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273 Cards in this Set
- Front
- Back
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Trimethoprim
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Antibiotic
Anti-metabolite Bacteriostatic Inhibits dihydrofolate reductase Synergy w/ sulfonamides Used alone for G- UTI |
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Sulfonamides
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Antibiotic
Anti-metabolie Bacteriostatic Inhibits dihydropteroate synthetase Synergy w/ trimethoprim Broad spectrum Uses: UTI, chlamydia (oral), ulcerative colitis, comatose meningitis (IV) Nephrotoxicity, hemolysis, Stevens-Johnson rxn, crystalluria Pregnancy! |
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Penicillin + Tetracylines
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Bad!
Bactericidal + bacteriostatic |
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Penicillin + Aminoglycoside
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Prophylaxis & mixed infections
Aminoglycoside allows the penicillin to get in |
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Isoniazid + Rifampin
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TB
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Trimethoprim + Sulfamexazole
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Pneumocystis carinii pneumonia (HIV)
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Sulfonamides + Trimethoprim
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Synergy together
Two bacteriostatics together |
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Penicillins
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Antibiotics
Cell-Wall Synthesis Inhibitors Block transpeptidase reaction (binds PBPs) Excreted Gram+ (except broad-spectrum ones) ONLY active against dividing bacteria Least toxic, most allergenic Penicillin G - neurotoxicity |
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Penicillin Resistance
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Beta-lactamases (penicillinases) cleave the beta-lactam ring
Penicillin-Binding Proteins less responsive |
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Cephalosporins
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Antibiotics
Cell-Wall Synthesis Inhibitors Treat klebsiella Gram- and gram+ No repository form Block transpeptidase reaction Allergy, bleeding disorders (reverse with Vit K) Alcohol (disulfiram disorders) |
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Vancomycin
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Antibiotic
Cell-Wall Synthesis Inhibitor Bactericidal C. diff (oral), MRSAs Bone & CSF IV for everything other than C. diff 80% excreted Narrow spectrum: strep, pneumo, staph, some anaerobes Flushing (histamine), ototoxicity, nephrotoxicity |
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Bacitracin
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Antibiotic
Cell-Wall Synthesis Inhibitor C. diff (oral), topical (little absorbed this way) Gram+ Nephrotoxic |
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Cycloserine
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Antibiotic
Cell-Wall Synthesis Inhibitor Blocks alanine racemase |
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Rifampin
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Antibiotic
Nucleic Acid Inhibitor Inhibits RNA polymerase Birth control pills, other drugs (enhances breakdown) |
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Ciprofloxacin
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Antibiotic
Quinolone Blocks DNA gyrase |
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Metronidazole
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Antibiotic (antiparasitic)
Nucleic Acid Inhibitor Blocks synthesis of nucleic acids (bactericidal) C. diff (1st choice)! Preop, endocarditis Obligate anaerobes ONLY GI, carcinogenic, alcohol (disulfiram-like reaction) |
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Isoniazid
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Antibiotic
Liver toxicity |
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All antibiotics
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GI toxicity
Cross-sensitivity can occur; they act as haptens |
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Polymyxins
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Antibiotic
Cell Membrane Affector Bind phosphatidyl ethanolamine rich areas Form pores in cell membranes Gram- Oral (g- in gut), IM (UTIs), topical (w/ bacitracin/neomycin) Nephrotoxicity (phosphatidyl ethanolamine in kidney) |
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Cholistins
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Newer polymyxins
Less toxic |
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Chloramphenicol
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Antibiotic
Protein Synthesis Inhibitor Binds 50S; inhibits chain elongation Bacteriostatic G- Salmonella, typhoid fever, rickettsia (Rocky Mountain Spotted Fever) Inhibits P450, toxic to marrow, hemolysis (red cell anemia) Phenytoin & cumadin (P450); pregnancy |
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Erythromycin
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Antibiotic
Protein Synthesis Inhibitor Binds 50S; inhibits chain elongation |
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Clindamycin
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Antibiotic
Protein Synthesis Inhibitor Binds 50S; inhibits chain elongation; bacteriostatic & bactericidal Oral; excreted in bile Broad spectrum; g+ & g- Uses: G+ bone infx; anaerobic pneumonia; MRSAs; strep, staph, bacteriodes Causes C. diff! |
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Tetracyclines
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Antibiotics
Protein Synthesis Inhibitors Block tRNA from binding 30S Bacteriostatic Oral Well-distributed Uses: mycoplasma, chlamydia, rickettsia (1st choice Rocky Mountain Spotted Fever), severe acne Hepatotoxicity, neurotoxicity Pregnancy |
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Aminoglycosides
