Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
170 Cards in this Set
- Front
- Back
|
Alfentanil (Alfenta)
|
Opioid - Strong Agonist
- similar to fentanyl - less potent and shorter acting than fentanyl |
|
|
Fentanyl (Actiq, Duragesic)
|
Opioid - Strong Agonist
- mu - anesthesia (post op, labor, cardiac surgery) - CA (transdermal) SE: muscular rigidity of abd & chest wall, pupil constrict |
|
|
Heroin
|
Opioid - Strong Agonist
- no medical use - increased euphoric and lasts 1/2 as long as morphine - converted to morphine in the body - crosses BBB more readily than morphine |
|
|
Hydrocodone
|
Opioid - Strong Agonist
- Mod - Severe pain (combo w/acetaminophen or ibuprofen) - Antitussive |
|
|
Hydromorphone (Diludid)
|
Opioid - Strong Agonist
- Severe pain - preferred over morphine in pts w/renal dysfxn - 8 -10 x more potent than morphine |
|
|
Meperidine (Demerol)
|
Opioid - Strong Agonist
- Beer List - mu and k - short - term analgesia (oral & parentally) - SE: dilates pupils, hyperactive reflexes, dry mouth etc. - CI: MAOIs + other antipsychotics, geriatric and impaired renal fxn |
|
|
Methadone (Dolophine)
|
Opioid - Strong Agonist
- mu, antagonist of NMDA - analgesic of nociceptive & neuropathic pain -used for w/d of morphine and heroin abusers - SE: lipophilic - toxicity, torsades de pointes |
|
|
Morphine
|
Opioid - Strong Agonist
- k receptors of dorsal horn of spinal cord (increases pain threshold) and alters brain perception of brain - analgesia, diarrhea (drops on tongue), antitussive, PE - SE: N/V/Constipation (give stool softener/lax), pinpoint pupils, resp. depression, urinary retention, increase prolactin, increase growth hormone, increase ADH - CI: prego/labor, asthma, neonates, elderly, head/brain injury |
|
|
Oxycodone (Oxycotin)
|
Opioid - Strong Agonist
- severe pain - abuse of crushing sustained releasing prep - many deaths |
|
|
Oxymorphone (Opana)
|
Opioid - Strong Agonist
- narcotic analgesia - similar potency to hydromorphone |
|
|
Remifentanol (Ultiva)
|
Opioid - Strong Agonist
- similar to fentanyl - less potent and shorter acting |
|
|
Sufentanil (Sulfenta)
|
Opioid - Strong Agonist
- similar to fentanyl - more potent |
|
|
Tapentadol (Nucynta)
|
Opioid - Strong Agonist
- mu - NE reuptake inhibitor - severe, acute, chronic pain - CI: MAOIs or those who have taken MAOIs in last 14 days |
|
|
Codeine
|
Mod/Low Agonists
- converted to morphine by CYP450 2D6 - antitussive, analgesia, sedation, euphoria - 30% potency of morphine - being replaced by dextromethorphan in OTC |
|
|
Buprenorphine (Buprenex)
|
Mixed agonist/antagonist - Opioid
- mu agonist - opioid detox - mod - severe pain - SE: precipitate w/d symptoms (less severe than methadone), HTN, nausea, dizziness, resp. depression |
|
|
Butorphanol (Stadol)
|
Mixed agonist/antagonist - Opioid
- limited tx for chronic pain - parental - SE: precipitate w/d symptoms, psychotomimetic symptoms (mimics psychosis) - less than Pentazocine |
|
|
Nalbuphine (Nubain)
|
Mixed agonist/antagonist - Opioid
- limited tx for chronic pain - parental - SE: precipitate w/d symptoms, psychotomimetic symptoms (mimics psychosis) - less than Pentazocine |
|
|
Pentazocine (Talwin)
|
Mixed agonist/antagonist - Opioid
- agonist on k & weak antagonist on mu and delta - moderate pain (oral & parental) - SE: precipitate w/d symptoms, psychotomimetic symptoms (mimics psychosis) |
|
|
Nalmefene (Revex)
|
Antagonist - Opioid
- alcohol dependence - pathological gambling |
|
|
Naloxone (Narcan)
|
Antagonist - Opioid
- displaces all receptor-bound opioid molecules and reverses morphine OD - competitive antagonist (mu*, k*, and delta) - reverse coma and resp. depression of opioid OD - IV - SE: precipitates w/d symptoms w/n 30 sec of administration |
|
|
Naltrexone (Depade)
|
Antagonist - Opioid
