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351 Cards in this Set

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Trimethropin MOA
Folic Acid Reductase inhibitor
Sulfonamide MOA
ParaAminoBenzoicAcid competitive inhibitor
TMP-SMX
Trimethropin-Sulfamethoxazole
Use: UTI, prophylaxis for Pneumocystis carinni in AIDS with CD4 below 200; Prostatitis (assuming E Coli)
ADR:
Contraindicated in pregnancy => Interferes with folate metabolism during the first trimester and increases the risk of kerintincurus during the third trimester.
Stevens-Johnson Syndrome -> toxic epidermal necrolysis
Displace unconjugated bilirubin -> kernicterus
Blood dyscrasias in G6PD deficient (african/medit.)
Quinalones/Flourquinalones MOA
Inhibit topoisomerase (DNA gyrase) -> cidal inability to replicate DNA
Gram - cocci, rods, acid-fast bacilli
Dist: most fluids except CSF
Flouroquinalones = "floxacin"
Ciprofloxacin
flouroquinalone
Inhibit topoisomerase (DNA gyrase)
Use: Prostatitis (assuming E Coli)
ADR: C-diff, tendon damage, contraindicated in pregnancy due to cartilage damage
Levofloxacin
flouroquinalone
Good respiratory drug
Inhibit topoisomerase (DNA gyrase)
ADR: C-diff, tendon damage, contraindicated in pregnancy due to cartilage damage
Cephalosporins MOA
Beta-lactam -> inhibit cell wall synthesis
1st gen = gram +; don't cross BBB
2nd gen = gram + plus gram - ; don't cross BBB
3rd gen = more gram - ; cross BBB
Cephalexin
1st gen Cephalosporin (Beta-lactam)
Surgery prophylaxis
Cefotetan
2nd gen Cephalosporin (Beta-lactam)
Bacteroides fragilis
Cefamandole
3rd gen Cephalosporin (Beta-lactam)
Use: Meningitis with Pseudomonas
SE: reaction with ethanol similar to that produced by disulfiram
Cefoperazone
3rd gen Cephalosporin (Beta-lactam)
Use: Meningitis with Pseudomonas
SE: disulfiram-like reaction is characterized by nausea, vomiting, headaches and hypotension after consuming alcohol
Ceftriaxone
3rd gen Cephalosporin (Beta-lactam)
Use: DOC N. gonorrhoeae; Meningitis with Pseudomonas, E. coli, K. pneumonia, H. influenzae
Penicillin MOA
Inhibit cell wall synthesis
Beta-lactam
3 types:
1: Penicillin G (parenteral), V (oral), Amoxicillin (oral), Ampicillin (O & P)
2: PenicillinAse Resistant Penicillins (PARPs)
3: AntiPseudomonal Penicillins (APPs)

ADR: allergy -> Jared-Hirshheimer rxn
Penicillin G
Parenteral
Use: DOC syphillis
SE: K+ salt -> hyperkalemia in renal failure
Penicillin V
Oral
Amoxicillin
Beta-lactam -> inhibits cell wall synthesis
Like Penicillin, wider spectrum, sensitive to penicillinase
Oral--better bioavailability in the gastrointestinal tract than ampicillin
Use: sinusitis DOC
SE: "amoxicillin rash.” It typically begins on the trunk >72 hours after beginning the medication, then spreads, and is non-pruritic. As it is not a true allergic reaction, the current regimen may be continued and there is no contra-indication to future penicillin use.
Ampicillin
Beta-lactam -> inhibits cell wall synthesis
Like Penicillin, wider spectrum, sensitive to penicillinase
Parenteral
characteristic rash in those with infectious mononucleosis
PARPs treats
Penicillin-ase Resistant Penicillins treat Staph Aureus, Staph Epidermiis
Nafcillin
PARP parenteral DOC
Methicillin
PARP
APP MOA
Antipseudomonal penicillins against gram + and gram -
SE: Na+ salt -> sodium overload
Ticarcillin
Pipercillin
APP--Antipseudomonal penicillin
Wider spectrum penicillins
Use: activity against Pseudomonas aeruginosa.
Vancomycin
Cell wall inhibitor--inhibits cell wall synthesis by binding to the D-Ala terminus of peptidoglycan preventing elongation of the chain
Use: Reserve drug for MRSA, C Diff pseudomembranous colitis
Oral -> activity confined to GI tract = C Diff treatment
IM -> not used due to injection site pain
IV -> slow else "red neck syndrome" = facial flushing
ADR: nephrotoxic, ototoxic
Name the common 50 S Inhibitors
Buy AT 30, CELL at 50
Chloramphenicol, erythromycin, Lycomycin, CLindamycin
Erythromycin
50S Inihibitor
Macrolide
Does not cross BBB
Liver metabolism, excreted by bile--not useful for UTI
DOC: Chlamydia, Mycoplasma, Legionella
Clarithromycin/Azithromycin
Like erythromycin, 50S inhibitor
Macrolide
Use: Community-aquired and atypical pneumonia
Clindamycin
50 S Inhibitor
ADR: most likely to cause C-diff pseudomembranous colitis
backup for gram+; anaerobic, vaginitis, acne
Lincomycin
50 S Inhibitor
Older preparation of Clyndamycin
ADR: C-diff
Chloramphenicol
50 S Inhibitor
IV only
Crosses BBB
ADR: blood dyscrasias, bone marrow suppression, Gray Baby syndrome
30 S Inhibitors
Buy AT 30, CELL at 50
Aminoglycosides (gentamicin, streptomycin, tobramycin), tetracycline
Streptomycin
30 S Inhibitor
Aminoglycoside
ADR: crosses placenta -> deafness, ototoxic, nepthrotoxic
Tobramicin
30 S Inhibitor
Aminoglycoside
ADR: crosses placenta -> deafness, ototoxic, nepthrotoxic
Gentamicin
30 S Inhibitor
Aminoglycoside
ADR: crosses placenta -> deafness, ototoxic, nepthrotoxic
Tetracycline
30 S Inhibitor
Tetracycline=renal excretion -> UTI
ADR: teeth (contraindicated 8 - 12 yrs old), photosensitivity
MRSA treated with
Vancomycin +- Gentamycin +- Rifampin
Doxycycline
30 S Inhibitor
like Tetracycline but hepatic excretion -> preferred if renal failure
Use: DOC Chlamydia trachomatis (use erythromycin if pregnant); dog and cat bites for Pastuerella if allergic to sulfa drugs and penicillin; DOC for Borrelia burgdorferi (Lyme Disease); Prostatitis (assuming E Coli)
ADR: photosensitivity; contraindicated in pregnancy => Interferes with folate metabolism during the first trimester and increases the risk of kernicterus during the third trimester.