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Antibiotics
Bind to 30S, inhibit protein synthesis Bactericidal Parenteral, good bone penetration Broad spectrum; mainly against G- Nephrotoxicity, neurotoxicity (auditory/vestibular) |
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Streptomycin
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Antibiotic
Aminoglycoside TB, mycobacterial, non-TB infections Endocarditis (w/ penicillin) Pregnancy (CN VIII damage; skeletal defects) |
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Dicloxacillin
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Antibiotic
Penicillinase-Resistant Penicillin |
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Oxacillin
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Antibiotic
Penicillinase-Resistant Penicillin |
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Nafcillin
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Antibiotic
Penicillinase-Resistant Penicillin |
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Cloxacillin
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Antibiotic
Penicillinase-Resistant Penicillin |
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Penicillin G
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Antibiotic
All routes Repository - syphilis |
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Penicillin V
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Antibiotic
Oral only |
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Ampicillin
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Antibiotic
Broad-Spectrum Penicillin Kills gram- b/c of lipophilic side chains G- meningitis |
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Carbenicillin
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Antibiotic
Broad-Spectrum Penicillin Kills gram- b/c of lipophilic side chains Pseudomonas, ampicillin-resistant bacteria |
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Clavulanic Acid
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Beta-Lactamase Inhibitor
Potentiates antibiotics by preventing breakdown |
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Sulbactam
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Beta-Lactamase Inhibitor
Potentiates antibiotics by preventing breakdown |
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Tazobactam
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Beta-Lactamase Inhibitor
Potentiates antibiotics by preventing breakdown |
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Imipenem
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Antibiotic
Carbapenem Serious infections Seizures Use with cilastatin (stops its metabolism) |
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Azteronam
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Antibiotic
Monobactam Kills gram- only (pseudomonas, serratia, E. coli) |
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3rd Gen Cephalosporins
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Antibiotic
Gram- meningitis (gets into CSF), gonorrhea |
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2nd Gen Cephalosporins
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Antibiotic
Penicillin-resistant bacteria |
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Cefepime
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Antibiotic
4th Gen Cephalosporin |
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4th Gen Cephalosporins
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Antibiotic
Haemophilus, neisseria Penetrates CSF |
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Cefazolin
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Antibiotic
1st Gen Cephalosporin |
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1st Gen Cephalosporins
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Antibiotic
Surgery prophylaxis Inexpensive |
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Cephalosporin Resistance
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Cephalosporinases (like penicillinases)
Can use against penicillin-resistant bacteria! |
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Macrolides
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Antibiotics
Concentrated in liver (excreted in bile) G+ Erythromycin, semi-synthetic erythromycins Bind 23S RNA of 50S subunit Uses: 1st choice mycoplasma, alt. to penicillin G, Legionnaire's, pneumonia, chlamydia, rickettsia |
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Clarithromycin
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Antibiotic
Macrolide (G+); Semi-Synthetic Erythromycin Broader spectrum, better permeability Inhibits P450 |
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Azithromycin
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Antibiotic
Macrolide (G+); Semi-Synthetic Erythromycin Broader spectrum, better permeability Long half-life (3 days) Penetrates more at low serum level Does NOT inhibit P450 |
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Erythromycin
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Antibiotic
Macrolide (G+) Inhibits P450 |
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Macrolide Resistance
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Ribosomes don't bind it
Never use alone for bad staph infection |
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Clindamycin Resistance
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Subunit stops binding
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Dificid
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Antibiotic
C. diff |
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Vancomycin Resistance
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If resistant, treat with tigecycline/synercid/linezolid
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Tigecycline
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Antibiotic
Vancomycin-resistant bacteria |
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Synercid
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Antibiotic
Vancomycin-resistant bacteria Mix of 2 bacteriostatics |
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Linezolid
