Medications

Front 1

Heparin

Back 1

Forms complex with antithrombin III - inactivates IIa and Xa - increases function of antithrombin III.

Hint 1

thrombocytopaenia: bruising, haemorrhage, alopecia.

Front 2

Enoxaparin

Back 2

Forms complex with antithrombin III - inactivates Xa - increases atIII.

Hint 2

GIT bleeding and bruising. safer in pregnancy, longer t1/2 than heparin.

Front 3

Streptokinase (plasminogen)

Back 3

binds to plasminogen and converts it to plasmin - breaks down fibrin clot, dissolves thrombus

Hint 3

degradation of clotting factors leading to haemorrhage. allergic reaction.

Front 4

Mannitol (osmotic)

Back 4

increases plasma osmolarity - osmotic diuresis - draws water out from brain tissue into extracellular space.

crystallizes at lo temp: warm in hot water and shake.

Hint 4

dry mouth, thirst, hypoT, fluid shift leading to pulmonary congestion, electrolyte imbalances/loss, acidosis, headache, dizziness, blurred vision, GI, local pain and phlebitis.

Front 5

Benzylpenicillin (B-lactam)

Back 5

B lactam: bactericidal, inhibits cell wall synthesis

Hint 5

GI, hypersensitivity, convulsions at hi doses

Front 6

Ceftriaxone (gram -ve)

Back 6

B lactam: bactericidal, inhibits cell wall synthesis. wider spectrum of activity against Gram -ve beta-lactamase producing bacteria

Hint 6

GI, hypersensitivity, pain on IM. rare: hepatic failure, haematological dysfunction

Front 7

Vancomycin (glycopeptide)

Back 7

bactericidal, inhibits synthesis of glycopeptide layer. only for those sensitive to B-lactams

Hint 7

chills, fever, phlebitis, hypersensitivity, nephrotoxicity (increased in children and old). rapid infusion: red man.

Front 8

Dexamethasone (gene)

Back 8

Corticosteroid: regulates gene expression therefore alters immune response. inhibits helper T cells, decreases protein synthesis, decreases neutros and macros, stabilises mast cells.

Hint 8

hyperglycaemia, dislipidaemia, increased protein breakdown (because it stimulates degradation of fat and protein, alters carb and fat metabolism therefore increases BSL.)

Front 9

Phenytoin (t/c and complex partial) (Na+ transport)

Back 9

alters transport of sodium ions via inactivation of channels thereby stabilising cell membrane. (rarely used long term due to unpredictable plasma levels)

Hint 9

cognitive impairment, dizzy, ataxia, gum hypertrophy, hirsutism, megoblastic anaemia, fetal malformations, hypersensitivity (derm). 80-90% binds to albumin: inhibited by aspirin and valproate.

Front 10

Carbamezapine (simple and complex partial, t/c) (inactivates channels)

Back 10

decreases neuronal excitability through inactivation of Na+ channels. also binds to BZ receptors.

Hint 10

dizzy, drowsy, GI, visual disturbances, fatigue, confusion, rash, ataxia, decreased WCC, hypothyroidism, birth defects. take with meals.

Front 11

Sodium valproate (gen. and part.) (GABA 3, T-type)

Back 11

enhances GABA release, increases GABA r density, decreases GABA degradation, block Na+ channels and T-type calcium channels.

Hint 11

hepatotoxicity, abnormal coag parameters, drowsy, slurred speech, tremors, GI, weight gain, foetal malformations.

Front 12

Clobazam and Clonazepam

Back 12

Affect GABA.

Hint 12

as for sodium valproate?

Front 13

ACE inhibitors (pril) (a/na)

Back 13

block ACE - relax blood vessels, decrease contraction force, decrease a and na (decrease afterload and hypertrophy), decrease aldosterone.

Hint 13

dry cough, hyperkalaemia, hypoT. (ang II blocker sartan if dry cough persists)

Front 14

Beta blocker (lol)

Back 14

selective: decrease HR, contractility and renin release.

non-selective: (carv, pind, propan) bronchoconstriction, decreased BGL.

Block catecholamines, decrease pathology of compensation (decrease ischaemia and arrythmias, increase perfusion)

Hint 14

decrease HR, ortho HT, mask hypo in DM, erectile dysfunction, vivid dreams (atenolol)

Front 15

Spironolactone (aldo, Na+)

Back 15

block sodium channels and aldosterone - inhibit Na absorption - increase Na+ and decrease K+ excretion. Decrease myocardial response to NA (natriuretic petide decrease due to aldosterone block) and decrease remodelling

Hint 15

hyperkalaemia, gynocomastia, post menopausal bleed.

Front 16

Frusemide (Cl, Na)

Back 16

Short acting on ascending loop of Henle. inhibits reabsorption of Cl- and Na+ into interstitial - decrease vascular volume

Hint 16

electrolyte disturbances. hyponatraemia. 1st line for acute HF.

Front 17

Eplerenone (ald ant)

Back 17

Aldosterone antagonist: increases sodium and water excretion.

Front 18

Hydralazine (dil art)

Back 18

dilates arterioles - decreases afterload.