TB Treatment
Isoniazid + Rifampin + Pyrazinamide + Ethambutol +- Streptomycin
Isoniazid
TB treatment
Inhibits mycolic acid synthesis in mycobacterium tuberculosis
ADR: hepatitis, peripheral neuritis, lupus, seizure--give B6 (pyridoxine) with it to prevent seizure.
Rifampin
TB treatment
Inhibits DNA-dependent RNA polymerase
SE: orange-colored body fluids, induces CYP450 making drugs clear faster
Pyrazinamide
TB treatment
Cidal at pH 5.5, taken up by macrophages that carry intracellular TB
ADR: hepatitis, arthralgia and elevated uric acid
Ethambutol
TB treatment
Disrupts arabinogalactan in cell wall
ADR: red-green color discrimination and visual acuity=optic neuritis
Streptomycin
TB treatment
Aminoglycoside--30 S Inhibitor
ADR: nephrotoxic, ototoxic
Beta 2 Agonist MOA
Stimulate B2 receptors in lung => activates adenylate cyclase => Increased cAMP => phosphokinase phosphorylation of myosin =>relaxation of bronchial smooth muscle
ADR: lose effectiveness over time
Albuterol
Short-acting B2 agonist
asthma rescue
Levalbuterol
Short-acting B2 agonist
asthma rescue
Salmeterol
Long-acting B2 agonist
Asthma
Use ONLY with corticosteroid for asthma
Formoterol
Long-acting B2 agonist (rapid)
Asthma
Use ONLY with corticosteroid for asthma
Methylxanthines MOA
Inhibit phosphodiesterase, which decreases breakdown of cAMP, resulting in increased brochodilation
Theophylline
Methylzanthine-- iinhibits phosphodiesterase, which decreases breakdown of cAMP, resulting in long-term brochodilation
Use: COPD, asthma alternative to B2 agonist
ADR: dry mouth, think caffeine--CNS stimulation
SE: overdose => seizure
Anticholinergic/Antimuscarinics MOA
Non-selective antagonist of acetylcholine at peripheral muscarinic receptors (M3 in airway smooth muscle)
Ipratropium
short-acting Anticholinergic/Antimuscarinics
COPD, asthma
Tiotropium
short-acting Anticholinergic/Antimuscarinics
Use: COPD, asthma
Mast Cell Stabilizer MOA
Prevent histamine and leukotriene release by mast cell degranulation
"crom"
Cromolyn sodium
Mast Cell Stabilizer
Asthma prophylactic and maintenance. Does NOT relax brochi
Nedocromil
Mast Cell Stabilizer
Asthma prophylactic and maintenance. Does NOT relax brochi
Inhaled Corticosteroid MOA
Anti-inflammatory
Inhibits phospholipase A2 => decreased lipoxygenase (=> decreased leukotrienes) and decreased cyclooxygenase (=> decreased thromboxane => decreased bronchoconstriction)
Uses: asthma step 2,3,4 and severe COPD
Flunisolide
Inhaled Corticosteroid
Uses: asthma step 2,3,4 and severe COPD
SE: oral candidiasis
Beclomethasone
Inhaled Corticosteroid
Uses: asthma step 2,3,4 and severe COPD
ADR: oral candidiasis
Predisone
Systemic Corticosteroid
Uses: acute asthma/COPD, SLE
SE: can cause peptic ulcers or worsen existing ulcers
Dexamethasone
Systemic Corticosteroid
Uses: acute asthma/COPD
SE: can cause peptic ulcers or worsen existing ulcers
Leukotriene Inhibitors MOA
Inhibit leukotriene receptor (zafirlukast, montelukast) or lipoxygenase (zileuton)
Uses: long-term control of mild asthma
Zafirlukast
Inhibit leukotriene receptor
Uses: long-term control mild asthma
ADR: hypersensitivity
Montelukast
Inhibit leukotriene receptor
Uses: long-term control of mild asthma
ADR: hypersensitivity
Zileuton
Lipoxygenase Inhibitor results in less leukotrienes
Uses: long-term control of mild asthma
ACE Inhibitor MOA
Angiotensin converting enzyme inhibitor in prevents conversion of angiotensin I to angiotensin II in plasma and prevents inactivation of bradykinin => decreased angiotensin II, thus blocks angiotensin II's vasoconstriction of blood vessels, decreased aldosterone secretion, allows bradykinin to potently vasodilate.
Lowers BP, prevents renal disease, diabetic nephropathy, post-MI HF
"pril"
Captopril
ACE Inhibitor
ADR: dry hacking cough, angioedema, hyperkalemia
Contraindicated: pregnancy, renal artery stenosis
Lisinopril
ACE Inhibitor
ADR: dry hacking cough, angioedema, hyperkalemia
Contraindicated: pregnancy, renal artery stenosis
Angiotensin Receptor Blockers MOA
Block angiotensin II receptor => directly causes vasodilation, reduces secretion of vasopressin (ADH), reduces production/secretion of aldosterone. Allows bradykinin to be inactivated. Used in those with adverse effects of ACE Inhibitors.
Use: Hypertension, diabetic nephropathy
Losartan
ARB
Beta Blocker MOA
Antagonize catecholamines by inhabiting adrenergic receptors.
Beta 1 blocker => decrease rate and force of heart contraction. Decrease AV nodal conduction for supraventricular arrythmias. Slow phase 4 => slow rhythm
Beta 2 blocker => decrease bronchodilation, block bladder wall relaxation. Decreases renin secretion=> decreased vascular resistance.
B1-selective starts with letters "A-M"
Non-selective starts with letters "N-Z" and contraindicated in patients with asthma. This is because they block the beta-2 receptors that cause bronchodilation
Atenolol
B1-selective blocker (Class II Antiarrythmic)
Metoprolol
B1-selective blocker (Class II)
SE: bradycardia, exercise-induced syncope, and worsening of obstructive lung disease
Propanolol
B1B2 blocker (Class II)--nonselective
Use: essential tremor
SE: contraindicated in patients with asthma. This is because they block the beta-2 receptors that cause bronchodilation. hyperlipidemia.
Calcium Channel Blocker MOA
Block Ca++ channels in AV nodal cells and pacemakers> increased PR interval.
=Used to slow conduction in SA and AV nodes. Dihidropyridines (nifedipine) and Nondihydropyridines (verapamil and diltiazam)
Verapamil
CCB (Class IV)
Nondihydropyridine
Use: supraventricular tachycardia (maintenance after adenosine)
SE: Cutaneous flushing
ADR: constipation
Diltiazam
CCB (Class IV)
Nondihydropyridine
Use: supraventricular tachycardia (maintenance after adenosine)
SE: Cutaneous flushing
ADR: constipation
Class 1A Na+ Channel blockers MOA
Block fast Na+ channels.
Prolong phase 0 and phase 3 repolarization.