- same as naloxone, but longer duration - single dose blocks effect of injected heroin for up to 48 hrs - + clonidine is used for rapid detox of opioids - chronic alcoholism, however (benzodiazepine and clonidine preferred) - AE: hepatotoxic |
|
|
Tramadol (Ulrtam)
|
Analgesic
- mu and weakly inhibits NE and Serotonin reuptake - mod - mod/severe pain - SE: resp. depression, anaphylaxis, toxic w/use of MAOIs, TCAs, and SSRIs |
|
|
Misoprostol
|
Prostaglandins - PGE1 analog
- Protects mucosal lining during chronic NSAID use (reduces gastric acid and secretes mucus and bicarb) - Induces labor, abortions, cervical ripening - Category X - SE: abd pain, diarrhea, spotting, HA, infxn, uterine damage, fetal brady, death |
|
|
Iloprost
|
Prostaglandins - PGI2 anaolg
- Pulmonary HTN (potent pulm artery dilator) - increases O2 delivery and cardiac index - inhibits TXA2 - SE: dizzy, HA, flushing, fainting, bronchospasm, cough - Inhaled |
|
|
Latanoprost
|
Prostaglandins - PGF2a
- reduce intraocular pressure (open angle glaucoma) - SE: burred vision, iris color change, foreign body sensation |
|
|
Travoprost
|
Prostaglandins - PGF2a
- reduce intraocular pressure (open angle glaucoma) - SE: burred vision, iris color change, foreign body sensation - as/more effective than Timolol |
|
|
Bimatoprost
|
Prostaglandins - PGF2a
- reduce intraocular pressure (open angle glaucoma) - SE: burred vision, iris color change, foreign body sensation - treats Eyelash hypotrichosis - increases # eyelashes |
|
|
Alprostadil
|
Prostaglandins - PGE1 analog
- increase cAMP - increase protein kinase & relax smooth muscle - ED - Keeps ductus arteriosus patent! in neonates w/congential heart dysfxn until surgery - urethral suppository, cavernosa injection, IV - ED SE: priapism, hypotension, dizzy, syncope - DA SE: apnea, fever, sepsis, seizure |
|
|
Lubiprostone
|
Prostaglandins - PGE1 derivative
- stimulates Cl- channels - increases luminal secretion - softer stools and increase motility - Chronic idiopathic constipation & IBD - SE: nausea - most common |
|
|
Aspirin (ASA)
|
NSAID - Salicylic acid derivative
-irreversible inactivates COX - prophylactic CV events - most common use - anti-inflam, anti-pyretic, anti-analgesic - RA, gout, OA, rheumatic fever - low-mod myalgias - HA, arthralgia, acne, cornwarts, calluses AVOID in < 20 y/o w/viral infxn --> Reye syndrome |
|
|
Ibuprofen
(Flurbiprophen, Ketoprophen, Fenoprophen, Naxoprophen, Oxaprozin) |
NSAID - Proprionic acid derivatives
- reversibly inactivates COX - anti-inflam, anti-pyretic, analgesic - IV : Close patent ductus arteriosus! (less SE than indo) - Oxaprozine = longest 1/2 life |
|
|
Indomethacin
|
NSAID - Acetic acid derivative
- reversibly inhibits COX - acute gout, close patent DA, ankylosing spondylitis, OA in hip - anti-inflam, analgesic, anti-pyretic (not really used for fever) - SE: interstitial nephritis |
|
|
Sulindac
|
NSAID - Acetic acid derivative
- reversibly inhibits COX - RA, acute gout, ankylosing spondylitis and OA - Interstitial nephritis (less than indo) |
|
|
Etodolac
|
NSAID - Acetic acid derivative
- reversibly inhibits COX |
|
|
Piroxicam
|
NSAID - Oxicam derivative
- inhibits both COX 1 and 2 w/preference for 2 - but at high doses = nonselective - RA, ankylosing spon, OA |
|
|
Meloxicam
|
NSAID - Oxicam derivative
- inhibits both COX 1 and 2 w/preference for 2 - but at high doses = nonselective - RA, ankylosing spon, OA - less GI effects than Piroxicam |
|
|
Mefenamic acid & Meclofenamate
|
NSAID - Fenamate
- No advantage over other NSAIDs - SE: interstitial nephritis, severe diarrhea, IBS, hemolytic anemia |
|
|
Diclofenac
|
NSAID - Heteroaryl acetic acid
- long term tx for RA, OA, and Ankylosing spond. - most potent - accumulates in synovial fluid |
|
|
Tolmetin
|
NSAID - Heteroaryl acetic acid
- long term tx for RA, OA, and Ankylosing spond. - effective anti-inflam, analgesic, and antipyretic |