Hint 18

hypoT, tachy, headache, flushing.

Front 19

Isosorbide dinitrate (vasodil)

Back 19

vasodilator - decreases preload

Hint 19

hypoT, tachy, headache, flushing.

Front 20

Glycerol trinitrate

Back 20

NO donor: nitrate - NO - increased cGMP - dilatation

Hint 20

hypoT, tachy, headache, flushing.

Front 21

sodium nitroprusside (NO)

Back 21

breaks down to NO - dilates arteries and veins

Hint 21

hypoT, tachy, headache, flushing.

Front 22

Digoxin (increases Ca+)

Back 22

cardiac glyoside/inotropic: positive inotrope - increases calcium availability - increases force of myocardial contraction - decreases HR and AV conduction speed. for AF and flutter

Hint 22

narrow therapeutic index. more common in those with hypokalemia as competes with K for binding site on Na/K pump. GIT, drowsy, dizzy.

Front 23

nitroprusside, vasopressin (ADH) and phenelyphrine.

Back 23

used in cardiogenic shock: vasoconstriction, water retention.

Hint 23

HT, electrolyte disturbances, headache.

Front 24

dobutamine (mime)

Back 24

sympathomimetic, stimulates B1 receptors, increasing cardiac contractility and output.

Hint 24

hypertension, angina, tachy, dysrrythmias.

Front 25

Bupropion (NA/DA re)

Back 25

reduces nicotine cravings by inhibiting NA and DA reuptake. active metabolite has t1/2 of 20hrs.

Hint 25

insomnia, agitation, visual, decreased concentration, rash.

Front 26

Naltraxone (O R antagonist)

Back 26

opioid receptor antagonist: blocks action of endogenous opioids released by alcohol - decreasing pleasure of it and cravings.

Hint 26

anxiety, insomnia, nausea, headache, dizzy, fatigue, rare: hepatotoxicity in doses over 50mg/day.

Front 27

Disulfiram (i dehy)

Back 27

inhibits aldehyde dehydrogenase: blocks degradation of acetaldehyde to water and CO2 - accumualtes - potent vasodilator - when drinking: intense flushing and throbbing headache

Hint 27

GIT, BP changes, hyperventilation due to bronchodilation.

Front 28

Zidovudine, lamivudine

Back 28

nucleoside analogue reverse transcriptase inhibitors NARTI

Front 29

Ritonavir, Atazanavir

Back 29

protease inhibitors

Front 30

Nevirapine

Back 30

non-nucleoside reverse transcriptase inhibitors NNRTI

Front 31

Pamidronate (i clast)

Back 31

bisphosphonates: inhibit osteoclast activity, for bone pain in prostate cancer

Front 32

Leuprolide (T)

Back 32

GnHR analogue: blocks LH, FSH and decreases T.

Front 33

Flutamide, cyproterone (anti-a)

Back 33

Anti-androgen: inhibit androgen uptake by prostate.

Hint 33

toxic hepatitis and gynaecomastia.

Front 34

transdermal oestrogen replacement therapy (osteoporosis)

Back 34

blocks osteoclasts. prolongs osteoblast life by blocking apoptosis.

Hint 34

linked to breast cancer

Front 35

Tamoxifen

Back 35

Selective estrogen receptor modulator (TERM): increases oestrogen uptake in bone, inhibits osteoclasts

Front 36

Magnesium supplement

Back 36

prevents formation of brittle bones.

Front 37

Calcitonin (slows clast)

Back 37

slows osteoclast activity.

Front 38

Ibuprofen (cox)

Back 38

used in osteoarthritis: inhibits activity of COX1 and COX 2 - inhibits prostaglandins. reduces pain and inflammation.

Hint 38

Irritates gastric mucosa, increase HCl and pepsin secretion - ulcers.

deceases GF - water and Na+ retention: HT.

Front 39

Paracetamol (PG)

Back 39

inhibition of central PG synthesis and modulation of 5-HT pathways.

Hint 39

toxic metabolite: hepatotoxicity.

Front 40

Narcotic analgaesics (Opioid agonist)

Back 40

opioid agonism, increase production of endogenous opioids (enkephalins, endorphins, dynorphins), suppress pain message in CNS (inhibit substance P).

Morph: slow onset, low lipid solubility.

Fentanyl: 100x more potent, high lipid solubility, short onset and duration. s/c and transderm. in Ca pts.

Hint 40

addiction, withdrawal, stimulate CTZ and emetic centre in MO: N&V.

stim. of opioid receptors in gut: constipation. histamine release: flush.,

depression of resp and cough reflex.

tolerance: receptor sensitivity and expression.

Front 41

Burprenorphine

Back 41

potent narcotic and partial agonist. decreased abuse potential.

Hint 41

long t1/2 (6-8). N&V.

extensive first pass hepatic metabolism: can be sublingual.

Front 42

Alkylating agents: Chlorambucil, Carboplatin (bind, reverse)

Back 42

cell cycle non-specific drugs. bind to DNA and irreversibly disable mechanism for cellular division.

