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197 Cards in this Set
- Front
- Back
H1 Antagonist (1st generation)
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Side Effects: sedation (permeable to BBB - hits H4-R); orthostatic hypotension (adrenergic block); dry mouth, impaired vision & accommodation; antiparkinsonism (cholinergic block); serotonin block; Uses: motion sickness/Meniere's disease (cholinergic block); local anesthesia (voltage gated Na channel block at high doses; alternative if lidocaine allergy); allergies (urticaria, rhinitis); cough suppression; somnifacients; ineffective for asthma
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H1 Antagonist (2nd generation)
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Side Effects: no sedation (non-permeable to BBB); orthostatic hypotension (adrenergic block); dry mouth, impaired vision & accommodation; antiparkinsonism (cholinergic block); serotonin block; Uses: less effective for motion sickness (cholingeric block); local anesthesia (voltage gated Na channel block at high doses; alternative if lidocaine allergy); allergies (urticaria, rhinitis); cough suppression; somnifacients; ineffective for asthma
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Chlorpheniramine
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"H1 Antagonist (1st generation)
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Diphenhydramine
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H1 Antagonist (1st generation)
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Pyrilamine
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H1 Antagonist (1st generation)
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Cyclizine
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H1 Antagonist (1st generation)
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Promethazine
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H1 Antagonist (1st generation); orthostatic hypotension
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Cyproheptadine
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H1 Antagonist (1st generation); 5HT Antagonist - use for postgastrectomy dump syndrome (prevent diarrhea)
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Fexofenadine
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H1 Antagonist (2nd generation)
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Loratadine
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H1 Antagonist (2nd generation)
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Cetirizine
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H1 Antagonist (2nd generation)
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Acrivastine
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H1 Antagonist (2nd generation)
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Buspirone
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5HT Agonist; anxiolytic
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Sumatriptan (triptans)
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5HT Agonist; 5HT1d/1b agonists; treat migraines (vasoconstriction and reduce blood flow in brain) - repeat use not as effective
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Odansetron
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5HT Antagonist; 5HT3 block - treat acute chemotherapy induced nausea and vomiting; not good for motion sickness; efficacy enhanced with dexamethasone/NK1 antagonist; headaches, dizziness, constipation
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Ritaserine
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5HT Antagonist; 5HT2 block - reduce thromboxane formation, alter bleeding time
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Ketanserin
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5HT Antagonist; 5HT1c, 5HT2 block - treat hypertension (receptors in bood vessels)
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Dinoprostone (Prostin E2, Prepidil, Cervidil)
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PGE2 Analog; labor facilitation (local administration, oxytocic use); 2nd trimester abortion; prevention of NSAID induced peptic ulcer
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Misoprostol
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PGE1 Analog; used in combination with RU-486 & an antiprogestin (mifepristone) - day after pill for early abortion; prevention of NSAID induced peptic ulcer; orally active; cytoprotective (gastric) - increase bicarbonate & mucus secretion, decrease HCl secretion (at high concentrations); uterine cramps, menstrual disorders, GI
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Alprostadil
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PGE1 Analog; PGI2 Analog; maintains patency of ductus arteriosus; treat erectile dysfunction (2nd line); prevention of NSAID induced peptic ulcer
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Carboprost tromethamine
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PGF2a Analog; 2nd trimester abortion; controls unresponsive postpartum hemorrhage
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Latanoprost
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PGF2a Analog; treat glaucoma; topically active
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Bimatoprost
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PGF2a Analog; treat glaucoma
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Travoprost
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PGF2a Analog; treat glaucoma
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Epoprostenol (Flolan)
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PGI2 Analog; treat primary pulmonary hypertension
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Iloprost
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PGI2 Analog; treat primary pulmonary hypertension
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Trepostinil
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PGI2 Analog; treat primary pulmonary hypertension
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Indomethacin
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NSAID-COX1
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Sulindac
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NSAID-COX1
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Ibuprofen
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NSAID-COX1/2
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Nabumetone
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NSAID-COX2
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Aspirin
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NSAID-COX (irreversible)
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Celecoxib (Celebrex)
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NSAID-COX2; less potent than Refecoxib (Vioxx); treat arthitis
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Rofecoxib (Vioxx)
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NSAID-COX2; increased incidence MI-withdrawn from market
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Naproxen
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NSAID-COX1/2; treat arthritis
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Dexamethasone
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Glucocorticoid-PLA2 inhibition; antiemetic (mechanism unknown)
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Monteleukast (Singulair)
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LTD4 Antagonist; treat asthma, bronchoconstriction
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Zafirleukast (Accolate)
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LTD4 Antagonist; treat asthma, bronchoconstriction
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Zileuton (Zyflo)