|
|
Ketorolac
|
NSAID - Heteroaryl acetic acid
- potent analgesic - short term mod-severe pain - post op pain - allergic conjunctivitis - AE: FATAL peptic ulcers, GI bleeding, perforations - use only up to 5 days (1st dose IM or IV) - not used in pedi |
|
|
Nabumetone
|
NSAID
- RA and OA - effective anti-inflam, analgesic, and antipyretic - Low incidence of SE - Caution in hepatic impairment |
|
|
Celecoxib
|
NSAID
- selectively inhibits COX 2 more than 1 - RA, OA, acute mod pain - adjuvant in familial adenomatous polyposis to reduce # of polyps - COX 2 inhibitors --> higher risk for MI and stroke - CI: sulfa allergy, renal insufficiency, severe heart dz, volume depletion, hepatic failure |
|
|
Acetaminophen
|
Analgesic (not an NSAID)
- inhibits prostaglandin synthesis in the CNS - analgesic and antipyretic - Good for children and gouty patients - N-acetylcysteine = give w/n 10 hrs if OD --> binds to NAPDI and saves the liver - AE: hepato and renal necrosis at large or prolonged doses |
|
|
Methotrexate
|
DMARD - immunosuppresant
- RA mainstay - Psoriatic arthritis - Ca (higher doses) - SE: mucosal ulcerations, nausea, cytopenias, cirrhosis, acute pneumonia-like syndrome w/chronic admin. - Take Leucovorin qd after MTX to help reduce SE |
|
|
Leflunomide
|
DMARD - irreversibly binds/inhibits DHODH (necessary for pyrimidine synthesis)
- reduces pain, inflammation, and progression of RA - mono therapy or in combo - SE: HA, diarrhea, nausea, alopecia, wt loss, allergic rxn, flu-like, skin rash, hypOkalemia - CI: teratogenic - child bearing age |
|
|
Hydroxychloroquine
|
DMARD - inhibits phospholipase A2 and plt aggregation
- Early mild RA & Malaria - SE: ocular toxicity - retinal damage and corneal deposits, CNS disturbances, GI upsets, skin discolorations/eruptions - often combines w/MTX |
|
|
Sulfasalazine
|
DMARD
- Early mild RA - in combo w/MTX or hydroxychloroquine - SE: leukopenia |
|
|
D-Penicillamine
|
DMARD - cysteine analog
- slows progression of bone destruction of RA - add on therapy to glucocorticoids/NSAIDs - chelating agent in poisoning of heavy metal - AVOID use w/DMARD |
|
|
Gold Salts (Auranofin)
|
DMARD
- decreases progression of RA - needs meticulous monitoring for toxicity - not used often due to $$ |
|
|
Azathioprine
|
DMARD - purine analog
- metabolized to 6-mercaptopurine - kidney transplant rejection - RA, SLE, psoriatic arthritis - dose adjust if pt has low thiopurine S-methyltransferase - prohibitive risk of neoplasia if previously tx w/alkalating agents - CI - prego (teratogenic) |
|
|
Cyclophosphamide
|
DMARD - alkalating agent - related to nitrogen mustard
- cytotoxic effect on T and B cells (more so B) - off label use for RA - CI: prego - Teratogenic - AE: cytotoxic to kidneys and heart, increase risk of infxn and bleeding, GI, alopecia, infertility |
|
|
Glucocorticoids
|
Used to bridge the time until DMARDS take effect
- RA - example: Prednisone 10 mg |
|
|
Etanercept
|
Biologic therapy for RA
- TNFa inhibitor - mod - severe RA (alone or combo) - polyarticular-course juvenile RA, psoriatic arthritis, psoriasis, ankylosing spon. - Sc 2 x weekly |
|
|
Adalimumab
|
Biologic therapy for RA
- TNFa inhibitor - Lowers MMP-1, MMP3, CRP, and markers of cell turnover - mod - severe RA, psoriatic arthritis, ankylosing spon., Crohn's - SE: infxns (UTI, URI etc), HA, nausea, agranulocytosis, rash - Sc q wk or q 2 wks |
|
|
Infliximab
|
Biologic therapy for RA
- TNFa inhibitor - Chimeric IgG monoclonal antibody - RA (w/poor response to MTX monotherapy) - plaque psoriasis, Ulcerative Colitis, ankly spon., Crohn's - SE: fever, chills, pruritis, urticaria, pneumonia, cellulitis, pancytopenia: leuko, neutro, thrombo - IV infusion over 2 hrs - Do Not use alone (build antibodies) |
|
|
Golimumab
|
Biologic therapy for RA
