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185 Cards in this Set
- Front
- Back
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SSRI:
F.P.S.F.E.C. |
-Fluoxetine
-Paroxetine -Sertraline -Fluvoxamine -Escitolpram -Citolopram |
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Imipenem: DOC for...
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Enterobacter
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Triple tx for leprosy
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-Rifampin
-Dapsone -Clofazimine |
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NRTI that tx Chronic Hep B
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-Lamivudine
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Guanosine analogue for RSV bronchiolitis and Hep C
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Ribavirin
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Guanosine analogue for Hep B tx
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Entecavir
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Azoles so toxic that you can only use for cutaneous fungal infx?
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-Miconazole and Clotrimazole
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Why Fluconazole better than Ketocanozole?
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-effects on gonadal and adrenal steroid synth are minimal
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Cause and Tx of Serotonin Syndrome
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1. SSRI + MAOI
2. Crypropheptadine (5HT2 antag) |
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Cause and Tx of NMS?
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1. Typical Antipsychotics
2. Tx by Dantrolene and Bromocriptine |
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Tx for Benzo overdose?
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Flumazenil (competitive antag at GABA)
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Cause and Tx for Malignant Hyperthermia
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1. Halothane + Succinylcholine
2. Tx w/ Dantrolene |
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2nd generation antihistamine w/ lowered sedation SEs
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-Loratidine
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How does Niacin work?
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-inhibis lipolysis in ADIPOSE tissue and reduces VLDL that is released into the circulation by the liver
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Tx for B-blocker overdose?
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-Glucagon (increases cAMP)
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Antidote for opiod overdose?
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-Naloxene
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Fomepizole?
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-inhib ETOH DH and used for methanol (metabolic acidosis and visual disturbances) or ethylene glycol overdose
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Finasteride
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-5 alpha reductase inhib (SE of gynecomastia)
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Tamsulosin?
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-alpha 1 adrenergic antag
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Tolterodine?
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-musc receptor inhib for BPH
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Flutamide
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-nonsteroidal competitive inhib of andros at the testosterone receptor
-tx prostate cancer |
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Hydralazine
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-decrease afterload
-1st line for HTN in prego w/ methyldopa |
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Adenosine
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-DOC for paroxysmal SVT and AV nodal arrhythmia
-antag by theophyline |
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Nitroprusside
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-DOC for HTN emergencies
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AE of Nitro
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-Cyanide toxicity
-give amyl nitrite followed by sodium thiosulfate |
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Minoxidil
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-Opening K+ channel, hyperpolarization of SM
SE: hypertrichosis |
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ETA receptor antag for pulm HTN?
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Bosentan
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Clopidogrel/Ticlopidine
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-block ADP receptor
-inhib fibrinogen binding by preventing gIIb/IIIa expression |
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Alteplase
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-converts plasminogen to plasmin
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Abciximab
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-MAB that binds to gIIb/IIIa on activated platelets preventing aggregation
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Cisplatin
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-cross links DNA (use for testicular, bladder, ovary, lung cancers)
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Raloxifene
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-SERM used to tx BC and osteoporosis
-*does NOT cause endometrial cancer b/c it is an endomet antag and not a partial agonist |
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Trastuzumab
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-Mab against HER-2
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DOC for Tonic clonic seizures that also is good for Bipo
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Valproic Acid
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Ezetimibe
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-prevents absorption of cholesterol
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Why is morphine CI for pain a/w biliary colic?
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-it causes contractions of the sphincter of oddi
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Cilostazol
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-PDE inhib used for intermittent claudication caused by PAD
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Efaviraz
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-NNRTI
-DOES NOT incorporate itself into viral DNA |
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1st line for Petit Mal
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-Ethosuxamide
se: can cause Steven Johnson |
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3 top drugs for E. coli
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-Doxy, cipro, TMP - SMX
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Gemfibrozil
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-enhances the activity of LPL which hydrolyzes TGs including VLDLs circulating in the periph
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MOA of Valproic Acid
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-Inc Na+ channel activation and also Inc GABA concentration
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1st line prophylaxis for Status Epilepticus
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-Phenytoin
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1st line Tx for Acute Status epilepticus
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-Diaxepam and Lorazepam
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Carbamezepine
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-1st line tx for Tonic clonic and Trigeminal Neuralgia
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Significant SE for Carbamezepine
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Agranulocytosis and aplastic anemia
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3 drugs that improve survival in CHF
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-ACEIs, Spironolactone, Metopropolol
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Prophylaxis for Cyrptococcus Neoforms in AIDS pts
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-Fluconazole
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Voriconazole
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? best drug for aspergillus
-Caspofungin may be used for invasive |
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1st degree AV blocks caused by...