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Antibiotic
Vancomycin-resistant bacteria Inhibits protein synthesis |
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Amikacin
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Antibiotic
Aminoglycoside Resistant to enzymes (resistance) Broadest spectrum |
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Aminoglycoside Resistance
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Metabolized by bacteria enzymes
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Kanamycin
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Antibiotic
Aminoglycoside Topical, oral (reduce gut flora before surgery) |
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Neomycin
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Antibiotic
Aminoglycoside Topical, oral (reduce gut flora before surgery) |
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Gentamycin
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Antibiotic
Aminoglycoside IM, topical, intrathecal (G- meningitis) |
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Tobramycin
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Antibiotic
Aminoglycoside IM, topical, intrathecal (G- meningitis) |
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Netilmicin
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Antibiotic
Aminoglycoside IM, topical, intrathecal (G- meningitis) |
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Spectinomycin
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Antibiotic
Aminoglycoside IM Gonorrhea in penicillin-allergic |
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Sulfasalazine
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Antibiotic
Sulfonamide Ulcerative colitis |
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Sulfanilamide
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Antibiotic
Sulfonamide Inhibit PABA (needed for bacteria to make folate) |
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Sulfamethoxazole
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Antibiotic
Sulfonamide Oral, sodium salt IV, topical |
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Sulfonamide Resistance
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Enzyme binds drug less (dihydropteroate synthetase)
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Nitrofurantoin
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Antibiotic
Urinary Antiseptic (pH <5.5) |
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Methenamine Mandelate
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Antibiotic
Urinary Antiseptic (ph <5.5) Release formaldehyde (antibacterial) Sulfonamides (form compounds w/ formaldehyde) |
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Hippurate
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Antibiotic
Urinary Antiseptic (ph <5.5) Release formaldehyde (antibacterial) Sulfonamides (form compounds w/ formaldehyde) |
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Nalidix Acids
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Antibiotic
Urinary Antiseptic (pH <5.5) Coliform UTI |
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Oxolinic Acids
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Antibiotic
Urinary Antiseptic (pH <5.5) Coliform UTI |
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Chloramphenicol Resistance
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Chloramphenicol acetyl transferase causes resistance
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Tigecycline
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Antibiotic
Tetracycline Slow IV, 42.4 hr half-life Use in vancomycin-resistant |
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Doxycycline
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Antibiotic
Tetracycline 16-20 hr half-life Hepatotoxicity, phototoxicity, bone/teeth devo Children, pregnancy |
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Minocycline
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Antibiotic
Tetracycline 16-20 hr half-life Hepatotoxicity, phototoxicity, bone/teeth devo Children, pregnancy |
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Tetracycline Resistance
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Less 30S affinity
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Tolfnaftate
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Antifungal
Anti-Dermatophyte |
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Terbinafine
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Antifungal
Anti-Dermatophyte Nail infections Block ergosterol synth (buildup of squalenes) Pregnancy |
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Griseofulvin
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Antifungal
Anti-Dermatophyte Toenail fungus Oral (only oral anti-dermatophyte) Disrupts mitosis |
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Miconazole
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Antifungal
Anti-Dermatophyte; Mucocutaneous Non-triazole Topical (yeast infections, athlete's foot) Inhibit P450 & steroid production, hepatotoxicity, GI upset |
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Clotrimazole
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Antifungal
Anti-Dermatophyte; Mucocutaneous Non-triazole Topical, throat Inhibit P450 & steroid production, hepatotoxicity, GI upset |
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Fluconazole
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Antifungal
Anti-Dermatophyte; Systemic; Mucocutaneous Triazole (less tox) Chronic infections Inhibit P450 & steroid production, hepatotoxicity, GI upset |
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Itraconazole
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Antifungal
Anti-Dermatophyte; Systemic; Mucocutaneous Triazole (less tox) Oral & injection Inhibit P450 & steroid production, hepatotoxicity, GI upset |
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Ketoconazole
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Antifungal
Anti-Dermatophyte Triazole (less tox) Inhibit P450 & steroid production, hepatotoxicity, GI upset |
