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145 Cards in this Set
- Front
- Back
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Polyethylene glycol
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osmotic diuretic
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Palivizumab
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monoclonal ab against F protein on surface of paramyxoviruses
prevents pneumonia in premature infants |
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Beta lactamase inhibitors
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Tazobactam, clavulanic acid, sulbactam
works against bacteroides and pseudomonas |
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Metoprolol
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selective beta 1 adrenergic antagonist
b1 receptors on cardiac tissue and renal juztaglomerular cells cardiac effects + blocks catacholamine-induced renin release in kidney |
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Thiazides
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Hyper uricemia, calcemia, glycemia, lipidemia
Hypo kalemia, tension |
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Zileuton
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inhibits 5 lipoxygenase
dec synthesis of ltb4, ltc4, ltd4, lte4 |
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Montelukast
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leukotriene receptor antagonist
dec activity of ltc4, ltd4, lte4 |
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Block cell wall synthesis by inhibition of peptidoglycan cross-linking
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penicillin, methicillin, ampicillin, piperacillin, cephalosporins, aztreonam, imipenem
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Block peptidoglycan synthesis
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bacitracin, vancomycin
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Block nucleotide synthesis
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sulfonamides, trimethoprim
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Block DNA topoisoperases
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fluroquinolones
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Block mRNA synhesis
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Rifampin
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Damage DNA
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Metronidazole
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Block protein synthesis at 50S ribosomal subunit
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Chloramphenicol, macrolides, clindamycin, streptogramins, linezolid
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Block protein synthesis at 30S ribosomal subunit
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Aminoglycosides, tetracyclines
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Penicillinase-resistant penicillins
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Methicillin, nafcillin, dicloxacillin
has a bulkier R group use Naf for Staph! |
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SE of methicillin
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interstitial nephritis
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Ampicillin/Amoxicillin
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aminopenicillins
amOx has greater Oral bioavailability extended spectrum- HELPSS kill enterococci H flu, E coli, Listeria, Proteus mirabilis, Salmonella, Shigella, enterococci |
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Combine amox/ampicillin with clavulanic acid to
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Protect against bea lactamase
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Antipseudomonals
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TCP- Take Care of Pseudomonas
Ticarcillin, Carbenicillin, Piperacillin |
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Beta lactamase inhibitors
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CAST
Clavulanic Acid, Sulbactam, Tazobactum add to penicillin antiobiotic to protect antibiotic from destruction by beta lactamase |
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Cephalosporins dont work against
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LAME
Listeria, Atypicals (chlamydia, mycoplasma), MRSA, Enterococci |
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Ceftriaxone
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3rd gen cephalosporin
used for meningitis and gonorrhea |
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Ceftazidime
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3rd gen cephalosporin
used for Pseudomonas |
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SE of cephalosporins
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vit K def, cross hypersens with penicillins, inc nephrotoxicity of aminoglycosides, disulfiram like rxn with ethanol
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Aztreonam
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monobactam resistant to beta lactamases, synergistic with aminoglycosides, for gram neg rods only!
