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98 Cards in this Set
- Front
- Back
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What are all the TB drugs? |
Rifampin Isoniazid Pyrazinamide Ethambutol |
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MOA of rifampin and ADRs? |
prevents mRNA synthesis (transcription) via binding to DNA polymerase
ADRs: hepatotoxic, pink urine and tears, exudative conj'itis |
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MOA of isoniazid and ADRs? |
Inhibits CW synth
ADRs: possible vit B6 deficiency = periph neuropathy, rarely optic neuritis/atrophy |
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MOA of ethambutol and ADRs? |
inhibits arabinosyl transferase (inhibits CW synth)
ADRs: OPTIC NEURITIS! Usually retro and bilateral, usually reversible but can be irreversible damage, colour vision defects |
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What is Tamiflu? |
inhibitor of influenza A and B neuroamidase which prevents spread of virus along mucous membranes
ADR: conj'itis |
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zidovudine/Retrovir |
- HIV therapy - nucleoside analogue of thymidine - inhibits reverse transcriptase - major of three component therapy for HIV - AZR used during preg to prevent transfer to fetus
ADRs: bone marrow suppression, lactic acidosis, myopathy, macular edema |
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ribavirin |
- Hep C therapy used with interferon
MOA: viral RNA polymerase inhibitor
ADRs: conj'itis most common RD, Ischemia, Bleeding (ret heme), A/V occlusions, Neuritis. |
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Herpes viruses are which type of virus?
How to antiherpetic meds work? |
DNA viruses
Inhibit DNA polymerase (inhibit viral DNA synth) |
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trifluridine (Viroptic) 1% |
- topical AV - HSV Keratitis - 1 gt 9x/day - contains thimerosal |
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acyclovir (Zovirax) valacyclovir (Valtrex) famciclovir (Famvir) |
indicated for cold sores, shingles, genital sores, HSV keratitis, VZV keratitis, phyphylaxis.
ADRs: HA and GI disturbances esp if renal dysfx |
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ganciclovir (Zirgan) |
topical DNA polymerase inhibitor (only need 1 gt 5-6x/day) and reduced toxicity (BZK instead of thimerosal)
Indicated for HSV keratitis and CMV retinitis |
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foscarnet (Foscavir) |
tx for CMV retinitis when ganciclovir fails OR for HSV keratitis in px with AIDS - IV injection - |
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natamycin (Natacyn) |
anti fungal
MOA: bind to ergosterol and forms pores leading to cell death |
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Amphotericin B |
BS anti fungal available topical and IV
nephrotoxic |
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nystatin |
used for Candida oral infections, yeast infections (not ophthalmic use) |
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ketoconazole (Nizoral) fluconazole (Diflucan) |
MOA: inhibits synth of ergosterol
hepatotoxic and increasing resistance |
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chloroquine |
MOA: causes heme buildup which is toxic to intraerythrocytic malaria parasite; also inhibits PL-A
ADRs: whorl keratopathy, Bull's eye maculopathy*
*chloroquine binds to melanin in RPE cells causing localized RPE damage and migration into ONL and OPL |
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RFs for retinopathy if px on chloroquine? |
dose > 3 mg/kg/day duration of tx > 5yrs Age > 60 Liver disease Kidney disease Other retinal disease High %Body fat
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hydroxychloroquine |
MOA inhibits PLA2 Indications: Lupus, RA, Malaria prophylaxis
ADRs: whorl keratopathy (only at supra therapeutic doses), Bull's eye mac |
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RFs for retinopathy if px on hydroxychloroquine? |
dose > 6.5 mg/kg/day dose > 400 mg Weight < 135 lbs if on std dose Kidney disease Liver disease Duration of tx > 5 years Age > 60 High %Body fat Other retinal disease |
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triamcinolone (Kenalog) |
MOA - steroid, inhibits PLA2
DME, Grave disease, intermediate uveitis, chronic CME
ADRs: increased IOP, endophthalmitis, depigmentation of eyelid in darker skinned ppl |
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aspirin |
MOA Irreversible COX-1 and COX-2 inhibitor
antipyretic, anti-inflamm, analgesic, anticoagulant
ADRs: Reye syndrome in children, hemes |
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indomethacin (Indocin) ibuprofen (Advil, Motrin) naproxen |
MOA reversible COX-1 and COX-2 inhibtor
ADRs: hemes, GI bleeding, MI, CV events. Contraindicated in px with H/O CAD or stroke.
ibuprofen approved age 6 months |
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ADRs of indomethacin? |
in addition to GI bleeding, hemes, MI, CV events: - whorl keratopathy and pigmentary changes in macula |
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misoprostol (Cytotec) |
PGE1 (similar to PGE2)
prevention and tx of NSAID related stomach ulcers |
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celecoxib (celebrex) |
selective COX-2 inhibitor.