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5-Lipoxygenase Inhibitor; prevention of exercise induced asthma (fast acting)
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Dazoxiben
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TXA2 Synthase Inhibitor; treat acute and chronic coronary artery disease
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Hydrazaline
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Renal Vasodilation
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Minoxidil
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Renal Vasodilation
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ACE Inhibitor
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Side Effects: dry cough (linked to elevation of bradykinin/substance P which are broken down by ACE); angioedema; fetus toxicity in pregnant women (renal development) Uses: Antioxidant function, reduce aldosterone secretion, block angiotensin I->angiotensin II; minimize vascular disease in diabetics
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Captopril
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ACE Inhibitor
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Enalapril
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ACE Inhibitor
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Ramipril
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ACE Inhibitor
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Losartan
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AT1 Blocker
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Aliskiren
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Renin Inhibitor; treat hypertension, CHF
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Calcium Channel Blocker
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Mechanism: blocks L-Type Ca channel; decrease SA node rate, increase AV node refractory period; dilate arterioles; Side Effects: no orthostatic hypotension; dizziness; headaches; peripheral edema (ankle); bradycardia (verapamil, diltiazem); mild diuretic effect; Contraindications: beta blockers (especially with verapamil and diltiazem); Uses: supraventricular arrhythmia; Raynaud's; prevent premature labor; epilepsy (cerebral vasodilation); esophageal motor disorders
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Verapamil
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Calcium Channel Blocker - Phenylalkylamine (more selective for cardiac than vascular tissue); treat atrial arrhythmias, vascular headache prophylaxis, blocks p170 glycoprotein; extension metabolism in liver (low bioavailability if hepatic insufficiency)
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Nifedipine
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Calcium Channel Blocker-Dihydropyridine; oral and sublingual; causes rapid fall in blood pressure
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Nicardipine
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Calcium Channel Blocker-Dihydropyridine; treat subarachnoid hemorrhage (if blood pressure elevated)
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Amlodipine (Norvasc)
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Calcium Channel Blocker-Dihydropyridine ("kinder and gentler")
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Felodipine
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Calcium Channel Blocker-Dihydropyridine
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Isradipine
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Calcium Channel Blocker-Dihydropyridine
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Nimodipine
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Calcium Channel Blocker-Dihydropyridine; treat subarachnoid hemorrhage (if blood pressure not elevated)
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Diltiazem
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Calcium Channel Blocker-Benzothiazipine
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Bepridil
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Calcium Channel Blocker (last resort); sodium channel blocking activity; pro-lithium activity
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Nitrates
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Side Effects: orthostatic hypotension, tachycardia, headache, tolerance
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Amyl Nitrite
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Nitrates; inhalational; no longer used; "poppers"
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Nitroglycerin
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Nitrates
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Glygeryl Trinitrate
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Nitrates
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Isosorbide Dinitrate
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Nitrates
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Isosorbide Mononitrate
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Nitrates; active metabolite of Isosorbide Dinitrate; 100% bioavailability
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Erythrityl Tetranitrate
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Nitrates
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Methylxanthines
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Mechanism: adenosine antagonism; inhibition phosphodiesterases; histone deacetylation
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Theophylline
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Methylxanthine; poor solubility; complex with ethylenediamine to form aminophylline; treat COPD, asthma; low therapeutic index-must be able to measure plasma levels; rapid oral absorption; elimination by liver metabolism (cimetidine inhibits CYP450 and can increase theophylline levels)
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Caffeine
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Methylxanthine
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Theobromine
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Methylxanthine
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Ergot Alkaloids
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Mechanism: agonism, partial agonism, and antagonism at serotinergic, adrenergic, and dopaminergic receptors; amides more active at serotonin receptors, amino acids have alpha-adrenergic and dopaminergic actions; Side Effects: overdose-gangrene and vasospasm not reversible by alpha or serotonin antagonists; GI; hallucinations (LSD); intense vasoconstriction; Uses: migraine; post-partum uterine bleeding (increase in frequency and contractile force of uterine smooth muscle at low doses; prolonged contraction at high doses); Contraindications: hypertension, vascular disease, pregnancy
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Ergonovine (ergometrine)
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Ergot Alkaloids-Amine; treat post-partum uterine bleeding (greatest selectivity for uterine smooth muscle; oxytocin 1st line)
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Methyl ergonovine
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Ergot Alkaloids-Amine
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Methysergide
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Ergot Alkaloids-Amine
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Ergotamine
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Ergot Alkaloids-Amino Acid; diagnostic test for migraine
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Dihydroergotamine
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Ergot Alkaloids-Amino Acid
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Bromocriptine
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Ergot Alkaloids-Amino Acid; inhibits prolactin release (dopamine agonist); treat pituitary tumor
