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127 Cards in this Set
- Front
- Back
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strong mu agonists
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morphine
hydromorphone oxymorphone methadone meperidine fentanyl sufentanil remifentanil levorphanol |
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antitussives
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dextromethorphan
codeine levopropoxyphene |
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mild to moderate agonists
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codeine
oxycodone hydrocodone propoxyphene diphenoxylate loperamide |
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opioids used for diarrhea
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diphenoxylate
loperamide |
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mixed agonists/antagonists/and partial agonists
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nalbuphine
buprenorphine butorphanol pentazocin |
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opioids that cause increase in HR and BP
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butorphanol
pentazocine |
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tramadol
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inhibits serotonin and NE
less resp. depression less neonatal resp. depresion |
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opioid antagonists
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naloxone
naltrexone nalmefene |
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naloxone
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opioid overdose
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naltrexone
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ETOH addiction
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mechanism of opioids
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inhibit adenylyl cyclase activity
inhibit presynaptic Ca influx and activation of postsynaptic K channels in the dorsal horn of the spinal cord reduce neurotransmitter release: NE, substance P, glutamate, serotonin |
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highly lipophilic opioid
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fentanyl
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1000x more potent than morphine
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sufentanil
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inhibit synthesis of peptidoglycan by inhibiting transpeptidase
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penicillin
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anti-pseudomonal penicillins
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ticarcillin
mezlocillin |
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inhibit beta lactamases
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clavulanate
sulbactam tazobactam |
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augmentin
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amoxacillin + clavulanate
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unasyn
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ampicillin + sulbactam
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zocyn
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pipercillin + tazobactam
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inhibit transpeptidase blocking cross link formation of peptidoglycan
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cephalosporins
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cephalosporin to treat gonorrhea
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3rd generation
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cephalosporin to treat pseudomonas
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cefepime
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inhibits transpeptidase blocking cross link formation of peptidoglycan used for serious infections but not MRSA
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carbapenems
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inhibits dehydropeptidase, slowing degradation of imipenem (carbapenem)
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cilastin
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monobactam
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aztreonam
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inhibits transpeptidase blocking cross link formation of peptidoglycan
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carbapenems
monobactams penicillin cephalosporins |
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d-ala d-ala preventing binding of transpeptidase, used for MRSA, nephrotoxic, ototoxic, red man syndrome
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vancomycin
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inhibits dephosphorylation of C55 isoprentyl pyrophosphate carrier, blocks addition of UDP to lipid carrier
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bacitracin
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inhibits enol pyruvate transferase
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fosfomycin
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bind 23S RNA subunit of 50S ribosomal subunit
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protein synthesis inhibitors
(streptogramins, oxazolidinones, macrolides, ketolides, lincosamides, chloramphenicol) |
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streptogramins
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quinupristin/dalfopristin
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inhibit peptidyl transferase blocking elongation of peptide, used to treat VRE, MRSA, PRSP, SP
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quinupristin/dalfopristin
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inhibit transpeptidase-> inhibit synthesis of peptidoglycan
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penicillin
Cephalosporins Carbapenems monobactams |
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aminoglycosides used against P. aeruginosa
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amikacin
gentamicin |
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bind 16S to the 30S ribosomal subunit and prevent docking of tRNA on the ribosome
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aminoglycosides
tetracyclines glycycycline |
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competitively inhibit folic acid production by supressing the activity of dehydropteroate synthase
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sulfonamides
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inhibit dihydrofolate reductase
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trimethoprim
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block bacterial DNA synthesis (transcription and replication)
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fluoroquinolones
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Side effects: nephrotoxic, ototoxic
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aminoglycosides
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drug used for vaginitis
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metronidazole
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drug used topically for UTIs
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mupirocin
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used for UTI prophylaxis
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methenamine
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used for acute and chronic UTIs
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nitrofurantoin
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TB drug that can alter vision and should not be used in young children
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ethambutol
