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35 Cards in this Set

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Crosslinking of DNA induces apoptosis
Cisplatin/Platinol
For solid tumors, bladder CA and mets from testicular CA. Delivered via IV
N/V, rash, High frequency hearing loss, tinnitus, bone marrow suppression, anaphylaxis, hypo Mg and Ca
Binds to HER2 sites in breast CA tissue & inhib proliferation of cells that over-express HER2 protein decrease in # cells in S phase
Trastuzumab/ Herceptin
Monoclonal Ab chemo
METS breast CA
IV
Does not cross BBB
Fever
Chills
N/V
Abd pain
Back pain
CHF
Caution w/ pts hx of cardiac conditions

Binds to estrogen receptor & blocks RNA synthesis
Tamoxifen/ Valodex
Estrogen agonist/ antagonist chemo
1st line tx estrogen receptor + breast CA
Hot flashes
N/V
Skin rash
Vaginal bleeding
Vaginal d/c
Reversible binds to B-tubulin subunit & promotes polymerization & stabilization of polymer rather than disassembly
Paclitaxel/ Taxol
Microtubule inhibitor chemo
Adv ovarian CA
METS breast CA
IV
$100,000/ year
N/V
Loss of appetite
Change in taste
Thinned/brittle hair
Jt pain
Change in nail color
Tingling in extremities
Change in bowel habits
Fever
Chills
Cough
Sore throat
Difficulty swallowing
Dizziness
SOB
Severe exhaustion
Skin rash
Facial flushing
CP

Inhib DNA replication, transcription of RNA & NA fxn
Alkylating agent
Cyclophosphamide/ Cytoxan
Hodgkin’s lymphoma
NH lymphoma
ALL
Breast CA
Ovarian CA
Lung CA
Multiple myeloma
Sarcoma
CLL
Mycosis fungoides
Neuroblastoma
Retinoblastoma
PO
IV
N/V/D
Abd pain
Nephrotoxicity
Inhibits DNA protein synthesis
Abx-like CA drug
Doxorubicin/ Adriamycin
Breast CA
Lung CA
Esophageal CA
Ovarian CA
Gastric CA
Hodgkin’s lymphoma
NH Lymphoma
Sarcomas
Myelomas
ALL
IV
Fatigue
N/D
Loss of appetite
Hair loss
Pain, redness or swelling at injection site
Red urine (1-2 days after tx)
Cardiotoxicity
Comp inhib dihydrofolate reductase; inhib cells that are in S-phase & may also inhib protein synthesis to decreasing co-factors for FOLATE, thus arresting cells in G-1 phase
Methotrexate
Anti-metabolite chemo
DMARD
Immunosuppressive
Lung CA
Breast CA
Leukemia
Hodgkin lymphoma
NH lymphoma
Cutaneous T-cell lymphoma
Head/Neck CA
Osteosarcoma
Psoriasis
RA
UC
Crohn’s Dz
Graft-vs. -host dz
PO
IV
IM
PR
Renal excretion (majority of drug eliminated by kidneys w/in 1st 12 hrs after administration)
N/V/D
Stomatitis
Alopecia
Myelosuppression
Periph neuropathy
Pulmonary fibrosis
Renal damage
Liver damage
Teratogen
Abortifacient
Leukoviran (Folic Acid derivative if FA stores become too depleted d/t methotrexate)
Agonist of nicotinic receptor
No immediately broken down by ACh-esterase, w/ resultant blockade of occupied receptor to circ ACh
Succinylcholine/ Anectine
Neuromuscular blocker
Induction & maintenance of skeletal muscle paralysis for intubation & ventilation during general anesthesia
IM
IV
Onset 30-60 sec
Duration 3-5 min
Doesn’t produce unconscious or anesthesia
Dysrhythmia
Post-op myalgias
 Gastric pressure
 Risk reflux
Malignant hypothermia
CI conscious pts x emergency situations
Potentiation of GABA receptor activity  slowing channel-closing time & acting as Na channel blocker
Propofol/ Diprivan
IV anesthetic
General anesthesia
IV
Half-life: b/w 2-24 hrs
Rapidly distributed to periph tissues
HA
N
Hypotension
Respiratory depression
Death
increased GABA response
Thiopental/ Pentothal
Barbiturate
General anesthesia
IV
Onset <30 sec
Duration 30-40 min
Stored in fat
Weak analgesic
Respiratory depression
Hypotension
HA
N
Binds GABA, glutamate & glycine receptors, & also inhib conduction in activated K channels (glycine inhib motor fxn & glutamate inhib mimics NMDA effects)
Isoflurane/ Florane
Inhaled anesthetic
General anesthesia
Inhaled
Onset <1.5 min
Stored in fat
N/V
Shivering
HA
Mental status changes
Malignant hyperthermia (rare)
Numbing of stretch receptors in bronchus diminishing cough reflex
Benzonatate/ Tessalon
Local anesthetic
Non-narcotic anti-tussive
PO (soft gel pearls) HA
Constipation
Do not chew d/t numbing oral cavity
Temp reduction of nerve membrane permeability to Na  AP’s cannot be generated or propagated & N conduction is diminished
Lidocaine/ Xylocaine
Local anesthetic
Topical
Infiltration
Nerve block
Ophthalmic
Epidural
Intrathecal
Ventricular arrhythmias (IV)
Topical gel
Patch
SQ
IM
IV
Onset <1.5 min
Most freq used local
Altered taste
Oral numbness
Light-headedness
Tinnitus
Hypotension (IV)
Bradycardia (IV)
Tachycardia (if Epi added)
Reduce inflamm via anti-mitochondrial activity & induced cell apoptosis
Gold Salts
RA
IBD
Psoriatic arthritis
Membranous nephritis
Lupus erythematosus
Juvenile RA
Poly-arthritis (children)
PO
IM
Up to 2 months to achieve steady state
ecreased Appetite
N/D
Hair thinning
Rash
Thrombocytopenia
Renal toxicity