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Cabergoline
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Ergot Alkaloids; dopamine agonist
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Pergolide
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Ergot Alkaloids; dopamine agonist
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Sildenafil (Viagra)
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PDE Inhibitor
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Tadalafil (Cialis)
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PDE Inhibitor
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Vardenafil (Levitra)
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PDE Inhibitor
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Beta Blocker
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Contraindications: Prinzmetal angina; asthma; COPD; Raynaud's; peripheral artery disease; sinus bradycardia; AV block; diabetes
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Acebutolol
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Beta Blocker; B1; partial agonist
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Atenolol (Tenormin)
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Beta Blocker; B1; nightmares
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Betaxolol
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Beta Blocker; B1
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Bisoprolol
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Beta Blocker; B1
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Esmolol (Reviblock)
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Beta Blocker; B1; rapidly metabolized (found in crash carts)
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Propanolol
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Beta Blocker; anesthetic action; nightmares
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Diuretic - Carbonic Anhydrase Inhibitor
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Uses: Glaucoma (open angle); altitude sickness prophylaxis; short term diuretic; catamenial epilepsy; correct metabolic alkalosis; alkalinize urine - increase solubility of uric acid and cysteine, increase aspirin excretion, increase phosphate excretion; Side Effects: hypercloremic metabolic acidosis; renal stone formation; renal potassium wasting; hepatic encephalopathy; Contraindications: potassium depletion; hepatic encephalopathy
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Acetazolamide (Diamox)
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Diuretic - Carbonic Anhydrase Inhibitor
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Dichlorphenamide
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Diuretic - Carbonic Anhydrase Inhibitor
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Methazolamide
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Diuretic - Carbonic Anhydrase Inhibitor
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Glycerin
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Diuretic - Osmotic; oral
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Isosorbide
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Diuretic - Osmotic; oral
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Mannitol
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Diuretic - Osmotic; IV
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Urea
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Diuretic - Osmotic; IV
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Diuretic - Loop (High Ceiling)
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Sulfonamides except for ethacrynic acid; secretion inhibited by NSAID, probenecide; decreases both concentrating and diluting ability of kidney; Mechanism: blocks Na+/K+/2Cl- (greater Cl- than Na+ loss); Uses: acute hyperglycemia, hyperkalemia, acute renal failure, anion overdose, hypertension, CHF, cirrhosis of liver, nephritic syndrome, chronic heart failure, acute renal failure; Side Effects: Ca, Mg loss; venodilation; decreased pulmonary wedge pressure; isosthenuria; increased prostaglandin & renin release; blockade tubuloglomerular feedback; hypokalemic metabolic alkalosis; hyperuricemia; interstitial nephritis (if sensitive to sulfonamides); hyperglycemia
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Furosemide (Lasix)
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Diuretic - Loop (High Ceiling); ototoxicity
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Ethacrynic Acid (Edecrin)
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Diuretic - Loop (High Ceiling); prodrug; give if sulfa allergy
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Bumetanide (Bumex)
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Diuretic - Loop (High Ceiling); less dependent on tubular organic acid secretion (more lipophilic); more potent than furosemide
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Torsemide (Demadex)
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Diuretic - Loop (High Ceiling)
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Azosemide
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Diuretic - Loop (High Ceiling)
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Muzolimine
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Diuretic - Loop (High Ceiling)
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Piretanide
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Diuretic - Loop (High Ceiling)
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Tripamide
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Diuretic - Loop (High Ceiling)
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Brain Natriuretic Peptide
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produced in ventricular myocytes; marker for CHF; inhibits renin release; fosters loss of salt and water
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Diuretic - Thiazide
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Mechanism: block Na+/Cl- symporter in distal convoluted tubule; Uses: edema in heart, liver and renal disease; decrease blood pressure, potentiates antihypertensive drugs; calcium nephrolithiasis and osteoporosis (increases Ca2+ reabsorption, causes hypocalciuria); nephrogenic diabetes insipidus; Side Effects: reduce GFR; hypokalemia, hypochloremia, dilutional hyponatremia, decreased glucose tolerance (diabetogenic effect with higher doses), hyperuricemia, hypercalcemia, hypokalemia (digitalis toxicity, quinidine induced torsades de pointes); Contraindications: CHF (decreased GFR)
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Bendroflumethiazide
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Diuretic - Thiazide
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Chlorothiazide
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Diuretic - Thiazide; low potency
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Hydrochlorothiazide
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Diuretic - Thiazide; prolonged duration of action; side effects above 25mg
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Hydroflumethiazide
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Diuretic - Thiazide
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Methyclothiazide
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Diuretic - Thiazide
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Polythiazide
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Diuretic - Thiazide
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Trichlormethiazide
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Diuretic - Thiazide
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Indapamide (Lozol)
