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159 Cards in this Set

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cortisol hydrocortisone
1. short acting glucocorticoid
2. Used for replacement anti-inflam.
3. Side effects-suppress HPA
increases phys. response
4. Lots of interactions
Prednisone
1. intermediate acting glucocorticoid
2. Used for replacement anti-inflam.
3. Side effects-suppress HPA
increases phys. response
4. Lots of interactions
Prednisolone
1. intermediate acting glucocorticoid
2. Used for replacement anti-inflam.
3. Side effects-suppress HPA
increases phys. response
4. Lots of interactions
Methyl-prednisolone
1.intermediate acting glucocorticoid
2. Used for replacement anti-inflam.
3. Side effects-suppress HPA
increases phys. response
4. Lots of interactions
Dexamethasone
1.Long- acting glucocorticoid
2. Used for replacement anti-inflam.
3. Side effects-suppress HPA
increases phys. response
4. Lots of interactions
Betamethasone
1.Long- acting glucocorticoid
2. Used for replacement anti-inflam.
3. Side effects-suppress HPA
increases phys. response
4. Lots of interactions
Mifepristone
1. Glucocorticoid antagonist
2. Used for hypercoticism
3. Side effects- acute adrenal insuffic.
4. ?
Thyrotropin
1. thyroid stimulating hormone from bovine
2. Used for -
a. hypothyroidism
b. diff. between prim. and second
c. thyroid carcinoma increase uptake of 131Iodine.
3. S/E- N/V, HA, fever, sinus tach., and fib.
4. Sympathomimietics, hepatic ez inducers, estrogen incr. levels of TBG
Recombinate TSH
1. recombinate TSH
2. Used for -
a. hypothyroidism
b. diff. between prim. and second
c. thyroid carcinoma increase uptake of 131Iodine.
3. S/E- N/V, HA, fever, sinus tach., and fib.
4. Sympathomimietics, hepatic ez inducers, estrogen incr. levels of TBG
Levothyroxine sodium
1. thyroid hormone
2. used for hypothyroidism and TSH suppresion
3. S/E- HA,insomnia, fever, tremors, cardiac arrhyth., tachycardia, diarrhea, weight loss, amenorrhea
4.lots of rx, incr. anticoags., incr. estogen binding, aspirin, phenytoin, andros, carbamazepine all decrease binding.
Liothyronine
1. thyroid hormone
2. used for hypothyroidism and TSH suppresion
3. S/E- HA,insomnia, fever, tremors, cardiac arrhyth., tachycardia, diarrhea, weight loss, amenorrhea
4.lots of rx, incr. anticoags., incr. estogen binding, aspirin, phenytoin, andros, carbamazepine all decrease binding.
Liotrix
1. combination thyroid hormone
2. used for hypothyroidism and TSH suppresion
3. S/E- HA,insomnia, fever, tremors, cardiac arrhyth., tachycardia, diarrhea, weight loss, amenorrhea
4.lots of rx, incr. anticoags., incr. estogen binding, aspirin, phenytoin, andros, carbamazepine all decrease binding.
Propylthiouracil
1. thioureylene class of anti-thyroid drug
2. used for hyperthyroidism, Graves disease, thyroid storm
3.S/E- HA, vertigo, edema, N/V, rash- urticaria, pruitus, alopecia
4. Reduces response to oral anticoagulants
Methimazole
1. thioureylene class of anti-thyroid drug
2. used for hyperthyroidism, Graves disease, thyroid storm
3.S/E- HA, vertigo, edema, N/V, rash- urticaria, pruitus, alopecia
4. Reduces response to oral anticoagulants
Lugol's Solution
1. strong Iodine solution
2. Used for hyperthyroidism- preoperative period n prep for surgery, thyroid storm
3. S/E- N/V, diarrhea, acne, hypersensitivity type III angioedema, induction of goiter or myxedema
4. alters free lithium conc.
