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239 Cards in this Set

  • Front
  • Back
alpha 2 agonist
decrease SANS outflow , AE- edema and CNS dep , DI- TCA decrease antiHTN effects
clonidine
alpha 2 agonist, opiate withdrawal
methyldopa
alpha 2 agonist, HTN in preg women , AE- + coombs
reserpine
intereferes with storage vesicles, SEVERE DEPRESSION, increased GI secretions
guanethidine
inhibits NE release, AE- TCA block reuptake
alpha 1 blocker
decrease arteriloar ad venous resiscntace, reflexc tachycarida, -zosin, USE- HTN and BPH, AE- orthostatic hypotention and urinary incon, good lipid profile
B blockers
CI- diabetics, vasopsoams, asthma
hydralazine
decrease TPR via arteriolrar dilation,SLE like syn, use for pregnancy , act via NO2
nitroprusside
AE- CN toxicity, use- HTN emergecy , act via NO2
minoxidil
arteriolar vasoldation, open K channles , USE- male baldness(rogaine) AE- diabetogenic(decreases insulin)
CCBs
antiartyhmic, HTN, angina, AE- ginigival hyperplasia(dipines), verampil
verampil
CCB that works on hrt , AE- constipation
DIPINE
CCB that works on blood vessel
dialtezam
CCB that can work on hert and blood vessel
captopril
ACEI, blocks form of Ang II, AE- dry cough, hyperkalemia, ARF, angioedema , USE- mild to mod HTN, CHF
losaratan
block AT1 receptor, no dry cough , USE- mild to mod HTN, CHF
aliskerin
renin inhibitors, no dry cought, USE- mild to mod HTN
ANTI HTN in angina
B blockers, CCBs
ANTI HTN in diabetes
ACEI, ARBs
ANTI HTN in HF
ACEI, ARBs, Beta blockers
ANTI HTN in post MI
B blockers
ANTI HTN in BPH
alpha blockers
ANTI HTN in dyslpipidemia
alpha blockers, CCBs, ACEI/ ARB
Bosetan
vasoconstrictior, CI- pregnancy ,USE- pu; HTN
epoprosteronol
infusion pump for pul HTN
sildenafil
PDE inh, increased cGMP, USE- pul HTN
methoxamine
paraxysmal atrial tachycarida through vagal refelx
isoproteronol
B1 and B3 agonist, USE- bronchospasm and AV block, AE0 flushing
Dobutamine
B1 agonsit, USE- CHF
selevctive B2
salemterol, albuterol, terbutaline used in asthma
methy phenidate
use in narcolepsy and ADHD, displaces NE from mobile pool
reuptake inhibitor
cocaine and TCA
mirtazapine
selective alpha 2 blocker, used as antidepressent, increases appetite- USE- anorexia
timolol
glaucoma , blocks action of NE, decrease aqueosu humor formation, for open glucoma
propranol
thyrotoxicosis, performance anxiety, essential tremor , essential trempor, agoraphobia, social phobia
sotalol
K channel blocking and B blocking , slows phase III, B 1 blockage, USE- life threatening ventricular arrthmias
pilocarpine
increases aqueous humor outflow, for glaucoma , M3- ocntraction of cilirary muscle
Quinidine
cinchonism(GI, ocular dysfunction, CNS exlciation), torsades, DI- hyperkalemia, toxic with digoxin, Class IA
procainamide
IA antiarrthmic, AE- SLE like syn, torsades , hematoxcity, thrombocytopenia
IA antiarrthmic
block open or activated state Na channels
IB antiarrthmic
preference for damaged tissue, prefers partially depoalzied tissue, lidocaine, mexiletene
lidocaine
IB, post MI, AE- sexiures, less cardiotxoicity
mexiletine
IB antiarrthmic
flecainadie
IC, increased sudden death,
esmolol
IV, acute SVTs, beta blocker
B blocker as antiarthmcis
prophylasix post MI, SVTs , decrease slope of phase 4 of AP in SA node
Ventricular arrthmias
IA, III
SVTs
II, IV
III antiarthmics
decreas IK(delayed rectified) sloe down phase 3, amiodarone, sotalol
amiodarone