- TNFa inhibitor - RA - SE: increase in hepatic enzymes (monitor), malignancies, TB - Sc once monthly - in combo w/MTX or non-bio DMARD |
|
|
Certolizumab pegol
|
Biologic therapy for RA
- "Unique" - anti TNF w/Fab fragment - RA - q 2 wks in combo w/ MTX |
|
|
Anakrin
|
Biologic therapy for RA
- IL - receptor agonist - prevents inflammation, stops degradation and bone resorption |
|
|
Abatacept
|
Biologic therapy for RA
- Fusion protein of CTLA4 - binds to CD80/CD86 - deactivates T lymphocytes - mod to severe RA who have failed 1 or more DMARD - SE: TB, neutropenia - Sc qd if good kidneys - Sc qod if bad kidneys |
|
|
Rituximab
|
Biologic therapy for RA
- chimeric murine/human monoclonal antibody - directed against CD20 of B cells - depletes B cells - mod to severe RA (combo w/MTX) - used in adults w/poor response to 1 or more TNF inhibitors - reduce joint erosion and space narrowing - 1st time infusion rxn - common - IV via two 1000mg infusion separated by 2 wks w/Methylprednisolone 100mg 30 min prior |
|
|
Colchicine
|
Plant alkaloid - inhibits leukocyte entry into effected joint by binding to Tubulin
- Gout prophylaxis - reduces frequency of attacks - Fatal dose: 7 - 10 mg - CI: prego - replaced by NSAIDs in acute attacks - SE: myopathy, neutropenia, aplastic anemia, alopecia |
|
|
Allopurinol
|
Xanthine oxidase inhibitor - Purine analog
- interferes w/uric acid synthesis - Primary and Secondary Hyperuricemia or gout w/renal dz - preferred in pts w/overproduction of uric acid - SE: acute attacks w/n 1st few wks of therapy, nausea, diarrhea, skin rash - combine w/NSAIDs during first few wks for acute attacks |
|
|
Febuxostat
|
Xanthine oxidase inhibitor - new
- Gout |
|
|
Probenecid
|
Uricosuric agent - increase uric acid secretion
- inhibit the urate ion exchanger in the proximal tubule - Gout - blocks tubular secretion of PCN, increases abx levels - 1st line for gout associated w/reduced urinary excretion or uric acid - CI: Cr clearance < 50mL/min |
|
|
Sulfinpyrazone
|
Uricosuric agent - increase uric acid secretion
- inhibit the urate ion exchanger in the proximal tubule - Gout - 1st line for gout associated w/reduced urinary excretion or uric acid - CI: BM suppression (CBC monitoring needed) |
|
|
Danazol
|
Androgen
•Treatment of endometriosis and fibrocystic breast disease •Can decrease adrenal function |
|
|
Fluoxymesterone
|
Androgen
•Hypogonadism caused by testicular dysfunction or failure of hypothalamus/pituitary •Senile osteoporosis •Chronic wasting associated with HIV or cancer |
|
|
Oxandrolone
|
Androgen
•Has anabolic activity 3-13 times that of testosterone •Hypogonadism caused by testicular dysfunction or failure of hypothalamus/pituitary •Senile osteoporosis •Chronic wasting associated with HIV or cancer |
|
|
Testosterone
|
Androgen
•Ineffective orally due to first pass metabolism •Hypogonadism caused by testicular dysfunction or failure of hypothalamus/pituitary •Senile osteoporosis •Chronic wasting associated with HIV or cancer |
|
|
Testosterone enanthate
|
Androgen
•C17 ester of testosterone→ addition of esterified lipid increases duration of action •Hypogonadism caused by testicular dysfunction or failure of hypothalamus/pituitary •Senile osteoporosis •Chronic wasting associated with HIV or cancer |
|
|
Bicalutamide
|
Antiandrogen
•Treatment of prostate cancer |
|
|
Dutasteride
|
Antiandrogen
•Benign Prostatic Hypertrophy |
|
|
Finasteride
|
Antiandrogen
•Benign Prostatic Hypertrophy |
|
|
Flutamide
|
Antiandrogen
•Treatment of prostatic carcinoma in males |
|
|
Nilutamide
|
Antiandrogen
•Treatment of prostate cancer |
|
|
Cyclosporine (Neoral)
|
Selective Cytokine Inhibitor
- Beauveria nivea - soil fungus - Calcineurin blocker - inhibits IL-2 synthesis - Kidney, liver, heart transplant (induction & maintenance tx) - alternative to MTX in RA, psoriasis, IBD, xerophthalmia - AE: nephro, neuro, hepato toxic, hirsutism, gum hyperplasia |