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drug that inhibits mycobacterial arabinosyl transferases
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ethambutol
ethionamide (2nd line drug) |
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most active TB drug, inhibits synthesis of mycolic acids
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isoniazid
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TB drug that can cause peripheral neuritis, hepatitis, CNS symptoms
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isoniazid
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drug that binds the B subunit of bacterial DNA dependent RNA polymerase inhibiting RNA synthesis
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rifampin
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drug that causes orange body fluids
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rifampin
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2nd line TB drug that inhibits folic acid synthesis (PABA analog)
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aminosalicylic acid
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drug that inhibits D-alanine ligase and racemase, causes psych and CNS changes
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cycloserine
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inhibits mycobacterial arabinosyl transferase and enhances the activity of lipophilic drugs
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ethionamide
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2nd line TB drugs
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cycloserine
aminosalicylic acid ethionamide |
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binds ergosterol in fungal cell membrane altering membrane permeability causing massive leakage of intracellular ions and macromolecules
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polyenes: amphotercin B, nystatin
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side effect of amphotercin B
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nephrotoxic
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targets beta 1,3 glucan synthesis which interferes with cell wall biosynthesis
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echinocandins (caspofungin)
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transported across the fungal cell membrane by cytosine permease and converted to 5FU, inhibits DNA and RNA synthesis, use with amphotercin B
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flucytosine
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Side effect of flucytosine
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bone marrow suppression
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binds mitotic spindle fibers inhibiting cell division incorporated into new keratin
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griseofulvin
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interferes with sterol biosynthesis by inhibiting the enzyme squalene 2,3 epoxidase decreasing the amount of ergosterol an causing squalene accumulation
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terbinafine
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Side effect of azoles
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interfere with Cytochrome P450 metabolism
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inhibit demtehylation of lamosterol causing ergosterol depletion
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azoles (ketoconazole, itraconazole, fluconazole, voriconazole, posaconazole)
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antifungal with excellent CNS penetration with the lowest Cytochrome P450 affinity
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fluconazole
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preferred antifungal for histoplasmosis and blastomyces
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itraconazole
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azole used for fluconazole resistance
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voriconazole
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side effect of voriconazole
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visual disturbances
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drug of choice for aspergillus
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voriconazole
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drug used to prevent invasive fungal infections in immunocompromised, glucuronidated, very lipophilic and penetrates CNS
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posaconazole
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converted to active triphosphate and competitively inhibit HIV reverse transcriptase and terminate viral DNA synthesis
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nucleotide reverse transcriptase inhibitors
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Side effects of NRTIs
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bone marrow suppression
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NRTI drug names
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zidovudine
didanosine lamivudine emtricitabine stavudine abacavir |
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NtRTI drug name
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tenofovir
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non-nucloside reverse transcriptase inhibitors drug names
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nevirapine
efavirenz |
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inhibit HIV RT by directly binding to the enzyme and altering the position of critical amino acids within the catalytic site preventing viral DNA synthesis
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NNRTIs
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SE of NNRTIs
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lactic acidosis
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inhibit viral enzyme responsible for maturation of viral proteins
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protease inhibitors
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class toxicity of protease inhibitors
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lipodystrophy, inhibit Cytochrome P450
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protease inhibitors drug names
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ritonavir
fosamprenavir lopinavir/ritonavir atazanavir tipranavir darunavir |
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36AA synthetic peptide that inhibits fusion of HIV virus to CD4 cell membrane receptor and blocks transfer of viral RNA into CD4 cell
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fusion/entry inhibitors
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fusion/entry inhibitors names
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enfuvirtide
maraviroc |
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drugs that target viral thymidine kinase that converts drugP->drugPPP and inhibits viral DNA polymerase
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anti-herpetic agents
acylcovir famciclovir valacyclovir |
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anti-herpetic agents
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acyclovir
famciclovir valacyclovir |
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anti-CMV agents
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foscarnet
ganciclovir valganciclovir |
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inhibits cleavage of pyrophosphate from deoxynucleotide triphosphate by inhibiting viral polymerase thus preventing the formation of the phosphate backbone of viral DNA
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foscarnet
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drugs used for HBV and HIV