I, II, III, IV, long half life, AE- pul fibrosis, hepatoxicity, thyroid dysnfcion, blue skin( high Vd)
adenosine
DOC for paroxysmal supraventricualr tachycardias and AV nodal arrythmias, short half life
Magnesium
USE- torsades
digoxin
inh of cardiac Na K ATPase, increased intracellular CA, increased contractile force , inhibition of neuronal NaK ATPase-->increased diastolic filing, INCREASED CONTRACTILITY , long half life, large tissue protein bomding, USE- CHF, SVT, AE- anorexia, CNS, arrthmias, MANGEMENT- Fab antibodies
inamironone and milrinoine
increase cAMP in hrt, increased ionotropy, increased cAMP in smooth muscle--> decreased TPR
Nesiritide
recomb BNP, increased cGMP , use for acute decompensated CHF
nitroglycerin
AE- orthostatic hypertension, tachyphylaxis, cadiotox with digoxin, USE- angina
nefidipine
CCB used for vaspospastic angina
carvedilol
angina of effort
ranolazine
blocks late inward Na current in cardiac myocytes decreasing Ca acculumation( Ca accumulates in ischemic tissue to due increased Na)
theophylline
PDE inhibitors, tx for status epilepticius, AE- carditoxicity
Acetazolamide
CA inh in PT, decreased H in PCT, increased Na and HCO3 in lumen,USE- galucoma, acute mountain sickes, metabolic alkalisis, AE- ACIDOSIS, RENAL STONES, SULFONAMIDE HYPERSENSITIVTY , dx- INCREASED HCO3 in urine
Mannitol
inhbits water reabsortions through out the tubule, increased urine volumne
Ethacrinic acid
loop diurecti, no allergies to sulfanamide, INCREASED Ca in urine
Furosemide
loop diurecti, allergies to sulfanamide, INCREASED Ca in urine , USE- acute pul edema
Thiazides
Na Cl transport inhibitor in EARLY DISTAL, USE- calcium stones, AE- HYPERCALCEMIA, nephrogenic DI , CI in diabetics but can be given as antihypertinces(works well with AA men) , drugs- indapamide, metolazone, hydrocholrothiazide
Spironolactone
early collecting duct , aldosterone antagonist, uSE- antiandrogenic, CHF, AE- hyperkalemia+acidosis
Amiloride and triamterone
Na channel blockers, USE-LI induced nephrogenic diabetes(amiloride), AE- hyperkalemia+acidosis
Loops
Na/K/Cl transport inhibitor in ASCENDING LIMB, INCREASED Ca in urine , ethacrinic acid, furosemide , USE- acute pul edema, ARF , AE- otoxicity, DI- aminoglycosides(increased otoxictiy), lithium, digoxin
lovastatin
HMG CoA reductase, MOA- decreased VLDL synthesis and decreased LDL, AE- rhabdomyolysis, hepatoxicity, DI with gemfibrozil(increased rhabdomyolsis), increased toxcitiy with CYP 450 inh
cholestryamine and colestipol
bile acid sequenstrant, increaed LDL expression, AE- increased VLDL and TAGs, MALABSORPTION OF FAT SOLUBLE VITAMINS , CI- hypertriglycerderimia
niacin
inhibition of VLDL syntehsis, decreased VLDL, AE- intesse PRURITIS made better with aspirin
gemfibrozil, fenofibrate
fibrates, bind to PPAR alpha and increase expression of lipoprotein lipases, increases HDL in most pts, USE- hypertriglycedemia, AE- gall stones, myositis
ezetimibe
prevents intestinal reabsorption of cholestrol
drug for increased cholestrol
cholestryamine, colestipol, ezetimibe
drug for increased TAG
gemfibrozil
drug for increased cholestrol and triglycerides
statins, niacin, ezetimibe
alprozolam
anxiety, panic phobias
diazepam
anxiety, muscle relaxant
lorazepam
anxiety, status epilepticus , not metabolized by liver
midazolam
preop sedation, anesthesia
teazepam and oxazepam
sleep disorder benzo , not metabolized by liver
phenobarbitol
barbituate, DOC for epilepsy during pregnancy
thiopental
