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136 Cards in this Set
- Front
- Back
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P450 inducers.
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- quinidine
- barbituates - phenytoin - rifampin - griseofulvin - carbamazepine - st. Johns wart |
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P450 inhibitors.
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- isoniazid
- sulfonamides - cimetidine - ketokonazole - erythromycin - grapefruit juice |
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Antidote for benzodiazepine.
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flumazenil
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Antidote for opioids.
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naloxone
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Antidote for cyanide.
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methylene blue
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Antidote for organophosphate.
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pralidoxime
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Antidote for cholinesterase inhibitors.
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atropine
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Antidote for methotrexate.
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leucovorin
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Antidote for heparin.
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protamine
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Receptors that are coupled to Gq.
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- H1
- alpha1 - V1 - M1 - M3 |
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Receptors that are coupled to Gs.
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- beta1,2
- D1 - H2 - V2 |
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Receptors that are coupled to Gi.
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- M2
- alpha2 - D2 |
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1st line treatment for trigeminal neuralgia.
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carbamazepine
- increase Na channel inactivation |
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1st line treatment for partial seizures in pregnant women and children.
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phenobarbital
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Used for seizures of eclampsia.
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benzodiazepine
- increase GABA action |
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Drug used to treat absence seizure.
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ethosuximide (first line)
valproic acid |
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1st line treatment for acute seizure.
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benzodiazepine
- increase GABA action |
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What is this drug?
- COX-2 inhibitor - toxicity: risk of thrombosis, sulfa allergy |
celecoxib
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Which gout drug is this?
- depolymerize microtubules: impair leukocyte chemotaxis and degranulation |
colchicine
- acute treatment |
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Which gout drug is this?
- inhibit reabsorption of uric acid in PCT in the kidney - also inhibit secretion of penicillin |
probenecid
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Which gout drug is this?
- inhibit xanthine oxidase - interacts with AZA and 6-MP (metabolized by xanthine oxidase) |
allopurinol
- also treat tumor lysis associated urate nephropathy |
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Name this drug.
- low molecular weight heparin |
enoxaparin
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Name this drug.
- directly inhibit thrombin without involvement of antithrombin III |
Hirudin
- lepirudin - bivalirudin |
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Name this drug.
- interferes with gamma-carboxylation of vitamin K dependent clotting factors II, VII, IX, X and protein C and S. |
warfarin
- increase PT - teratogenic |
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Name this drug:
- inhibit platelet aggregation by irreversibly blocking ADP receptors -> inhibit GPIIb/IIIa expression -> inhibit fibrinogen binding - used for coronary stenting, decrease incidence of thrombotic stroke |
- clopidogrel
- ticlopidine |
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Name this drug:
- monoclonal antibody for GPIIa/IIIb |
abciximab
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Name this drug:
- folic acid analog that inhibit dihydrofolate reductase -> decreased dTMP -> decreased DNA synthesis - toxicity: myelosuppression (reversible with leucovorin), fatty liver change |
methotrexate
- used for leukemia, lymphoma - choriocarcinoma - abortion, ectopic pregnancy - RA, psoriasis |
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Name this drug:
- pyrimidine analogue covalently complexes folic acid -> inhibit thymidylate synthase -> decreased dTMP - toxicity not reversible with lucovorin, photosensitivity |
5-FU
- colon cancer - basal cell carcinoma |
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Name this drug:
- block de novo purine synthesis - acitvated by HGPRT, metabolized by xanthine oxidase (toxicity with allopurinol) |
6-MP
- leukemias - lymphomas (not CLL or Hodgkins) |
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Name this drug:
- inhibit DNA polymerase - treat AML |
araC (cytarabine)
- cytotixicity: leukopenia, thrombocytopenia, megaloblastic anemia |
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Name some alkylating agents.
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- cyclophosphamide, ifosfamide: hemorrhagic cystitis (preventable with mesna)
- nitosoureas - cisplatin: nephrotoxicity, acoustic nerve damage - bulsulfan: pulmonary fibrosis, hyperpigmentation |
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Name some intercalating agents.
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- doxorubicin, daunorubicin: cardiotoxicity
- dactinomycin |
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Name this drug:
- induce free radical formation which cause DNA breaks - cause pulmonary fibrosis |
bleomycin
- trsats testicular cancer, lymphomas |
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What is the ABVD regimen used for Hodgkin's lymphoma?
