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166 Cards in this Set

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Somatropin, Somatrem
Somatropin = recombinant GH
Sermorelin
GHRH analog
Mecasermin
Recombinant human IGF-1/IGF-3 complex
Pegvisomant
GH receptor antagonist
Octreotide
Somatostatin Analog
Bromocriptine, Cabergoline
Dopamine Agonists
Menotropins
Human menopausal gonadotropins (hMG)
Follitropin and Urofollitropin
Purified FSH
hCG
Extracted and purified from urine (given IM)
Gonadorelin, Goserelin, Leuprolide, Nafarelin
GnRH analogs
Cetrorelix, Ganirelix
GnRH Receptor Antagonists
Corticotropin, Cosyntropin
Adrenocorticotropic Hormone Analog
Oxytocin
Pharmacokinetics: Half life of 5 minutes
Atosiban
Oxytocin Antagonist
Vasopressin, Desmopressin
Released in response to rising plasma tonicity or falling BP
Conivaptan
Vasopressin Antagonist
Hydrocortisone
Stimulates/is required for gluconeogenesis (mostly) and glycogen synthesis in fasting state
Prednisone, Methylprednisolone, Dexamethasone, Beclomethasone, Triamcinolone
Synthetic Glucocorticoids
Fludrocortisone
Synthetic Corticosteroid (similar to Aldosterone), most commonly prescribed salt-retaining hormone
Spironolactone
Mineralocorticoid Antagonist
Mifepristone
Progesterone Antagonist: Antagonist at glucocorticoid and progesterone receptors
Aminoglutethimide
Corticosteroid Synthesis Inhibitor
Ketoconazole
Corticosteroid Synthesis Inhibitor (anti-androgen)
Metyrapone
Corticosteroid Synthesis Inhibitor
Estradiol, Estrone, Conjugated estrogen (Premarin), Ethinyl Estradiol, Quinestrol, Mestranol
Pharmacokinetics: Oral, IM, transdermal, and topical
Tamoxifen, Raloxifene
Selective Estrogen Receptor Modulators (SERMs)
Fluvestrant
Selective Estrogen Receptor Downregulator (SERDs)
Letrozole, Anastrozole, Exemestane
Aromatase Inhibitors, inhibit the conversion of androgens to estrogen
Danazol
Inhibitor of P450 in gonadal steroid synthesis
Clomiphene
Estrogen antagonist in the hypothalamus and anterior pituitary
Medroxyprogesterone, Norgestrel, Norethindrone, Norgestimate
Uses: Contraception (+/- estradiol), HRT (with estrogen), promote and maintain pregnancy, used in ovarian suppression, diagnosing endogenous estrogen secretion
Testosterone, Oxandrolone, Stanozolol, Fluoxymesterone, Oxymetholone, Nandrolone, Methyltestosterone, Oxymetholone
Use: Substitution therapy in hypogonadism, increases bone density (osteoporosis), can increase muscle mass, use in aplastic anemia
Flutamide, Bicalutamide, Nilutamide
Androgen Receptor Antagonists
Finasteride, Dutasteride
5-α reductase inhibitors, inhibiting the conversion of testosterone to dihydrotestosterone
Cyproterone Acetate
Anti-androgen
Insulin Lispro, Insulin Aspart, Insulin Glulisine
Rapid-acting Insulins
Crystalline Zinc Insulin (Regular Insulin)
Short-acting Insulin
Neutral Protamine Hagedorn (NPH) Insulin
Intermediate-acting Insulin, also called Isophane Insulin
Insulin Glargine, Insulin Detemir
Long-acting Insulins
Drugs that can cause Hypoglycemia
Ethanol: inhibits gluconeogenesis
Drugs that can cause Hyperglycemia
Direct effects countering insulin: Epinephrine, glucocorticoids, atypical antipsychotics, HIV protease inhibitors
Tolbutamide
First-generation Sulfonylurea
Chlorpropamide
First-generation Sulfonylurea
Glyburide (Glibenclamide), Glipizide, Glimepiride
2nd Generation Sulfonureas
