Pharm Block 2 Drugs

Front 1

Acetazolamide

Back 1

Diamox Carbonic anhydrase inhibitor Site 1 (prox tubule) Block Na+/H+ antiporter; inhibits HCO3- reabsorption & carbonic anhydrase ↓ CSF & intraocular volume Glaucoma, epilepsy, acute mountain sickness Alkalinized Urine --> Hyperchloremic Metabolic acidosis DI with Memantine

Front 2

Furosemide

Back 2

Lasix High-ceiling ("Loop") Site 2 (Asc. Limb) Block Na+/K+/2Cl- (NKCC2 transporter); acts on tubular side of cell; effective natriuretic; ↑ renal blood flow Diuresis; vasodilator Edema (acute and/or pulmonary), ↑ Ca2+; HTN in pts w ↓ renal blood flow PO or subq Half-life = 50 min Hypokalemia, ototoxicity, hypochloremic metabolic alkalosis, hyperglycemia, hyperuricemia, hypertriglyceridemia, GI problems, hypomagnesemia, hypotension must be secreted into proximal tubule; counter-current washout; DI w/ COX inhibitors, propranolol, organic acids, albumin binders

Front 3

Bumetanide

Back 3

Bumex High-ceiling Site 2 NKCC2 blocker; 4x as potent as furosemide Diabetic pts or pts allergic to furosemide Less hyperglycemia OH DANG!- ototoxicity, hypokalemia, dehydration, allergy (sulfa), nephritis, gout

Front 4

Ethacrynic acid

Back 4

Edecrin High-ceiling Site 2 NKCC2 blocker w/o sulfonamide group Pts w/ sulfa allergy More GI problems, less hyperglycemia

Front 5

Torsemide

Back 5

Demedex High-ceiling Site 2 NKCC2 blocker w/ 2x greater bioavailability Long half-life (QD dose)

Front 6

Chlorothiazide

Back 6

Diuril Thiazide Site 3 (DCT) Block Na+/Cl- cotransport; produce hyperosmolar urine Long-term therapy HTN management, CHF, hypercalciuria, mild edema, diabetes insipidus PO Long half-life, 1-3 weeks for effect ↓ K+ (supplement with K+ diet, salts, or spironolactone); ↓ Na+; hyperuricemia; orthostatic hypotension, ↑ Ca2+, ↑ glucose, hyperlipidemia (may return to normal); hypersensitivity; impaired excretion of Li+; metabolic alkalosis; toxic with digitalis; decrease renal BF Not useful if GFR < 30 ml/min

Front 7

Hydrochlorothiazide

Back 7

Hydrodiuril Thiazide Site 3 NCC blocker, more potent than CTZ

Front 8

Spironolactone

Back 8

Aldactone K+-sparing Site 4 (Collecting tubule) Aldosterone receptor antagonist (competitive); blocks aldosterone Na+/K+ exchange; inhibits K+ loss Slight Na+ excretion & diuresis K+ protection from diuretics; strong action in CHF or liver cirrhosis, hyperaldosteronism PO with food Slow on/off (steroid action) Hyperkalemia (bad in DM or ↓ GFR); gynecomastia, impotence, menstrual irregularities never with physiological antagonist

Front 9

Eplerenone

Back 9

Ispra K+-sparing Site 4 Specific mineralocorticoid receptor antagonist Combo w/ site 3 diuretics HTN, post-MI, K+ protection Hyperkalemia

Front 10

Triamterene

Back 10

Dyrenium K+-sparing Site 4 Physiologic antagonist of aldosterone (electrogenic, fast-acting); inhibits Na+ channel influx, dissipates transepithelial potential PO Half-life = 3 hours Rare nephrotoxicity w/ indomethacin

Front 11

Amiloride

Back 11

Midamor K+-sparing Site 4 PO Half-life = 6-9 hours hyperkalemia, increased Li reabsorption, elevate urate