Blocks the activation of toll-like receptors on dendritic cells, thus limiting inflamm process
Hydroxychloroquine/ Plaquenil
Immunosuppressant
Anti-malarial
RA
SLE
Sjogren’s syndrome
Malaria
Lyme’s dz
PO
Overdose (w/in 30 min)
- Drowsiness
- HA
- Vision problems
- SOB
- Convulsions
Abd cramps
D
 Appetite
Vision difficulties
Tinnitus
Hearing loss
Diminished reflexes
Hives
Itching
Rash
Hair loss
Weakness
Anemia
CI pts w/ G6PD enzyme deficiency d/t severe anemia
Neutralizes TNF by binding w/ high affinity to soluble TNF & trans-membrane forms of TNF, thus preventing effective binding of TNF w/ its receptors
Infliximab/ Remicade
DMARD
Recombinant- DNA drug
RA
Crohn’s Dz
UC
IV
- Administered at 6-8 wk intervals GI upset

Reduction if inflamm response via anti-TNF therapy
Etanercept/ Enbrel
DMARD
Recombinant- DNA drug Mod-severe RA
Mod-severe polyarticular JA
Psoriatic arthritis
Ankylosing spondylitis
Mod-severe plaque psoriasis
SQ
reduced Resistance to infxn
increased Risk leukemia
increased Risk lymphoma
increased Risk solid tumors
Liver injury
CHF
Demyelinating CNS d/o’s
Fatal blood d/o’s
T-cell inhibition  blocking signals to lymphocytes to produce IL-1 to IL-4 & IFN-gamma
Immunosuppressant (related to Macrolide Abx)
Tacrolimus/ Prograf
Protection against rejection of organ transplant
Eczema
PO
IV
Topical
100x more potent than Cyclosporine N/V/D
Loss of appetite
increased BP
increased Risk infxn

T-cell inhibition blocking signals to lymphocytes to produce IL-1 to IL-4 & IFN-gamma
Immunosuppressant (derived from soil fungi)
Cyclosporine/ Sandimmune

Prevent transplant rejection (kidney, liver & heart)
RA
Psoriasis
PO
IV
Blood levels must be carefully monitored
* Blood levels INCREASED when pts drink grapefruit juice* N/V/D
Loss of appetite
 BP
Kidney damage
Tremors
HA
Seizures
Excessive hair growth
Excessive gum growth
Coma
Gout
Confusion

Inhib purine synthesis block protein synthesis in cells that experience rapid turnover
Azathiopine/ Imuran
Purine anti-metabolite immunosuppressant
Prevention of transplant rejection
IBD
SLE
RA
PO
IV
Metabolites excreted in urine
Blood levels must be carefully monitored
Hair loss
Bone marrow suppression
GI toxicity
Leukopenia
Thrombocytopenia
decreased Ability to fight infxn
Pancreatitis
Birth defects
Affects gene transcription to either stimulate or repress protein production
decreases Inflammation of bronchial wall
Triamcinolone/ Azmacort
Synthetic corticosteroid
Asthma (not acute attack)
COPD
Oral inhaler
Do not use >4x/day Thrush
Sore throat
Nosebleeds
 Coughing
HA
Runny nose
 Resistance to infxn
Hyperglycemia
DM
Severe bone loss
Avascular necrosis
Cataracts
Myopathy
Thinning of skin
Diminished wound healing
Easy bruising
Insomnia
Mental status changes
increased Appetite
Affects gene transcription to either stimulate or repress protein production
high potency
Dexamethasone/ Decadron
Fluorinated Glucocorticoid
Corticosteroid Inflamm & allergic conditions
Reactive airway dz
Allergies
Arthritis
AI conditions
Replacement tx Addison’s dz
decreased Intracranial press (IV)
PO
IV
Topical
Inhaled
Long duration (24-72+ hrs)
Minimal mineralcorticoid effects decreased Resistance to infxn
Hyperglycemia
DM
Severe bone loss
Avascular necrosis
Cataracts
Myopathy
Thinning of skin
Diminished wound healing
Easy bruising
Insomnia
Mental status changes
increased Appetite