Repaglinide, Nateglinide
Meglitinides
Metformin
Biguanide, 1st line treatment for DM Type 2
Pioglitazone, Rosiglitazone
Thiazolidinediones (Glitazones)
Acarbose, Miglitol
α-Glucosidase Inhibitors (competitive inhibitors)
Exenatide
Glucagon-like Polypeptide 1 (GLP-1) Analog [Incretin Analog]
Sitagliptin
Inhibitor of DPP-IV
Pramlintide
Synthetic Amylin Analog
Colesevelam
Bile-acid Sequestrant
Glucagon
Uses: Severe Hypoglycemia, Radiology of the bowel (relaxes the intestine), β-blocker poisoning
Thyroxine T4 (Levothyroxine) and Triodothyronine T3 (Liothyronine)
Thyroid Hormones
Propythiouracil (PTU), Methimazole
Thioamides
Iodine and Iodide Salts
-Used as a short-term inhibition of thyroid hormone synthesis (Wolff-Chiakoff Effect)--> after 10-14 days iodide effect escapes
Radioactive Iodine
Taken up and sequestered by the thyroid gland--> damage through emission of toxic β-particle
Other Anti-thyroid Drugs
1)β-blockers--> Useful in controlling CVS effects, especially during the thyroid storm
Teriparatide
Recombinant PTH (DNA analog)
Vitamin D
Acts by activating steroidal nuclear receptor
Calcitonin
Peptide Hormone
Sevelamer
Phosphate binding drug used to prevent hyperphosphatemia in patients with chronic renal failure
Calcium Salts
Oral: Ca carbonate/citrate/lactate
Bisphosphonates: Etidronate, Alendronate, Pamidronate, Risedronate
MOA: Inhibit osteoclastic activity by disrupting the mevalonate pathway--> decreasing the osteoclast H+ ATPase
Cinacalcet
Activates the Ca2+ sensing receptors in parathyroid cells-- suppression of PTH synthesis and release
Other Drugs Affecting Calcium Homeostasis
1) Fluoride--> Chronic exposure can lead to new bone synthesis which is denser, but brittle
Echinacea (E purpurea)
Active elements: Flavonoids, polyacetylenes and caffeonyl conjugates
Ephedra (Ma Huang)
Combination of ephedrine + pseudoephedrine
Garlic (Allium satium)
Active component: Organic thiosulfinate, which is converted into allicin
Ginkgo
Active constituents: Flavone glycosides and terpenoids
Ginseng
Active component: Ginsenosides
Milk Thistle
Active component: Silymarin (flavonolignans)
St. John's Wort
Active ingredients: Hypericin and hyperforin
Saw Palmetto
Active components: photosterols, aliphatic alcohols, polyprenes, and flavanoids
Coenzyme Q10 (Ubiquinone)
Purified Nutritional Substance
Glucosamine
Purified Nutritional Substance
Melatonin
Effects: Improves sleep onset, duration and quality--> used in sleep disorders and in those with jet lag
Black Cohosh (Actaea racemosa)
May possess analgesic, sedative and anti-inflammatory properties
Kava
Active compound: kavalactone
3-Step Ladder
Step 1: Aspirin, Acetaminophen, NSAIDs
End of life question (will be on the test)
Morphine is the DOC for Breathlessness in end-of-life care
Aspirin Toxicity
Poisoning: uncoupling of oxidative phosphorylation and disruption of normal cellular metabolism--> Impaired ability to generate ATP
Acetominophen Toxicity
Severe Cases: Fulminant liver failure--> Hepatic encephalopathy--> death
Amphetamine/Stimulant Toxicity
At high doses: Agitation, acute psychosis, HTN, tachycardia, TACHYARRHYTMIAS
Anticholinergic Toxicity
Signs: Red as a beet (Skin flushed), Hot as a hare (hyperthermia), Dry as a bone (dry mucous membranes/lack of sweating), Blind as a bat (blurred vision, cycloplegia, pupillary dilation), Mad as a hatter (confusion, delirium) + Tachycardia