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-Digoxin, CCB, and B-Blockers
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Zileuton
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-inhib lipoxygenase (Arachodonic acid --> LTB4 - LTE4)
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Methimazole
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-slo acting anti-thyroid drug that interferes w/ synth of thyroid hormones
-inhib of iodine organification and coupling in the thyroid not periph |
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Alprastadil
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-PGE1 to keep open PDA
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Didanosine
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-NRTI w/ dose limiting AE of pancreatitis
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Zidovudine
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-NRTI used to prevent vertical transmission to the fetus
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5-FU
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-pyrimidine analog for Colon cancer and Basal cell carc
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Indinavir
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-protease inhib
-causes kidney stones if pt is dehydrated |
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TMP-SMX prophylaxis w/ AIDS
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-for PCP (jirovecci) at CD4 < 200
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Ganciclovir and AIDS prophylaxis
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-prophylaxis for CMV when CD4 <100
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PTU
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-inhib of iodine organification and coupling in the thyroid AND inhib of peripheral conversion of thyroxine to thiodothryonine
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Calcitonin and osteopenia/osteoporosis
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-for pts with these conditions that are also at increased risk for DVTs because SERMs (Raloxifene) and bisphosphonates increase this risk
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SE of Bleomycin
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-pulm fibrosis
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SE of Cisplastin
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-neurotoxicity and permanent kidney damage
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SE of Vincristine
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-peripheral neuropathy
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PCP
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-psychosis, violence impulsiveness, fever, tachy, horizontal AND vertical nystagmus
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MOA of phenytoin
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-not only blocks Na+ channels to increase refractory period of neurons, the drug inhibits glutamate release from excitatory presynaptic neurons
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Name 3 alkalating agents
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-Cisplatin
-Cyclophosphamide -Procarbazine |
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Acetazolamide
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-prevents reab of HCO3- from the proximal tubules thus causing hypercloric acidosis
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Metoclopramide
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-antiemetic and prokinetic drug that stimulates peristalsis
-blocks dopamine receptors and can have extrapyramidal SEs |
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Pramipexole and Ropinirole
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-synthetic dopamine agonists used as alternatives when levodopa no longer works
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Entacapone
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-COMT inhib that inhibs the breakdown of levodopa in periph so that more can cross the BBB
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Hydroxychloroquine
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DMARD that causes retinal deposits
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Thioridazine
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antipsychotic that causes retinal deposits
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Trihexyphenyl
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-musc antag for Parkinsons
-SE: blurred vision from cycloplegia |
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Phenytoin during Prego
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-Fetal Dilantin Syndrome: microcephaly, midfacial abnormalities and hypoplasia of fingers and toes
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Prophylaxis DOC for Cryptococcal Meningitis
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-Fluconazole
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Promexerine
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-drug used to tx N/V after chemo if Ondansetron fails
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Most frequent SE of Lithium
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-tremor
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What is the only opiod w/ mydriasis?
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-MeperiDine (Demerol)
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DOC for Tourettes
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-Pimozide: dopamine receptor blocker
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Gold Standard Tx of Acute sinusitis and the big 3 that it works on?
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-Amoxicillin/Clavulanate
-Strep PNA, H. Flu, Mor Cat |
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Aspirin Toxicity
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-GI distress, tinnitus and hyperthermia
-causes elevated LTs that can lead to bronchospasms |
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Buspirone
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-Anxiolytic that is not a benzo and therefore does not cause sedation, CNS depression or dependence
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Rare but serious SE of Clopidogrel
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TTP
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Protamine
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-antidote for heparin
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Succinylcholine
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-ACh agonist at the NMJ--> depolarizing agent that leads to fasiculations that lead to paralysis
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Baclofen
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-used to decrease muscle spasms
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Thiopental
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-short acting Barbituate that can exacerbate acute intermittent porphyria (Inc ALA and porphobilogen)
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MOA of Ethosuximide
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-Blocks Ca++ channels in thymus
-MC SE is GI distress |
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Ivermectin
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-activation of glutamate gated Cl- channels
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Donepezil
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-ACh inhib used particularly for AD
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What increases the effectiveness of local anesthetics?
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-Low IC pH and high EC pH
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Rimantadine is CI in ?
