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197 Cards in this Set

  • Front
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H1 Antagonist (1st generation)
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
H1 Antagonist (2nd generation)
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
Chlorpheniramine
"H1 Antagonist (1st generation)
Diphenhydramine
H1 Antagonist (1st generation)
Pyrilamine
H1 Antagonist (1st generation)
Cyclizine
H1 Antagonist (1st generation)
Promethazine
H1 Antagonist (1st generation); orthostatic hypotension
Cyproheptadine
H1 Antagonist (1st generation); 5HT Antagonist - use for postgastrectomy dump syndrome (prevent diarrhea)
Fexofenadine
H1 Antagonist (2nd generation)
Loratadine
H1 Antagonist (2nd generation)
Cetirizine
H1 Antagonist (2nd generation)
Acrivastine
H1 Antagonist (2nd generation)
Buspirone
5HT Agonist; anxiolytic
Sumatriptan (triptans)
5HT Agonist; 5HT1d/1b agonists; treat migraines (vasoconstriction and reduce blood flow in brain) - repeat use not as effective
Odansetron
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
Ritaserine
5HT Antagonist; 5HT2 block - reduce thromboxane formation, alter bleeding time
Ketanserin
5HT Antagonist; 5HT1c, 5HT2 block - treat hypertension (receptors in bood vessels)
Dinoprostone (Prostin E2, Prepidil, Cervidil)
PGE2 Analog; labor facilitation (local administration, oxytocic use); 2nd trimester abortion; prevention of NSAID induced peptic ulcer
Misoprostol
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
Alprostadil
PGE1 Analog; PGI2 Analog; maintains patency of ductus arteriosus; treat erectile dysfunction (2nd line); prevention of NSAID induced peptic ulcer
Carboprost tromethamine
PGF2a Analog; 2nd trimester abortion; controls unresponsive postpartum hemorrhage
Latanoprost
PGF2a Analog; treat glaucoma; topically active
Bimatoprost
PGF2a Analog; treat glaucoma
Travoprost
PGF2a Analog; treat glaucoma
Epoprostenol (Flolan)
PGI2 Analog; treat primary pulmonary hypertension
Iloprost
PGI2 Analog; treat primary pulmonary hypertension
Trepostinil
PGI2 Analog; treat primary pulmonary hypertension
Indomethacin
NSAID-COX1
Sulindac
NSAID-COX1
Ibuprofen
NSAID-COX1/2
Nabumetone
NSAID-COX2
Aspirin
NSAID-COX (irreversible)
Celecoxib (Celebrex)
NSAID-COX2; less potent than Refecoxib (Vioxx); treat arthitis
Rofecoxib (Vioxx)
NSAID-COX2; increased incidence MI-withdrawn from market
Naproxen
NSAID-COX1/2; treat arthritis
Dexamethasone
Glucocorticoid-PLA2 inhibition; antiemetic (mechanism unknown)
Monteleukast (Singulair)
LTD4 Antagonist; treat asthma, bronchoconstriction
Zafirleukast (Accolate)
LTD4 Antagonist; treat asthma, bronchoconstriction
Zileuton (Zyflo)
5-Lipoxygenase Inhibitor; prevention of exercise induced asthma (fast acting)
Dazoxiben
TXA2 Synthase Inhibitor; treat acute and chronic coronary artery disease
Hydrazaline
Renal Vasodilation
Minoxidil
Renal Vasodilation
ACE Inhibitor
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
Captopril
ACE Inhibitor
Enalapril
ACE Inhibitor
Ramipril
ACE Inhibitor
Losartan
AT1 Blocker
Aliskiren
Renin Inhibitor; treat hypertension, CHF
Calcium Channel Blocker
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
Verapamil
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)
Nifedipine
Calcium Channel Blocker-Dihydropyridine; oral and sublingual; causes rapid fall in blood pressure