Ipodate
1. Contrast agent
2. Used orally for hyperthy. and thy. storm
3. S/E- few cation with preg.
4. does not effect radioiodine uptake
Iopanoic Acid
1. Contrast agent
2. Used orally for hyperthy. and thy. storm
3. S/E- few cation with preg.
4. does not effect radioiodine uptake
Diatrizoate
1. Contrast agent
2. Used IV for hyperthy. and thy. storm
3. S/E- few cation with preg.
4. does not effect radioiodine uptake
Gonadorelin
1.GnRH
2. use- central amenorrhea and idiopathic hypogonadotropic hypogonad...
3.s/e- ovarian hyperstimulation and anaphylaxis
4. interactions- 0
Name the three GnRH analogs?
Leuprolide, goserelin, nafarelin (nasal)
What does the GnRH analog do?
1.Ovulation suppression
2.used in prostatic and breast cancer, 3.endometriosis,
4.and to suppress idiopathic precocious puberty
Leuprolide
1. GnRH analog
2. use- ovulation suppression, prostatic and breast cancer, endometriosis, precocious puberty
3. s/e- androgen like effects
4. Inter.-pregnancy and lactation,,,osteoporosis
goserelin
1. GnRH analog
2. use- ovulation suppression, prostatic and breast cancer, endometriosis, precocious puberty
3. s/e- androgen like effects
4. Inter.-pregnancy and lactation,,,osteoporosis
nafarelin
1. GnRH analog
2. use- ovulation suppression, prostatic and breast cancer, endometriosis, precocious puberty
3. s/e- androgen like effects
4. Inter.-pregnancy and lactation,,,osteoporosis
What is the GnRH antagonist?
Ganirelix
Ganirelix
1. GnRH antagonist
2. used to control ovarian hyperstimulation
3. s/e- abd pain, ha, ovarian hyperstimulation syndrome
4. inter.- preg, lactation
Name the GHRH analog?
Sermorelin
Sermorelin
1. use-GH deficiency
2. s/e- facial flushing, n/v
3. inter.- insulin, glucocorticoids, NSAIDS, clonidine, levodopa and antimuscarinic drugs
name the two GH analogs
Somatropin and Somatrem
Somatropin
1. recombinate GH
2. used for GH defic., turner's, AIDS wasting or cachexia
s/e- ha, intracranial hypertension, muscle pain, hyperglycemia, antibody reaction, leukemia
4. contra- do not use once epiphyses close, corticosteroids, sex steroids
Somatrem
1. recombinate GH analog
2. used for GH defic., turner's, AIDS wasting or cachexia
s/e- ha, intracranial hypertension, muscle pain, hyperglycemia, antibody reaction, leukemia
4. contra- do not use once epiphyses close, corticosteroids, sex steroids
Octreotide
1. somatostatin analog
2. used in acromegaly and suppression of GH tumors
3.s/e- supression of insulin release, gallstone formation, GI effects
4. additive effects on Beta blockers and Ca channel blockers
Bromocriptine
1. D2 receptor agonist
2. used for hyperprolactinemia, acromegaly, and parkinson's
3. s/e- n/v, dizzy, ortho hypotension, seizures, arrhythmias, stroke
4. inter-phenothiazine, butyrophenones and antihypertensive agents
Name the three main ovulation stimulating drugs/
1. human chorionic gonadotropin (mostly LH)
2. Menotropins (mix LH/FSH)
3. Urofollitropin (only FSH)
human chorionic gonadotropin
1. used in infertility to induce ovulation and in hypogonadism
2. s/e- ovarian elargement, hyperstimulation, thromboembolism
Menotropins
1. contains FSH and LH from pee of menopausal women.
2.used in infertility and induces ovulation
3. s/e- ovarian enlargement, hyperstimulation and tromboembolism
Urofollitropin
1. Pure FSH
2. Induces ovulation in women with PCOS
3.s/e- ovarian enlargement, hyperstimulation and thromboemoblism
What two drugs are used to treat diabetes insipidus, hemophilia A, VWD, and Enuresis?