Front 12

Dopamine

Back 12

Hemodynamic a1, b1, DA receptor agonist ↑ blood flow & GFR, ↓ counter-current exchange Renal vasodilator w/ dobutamine post-MI

Front 13

Caffeine

Back 13

Hemodynamic Vasa recta

Front 14

Mannitol

Back 14

Osmotic Plasma compartment Countercurrent washout, 4 attributes: inert, osmotically active, filtered not reabsorbed, not metabolized; prevent reabsorption of water Cerebral edema, glaucoma, prophylaxis of acute renal failure IV Excess CSF volume if removed rapidly: HA, nausea, vomiting; contraindicated in anuria, peripheral edema, CHF, & dehydration

Front 15

Isosorbide

Back 15

Osmotic Plasma compartment Eye surgery IV or PO

Front 16

Propranolol

Back 16

β-blocker Antagonize stretch receptors and ↓ renin release HTN, tremor Ineffective when plasma renin activity is low

Front 17

Clonidine

Back 17

"α2-agonist/CNS adrenolytic
" HTN

Front 18

Methyldopa

Back 18

CNS adrenolytic HTN

Front 19

Captopril

Back 19

Capoten PDP (ACE) inhibitor; has sulfhydryl group Block conversion of angiotensin I to II. ↑ Renin release ↓ blood pressure & aldosterone secretion HTN (w/ DM nephropathy), CHF, angina, post-MI PO w/o food Half life= 1.5-2 hours Hypoglycemia w/ insulin (due to sulpher moeity) proteinuria, hypogustia, hypersensitivity, cough, neutropenia; DO NOT use in combination with triamterene or amiloride: hyperkalemia

Front 20

Enalapril

Back 20

Vasotec PDP inhibitor; has carboxyl group; prodrug → enalaprilat (active) PO w/ or w/o food; IV enalaprilat Half-life = 11 hours (QD dose) fewer side effects

Front 21

Lisinopril

Back 21

Zestril PDP (ACE) inhibitor PO w/ or w/o food Half-life = 12 hours no plasma binding

Front 22

Benazepril

Back 22

Lotensin most potent PDP inhibitor

Front 23

Losartan K

Back 23

Cozaar Angiotensin II receptor antagonist Blocks binding of angiotensin II to AT-1 receptors Alone or + HCTZ (Hyzaar) PO Half-life of metabolite = 9 hours Dizziness, hyperkalemia excreted in bile

Front 24

Valsartan

Back 24

Diovan Angiotensin II receptor antagonist Alone or + HCTZ (Diovan HCT) PO w/o food

Front 25

Aliskiren

Back 25

Non-Peptide Renin Inhibitor "Blocks production via the classical pathway of all forms of angiotensins.
" PO poor bioavailability (3%) but long half life Diarrhea, hyperkalemia Does not inhibit kinins

Front 26

Fludrocortisone

Back 26

Aldosterone agonist Mineralocorticoid Given w/ glucocorticoid Adrenal insufficiency PO

Front 27

DOCA (deoxocorticosterone acetate)

Back 27

Aldosterone agonist IV or IM (in oil)

Front 28

Spironolactone

Back 28

Aldactone Aldosterone competitive antagonist Binds to mineralocorticoid, androgen & progestin receptors HTN, CHF weakly diuretic

Front 29

Eplerenone

Back 29

Inspra Aldosterone competitive antagonist more specific mineralcorticoid agonist HTN, post-MI

Front 30

Triamterene

Back 30

Aldosterone physiological antagonist DO NOT use with ACE inhibitors K+ sparing

Front 31

Amiloride

Back 31

Aldosterone physiological antagonist

Front 32

Allopurinol

Back 32

Zyloprim Xanthine oxidase inhibitor Inhibits biosynthesis of uric acid (competitive antagonist) Long-term therapy Chronic, tophagous gout w/ ↑ urate production, ↓ renal function PO May precipitate gout attack on initiation of therapy; GI sx, skin rash, hypersensitivity; drug interactions Use if hypersensitivity to uricosuric agents