ADRs: SJS, conj'itis |
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pseudoephedrine (Sudafed) |
nonspecific alpha and beta adrenergic agonist
ADRs: tachycardia, nervousness, diplopia, blurred VA, caution if high IOP |
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Where are H1 and H2 receptors located |
H1: SM of bronchi, BVs and intestine
H2: GI parietal cells, pulmonary BVs, heart, immune cells |
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diphenhydramine brompheniramine promethazine |
first generation H1 blocker
ADRs: causes drowsiness (penetrates CNS), mydriasis, DE, dry mouth tachycardia |
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fexofenadine (Allegra) loratadine (Claritin) |
second generation H1 blockers - less lipid soluble so less CNS effects
ADRs: oculogyric crisis, DE, dry mouth |
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ranitidine (Zantac) cimetidine (Tagamet) |
MOA: bind to H2 receptor on parietal cells, prevents histamine stimulation of gastric acid secretion
ADRs: gynecomastia, loss of libido, diarrhea |
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esomeprazole (Nexium) |
proton pump inhibitor
inhibits H+/K+/ATPase pump
indication: GERD |
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sucralafate |
binds to damages stomach ulcer tissue (protects against acid) |
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salmeterol |
long acting beta-2 agonist
used for maintenance of COPD and asthma symptoms (not as rescue inhaler) |
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terbutaline albuterol |
(Ventolin)
short acting beta 2 agonist
rescue inhalers for px with asthma/COPD |
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isoproteranol |
nonspecific beta agonist |
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ipratopium |
(Atorvent)
muscarinic antagonist!!!
Blocks M receptors @ bronchial SM
Caution if narrow angles |
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zafirlukast motelukast |
leukotriene receptor antagonists
indications: asthma, allergic rhinits |
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theophylline (Theo-Dur) |
Inhibits PDE = increased cAMP
narrow therapeutic index
Beta blockers can mitigate bronchodilatory effect |
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acetylcysteine (MucoMyst) |
Breaks disulphide bonds in mucous to reduce viscosity |
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methotrexate |
MOA: inhibits dihydrofolate reductase (inhibits DNA synthesis)
AND in RA immunosuppressant and anti-inflammatory
ADR: myelosuppression = increased risk for opportunistic infection
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cyclosprorine |
MOA: prevents rejection of organ transplants via inhibition of the release and production of IL-2 (responsible for activation of T-cells)
ADRs: opportunistic infection, malignancies, kidney dysfx, |
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What is Reversible Posterior Leukoencephalopathy Syndrome |
- HA - altered consciousness, seizures - visual disturbances - Dx by MRI |
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azathioprine |
purine analogue therefore inserts into DNA/RNA and stops replication indications: RA, prevention of kidney rejection, ocular myesthenia
ADRs: high risk of secondary lymphoma |
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tamoxifen |
indications: tx of BC used during tx and for 5 yrs after MOA: competitive inhibition at estrogen receptors (affects cancer cells in the breast)
ADRs: crystalline retinopathy, whorl keratopathy, thromboembolism, |
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acetaminophen |
MOA: unknown
indications: analgesic, antipyretic
* Can be used in px of ALL ages including newborns
ADRs: hepatotoxic |
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cyclobenzaprine |
MOA: decreases voluntary motor activity (inhibits tonic activity of alpha and gamma motor neurons)
indication: tx of muscle spasm
ADRs: anticholinergic effects |
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tramadol |
Mu receptor agonist (but NOT a true opiate)
inhibits serotonin and norepinephrine uptake within ascending pain pathways
ADRs: dry mouth, dizziness, sedation, nausea |
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meperidine |
opiate analgesic Mu, Kappa and Delta receptor agonist; potent and addictive
ADRs: miosis, resp. depression, drowsiness, sedation, papilledema, seizures |
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naloxone |
opioid antagonist used to reverse effects of opiates |
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sumatriptan |
5-HT1B and 1D receptor agonist present on vascular SM cells of cranial arteries
ADRs: systemic vasoconstriction |
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chlorpromazine thiridazine |
antipsychotic Dopa receptor antagonist |
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amantadine (Symmetrel) |
potentiates dopamine effects (blocks reuptake augments release of dopamine)` |
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bromocriptine |
dopa agonist also used to treat pituitary adenomas |
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methylphenidate (Ritalin) |
ADHD meds recall also increase dopa release
ADRs mydriasis and DE |
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donepezil |
(Aricept) CNS acetylcholinesterase inhibitor!!!