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Azoles
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Inhibit ergosterol synthesis by preventing lanosterol demethylation
Broad spectrum (candidiasis, dermatophytes, aspergillosis) Need stomach acid to be absorbed! Inhibit P450 & steroid production, hepatotoxicity, GI upset |
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Voriconazole
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Antifungal
Anti-Dermatophyte; Triazole (less tox) Most potent! Inhibit P450 & steroid production, hepatotoxicity, GI upset |
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Posaconazole
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Antifungal
Anti-Dermatophyte; Triazole (less tox) Aspergillis in immunocompromised Inhibit P450 & steroid production, hepatotoxicity, GI upset |
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Flucytosine
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Antifungal
Systemic Fluoridated pyrimidine Turns into FdUMP & FUTP --> X RNA & DNA synth NEVER alone b/c of resistance GI upset, enterocolitis, hepatotoxicity, bone marrow tox/anemia |
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Flucytosine Resistance
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Permease mutation
Sensitive fungi must have permease enzyme |
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Caspofungin
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Antifungal
Systemic Inhibit beta-glucan synthesis Used when other antifungals don't work |
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Micafungin
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Antifungal
Systemic Inhibit beta-glucan synthesis Used when other antifungals don't work |
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Amphotericin B
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Antifungal
Systemic; Mucocutaneous Gold standard acute treatment for advanced infx Polyene; pokes holes in ergosterol of membrane Oral (GI), IV, catheter (bladder) Hypersentivity, nephrotoxicity |
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Nystatin
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Antifungal
Mucocutaneous Polyene; pokes holes in ergosterol of membrane NEVER systemic (topical) |
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Acyclovir
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Antiviral
No viral DNA polymerase HSV, varicella zoster IV (bad oral bioavailability) GI, nephrotoxicity, headache |
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Valacyclovir
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Antiviral
Acyclovir Analog HSV, CMV |
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Famciclovir
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Antiviral
Acyclovir Analog HSV, CMV |
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Ganciclovir
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Antiviral
Acyclovir Analog CMV |
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Valganciclovir
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Antiviral
Acyclovir Analog CMV |
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Foscarnet
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Antiviral
Inhibits viral DNA polymerase HSV w/ HIV, CMV Less marrow suppression |
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Gamma-Globulins
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Antiviral
Block absorption & penetration of virus Give during incubation period |
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Zanamivir
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Antiviral
Inhibits neuraminidase; viral cells clump, can't be taken up Influenza A & B |
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Amantadine
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Antiviral
Reduce uncoating (binds M2, preventing acidity) Influenza A, Parkinson's |
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Rimantadine
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Antiviral
Reduce uncoating (binds M2, preventing acidity) Influenza A, Parkinson's |
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Didanosine
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Antiviral
Nucleoside RTI (HIV) Lactic acidosis, fat wasting, hyperlipidemia Peripheral neuropathy |
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Emtricitabine
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Antiviral
Nucleoside RTI (HIV) Lactic acidosis, fat wasting, hyperlipidemia |
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Abacavir
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Antiviral
Nucleoside RTI (HIV) Lactic acidosis, fat wasting, hyperlipidemia |
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Tenofovir
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Antiviral
Nucleoside RTI (HIV) Hep B Lactic acidosis, fat wasting, hyperlipidemia |
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Zidovudine
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Antiviral
Nucleoside RTI (HIV) Lactic acidosis, fat wasting, hyperlipidemia Nausea, headache, anemia, neutropenia |
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Lamivudine
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Antiviral
Nucleoside RTI (HIV) Hep B Lactic acidosis, fat wasting, hyperlipidemia |
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Efavirenz
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Antiviral
Non-Nucleoside RTI (HIV) |
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Nevirapine
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Antiviral
Non-Nucleoside RTI (HIV) |
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Indinavir
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Antiviral
Protease Inhibitor (HIV) GI, hyperglycemia, + cholesterol, inhibit P450 |
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Darunavir
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Antiviral
Protease Inhibitor (HIV) GI, hyperglycemia, + cholesterol, inhibit P450 |
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Atazanavir