short acting, anesthesia, barbituate
zolpidem and zaleplon
BZ1 receptor agonist, sleep disorders(less effect on cognition)
barbituates
CYP inducer, CI in porphyria
busipirone
5HTA partial agonist, used for GAD
methanol
results in formaldehyde- irreversible tisue damage, ocular damage, resp failure
ethylene glycol
reumts in production of oxalic acid, nephrotoic acid, CNS depression
ethanol
results in acetic acid, acetaldehyde combines with folate to inactivate it, combies with thiamine to decrease availability
disulfiram
inhibits acetaldehyde dehydrogenase, similar rxn with- metronidazole, griseofulvin, cefoperazone, cefotetan, chlorpropramide
chronic alcoholism
msucle wasting, gout, fatty liver, hypoglycemia
Phenytoin
blocks Na channel in their inactivated state, USE- seziures except absence, PK- zero order kinetics, AE- gingival hyperlasia, hirsuitism, osteomalacia, megaloblastic anemia, TERATOGENIC( cleft lip and palate)
Carbamazepine
blocks Na chaniinel in activated state, DOC- trigem neuralgia, used for manic bipolar disorder, PK- CYP 450 inducer, AE- INCREASED ADH, steven johnson syndrome, TERATOGENIC( spina bifida and cleft lip and palate)
valproic acid
GABA transaminas inibitor, blcokage of T type Ca channels, USE- migraine prophylaxis, mania of bipolar disorders, AE- pancreatitis, alopecia, TERATOGEIC( spina bifida)
Ethosuximide
blockage of T type Ca, USE- absence seizure, AE- decreased efficacy of oral contraceptives via CYP induction
felbamate and lamitrigine
block Na channels and glutamate receptors , AE- hepattoxcitiy and aplastic anemia(felbamate), steven johnson( lamotrigine)
gabapentin
increased GABA effects, USE- neuropathic pain
NO2
diffusion hypoxia, spon abortion, low blood gas, rapid onset and recovery, high MAC
halothate
low MAC, higher blood gas ratio, malignant hyperthermia, cardiac arrythmias
profol
antiemetic, anesthesia- initation and maitaines
fentanyl
opiate, anesteha
ketamine
dissociative anethesia, NMDA receptor antagonist, hallucination, increased ICP, vivid nightmares
felbamate
anesthetic blocking NMDA receptor
tetrodotoxin
puffer fish. Block inactivated Na channels, decreased Na influex
ciguatoxin
bind to activated Na channle, cause inactvation, prolong Na influx, desesensitixe and inactivate
esters
procaine, cocaine, cause allergeis due to PABA(paraaminobenzoic acid)
amides
lidocaine, bupivacaine
local analgesics
nonionized form crosses axoimanl membrane, from within ionized form blocks the inacticated Na channel, slows recovery and prevents propogation of action potentials, esters and amides, AE- cadiotxoic,, neruotoxic
cocaine
vasocontiction by blocking NE uptake
tubocurarine
competitive, non depol, reversible with AcHE, no CNS effects
Atracurium
nondepol blocker, safe in hepatic and renal impariment because spon inactiavation to laudanosine( this could cause seizures)
mivacurium
short duration nondepol blockers
succinylcholine
nicotinic agonist, noncome depol blocker, no effect of AchE when desenstivzed, AE- malignant hyperthermia, hyeperkalemia, genetic polymorphism(slow metabs could be problematic)
baclofen
GABA B receptors, use for spasticity
dantrolene and bromocriptine
tx for malig hyperthermia
MAC
lower MAC- more potennt
blood gas ratio
high- slower onset and slower recovery
IV anethetics
thiopental, midozolam, propodol, fentanyl, ketamine
dantrolene
blocks Ca release from muscle SR, tx for NMS
CI in opids use