|
|
Tacrolimus (Prograf)
|
Selective Cytokine Inhibitor
- Streptomyces tsukubaensis - Calcineurin blocker - inhibits IL-2 synthesis - Kidney and liver rejection (maintenance & rescue tx in pts w/rejection to cyclo) - Atopic dermatitis (ointment) - Oral (preferred) or IV w/fatty meal - AE: *InsulinDependentDM in AA and Hispanic - favored/more potent than cyclo |
|
|
Sirolimus (Rapamune)
|
Selective Cytokine Inhibitor
- Streptomyces hygroscopicus - Blocks cytokine-stimulated cell proliferation - interferes w/Signal 3 - Renal transplant (maintenance & chronic rejection) - Heart stents = sirolimus coated - synergistic w/cyclo! |
|
|
Everolimus (Zortress)
|
Selective Cytokine Inhibitor
- Blocks cytokine-stimulated cell proliferation - Renal transplant - 2nd line for adv. Renal Carcinoma - AE: increased angioedema w/ACE-I, increased risk of kidney arterial/venous thrombosis --> loss of transplant |
|
|
Azathioprine (Imuran)
- used in combo w/C.S., cyclo and tacrolimus |
Antimetabolite: inhibits purine synthesis
- Decreases DNA/RNA synthesis - Maintenance tx for transplants - 2nd line for IBD - Alternative for severe RA AE: BM suppression, leukopenia w/ ACE-I or Cotrimaxaole, N/V * must decrease dose by 60% if w/Allopurinol |
|
|
Myclophenolate mofetil (Cellcept)
- used in combo w/C.S., cyclo and tacrolimus |
Antimetabolite: inhibits purine synthesis
- Decreases B & T cell fxn, proliferation, and recruitment - Replaced Imuran - Kidney, Liver, Heart transplant (maintenance and chronic rejection) - AE: N/V/D, abd pain, leukopenia, anemia - AE: at high doses - CMV infxn |
|
|
Mycophenolate sodium (Myfortic)
- used in combo w/C.S., cyclo and tacrolimus |
Antimetabolite: inhibits purine synthesis
- Same use as Myclophenolate mofetil - Enteric coated - Decreased GI effects |
|
|
Antithymocyte globulins (Atgam)
|
Anitbody - good for Acute rejection, prolongs graft survival
- develops in thymus - destroys T-lymphocytes - IV: polyclonal - Give at time of transplant (prevent early rejection) - treats severe infxns, renal allograft rejection, aplastic anemia AE: F/Chills, leukopenia, thrombocytopenia, rash, viral infxns (CMV) |
|
|
Muromonab-CD3 (OKT3)
|
Anitbody - good for Acute rejection, prolongs graft survival
- destroys T-lymphocytes - IV: monoclonal (rarely used) - acute and glucocorticoid resistant rejections in solid organs - decreases T cells from donor's BM prior to transplant CI: prego/breastfeed, seizures, uncompensated HF AE: anaphylaxis, high fever (common), cerebral edema, aseptic meningitis - Cytokine storm! --> premedicate w/methylpred, diphenhydramine, acetaminophen |
|
|
Basiliximab (Simulact)
|
Anitbody - good for Acute rejection, prolongs graft survival
- IL-2 receptor antagonist - IV: monoclonal - Acute rejection in renal (prophylaxis) - Combo w/C.S. and cyclosporine - AE: GI |
|
|
Daclizumab (Zenapak)
|
Anitbody - good for Acute rejection, prolongs graft survival
- IL-2 receptor antagonist - IV: removed from market d/t decreased demand - Acute rejection in renal (prophylaxis) - Combo w/C.S. and cyclosporine - AE: GI |
|
|
Alemtuzumab (Campath)
|
Anitbody - good for Acute rejection, prolongs graft survival
- against cell surface glycoprotein CD52 - decreases T lymphocytes - IV: monoclonal - CLL - refractory B cell - Combo w/Sirolimus & low dose Prograf and Neoral in place of C.S. - AE: neutropenia, anemia, pancytopenia, cytokine storm - premedicate |
|
|
Prednisone (Deltasone)
& Methylprednisolone (Medrol) |
Corticosteroid - inhibits IL-1 production (early in cascade)
- Acute rejection of solid organs - Chronic graft vs host disease AE: diabetogenic, hypercholesterol, cataracts, osteoporosis, HTN, Cushings - may give insulin to help with diabetogenic effects |
|
|
Prednisone (Deltasone)
& Prednisolone |