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Diuretic - Thiazide-like
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Chlorthalidone (Hygroton)
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Diuretic - Thiazide-like
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Metolazone
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Diuretic - Thiazide-like
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Quinethazone
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Diuretic - Thiazide-like
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Diuretic - Potassium Sparing
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Mechanism: block ENaC in collecting tubule (bind alpha subunit); Side Effects: hyperkalemia, acidosis
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Amiloride
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Diuretic - Potassium Sparing; treat edema & hypertension together with thiazides; treat Liddle's syndrome; treat lithium induced nephrogenic diabetes insipidus; Gitelman's syndrome
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Triamterine
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Diuretic - Potassium Sparing; interaction with NSAIDS
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Mineralocorticoid Receptor Antagonist
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Uses: edema and hypertension with thiazides, primary aldosteronism, secondary aldosteronism, diuretic of choice for edema in hepatic cirrhosis, reduce morbidity and mortality in class II and class IV heart failure
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Eplerenone
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Mineralocorticoid Receptor Antagonist; weaker but more selective (no androgen antagonist activity)
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Spironolactone
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Mineralocorticoid Receptor Antagonist; androgen antagonist activity; hyperkalemia; gynecomastia (anti-androgenic effects); gastritis; peptic ulcer disease; drowsiness; lethargy
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Conivaptan
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Vasopressin receptor antagonist
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NaHCO3
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Antacid - systemic, irreversible; alkalosis
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CaCO3
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Antacid - nonsystemic, reversible
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Mg(OH)2
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Antacid - nonsystemic, reversible; renal insufficiency and diarrhea
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Al(OH)3
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Antacid - nonsystemic, reversible; constipation
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Pirenzepine
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M1 Antagonist
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Telenzepine
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M1 Antagonist
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Pipenzolate
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Muscarinic Antagonist
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Propantheline
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Muscarinic Antagonist
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Antihistamine - H2 Antagonist
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Uses: reduce acid secretion; Side Effects: GI (diarrhea, constipation); headache; breast enlargement; confusion in elderly patients; fatigue; muscle pain; inhibits P450 (mostly Cimetidine)
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Cimetidine
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Antihistamine - H2 Antagonist; least potent
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Ranitidine
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Antihistamine - H2 Antagonist; inhibits P450 less potently than Cimetidine (more potent than Cimetidine so no significant interactions with P450)
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Famotidine
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Antihistamine - H2 Antagonist; most potent
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Nizatidine
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Antihistamine - H2 Antagonist; highest bioavailability (90%)
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H+/K+ ATPase Inhibitor - substituted benzimidazoles
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Uses: antimicrobial activity (H. pylori); Side Effects: GI; increase gastrin secretion; increased susceptibility to infections; modified absorption of drugs
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Omeprazole
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H+/K+ ATPase Inhibitor - substituted benzimidazoles
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Lansoprezole
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H+/K+ ATPase Inhibitor - substituted benzimidazoles
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Sucralfate
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Gastric Protective Agent; indigestion, constipation
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Bismuth
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Gastric Protective Agent; antimicrobial activity; antidiarrheal
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Metoclopramide
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Dopamine Antagonist; Cholinomimetic properties - use to increase gastric emptying in reflux esophagitis and emergency surgery; 5HT4 agonist; 5HT3 antagonist; treat nausea and vomiting due to chemotherapy
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Castor Oil
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Laxative - Stimulant; increases cAMP; effect in small intestine
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Diphenylmethane
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Laxative - Stimulant; effect in large intestine
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Bisacodyl
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Laxative - Stimulant; effect in colon
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Phenolphthalein
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Laxative - Stimulant
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Anthraquinones (senna, cascara, aloes)
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Laxative - Stimulant; effect in colon; stimulates enteric nerves in increase motility
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Sulfate and phosphate salts of Mg, Na, K
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Laxative - Osmotic; Contraindication - Mg salts in renal insufficiency; dilute solutions more rapid onset
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Psyllium
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Laxative - Bulk ; treat IBS-C
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Bran
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Laxative - Bulk
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Cellulose
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Laxative - Bulk
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Glycerin
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Laxative - Lubricant
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Mineral Oil
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Laxative - Lubricant
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Dioctyl sodium sulfosuccinate (Docusate)
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Laxative - Surface acting
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Lactulose