head injuries, pul dysfunction(except pul edema), hepatic and renal dysfucntion, adrenal or thyroid def, pregnancy
meripridine
opioid full agnosit, antimuscardinic, met to normepridine-->serotonin syndrome and seziures
methadone
maintains opioid addiction
codeine
cough supressant
dextromorphan
opid related, cough supressant
loperamide
opoid rel, diarrhea
opidoid management of withdrawal
methadone and clonidine(decreases NE release)-->decreases SANs response
opoid mgmt of acute txocitiy
IC nalazone
opoid withdrawal
yawning, lacrimation, salivation, rhinorea, CNS origin, pain, anxiety, sweating, G I coulple, u- strongest
nalbuphine and pentazocine
K agonist- spinal analgesia and dysphoria, u antagonist- preciptation of withdrawal
naloxone
opoid antagonist, IV, reverse resp dep
naltrexone
decrease craving of alc and opiate addiction
methylnaltrexone
opioid anatgonist, opioid rel constipation
DA agonist
dyskinesia(hyper movement)
DA antagonist
pseudoparkinsosm(nigrostriatal) , gynecopastia, amenoreha/galactorreha (tuveroinfedibular)
mesolimbic pathway
cell bodies in midbrain, reiforcement of behavior increased DA in nucelus accumbens
amporphine
DA agonsit, emetic
D1
Gs
D2
Gi
D2A
nigrostriatal
D2C
mesolimbic , clozapine
levodopa
prodrug, converted by decarbozylase, give with carbidopa(inhbits peripheral decarboxylase) AE- dyskinesia, psychosis, hypotension
tolcapone and entacapone
inhibit COMT and enhances uptake and effciacy, tolcapone- hepatoxic
seleginine
MAO B selective inhbitor, NO TYRAMINE INTERACTION AE- dyskeniea, psychosis, amnesia(met by aphetamine- will test + in drug test)
bromocriptine
hyperprolactinoma and acromegaly , DA receptor acgonist , AE- psychosis and dyskinesia
pramipexole and ropinirole
DA receptor agonist
benztropine, trihexyphenydyl, diphenhydramine
decreases Ach function, muscarinic blocker, decreases tremor and rigidity, AE- antimuscarinic(atropine like)
amantidine
antiviral, blocks muscarinin increased DA release, AE- LIVEDO RETICULARIS
antimuscarinic use in psychosis
for acute EPS( pseduoparkinsonism, akathesia, dystonia)
atypical antipsychotic
chronic EPS for tardive dyshyemia
antipyschotic AE
EPS, dysphoria(decreases compliance), endocrine( NMS, increased prolactin, wt gain) , hypotnesion due to alpha blockage
Typicals
chlorpromazine, thioridazine, fluphenazile, haloperidol
atypicals
clozapine, olanzapine, risperidone, aripiprazole
thioridiazine
better antimusacrin, incrased sedation, increased alpha blockate, cardiac toxicity(quinidine like), retinal deposits, allergies , typical antipsych
haloperidol
NMS and TD, typical antipsych
clozapine
block D2C and 5HT2, AE- agranulocystosis, NO TD, increased salivation(due to serotnin) , seziures(due to antimuscarinic) , atypical antipsychotic
olanzapie and risperidone
atypical, blocks 5HT2 improves negative symptoms
aripiprazole
partial agonist of D2, blocks 5HT2 receptors
phenelzine and tranylcypromine
MAOI , use- atypical depression, AE- HYPERTENSIVE CRISSI, DI with tyramine, TCA, levodopa, alpha 1 agonist, SEROTONIN SYN
serotonin syn
sweating, rigidity, myoclonus, hyperthermia, ANS instabiliy, seizures , Drugs- SSRI, TCA, meperidine
TCA
amitriptiline, imipramine, clomipramine, non specific block of 5HT and NE, DI- hypertensive crisis with MAOI, seronin syn, AE- 3 Cs(coma, convusion, cardiotoxic)
clomipramine
TCA for OCD
amytriptyline
TCA for neuropathic pain, can also use carbemazepine
imipramine