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Vancomycin
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blocks peptidoglycan synthesis, binds D ala D ala portion of cell wall precursors, for gram positives only, serious multidrug resistant organisms- S aureus, enterococci, c difficile
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Red man syndrome
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Vanco toxicity
nephrotoxicity, ototoxicity, thrombophlebitis, diffuse flushing |
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Aminoglycosides
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req oxygen for uptake, not effective against anaerobes, bactericidal, for severe gram neg rod infxns
GNATS gentamycin, neomycin, amikacin, tobramycin, streptomycin Teratogen! |
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Aminoglycoside used for bowel surgery
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Neomycin
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Aminoglycoside + cephalosporin
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nephrotoxicity
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Aminoglycoside + loop diuretic
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ototoxicity
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Resistance to aminoglycosides
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transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation
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Demeclocycline
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a tetracycline- bacteriostatic, bind to 30S
ADH antagonist, acts as Diuretic in SIADH |
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Doxycycline
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fecal elimination
can be used in renal failure pts |
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Macrolides
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erythromycin, azithromycin, clarithromycin
inhib protein syn by blocking translation- macroSLIDES bind 23S rRNA of the 50S ribosomal subunit, bacteriostatic used against atypical pneumonias- chlamydia, mycoplasma, legionella |
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Macrolide tox
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prolonged QT interval- especially erythromycin
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Chloramphenicol
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tx meningitis, tox- anemia dose dep, aplastic anemia dose indep, gray baby syndrome in premature infants bc they lack liver UDP glucuronyl transferase
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Treat anaerobes ABOVE the diaphragm
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Clindamycin
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Treat anaerobes BELOW the diaphragm
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Metronidazole
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Sulfonamides
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inhibit dihydropteroate synthase
displcaces other drugs from albumin ex warfarin, causes hemolysis if G6PD deficient, tubuloinerstitial nephritis, kernicterus in infants |
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Trimethoprim
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inhibits dihydrofolate reductase
Treats Marrow Poorly tox causes megaloblastic anemia, leukopenia, granulocytopenia- may get better with folinic acid |
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TMP-SMX
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causes sequential block of folate synthesis
used for UTIs, Shigella, Salmonella, Pneumocystis jiroveci |
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Leucovorin rescue
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Supplement folinic acid in pts taking trimethoprim to dec bm tox
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Can't take with milk, antacids or iron containing preparations
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Tetracycline
because divalent cations inhibit its absorption in the gut |
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Can't take with antacids
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Fluoroquinolones
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Fluoroquinolones
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inhibit DNA gyrase (topoisomerase II)
-oxacin hurts attachments to your BONES- damage to cartilage |
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tx Pseudomonas
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TCP- ticarcillin, carbenicillin, piperacillin
Ceftiazidime Fluoroquinolones |
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Metronidazole
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GET GAP on the Metro
Giardia, Entamoeba, Trichomonas, Gardnerella, Anaerobes (bacteroides, c diff) h Pylori as part of triple tx |
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tx MRSA
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vancomycin
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tx VRE
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linezolid and streptogramins
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Prophylaxis for gonorrhea
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Ceftriaxone
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Prophylaxis for meningococcal infxn
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Ciprofloxacin
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Empiric therapy for community acquired pneumonia
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outpatient setting- macrolides
inpatient setting- fluoroquinolones ICU- beta lactam + (fluroquinolone OR azithromycin) |
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Fluconazole
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inhibits ergosterol synthesis by inhib p450 enzyme that coverts lanosterol to ergosterol
can cross BBB tx cryptococcal meningitis in AIDS pts, candidal infxns of all types |
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Azole tox
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hormone synthesis inhibition- gynecomastia, liver dysfunction- inhib cyt P450, fever, chills
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Amphotericin B
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tox fevers chills "shake and bake hypotension, nephrotox, arrhythmias, anemia, IV phlebitis, hydration and liposomal form helps
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Caspofungin