Nicardipine
Calcium Channel Blocker-Dihydropyridine; treat subarachnoid hemorrhage (if blood pressure elevated)
Amlodipine (Norvasc)
Calcium Channel Blocker-Dihydropyridine ("kinder and gentler")
Felodipine
Calcium Channel Blocker-Dihydropyridine
Isradipine
Calcium Channel Blocker-Dihydropyridine
Nimodipine
Calcium Channel Blocker-Dihydropyridine; treat subarachnoid hemorrhage (if blood pressure not elevated)
Diltiazem
Calcium Channel Blocker-Benzothiazipine
Bepridil
Calcium Channel Blocker (last resort); sodium channel blocking activity; pro-lithium activity
Nitrates
Side Effects: orthostatic hypotension, tachycardia, headache, tolerance
Amyl Nitrite
Nitrates; inhalational; no longer used; "poppers"
Nitroglycerin
Nitrates
Glygeryl Trinitrate
Nitrates
Isosorbide Dinitrate
Nitrates
Isosorbide Mononitrate
Nitrates; active metabolite of Isosorbide Dinitrate; 100% bioavailability
Erythrityl Tetranitrate
Nitrates
Methylxanthines
Mechanism: adenosine antagonism; inhibition phosphodiesterases; histone deacetylation
Theophylline
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)
Caffeine
Methylxanthine
Theobromine
Methylxanthine
Ergot Alkaloids
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
Ergonovine (ergometrine)
Ergot Alkaloids-Amine; treat post-partum uterine bleeding (greatest selectivity for uterine smooth muscle; oxytocin 1st line)
Methyl ergonovine
Ergot Alkaloids-Amine
Methysergide
Ergot Alkaloids-Amine
Ergotamine
Ergot Alkaloids-Amino Acid; diagnostic test for migraine
Dihydroergotamine
Ergot Alkaloids-Amino Acid
Bromocriptine
Ergot Alkaloids-Amino Acid; inhibits prolactin release (dopamine agonist); treat pituitary tumor
Cabergoline
Ergot Alkaloids; dopamine agonist
Pergolide
Ergot Alkaloids; dopamine agonist
Sildenafil (Viagra)
PDE Inhibitor
Tadalafil (Cialis)
PDE Inhibitor
Vardenafil (Levitra)
PDE Inhibitor
Beta Blocker
Contraindications: Prinzmetal angina; asthma; COPD; Raynaud's; peripheral artery disease; sinus bradycardia; AV block; diabetes
Acebutolol
Beta Blocker; B1; partial agonist
Atenolol (Tenormin)
Beta Blocker; B1; nightmares
Betaxolol
Beta Blocker; B1
Bisoprolol
Beta Blocker; B1
Esmolol (Reviblock)
Beta Blocker; B1; rapidly metabolized (found in crash carts)
Propanolol
Beta Blocker; anesthetic action; nightmares
Diuretic - Carbonic Anhydrase Inhibitor
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
Acetazolamide (Diamox)
Diuretic - Carbonic Anhydrase Inhibitor
Dichlorphenamide
Diuretic - Carbonic Anhydrase Inhibitor
Methazolamide
Diuretic - Carbonic Anhydrase Inhibitor
Glycerin
Diuretic - Osmotic; oral
Isosorbide
Diuretic - Osmotic; oral
Mannitol
Diuretic - Osmotic; IV
Urea
Diuretic - Osmotic; IV
Diuretic - Loop (High Ceiling)
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
Furosemide (Lasix)
Diuretic - Loop (High Ceiling); ototoxicity
Ethacrynic Acid (Edecrin)
Diuretic - Loop (High Ceiling); prodrug; give if sulfa allergy
Bumetanide (Bumex)
Diuretic - Loop (High Ceiling); less dependent on tubular organic acid secretion (more lipophilic); more potent than furosemide
Torsemide (Demadex)
Diuretic - Loop (High Ceiling)
Azosemide
Diuretic - Loop (High Ceiling)
Muzolimine
Diuretic - Loop (High Ceiling)
Piretanide
Diuretic - Loop (High Ceiling)
Tripamide
Diuretic - Loop (High Ceiling)
Brain Natriuretic Peptide