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A: Doxorubicin (adriamycin)
B: bleomycin V: vinblastin D: Dacarbazine |
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Name this drug:
- inhibit ribonucleotide reductase - s phase specific - increase fetal hemoglobin |
hydroxyurea
- used for melanima, CML, sickle cell anemia |
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Name this drug:
- inhibit topoisomerase II, increase DNA degradation - G2 , S phase specific |
etoposide
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Name this drug:
- trigger apoptosis - cause cushing like symptoms, immunosuppression, cataracts, acne, oeteoporosis, peptic ulcers, hyperglycemia, hypertension, psychosis |
prednisone
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Name this drug:
- estrogen receptor antagonist in breast, agonist in bone, partial agonist in endometrium - increased risk of endometrial cancer, hot flashes |
tamoxifen
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Name this drug:
- estrogen receptor antagonist in breast and endometrium, agonist in bone |
raloxifene
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Name this drug:
- monoclonal antibody against HER-2 receptor - cardiotoxicity |
trastuzumab
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Name this drug:
- bcr-abl tyrosine kinase inhibitor |
imatinib (Gleevac)
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Name this drug:
- M phase alkaloids - block polymerization of microtubules |
- vincristine: neurotoxicity, paralysis ileus
- vinblastine: marrow suppression |
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Name this drug:
- M phase agent - hyperstabilize polymerized microtubules |
Paclitaxel (taxols)
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Drug to use in malaria for patients with psoriasis.
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chloroquine contraindicated because it will worsen psoriasis.
should use combination drug - proguanil - atovaquone |
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Treatment for ALS.
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Riluzole: inhibit glutamic neurotransmission
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Mechanism of phenytoin and carbamazepine.
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increase Na+ inactivation
- treat partial seizure (simple complex) - treat generalized seizure (tonic clonic) - phenytoin is also antiarrhythmic IB |
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Mechanism of lamotrigine.
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- block voltage gated Na channels
- treat partial seizure (simple complex) - treat generalized seizure (tonic clonic) |
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Mechanism of gabapentin.
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- increase GABA release
- treat partial seizure (simple complex) - treat generalized seizure (tonic clonic) |
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Mechanism of topiramate.
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- block voltage gate Na channel and increase GABA action
- treat partial seizure (simple complex) - treat generalized seizure (tonic clonic) |
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Mechanism of phenobarbital.
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- increase GABA action
- treat partial seizure (simple complex) - treat generalized seizure (tonic clonic) - used as induction anesthetics - good in kinds and pregnant women |
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Mechanism of clopidogrel.
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- irreversible block ADP receptor on platelet, preventing IIb/IIIa expression
- used in acute coronary syndrome, coronary stenting - toxicity: neutropenia |
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Mechanism of valproic acid.
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- increase Na channel inactivation and increase GABA concentration
- treat partial and generalized seizures (tonic-clonic, absence) - also treat bipolar disorder |
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Mechanism of ethosuximide.
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- block T type Ca channel (thalmic)
- first line for absence seizure - also treat bipolar disorder |
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First line treatment for status epilepticus.
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benzodiazepine (increase frequency of Cl opening)
- diazepam - lorazepam |
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Why is barbituate contraindicated for use of anesthesia in patients with porphyria?
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barbituate induce ALA synthase
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Most common anesthetic drug used for endoscopy.
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benzodiazepines (midazolam)
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Mechanism of dantrolene.
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- prevent release of Ca from SR of skeletal muscle
- used in malignant hyperthermia (halothane) and neuroleptic malignant syndrome (antipsychotics) |
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Signs of neuroleptic malignant syndrome caused by antipsychotics.
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- rigidity
- myoglobinuria - autonomic instability - hyperpyrexia |
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Signs of tardive dyskinesia caused by antipsychotics.
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- stereotypical oral-facial movements (DA receptor sensitization)
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Name some TCAs.
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immipramine
amitryptyline desipramine nortriptyline clomipramine doxepin amoxapine |
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Name some MAO inhibitors.
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phenelzine
tranylcypromine - increase amine neurotransmitters - toxicity: hypertensive crisis with tyramine ingestion |
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What type of drug is this?
- hypertensive crisis with tyramine ingestion - contraindicated with SSRI or merperidine (serotinin syndrome) |
MAO inhibitors
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This MAO inhibitor has more anticholinergic effect.
- can trigger narrow angle glaucoma - good for use in parkison patients |
amytryptyline
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Signs of serotonin syndrome.
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- hyperthermia
- muscle rigidity - cardiovascular collapse |
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Name this antidepressant.
- used for smoking sessation - may cause seizure in bulimic patients - do not cause sexual side effects |
bupropion
- mechanism unknown |
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Name this antidepressant.
- inhibit serotonin, NE, DA reuptake - also used in generalized anxiety disorder |
venlafaxine
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Name this antidepressant.
- alpha 2 antagonist (increase NE and serotonin release) - 5-HT2 and 5-HT3 antagonist - toxicity: sedation, increased appetite, dry mouth |
Mirtazapine
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Name this antidepressant.
- inhibit serotonin reuptake - toxicity: sedation, nausea, priapism, postural hypertension |
trazodone
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This drug is often used in patients undergoing chemo to increase appetite.