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Laxative; reduce blood ammonia in chronic portal hypertension and hepatic encephalopathy
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Polyethylene glycol
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Laxative
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Diphenoxylate
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Opioid - Meperidine analogue; combined with atropine to prevent abuse (Lomotil); antidiarrheal; habit forming; adverse effects with barbiturates, alcohol, MAO-I
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Loperamide (Imodium)
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Opioid - Piperidine analogue; doesn't cross BBB (less abuse, interactions with barbiturates, alcohol); treat IBS-D
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Kaolin
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Antidiarrheal; often used with opiates
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Ursodiol
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Bile Acid; treat cholesterol gallstones
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Lubiprostone
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PGE Analog; activates type 2 Cl- channel (ClC-2); treat IBS-C
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Dicyclomine
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Muscarinic Antagonist; antispasmodic; treat IBS-D
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Hyoscyamine
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Muscarinic Antagonist; antispasmodic; treat IBS-D
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Alosetran
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5HT Antagonist; 5-HT3; treat IBS-D; decreases pain, bloating, nausea; causes severe constipation, ischemic colitis
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Tegaserod
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5HT Agonist; 5-HT4; treat IBS-C; cardiovascular complications-withdrawn
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5-ASA
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5-ASA formulation; topical effects; bound to sulfasalazine to prevent absorption in small intestine; cleaved in terminal ileum; Side Effects:nausea, GI, headaches, arthralgias, myalgias, bone marrow suppression, allergy to sulfasalazine
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Pentasa
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5-ASA formulation; time release in small intestine
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Asacol
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5-ASA formulation; pH sensitive release (pH 7) in distal ileum, colon
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Lialda
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5-ASA formulation; pH sensitive release in colon
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Methylprednisone
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Glucocorticoid; antiemetic (mechanism unknown)
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Budesonide
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Glucocorticoid; prednisone analog
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Azathioprine
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achieve and maintain remission in inflammatory bowel disease; better bioavailability; liver toxicity, bone marrow suppression; reduce dose if on allopurinol (which interferes with metabolism)
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6-mercaptopurine
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achieve and maintain remission in inflammatory bowel disease; liver toxicity, bone marrow suppression; reduce dose if on allopurinol (which interferes with metabolism)
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Methotrexate
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Antimetabolite; inhibits dihydrofolate reductase; prevents synthesis of purines and thymidine; oral, intramuscular, subcutaneous; treat inflammatory bowel disease (not antiproliferative at these doses; interfere with IL-1); bone marrow suppression, megaloblastic anemia, alopecia; folate supplementation to decrease side effects
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TNF-a Antibody
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Uses: inflammatory bowel disease (1/3 lose efficacy) Side Effects: infections, serum sickness type illness, liver failure, demyelinating disorders, CHF
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Infliximab
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TNF-a Antibody; IV
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Adalimumab
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TNF-a Antibody; subq injection
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Certolizumab
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TNF-a Antibody; subq injection
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Natalizumab
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Anti-Integrin Antibody; alpha 4 subunit of integrin; treat intractable Crohn's disease; Contraindications: other immunosuppressive therapies
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Aprepitant
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Neurokinin Antagonist; treat nausea/vomiting with chemotherapy
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Droperidol
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Dopamine Antagonist - D2 block; treat nausea/vomiting
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Meclozine
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H1 Antagonist; lacks drowsiness; treat nausea/vomiting
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Nabilone
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Cannabinoid; treat nausea/vomiting after chemotherapy
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Dronabinol
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Cannabinoid; treat nausea/vomiting after chemotherapy
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Guanadrel
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Peripheral Inhibitor
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Guanethidine
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Peripheral Inhibitor
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Reserpine
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Peripheral Inhibitor
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Clonidine
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Central Alpha-2 Agonist
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Guanabenz
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Central Alpha-2 Agonist
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Guanfacine
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Central Alpha-2 Agonist
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Methyldopa
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Central Alpha-2 Agonist; treat preeclampsia; no orthostatic hypotension
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Doxazosin
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Alpha-1 Blocker
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Prazosin
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Alpha-1 Blocker; decreases PVR; minimal tachycardia (baroreceptor reflex); orthostatic hypotension, sexual dysfunction; use with B-blockeres in pheochromocytoma
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Terazosin
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Alpha-1 Blocker
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Sodium Nitroprusside
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treat acute hypertensive emergencies
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