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-Liver failure (Amantidine) is not
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MOA of Baclofen
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-spasmolytic used for cerebral palsy
-binds to GABA - b and reduces release of excitatory NTs |
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Cilostazol
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-PDE inhib (enzyme responsible for breakdown of cAMP) --> inhib platelet agg
-also direct arterial vasodilator -used for pts w/ intermittent claudication |
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Lithium during prego
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-Ebstein's anomaly = apical displacement of tricuspid valve leaflets, decrease RV volume and atrialization of RV
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Aminocaproic acid and tranexamic acid
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-inhib fibrinolysis by inhibiting plasminogen activation
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Dantolene MOA
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-acts on ryanodine receptor and prevents further release of Ca++ into cytoplasm of muscle fiber
-tx of malig hyperthermia |
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Typical Antipsychotics:
High vs Low potency |
1. High potency -> extra pyramidal sx, less likely to cause anti-cholinergic and anti histamine SEs
2. Low potency, more likely to cause these SEs MOA of both = block D2 receptors |
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Typical Antipsychotics:
High vs Low potency names |
1. High: Haloperidol, Fluphenazine, Pimozide
2. Low: Chlorpromazine, Thioridazine |
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Atypical Antipsychotics
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-Clozapine, risperidone, olanzapine, queitiapine, A to Z
-tx + and - sx -block dopamine and 5HT2 |
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1st gen anti-histamines
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-hydrozyzine, promethazine, chlorphenramine, diphenhydramine
-SE blocking: muscarinic (blurry vision, dry mouth, urinary retention), serotonic (appetite stim), alpa adrenergic (postural dizziness) |
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Fexofenadine
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-2nd gen antihistamine w/ none of the SE of 1st gen
-not lipophilic so can't cross BBB |
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Ondansetron
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-inhibs serotonin 5-HT3 receptors in GI tract, area postrema, and solitary nucleus tract
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Filgastim
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-granulocyte CSF analog for pts w/ neutropenia
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Dexrazoxane
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-iron chelating agent that can prevent antracycline (doxorubicin) induced cardiotoxicity
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Amifostine
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-cytoprotective free radical scavenger used to decrease nephrotoxicity a/w platinum containing and alkylating chemo agents
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cyclosporine
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-used in transplant pts to prevent rejection
-decreases synth of IL-2 and therefore inhibs T-cell proliferation |
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MOA of Benzos
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-Increase frequency of Cl- channel opening --> Increasing GABA-A activity
-used for: anxiety, acute seizure, alcohol withdrawal |
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Adenosine
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-DOC for PSVTs
-rapidly activating and cleared (T1/2 < 10 seconds) -SE: chest burning (bronchospasm), flushing, and high grade block |
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ACEIs
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-decrease ATII and aldosterone
-dec ATII --> Inc reninin and ATI -Bradykinin levels will also increase |
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MOA of Ethambutol
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-inhibs arabinosyl transferase
-essentially prevents carb polymerization necessary for mychobact cell wall synth |
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MOA of INH
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-inhibs mycolic acid synth
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Zolpidem
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-short acting hypnotic struct unrelated to benzos but also works on the GABA-A receptor
-less tolerance/addiction/withdrawal -no anti-convulsant properties |
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Amiodarone and Torsades de Pointes
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-Class III, Increase QT d/t K+ mediated repolarization but low incidence of torsades de pointes unlike class IA or IIIA
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MOA of metformin
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-decrease blood sugar by INC glycolysis, DEC GI glucose absorption and DEC gluconeogenesis
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Desmopressin
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-synthetic analog of ADH
-inc vWF release and factor VIII from endothelial cells -helps pts w/ mild form of vWB ds and mild/mod hemophilia A -also used for tx of enuresis (DI) |
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Spironolactone and women
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-blocks andro receptors at hair follicles and decreases testosterone
-can use in women w/ idipathic hirsutism |
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Clomiphene
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-anti estrogen that increases synth of Gn-RH and consequently gonadotropins
-tx infertility esp when a/w anovulation |
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What B-blockers are CI in angina?
