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;
351 Cards in this Set
- Front
- Back
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 |