Arginine Vasopressin and Desmopressin
Arginine Vasopressin
1. Post Pit Hormone
2. used for DI, Hemo A, VWD, and Enuresis
3. s/e- WATER INTOX, and vasoconstriction
4. Drug Potentiators- carbamazepine, chlorpropamide, TCA
5. Inhibtors- Li, Heparin, epi, ethanol
Desmopressin
1. syn. analog of vasopressin
2. used for DI, Hemo A, VWD, and Enuresis
3. s/e- WATER INTOX, and vasoconstriction
4. Drug Potentiators- carbamazepine, chlorpropamide, TCA
5. Inhibtors- Li, Heparin, epi, ethanol
Oxytocin
1. post pit hormone
2. used IV to induce labor contraction,,, IM prevent post-part. hemorrhage,,,Nasal to induce milk let down
3.s/e- arrhythmias, CNS stim, excessive Ut contractions, hyponatremia
4.Contra- abnormal fetal presentation, prematurity, cephalopelvic disproportion
What two drugs are used for acromegaly?
bromocriptine and octreotide
What three drugs cause androgen like side effects? these drugs are used for ovulation suppresion
Leuprolide
goserelin
nafarelin
what does FSH do?
1. Stimulates the ovarian follicle and controls estrogen release.
2. Stimulates spermatogenesis
What does LH do?
1. Promotes development and maintenance of corpus luteum.
2. Controls testosterone production in Leydig cells.
What is the reasoning behind the short t1/2 of GH and GH analogs but the long length of effects that they produce?
GH is a stimulator of IGF (insulin like growth factor), which are maintained in the plasma and peak in concentration at 20 hrs. Clearance is slow.
Name the antithyroid drugs?
1. thioreylenes- propylthioruacil, methimazole, carbimazole
2. Iodide- Logol's solution, potassium iodide
3. Iodinated contrast media- Ipodate & iopanic acid (oral), diatrizoate (IV)
How does the action of PTU differ from the other thioureylenes (methimazole & carbimazole)?
PTU inhibits peripheral conversion of T4 to T3, while the coabimazole and methimazole inhibit the coupling of MIT to DIT.
A patient has a thyroid carcinoma, to inhance I131 uptake, you would administer this drug or drugs?
Thyrotropin or possibly thyrogen (orphan drug), to simulate increase in TSH
What is the enzyme and location that T4 is converted to T3?
5-deiodinase takes off the extra iodine off mainly in the liver, but some in the kidney and thyroid.
Which thyroxine is active when bound to thyroxine binding globulin (TBG)?
Neither, only the free thyroxine in active. T4 has a greater affinity for the TBG.
Name the three thyroid hormone replacement drugs?
1. Levothyroxine (T4)- drug of choice due to duration of action.
2. Liothyroxine (T3)
3. Liotrix (mix T3 and T4)-no extra benefits
Name three adjuct therapies useful in the control of hyperthyroidism?
1. Beta-adrenergic antagonists- propanalol or antenalol, conteracts sypathmimetic effects.
2. Calcium channel blockers- diliazem, helps with tachy arrhythmias
3. corticosteriods- dexamethasone, inhibits peripheral conversion of T4 to T3
Name three drug types that inhibit conversion of T4 to T3?
1. PTU (one of the thioureylenes)
2. Iodinated contrast media
3. Corticosteriods-dexamethasone
What are the main short acting glucocorticoids and how long do they last?
Hydrocortisone and cortisone
8-12 hours
What are the main intermediate acting glucocorticoids and what is their duration?
Prednisone and
(methyl)prednisolone
18-36 hours, first choice for chronic use
What are the main long-acting glucocorticoids and what is their use and duration?
Betamethasone and dexamethasone, use in acute cases such as septic shock
duration 1-3 days
If a patient has brain edema what glucocorticoid would you prescribe and why?
either betamethasone or dexamethasone, due to its long acting properties and this is an acute situation
what are the main side effects of long term treatment with glucocorticoids?