β-Blocker Toxicity
Propranolol is most toxic-->blocks Na+ channels at high doses and is lipophilic (CNS effects)
Calcium Channel Blocker Toxicity
Effects: Depress SA automaticity and slow AC node conduction, reduce CO and BP
TCA Toxicity
Normal Action: Antagonists at muscarinic receptors, are α-blockers (vasodilation/hypotension), and have quinidine-like depressant effects (blockade of fast Na+ channels) which slow conduction and depresses cardiac contractility
MAOI Toxicity
Signs: Severe HTN reactions with tyramine-containing foods/drugs (aged cheese, red wine, phenylpropanolamine, ephedrine)
Neuroleptic Malignant Syndrome
Hyperthermic Disorder seen in patients who use Anti-psychotic agents (dopamine agonists)
Opioid Toxicity
Mild/moderate overdose: Lethargy, SMALL PUPILs, BP/pulse rate decreased
Sulfonylurea and Meglitinide Toxicity
Treatment: Glucose bolus + IV OCTREOTIDE
CO Toxicity
Colorless, tasteless, odorless, and nonirritating gas
Ethanol Toxicity
Treatment: IV DEXTROSE (glucose), THIAMINE (for Wernicke-Korsakoff syndrome), and correct electrolyte balance
Methanol Toxicity
Metabolized into formaldehyde and FORMIC ACID (toxic)
Ethylene Glycol Toxicity
Used in heat exchangers, coolents, antifreeze formulations, industrial solvents and hydraulic brake fluids
Organophosphate/Carbamate Toxicity
Normal Action: Cholinesterase Inhibitors
Warfarin Toxicity
Rodenticide
Cyanide Toxicity
Common in plastic/jewelry manufacturing, burning of wool/silk, consumption of cassava root or apricot seed
Lead Toxicity
From industrial exposure, lead-containing paint chips (children)
Arsenic Toxicity
Toxicity (increasing order): Organic arsenicals < pentavalent aresenic < trivalent arsenic < arsine
Mercury Toxicity
Found in the industries such as battery, thermometer, and barometer
Iron Toxicity
Acute iron toxicity: Vomiting, GI bleeding, lethargy, and GRAY CYANOSIS
Tranylcypromine, Phenelzine, Isocarboxazid, Selegiline
MAOIs: Increase levels of NE, serotonin, and dopamine
Amitriptyline, Clomipramine, Desipramine, Imipramine, Nortriptyline
TCAs: Block SERT and NET in addition to α-adrenergic, muscarinic, histamine, and 5-HT receptors
Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram, Escitalopram
SSRIs: specifically inhibit serotonin uptake
Venlafaxine, Duloxetine
SNRIs
Bupropion
Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs): inhibits uptake and increases release
Nefazodone, Trazodone
5HT2 Antagonist and (general) Reuptake Inhibitors (SARIs)
Mirtazapine
Noradrenergic and Specific Serotonergic Anti-depressants (NASSA)
Lithium
Use: Prophylactically for manic-depressive episodes and in treatment of manic episodes
Alternatives to Lithium
Valproate/Carbamazepine are commonly used
Chlorpromazine, Fluphenazine, Haloperidol, Thioridazine, Thiothixene
Classical Antipsychotics
Olanzapine, Clozapine, Quetiapine, Risperidone, Aripiprazole, Ziprasidone,
Atypical Antipsychotics
Benzodiazepines
Sedatives--> NON-LINEAR dose-response curve
Barbituates
Sedatives--> LINEAR dose-response curve
Zolpidem, Zaleplon, Eszopiclone
Non-benzodiazepine Benzodiazepine Receptor Agonists
Buspirone
5-HT1A PARTIAL Agonist, Anxiolytic
Ramelteon
Agonist at MT1/MT2 Melatonin Receptors
Chloral Hydrate, Meprobamate, Paraldehyde
Older Sedative-Hypnotics
Other Sedative (related) Drugs
