Usmle Pharm Flashcards

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Abciximab

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Monoclonal antibody to fibrin receptor (glycoprotein IIb/IIIa) on platelets. Used to prevent clotting after coronary angioplasty

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Acetaminophen

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Antipyretic analgesic: very weak cyclooxygenase inhibitor; not anti−inflammatory. Less toxic than aspirin but more dangerous in overdose (causes hepatic necrosis−antidote: acetylcysteine)

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Acetazolamide, dorzolamide

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Carbonic anhydrase inhibitor diuretic: produces a NaHCO3 diuresis, results in bicarbonate depletion, and therefore has self−limited action. Used in glaucoma and mountain sickness. Dorzolamide is a topical analog for glaucoma

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Acetylcholine

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Cholinomimetic prototype: transmitter in CNS, ENS, all ANS ganglia, parasympathetic postganglionic synapses, sympathetic postganglionic fibers to sweat glands, and some skeletal muscle vasodilator synapses

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Acyclovir

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Antiviral: inhibits DNA synthesis in herpes simplex and varicella zoster. Requires
activation by viral thymidine kinase (TK− strains are resistant). Tox: behavioral effects and nephrotoxicity (crystalluria), but not myelosuppression

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Adenosine

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Antiarrhythmic: unclassified ("Group V"); parenteral only. Hyperpolarizes AV nodal tissue, blocks conduction for 10−15 sec. Used for nodal reentry arrhythmias

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Allopurinol

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Antigout: inhibitor of xanthine oxidase; reduces production of uric acid

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Albuterol, metaproterenol, terbutaline

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Important β2−agonists; used mainly for asthma.

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Alprazolam

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Benzodiazepine sedative−hypnotic: widely used in anxiety states, selectivity for panic attacks and phobias; possible antidepressant actions. Tox: psychologic and physical dependence, additive effects with other CNS depressants

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Alteplase (rt−PA)

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Thrombolytic: human recombinant tissue plasminogen activator. Used in acute MI to recanalize the occluded coronary. Occasionally used in pulmonary embolism, stroke. Tox: bleeding

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Amiloride

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K+−sparing diuretic: blocks Na+ channels in cortical collecting tubules

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Aminoglutethimide

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Nonsteroid inhibitor of steroid synthesis: reduces conversion of cholesterol to the hormone precursor, pregnenolone. Used in metastatic breast cancer

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Amiodarone

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Group IA and III antiarrhythmic: broad spectrum, blocks sodium, potassium, calcium channels, beta receptors. High efficacy and very long half−life (weeks−months). Tox: deposits in tissues; hypo− or hyperthyroidism; pulmonary fibrosis

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Amitriptyline

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Tricyclic antidepressant: blocks reuptake of norepinephrine and serotonin. Tox: atropine− like, postural hypotension, sedation; cardiac arrhythmias in overdose, additive effects with other CNS depressants

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Amoxicillin

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Penicillin: wider spectrum than pen G with activity similar to ampicillin but greater oral bioavailability; less adverse effects on GI tract than ampicillin. Susceptible to penicillinases unless used with clavulanic acid. Tox: penicillin allergy

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Amphetamine

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Indirectly acting sympathomimetic: displaces stored catecholamines in nerve endings. Marked CNS stimulant actions; high abuse liability. Tox: psychosis, HTN, MI, seizures

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Amphotericin B

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Antifungal: polyene drug of choice for most systemic mycoses; binds to ergosterol to disrupt fungal cell membrane permeability. Tox: chills and fever, hypokalemia, hypotension, nephrotoxicity (dose−limiting, possibly less with liposomal forms)

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Ampicillin

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Penicillin: wider−spectrum than pen G, susceptible to penicillinases unless used with sulbactam. Activity similar to pen G, plus E coli, H influenzae, P mirabilis, Shigella. Synergy with aminoglycosides versus enterococci and listeria. Tox: penicillin allergy; more adverse effects on GI tract than other penicillins; maculopapular skin rash

*Drug of choice for Lysteria monocytogenes
*Enterococci
Resistance:
*Klebsiella (inherent)
*H. influenzae (emerging)
*E. coli (emerging)

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Pen G activity:
*Gram (+) cocci (Strep)
*Gram (-) cocci (Neisseria)
*Gram (+) bacilli
*Spirochetes (drug of choice for syphilis)

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Anistreplase (APSAC)

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Thrombolytic: bacterial streptokinase complexed with human plasminogen. Longer acting in body than other thrombolytics (rt−PA, streptokinase, urokinase). Tox: bleeding, allergy to streptococcal protein

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Aspirin

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NSAID prototype: inhibits cyclooxygenase (COX) I and II irreversibly. Potent antiplatelet agent as well as antipyretic analgesic anti−inflammatory drug

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Atenolol

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Beta1−selective blocker: low lipid solubility, less CNS effect; used for HTN. (Note mnemonic for beta1−selective blockers: their names start with A through M. [Exceptions: carteolol & labetalol are not selective])

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Atropine

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Muscarinic cholinoceptor blocker prototype: lipid soluble, CNS effects. Tox: "red as a beet, dry as a bone, mad as a hatter," urinary retention, mydriasis

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Azithromycin

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Antibiotic: similar to erythromycin, but greater activity versus chlamydia and streptococci; long half−life due to tissue accumulation. Tox: GI distress, but no inhibition of drug metabolism

Most common uses = Community Acquired (CA)-pneumonia & genital infections

Effective:
*CA-pneumonia (mycoplasma, chlamydiae, legionella, mild S. pneumoniae)
*Chlamydia trachomatis (PID, urethritis, cervicitis—doesn't treat Neisseria gonorrhea [GC]!)
*Protects contacts in pertussis cases
*Campylobacter gastroenteritis
*Helicobacter pylori (w/ other drugs)
*Bartonella (e.g., Cat-Scratch disease)
*Non-TB mycobacteria (M avium, M Kansasi, M scrofulaceum)
*Second-line for:
-syphilis
-URIs (M catarhalis, H influenzae, S pneumoniae)
-GAS pharungitis
Resistance:
*S pyogenes (common)
*S pneumoniae (common)
*N. gonorrhea
(inherent?)

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Baclofen

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GABA analog, orally active: spasmolytic; activates GABAB receptors in the spinal cord

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Benztropine

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Centrally acting antimuscarinic prototype for parkinsonism

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Bethanechol

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Muscarinic agonist: choline ester with good resistance to cholinesterase; used for atonic bowel or bladder

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Botulinum

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Toxin: enzyme produced by Clostridium botulinum; interacts with fusion/docking proteins to block release of acetylcholine vesicles

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Bromocriptine

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Ergot derivative: dopamine agonist in CNS; inhibits prolactin release. Used in parkinsonism and hyperprolactinemia. Tox: CNS, dyskinesias, hypotension

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Bupivacaine

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Long−acting amide local anesthetic prototype: greater CV toxicity than most local anesthetics

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Buspirone

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Anxiolytic: atypical drug that interacts with 5HT1A receptors; slow onset. Minimal potentiation of CNS depressants including ethanol; negligible abuse liability

Used for General anxiety disorder