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-Pindolol and acebutolol
-they are partial B-agonists |
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tPA MOA and major SE
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-Fibrin specific fibrinolytic
-may cause reperfusion arrhythmia on arterial reopening (usually benign) |
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cyclosporine and tacrolimus
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-calcineurin inhibs given w/ kidney transplant to prevent acute rejection (T-cell sens against graft MHC ags)
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Corticosteroids: Acute effect on CBC
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-Increase PMNs d/t "demargination" of PMN previously attached to the vessel wall
-decrease lymphos, monos, basos, eosinophils |
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Tx of lung abscesses in ETOH pts
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-Clindamycin
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Octreotide
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-synthetic analog of somatostatin w/ longer T1/2
-controls the sx of carcinoid syndrome |
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Ampho B
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-polyene antifungal notorious for its renal toxicity --> severe hypokalemia and hypomagnesemia
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Warfarin and Protein C def
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-transient procoag/anticoag imbalance present at start of tx is further exaggerated by Protein C def leading to relative hypercoag state w/ thrombotic occlusion of microvasc and skin necrosis
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Acute Theophyilline Intoxication
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-abd pain, V/D, cardiac arrhythmias and seizures
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2 classes of Dopamine agonists
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1. Ergot compounds: Bromocriptine and Pergolide
2. Non ergot: Pramipexole and ropinerole |
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Selegiline
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-decreased central dopamine degradation, MAO-B inhib used to delay clinical progression of PD
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MOA of Vincristine
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-bind to B-tubulin, preventing polymeriztion of MT proteins = M phase specific cytotoxicity
-main dose limiting SE is neurotoxicity which commonly manifests as neuropathy |
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Valproate and pregos
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-increases risk of NT defects d/t inhib of intestinal folic acid reabsorption
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Cardiotoxicity d/t TCA overdose
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-quinidine like effect on cardiac conduction system, QRS and QT prolongation w/ cardiac dysrrhythmias d/t inhib of fast Na+ chan
-tx w/ NaHCO3 |
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Bumetaninde
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-Loop diuretic, tx pulm edema, CHF and periph edema
-SE: hypokal, hypomag, hypocal |
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Triamterene
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-K+ sparing
-blocks Na+ in distal tubule and collecting duct |
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Nitroprusside MOA
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-balanced venous and arterial vasodilator
-decreases LV preload and afterload resulting in adequate CO at a lower LVEDP |
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Tx of Acetominophen Toxicity
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-N-acetyl cysteine
-provides sulfhydryl groups and also acts as a glutathionine substitute and binds to the toxic metab NAPQI |
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Meds that Increase serum uric acid levels:
NHCP |
-Niacin
-Hydroclorothiazide -Cyclosporine -Pyrazinamide |
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Rituximab
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-used in lymphoma immunotherapy that specifically targets the CD20 surface Ig
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IL-2
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-regulates the act and differentiation of T cells to aid in tumor cell destruction
-Tx: RCC and melanoma |
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Imatinib
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-potent inhib of the BCR/ABL protein tyrosine kinase
-inhibs the cellular prolif of BCR/ABL expressing cells w/out inducing apoptosis |
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Colchine MOA
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-inhibs leukocyte migration and phagocytosis by blocking tubulin polyermization
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Carbamazepine MOA
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-blocks voltage gated Na+ channels and decreases Ca++ current in thalamic neurons
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Dexrazoxane
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-iron chelating agent that decreases form of O2 free radicals by doxorubicin and is the most effective method of preventing dilated cardiomyopathy in these pts
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Terbinafine MOA
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-inhib synth of ergosterol by inhibiting squalene epoxidase
-tx dermatophytosis |
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Flucytosine MOA
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-transformed to 5 FU in fungal cells
-inhibs fungal protein synth by replacing uracil w/ 5- Fluorouracin in fungal mRNA |
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Where do Neuroleptics block dopamine?
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-mesolimbic-mesocortical (frontal cortex) pathway
-this is hyperactive in schizo |
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Probencid MOA
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-decreased PCT uric acid reabsorption
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Reserpine MOA
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-blocks the storage of adrenergic mediators in presynaptic vesicles
-decreased synaptic cleft [NE] -predisposes to depression b/c depletes NE and serotonin from the presynaptic vesicles of CNS |
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***3 drugs that may causes seizures
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1. Buproprion (antidepressant)
2. Isoniazid (anti-TB, if given w/out B6) 3. Imipenem |
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Spironolactone in HF pts
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-benefits are secondary to inhib of the neurohormonal effects of aldosterone, therefore less ventricular remodeling and cardiac fibrosis
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Cutaneous flushing of niacin is d/t
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-prostaglandins
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Capsaicin
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-reduces pain by decreasing the levels of substance P in the PNS
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Vitamins and Parkinsons Tx
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-B6 increases the peripheral metabolism of Levadopa which decreases its effectiveness