Front 33

Febuxostat

Back 33

Uloric Xanthine oxidase inhibitor Inhibits biosynthesis of uric acid (more specific than allopurinol) Reduced frequency of hypersensitivity compared to allopurinol Increased CV adverse effects

Front 34

Colchicine

Back 34

Impairs chemotaxis of granulocytes into gouty joints Acute therapy or + probenecid Acute gout attacks Nausea & vomiting Most likely interferes with tubulin activity

Front 35

Pegloticase

Back 35

Krystexxa Uricase Recombinant Exogenous enzyme (uricase) oxidizes uric acid to alltoin (highly water soluble) Acute reduction of serum urate Treatment of gout unresponsive to standard therapy IV infusion

Front 36

Probenecid

Back 36

Benemid Uricosuric High doses ↑ urate excretion, ↓ urate reabsorption & secretion (competitive inhibition) Long-term therapy Chronic gout or 1-shot treatment of uncomplicated gonococcal + long-acting penicillin (blocks secretion) PO GI problems, kidney stones, hypersensitivity; Low dose: "paradoxical effect" ↓ urate excretion and ↑ plasma urate; aspirin prevents actions on urate; additive actions with sulfinpyrazone; antagonizes diuretics highly lipid soluble; passive reabsorption from nephron

Front 37

Sulfinpyrazone

Back 37

Anturane Uricosuric Metabolite of phenylbutazone, strong acid; ↑ urate excretion Chronic gout w/ hypersensitivity to probenecid More GI problems, less hypersensitivity antithrombotic properties of unknown mechanism

Front 38

Ethanol

Back 38

alcohol Sedative- hypnotic Binds to GABAa receptor to open Cl- channels; inhibits NMDA glutamate receptors rapidly absorbed by GI; Liver EtOH dehydrogenase or MEOS → aldehyde dehydrogenase → acetate (uses NADH/NADPH) zero-order kinetics: 1 drink(6-8g)/hr Methanol toxicity Disinhibition, CNS depression (ataxia, slurred speech, coma, delirium); risk of aspiration, vasodilation, cardiac depression, diuresis, blackouts Cirrhosis, pancreatitis, PUD, malnutrition, CA, FAS, Wernicke- Korsakoff thymine deficiency (causes neuropathy, confusion) Anxiety, insomnia, anorexia, sympathetic autonomic hyperactivity, delirium tremens, seizures; subsides within 3-7 days OD: supportive, prevent aspiration; Chronic: rehab, thiamine; Withdrawal: BZ for seizure, haldol, clonidine Inhibits metabolism and duration of warfarin and phenytoin; contraindicated with drugs irritating the GI; cross-tolerance w/ benzodiazepines & barbiturates

Front 39

Disulfiram

Back 39

Adjunct to treat alcoholism

Front 40

Naltrexone

Back 40

Alcoholism

Front 41

Acamprosate

Back 41

Alcoholism

Front 42

Methanol

Back 42

Blurred vision, blindness, seizures, coma, acidosis Supportive therapy, ethanol Necrosis of bilateral putamina & claustra, toxic to retinal ganglion cells

Front 43

Ethylene Glycol

Back 43

renal insufficiency/injury due to metabolic acidosis and oxalate deposition in the kidney. Ethanol, Fomepizole

Front 44

Thiopental

Back 44

IV general anesthesia Drowsiness, respiratory depression; induce hepatic δ-aminolevulinic acid synthase (worsen acute intermittent porphyria); add to EtOH CNS depression; ↑ metabolism of steroid hormones (hepatic microsomal enzymes) Cellular & enzymatic tolerance; physical dependence Anxiety, insomnia, anorexia, autonomic hyperactivity (similar to EtOH) Respiratory support, gastric lavage, hemodialysis, osmotic diuretics cross-tolerance w/ other sedative=hypnotics

Front 45

Pentobarbital

Back 45

Preanesthesia, regional anesthesia

Front 46

Phenobarbital

Back 46

Epilepsy, w/drawal from Sedative-Hypnotics; congenital hyperbilirubin, neonatal jaundice