decreased slow wave sleep, works on phase IV of sleep, night terrors
fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine
slective blockade of 5HT reuptake , USE- depression, anxiety, DI- CYP inh(fluvoxamine and fluxetine), benzo
citalopram
safe for interactions
trazodone
5HT agonist, AE- arrthmias, pirapism
venlafazine
nonselective reuptake blocker devoid of ANS effects
buproprion
DA reuptake blocker, used in smoking cessation
Mirtazapine
alpha 2 antagonist, wt gain and anorexia
lithium
DOC for bipolar, decreases PIP2 and camp, AE- life threatining sezures, hypothyroidsimwith goiter(decreased TSH), NDI(decreased ADH)- tx with amiloride, chronic thazide decreases clearance of LI, use K sparing, teratogenic(ebsteins- malformed tricuspid)
methylphenidate
amphetatime like, AE- cardio toxicity, use- ADHD
atomoxetine
selective NE reuptake inhibitor, USE- ADHD
amphetamine
block reuptake of NE and DA, relase amines from mobule pool
benzo toxcitiy
tx with flumazenil, cant use for barbituate toxcitiy
benzo MOA
potnetiate GABA with GABA A (BZ1 and BZ2)
barbituate+ alcohol
lif threatening seziure
marijuana
interact of CB 1 and CB2
PCP
NMDA antagonist, AE- rhabdomylosysi, convulsions and edeath
ketamine
hallucinations, glutamate receptro antagonist
MDMA
5HT, excstasy, raves
inhanats
solvent abuse, multiple organ damage
macrolides
erythromycin, azithromycin clarithromycin, USE- g+, atypicals, C jejuni, MAC, H pylori, CYP inh, AE- stim gut motilin
clarithromycin
macroline with less GI symptosm
azitrhomycin
macrolide with least CYP inh , H pyroli
telitrhomycin
ketoline, macrolide resistn S pneumona
clindamycin
not macrolide but same mechanism and resistance, G+, b fragilis and anarobes, use in osteomylitis with g+, AE- C DIFFICLE COLITIS
linezolid
MOA- inhibits initation complex in bac translation, prevents formation of tRNA complex, USE- tx for VRSA and VRE, drug resist penumoccoa, 50 S
quinupristin-Dalfopristin
50S, like tetracycline, streptogramins, binding to 50S prevent interaction of amino acyl tRNA with acceptor site , USE- VRE, VRSA
sulfonamides
inhibit dihydropteroate synthetase , DON’T USE ALONE- resistance
trimethoprim and pyrimethamine
inhibit dihdrofolate reductase , Bone marrow suprresion, problemtatic in HIV pts
sulfasalazine
ulcertative coilitis and rheumatoid arthritis
Ag sulfadiazine
burns
GI conjugases
carbamezipine and phenytoin, allows for transport of folate
cotrimoxazole
trimethoprim-sulfamethoxazole, DOC for nocardia, listeria, g- infections, g+ infections, PCP, toxoplasm, AE- allergies, take with lots of water( to avoid stones), kernicterus in babeis, phototoxciiy
chloramphenicol
bacteriostatic, met by hepatic glucorination, CYP inh, dose dep marrow supreesion, back up for salmonella and ricettksa, AE- GRAY BABY SYN
Doxycyline
lipid soluble, proststis(gonorhea+chlamydia, boreilla , hepatic met
minocycline
menigicoocal carrier state( rifampin more frequent- organge body fluids)
Demeclocycline
SIADH
tigecycline
MRSA and VRE skin and complicated infections
ADH
increased by carbamazepine, decreased by LI , decreased by demeclocyline
tetracycline
chelators, bacteriostatic, borad- atypicas, h pylori, ricketsia, boreilla, brucella, vibrio, treponema(back up) , AE- tooth enamel dysplsia and decreased bone , CI in preggers( liver issues)
drugs that cause photoxicity
tetracucline, sulfonamide, quinolones
gentamicin, tobramycin, amikacin, streptomycin
aminoglycosides, AE- nephrotoxicity(ATN) , otoxicity, NEUROMUSCLAR BLOCKADE , once daily dosing
