulanic acid. Tox: penicillin allergy
Indirectly acting sympathomimetic: displaces stored catecholamines in nerve endings. Marked CNS stimulant actions; high abuse liability. Used in attention deficit hyperactivity disorder, for short-term weight loss, and for narcolepsy. Tox: psychosis, HTN, MI, seizures. Other indirect-acting sympathomimetics: ephedrine, pseudoephedrine.
Antifungal: polyene drug of choice for some systemic mycoses; binds to ergosterol to disrupt fungal cell membrane permeability. Tox: chills and fever, hypotension, nephrotoxicity (dose limiting; less with liposomal forms).
Penicillin: wider spectrum than penicillin G, susceptible to penicillinases unless used with sulbactam. Activity similar to that of penicillin G, plus E coli, H influenzae, P mirabilis, Shigella. Synergy with aminoglycosides versus Enterococcus and Listeria. Tox: penicillin alergy, more adverse effects on GI tract than other penicillins; maculopapular skin rash.
Prototype aromatase inhibitor used in estrogen-dependent cancers (eg, breast cancer). Letrozole is similar.
NSAID prototyp: inhibits cyclooxygenase (COX)-1 and -2 irreversibly. Antiplatelet agent as well as antipyretic, analgesic and anti-inflammatory drug. Tox: GI ulcers, allergy, bronchoconstriction, salicylism. Other NSAIDS: ibuprofen, indomethacin, keterolac, naproxen, and piroxicam.
β₁ selective blocker: low lipid solubility, less CNS effect; used for HTN. (Names of β₁ selective blockers start with A through M except for carteolol, carvedilol, and labetolol.) Tox: asthma, bradycardia, AV block, heart failure.
Nonbenzodiazepine hypnotic, acts via the BZ₁ receptor subtype and is reversed by flumazenil; less amnesia and muscle relaxation and lower dependence liability than benzodiazepines. Zaleplon is similar, but shorter acting.
Antiviral: prototype NRTI used in combinations for HIV infections and in prophylaxis for needlesticks and vertical transmission. Tox: severe myelosuppresion. Other NRTIs: abacivir, didanosine (ddI), lamivudine (3TC), stavudine (d4T), and zalcitabine (ddC).
Zidovudine (ZDV)
Oral anticoagulant prototype: causes synthesis of nonfunctional versions of the vitamin K-dependent clotting factors (II, VII, IX, X). Tox: bleeding, teratogenic. Antidote: vitamin K, fresh frozen plasma.
Antineoplastic plant alkaloid: cell cycle (M phase)-specific agent; inhibits mitotic spindle formation: Tox: peripheral neuropathy. Vinblastine, a congener, causes myelosuppresion.
Calcium channel blocker prototype: blocks L-type channels; cardiac depressant and vasodilator; used in HTN, angina, and arrhythmias. Tox: AV block, CHF, constipation. Diltiazem, like this drug, has more depressant effect on heart than dihydropyridines (eg, nifedipine).
Glycopeptide bactericidal antibiotic: inhibits synthesis of cell wall precursor molecules. Drug of choice for methicillin-resistant staphylocci and effective in antibiotic-induced colitis. Dose reduction required in renal impairment (or hemodialysis). Tox: ototoxicity, hypersensitivity, renal dysfunction (rare).
Antivonvulsant: primary drug in absence, tonic-clonic, and myoclonic seizure states. Also used commonly for bipolar disorder. Tox: GI distress, hepatic necrosis (rare), teratogenic (spina bifida), inhibits drug metabolism.
Valproic acid
Indirectly acting sympathomimetic prototype: releases or displaces norepinephrine from stores in nerve endings. Presence in certain foods may cause potentially lethal hypertensive responses in patients taking MAO inhibitors.
Nondepolarizing neuromuscular blocking agent prototype: competitive nicotinic blocker. Releases histamine and may cause hypotension. Analogs: pancuronium, atracurium, vecuronium, and other "-curiums" and "-oniums". Tox: respiratory paralysis. Antidote: cholinesterase inhibitor, eg, neostigmine.
Antimicrobial drug combination: causes synergistic sequential blockade of folic acid synthesis. Active against many gram-negative bacteria, including Aeromonas, Enterobacter, H influenzae, Klebsiella, Moraxella, Salmonella, Serratia, and Shigella. Tox: mainly due to sulfonamide; includes hypersensitivity, myelotoxicity, kernicterus, and drug interactions caused by competition for plasma protein binding.
Trimethoprim-sulfamethoxazole (TMP-SMX)
Toxin: potent sodium channel blocker, blocks action potential propagation in nerve, heart, and skeletal muscle. From puffer fish, California newt. Tox: paresthesias, paralysis. Saxitoxin (paralytic shellfish poison) is similar.
Antibiotic: class prototype; bacteriostatic inhibitor of protein synthesis (30S). Broad spectrum, but many resistant organisms. Used for mycoplasmal, chlamydial, rickettsial infections, chronic bronchitis, acne, cholera; a backup drug in syphilis. Tox: GI upset and superinfections, Fanconi's syndrome, photosensitivity, dental enamel dysplasia.
Selective estrogen receptor modulator (SERM): blocks estrogen (E) receptors in breast tissue; activates endometrial E receptors. Used in E receptor-positive cancers, possibly prophylactic in high-risk patients. Toremifine is similar.
5-HT1D receptor agonst: used to abort migraine attacks. Tox: coronary vasospasm, chest pain, or pressure. Others: naratriptan, rizatriptan, zolmitriptan.
Depolarizing neuromuscular relaxant prototype: short duration (5 min) if patient has normal plasma cholinesterase (genetically determined). No antidote (compare with tubocurarine). Implicated in malignant hyperthermia.
Thrombolytic: protein from streptococci that accelerates plasminogen-to-plasmin conversion. Tox: bleeding, allergy.
Antibiotics: Syndercid is the combination of quinupristin and dalfopristin; bactericidal inhibitors of protein synthesis. Intravenous use for drug-resistant gram-positive cocci including MRSA (methicillin-resistant S aureus), VRE (vancomycin-resistant enterococci), and pneumococci. Tox: infusion-related pain, arthralgia, myalgia. Linezolid is another inhibitor of protein synthesis used for drug resistant gram-positive cocci, inluding PRSP (penicillin-resistant S pneumoniae) strains.
Class III antiarrhythmic prototype: blocks K channels. Used for atrial and ventricular arrhythmias. Tox: torsades de pointes arrhythmias. Others in group: ibutilide, dofetilide.
Aldosterone receptor antagonist: K-sparing diuretic action in the collecting tubules; used in aldosteronism, HTN, and female hirsutism (androgen receptor blocking action). Tox: hyperkalemia, gynecomastia. Eplerenone, used in HTN and HF, is a more selective aldosterone antagonist.
Inhibits phosphodiesterase (PDE) 5, preventing breakdown of cGMP, which promotes vascular vasodilation. Used for erectile dysfunction. Tox: severe hypotension when combined with nitrates, impaired blue-green color vision.