1.decrease bone density
2. hypocalcemia
3. hyperglycemia (DM)
4. Increase PUD
5. Prolonged use causes sleep disturbances and depression w/psychosis
What is mifepristone used for?
Is used in hypercortisolism (Cushings's). It blocks the glucocorticoid receptors.
Fludrocortisone
1. Mineralocorticoid agonist
2. used for hypoaldosteronism
3. s/e- salt retention and hypertension
4. inter- high doeses resemble glucocorticoids
Spironolactone
1. Mireralcorticoid antagonist
2. used for hyperaldosteronism
3. s/e- hyperkalemia
4. inter- salicylates block secretion of active metabolite
Aminoglutethimide
1. Synthesis inhibitor
2. used in cushing's and breast cancer
3. s/e- GI, adrenal insuff.
4. inter- many P450, CYP3A
Ketoconazole
1. syn inhib.
2. used in cushing's (most effective)
3. s/e- hepatic disfunction, PVC
4. inter-second generation antihistimines
Trilostane
1. Syn. inhib.
2. used in cushing's
3. s/e adrenal insuff.
4. inter-?
Mitotane
1. syn inhib
2. used for adenocortical carcinoma
3. s/e- anorexia, nausea, lethargy
4. inter-?
What is the function of aldosterone?
regulation of Na+ and K+ in extracellular fluid.
-increase K+ and H+ excretion
-Increases Na+ and H2O retention
What is the common precursor for cortisol and aldosterone?
Progesterone
Where does aldosterone work?
distal collecting tuble to excrete K+ and resorb Na+
What three actions occur in response to aldosterone binding to the epithelial cells of the distal collecting duct's DNA?
1. Increase permiability to water (gap juncts)
2. Increase cycling of Na+ channels
3. Increase the number of Na+ channels.
AIP
Aldosterone induced protiens are the product of aldosterone binding to the DCT epithelial cells DNA. Causes the 3 changes in DCT- Increase permiability to water, increase cycling and number of Na+ channels.
How does spironolactone work, and why does it's effects last so long when its t1/2 is 1.4 hrs?
It competively binds the ALDO-MR to form a SPIRO-MR(miner. receptor), stopping the formation of AIP's. Its active metabolite (canrenone) has a t1/2 of 16.5 hrs.
What would you use spironolactone for?
1. adrenal adenomas
2. bilat. adrenal hyperplasia
3. cardiac failure (fluid loss needed)
4. heptic cirrhosis
5. nephrotic syndromes
trilostane is used for what and what is its mechanism?
It is used in the treatment of cushing's syndrome by inhibiting the 3Beta-hydroxysteroid dehydrogenase (HSD) which is used to convert pregnenolone to progesterone.... leads to a block in both cortisol and aldosterone
Name the 5 natural estrogens?
1. estradiol
2. estrone
3. estradiol valerate
4. estradiol cypionate
5. estradiol-norethindrone
Name the 3 conjugated estrogens?
1. Estrone & equilin sulfate esters
2. Estrone & equilin plant derivatives
3. estrogne & medroxyprogesterone
Name the 2 synthetic estrogens steriods?
Ethinyl estradiol
Mestranol
Name the 2 synthetic non-steriods?
Diethylstilbestrol
Chlorotrianises
What is Raloxifene used for?
Osteoporosis only
What are the common life threatening side effects of estrogen therapy?
1. throboembolism stroke (due to increased factor VII and vit K clotting factors)
2. hypertension
3. GB disease
4. reactivate endometri.
What are the common side effects of estrogen therapy?
1. N/V
2. breast tenderness
3. migraine
4. edema
5. Mood instability
What form of estrogen can be given orally? why?
the sulfate esters of estrone and equilin, from plants and female horse pee, hydrolysed in the gut to remove sulfate and allow absorbtion of estrogen with less first pass metabolism
What are the metabolic effects of estrogen?
1. increase-
triglycerides, HDL/LDL ratio, clotting factors, and protien carrier protiens
2. decrease-
bone resorbtion, cholesterol, and
antithromin III
EREs what are they?
estrogen response elements in the target genes that result in and increase or decrease of transcription of hormone regulated genes.