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lamivudine
tenofovir emtricitabine |
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drugs against hepatitis C
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pegylated interferon
ribavirin |
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anti-influenza agents
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oseltamivir
zanamivir |
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viral neuraminidase inhibitors (enzyme responsible for releasing virus from infected cells)
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oseltamivir, zanamivir (anti-influenza)
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hep B drugs
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pegylated interferon
lamivudine adefovir (like tenofovir) entecavir tenofovir emtricitabine |
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ester local anesthetics
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procaine
chloroprocaine tetracaine |
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ester allergies due to
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metabolism to PABA
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max dose of procaine
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1000mg
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max dose of chloroprocaine
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800-1000mg
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epinephrines effect when used with local anesthetics
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vasoconstrictor, prolongs duration
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amide local anesthetics
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lidocaine
prilocaine mepivacaine bupivacaine levobupivacaine etidocaine ropivacaine |
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caution with local amide anesthetics
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liver metabolized, caution in liver failure
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max dose of lidocaine
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4.5mg/kg or 300mg
7.5mg/kg or <500mg |
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max dose of prilocaine
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400mg within 2 hours
SE: methemoglobinemia |
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mepivacaine
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7mg/kg, <400mg
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bupivacaine SE and max dose
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cardiac toxicity
175 225mg w/epi 400mg |
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levobupivocaine max dose
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300mg
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etidocaine max dose
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4mg/kg or 300mg
5.5mg/kg or 400mg |
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ropivacaine max dose
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275mg
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SE of halogenated hydrocarbons
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dose dependent drop in BP
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halogenated hydrocarbons
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halothane
isoflurane enflurane sevoflurane desflurane |
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halogenated hydrocarbon that is unstable in the presence of CO2 absorber
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sevoflurane
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short acting barbituate
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thiopental
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benzodiazepine example
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midazolam
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antagonist of benzodiazepines
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flumazenil
(no antidote for barbituate thiopental) |
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cause anterograde amnesia, "balanced amnesia"
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midazolam
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very commonly used IV agent for induction and maintenance of anesthesia, causes minimal postop confusion, antiemetic
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propofol
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used in patients at risk of hypotension, causes minimal cardiac and respiratory depression, inhibits steroidogenesis
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etomidate
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IV general anesthetic that causes dissociative anesthesia, emergence phenomenon, stimulates heart
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ketamine
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opioid that does not prolong labor
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meperidine
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anti-epileptic drugs
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carbamazepine
oxcarbazepine ethosuximide gabapentin lamotrigine levetiracetam phenytoin fosphenytoin tiagabine topiramate valproic acid phenobarbitol benzodiazepines clonazepam diazepam lorazepam |
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drug used for ataxia and cerebellar dysfunction, electrophysiologic evidence of peripheral neuropathy, causes gingival hyperplasia, osteomalacia
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phenytoin
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anti-epileptic used to treat peripheral neuropathy
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gabapentin
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block glutamic receptors, inhibit Ca currents, inhibit Na channels, potentiate GABA neurotransmission
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anti-epileptic drugs
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GABA neurotransmitter
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inhibitory- target Cl
anti-anxiety sedative anti-epileptic |
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Glutamate
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excitatory
target NMDA and non-NMDA, ionotrophic, G protein coupled receptors, too much stimulation- neurotoxic anti-epileptic drugs anti-psychotic (investigational) neuroprotective agents |
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glycine
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inhibitor
target Cl channel co-transporter with glutamate glycine antagonists: convulsants |
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acetylcholine
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primary central nucleus in nucleus basalis of meynert
used to treat: parkinson's alzheimer's |
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dopamine
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D1: excitatory
D2: inhibitory treat: parkinson's schizophrenia emesis ADHD |
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norepinephrine
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acts on alpha and Beta receptors
tx: mood disorders narcolepsy obesity |
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5 hydroxytriptamine
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treat
anxiety mood disorders bulimia migraine emesis psychosis |
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histamine
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regulate arousal
body temperature vascular dynamics |
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peptides
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act with coexisting transporters
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