produced in ventricular myocytes; marker for CHF; inhibits renin release; fosters loss of salt and water
Diuretic - Thiazide
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)
Bendroflumethiazide
Diuretic - Thiazide
Chlorothiazide
Diuretic - Thiazide; low potency
Hydrochlorothiazide
Diuretic - Thiazide; prolonged duration of action; side effects above 25mg
Hydroflumethiazide
Diuretic - Thiazide
Methyclothiazide
Diuretic - Thiazide
Polythiazide
Diuretic - Thiazide
Trichlormethiazide
Diuretic - Thiazide
Indapamide (Lozol)
Diuretic - Thiazide-like
Chlorthalidone (Hygroton)
Diuretic - Thiazide-like
Metolazone
Diuretic - Thiazide-like
Quinethazone
Diuretic - Thiazide-like
Diuretic - Potassium Sparing
Mechanism: block ENaC in collecting tubule (bind alpha subunit); Side Effects: hyperkalemia, acidosis
Amiloride
Diuretic - Potassium Sparing; treat edema & hypertension together with thiazides; treat Liddle's syndrome; treat lithium induced nephrogenic diabetes insipidus; Gitelman's syndrome
Triamterine
Diuretic - Potassium Sparing; interaction with NSAIDS
Mineralocorticoid Receptor Antagonist
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
Eplerenone
Mineralocorticoid Receptor Antagonist; weaker but more selective (no androgen antagonist activity)
Spironolactone
Mineralocorticoid Receptor Antagonist; androgen antagonist activity; hyperkalemia; gynecomastia (anti-androgenic effects); gastritis; peptic ulcer disease; drowsiness; lethargy
Conivaptan
Vasopressin receptor antagonist
NaHCO3
Antacid - systemic, irreversible; alkalosis
CaCO3
Antacid - nonsystemic, reversible
Mg(OH)2
Antacid - nonsystemic, reversible; renal insufficiency and diarrhea
Al(OH)3
Antacid - nonsystemic, reversible; constipation
Pirenzepine
M1 Antagonist
Telenzepine
M1 Antagonist
Pipenzolate
Muscarinic Antagonist
Propantheline
Muscarinic Antagonist
Antihistamine - H2 Antagonist
Uses: reduce acid secretion; Side Effects: GI (diarrhea, constipation); headache; breast enlargement; confusion in elderly patients; fatigue; muscle pain; inhibits P450 (mostly Cimetidine)
Cimetidine
Antihistamine - H2 Antagonist; least potent
Ranitidine
Antihistamine - H2 Antagonist; inhibits P450 less potently than Cimetidine (more potent than Cimetidine so no significant interactions with P450)
Famotidine
Antihistamine - H2 Antagonist; most potent
Nizatidine
Antihistamine - H2 Antagonist; highest bioavailability (90%)
H+/K+ ATPase Inhibitor - substituted benzimidazoles
Uses: antimicrobial activity (H. pylori); Side Effects: GI; increase gastrin secretion; increased susceptibility to infections; modified absorption of drugs
Omeprazole
H+/K+ ATPase Inhibitor - substituted benzimidazoles
Lansoprezole
H+/K+ ATPase Inhibitor - substituted benzimidazoles
Sucralfate
Gastric Protective Agent; indigestion, constipation
Bismuth
Gastric Protective Agent; antimicrobial activity; antidiarrheal
Metoclopramide
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
Castor Oil
Laxative - Stimulant; increases cAMP; effect in small intestine
Diphenylmethane
Laxative - Stimulant; effect in large intestine
Bisacodyl
Laxative - Stimulant; effect in colon
Phenolphthalein
Laxative - Stimulant
Anthraquinones (senna, cascara, aloes)
Laxative - Stimulant; effect in colon; stimulates enteric nerves in increase motility
Sulfate and phosphate salts of Mg, Na, K