Quinidine
Class 1A Na+ Channel blockers
ADR: cinchonism (headache and tinnitus), torsade de pointes due to increased QT interval
Procainamide
Class 1A Na+ Channel blockers
ADR: SLE-like syndrome
Disopyramide
Class 1A Na+ Channel blockers
Class 1B Na+ Channel blockers MOA
Block inactives fast Na+ channels. Shorten phase 2 and thus shorten AP length
Mexiletine
Class 1B Na+ Channel blocker
Shortens phase 2 => shorter AP
Lidocaine
Class 1B Na+ Channel blocker
Shortens phase 2 => shorter AP
Use: DOC ventricular arrhythmias from M.I. by slowing depolarization in ischemic tissue only
SE: common side-effects include tremor, slurred speech and seizures because it passes the blood-brain barrier
Phenytoin
Class 1B Na+ Channel blocker
Shortens phase 2 => shorter AP
SE: enhance CYP450 making other drugs clear faster, hirsutism, gingival hyperplasia and peripheral neuropathies; osteomalacia from Vitamin D deficiency
ADR: teratogenic--leads to fetal dilantin syndrome characterized by microcephaly, midfacial abnormalities and hypoplasia of the finger and toe nails
Class 1C Na+ Channel blocker MOA
Block fast Na+ channels especially in purkinje fibers. Depress phase 0. No change in AP length.
Flecainide
Class 1C Na+ Channel blocker
Contraindicated post-MI=proarrythmic
Ecainide
Class 1C Na+ Channel blocker
Contraindicated post-MI=proarrythmic
Propafenone
Class 1C Na+ Channel blocker
Contraindicated post-MI=proarrythmic
K+ Channel blocker MOA
Class III Antiarrythmic slows phase 3 repolarization of AP. Increase AP duration and QT interval.
Use: ventricular tachycardia
Amiodorone
K+ Channel blocker (class 3)
Use: DOC ventricular tachycardia, ventricular fibrillation; prolongs action potential more than any other drug and has half-life of weeks
ADR: pulmonary fibrosis, hepatotoxicity, hypo/hyperthyroidism
SE: inhibits metabolism of Warfarin so must reduce dose
Sotalol
Beta blocker with K+ Channel blocker (class 3) attributes
Slows phase 3 => increased QT
ADR: torsade de pointes
Ibutilide
K+ Channel blocker (class 3)
Use: ventricular tachycardia
Dofetilide
K+ Channel blocker (class 3)
Use: ventricular tachycardia
Adenosine
Antiarrythimic that slows AV conduction by transient heart block of the AV node. Short-acting. Delivered IV for chemical conversion of supraventricular tachycardia.
SE: Cutaneous flushing
Digoxin
Cardiac glycoside. Direct inhibition of Na+/K+ ATPase => indirect inhibition of Na+/Ca++ exchanger => increased calcium => positive inotropy=increased contractility. Stimulates Vagus nerve => decreased chronotropy=slower conduction
COX Inhibitors MOA for platelets
Irreversibly inhibits cyclooxegenase => decreased PGI2 => decreased platelet aggregation for life of platelet (7-10 days)
Aspirin
COX inhibitor
Use: antiplatelet, kawasaki dz (high dose)
ADP Receptor Antagonists MOA
Inhibit ADP binding to surface receptor => irreversible inhibition of platelets
Clopidogrel
ADP Receptor Antagonist
antiplatelet (Plavix)
Ticlopidine
ADP Receptor Antagonist
antiplatelet
GPIIB/IIIa Receptor Antagonists MOA
Inhibit GPIIb/IIIa receptor => no activation and no binding with fibrinogen, vWF, platelets
Abciximab
GPIIB/IIIa Receptor Antagonists
antiplatelet
PDE-3 Inhibitors MOA
Inhibit Phosphodiesterase-3 => decreased cAMP => decreased maturity of platelet from megakaryocyte
Anagrelide
PDE-3 Inhibitors
antiplatelet
Heparin
Antithrombin III enhancer for anticoagulation => affects 2, 9 ,10, 11, 12. Shared plus Intrinsic therefore follow PTT. Protamine sulfate for overdose.
Warfarin
Vitamin K Inhibitor for anticoagulation => interferes with gamma-carboxylation of vitamin K-dependent factors 2, 7, 9, 10, protein C, and protein S. Extrinsic system (factor 7) therefore follow with PT.
IV Vitamin K and fresh frozen plasma for overdose.
Teratogenic
"The EX-PresidenT went to WARfarin"
Argatroban
Thrombin IIa inhibitor for anticoagulation.
Use: Prophylaxis for DVT in hip surgery, heparin induced thrombocytopenia
Lepirudin
Thrombin IIa inhibitor for anticoagulation.
Use: Prophylaxis for DVT in hip surgery, heparin induced thrombocytopenia
Tissue Plasminogen Activators MOA
Convert plasminogen to plasmin => initiation of local fibrinolysis
Alteplase
Tissue Plasminogen Activators
Streptokinase
Tissue Plasminogen Activator
Can't use 2nd time due to immune response in 12 month period
HMG CoA Reductase Inhibitors MOA
Competitively inhibits HMG-CoA reductase (the rate-limiting step in cholesterol synthesis) => decreased cholesterol production in hepatocytes
SE: liver toxicity, muscle toxicity => myoglobinuria
"statin"
Lovastatin
HMG CoA Reductase Inhibitors => decreased LDL, decreased TG
ADR: myalgia, rhabdomyolysis => myoglobinuria, hepatotoxicity
Contraindicated in pregnancy
Bile Acid Sequestrant MOA
Non-absorbable resins bind bile acid in intesting => liver must use cholesterol to make more bile => reduces LDL
Use: hypercholesterolemia
ADR: bad taste, gi discomfort, extensive drug-drug interactions
Cholestyramine
Bile Acid Sequestrant
Decrease LDL, increase TG slightly
ADR: bad taste, gi discomfort, extensive drug-drug interactions
Colestipol
Bile Acid Sequestrant
Decrease LDL, increase TG slightly
ADR: bad taste, gi discomfort, extensive drug-drug interactions
Colesevelam
Bile Acid Sequestrant
Decrease LDL, increase TG slightly
ADR: extensive drug-drug interactions
Niacin
Decreases TG synthesis, increased LDL receptor activity, and Decreased HDL catabolism
SE: Cutaneous flushing (use aspirin)
ADR: hyperglycemia, hyperuricemia
PPAR-alpha Activators MOA
Activate PPAR => transcription of genes in lipoprotein metabolism like lipoprotein lipase => increases breakdown of triglycerides (including VLDL) in periphery and increases HDL
SE: cholesterol gallstones
"fibrate"
Gemfibrozil
PPAR-alpha Activator
Lowers TGs
ADR: hepatotoxicity (Increased LFT), myopathy
SE: cholesterol gallstones
Fenofibrate
PPAR-alpha Activator
Use: Lowers TGs
ADR: hepatotoxicity (Increased LFT), myopathy
SE: cholesterol gallstones
Cholesterol Absorption Inhibitors MOA
Selectively inhibits absorption of cholesterol in the small intestine to decrease LDL
Ezetimide
Cholesterol Absorption Inhibitor
ADR: diarrhea, GI distress
Alpha Adrenergic Antagonists MOA
Block alpha adrenergic receptors.