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Antiviral
Protease Inhibitor (HIV) GI, hyperglycemia, + cholesterol, inhibit P450 |
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Lopinavir-Ritonavir
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Antiviral
Protease Inhibitor (HIV) GI, hyperglycemia, + cholesterol, inhibit P450 |
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HIV Drugs
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Combine at least 2 RTIs
Protease inhibitors are standard with 2 RTIs |
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Enfuvirtide
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Antiviral
Fusion Inhibitor (HIV) |
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Marviroc
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Antiviral
Entry Inhibitor (HIV) |
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Raltegravir
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Antiviral
Integrase Inhibitor (HIV) |
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HPV Vaccine
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Antiviral
Preferred for HPV |
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Trichloroacetic Acid
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Antiviral
Topical for genital warts (HPV) |
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Podophyllin
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Antiviral
Topical for genital warts (HPV) |
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Cryothereapy
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Antiviral
Topical for genital warts (HPV) |
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Sinecatechins
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Antiviral
Topical for genital warts (HPV) |
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Imiquimod
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Antiviral
Topical for genital warts (HPV) |
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Podofilox
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Antiviral
Topical for genital warts (HPV) |
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Simeprevir
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Antiviral
Hep C |
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Telapravir
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Antiviral
Hep C |
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Palivizumab
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Antiviral
Hep B & Hep C Protease inhibitor Add-on to ribavarin + interferon |
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Ribavirin
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Antiviral
Hep C Reduces GMP (get less GTP) Use with interferon |
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Telbivudine
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Antiviral
Hep B |
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Adefovir
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Antiviral
Hep B |
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Entecavir
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Antiviral
Hep B |
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Interferons
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Antiviral
Hep B & Hep C Activate kinases to inhibit viral protein synthesis Injection (these are proteins, can't be taken orally) Flu everyday |
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Cinacalcet
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Calcium Homeostasis
Stimulates Ca receptors, decreases PTH Uses: hyperparathyroid from chronic renal disease, parathyroid cancer |
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PTH
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Calcium Homeostasis
Rapid effects Increase plasma Ca, increase bone turnover |
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Teriparatide
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Calcium Homeostasis
PTH analog Treat osteoporosis Increase plasma Ca, increase bone turnover |
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Cholecalciferol
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Calcium Homeostasis
Vitamin D3 Uses: rickets, osteomalacia, hypocalcemia, osteoporosis |
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Vitamin D
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Calcium Homeostasis
Slow effects (alters gene expression, protein synthesis) |
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Calderol
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Calcium Homeostasis
Vitamin D
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Rocaltrol
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Calcium Homeostasis
Vitamin D
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Calcipotriene
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Calcium Homeostasis
Vitamin D Uses: rickets, osteomalacia, hypocalcemia, osteoporosis; psoriasis |
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Doxercalciferol
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Calcium Homeostasis
Vitamin D |
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Calcitonin
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Calcium Homeostasis
Made from thyroid Rapid effects Decrease plasma calcium, decrease bone resorption Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis GI upset, hypersensitivity |
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Calcimar
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Calcium Homeostasis
Salmon calcitonin Decrease plasma calcium, decrease bone resorption Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis GI upset, hypersentivity |
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Miacalcin
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Calcium Homeostasis
Salmon calcitonin Decrease plasma calcium, decrease bone resorption Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis GI upset, hypersentivity |
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Cibacalcin
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Calcium Homeostasis