Hint 42

bone marrow suppresiion, leukopenia, bleeding, mouth ulcers, GI, liver damage.

Chlorambucil: decrease platelet count - alternative dose

Carboplatin: iv pins and needles.

Front 43

antibiotic type agents: Bleomycin, Doxorubicin (break DNA)

Back 43

bind to DNA and prevent synthesis of RNA and proteins. break DNA strands - free radicals

Hint 43

bone marrow suppresiion, alopecia, GI, hyperpigmentation.

Bleomycin: pulmonary toxicity

doxorubicin: ECG changes

incompatible with thalidomide: neuropathies.

Front 44

Antimetabolite-folic acid analogue: Methotrexate

Back 44

incorporated into DNA structure during replication: inhibits dihydrofolate reductase code misreading and DNA breakage. - disrupt synthesis of nucleic acids.

Hint 44

liver damage, pulmonary toxicity, bone marrow suppression, GIT ulceration and inflammation.

Front 45

Antimetabolite-pyrimidine analogues: 5-fluorouracil (5-FU)

Back 45

incorporated into DNA structure during replication,code misreading and DNA breakage. -blocks synthesis of pyrimidine nucleotides.

Hint 45

bone marrow suppression, GIT ulceration and inflammation. painful red hands and feet.

Front 46

Antimetabolite: purine analogue: Mercaptopurine

Back 46

incorporated into DNA structure during replication,code misreading and DNA breakage.

-blocks synthesis of purine analogues.

Hint 46

bone marrow suppression, GIT ulceration and inflammation.

Front 47

Tamoxifen (anti-E)

Back 47

anti-estrogen. inhibits IGF-1 and TGF

Hint 47

GI, impaired fertility, menstrual irregularities, hot flushes, dizziness, thromboembolism.

Front 48

Letrozole (aroma)

Back 48

aromatase inhibitor: advanced breast cancer, blocks eostrogen synthesis.

Hint 48

GI, impaired fertility, menstrual irregularities

Front 49

Interferon a 2a and 2b

Back 49

cytokine. increases cell-mediated immunity

Hint 49

flu symptoms, fever, malaise

Front 50

thalidomide (antiangiogenic)

Back 50

direct effect on myeloma cells. antiangiogenic activity and immunomodulator

Hint 50

neutropenia, orthostatic hypoT, dizziness, seizures, birth defects. incompatible: with cytotoxic antibiotics (neuropathies), alcohol, narcotics, benzos (CNS depression and death).

Front 51

Orlistat (lipase)

Back 51

lipase inhibitor = decreases the fat absorption in the intestine. for obesity

Hint 51

low BP and BGL

Front 52

Sibutramine (i the gang)

Back 52

inhibits the reuptake of 5-HT, DA & NA decreasing appetite.

Hint 52

low BP and BGL

Front 53

Sulfasalazine and Mesalazine (i PG)

Back 53

anti-inflammatory. inhibit local PG synthesis

Hint 53

haematological disorders (agranulocytosis). reversible male infertility.

Front 54

Azathioprine (immunosupp)

Back 54

immunosuppressant for chronic active UC and liver cirrhosis. Prevents cellular proliferation by damaging DNA structures and inhibits cellular inflammatory response.

Hint 54

bone marrow suppression (anaemia, thrombocytopaenia), susceptibility to infection, liver and kidney dysfunction.

Front 55

Infliximab (monoclonal)

Back 55

monoclonal antibody against TNF-a (inflammatory cytokine). chrohns)

Hint 55

increased susceptability to infection, rash, headache, GI, resp. distress and BP changes.

Front 56

Bortezomib (proteo)

Back 56

for multiple myeloma: inhibitor of proteosomes (intracellular enzymes)

Front 57

Neomycin (reduces ammonia)

Back 57

(hepatic encephalopathy) aminoglycoside antibiotic, wide spectrum against Gram -ve. reduces ammonia in the gut by killing bacteria.

Hint 57

hypersensitivity, GI.

Front 58

Cimetidine

Back 58

for pancreatitis. H2 receptor antagonist that inhibits gastric acid secretion.

Hint 58

headache, dizzy, inhibits cytochrome P-450 enzyme system-numerous interactions.

Front 59

Octreotide (SS)

Back 59

mimics somatostatin, inhibits GH release. (for hyperGH)

Front 60

Carbimazole & propylthiouracil (TH)

Back 60

Prevent incorporation of iodine, thus inhibiting synthesis of TH. Propylthiouracil blocks conversion T4 to T3.

Hint 60

↓ glucose metabolism, ↑ cholesterol/TG, low BP & HR, memory impairment, muscle cramps, constipation, weight gain, BMR decreases - cold intolerance

Front 61

Levothyroxine

Back 61

synthetic thyroxine. mimics, regulates metabolic rate and activity.

Front 62

Lithium and Phenytoin (Ca++)

Back 62

used in hyperparathyroidism to increase Ca++ levels.

Front 63

Hydrocortisone

Back 63

for adrenocortical hypofunction: corticosteroid, relieves inflammation.

Hint 63

immunosuppression, GIT, N&V,headache, dizziness.