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inhibits cell wall synthesis by inhibiting beta glucan synthesis
tx invasive aspergillosis tox gi upset, flushing |
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Tx onychomycosis- fungal infection of finger or toe nails
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Terbinafine- inhibits fungal enzyme squalene epoxidase
used to tx dermatophytoses tox abnml LFTs, visual disturbances |
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Chloroquine
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blocks plasmodium heme polymerase, used for Plasmodium spp
tox retinopathy, G6PD hemolysis |
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Amantadine
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blocks uncoating by M2 protein
"A Man 2 dine" takes off his Coat blocks influenza A, causes cerebellA problems, also for Parkinson's dse tox ataxia, dizziness, slurred speech |
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Zanamivir, oseltamivir
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inhibits influenze neuraminidase, dec release of virus progeny
tx both influenze A and B |
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Ribavirin
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inhibits IMP dehydrogenase, inhib synthesis of guanine nucleotides
tx RSV, chronic hep C tox hemolytic anemia, TERATOGEN |
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Acyclovir
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monophos by HSV/VZV thymidine kinase, inhibit DNA polymerase by chain termination, guanosine analog
tx HSV, VZV, EBV |
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Valacyclovir
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better oral bioavailability than acyclovir
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Famiciclovir
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tx herpes zoster
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Ganciclovir
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5' monophosphate formed by CMV viral kinase
tx CMV tox pancytopenia, renal tox valganciclovir-better bioavailability |
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Foscarnet
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pyroFOSphate analog, doesnt req activation by viral kinase
tx CMV retinitis when ganciclovir fails nephrotoxicity chelates calcium, induces renal wasting of mg, red release of PTH, contributes to hypocalcemia, can cause seizures |
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Cidofovir
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preferentially inhib viral DNA poly, does not req phos by viral kinase
tx CMV retinitis coadmin with probenecid to dec nephrotox |
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Protease inhibitors
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-navir
HIV-1 protease=pol gene, assembly of virions depends on it to cleave products of HIV mRNA into functional parts PIs prevent maturation of new viruses NAVIR TEASE a proTEASE |
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NRTIs
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competitively inhib nucleotide binding to reverse transcriptase and terminate DNA chain, must be phos by thymidine kinase to activate
tox bm suppression ex zidovudine ZDV |
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NNRTIs
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bind to reverse transcriptase at dif site than NRTIs
do NOT req phos to be active or compete with nucleotides have VIR in middle of name ex neVIRapine |
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Integrase inhibitor
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Raltegravir
inhib HIV genome integration into host cell chromosome tox hypercholersterolemia |
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Interferons
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glycoproteins syn by virus infected cells block replication of RNA and DNA viruses
IFN alpha- tx chronic hep B and C, kaposis sarcome IFN beta- MS IFN gamma- NADPH oxidase def tox neutropenia |
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Trazodone
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sedating effects, can be used with fluoxetine to tx depression with accompanying insomnia, SE PRIAPISM
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Verapamil
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non dihydropyridine ca channel blocker, often used for rate control in a fib, negative inotropic effect, also used as anti htn and ant angina
SE av nodal conduction abnormalities, constipation |
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Amlodipine
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dihydropyridine ca channel blocker
selective for vascular smooth muscle, does not effect heart SE peripheral edema |
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Digoxin
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tx impaired LV function, also second like for a fib, slows conduction through AV node
SE NVD |
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Aldesleukin
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recomb IL 2, used in RCC and metastatic melanoma
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Filgrastim
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G-CSF, recover bm
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Sargramostim
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GM-CSF, recover bone marrow
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Oprelvekin
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recomb IL 11, tx thrombocytopenia
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Cyclosporine
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inhibits calcineurin, blocks differentiation and activation of T cells, suppresses organ rejection after transplant, SE nephrotoxic- prevent with mannitol diuresis, gout
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Daclizumab
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monoclonal ab with high affinity for IL 2 receptor on activated T cells, prevent acute rejection of renal transplant
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Azathioprine
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antimetabolite precursoe to 6 MP, interferes with syn of nucleic acids, toxic to prolif lymphocyes, used in kidney transplant and autoimmune dso, tox bm suppression, active met metabolized by XO, tox inc with allopurinol!!!