Front 47

Cocaine

Back 47

Topical anesthesia (inherent vasoconstriction) Euphoria, ↑ activity, ↓ appetite, sympathetic stimulation, sexual arousal; insomnia, anxiety, tachycardia, HTN, sexual dysfunction Huge tolerance; anxiety, insomnia, psychological dependence; CVA, seizure, coronary vasospasm, MI, psychosis; nasal perforation, "crack baby" (cocaine) Crash: anxiety, fatigue, hypersomnia, hunger; Withdrawal: drug craving, anhedonia, depression, dysphoria

Front 48

Amphetamine

Back 48

ADHD, narcolepsy (+) necrotizing arteritis

Front 49

Nicotine

Back 49

Patch, gum, inhalant for nicotine dependence ↑ motor activity, cognitive function, ADH, ↑ BP & HR, GI tract tone; ↓ appetite, N&V CANCER, Cellular, some metabolic tolerance; develops rapidly, long-lasting; psychological dependence ↓ DA in nucleus accumbens; craving, tremor, dizziness, irritability, anxiety, ↑ appetite Nicotine treatments + behavioral therapy; may use antidepressants: Bupropion; Varenicline (nicotine receptor antagonist) It's the smoooooooke..., crosses placenta

Front 50

Marijuana/Dronabinol

Back 50

N&V from CA chemo, appetite stimulant in AIDS; ↓ intraocular pressure in glaucoma; neuropathic pain Euphoric state, ↑ appetite, relaxation; tachycardia, red eyes, laughter, inattention, tremulosness, ↓ ST memory Lung damage from smoke; cognitive impairement No demonstrated physical dependence/ withdrawal syndrome

Front 51

LSD

Back 51

Dilated pupils, ↑ BP, tachycardia; Good Trip: altered consciousness, euphoria, ↑ sensory awareness, introspection; Bad Trip: anxiety, agitation, panic reactions, psychosis, hallucinations Tolerance, cross-tolerance w/ LSD, psilocybin, mescaline BZ and therapy

Front 52

Phencyclidine

Back 52

Euphoria, personality dissociation, poor judgment, aggression, psychosis; hallucinations, seizures, respiratory depression, coma; renal failure, rhabdomyolysis Induced vomiting, respiratory support, seizure control w/ BZ, reduce sensory stimulation

Front 53

Hydrochlorothiazide

Back 53

HCTZ Thiazide diuretic ↓ reabsorption of Na+; loss of Cl-, K+, Mg2+, water ↓ vascular volume, ↓ TPR HTN, CHF, hypercalciuria, diabetes insipidus Hypokalemia, hyponatremia, gout, volume depletion First step therapy for prevention of HF

Front 54

Furosemide

Back 54

Lasix Loop diuretic Inhibits Na+/K+/Cl- cotransport ↓ vascular volume, ↓ TPR CHF, pulmonary edema (acute, rapid onset) Ototoxicity, hypokalemia, gout, hypovolemia, hypomagnesemia

Front 55

Spironolactone

Back 55

Aldosterone competitive antagonist (K+ sparing) K+ retention, Na+ excretion ↓ vascular volume CHF, cirrhosis Hyperkalemia with ACE Inh or ARB; gynecomastia, GI upset, mental confusion

Front 56

Eplerenone

Back 56

Aldosterone competitive antagonist (K+ sparing) K+ retention, Na+ excretion ↓ vascular volume CHF, cirrhosis Hyperkalemia with ACE Inh or ARB; gynecomastia, GI upset, mental confusion

Front 57

Amiloride

Back 57

Dyrenium K+-sparing Physiologic antagonist of aldosterone (electrogenic, fast-acting); inhibits Na+ channel influx, dissipates transepithelial potential

Front 58

Atenolol

Back 58

Tenormin β1-blocker ↓ BP, afterload ↓ CO, ↓ renin activity HTN Less bronchial constriction; careful in CHF, asthma, COPD, and heart block pts QD or BID; longer T1/2 than metoprolol

