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134 Cards in this Set

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Phenobarbital

(Luminal)
Dose: 100-200mg/day
TR: <40mcg/mL
SE: macro anemia (folic def.), rash, SJS, 3A4 inducer
Primidone
(Mysoline)
Met: Hepatic into Phenobarbital
Phenytoin
(Dilantin)
Dosing: 5mg/kg/day
TR: Free 1-2mcg/mL
PK: Met fosphenytoin (1.5:1), highly protein bound, 3A4 inducer
SE: >50mg/min decrease BP and thombopleb, macro anemia, SJS, gingival hyperplasia, lupus-like syndrome
Carbamazepine
(Tegretol), for bipolar (Equetro)
Dosing: 300-600 BID-TID
TR: 6-10mg/L
SE: hep, BMS-R,W,T-->aplastic anemia, SIADH, hypoNa, SJS
PK: 3A4 inducer/substrate, autoinducer 1st month
Ethosuximide
(Zarontin) for Absence Seizures
Dosing: 500mg/day, increase 500mg/wk-->2gm
TR: 50-100 mcg/mL
SE: BMS-W, rash, lupus-like, hiccups
Valproic acid/Divalproex
(Depakene, Depakote)
PK: 50-100 ug/L-->5gm/day
SE: hep, pancreatitis, BMS-T, change menstrual, SJS, alopecia, wt gain
Gabapentin
(Neurontin)
Dosing: Max 3.6gm, renal decrease dose
SE: weight gain, edema
Topiramate
(Topamax)
SE: met. acidosis, kidney stones, glaucoma
Levetiracetam
(Keppra)
SE: renal
Metabolic Acidosis
Methanol
Uremia
DKA
Paraldehyde
Isopropyl
Lactic Acidosis
Ethanol
Salicylates
MAO Inhibitors
SE: Tyramine--> HTN crisis
Drugs: tranylcypromine (Parnate), Phenylzine (Nardil)
TCAs
NE>5HT
SE: arrythmias, anticholinergic
Drugs: Amoxapine (Ascendin), Amitriptyline (Elavil), Nortriptyline (Pamelor, Aventyl)
Tetracyclines
5HT>NE
Mirtazepine (Remeron)
SE: appetite stimulant, sedation
SSRI's
Fluoxetine (Prozac): increase t1/2, wt gain, bleeds
SE: flu-like
APs
SE: increase ST-seg, orthostasis, BMS-W(clozapine), increase BS
EPS
Tx: Antichols, Benztropine (Cogentin), Benadryl, trihexyphenyldate
TD
Tx: Vit E
Dystonia
Tx: Antichol
Akathesia
Tx: Antichol, BBs
NMS
Neuroleptic Malignant Syndrome
Tx: DA agonist (bromocriptine, amantadine, dantrolene)
Non-acetyl Salicylates
Choline (Arthrogen), Salsalate (Disalcid), Diflurisol (Dolabid)
SE: NO platelet effects, rarely GI
Morphine
(Avinza and Kadian)
PK: active metabolite increase in renal dysfx
Fentanyl
Patch: Duragesic, Lozenge: Actiq, Efferv. Tab: Fentone
DI: azoles, clarithromycin increase levels
Non-biologic DMARDS
Methotrexate (Rheumatrex)
Lefluonamide (Arava)
Hydroxychloroquine (Plaquenil)
Sulfasalazine (Azulfidine)
Cyclophosphamide (Cytoxan)
Azathioprine (Imuran)
Cyclosporine (Neoral)
Minocycline (Minocin)
Biologic DMARDs
Infliximab (Remicade)
Etanercept (Enbrel)
Adalimumab (Humira)
Drugs that cause Hyperuricemia
Niacine, thiazides, low-dose ASA, pyrazinamide, Ethambutol, cyclosporine, antineoplastics
Colchicine
(Colcrys)
PK: decrease dose with renal dysfx (hemorrhagic gastroenteritis)
Allopurinol
(Zyloprim)
SE: BMS-W, SJS, may precipitate acute gout attack
PK: renal dysfx (blood dyscrasia, SJS)
COPD Treatment
Bronchodilators (Albuterol or ipratropium), ICS
Asthma Treatment
PRN albuterol, ICS, LABA
End of therapy: montelukast, theophylline
SABA
Albuterol (Proventil), Levalbuterol (Xopenex)
SE: increase HR, decrease K/Mg, Increase BS, tolerance
LABA
Salmeterol (Serevent), Formeterol (Foradil)
Anticholinergics
Ipratropium (Atrovent), Tiotropium (Spiriva)
1st line COPD
SE: Increase HR
Methylxanthines
Theophylline, Aminophylline (salt, IV)
PK: zero order
SE: seizures, decrease BP, arrhythmias, decrease K
Leukotriene inhibitors
Montelukast (Singulair)
Last line for asthma
SE: psychosis, hepatitis
PUD causes
H.Pylori (#1)
NSAID induced, alcohol induced
Cushings, RA
Cimetidine
(Tagamet), H2 Antagonist
DI: 3A4, 1A2, 2C9
SE: hep, gynecomastia, hallucinations
PPI
Heal ulcers, no tolerance, on empty stomach
SE: rebound, C.Diff, rash, osteoporosis, fractures