Hydroxyzine: Antihistamine with antiemetic activity
Benztropine and Trihexyphenidyl
Anti-muscarinics used to treat parkinsonism
Levodopa + Carbidopa = Sinemet
Precursor of dopamine
Pramipexole, Ropinirole
Nonergot Dopamine Agonists
Rotigotine
Nonergot Dopamine Agonist
Apomorphine
Nonergot Dopamine Agonist
Selegiline (Deprenyl)
Selective and irreversible inhibitor of MAO-B (which selectively metabolizes dopamine)
Rasagiline
Selective and irreversible inhibitor of MAO-B (which selectively metabolizes dopamine)
Tolcapone, Entacapone
Catechol-O-Methyltransferase Inhibitors (COMT)
Amantadine
Antiviral drug used for Parkinson's Disease
Anti-epileptic Drugs
DOC for Simple/Complex Partial and Secondarily Generalized tonic-clonic seizures: Carbamazepine, Oxacarbazepine, Lamotrigine, Phenytoin
Phenytoin
Anti-epileptic
Carbamazepine
Anti-epileptic
Lamotrigine, Zonisamide
Anti-epileptic
Valproate
Anti-epileptic
Topiramate
Anti-epileptic
Ethosuximide
Anti-epileptic
Tiagabine
Anti-epileptic
Vigabatrin
Anti-epileptic
Gabapentin, Pregabalin
Anti-epileptics
Caffeine, Theophylline, Theobromine
Methylxanthines
Cocaine
MOA: Inhibits DOPAMINE, NE, and serotonin uptake
Amphetamine, Methamphetamine, Phenmetrazine, Methylphenidate
MOA: Increase release of catecholamines, weak inhibitors of MAO, possible direct catecholaminergic agonists on the brain
Nicotine
Actions: ganglionic stimulation by depolarization (low doses) and ganglionic blockade at high doses
Heroin, Morphine, Codeine, Oxycodone, Meperidine, Fentanyl, Alfentanil, Remifentanil
Opioids
Marijuana
9-Tetrahydrocannabinol produces most of the effects
LSD, Mescaline, Psilocybin
MOA: Agonist effects at the 5-HT2 receptors in the CNS
Phencyclidine (PCP)
1st used as an anesthetic
MDMA
Actions: Fosters feelings of empathy and intimacy without impairing intellectual capacities
Volatile Organic Solvents
Inhalants including gasoline, paint thinner, lighter fluid, glue and degreasers
Nitrous Oxide
Inhaled Anesthetic, Gas
Halothane, Enflurane, Isoflurane, Desflurane, Sevoflurane, Methoxyflurane
Inhaled Anesthetics, Volatile Halogenated Hydrocarbons
Malignant Hyperthermia
AD phenomenon triggered by exposure to volatile inhalation anaesthetics and depolarizing skeletal muscle relaxants (succinylcholine)
Benzodiazepines as IV Anesthetics
Diazepam, Lorazepam, and MIdazolam
Propofol
Common IV Anesthetic used for induction/maintenance of anesthesia
Etomidate
IV Anesthetic
Ketamine
IV Anesthetic
Anti-muscarinic Anesthetic Adjuvants
Reasons: Amnesic effects, prevention of salivation and bronchial secretions, protection of heart form bradycardia caused by inhalational agents and neuromuscular blockers
Procaine, Cocaine, Tetracaine, Benzocaine
Ester Local Anesthetics
Lidocaine, Bupicaine, Prilocaine, Ropivacaine
Amide Local Anesthetics
Tubocurarine, Atracurium, Cisatracurium, Doxacurium, Mivacurium
Non-Depolarizing Neuromuscular blockers Benzylisoquinolines
Pancuronium, Pipecuronium, Rocuronium, Vecuronium
Non-Depolarizing Neuromuscular blockers Ammonio Steroids (contain esters hydrolyzed in the liver)
Succinylcholine
Depolarizing Neuromuscular Blocker
Chronic Spasmolytics acting in the CNS
Diazepam: Facilitates action of GABA at GABAa receptors
Chronic Spasmolytics acting on the Skeletal Muscle
Dantrolene and Botulism
Cyclobenzaprine
Used for relief of ACUTE muscle spasm