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megestrol acetate (similar to progesterone)
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What is this asthma medication? what are some toxicities?
- phosphodiesterase inhibitor - adenosine antagonist |
theophylline
- sinus tachycardia - tremors - seizures |
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Mechanism of this drug:
- ipratopium |
- competitive block muscarinic receptors
- used for asthma prevention and COPD |
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List some 1st generation H1 blockers.
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diphenhydramine
dimenhydrinate chlorpheniramine |
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List some 2nd generation H1 blockers.
these do not cross BBB and have no anticholinergic effect |
loratidine
fexofenadine desloratadine cetirizine |
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Mechanism and toxicity of sulfonureas.
- glipizide - glyburide - glimerpiride |
Mechanism:
- bind to ATP-dependent K channel -> inhibit K efflux -> depolarizing beta cell -> Ca influx to the cell -> increased insulin release Toxicity - hypoglycemia - weight gain - photosensitivity - avoid in severe liver disease |
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Which drug class has similar mechanism as sulfonylurea?
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meglinide
- shorter acting - different binding site on ATP-dependent K channel |
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Mechanism of this drug:
exenatide |
- GLP-1 analogue: stimulate amylin release, inhibit brain center, inhibit glucagon
- treat DM2 |
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Mechanism of this drug:
sitagliptin |
- DDP4 inhibitor: decrease GLP-1 breakdown
- treat DM2 |
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Mechanism of this drug:
pramlintide |
- amylin analogue: slow gastric emptying, inhibit brain center, inhibit glucagon secretion
- treat both DM1 snf DM2 |
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Mechanism of this drug:
alpha-glucosidase inhibitor - acarbose - miglitol |
- inhibit enzymes in small intestine brush boarder and pancreatic amylase -> decreased carbohydrate digestion
- DM2 treatment - contraindicated in IBD |
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Mechanism and toxicity of this drug:
metformin |
- enhance glucose utilization in mucle and liver by increasing glucose transporters at the cell surface
- decrease FFA - toxicity: decrease in B12, lactic acidosis, netallic taste |
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Mechanism of this drug:
thiazolidinediones - rosiglitazone - pioglitazone |
- bind to PPAR -> decrease liptin, increase adiponectin, decreased insulin resistance
- toxicity: risk of fracture in women (osteoporosis) |
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Mechanism of selegiline.
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- MAO-B inhibitor: increase DA
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Mechanism of clozapine.
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- block D4 receptor: treats negative symptoms of schizophrenia.
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Name a drug that treat epileptic encephalopathy.
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felbamate
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Mechanism of paroxetine.
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- selective serotonin reuptake
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Mechanism of baclofen.
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- GABA agonist
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Name a GABA antagonist.
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picrotoxin
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Mechanism of strychnine.
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- glycine receptor blocker
- anticonvulsive |
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Mechanism of phencyclidine (PCP).
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NMDA antagonist
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Treatment for leshmaniasis.
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sodium stibogluconate
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Treatment for toxoplasmosis.
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sulfadiazine + pyrimethamine
- inhibit folate synthesis |
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Drug for MAC prevention.
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azithromycin
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appetite suppressants.
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- fenfluramine
- phentermine cause pulmonary HTN -> RVH -> sudden cardiac death |
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Mechanism of this drug:
- misoprostol |
- PGE1 analogue: increase mucous barrier, decrease acid secretion
- Toxocity: diarrhea, abortifacient |
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Mechanism of this drug:
PPI - omeprazole - lansoprazole |
- irreversibly inhibit H/ATP pump in stomach parietal cells
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Name this drug:
Toxicity - P450 inhibitor - antiandrogenic: increase prolactin, gynecomastia, impotence - cross BBB: confusion, dizziness, headaches - cross placenta |
cimetidine
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Mechanism of this drug:
- ondensetron |
5-HT3 antagonist
- antiemetic - cause constipation, headache |
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Mechanism of this drug:
- metoclopramide |
- D2 receptor antagonist
- prokinetic agent: used for diabetic and post-surgery gastroparesis - toxicity: parkinsonian effect, restlessness - contraindicated in small bowel obstruction |
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Mechanism of this drug:
- infliximab |
monoclonal antibody to TNF cytokine
- used for IBD |
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Side effects of antacids.
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- hypokalemia
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Side effects of this drug:
ethanbutol - inhibit bacterial cell wall synthesis by inhibiting arabinosyl transferase |
- optic neuritis
- red-gree color blindness - peripheral neuropathy - arthralgia - vertical nystagmus |
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Name some short acting benzodiazepines.
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- alprazolam
- triazolam - oxazepam |
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Name some medium acting benzodiazepines.
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- estazolam
- lorazepam - temazepam |
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Name some long acting benzodiazepines.