Alpha 1= radial (dilator) m in eye, vascular smooth muscle, prostate => relax smooth muscle in the prostate and the bladder neck
Alpha 2= walls of GI.
Use: BPH, lower blood pressure
Alpha 1="osin"
Alfuzosin
Alpha 1 selective Adrenergic Antagonist-uroselective
relax smooth muscle in the prostate and the bladder neck
Use: BPH
Tamsulosin
Alpha 1 selective Adrenergic Antagonist-uroselective
relax smooth muscle in the prostate and the bladder neck
Use: BPH
AE: impaired ejaculation, orthostasis
-bendazole
Antihelminth that reduces glucose transport
Diethylcarbamine
Antihelminth
Use for elephantitis caused by Wucheria bancrofti and Loa Loa
Ivermectin
Antihelminth that hyperpolarizes by affecting GABA, glutamate, and chloride channels
Use for Onchocerca volvulus
Praziquantel
Antihelminth that causses loss of intracellular calcium => paralysis
Use: schistosoma, taenia solium, diphylobothrium latum
Metronidazole
Anti-protozoan
Use for entamoeba, giardia, trichomonas vaginalis
AE: metallic taste, disulfiram-like reaction is characterized by nausea, vomiting, headaches and hypotension after consuming alcohol
Chloroquine
Anti-protozoan
Use: plasmodium falciparum (malaria)
Hydroxychloroquine
Use: Anti-malarial, DMARD--Inflammation reduction in Rheumatoid Arthritis
SE: retinal deposits
H2 Blocker MOA
Anti-ulcer by reversibly blocking Histamine type 2 receptor => decreased H+ secretion by parietal cells
"dine"
Cemetidine
H2 Blocker
SE: inhibits Warfarin metabolism so must reduce dose
Famotidine
H2 Blocker
Nizatadine
H2 Blocker
Ranitidine
H2 Blocker
Proton Pump Inhibitors MOA
Irreversibly inhibit H+/K+ ATPase in stomach parietal cells => decreased acid secretion
"prazole"
Omeprazole
PPI
Lansoprazole
PPI
Pantoprazole
PPI
Sucralfate
Sulfated polysacharide that binds to ulcer for physical protection
AE: constipation, contraindicated in renal failure
Misoprostol
PGE1 analog => secretion of mucous barrier.
Use: patients on NSAIDs to prevent ulceration, labor induction
Bismuth
Increase production of bicarb and mucous with antibacterial actions.
Use: H. pylori treatment.
H. Pylori Triple Therapy
PPI
Clarithromycin
Amoxycillin or Metronidazole
=PCAM
H. Pylori Quadruple Therapy
PPI
Metronidazole or Clarithromycin
Amoxicillin or Tetracycline
Bismuth
GnRH/LHRH Agonists MOA
Gonadotropin releasing hormone analog that result in downregulation of GnRH receptors on pituitary if given constantly (vs. pulsatile as normal) => medical castration
Use: palliative advance prostate cancer, hormone receptor positive breast cancer , endometriosis
Leuprolide
GnRH/LHRH Agonists
Use: palliative advance prostate cancer, hormone receptor positive breast cancer , endometriosis
Goserelin
GnRH/LHRH Agonists
Use: palliative advance prostate cancer, hormone receptor positive breast cancer , endometriosis
Triptorelin
GnRH/LHRH Agonists
Use: palliative advance prostate cancer, hormone receptor positive breast cancer , endometriosis
Antiandrogens MOA
Block androgen receptors for testosterone and DHT.
Use: flare protection when started on GnRH agonist
"lutamide"
Flutamide
Antiandrogen--androgen receptor blocker
Use: flare protection when started on GnRH agonist
Bicalutamide
Antiandrogen--androgen receptor blocker
Use: flare protection when started on GnRH agonist
Nilutamide
Antiandrogen--androgen receptor blocker
Use: flare protection when started on GnRH agonist
5 alpha reductase inhibitors MOA
Inhibit conversion of testosterone to DHT to reduce prostate hyperplasia
Use: BPH
"asteride"
Finasteride
5 alpha reductase inhibitor
Use: BPH, male pattern baldness
AE: impotence and decreased libido
Dutasteride
5 alpha reductase inhibitor
Use: BPH
AE: impotence and decreased libido
Phosphodiesterase 5 Inhibitors MOA
Inhibit PDE5 => decreased degradation of cGMP => increased intracellular Ca++ and relaxation of vascular smooth m. of corpus cavernosa
Sildenafil
Phosphodiesterase 5 Inhibitor
Use: erectile dysfunction
Tadalafil
Phosphodiesterase 5 Inhibitor
Use: erectile dysfunction
Vardenafil
Phosphodiesterase 5 Inhibitor
Use: erectile dysfunction
Mannitol
Osmotic diuretic
Use: cerebral edema
Acetazolamide
Carbonic anhydrase inhibitor in proximal tubule => reduced reabsorption of NaHCO3 in proximal tubule => less bicarb and NaHCO3 diuresis
Use: glaucoma, metabolic alkalosis, altitude sickness
Toxicity: sulfa allergy, acidosis
Furosemide
Loop diuretic that inhibits Na+/K+/2CL- cotransport in thick ascending limb of loop of Henle. "Loops lose calcium"=Ca++ loss.
Use: CHF edema, hypertension, hypercalcemia
AE: ototoxicity (vertigo, nausea and hearing loss), hyponatremia, hypokalemia, hypercalciuria, sulfa allergy, interstitial nephritis
Can use if low renal function since metabolism shifts to non-renal.
Ethacrynic Acid
Loop diuretic that inhibits Na+/K+/2CL- cotransport in thick ascending limb of loop of Henle. For those allergic to sulfa.
Use: Edema, hypertension, hypercalcemia, hyperuricemia
Hydrochlorothiazide
Thiazide diurectic that inhibits NaCl resorption in distal convoluted tubule => decreases ability to dilute in distal tubule. Decreases Ca+ excretion since Ca+ doesn't have to compete with Na+ (increases Calcium!)
Use: Hypertension, idiopathic hypercalciuria (stone formers)
AE: hypokalemia, hypercalcemia, hypernatremia, hyperglycemia, hyperuricemia, sulfa allergy
K+ sparing diuretics MOA
Diuretics that are competitive aldosterone antagonists (or Na+ blockers) in the collecting tubule => increased Na+ absorption and decreased K+ excretion
Spironolactone
K+ sparing diuretic = competitive aldosterone antagonist =>increased Na+ excretion and decreased K+ excretion
Use: heart failure, hypokalemia, Conn's syndrome
AE: hyperkalemia, gynocomastia
Triamterene
K+ sparing diuretic acts by blocking Na+ channels, and K+ spared due to coupling
Use: hyperaldosterism, K+ depletion, CHF
SE: hyperkalemia
Amiloride
K+ sparing diuretic acts by blocking Na+ channels, and K+ spared due to coupling
L-DOPA
Dopamine precursor used for parkinson's treatment
Usually delivered with carbidopa, a peripheral dopa decarboxylase inhibitor that prevents peripheral breakdown of L-DOPA. Note that L-DOPA, but not Dopamine, can cross the BBB.