H.Pylori treatment
x10-14days

PPI BID/Esomprazole QD+Clarithromycin+amox/metron

H2/PPI/Esom+Metronidazole+tetracycline/amox+bismuth
DKA
metabolic acidosis
Rapid Insulin
Post-Prandial
Lispro (Humalog)
Aspart (Novolog)
SE: hypoglycemia, weight gain, inj. site rxn
Long Insulin
Glargine (Lantus): Forms microprecipitates in tissue
Detemir (Levemir): Binds to albumin
SE: wt gain, hypoglycemia, inj. site rxn
Sulfonylureas
increase insulin secretions
SE: wt gain, SJS
Glyburide (Diabeta, Micronase)
Glipizide (Glucotrol)
Glimepiride (Amaryl)
Biguanides
increase insulin utilization, inhib gluconeo
SE: LA, wt loss
Metformin (Glucophage)
Alpha-glucosidase Inhibitors
Prevent breakdown of complex carbs
SE: gas, decrease BS (must give glucose, NOT sucrose)
Acarbose (Precose)
Miglitol (Glyset)
TZDs
Increase insulin utilization, inhib gluconeo
SE: SOB, HF, MI, decrease BMD, edema
Meglitinides
increase insulin secretion (Glucose dep), w/ meals
SE: decrease BS
Repaglinide (Prandin)
Nateglinide (Starlix)
Incretin Based: DPP4
increase insulin synth and secretion
SE: pancreatitis, SJS
Sitagliptin (Januvia)
Saxagliptin (Onglyza)
Incretin Based: GLP1
stims insulin secretion, increases satiety, slows gastric emptying time
SE: wt loss, pancreatitis, renal insuff
Exenatide (Byetta)
Renal Failure
Pre-Renal: dehydration, BUN/SCr >20:1
Intrinsic: contrast dye
Post-Renal: obstruction
Thiazide diuretic
HCTZ, Chlorthalidone (Hygrotan), Indapamide (Lozol)
SE: increase lipids, pancreatitis, sx dysfx, rash, increase BS, increase uric, decrease Na/Mg/K, increase Ca
Loop diuretic
Furosemide, Torsemide, Bumetinide, Ethacrynic Acid
SE: decrease Ca, pre-renal failure
K-Sparing diuretic
Spironolactone (Aldactone): gynecomastic
Amiloride (Midamore)
Triamterene (Dyrenium): kidney stones
Non-selective B1, B2
Propranolol
Selective B1-BB
Metoprolol (Toprol, Lopressor)
Non-Selective B1, B2, alpha
Carvedilol (Coreg), Labetalol (Normodyne, Trandate)
Intrinsic SA BB
Acebutolol (Sectrol)
NO properties BB
Nebivolol (Bystolic)
Class III (K block) BB
Sotalol (Betapace, AF)
SE: Torsades
Class II BB
All BBs
Clonidine
(Catapress PO, Patch)
Centrally acting Anti-adrenergic agents
SE: rebound
HTN crisis: Emergency
End organ damage
Tx: IV Nitroprusside (cyanide, no renal)
HTN crisis: Urgency
NO end organ damage
Tx: PO Labetolol
Direct Vasodilators
Hydralazine (Apresoline): reflex tachy, Lupus-like
Minoxidil (Lonifen, Rogaine)
EBM: resistant HTN, ESRD
Alpha-1 Adrenergic Blockers
Terazosin (Hytrin)
Doxazosin (Cardura)
SE: 1st dose syncope, ortho, reflex tachy
EBM: BPH, resistant HTN
Direct Renin Inhibitors
Aliskiren (Tekturna)
Alkylating Agents
Busulfan (Myleran)
Cyclophosphamide (Cytoxan)
Ifosfamide (Ifex)
Melphalon (Alkavan)
Cyclophosphamide
(Cytoxan)
PK: met acrolein-->hemorrhagic cystitis
Prevention: hydration, mesna (Mesnex)
Platinum Analogues
Carboplatin (Paraplatin)
Cisplatin (Platinol)
SE: ototoxicity, nephrotoxicity (prevent with Hydration, Amifostine/Ethyol)
Anthracyclines
Dounorubicin (Cerbidine): Life=550
Doxorubicin (Adrimycin): Life=550
Idarubicin (Idamycin): Life dose=137.5mg/m2
SE: cardiotoxic (prevent with dexrazoxane/Zinecard)
Chemo Antibiotics
Bleomycin (Blenoxane): pulm fibrosis
Bactinomycin (Cosmegen): pediatric
Chemo Antimetabolites
Methotrexate (Amethopterin): FA antag,
>1gm/m2: BMS-W, GI damage (Leucovorin rescue)
Cytarabine (Cytosar, Ara-C): conjunctivits, slurred speech
Fluorouracil (Adrucil, 5-FU)
Vinca Plant Alkaloids
Lung, Testicular Cancer
Vincristine (Oncovin)
Vinblastine (Velban)
SE: neurotoxicity
Taxanes
Lung, Ovarian, Prostate Cancer
Paclitaxel (Taxol)
Docetaxel (Taxotere)
SE: neurotoxicity
Camptothecins
Colorectal Cancer
Irinotecan (Camptosar)
SE: GI!!!