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- chlordiazepoxide
- clorazepate - diazepam - flurazepam |
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Side effects of this drug:
aminoglycoside - bacteriocidic - inhibit initiation complex formation by binding to 30s |
- ototoxicity
- nephrotoxicity - teratogen |
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Side effects of this drug:
tertracyclin - bind to 30s, prevent attachment of aminoacyl-tRNA |
discoloration of teeth
inhibit bone growth in children contraindicated in pregnancy |
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Mechanism of this drug:
macrolides |
- bind to 50s
- block translocation -> block translation |
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Side effects of this drug:
chloramphenicol - inhibit 50s peptidyltransferase activity |
- anemia
- aplastic anemia - gray baby syndrome (they lack liver UDP-glucuronyl transderase) |
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Why can't you take doxycyclin with milk, antacids, or iron-containing preparations?
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divalent cations inhibit its absorption in the gut
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Mechanism of this drug:
clindamycin |
- block peptide bond formation at 50s
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Name some penicillinase resistant penicillins.
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- methicillin
- nafcillin (for staph) - dicloxacillin |
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Mechanism of penicillin.
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prototype beta-lactam
- bind penicillin-binding protein - block transpeptidase cross-linking of cell wall - activate autolytic enzymes |
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Name this drug:
Mechanism - penicillinase sensitive beta-lactam - combined with clavulanic acid (a penicillinase inhibitor) |
Ampicillin, amoxicillin
- gram positives - gram negative rods: enterococci |
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Medications that can be used to treat pseudomonas.
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- piperacillin
- 3rd gen cephalosporin (ceftriaxone, cefotaxime, ceftazidime) - 4th gen cephalosporin: cefepime - fluroquinolones (contraindicated in pregnancy) |
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Spectrum of 1st gen cephalosporin
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- gram +
- Protus, E. coli, Klebsiella |
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Spectrum of 2nd gen cephalosporin.
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- gram +
- H. infuenza, Enterobacter, Neisseria, Protus, E. coli, Klebsiella, Serratia |
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Spectrum of 3rd gen cephalosporin.
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- gram -: serious infections resistant to other beta-lactams, meningitis
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Spectrum of 4th gen cephalosporin.
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- pseudomonas
- gram+ |
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Mechanism of this drug:
- aztreonam (a monobactam) |
- monobactam resistant to beta-lactamase
- bind to PBP3, inhibit cell wall synthesis - treat gram - rods |
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Spectrum of this drug:
- imipenem (a carbapenem) |
broad
- gram + - gram - - anaerobes - drug of choice for enterobacter |
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Name this antibiotic:
- always administered with cilastatin (inhibitor of renal duhydropeptidase I) to decrease inactivation in renal tubules |
imipenum
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Side effects of this drug:
vancomycin |
- nephrotoxicity
- ototoxicity - thrmobophlebitis - red-man syndrome (diffuse flushing): preventable with antihistamines |
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Name this lipid lowering drug and its side effects:
- HMG-coA reductase inhibitor |
statins
- myalgia - increase liver enzyme |
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Name this lipid lowering drug and its side effects:
- inhibit VLDL synthesis - increase lipoprotein lipase activity - decrease reklease of FFA |
Niacin
- facial flushing and pruritis - increase liver enzymes - avoid in diabetics (increase glucose) - avoid in gout (increase uric acid) - avoid use with statins (increase myalgia) |
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Name this lipid lowering drug and its side effects:
- increase lipoprotein lipase activity - decrease TG |
Fibrates
- gall stones - increase liver enzymes - potentiate warfarin - myosiits - may increase LDL |
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Which lipid lowering drug may increase TG?
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bile acid binding resin
- used in young and pregnant people |
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Name this lipid lowering drug:
- cholesterol absorption inhibitor |
ezetimibe
- do not use with liver disease - may cause gall stones |
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Name this lipid lowering drug:
- inhibit acyl coA - decrease macrophage storage of cholesterol |
avasimibe
- does not reduce cholesterol levels - just prevent plaque formation |
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Name some digoxin toxicity.
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- AV block
- ventricular tachycardia - hyperkalemia - yellow halo arround eyes |
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Treatment for iron poisoning.
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deferoxamine
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Side effect:
- methotrexate |
- myelosuppression (reversible with leucovorin)
- liver toxicity: fatty liver |
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Side effect:
- 5-FU |
- myelosuppression (not reversible with leucovorin)
- photosensitivity - can rescue with thymidine |
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Side effect:
- cyclophosphamide |
- hemorrhagic cystitis (prevented with mesna)
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Side effect:
vincristine |
- peripheral neuropathy
- paralytic ileus |
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Side effect:
imatinib (gleevac) |
fluid retention
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Side effect:
trastuzumab (HER2 antibody) |
cardiotoxicity
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