Laxative - Osmotic; Contraindication - Mg salts in renal insufficiency; dilute solutions more rapid onset
Psyllium
Laxative - Bulk ; treat IBS-C
Bran
Laxative - Bulk
Cellulose
Laxative - Bulk
Glycerin
Laxative - Lubricant
Mineral Oil
Laxative - Lubricant
Dioctyl sodium sulfosuccinate (Docusate)
Laxative - Surface acting
Lactulose
Laxative; reduce blood ammonia in chronic portal hypertension and hepatic encephalopathy
Polyethylene glycol
Laxative
Diphenoxylate
Opioid - Meperidine analogue; combined with atropine to prevent abuse (Lomotil); antidiarrheal; habit forming; adverse effects with barbiturates, alcohol, MAO-I
Loperamide (Imodium)
Opioid - Piperidine analogue; doesn't cross BBB (less abuse, interactions with barbiturates, alcohol); treat IBS-D
Kaolin
Antidiarrheal; often used with opiates
Ursodiol
Bile Acid; treat cholesterol gallstones
Lubiprostone
PGE Analog; activates type 2 Cl- channel (ClC-2); treat IBS-C
Dicyclomine
Muscarinic Antagonist; antispasmodic; treat IBS-D
Hyoscyamine
Muscarinic Antagonist; antispasmodic; treat IBS-D
Alosetran
5HT Antagonist; 5-HT3; treat IBS-D; decreases pain, bloating, nausea; causes severe constipation, ischemic colitis
Tegaserod
5HT Agonist; 5-HT4; treat IBS-C; cardiovascular complications-withdrawn
5-ASA
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
Pentasa
5-ASA formulation; time release in small intestine
Asacol
5-ASA formulation; pH sensitive release (pH 7) in distal ileum, colon
Lialda
5-ASA formulation; pH sensitive release in colon
Methylprednisone
Glucocorticoid; antiemetic (mechanism unknown)
Budesonide
Glucocorticoid; prednisone analog
Azathioprine
achieve and maintain remission in inflammatory bowel disease; better bioavailability; liver toxicity, bone marrow suppression; reduce dose if on allopurinol (which interferes with metabolism)
6-mercaptopurine
achieve and maintain remission in inflammatory bowel disease; liver toxicity, bone marrow suppression; reduce dose if on allopurinol (which interferes with metabolism)
Methotrexate
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
TNF-a Antibody
Uses: inflammatory bowel disease (1/3 lose efficacy) Side Effects: infections, serum sickness type illness, liver failure, demyelinating disorders, CHF
Infliximab
TNF-a Antibody; IV
Adalimumab
TNF-a Antibody; subq injection
Certolizumab
TNF-a Antibody; subq injection
Natalizumab
Anti-Integrin Antibody; alpha 4 subunit of integrin; treat intractable Crohn's disease; Contraindications: other immunosuppressive therapies
Aprepitant
Neurokinin Antagonist; treat nausea/vomiting with chemotherapy
Droperidol
Dopamine Antagonist - D2 block; treat nausea/vomiting
Meclozine
H1 Antagonist; lacks drowsiness; treat nausea/vomiting
Nabilone
Cannabinoid; treat nausea/vomiting after chemotherapy
Dronabinol
Cannabinoid; treat nausea/vomiting after chemotherapy
Guanadrel
Peripheral Inhibitor
Guanethidine
Peripheral Inhibitor
Reserpine
Peripheral Inhibitor
Clonidine
Central Alpha-2 Agonist
Guanabenz
Central Alpha-2 Agonist
Guanfacine
Central Alpha-2 Agonist
Methyldopa
Central Alpha-2 Agonist; treat preeclampsia; no orthostatic hypotension
Doxazosin
Alpha-1 Blocker
Prazosin
Alpha-1 Blocker; decreases PVR; minimal tachycardia (baroreceptor reflex); orthostatic hypotension, sexual dysfunction; use with B-blockeres in pheochromocytoma
Terazosin
Alpha-1 Blocker
Sodium Nitroprusside
treat acute hypertensive emergencies