ADRs cats, blurred VA, low IOP |
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MOA of antidepressants? |
increase serotonin levels in CNS TCAs and MAOIs also increase norepinephrine ADRs: weight gain, fatigue, sexual dysfunction |
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MOA of Prozac? |
this is a SSRI inhibits reuptake of serotonin in CNS |
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Why SSRI better than TCA or MAOI |
- less ADRs - less dangerous - no anticholinergic effects - less drug interactions - not fatal if overdose - no interactions with food, wine etc |
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What is serotonin syndrome? |
excess serotonin - mental status change - autonomic hyperactivity - tremor |
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amitryptiline |
TCA inhibits NE and serotonin reuptake |
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imipramine |
TCA inhibits NE and serotonin reuptake |
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phenelzine |
MAOI recall MAO responsible for breaking down NE and serotonin
* interacts with tyramine in foods * glauc and nystagmus known ADRs |
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What can occur when MAOI and TCA taken simultaneously? |
- serotonin syndrome - lethal hypertensive crisis |
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diazepam |
anxiolytic binds GABA causing hyper polarization and open Cl channels indication: sedation, alcohol W/D |
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phenytoin |
anticonvulsant - acts on GABA NE and ACh
ADRs: nystagmus, diplopia, EOM palsy, ataxis, gingival hyperplasia |
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phenobarbitol |
anticonvulsant MOA: AMPA receptor blockade reduced excitatory trans - seizures - sedation |
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topiramate |
anticonvulsant ADRs: nystag, diplop, blurred VA rare: conjunc'itis, lacrimation changes, myopia, choroidal edema, acute angle closure |
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Name the classes of meds for DM |
- biguanides - sulfonylureas - thiazolidinediones |
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metformin |
biguanide MOA decreases gluconeogenesis Doesn't cause hypoglycaemia! |
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glipizide glyburide chlorpropamide |
sulfonylureas increase secretion of insulin from beta cells, decrease glucagon release, increase sensitivity to insulin ADRs: sulfa moieties, can cause severe hypoglycaemia |
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caution os beta blockers in px with DM? |
- beta blockers mimic signs of hypoglycaemia and hypothyroidism - increased risk of hypoglycaemia if px is taking sulfonyureas |
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pioglitazone |
thiazolidinadione activates peroxisome proliferator activated gamma (increase glucose uptake into muscle and fat tissues) - insulin resistance ADRs: macular edema |
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sildenafil vardenafil |
phosphodiesterase inhibitors (PDE-5 breaks down cGMP in penis during erection) ADRs: priapism, flushing, HA, cyanopsia, NAION, photosensitivity |
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prazosin |
alpha-1 antagonist used in tx of benign prostatic hypertrophy (relaxes SM in urinary tract; decreases obstruction to urinary outflow) - can tx HTN |
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terazosin |
alpha-1 antagonist used in tx of benign prostatic hypertrophy (relaxes SM in urinary tract; decreases obstruction to urinary outflow) - can tx HTN |
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tamsulosin |
alpha-1 antagonist used in tx of benign prostatic hypertrophy (relaxes SM in urinary tract; decreases obstruction to urinary outflow) - floppy iris syndrome |
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Name classes of antihypertensives |
1. ACE inhibitors 2. Angiotensin-II receptor antagonists 3. Beta blockers 4. Ca2+ channel blockers 5. Diuretics 6. Other |
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lisinoril |
ACE inhib (prevents formation of AT2 and stops bradykinin activity) ADRs: cough, angioedema |
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losartan |
Angiotensin II receptor antagonist (inhib AT2 contraction of SM and stim of aldosterone secretion) |
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propranolol labetolol |
nonselective beta 1 and 2 antagonist also block release of renin from kidney |
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metoprolol atenolol |
beta-1 selective antagonist |
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verapamil |
Ca2+ channel blocker - decreases peripheral vascular resistance - decreases contractility (major effect)
* since increases peripheral vascular resistance, some benefit in tx of glaucoma |
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furosemide |
loop diuretic |
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hydrochlorothiazide |
diuretic acts on DCT for HTN - inhibits NaCl reabsorption - dcreases Ca2+ excretion into loop
ADRs: acute ACG, transient myopia |
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spironolactone |
K+ sparing diuretic blocks aldosterone action at DCT and CD
ADRs: hyperkalemia, antiandrogen effects |
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mannitol |
hyperosmotic diuretic increases plasma osmolarity
contraindications: kidney failure, dehydration, pulmonary edema |
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clonidine |
CNS alpha 2 agonist (decreases sympathetic outflow, increases parasymp) - decreases PVR and HR |
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digoxin |
tx of CHF inhibits Na/K/ATPase enzyme (increases intracellular Ca2+) ADRs: retrobulbar neuritis, BY colour defect, entoptic phenomenon |
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amiodarone |
anti arrhythmia Blocks K+ channels ADRs: whorl keratopathy, NAION, anterior lens deposits |
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warfarin |
vitamin K antagonist also interferes with clotting factors II VII IX X - D/C 96-115 hrs pre cat sx - no preg |
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clopidogrel |
inhibits ADP receptor @ platelets (irreversible effect) |
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atorvastatin |
inhib HMG CoA reductase --> lowers LDL/Triglycerides
ADRs: myopathy, hepatotoxicity
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gemfibrozil |
binds to peroxisome proliferator alpha - increases activity of lipoprot lipase (breaks down VLDL) |
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cholestyramine |
binds to bile in intestine and prevents reabsorption |
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isotretinoin |
reduced oil production @ seb glands
ADRs: blepharoconjunctivitis, DE, pseudotumor, nyctalopia, teratogenic |
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metronidazole |
topical for rosacea |
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What is Wernicke encephalopathy |
caused by thiamine deficiency/chronic alcoholism - ophthalmoplegia, confusion, ataxia - reversed with thiamine - untreated: leads to Korsakoff syndrome |