These two drugs allow for oral use for estrogen therapy by substituting a ethinyl at the C17 position, inhibiting first past metabolism?
Ethinyl estradiol and mestranol
Natural estrogens are primarily bound to what protien in circulation?
SHBG- sex hormone binding globulin (or sex steroid binding globulin)
Synthetic estrogens are primarily bound to what protien in plasma?
albumin
Progestins are bound to what protein in plasma?
corticosteroid binding globulin
What is the primary path for excretion of raloxifene?
unlike the other estrogens which are secreted in the urine, raloxifene is excreted in the feces
What estrogen drugs can be used in oral form?
1. estrone and equilin sulfate esters
2. estrone and equilin plant derv.
3. ethinyl estradiol
4. mestranol
5. diethylstilbestrol(syn)
6. chlorotrianisene (synthetic)
Clomiphene
1. antiestrogen
2. used for infertility
3. s/e- hot flashes, blurred vision, ovarian enlargement, cysts, increased mult. births
4. inter- teratogenic, do not use if already preg.
Tamoxifen
1. antiestrogen
2. Used for breast cancer and infertility
3. s/e- NV, HFlashes, vag. bleeding, PE, stroke, Hyperlipidemia, increase risk of endo. cancer
4. Warfarin, rifampin, phenobarb, clarithromycin, cyclosporine, NSAIDS, and P450 related drugs
Toremifene
1. antiestrogen
2. Used for breast cancer and infertility
3. s/e- NV, HFlashes, vag. bleeding, PE, stroke, NO HYPERLIPIDEMIA, increase risk of endo. cancer
4. Warfarin, rifampin, phenobarb, clarithromycin, cyclosporine, NSAIDS, and P450 related drugs
What two GnRH antagonist are used as antiestrogens for fertility related issues?
Leuprolide and ganirelix
Name the reversible aromatase inhibitor?
Anastrozole
Name the irreversible arromatase inhibitor?
Exemestane
Anastrozole
1. reversible aromatase inhibitor
2. used in advanced breast cancer in Postmen. women
3. s/e- GI, fatigue, HA, HF, edema, weight gain
4. Inter-do not use in preg. or liver problemed pts.
Exemestane
1. IRreversible aromatase inhibitor
2. used in advanced breast cancer in Postmen. women
3. s/e- GI, fatigue, HA, HF, edema, weight gain
4. Inter-do not use in preg. or liver problemed pts.
This antiprogestin drug is used for early abortions and possible endometriosis and breast cancer?
Mifepristone
Where does clomiphene bind and what is its confirmation?
Its confirmation is a mix of both cis(estrogenic) and trans (antiestrogenic), however, it main site of func. is at the pituitary, where it binds the estrogen receptors to inhibit the negative feedback of estrogen on the GnRH. Therefore, more FSH and LH are released.
Name the three triphenylethylene class drugs.
Tamoxifen (trans isomer, antiestrogenic)
Toremifene
Clomiphene (cis and trans mix)
Both clomiphene and toremifene, tamoxifen have long t1/2, however, what is the different reasoning?
clomiphene is extensivly protein bound and goes through enterohepatic recycling. t1/2 5-7days
Tamoxifen is broken down to a more active metabolite
4-hydroxy tamoxifen which has a t1/2 4-11 days
All 3 triphenylethylenes go through enterohepatic recirculation and excreted in the feces.
What is the main difference in side effects between tamoxifen and toremifene?
tamoxifen can cause hyperlipidemia
Which aromatase inhibitor is a steroid?
exemestane is an irreversible steroid binder

anastrozole is not a steroid and is reversible
aromatase inhibitors cause weight gain b/c?
the build up of androgenes, causes muscle increase, increase in water retention
Which androgens/androgen like drugs are used for hypogonadism, delayed puberty, testicular failure, or hypopituitarism?
1. testosterone
2. DHT
3. Transdermal test.
4. Test. cypionate (ester derivative of test.)
This synthetic testosterone is used to treat endometriosis and angioneurotic edema?