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APA mainstay therapy for acute mania
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-mood stabilizer (lithium, valproate, carbamazepine)
***PLUS*** -atypical antipyschotics (eg olanzapine) |
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Pioglitazone (TZDs)
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-improve insulin resistance by binding to PPAR - Y (transcriptional regulation for genes involved in glucose and lipid metabolism)
-most important gene regulated by PPAR-Y is adiponectin, TZDs increase levels which are low in DM II |
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DOCs for HIT
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-Hirudin, lepirudin, argotroban are direct thrombin inhibitors
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Dipyridamole and Cilostazol
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-inhib platelet aggregation by inhibiting PDE activity and therefore increasing cAMP
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Direct arteriolar vasodilators
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-Hydralazine and minoxidil
-cause reflex symp activity resulting in tachycardia and edema -often given in combo w/ sympatholytics and diuretics |
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TNF A inhibs
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-infliximab, etanercept, adalimumab
-decrease macrophage fxn and may cause reactivation of TB |
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Nitrates in pts w/ stable angina
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-act primarily as venodilators causing DEC in cardiac work by DEC LV filling volume (preload)
***this is the main effect |
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Mannitol MOA
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-works by INC plasma or tubular fluid osmolarity -->INC extraction of H20 from Interstitial space into the vasc space or tubular lumen
-Major SE of severe aggressive osmotic diuretics is pulmonary edema |
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Ethambutol
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-inhib the synth of mycobacterial cell wall
-resistance develops when the mycobacteria INC production of ARABINOSYL TRANSFERASE |
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Foscarnet
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-analog of pyrophosphate that can chelate Ca++ and promote nephrotoxic renal Mg wasting
-results in hypocalcemia and hypomag |
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Gangiclovir major SE
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-a/w severe neutropenia
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Dobutamine MOA
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-relatively selective B1 agonist that INC HR, contractility (this is the only desired effect), conducing velocity, and myocardial O2 consumption
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Adenosine and dipyridamole
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-selective vasodilators of CORONARY vessels
-can lead to coronary steal which DEC blood flow to ischemic areas and leads to hypoperfusion thus potentially worsening the ischemia |
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Prophylaxis for MAC?
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-Azithromycin at CD4+ of < 50
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Clomiphene citrate
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-anti-estrogen that stims ovulation by blocking feedback inhib of estrogen on the hypothalamus--> INC release of pituitary gonadotropins
***use in women w/ ovulatory failure |
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Lithium SE
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-nephrogenic DI by impairing vasopressin stimulated aquaporin mediated reabsorption in the collecting duct
-a RENAL tubular dysfxn |
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CI of metoclopramide
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-commonly used to tx vomiting or gastric stasis
-CI in parkinsons b/c it can exacerbate and trigger EPS d/t antagonistic effect on dopamine receptors |
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Phenylephrine
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-selective alpha 1 receptor agonist that INC TPR and SYSTOLIC BP and DEC pulse P and HR
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Cyclosporine
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-calcineurin inhib that DEC the transcription of the IL-2 gene and therefore DEC activation of T-lymphocytes in response to Ag stim
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CCB and subarachnoid hemorrhage
|
-Nimodipine has been shown to DEC morbidity and mortality d/t cerebral vasopsasm when used as a preventative agent after subarachnoid hemorrhage
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Omalizumab
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-recombinant humanized IgG1 Ab that binds w/ IgE to inhibit actions w/ mast cells
-acceptable add on tx for pts w/ severe allergic asthma |
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Primodine
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-an anti-epileptic that is metab to phenobarbital and PEMA
-all 3 compounds are active anti-convulsants |
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Nifedipine and HTN
|
-causes peripheral vasodilation which may result in reflex tachy and thus is an anti-HTN drug useful in pts w/ bradycardia
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Cidofovir
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-broad spec anti-viral nuceotide analog of cytosine monophos
-***does not depend on the presence of virally encoded kinase (Acyclovir does) to convert to active nucleoside triphosphate form (which comp inhibs viral DNA polymerase) |
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Atropine and organophosphate poisoning
|
-reverses the muscarinic effects but does not prevent the development of nicotine effects such as muscle paralysis
-Pralidoxine is the only medication that reverses both muscarinic and nicotinic SEs |
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Digoxin toxicity
|
-may manifest as a change in color vision and anorexia, ventricular dysarrhythmias, H/A, fatigue and confusion
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Paclitaxel MOA and usage
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-fxns by binding b-tubulin and preventing micrtubule breakdown, thus causing arrest of the cell in the M phase
-therefore prevents stent restenosis by preventing intimal hyperplasia |
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Enfuviride MOA
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-HIV entry inhib agent, fxns by interfering w/ gp41-mediated HIV binding to host cells and cell-cell transmission
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Sotalol MOA and SEs
|
-both Beta blocking properties (causing brady) and Class 3 anti-arrhythmic (K+ channel blocking)
-prolongs both the PR and QT |
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Tx of painful diabetic neuropathy?
|
-TCAs
-duloxetine |
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Etoposide MOA and usage
Podophyllin MOA and usage |
-blocks topoisomerase ability to seal breaks leading to chromosomal breaks
-testicular and small cell cancer -Podophyllin has the same MOA but is used for genital warts |