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Muromonab-CD3 (OKT3)
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monoclonal ab that binds CD3 on surface of T cells, immunosuppression, can also reverse acute transplant rejection
tox cytokine release syndrome, hypersens rxn |
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Abciximab
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targets glycoprotein IIb/IIIam prevents cardiac ischemia in unstable angina and pts tx with percutaneous coronary intervention
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Trastuzumab (Herceptin)
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targets erb B2, tx HER2 overexpressing breast cancer
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Rituximab
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targets CD20, tx B cell NHL
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Omalizumab
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targets IgE, tx severe asthma
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Mainstay for tx of acute mania
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mood stabilizing agent- lithium, valproate, or carbamazepine plus an atypical antipsychotic ex olanzapine
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Aspirin
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inhibits COX- TXA2 synthesis
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Ticlopidine and clopidogrel
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inhbits ADP induced expression of GpIIb/IIIa
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Abciximab
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inhibits GpIIb/IIIA directly
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Lead poisoning tx
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Dimercaprol and EDTA are 1st line
Succimer in kids |
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Sotalol
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has both beta adrenergic blocking properties and class 3 antiarrhythmic (K+ channel blocking) properties
prolongs both the PR and QT interval |
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Trimethoprim
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inhibits bacterial dihydrofolate reductase
Treats Marrow Poorly |
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Protein kinase A responsible for
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Intracellular effects of G protein/ adenylate cyclase second messenger system
some hormone receptors that use this mechanism include TSH, glucagon, PTH and beta adrenergic receptors |
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Ketamine
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NMDA receptor anagonist
blocks actions of glutamate, blocks morphine tolerance |
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Alprazolam
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benzodiazepine
half life less than 12 hours useful for acute anxiety |
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5 HT3 receptor antagonists
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ondansetron, granisetron, dolasetron
highly effective in preventing chemo induced vomiting by blocking vagus med N and V in medulla oblongata's vomit center and blocking serotonin in chemoreceptor trigger zone |
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Dexrazoxane
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iron chelating agent help prevent anthracycline induced (e doxorubicin) cardiotoxicity
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Valproic acid
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used as both anticonvulsant and mood stabilizer
dec propagation of abnml AP by enhancing inhib of GABA in CNS inc GABA synthesis and dec breakdown |
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Hep B associated with
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serum sickness like syndrome in the prodromal period
can present with malaise, fever, skin rash, pruritis, lymphadenpathy and joint pain followed by elevations in ALT and AST, ALT>AST, followed by rise in bilirubin and alk phos |
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Enoxaparin
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LMW heparin, act more on Xa, better bioavailability, 2-4 times longer half life, can be administered sub q and without lab monitoring
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Lepirudin, bivalirudin
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directly inhibit thrombin
sued as alternative to heparin for anti coag in pts with HIT |
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Warfarin
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interferes with normal syn and gamma carboxylation of vit k dep clotting factors 2 7 9 10 protein c and s, met by cyt p450, effect on extrinsic pathway- inc PT
teratogenic, skin tissue necrosis, drug drug interactions |
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Clopidogret, ticlopidine
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inhib platelet aggregation by irr blocking ADP receptors, inhib fibrinogen binding by preventing glycoprotein IIb/IIIa expression
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Cilostazol, dipyridamole
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phosphodiesterase III inhibitor, inc cAMP in platelets, dec aggregation
vasodilator tox nausea HA facial flushing hypotension abd pain |
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Abciximab
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monoclonal ab that directly binds to glycoprotein receptor IIb/IIIa on activated platelets, prevents aggregation
tx acute coronary syndromes, percutaneous transluminal coronary angioplasty tox bleeding, thrombocytopenia |
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Vinca alkaloids
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inhibit microtubule formation
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Paclitaxel
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inhibit microtubule disassembly
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Methotrexate
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folic acid analog inhibits dihydrofolate reductase, dec dTMP, dec DNA and protein syn
tx for leukemias, lymphomas, choriocarcinoma, sarcomas, abortion, ectopic preg, RA, psoriasis tox myelosuppression- rev with leucovorin (folinic acid) rescue |
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5 FU
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pyrimidine analog, bioactivated to 5F-dUMP, covalently complexes folic acid, inhib thymidylate synthase
synergy with MTX, tx colon ca, solid tumors, topical for basal cell ca tox irr myelosuppression, photosensitivity |
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6 MP