MAO-B Inhibitors MOA
Block catabolism of dopamine
Use: Parkinson's
"ge/giline"
Selegeline
MAO-B Inhibitor blocks catabolism of dopamine
Use: adjunct to L-DOPA in Parkinson's
Rasagiline
MAO-B Inhibitor blocks catabolism of dopamine
Use: adjunct to L-DOPA in Parkinson's
COMT Inhibitor MOA
Block catabolism of dopamine. Entacapone inhibits peripheral catabolism of levodopa and Tolcapone inhibits central catabolism. These lead to more levodopa in the brain and its conversion to dopamine.
Use: Parkinson's
"capone"
Tolcapone
COMT Inhibitor blocks CENTRAL catabolism of dopamine
Use: adjunct to L-DOPA in Parkinson's
Entacapone
COMT Inhibitor blocks PERIPHERAL catabolism of levodopamine
Use: adjunct to L-DOPA in Parkinson's
Lamotrigine
Na+ channel blocker
Use: Anti-seizure (partial, tonic-clonic)
SE: less than other drugs, but life-threatening skin rash via hypersensitivity--immediately stop tx!
Phenytoin
1B Na+ channel blocker
Use: seizure (partial and tonic-clonic)
SE: enhance CYP450 making other drugs clear faster, hirsutism, gingival hyperplasia and peripheral neuropathies; osteomalacia from Vitamin D deficiency
ADR: teratogenic--leads to fetal dilantin syndrome characterized by microcephaly, midfacial abnormalities and hypoplasia of the finger and toe nails
Carbamazepine
Blocks Na+ channels
Use: seizure (partial and tonic-clonic), mania of bipolar as a mood stabilizer
AE: induces CYP450, teratogenic
Valproic acid
Inhibits GABA transaminase
Use: seizure (tonic-clonic and absence), mania of bipolar as a mood stabilizer
AE: teratogenic--neural tube defects,hepatotoxicity (monitor LFT regularly)
Ethosuximide
block Ca++ channels and thalamic neurons
Use: DOC absence seizures (safer than valproic acid!)
SE: EFGH mnemonic--Ethosuximide=>Fatigue, GI, Headache
Methylphenidate
Stimulant
Use: ADHD
Adderol
Stimulant - amphetamine
Use: ADHD
Morphine
Mu agonist
Use: analgesia, sedation
AE: euphoria, nausea, respiratory depression, miosis, constipation
Meperidine
Mu agonist
Use: fast onset, short acting for labor
Fentanyl
Mu agonist
Use: anesthesia and breakthrough pain
Codeine
Mu agonist
Use: cough relief
Naloxone
Mu receptor antagonist
Use: antidote for opiod overdose
Tricyclic Antidepressants MOA
Blockade of 5HT and NE reuptake=>downregulation of receptors at post-synaptic site
SE: cardio (dysrhythmias, QRS and QT elongation=quinidine-like effect--must antidote with NaHCO3), anticholinergic (dry mouth, urine retention), CNS (sedation, seizures) => coma, cardiotoxicity, and convulsions
Amitriptyline
Tricyclic Antidepressant blocks 5HT and NE reuptake
SE: dysrhythmias, dry mouth, seizures
Imipramine
Tricyclic Antidepressant blocks 5HT and NE reuptake
SE: dysrhythmias, dry mouth, seizures
Clomipramine
Tricyclic Antidepressant blocks 5HT and NE reuptake
SE: dysrhythmias, dry mouth, seizures
SSRI MOA
Selective blockade of 5HT reuptake
SE: serotonin syndrome (treat with cyproheptadine, a 5HT receptor antagonist)
Fluoxetine
SSRI-Selective blockade of 5HT reuptake
Use: depression, panic attack prevention
SE: serotonin syndrome
Paroxetine
SSRI--Selective blockade of 5HT reuptake
Use: depression, panic attack prevention
SE: serotonin syndrome
Sertraline
SSRI: Selective blockade of 5HT reuptake (Zoloft)
Use: depression, OCD
SE: serotonin syndrome
Does NOT cause weight gain
Buspirone
5HT partial agonist
Use: Generalized anxiety disorder
Note: unlike benzodiazepines, this doesn't cause sedation, CNS depression or dependence. It is indicated for general anxiety because it takes weeks to take effect.
Lithium
Mood stabilizer
Use: DOC bipolar disorder
SE: hyponatremia, nephrogenic diabetes insipidus => polydipsia and polyuria
ADR: teratogenic--congenital cardiac abnormalities
Benzodiazepine MOA
GABA agonist--potentiate GABA receptor, a chloride channel, by increasing the frequency of its opening
Metabolized outside the liver
Use: Insomnia, acute anxiety attack, DTs in alcohol addiction
"pam and lams"
Diazepam
Benzodiazepine--bind to the GABA receptor, which is also a chloride channel, and increases its frequency of opening
Use: anxiety disorder--acute attack
Safe to use in liver dysfunction because they are metabolized outside the liver
Alprozalam
Benzodiazepine--bind to the GABA receptor, which is also a chloride channel, and increases its frequency of opening
Use: anxiety disorder--acute attack
Safe to use in liver dysfunction because they are metabolized outside the liver
Barbituate MOA
GABA agonist -- GABA independent
Phenobarbitol
Barbituate
Use: Sedative
SE: enhance CYP450 making other drugs clear faster
Polyenes MOA
Antifungal targets ergosterol in cell membrane, creates pores, and disrupts integrity => osmotic fragility
Amphotericin
Polyene antifungal => pores => osmotic fragility
Systemic tx
Nystatin
Polyene antifungal => pores => osmotic fragility
Oral
Candida only
Natamycin
Polyene antifungal => pores => osmotic fragility
Opthamological
Candida and Aspergillus
Allylamine MOA
Antifungal targets squalene 2-3 epoxidase, preventing conversion of sqaulene to lanosterol (and thus ergosterol) => squalene surplus
Terbinafine
Allylamine antifungal targets squalene 2-3 epoxidase
Topical (local) or oral (systemic)
Use: DOC onychomycosis, tinea cruris, tinea corporis, tinea pedis, tinea unguium
ADR: contraindicated in preg.