Danazol
Name 4 testosterone drugs that are used to treat angioneurotic edema?
1. Fluoxymesterone
2. methyltestosterone
3. oxandrolone
4. Danazol (synthetic, the rest are derivatives)
What two test. drugs are used to treat SLE and DM(II)?
Fluasterone and dihydroepiandrosterone
Ketoconazole
1. antifungal that inhibits androgen synthesis
2. used in advanced Prost. cancer
3. s/e- GI, impotence, hepatotoxicity
4. Inter- antacids, warfarin, benzodiazepines
Finasteride
Proscar
1. 5-alpha reductase inhibitor, stop test. from turning into DHT
2. used for BPH, and baldness
3.s/e- impotence gynocomastia, hepatic issues
4. inter- liver disease
Flutamide
1. androgen antagonist
2. used meta. prostatic carcinoma in combo w./GnRH antagonist
3. s/e- GI, anemia, hepatitis, leucopenia
Nilutamide
1. androgen antagonist
2. used meta. prostatic carcinoma in combo w./GnRH antagonist
3. s/e- GI, anemia, hepatitis, leucopenia
Bicalutamide
1. androgen antagonist
2. used meta. prostatic carcinoma in combo w./GnRH antagonist
3. s/e- GI, anemia
why should you not use alkylated testosterones for hypogonadism replacement therapy?
long term treatment causes liver damage
Danazol is used to treat what two female disorders?
endometriosis and fibrocystic breast disease
How does nilutamide differ from flutamide and bicalutamide?
It is a irreversible receptor antagonist

they are all nonsteroidal, but flute and bical are competative receptor antagonist
Which androgen receptor antagonist would be used in conjunction with an orchiectomy?
nilutamide
Name the type-I short acting insulins?
insulin lispro, human insulin
Name the type-I intermediate acting insulins?
isophane insulin, insulin-zinc suspension (Lente)
Name the type-I long acting insulins?
insulin-zinc suspension(Ultralente)
protamine-zinc insulin
Name the three main inhibitors of Beta-cell release of insulin?
1. somatostatin
2. glucogon
3. alpha-agonist(a2)
Name some drugs that inscrease secretion of insulin from B-cells?
beta agonist, cholinergic agonist, sulfonylureas
lispro is derived from what?
e coli- proline lysine transposition, fast acting, similar to IGF-I
How do salicylates potentiate the effect of insulin?
increase beta cell sensitivity to insulin
Beta agonist and epinepherine cause an increase in the release of insulin, but adversly cause hyperglycemia,,,how is this possible?
Although there is an increase in insulin which should lower blood sugar, both beta agonists and epinephrine increase sympathetic response(fight)and increase gluconeogenisis, with a net increase in overall glucose....
chlorpropamide
1. sulfonylurea- 1st gen
2. used Type II DM
3. s/e- hypoglycemia
4. many inter
glipizide
1. sulfonylurea- 2st gen
2. used Type II DM
3. s/e- hypoglycemia
4. many inter
metformin
1. biguanide
2. type II DM
3. s/e- N/diarrhea
4. many
Name the three thiazolidinediones and their use?
troglitazone, risoglitazone, pioglitazone
type II DM
Troglitazone has what possible complication?
cardiac side effects
repaglinide
1. meglitinide
2. used for type II DM
3. hypoglycemia
4. increase effect with hepatic dysfunction
acarbose
1. alpha-glucosidase inhibitor
2. type II DM
3. malabsorption, flatulence
4. many
glucagon
1. hyperglycemic agent
2. NV
3. poss. HT crisis
How do the sulfonylureases work?
increase beta cell secretion of insulin
How do the biguandes work?
Goats rue increases metabolism of glucose
Thiazolidinediones cause what?
they cause a resensitization of target tissues to insulin,,, no effect on insulin
What are the differences between these drugs
1.chlorpropamide, 2.clomiphene, 3.chlorotrianisese?