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purine analog, dec de novo pruine syn, activated by HGPRTase
tx leukemias, lymphomas bone marrow tox metabolized by XO- inc tox with allopurinol! |
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Cytarabine (ara-C)
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pyrimidine analog, inhib DNA polymerase, tx AML, ALL, NHL
tox leukopenia, thrombocytopenia, megaloblastic anemia |
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Dactinomycin (ACTinomycin D)
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intercalates DNA
tx wilms, ewings, rhadomyosarcoma, childhood tumors children ACT out myelosuppression |
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Doxorubicin (adriamycin), daunorubicin
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generate free radicles, noncovalently intercalate in DNA, dec replication
tx Hodgkins (part of ABVD), myelomas, sarcomas, solid tumors Cardiotoxicity, myelosuppression, alopecia |
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Bleomycin
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induces free radical formation, double stranded DNA breasks
tx testicular cancer, Hodgkins pulmonary fibrosis |
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Etoposide (VP 16), teniposide
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inhib topoisomerase II, inc DNA degradation
small cell ca of lung and prostate, testicular ca myelosup |
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What partially prevents hem cysitis secondary to cyclophosphamide tox
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Mesna- thiol group binds toxic metabolite
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Cyclophosphamide, ifosfamide
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alkylating agent, covalently x link DNA at guanine N-7
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Nitrosoureas- carmustine, lomustine, semustine, streptozocin
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alkylating agent, cross BBB into CNS, tx brain tumors inc GBM, CNS tox- dizziness, ataxia
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Busulfan
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alkylates DNA, tx CML
tox pulm fibrosis, hyperpigmentation |
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Vincristine, vinblastine
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alkaloids bind to tubulin in M phase and block polymerization so mitotic spindle cant form
tx HL, wilms, choriocarcinoma, ALL cristine- neurotox, paralytic ileus BLASTine BLASTS Bone marrow- suppression |
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PacliTAXel
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hyperstabilize polymerized microtubules in M phase so they cant break down
tx ovarian and breast ca myelosup and hypersensitivity |
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Prevent nephrotoxicity of cisplatin with
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amifostine- free radical scavenger
and chloride diuresis |
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Hydroxyurea
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inhib ribonucleotide reductiase, dec DNA Synthesis- S phase specific
tx melanoma, CML, sickle cell dse |
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Raloxifene
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SERM, no inc in endometrial ca bc endometrial antagonist
tamoxifen inc risk of endometrial ca, partial agonist effects, hot flashes |
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Trastuzumab (Herceptin)
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monoclonal ab against HER-2 (erb b2) a tyrosine kinase
tx met breast ca tox cardio |
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Imatinib
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Gleevec
philadelphia chrom bcr-abl tytosine kinase inhib tx CML, GIST tox fluid retention |
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Rituximab
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monoclonal ab against CD20, found on most B cell neoplasms
tx NHL, RA with mtx |
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Anastrozole
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inhibits aromatase, used for tx of estrogen dep breast cancers
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Magnesium hydroxide
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antacid
causes diarrhea |
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Aluminum hydroxide
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antacid
causes constipation |
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tx for acute iron toxicity
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Deferoxamine
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tx for lead poisoning
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dimercaprol and EDTA
succimer for kids |
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Demeclocycline
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inhibits effect of ADH on collecting tubules, causing los of fH20 in urine, used in pt with scc of lung
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Clozapine SE
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granulocytopenia, seizures
need to monitor WBC counts for duration of tx acts on D4 receptors |
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Niacin SE
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acute flare of gouty arthritis
facial flushing and warming most effective agent to raise HDL |
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Gemfibrozil SE
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myopathy and hepatoxicity
severe myopathy risk inc when combined with statins |
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Sx of botulinum neurotoxin ingestion
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diplopia, dysphagia and dysphonia occurs 12-46 hrs after consumption
prevents release of ACh from nerve terminals at NMJ, preventing muscular contraction |
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Atropine
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blocks vagal influence on SA node, inc HR in interior MI pts who had block in RCA, artery responsible for SA node perfusion
SE muscarinic receptor antagonism, mydriasis- narrow anterior chamber and dec outflow of aq humor, can precipiate glaucoma in ots with inc intraocular pressure |
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Tx gonococcal infxn
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ceftriazone for gon infxn and
azithromycin for concomitant infxn- most common chlamydia trachomatis |
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Bosetan
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competitive endothelin receptor antagonist, used to tx primary idiopathic pulm arterial htn
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