Front 59

Propranolol

Back 59

Inderal β antagonist Equal β1 and β2; blocks NE and Epi blocks cardiostimulatory effects of NE and Epi and thus ↓ cardiac output, blocks β1 renin release and thus angiotensin formation (↓ O2 demand); crosses BBB HTN, arrhythmia, angina, migraine prophylaxis, anxiety, essential tremor reduction Careful in heart failure; blocks B2→worsens asthma, COPD, and emphysema; hypoglycemia; allergy complications; abrupt cessation of B antagonist can precipitate angina and increase risk of sudden death "PO has poor bioavalibility, 3-4 hours (large first-pass effect), competitive antagonist lipophilic & crosses BBB

"

Front 60

Prazosin

Back 60

Minipress α1 antagonist Blocks vascular α-1 receptors, arterial & venous: blocks NE effects Relax smooth muscle, vasodilation Benign prostatic hypertophy (BPH), mild to moderate HTN; heart failure (↓ pre- and afterload) Orthostatic hypotension, inhibits ejaculation, little reflex tachycardia "3 hour half-life (liver metabolism), not block A2 receptors & does not increase neural release of NE
"

Front 61

Carvedilol

Back 61

CoReg α1 antagonist, β antagonist *Pan beta (1&2) blocker→decreases cardiac, arterial, and kidney effects of B1&2 actions of NE *alpha 1 blocker→decreases vasoconstriction and BP *antioxidant→counteracts production of O2 radicals CHF Used with ACE inhibitors and diuretics; blocks ischemia, further damage

Front 62

Clonidine

Back 62

Catapres alpha 2 agonist prejunctional a2 receptors inhibit release of NE, decreases vasoconstriction through CNS (a2 receptors normally produce vasoconstriction) ↓ BP Hypertension; opioid withdrawal; diarrhea Rebound HTN, hypotension, dry mouth, sedation, should not be abruptly discontinued

Front 63

Enalapril

Back 63

Vasotec ACE Inhibitor ↓ BP, afterload increase vasodilation, decrease aldosterone CHF, HTN, MI, angina Cough, orthostatic hypotension, hyperkalemia, not in pregnancy! Cough from failure to inactivate bradykinin

Front 64

Losartan

Back 64

Cozaar ARB ↓ BP, afterload increase vasodilation HTN, CHF Orthostatic hypotension; hyperkalemia; not in pregnancy!

Front 65

Aliskiren

Back 65

Renin inhibitor Inhibit peptidase activity of renin: Reduce Angiotensin II vasodilation HTN hyperkalemia Same efficacy as ACEs/ARBs, may have greater renin rebound

Front 66

Verapamil

Back 66

Calan, Isoptin Ca2+ blocker: diphenylalkylamine Bind to subunit of L-type channel, ↓ Ca2+ influx ↓ vascular tone; ↓ HR (countered by baroreceptor reflex) HTN (mild to severe); angina due to spasm Headache, flushing, constipation, premature labor, peripheral edema; NOT in CHF, heart block, or WPW

Front 67

Nifedipine

Back 67

Procardia Ca2+ blocker: dihydropyridine cardiosparing ↓ vascular tone, less heart effect Short or sustained release

Front 68

Hydralazine

Back 68

Apresoline Direct arterial relaxants ↓ BP, afterload possible NO donor, mechanism not fully understood HTN, CHF Headache, flushing, slow acetylators: lupus-like syndrome Depends on rate of liver acetylation

Front 69

Minoxidil

Back 69

Loniten/Rogaine K+ arterial relaxants ↓ BP, afterload HTN, baldness Headache, flushing, hypertrichosis

Front 70

Omalizumab

Back 70

Xolair Anti-IgE antibody binds circulating IgE Long-term control Asthma & Allergic Rhinitis SubQ every 2-4 weeks long-acting not all patients respond to treatment