Corticosteroid - inhibits IL-1 production (early in cascade)
- Autoimmune diseases (RA, SLE, temporal arthritis, asthma) - used for "Flares" AE: diabetogenic, hypercholesterol, cataracts, osteoporosis, HTN, Cushings - may give insulin to help with diabetogenic effects |
|
|
Estradiol
|
Estrogen
•Most potent estrogen produced and secreted by ovary •Principal estrogen in premenopausal women |
|
|
Estrone
|
Estrogen
•1/3 estrogenic potency of estradiol •Primary circulating estrogen after menopause |
|
|
Ethinyl Estradiol
|
Synthetic estrogen
•Higher potency than natural estrogens •Commonly used in OCP's |
|
|
Mestranol
|
Synthetic Estrogen
•Demethylated to ethinyl estradiol |
|
|
Clomiphene
|
Selective Estrogen Receptor Modulator (SERM)
•Increases secretion of GnRH and gonadotropins→ stimulate ovary •Used to treat infertility associated with anovulatory cycles •Risk of multiple births is increased |
|
|
Raloxifene
|
Selective Estrogen Receptor Modulator (SERM)
•Antagonizes estrogen receptor in breast tissue •Decreases bone resorption, increases bone density, decreases vertebral fractures •Used to treat osteoporosis in postmenopausal women •Prophylaxis of breast cancer in high-risk women |
|
|
Tamoxifen
|
Selective Estrogen Receptor Modulator
•Competes with estrogen for binding to estrogen receptor in breast tissue •Palliative treatment of metastatic breast cancer in postmenopausal women •Prophylactic therapy to reduce risk of breast CA |
|
|
Desogestrel
|
•Synthetic progestin
|
|
|
Drospirenone
|
Synthetic progestin
•Commonly used in OCP's with ethinyl estradiol (YAZ) •Weight gain is less common |
|
|
Levonorgestrel
|
Synthetic progestin
•Possess some androgenic activity (structurally similar to testosterone) •PLAN B pill |
|
|
Medroxyprogesterone
|
Progestogen
•Injectable contraceptive •Can provide contraception for approx. 3 months •Associated with increased risk of osteoporosis |
|
|
Norelgestromin
|
Progestogen
•Transdermal patch w/ ethinyl estradiol (ORTHOEVRA) •Greater risk of thromboembolism |
|
|
Norethindrone
|
Synthetic progestin
•Possess some androgenic activity (structurally similar to testosterone) |
|
|
Norethindrone acetate
|
Synthetic progestin
•Possess some androgenic activity (structurally similar to testosterone) |
|
|
Norgestimate
|
Progestogen
|
|
|
Norgestrel
|
Synthetic progestin
•Possess some androgenic activity (structurally similar to testosterone) |
|
|
Progesterone
|
Natural hormone
•Not used widely as contraceptive b/c of its rapid metabolism |
|
|
Mifepristone
|
Anti-Progestin
•Abortion of fetus if administered early in pregnancy •Major adverse effects: uterine bleeding, possibility of incomplete abortion |
|
|
Prochlorperazine (Compazine)
|
Class: Phenothiazine; Antiemetic
Blocks dopamine receptors; for low to moderate nausea. Hypotension and restlessness are dose limiting |
|
|
Serotonin (5HT3) Receptor Blockers
|
Dolasetron, Granisetron, Ondansetron (Zofran), Palonsetron
Antagonists of serotonin receptors in visceral vagal afferent fibers and the chemoreceptor trigger zone Longer duration of action for emesis prevention; Used especially in chemo induced emesis |
|
|
Metoclopramide (Reglan)
|
Class: Substituted Benzamide
Effective at high doses against Cisplatin induced nausea/emesis. Can cause extrapyramidal side effects |
|
|
Butyrophenones
|
Droperidol and Haloperidol
Blocks dopamine receptors; Moderate effectiveness at emesis reduction |
|
|
Benzodiazepines Used in Chemo Induced Emesis
|
Alprazolam (Xanax) and Lorazepam (Ativan)
Useful for anticipatory vomiting Sedative, anxiolytic, and amnestic properties |
|
|
Corticosteroids Used in Chemo Induced Emesis
|
Dexamethasone (Decadron) and Methylprednisolone
Exact mechanism unknown, but may involve prostaglandins Most often used in combo with other drugs Can cause insomnia and hyperglycemia |
|
|