Human calcitonin Decrease plasma calcium, decrease bone resorption Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis GI upset, hypersentivity |
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Alendronate
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Calcium Homeostasis
Bisphosphonate Decrease bone turnover, bind hydroxyapatite Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis, hyperparathyroid GI, esophagitis |
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Ibandronate
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Calcium Homeostasis
Bisphosphonate Decrease bone turnover, bind hydroxyapatite Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis, hyperparathyroid GI, esophagitis |
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Zoledronic Acid
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Calcium Homeostasis
Bisphosphonate Decrease bone turnover, bind hydroxyapatite Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis, hyperparathyroid GI, esophagitis |
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Risendronate
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Calcium Homeostasis
Bisphosphonate Decrease bone turnover, bind hydroxyapatite Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis, hyperparathyroid GI, esophagitis |
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Etidronate
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Calcium Homeostasis
Bisphosphonate Decrease bone turnover, bind hydroxyapatite Uses: hypercalcemia of neoplasia, Paget's disease, osteoporosis, hyperparathyroid GI, esophagitis; osteomalacia |
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Denosumab
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Calcium Homeostasis
Decrease RANK-L, decrease bone resorption Uses: osteoporosis, bone loss from prostate cancer UTI, respiratory infection, expensive |
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Prednisone
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Calcium Homeostasis; Corticosteroid; Immunosuppression
Decrease Ca absorption from GI, increase renal Ca excretion Kill T cells Treat chronic hypercalcemia, inflammation Chronic --> osteoporosis, aseptic hip necrosis |
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Fluoride
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Calcium Homeostasis
Stabilizes hydroxyapatite, forms fluoroapatite Increases new bone growth Fluorosis, nausea, arthritis, CV collapse (extreme) |
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Estrogens
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Calcium Homeostasis
Decrease bone resorption Treat postmenopausal osteoporosis Increased breast cancer risk |
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Raloxifene
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Calcium Homeostasis; Estrogen Antagonist
Decrease bone resorption Treat postmenopausal osteoporosis Decreases risk of breast cancer NO increased breast cancer risk |
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Corticosteroids
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From adrenal cortex
Uses: anti-inflammatory, seasonal allergies (Type 1 hypersensitivity), immunosuppression, adrenal insufficiency, adrenal hyperplasia (in utero), topicals (derm & ophtho), leukemia, hypercalcemia, maturation of fetal lungs New proteins cause effects Liver metabolism; bile & urine excretion All ROI Catabolic, Na/H2O retention, Cushing's, ulcers, cataracts, infections |
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Hydrocortisone
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Corticosteroid
Short-acting |
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Cortisone
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Corticosteroid
Short-acting |
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Prednisolone
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Corticosteroid
Anti-inflammatory |
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Methylprednisolone
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Corticosteroid
Anti-inflammatory |
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Triamcinolone
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Corticosteroid
Anti-inflammatory |
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Dexamethasone
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Corticosteroid; Immunosuppression
Acute anti-inflammatory, for 5-10 days Kill T cells Diagnose hypo-pit-adrenal (Cushing's/Addison's means lots of cortisol produced; normal is reduced cortisol) |
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Betamethasone
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Corticosteroid
Acute anti-inflammatory, for 5-10 days |
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Becomethasone
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Corticosteroid
Seasonal allergies Inhaled |
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Flunoisolide
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Corticosteroid
Seasonal allergies Inhaled |
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Aldosterone
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Mineralocorticoid
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Fludrocortisone
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Mineralocorticoid
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Mineralocorticoids
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Released from zona glomerulosa
Controlled by K+ and RAA system |
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Spironolactone
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Antagonist of mineralocorticoids
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Epterenone
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Antagonist of mineralocorticoids
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Sex Steroids
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Released from zona reticularis
Controlled by ACTH |
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ACTH
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From POMC
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Testosterone