streptomycin
TB, DOC for bubonic plague and tularemia
CI in pregancy
aminoglycosides, fluroquinolones, sulfonamides, tetracycline
aminoglycosides(30S), linezolid(50S)
interenes with initiation, misreading of code(aminoglycosdies only- cidal)
tetracycline (30S)and dalfopristin/quinupristin (50S)
blocks attachemnt of aminoacyl tRNA to acceptor site(static)
chloramphenicol (50S)
inhibit the activity of peptidyl transferase(-static)
macrolides and clindamycin (50S)
ihibits translocation of peptidyl tRNA from acceptor to donor site
otoxoic
aminoglycosides, loop diuretics(ethycrinic acid more) , vancomycin
vancomyci
binds Dala Dala and hinders the transglyclation and invovlved in the elognation of peptidoglycan chains, NO ROLE IN PBPs, USE- MRSA, enterococci C difficiel(not DOC, metronizadle is) , resistance- termanial Dala is replaced by D lactate, orally for colitis, AE- red man syndrome, otoxotic
aztreonam
resistant to B lactmases, no cross allogeniencity, ONLY G-
Imipenem and Meropenem
Reistant to B lactams, nosocmial epiric for life threathening, give with CILASTATIN to prevent RENAL TOXCITIY , USE- enterobacter and pseudomonas, AE- seizures
cefazolin, cephalexin
first gen cephalosporin, surgical prolylacis, g+, NO ENTRY INTO CNS, long half life
cefotetat, cefaclor, cefuroxime
second gen cephalospin, cefuroxime enters CNS
ceftriazone, cefotaxime, cefdinir, cefixime
g+, g- rods and coci, epiric for menginitis and spesisi
cefipime
IV, reistant to beta lactamase, wide spect, enters CNS
cefoperazone, ceftriazole
bile eleminated
cefotetaan, cefoperazone
disulfiram like
inhibition of bacterial cell well synthesis
pencillins, cephalosporin, imipenem/meropenem, aztrenam, vancomycin
ihibitoion of bacterial protein sysntehsis
aminoglycosides, chloramphenicol, macrolindes, tetraclylines, strepgtamins, linezolid, clindamycin
inhibition of nucelic syntehsis
fluoroquinilone, rifampin
inhibition of folic acind syntehsis
sulfonamide, trimethoprim, prymethamine
pencillin and cephalosporins reistance
production of B lactamases, which cleave the beta lactam ring structure, change in PBPs, change in porin
aminoglycosides resistance
conjugate rxns that transfer acetyl, phosphoryl, adenyl groups
macrolides resistance
formation of methyltransferases that alter drug binding sites on 50S, active transport out of cells
tetracyclines resistance
increased pumping drug out of cell
sulfonamides resistance
change in sensitivty of inhibiton of target enzyme, increased PABA formation, exogenous folic acid
fluroquinilone resistance
change in sensivity to ninhbition of target enzymes, increased activity of transport systems that promote drug efflux
chloramphenicol resistance
formation of activating acetyl transferase
pencillin
interacts with cytoplasmic membrane binding proteins to inhibit transpeptidation reaction invovled in cross linking, AE- hypersensivity, interstitial nephritis with methicillin, JHR rxn with tx of syphulis(flushing joint pain, proof tht drug is working- used to be assessment too in olden days)
nafcillin, methicillin, oxacimmin
betalacatase resistant, staph
benzathine
long acting , pencillin G
amoxicillin
boreilla, H pylori
ampicllin
listeria
ticarcillin, piperacillin, azlocillin
extended spectrum, antipseudomonal, betalactamase sensitive
clavunic acid and sulbactam
irreversible B lactamase inhibitors
naficillin and oxacillin
eliminated via bile