Naftitine
Allylamine antifungal targets squalene 2-3 epoxidase
Topical
Use: tinea cruris, tinea corporis, tinea pedis, tinea unguium
Griseofulvin
Antifungal binds microtubules and accumulates in new keratin => antimitotic
Oral (systemic)
Use: tinea capitis, tinea corporis
Azole MOA
Antifungal targets 14 alpha demethylase that converts lanosterol to ergosterol
Clotrimazole
Azole antifungal targets 14 alpha demethlase that converts lanosterol to ergosterol
oral use: thrush (AIDS)
vaginal use: candidiasis
SE: decreased synthesis of steroids including cortisol and testosterone => decreased libido, increased LFTs
Miconazole
Azole antifungal targets 14 alpha demethlase that converts lanosterol to ergosterol
vaginal use: candidiasis
SE: decreased synthesis of steroids including cortisol and testosterone => decreased libido, increased LFTs
Fluconazole
Azole antifungal targets 14 alpha demethlase that converts lanosterol to ergosterol
oral use: cadiduria, cryptococcus meningitis (no aspergillus)
SE: decreased synthesis of steroids including cortisol and testosterone => decreased libido, increased LFTs
Antiviral for HSV and CMV MOA
Nucleoside analog to guanine that inhibits DNA synthesis
Acyclovir
Antiviral nucleoside analog to guanine that inhibits DNA polymerase synthesis of HSV
Valcyclovir
Antiviral nucleoside analog to guanine that inhibits DNA polymerase synthesis of HSV and VZV
Prodrug of acyclovir
Famciclovir
Antiviral nucleoside analog to guanine that inhibits DNA polymerase synthesis of HSV and VZV
Prodrug of penciclovir
Ganciclovir
Antiviral nucleoside analog to guanine that inhibits DNA polymerase synthesis of CMV
AE: bone marrow suppression
Idoxuridine
Antiviral nucleoside analog to pyrimidine that inhibits DNA polymerase synthesis of HSV and VZV
Podofilox
Antiviral that inhibits cell mitosis
Use: external gen. warts
Imiquimod
Antiviral induces mRNA encoding cytokines
Use: external gen. warts
Enfuvirtide
Fusion inhibitor for HIV tx
Injectible
AE: at injection site
Abacavir
Nucleoside reverse transcriptase inhibitor for HIV tx
HLA-B5701 test to see if pt is + => hi risk for anaphylaxis
Didanosine
Nucleoside reverse transcriptase inhibitor for HIV tx
AE: pancreatitis, neuropathy
Emtricitabine
Nucleoside reverse transcriptase inhibitor for HIV tx
Minimal toxicity
Stavudine
Thymadine analogue for HIV tx
AE: don't use in alcoholic, lipodystrophy
Tenofovir
Nucleoside reverse transcriptase for HIV tx
AE: renal toxicity
Zidovudine
AZT. Nucleoside reverse transcriptase for HIV tx
Prevents vertical transmission to fetus
AE: bone marrow suppression and anemia
Efavirenz
Non-nucleoside reverse transcriptase for HIV tx. Does NOT incorporate itself into viral DNA
AE: hallucinogenic, contra in preg.
Reltegravir
Integrase inhibitor for HIV tx
Use: rescue med
Atazanavir
Protease inhibitor
Use: HIV tx
ADR: use caution with H2 antagonists and PPIs
Indinavir
Protease inhibitor used for HIV tx
ADR: kidney stones, hyperbilirubinemia, hyperlipidemia
Cyclophosphamide
Ifosphamide
Anticancer--alkylating agent crosslinks DNA at guainine
AE: binds acrolein => hemorrhagic cystitis. Use mesna to trap acrolein.
Note: prodrug that is activated in liver, so liver disease decreases effectiveness.
Cisplatin
Anticancer--alkylating agent platinum analog crosslinks DNA
Use: genitourinary ca
AE: nephrotoxic, ototoxic. reduce with amifostine.
Busulfan
Anticancer--alkylating agent crosslinks DNA
Use: CML
AE: hepatic veno-occlusive disease
Methotrexate
Anticancer--antimetabolite/folic acid analog blocks dihydrofolate reductase => decreased DNA and protein synthesis
S Phase
AE: cerebellar dysfunction/stroke-like encephalopathy. rescue w/leucovorine
Use: rheumatoid arthritis, ectopic pregnancy/abortion; leads to accumulation of dyhydrofolate
SE: hepatic toxicity (test LFTs), teratogenic
6 Mercaptopurine
Anticancer--purine antimetabolite inhibits AMP and GMP synthesis
S Phase
AE: bone marrow suppression
SE: in chemotherapy patients taking 6 mercaptopurine, you must drop the dose since allopurinol prevents the breakdown of mercaptopurines
5 Fluorouracil
Anticancer--pyrimidine antimetabolite
S Phase
AE: bone marrow suppression, ischemic cardiac symptoms. rescue with thymidine
Vincristine
Vinblastine
Anticancer--vinka alkaloid binds tubulin to block microtubules from forming mitotic spindle
M Phase
AE:
Vinblastine blasts bone marrow
Vincristine causes neurotoxicity
Paclitaxel
Anticancer--stablilizes microtubules so mitotic spindle can't break down
M Phase
Bleomycin
Anticancer binds Fe and O2 and generates radicals
G2 Phase
AE: pulmonary fibrosis
Lispro
Rapid acting insulin
Aspart
Rapid acting insulin
Glulisine
Rapid acting insulin
Glargine
Long acting insulin
Detemir
Long acting insulin
Insulin Secretagogues MOA
Inhibit ATPase-sensitive K+ channel => depolarization => Ca++ influx => insulin secretion
Sulfonylureas and Meglitinides
SE: hypoglycemia
Chlorpropamide
Sulfonylurea insulin secretagogue
SE: hypoglycemia
Glipizide
Sulfonylurea insulin secretagogue
SE: hypoglycemia
Glyburide
Sulfonylurea insulin secretagogue
SE: hypoglycemia
Metformin
Insulin sensitizer
AE: metallic taste
Acarbose
Alpha glucosidase inhibitor => decreased breakdown of sugars
Use: type II DM
Miglitol
Alpha glucosidase inhibitor => decreased breakdown of sugars
Use: type II DM
Rosiglitazone
PPAR-Gamma activator increases the transcription of insulin responsive genes for control of glucose
Use: DM
AE: edema
AE: worsens lipid profile (except HDL) => increased MI
"Glitazones are gammas"
Pioglitazone
PPAR-Gamma activator that increases the transcription of insulin responsive genes for control of glucose
Use: DM
AE: edema
"Glitazones are gammas"
Glucocorticoid MOA
Like cortisol--inhibit Phospholipase a2 => decrease production of leukotrienes and expression of COX
AE: hyperglycemia, loss of mm mass, fat redistribution, hypertension, weakness, fractures ulcers, insomnia
"osone, isolone, olone"
Dexamethasone
Glucocorticoid
oral
Betamethasone
Glucocorticoid
injectable
Mineralcorticoid MOA
Like aldosterone for Na+/K+ and water balance, blood pressure regulation
AE: hypertension, electrolyte disturbance, fluid overload
Fludrocortisone
Mineralcorticoid
Use: replace aldosterone in adrenal insufficiency. Used as a test for diagnosing Conn's by suppressing aldosterone in a normal patient but not suppressing in Conn's patient.