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Sex steroid
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DHEA
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Weak androgen
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Glucocorticoids
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From zona fasciculata
Controlled by ACTH Cortisol is an example Increase glucose production (usually balanced by insulin) |
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Cortisol
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Glucocorticoid
Made from cholesterol Pregnenolone = rate-limiting Need cholesterol esterase & desmolase |
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Metyrapone
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Glucocorticoid antagonist
Stop cortisol |
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Mitotane
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Glucocorticoid antagonist
Stop cortisol |
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Corticosteroid Release Loop
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Hypothalamus -> CRH -> Pituitary -> ACTH -> Adrenal Cortex -> Cortisol -> Effects
Cortisol negatively feeds back on hypothalamus & pituitary |
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Lispro
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Rapid-Acting Insulin
Human |
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Crystalline Zinc
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Rapid-Acting Insulin
IV Inject 3-4x/day |
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Aspart
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Rapid-Acting Insulin
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Glulisine
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Rapid-Acting Insulin
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Insulin Preparations
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Short-acting ones mimic more
Always injected (stays in GI) Bad with stress, hyperthyroid, stopping exercise, more food, drugs Hypoglycemia, lipoatrophy |
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NPH
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Intermediate/Long-Acting Insulin
Add with zinc, Lispro, Aspart when need an immediate boost |
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Detemir
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Intermediate/Long-Acting Insulin
2x/day |
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Glargine
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Intermediate/Long-Acting Insulin
No peak, steady insulin |
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Exenatide
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Injectable Hypoglycemic
GLP-1 agonist Stabilizes beta cells Delays progress of Type 2 GI, expensive |
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Pramlintide
|
Injectable Hypoglycemic
Amylin derivative (normally increases insulin) Combine with insulin GI, hypoglycemia |
|
|
Tolbutamide
|
1st Gen Oral Hypoglycemic
Most-used |
|
|
Oral Hypoglycemics
|
Best for Type 2
Close K+ channels GI upset, hypoglycemia, less insulin sensitivity |
|
|
Tolzamide
|
1st Gen Oral Hypoglycemic
|
|
|
Chlorpropamide
|
1st Gen Oral Hypoglycemic
60 hr |
|
|
Metformin
|
Oral Hypoglycemic
Decreased glucose production Take with glyburide/glipizide Metallic taste, lactic acidosis, anorexia NO hypoglycemia! |
|
|
Acarbose
|
Oral Hypoglycemic
Decrease glucose absorbed by meal (inhibits alpha glucosidase) Flatulence, diarrhea, hypoglycemia |
|
|
Pioglitazone
|
Oral Hypoglycemic
Increase insulin-responsive genes Take with metformin |
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|
Repaglinide
|
Oral Hypoglycemic
Increase insulin secretion Take with meal |
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Glyburide
|
2nd Gen Oral Hypoglycemic
2nd gen's more potent |
|
|
Gilmepiride
|
2nd Gen Oral Hypoglycemic
2nd gen's more potent |
|
|
Glipizide
|
2nd Gen Oral Hypoglycemic
2nd gen's more potent |
|
|
Sitagliptan
|
2nd Gen Oral Hypoglycemic
2nd gen's more potent Increase GLP-1 & GIP (increases insulin secretion by inhibiting these proteins' metabolism) GI upset, hypoglycemia |
|
|
Canagliflozin
|
2nd Gen Oral Hypoglycemic
For Type 2 only Releases sugar through the kidney (inhibits sodium glucose transporter; can't reabsorb) Dehydration, hypoglycemia, UTI |
|
|
Estradiol
|
Coagulation, closes epiphyseal plate
Gradually increases during pre-ovulatory stage Na, H2O retention Estrogen replacement therapy/contraception |
|
|
Progesterone
|
Increases body temp (after ovulation)
Inhibits uterine contraction (stop early labor) Na, H2O retention Progesterone replacement therapy/contraception |
|
|
Danazol
|
Testosterone
Helps treat endometriosis Early puberty, prostatic hypertrophy, edema, CNS excitation, hepatotoxicity |
|
|
Fluoxymesterone
|
Anabolic Steroid
Early puberty, prostatic hypertrophy, edema, CNS excitation, hepatotoxicity |
|
|
Nandrolone
|
Anabolic Steroid
Early puberty, prostatic hypertrophy, edema, CNS excitation, hepatotoxicity |
|
|
Oxandrolone
|
Anabolic Steroid
Early puberty, prostatic hypertrophy, edema, CNS excitation, hepatotoxicity |
|
|
Leuprolide
|
Antiandrogen
GnRH analog (downregulates GnRH, get less testosterone) Always with flutamide 1st |
|
|
Flutamide
|
Antiandrogen
Androgen receptor blocker Used for prostate cancer Low libido, erectile dysfunction |
|
|
Finasteride
|
Antiandrogen
Inhibits 5-alpha-DHT Used for baldness, enlarged prostate |
|
|
Mifepristone
|
Progesterone Receptor Antagonist
Treats endometriosis Abortifation agent (uterine muscle contracts) |
|
|
Exemestane
|
Estrogen Inhibitor
Inhibits aromatase (turns androgens into estrogens) Used in breast cancers |
|
|
Fulvestrant
|
Estrogen Inhibitor
Full inhibitor |
|
|
Trastuzumab
|
Estrogen Inhibitor
Anti-HER2 antibody Used in breast cancers |
|
|
Clomiphene
|
Estrogen Antagonist
Weak partial ag. at pituitary Enhances follicular devo |
|
|
Tamoxifen
|
Estrogen Antagonist
Estrogen antagonist at breast, agonist elsewhere Premenopausal Decreases risk of breast cancer |
|
|
Conjugated Estrogens
|
Birth Control