Aprepitant (Emend)
|
Class: Substance P/Neurokinin-1 Receptor Blocker
Targets neurokinin receptors in the brain and blocks the actions of substance P. Used with decadron for moderate to highly ematogenic chemo Constipation and fatigue are major SE |
|
|
Antimotility Agents (For diarrhea)
|
Diphenoxylate + Atropine (Lomotil) and Loperimide (Imodium)
Activates presynaptic opiod receptors to inhibit acetylcholine release and decrease peristalsis Can contribute to toxic megacolon. Do no give to C. dif patients |
|
|
Adsorbents
|
Aluminum hydroxide and Methylcellulose
Antidiarrheal Adsorbs intestinal toxins or microorganisms &/or coats the intestinal mucosa; Much less effective than antimotility agents |
|
|
Bismuth Subsalicylate (Pepto Bismol)
|
Decreases fluid secretion in the bowel
Used for traveler's diarrhea. May turn the tongue and stool black |
|
|
Irritants/Stimulants
|
Bisacodyl (Correctal, Dulcolax), Castor Oil, and Senna (ExLax)
Treats constipation |
|
|
Bisacodyl (Correctal, Dulcolax)
|
Irritant/Stimulant
Directly stimulates intestinal mucosa nerve fibers to treat constipation Do not administer orally w/ PPIs, H2 blockers, or milk |
|
|
Castor Oil
|
Irritant/Stimulant
Breaks down into ricinoleic acid which causes peristalsis. Can cause uterine contractions. |
|
|
Senna (ExLax)
|
Irritant/Stimulant
Stimulates water and electrolyte secretion into the bowels. Used in combo with docusate for opioid induced constipation. Causes evacuation of the bowels in 8-10 hours. |
|
|
Bulk Laxatives
|
Methlycellulose (Citrucel) and Psyllium (Metamucil)
Hydrophilic colloids that form gels in the large intestine, causes water retention and increases peristalsis May cause intestinal obstruction, especially in immobile patients |
|
|
Saline and Osmotic Laxatives
|
Magnesium citrate, Magnesium hydroxide, Polyethylene glycol (Mirilax), Lactulose
Nonabsorbable salts that hold water in the intestine by osmosis Produces defecation in a few hours Polyethylene Glycol is used in bowel preps before colonoscopy or other bowel procedures. |
|
|
Docusate (Colace)
|
Stool softener
Surface active agents that become emulsified with stool. Used as prophylaxis rather than treatment May take days to work |
|
|
Lubricant Laxatives
|
Glycerine (Fleet) and Mineral Oil
Per Rectum Facilitates the passage of hard stool |
|
|
Lubiprostone (Amitiza)
|
Chloride channel activator
Activates Cl channels to increase fluid secretion into the intestinal lumen Used for chronic constipation Causes little change in electrolyte balance |
|
|
Benzodiazepines
|
Axiolytic
Enhances the effects of GABA by binding to chloride channels, keeping them open. Chloride influx hyperpolarizes the neuron, decreasing neuronal transmission. (Inhibits action potentials) SE: Drowsiness and confusion are the most common, ataxia at high doses, cognitive impairment, cross tolerance with alcohol Avoid in patients with narrow angle glaucoma |
|
|
Long acting benzodiazepines
|
Diazepam (Valium)
Chlordiazepoxide (Librium) Clorazepate (Tranxene) Quazepam (Doral) Flurazepam (Dalmane) |
|
|
Intermediate acting benzodiazepines
|
Alprazolam (Xanax)
Lorazepam (Ativan) Estazolam (Prosom) Temazepam (Restoril) |
|
|
Short acting benzodiazepines
|
Oxazepam (Serax)
Triazolam (Halcion) |
|
|
Alprazolam (Xanax)
|
Intermediate acting benzodiazepine
For the short and long term treatment of panic disorder |
|
|
Clonazepam (Klonopin)
Diazepam (Valium) Lorazepam (Ativan) |
Preferred for long term treatment of anxiety
Lorazepam- DOC for terminating seizures |
|
|
Chlordiazepoxide (Librium)
Clorazepate (Tranxene) Oxazepam (Serax) |
For the acute treatment of alcohol withdrawal seizures
|
|
|
Midazolam (Versed)
|
Used for the induction of anesthesia
|
|
|
Flurazepam (Dalmane)
Temazepam (Restoril) Triazolam (Halcion) |
Treats sleep disorders, but can cause long lasting drowsiness.