AE: hypertension, electrolyte disturbance, fluid overload
Metyrapone
Glucocorticoid Antagonist
Use: HPA suppression drug inhibits 11 beta hydroxylase.
Use to diagnose primary (doesn't bind => no change in cortisol and no increase in ACTH) or secondary adrenal insufficiency (binds to adrenal => decreases cortisol => increased ACTH).
Dexamethasone
Synthetic glucocorticoid
Use: Diagnosis of Cushing by suppression test. Normal = lo cortisol in morning. Cushings's = hi cortisol in morning since ACTH is out of control.
Levothyroxine
T4
Use: hypothyroidism
Liothyronine
Triiodothyronine
T3
Use: hypothyroidism
Antipsychotic MOA
Block dopamine type 2 post synaptic receptors
"zines and pines and dones"
Typical Antipsychotics
thioridazine
haloperidol
fluphenazine
chlorpromazine
SE: neuroleptic malignant syndrome
Atypical Antipsychotics
quetiapine
clozapine
olanzapine
risperidone
Haloperidol
Typical Antipsychotic--Dopamine blocker (excess dopamine is associated with psychosis and hyperkinetic movement disorders such as Huntington disease)
Use: antipsychotic, calm agitation in the elderly
SE: hyperprolactinemia due to dopamine antagonism=>lactation, neuroleptic malignant syndrome
Reserpine
Antipsychotic--Dopamine blocker (excess dopamine is associated with psychosis and hyperkinetic movement disorders such as Huntington disease)
SE: most likely to cause tardive diskinesia--involuntary facial movements (replace with clozapine)
Clozapine
Atypical Antipsychotic--Dopamine blocker (excess dopamine is associated with psychosis and hyperkinetic movement disorders such as Huntington disease)
Use: anti-suicidal
SE: monitor WBCs for agranulocytosis--drug of last resort
SNRI MOA
Inhibit reuptake of 5HT and norepinephrine
Use: Depression
Venlafaxine
SNRI
Duloxetine
SNRI
MAO Inhibitor MOA
Inhibit MAO => increased levels of NE, 5HT, and DA
Use: atypical depression
SE: serotonin syndrome, hypertensive crisis
ADR: can potentially interact with foods high in tyramine and result in dangerous hypertensive episodes. Tyramine is found in high quantities in aged cheeses, red wine, and cured meats.
Phenelzine
MAO Inhibitor
Use: atypical depression
SE: serotonin syndrome, hypertensive crisis
ADR: can potentially interact with foods high in tyramine and result in dangerous hypertensive episodes. Tyramine is found in high quantities in aged cheeses, red wine, and cured meats.
Tranylcypromine
MAO Inhibitor
Use: atypical depression
SE: serotonin syndrome, hypertensive crisis
ADR: can potentially interact with foods high in tyramine and result in dangerous hypertensive episodes. Tyramine is found in high quantities in aged cheeses, red wine, and cured meats.
Propylthiouracil
Limits hormone production and hormone conversion. Inhibits the enzyme thyroperoxidase, thus resulting in decreased thyroxine production AND inhibition of peripheral deiodination of T4 to T3.
Use: hyperthyroidism
Safer in pregnancy than methimazole since protein bound.
Methimazole
Methimazole inhibits the addition of iodine to thyroglobulin by the enzyme thyroperoxidase, a necessary step in the synthesis of triiodothyronine (T3) and thyroxine (T4).
Use: hyperthyroidism
Contraindicated in pregnancy
Pralidoxime
Reverses the phosphorylation of acetylcholinesterase in patients that have been exposed to pesticides or nerve gasses.
Use: pesticide exposure
Thiosulfate
Used after nitrites oxidize hemoglobin to methemoglobin => binds cyanide. Thiosulfate then scavenges cyanide ions and they are excreted renally.
Use: cyanide poisoning
Antidote for acetaminophen
N-acetylcysteine (sulfhydral group donor)
Antidote for TCAs
NaHCO3
Antidote for salicylates
NaHCO3 (alkalinize urine) and dialysis
Antidote for amphetamines (basic)
NH4Cl (acidify urine)
Antidote for anticholinesterases
atropine, pralidoxime
Antidote for Beta blockers
glucagon
Antidote for digitalis
stop dig, normalize K+, lidocaine, Mg++
Antidote for lead
CaEDTA
Antidote for mercury, arsenic, gold
dimercaprol
Antidote for cyanide
nitrite then thiosulfate
Antidote for methemoglobin
methylene blue
Antidote for carbon monoxide
100% O2
Antidote for methanol
ethanol, dialysis
Antidote for opiods
naloxone, naltrexone
Antidote for benzodiazepines
Flumazenil
Antidote for heparin
protamine
Antidote for ethylene glycol
fomepizole
Antidote for warfarin
vitamin K & fresh frozen plasma
Antidote for copper
penicillamine (Wilson's Dz)
Antidote for iron
Deferoxamine
Nitroprusside
Vasodilator
Transformed to cyanide to form cyanomethemoglobin. The cyanide is then metabolized to thiocyanate in the plasma. Test levels for serum thiocyanate.
Use: hypertensive emergency
Nitroglycerin
Vasodilates by releasing NO in smooth mm => increased cGMP and sm. mm relaxation.
veins >> arteries. decreases preload.
Use: angina
Buproprion
Antidepressant medication that blocks the reuptake of dopamine and norepinephrine.
Use: depression; aid in smoking cessation, as it acts as a nicotinic receptor antagonist. Known to be least likely to cause sexual side effects.
SE: seizure at high dose--caution in those with bullemia or anorexia
Memantine
NMDA receptor antagonist; helps prevent excitoxicity (mediated by Ca++)
Use: Alzheimer's
SE: dizziness, confusion, hallucinations
Donepezil
Acetylcholinesterase Inhibitor => decreased acetylcholine catabolism
Use: Alzheimer's
SE: nausea, dizziness, insomnia
Galantamine
Acetylcholinesterase Inhibitor => decreased acetylcholine catabolism
Use: Alzheimer's
SE: nausea, dizziness, insomnia
Rivastigmine
Acetylcholinesterase Inhibitor => decreased acetylcholine catabolism
Use: Alzheimer's
SE: nausea, dizziness, insomnia
Allopurinol
Uric acid reducer
Prodrug that leads to decreased purine metabolism by inhibiting the enzyme xanthine oxidase => decreased uric acid
Use: prophylaxis of gout
SE: in chemotherapy patients taking 6 mercaptopurine, you must drop the dose since allopurinol prevents the breakdown of mercaptopurines
Probenecid
Uric acid reducer
Inhibits proximal tubule reabsorption of urate
Use: prophylaxis of gout
Dantrolene
Muscle relaxant--prevents the release of calcium from the sacroplasmic reticulum of skeletal muscle
Use: malignant hyperthermia, a rare, life-threatening disorder triggered by general anesthesia. Also used for neuroleptic malignant syndrome (elevated vital signs, autonomic instability, rising CPK, muscle stiffness, obtundation, and agitation. Other symptoms include mutism, dystonia, and akinesia, as well as autonomic symptoms consistent with sympathetic overproduction) brought on by antipsychotics.