Front 71

Beclomethasone

Back 71

Beclovent, Vaneril; Beconase, Vancenase Corticosteroid Inhibit synthesis of inflammatory mediators Increase number and responsiveness of B2 receptors (relaxation) Emergency or long-term Asthma, Rhinitis Inhalation (chronic) or IV (acute); Topical for Rhinitis Rapid systemic metabolism High lipid solubility; Promotes oropharyngeal candidiasis, dysphonia (hoarseness), suppression of adrenal axis in children, bone loss? First of its class

Front 72

Flunisolide

Back 72

AeroBid; Nasalide Asthma, Rhinitis
Corticosteroid

Front 73

Ciclesonide

Back 73

Corticosteroid
prodrug that is activated by esterases in mucosal cells

Asthma, Rhinitis

Front 74

Budesonide

Back 74

Pulmicort; Rhinocort
Corticosteroid Asthma in young children, Rhinitis Nebulizer

Front 75

Methylprednisolone

Back 75

Solu-medrol Emergency Asthma IV

Front 76

Cromolyn

Back 76

Intal; Nasalcrom, Crolom
Cromone Prevents release of mediators from mast cells Inhibits early and late responses; long-term Asthma: antigen, cold, & exercise induced; Rhinitis Inhalation, prior to exercise; nasal spray, optic solution 4-8 week trial Will not abort an acute attack

Front 77

Nedocromil

Back 77

Tilade; Alocril Cromone Inhibits mast cell activation & chemotaxis Long-term control; prior to exercise or exposure to known antigen 3-4 days to be efffective

Front 78

Zileuton

Back 78

Zyflo Anti-leukotriene 5-lipooxygenase inhibitor Long-term control; attenuates bronchospasm and inflammatory response Asthma, Rhinitis PO Short-acting ↑ liver enzymes; interferes w/ drug metabolism: warfarin, propranolol, theophylline

Front 79

Montelukast

Back 79

Singulair Leukotriene receptor antagonist Asthma, Rhinitis PO Long-acting excreted in bile

Front 80

Ipratroprium

Back 80

Atrovent Muscarinic antagonist bronchodilatation, reduce secretion long-term control Asthma, intolerant to B agonists; Rhinitis slow onset, long duration local irritation

Front 81

Tiotropium

Back 81

Spiriva Muscarinic & Cholinergic antagonist Chronic Bronchitis, emphysema long acting

Front 82

Atropine

Back 82

Cholinergic antagonist

Front 83

Epinephrine

Back 83

Primatine, Bronkaid α & β-adrenergic agonist inhibit mast cell release, increase mucociliary clearance, relax airway smooth muscle long-term control, PRN for acute symptoms Asthma Inhalation, SubQ (emergency) immediate onset, short duration Vasoconstriction, Cardiac stimulation, skeletal muscle tremor; refractoriness (counteracted w/ corticosteroid); mask progression of disease

Front 84

Isoproterenol

Back 84

Isuprel, Medihaler-Iso, Vapolso β- adrenergic agonist Asthma Inhalation, parenterally

Front 85

Pirbuterol

Back 85

Maxair beta 2 agonist Asthma Inhalation

Front 86

Theophylline

Back 86

Methylxanthine Block adenosine receptors, inhibit cAMP phosphodiesterase, alter translocation of intracellular Ca acute & long-term control Asthma, chronic bronchitis, emphysema IV, PO widely variable: disease, drug & diet dependent Headache, insomnia, anxiety, behavioral & learning problems, N&V, heartburn, ulcers, tremor, convulsions, arrhythmias; very narrow TI good oral bioavailability; crosses BBB, placenta

Front 87

Diphenhydramine

Back 87

Benadryl Ethanolamine "First Gen" H1 receptor antagonist, muscarinic receptor antagonist Rhinitis, sedation, motion sickness, common cold prophylaxis PO onset within 30 min., max effect at 1-2 hrs, duration 3-6hrs Sedation, anti-cholinergic action, hypersensitivity, tolerance, CNS stimulation in children Cross BBB & placenta