1.first gen. sulonylurea for DMII
2. antiestrogen used for infertility
3.synthetic non-steroidal estrogen used for breast engorgment
What are the differences between these drugs
1. mifepristone 2.miotane 3.methimazole 4. mestranol 5. metformin
1. glucocorticoid antagonist used for hypercortisolism
2. mineralocorticoid syn inhibitor used for adenocortical carcinomas
3. thiorureylene class anti-thyroid
4. synthetic estrogen steroid
5.bigunade used in DMII
What are the differences between these drugs
1. risoglitazone
2.risedronate
1. thiazolidinedione for DMII
2. bisphosphonate used for Paget's
What are the differences between these drugs

1.goserelin,
2.ganirelix
3.glipizide
1. GnRH analog used for ovulation suppression
2. GnRH antagonist used for controled ovarian hyperstimulation
3. sulfonylurea second gen for DMII
What are the differences between these drugs
1. flutamide
2. fluasterone
3. fludrocortisone
1. androgen antagonist used for prostatic carcinoma in combo w/ GnRH ant.
2. derivative of DHEA used in SLE and DMII
3. mineralocorticoid agonist used in hypoaldosteronism
Alprazolam
xanex-
anti-anxiety
age-related decrease in hept. clearence
barbiturates
hypnotic sedatives

age-related decrease in hept. clearence
carbenoxolone
licorice extract used for PUD, causes renal damage
age-related decrease in hept. clearence
chlordazepoxide
benzo used as anti-anxiety and for ethanol withdraw
age-related decrease in hept. clearence
chlormethiazole
Chlormethiazole has sedative, muscle relaxant, and anticonvulsant properties. used for ethanol with draw

age-related decrease in hept. clearence
clobazam
antipsychotic benzo.
age-related decrease in hept. clearence
Desmethyldiazepam
is the active metabolite of clorazapate.
age-related decrease in hept. clearence
diazepam
age-related decrease in hept. clearence

it is indicated as an antianxiety agent, sedative, amnestic, anticonvulsant, skeletal muscle relaxant, anesthetic adjunct, and as a treatment for alcohol withdrawal.
imipramine
tricyclic antidepressent,, depression and enuresis

age-related decrease in hept. clearence
meperidine
Meperidine is recommended for relief of moderate to severe acute pain and has the unique ability to interrupt postoperative shivering,,similar to fentenyl
age-related decrease in hept. clearence
Nortriptyline
tricyclic antidepress.
Nortriptyline is used to treat depression and for the management of chronic, severe neurogenic pain
age-related decrease in hept. clearence
quinidine
antimalarial and antiarrythmic
age-related decrease in hept. clearence
theophylline
Theophylline relaxes the smooth muscle of the bronchial airways and pulmonary blood vessels. In patients with asthma, theophylline reduces airway responsiveness to histamine, methacholine, adenosine, and allergen
age-related decrease in hept. clearence
tolbutamide
The acute hypoglycemic action of tolbutamide is due to stimulation of pancreatic islet cells, which produces an increase in insulin secretion. Sulfonylureas are believed to bind to ATP-sensitive potassium-channel receptors on the pancreatic cell surface, thereby reducing potassium conductance and depolarizing the membrane.Since it is extensively metabolized to inactive metabolites, tolbutamide may be useful in the treatment of elderly patients or patients with renal disease.
age-related decrease in hept. clearence
Isoniazid
Isoniazid (INH) is used in the treatment of mycobacterial disease. TB first line treatment
Lorazepam
Lorazepam is an oral and parenteral benzodiazepine used in the treatment of anxiety and status epilepticus. Other uses include perioperative sedation induction and anterograde amnesia. Intravenous lorazepam has replaced intravenous diazepam as the drug of choice for the treatment of status epilepticus because lorazepam persists in the CSF longer than diazepam
Prazosin
Prazosin is an oral agent used primarily to treat hypertension. It is classified as a quinazoline and is similar to the other alpha1-antagonists doxazosin and terazosin, both of which are longer acting than prazosin.