Flurazepam- improves sleep problems even after discontinuing the drug |
|
|
Flumazenil (Romazicon)
|
Benzodiazepine antagonist
Reverses effects of benzodiazepines; GABA receptor antagonist; Given IV only SE: Dizziness, n/v, agitation, precipitates withdrawal, can cause seizures when taken w/ TCAs |
|
|
Drugs that treat eczema
|
topical steroids
Tacrolimus- immunosupressant elidel- immunosuppressant Sinequan- TCA (stops itch scratch cycle) |
|
|
Zinc preparation
|
Barrier treatment treats diaper dermatitis
|
|
|
Vitamin A/ Moisturizing ointment
|
diaper dermatitis
|
|
|
Salicylic acid
|
acne treatment
Keratolynic agent treats by desquamation |
|
|
Sulfur
|
acne treatment
Keratolynic agent treats by drying out skin |
|
|
Benzoyl Peroxide
|
Acne treatment
Dries skin, and suppresses bacteria SE: burning, peeling, local erythema, allergy |
|
|
Clindamycin
|
antibiotic to treat acne
|
|
|
Dapsone (Aczone)
|
treat acne
rarely used |
|
|
Doxycyline/ Minocycline
|
Inhibits bacterial protein synthesis
treats acne oral acne drug of choice! |
|
|
Tetracycline
|
treat acne
rarely used due to SE stains teeth brown |
|
|
Retin A micro
Avita Differin Tarazotene |
topical retinoids
sunburn caution! |
|
|
Issotrentoin (Accutane)
|
oral retinoid
treat acne TERATOGEN- IPLEDGE |
|
|
Tazarotene
Tars Anthralin Donovex |
topical drugs to treat psoriasis
|
|
|
Methotrexate
|
systemic drug to treat psoriasis
Class: antimetabolite |
|
|
Cyclosporine
|
oral systemic drug to treat psoriasis
immunosuppressant MOA: Selective inhibitor of cytokine production |
|
|
Remicade
Amevive Enbril Humera |
Biologic agents to treat psoriasis
usually inhibit TNF alpha |
|
|
Fluorouracil
Diclofenac sodium Imiquimod (Aldara) Aminolevulinic Acid + blue light |
drugs to treat actinic keratosis
Imiquimod- Stimulates immune response, innate and cell mediated immunity, apply at night and wash in morning |
|
|
Podophyllin
|
treats warts
Inhibits synthesis of DNA & mitosis = cell death, for genital warts Teratogenic! |
|
|
Podofilox
|
treats warts
inhibits mitosis repeat up to 4 cycles |
|
|
Imiquimod (Aldara)
|
treats warts
Stimulates immune response, innate and cell mediated immunity |
|
|
Kunecatechins
|
herbal wart removal
not for genital warts! |
|
|
Minoxidil (Rogaine)
|
Direct vasodilator- for hair loss
topical |
|
|
Finasteride (Propecia)
|
Hormonal agent- for hair loss
Blocking testosterone conversion to DHT (shrinks hair follicles) do not give to females does not regrow but rather stops loss! |
|
|
Lotrimin (clotrimazole ointment)
Nystatin (Mycostatin) Ketoconazole |
topical antifungals
|
|
|
Bacitracin
|
Bacteriostatic, cell wall inhibitor
Antibiotic: Cell Wall Inhibitor For gram + and anaerobic cocci topical! |
|
|
Bactroban
|
topical antibiotic
inhibits protein synthesis for gram + for impetigo! |
|
|
Diphenhydramine (Benadryl)
|
- H1 receptor blocker
1st generation Sedating, penetrate CNS Dry mouth Interactions with MAOIs Overdose |
|
|
Dimenhydrinate (Dramamine)
|
H1 blocker
1st generation Sedating, penetrate CNS Dry mouth Interactions with MAOIs Overdose |
|
|
Doxylamine (Unisom sleep tablets)
|
H1 blocker
1st generation used to induce sleep |
|
|
Promethazine (Phenergan)
|
H1 blocker
1st generation used for motion sickness same SE as other 1st generation |
|
|
Cetirizine (Zyrtec)
|
H1 blocker
second generation Weak potential for producing sedation most possible sedating drug out of the 2nd gen |
|
|
Desloratadine (Clarinex)
|
H1 blocker
2nd generation - Show the least sedation - Specifically bind H1 receptors and do not cross the BBB |
|
|
Fexofenadine (Allegra)
|
H1 blocker 2nd generation
- Show the least sedation - Specifically bind H1 receptors and do not cross the BBB |
|
|
Loratadine (Claritin)
|
2nd generation
H1 blocker - Show the least sedation - Specifically bind H1 receptors and do not cross the BBB |