Front 88

Chlorpheniramine

Back 88

Tavist, Chlor-Trimeton Alkylamine

Front 89

Hydroxyzine

Back 89

"First Gen" H1 receptor antagonist, muscarinic receptor antagonist

Front 90

Promethazine

Back 90

"First Gen" H1 receptor antagonist, muscarinic receptor antagonist

Front 91

Loratadine

Back 91

Claritin "Second Gen" H1 receptor antagonist Longer half life Absorption altered with grapefruit juice; arrhythmias No crossing of the BBB, no sedation, no anticholinergic action

Front 92

Desloratidine

Back 92

"Second Gen" H1 receptor antagonist Longer half life Absorption altered with grapefruit juice; arrhythmias No crossing of the BBB, no sedation, no anticholinergic action

Front 93

Fexofenadine

Back 93

"Second Gen" H1 receptor antagonist Longer half life Absorption altered with grapefruit juice; arrhythmias No crossing of the BBB, no sedation, no anticholinergic action

Front 94

Epinephrine

Back 94

Adrenalin Cl alpha receptor agonist Vasoconstriction Rhinitis Topical rapid onset Few systemic; rebound congestion, rhinitis medicamentosa, tachyphylaxis

Front 95

Phenylephrine

Back 95

alpha receptor agonist Vasoconstriction Rhinitis Topical rapid onset Few systemic; rebound congestion, rhinitis medicamentosa, tachyphylaxis

Front 96

Pseudoephedrine

Back 96

Sudafed, Afrinol PO slow onset, longer acting dizziness, tremor, insomnia, irritability, palpitations, HTN less potential for dependence

Front 97

Codeine

Back 97

Antitussive Opiod analgesic decreases sensitivity of cough center antitussive action at doses lower than those required for analgesia

Front 98

Dextromethorphan

Back 98

Pertussin Antitussive
Opiod sterioisomer decreases sensitivity of cough center no analgesic or addictive effect

Front 99

Guaifenesin

Back 99

Expectorant stimulate secretory activity, reduce viscosity of mucus Triggers vagal reflex - near emetic doses required

Front 100

Terpin hydrate

Back 100

Expectorant

Front 101

Iodides

Back 101

Expectorant

Front 102

Acetylcysteine

Back 102

Mucomyst reduces sputum viscosity Inhalation

Front 103

Chlorpromazine

Back 103

Thorazine Aliphatic Phenothiazine (PTZ) Low Antagonist at dopamine D2 receptors, mostly in mesolimbic & mesocortical tracts (therapeutic effect); also antagonize histamine H1-receptors (CNS), muscarinic cholinergic receptors (PNS), and α-adrenergic receptors (PNS) Schizophrenia, Schizoaffective Disorder, Mania, Tourette's syndrome, antiemetic (except thioridazine), Delusional disorder; Depression w/ psychotic features, Borderline Personality Disorder, severe agitation/violence, delirium, dementia SE's: Agranulocytosis, cholestatic jaundice, photosensitivity Impotence/sexual dysfunction, orthostatic hypotension (α-adrenergic blockade); sedation, weight gain (histamine H1 blockade); anticholinergic crisis; seizures, hyperprolactinemia; withdrawal-like syndrome (nausea, vomiting, insomnia, headache); neuroleptic malignant syndrome Additive: CNS depressants (sedative- hypnotics, alcohol), Levodopa, anticholinergics; antacids decrease absorption, TCAs reduce blood levels, smoking increases metabolism; macrolide antibiotics Improves positive symptoms

Front 104

Thioridazine

Back 104

Mellaril Antagonist at dopamine D2 receptors, mostly in mesolimbic & mesocortical tracts (therapeutic effect); also antagonize histamine H1-receptors (CNS), muscarinic cholinergic receptors (PNS), and α-adrenergic receptors (PNS)
Piperidine PTZ Low SE's: ↑ Q-T interval, arrhythmia, priapism, retrograde ejaculation Cardiotoxic - sudden death; retinal pigmentation and blindness Hydroxyzine potentiates toxicity