Methadone
Mu agonist
Use: opiate addiction
Helpful due to long half life
Tamoxifen
Selective estrogen receptor modulator--antagonist in breast, agonist in bone; blocks binding of estrogen in receptor-positive cells. Decreases osteoclast function of estrogen.
Use: breast cancer. prevents osteoporosis
SE: may increase risk of endometrial carcinoma, increased risk of DVT
Raloxifene
Selective estrogen receptor modulator--antagonist in breast, agonist in bone; blocks binding of estrogen in receptor-positive cells. Decreases osteoclast function of estrogen.
Use: breast cancer. Osteoporosis prevention.
Does not cause endometrial carcinoma like Tamoxifen because it is an endometrial antagonist.
SE: increased risk of DVT
Treatment for gonorrhoeae
Treat for gonorrhoeae and chlamydia
gon=ceftriaxone or flouroquinalone
chlamydia=azithromycin (1 dose) or doxycycline (multiday) or erythromycin (pregnacy)
Diphenhydramine
1st generation H1 blocker
Use: allergy, motion sickness, sleep aid
SE: sedation, antimuscarinic (blurry vision, dry mouth, palpitations, urinary retention, constipation)
Dimenhydrinate
1st generation H1 blocker
Use: allergy, motion sickness, sleep aid
SE: sedation, antimuscarinic (blurry vision, dry mouth, palpitations, urinary retention, constipation)
Chlorpheniramine
1st generation H1 blocker
Use: allergy, motion sickness, sleep aid
SE: sedation, antimuscarinic (blurry vision, dry mouth, palpitations, urinary retention, constipation)
Loratadine
2nd generation H1 blocker
Use: allergy
SE: less sedation than 1st gen since decreased entry into CNS
Fexofenadine
2nd generation H1 blocker
Use: allergy
SE: less sedation than 1st gen since decreased entry into CNS
Bisphosphanates MOA
Stabilize hydroxyapatite bone structure and induce osteoblasts to secrete inhibitors of osteoclasts => decreased bone resorption => decreased progression of osteoporosis
"ronate"
Alendronate
Stabilize hydroxyapatite bone structure and induce osteoblasts to secrete inhibitors of osteoclasts
Use: DOC for glucocorticoid-induced osteoporosis
SE: DVT
Etidronate
Stabilize hydroxyapatite bone structure and induce osteoblasts to secrete inhibitors of osteoclasts
Use: osteoporosis
SE: DVT
Pamidronate
Stabilize hydroxyapatite bone structure and induce osteoblasts to secrete inhibitors of osteoclasts
Use: osteoporosis
SE: DVT
Calcitonin
Decrease bone resorption via receptor on osteoclasts
Use: osteoporosis when increased risk of DVT (i.e., prior DVT, smoker)
DMARD MOA
Treat Rheumatoid Arthritis by affecting various factors
Entanercept
DMARD
binds TNF
SE: infections
Infliximab
DMARD
monoclonal Ab to TNF
SE: infections
Carbemazepine
DOC for trigeminal neuralgia
Hydroxyurea
Antineoplastic => increased HbF
Use: reduce occlusive attacks in sickle cell disease
Sumatriptan
5HT1d agonist. Binding in cerebral vessels => decreased migraine pain
Use: migraines
Phentolamine
Reversible nonselective (alpha 1 & 2) alpha-adrenergic antagonist
Use: control of hypertensive emergencies, most notably due to pheochromocytoma; cocaine-induced hypertension (Beta-blockers (i.e. metoprolol) or combined alpha and beta adrenergic blocking agents (i.e. labetalol) should be avoided in patients with a history of cocaine abuse. They can cause an unopposed alpha-adrenergic mediated coronary vasoconstriction, causing the worsening of myocardial ischemia and hypertension)
Desmopressin
Synthetic replacement for ADH (vasopressin)
Use: Diabetes insipidus; promoting the release of factor 8 in mild cases of hemophilia A
Nifurtimox
Use: DOC Trypanosoma cruzi (acute Chagas Dz only; no treatment for chronic)
Doxorubicine
Anticancer--generates free radicals that intercalate DNA=>breaks and less replication
SE: dilated cardiomyopathy
Sulfasalazine
Anti-inflammatory
Use: inflammation reduction in colon from ulcerative colitis
Three most likely drugs to induce lupus
Hydralazine (direct-acting smooth muscle relaxant)
Isoniazid (TB drug)
Procainamide (1A Na+ blocker)
Baclofen
spasmolytic--binds GABA-b receptors and reduces the release of excitatory neurotransmitters
Use: cerebral palsy
Atropine
Anticholinergic/Muscarinic Antagonist => Parasympathetic blocking
Use: Bradycardia, Organophosphate poisoning (Acetylcholinesterase inhibitor poison)
Alprostadil
PGE1 analog
Use: maintain patent ductus arteriosus until surgery (eg. transposition of great vessels)
Indomethacin
NSAID
Use: closes patent ductus arteriosus, acute gout
Isotretinoin
Oral retinoid
Use: Isotretinoin, or Accutane, is a Vitamin A derivative that is used carefully in severe acne to decrease sebum secretion from sebaceous glands.
SE: Suicidal ideation. Acute vitamin A toxicity can result in seizures, stroke, increased intracranial pressure, psychosis, liver damage, depression, and gastrointestinal upset. Papilledema and headache reflect increased intracranial pressure, increased transaminases and tryglycerides show liver damage, and GI upset is from immediate irritation
Odansetron
5-HT3 receptor antagonist
Use: DOC anti-emetic for chemotherapy-induced nausea
Bethanechol
Muscarinic agonist
Use: post-operative ileus
SE: urinary incontinence, diarrhea
Octreotide
Somatostatin analog--suppresses serotonin secretion
Use: DOC carcinoid syndrome.
Amantadine
Use: Influenza A
Effective if treatment is administered within the first 48 hours of symptoms or as prophylaxis
Excreted in kidney--contraindicated in kidney failure
Rimantadine
Use: Influenza A
Effective if treatment is administered within the first 48 hours of symptoms or as prophylaxis
Excreted in liver--contraindicated in liver failure
Mifepristone
Competitive inhibitor of progestins at progesterone receptors and glucocorticoid (RU-486)
Use: pregnancy termination, can be useful in Cushing's