Estrogen-type Increase breast cancer risk Decrease endometrial/ovarian cancer risk |
|
|
Diethylstilbestrol
|
Birth Control
Estrogen-type Causes offspring problems Increase breast cancer risk Decrease endometrial/ovarian cancer risk |
|
|
Ethinyl Estradiol + L-Norgestrel
|
Birth Control
Estrogen-type Triphasics & biphasics Increase breast cancer risk Decrease endometrial/ovarian cancer risk |
|
|
Mestranol
|
Birth Control
Estrogen-type Increase breast cancer risk Decrease endometrial/ovarian cancer risk |
|
|
Norethindrone
|
Birth Control
Progestin-type Oral Venous thromboembolism, abnormal uterine bleeding |
|
|
Etongestrel
|
Birth Control
Progestin-type Implant of estrogen Venous thromboembolism, abnormal uterine bleeding |
|
|
Levonorgestrel
|
Birth Control
Progestin-type Plan B Localized effects on motility & endometrium Venous thromboembolism, abnormal uterine bleeding |
|
|
Hydroxyprogesterone
|
Birth Control
Progestin-type Venous thromboembolism, abnormal uterine bleeding |
|
|
Medroxyprogesterone
|
Birth Control
Progestin-type Venous thromboembolism, abnormal uterine bleeding |
|
|
Progesterone
|
Birth Control
Progestin-type Venous thromboembolism, abnormal uterine bleeding |
|
|
Birth Controls
|
Venous thromboembolism, abnormal uterine bleeding
Feedback inhibition to hypothalamus. Inhibits FSH & LH Progestin increases cervical mucus Lowest dose of estrogen used (increases breast cancer risk) |
|
|
Pooled Immunoglobulins
|
Immunostimulation
Treats hypogammaglobulinemia/agammaglobulinemia |
|
|
INF-alpha
|
Immunostimulation
Treats cancer, hematologic malignancy |
|
|
Granulocyte-Macrophage Colony Stimulation Factor
|
Immunostimulation
Treats myelosuppression |
|
|
Interleukin-2
|
Immunostimulation
Activates killer cells Treats AIDS |
|
|
Levamisol
|
Immunostimulation
Antihelminthic Induces interferons |
|
|
BCG
|
Immunostimulation
Viable Mycobacterium bovis/non-viable Corynebacterium parvum Adjuvants for TB & cancer (stimulates immune system) |
|
|
Active Immunization
|
Immunoprotection
Against infections and cancer Long-lasting Take advantage of the amplified secondary response |
|
|
Passive Immunization
|
Immunoprotection
Against infections Ig to neutralize antigens Not long-lasting Give immediate protection |
|
|
Epinephrine
|
Hypersensitivity
Type 1 |
|
|
Theophylline
|
Hypersensitivity
Type 1 |
|
|
Cromolyn Sodium
|
Hypersensitivity
Type 1 Inhibits histamine release |
|
|
Antihistamines
|
Hypersensitivity
Type 1 2nd generation H1 blockers |
|
|
Corticosteroids w/ Azathioprine/Methotrexate
|
Hypersentivity
Type 2 Inhibits autoantibody production |
|
|
Corticosteroids w/ Azathioprine/Cyclophosphamide
|
Hypersentivity
Type 3 (immune complex allergies, rheumatoid arthritis, serum sickness) |
|
|
Combined Immunosuppressives
|
Hypersensitivity
Type 4 (graft rejection) |
|
|
Mycophenolate Mofetil
|
Immunosuppression
Inhibits purine/pyrimidine synthesis |
|
|
Cyclosporine A
|
Immunosuppression
Transplants Inhibit T cell activation & IL-2 formation (inhibition of calcineurin) Nephrotoxicity, hepatotoxicity, hypertension |
|
|
Tacrolimus (FK506)
|
Immunosuppression
Binds FK-binding protein, inhibiting calcineurin --> less IL-2 10-100x more potent than cyclosporine Nephrotoxicity, neurotoxicity, hyperglycemia |
|
|
Sirolimus (Rapamycin)
|
Immunosuppression
Binds FK-binding protein (less IL-2) Inhibits mTOR (less IL-2 receptors) Used in a combination for transplants Antagonizes FK506 Synergizes with cyclosporine A Increases cholesterol & TGs, GI upset, thrombocytopenia |
|
|
RhoGam
|
Immunosuppression
Kills fetal Rh(D)+ RBCs Prevents Rh hemolytic disease of newborn, immune response of Rh- mother to Rh+ baby |
|
|
Muromonab
|
Immunosuppression
Binds CD3 part of T cell receptor Used for renal rejection AFTER combo therapy failed |
|
|
Azathioprine
|
Immunosuppression
Oral Messes with nucleic acid metabolism, blocks cell-mediated immunity & antibody responses Combination with prednisone For severe RA Leukopenia, rash, fever, hepatotoxicity |
|
|
Cyclophosphamide
|
Immunosuppression
Most potent cytotoxic one Activated by P450 Very large single dose Kills lymphoid cells Myelosuppression, cystitis, SIADH (more ADH released; retain water) |
|
|
Anti-Lymphocyte AB
|
Immunosuppression
Kills T cells through complement For transplant & GVHD, pain, anaphylaxis, serum sickness With azathioprine/prednisone IM |
|
|
Adalimumab
|
Immunosuppression
Anti-TNFalpha |
|
|
Anakinra
|
Immunosuppression
IL-1 |
|
|
Etanercept
|
Immunosuppression
TNF-receptor fusion protein |
|
|
Infliximab
|
Immunosuppression
Anti-TNFalpha |
|
|
Abatacept
|
Immunosuppression
Anti-CD8 |
|
|
Levothyroxine
|
Hypothyroid
T4 Choice treatment Long half-life (1x daily) Low cost Not rapid (thyroid hormone regulates gene expression) Pregnancy - fetal thyroid concentrates it |
|
|
Liothyronine
|
Hypothyroid
T3 Short half-life 3-4x more potent than levothyroxine Higher cost Not good for routine Not rapid (thyroid hormone regulates gene expression) Pregnancy |
|
|
Thyroid Storm
|
Fever, increased T3 & T4 levels
From stopping hyperthyroid treatment/too much replacement/131-I Treat with propanolol (heart rate), PTU & methimazole (less thyroid hormone synthesis), NaI/KI (inhibit thyroid hormone) |
|
|
Graves' Disease
|
TSH receptor activating antibodies
Antibody made to thyroidal antigen |
|
|
131-I
|
Hyperthyroid
Beta rays 5-day half-life Destroys thyroid Treat contamination with NaI (outcompetes) |
|
|
Iodides
|
Hyperthyroid
Inhibit hormone release Decrease size & vascularity of thyroid Don't take with thiamides/radioactive iodine |
|
|
Propanolol
|
Hyperthyroid
Adjunct therapy Relieves thyroid symptoms |
|
|
Potassium Perchlorate
|
Hyperthyroid
Anion inhibitor (inhibits iodide transport) Blocks thyroidal uptake of iodine Rarely used - aplastic anemia |
|
|
Methimazole
|
Hyperthyroid
Thiazide Inhibits thyroid peroxidase Requires depletion of T4 10x more potent than propylthiouracil Nausea, GI (early); agranulocytosis |
|
|
Carbimazole
|
Hyperthyroid
Thiazide Inhibits thyroid peroxidase Requires depletion of T4 Nausea, GI (early); agranulocytosis |
|
|
Propylthiouracil
|
Hyperthyroid
Thiazide Inhibits thyroid peroxidase Requires depletion of T4 Nausea, GI (early); agranulocytosis |