Affects gene transcription to either stimulate or repress protein production
medium potency
Prednisone/ Deltasone
Glucocorticoid
Corticosteroid Inflamm & allergic conditions
Reactive airway dz
Allergies
Arthritis
AI conditions
Replacement tx Addison’s dz
Severe allergic rxns
Leukemia rxn
PO
Intermediate duration (18-36 hrs) decreased Resistance to infxn
Hyperglycemia
DM
Severe bone loss
Avascular necrosis
Cataracts
Myopathy
Thinning of skin
Diminished wound healing
Easy bruising
Insomnia
Mental status changes
increased Appetite
Affects gene transcription to either stimulate or repress protein production
low potency
Hydrocortisone/ Cortef
Glucocorticoid
Corticosteroid
Inflamm & allergic conditions
Reactive airway dz
Allergies
Arthritis
AI conditions
Replacement tx Addison’s dz
PO
IV
IM
Topical
Short duration (8-12 hrs)
decreased Resistance to infxn
Hyperglycemia
DM
Severe bone loss
Avascular necrosis
Cataracts
Myopathy
Thinning of skin
Diminished wound healing
Easy bruising
Insomnia
Mental status changes
increased Appetite
Inhibitor of cGMP PDE5, which is responsible for degradation of cGMP stores in corpus cavernosum
Smooth muscle lining blood vessels supplying cavernosum of penis, blood remains & erection maintained
Sildenafil citrate/ Viagra
PDE5 inhibitor ED
Pulmonary HTN
PO
25, 50 or 100 mg tablets
Doesn’t cz erection unless sexual stim
No more than 1 tablet daily HA
Flushing
Dyspepsia
Nasal congestion
Photophobia
Blurred vision
Cyanopsia
increased Intraocular pressure
Acute angle closure glaucoma
Ventricular arrhythmias
Severe hypotension
MI
Stroke
Priapism
CI
- Nitroglycerin
- Hx stroke or MI
- Renal or liver impairment
- Hypotension
- Hereditary degenerative retinal d/o
Limits conversion of testosterone to DHT by inhibiting type II 5-alpha-reductase
Finasteride/ Proscar
Anti-androgen BPH
Male-pattern baldness (lower dose)
Prostate CA
PO
No blood donation allowed while pt on med
decreased Libido
ED
Impotency
Depression
Breast swelling
Breast tenderness
Women who are pregnant should not handle crushed or broken tablets d/t risk of birth defects
Synthetic analog of GnRH
Interrupts production of both testosterone & estrogen
Leuprolide/ Lupron
Anti-androgenic hormone & anti-estrogenic hormone Prostate CA
Precocious puberty
Endometriosis
Uterine fibroids
IVF
SQ
IM
decreased Libido
Impotence
N/V
Hot flashes
Noc sweats
Arthralgias
Myalgias
Osteoporosis
Alters gene transcription
Androgenic hormone
Testosterone
Hypogonadism (males)
Pituitary dwarfism
Post-pubertal hypogonadism
ED
Decreased libido
Irritability
Loss of muscle mass or tone
 Rate of osteoporosis
Loss of 2ndary sex characteristics
Bone marrow stim
Anemia
Transsexual men
“Anti-aging”
Anabolic steroids
IM
Patch
Topical gel
SL lozenges
Not used in PO form d/t inactivation of 1st-pass metabolism AbN sexual maturation (children)
Liver AbN
Gynecomastia
Breast cysts
Cystic acne
Premature epiphyseal plate closure
 Aggression (“roid rage”)
AbN lipid levels (increased LDL & decreased HDL)
Edema
increased RBC mass may cz increased blood viscosity & sludging of blood increased risk ischemia
Binding to estrogen receptor sites in brain interferes w/ N negative feedback of estrogen on GnRH  release of LH & FSH & stim ovulation
Clomiphene/ Clomid
Estrogen receptor agonist Infertility
Amenorrhea
PO
Vaginal dryness
Vaginal bleeding
Breast tenderness
Anxiety
Hot flashes
Potentially CI if hx liver dz, breast or uterine CA
Blockade of progesterone receptors as well as czing decline in HcG levels decrease progesterone production by corpus luteum
Mifepristone/ Mifiprex
Synthetic steroid
Abortifacient
Abd pain
Uterine cramping
Vaginal bleeding/ spotting
N/V/D
Dizziness
Fatigue
Fever
Alters gene transcription
Derivative of progesterone
Medroxyprogesterone/ Provera
Contraception
DUB
PO
IM (Depo-form) Acne
Wt gain
Edema
Insomnia
Anxiety
increased Risk DVT
increased Risk cervicitis
increased Ratio LDL: HDL
CI hx DVT or breast, ovarian or uterine CA
Alters gene transcription
Prevention & tx osteoporosis
Post-menopausal sxs (hot flashes, vaginal dryness & itching)
Oral
Topical cream
Premarin
Conjugated estrogens
Progesterone should be added with women with uterus Vaginal bleeding
Breast tenderness
increased Risk DVT
increased Risk atherosclerosis
increased CAD
increased Risk uterine & breast CA
Folic acid supplement for use with Methotrexate
Leukoviran
Antidote in Tumor Lysis syndrome
L-Puranol
Antidote for malignant hyperthermia
Dantrolene