Chemos that cause mucositis
MTX, Ara-C, 5-FU, Anthracyclines, Bleomycin
NRTIs
become phosphorylated and integrate into HIV DNA
SE: LA, hepatic stenosis
Abacavir
NRTI, ABC, (Ziagen)
SE: hypersensitivity (HLAB-5701)
Didanosine
NRTI, DDI, (Videx)
SE: pancreatitis, peripheral neuropathy
Emtricitabine
NRTI, FTC, (Emtriva)
SE: hyperpigmentation of skin
Lamivudine
NRTI, 3TC, (Epivir)
SE: hyperpigmentation of skin
Stavudine
NRTI, D4T, (Zerit)
SE: pancreatitis, peripheral neuropathy
Tenofovir
NRTI, TDF, (Viread)
SE: decrease BMD, renal toxicity
Zidovudine
NRTI, AZT, (Retrovir)
SE: hep, BMS-R,W(macro), hyperpigmentation
NNRTIs
inhibit enzyme reverse transcriptase
SE: resistance, hep, SJS, QD dosing
Efavirenz
NNRTI, EFV, (Sustiva)
SE: CYP inhibitor and inducer, do NOT use in pregnancy
Etravirine
NNRTI, ETR, (Intelence)
SE: increase BP, peripheral neuropathy
Nevirapine
NNRTI, NVP, (Viramune)
Use during labor
Rilpivirine
NNRTI, RPV, (Edurant)
Protease Inhibitors
All 3A4 substrates and inhibitors
SE: increase lipids, CAD, hep, increase BS, met. syndrome
Atazanavir
PI, ATV, (Reyataz)
Darunavir
PI, DRV, (Prezista)
Fosamprenavir
PI, FPV, (Lexiva)
Lopinavir/ritonavir
PI, LPV/RTV, (Kaletra)
Nelfinavir
PI, NFV, (Viracept)
Ritonavir
RTV, (Norvir)
Use as PK enhancer to inhibit PI metabolism
Saquinavir
PI, SQV, (Invirase)
Integrase Inhibitors
Raltegravir, RAL (Isentress): increase CK, myopathy
CCR5 Antagonist
Maraviroc, MVC (Selzentry)
Salvage regimen
SE: hep, 3A4 inhibitor
Fusion Inhibitor
Enfuvirtide, T20 (Fuzeon)
Bile Acid Sequestrants
decrease LDL, increase TG
Cholestyramine (Questran)
Colestipol (Colestid)
Niacin
increase HDL, decrease TG, decrease LDL
(Nicotinic Acid, Vit B3)
SE: hep, increase BS/UA, flush, myopathy
HMG-CoA Reductase Inhibitors
decrease LDL/TG, increase HDL
SE: hep, myopathy, red urine
Most potent: Atorvastatin, Rosuvastatin, Simvastatin
Fibric Acid Derivatives
Decrease TG, increase HDL
SE: gallstones, hep
Gemfibrozil (Lopid)
Fenofibrate (Tricor)
Ceftriaxone
(Rocephin)
Do not use in renal disease, neonates
NMTT side chain
Cefoperazone, Cefamandole, Moxalactam, Cefmetazole, Cefotetan
--> Disulfiram-like rxn, coagulopathies
Vancomycin
PK: renal elim, peak 40, trough 5-10
SE: red man syndrome, nephrotoxicity
Aminoglycosides
Gentamycin, Tobramycin
PK: Traditional (PK 10h, trough 2h), Consolidated (7mg/kg, Hartford Nomo)
SE: nephrotoxiity, neurotixic, ototoxic
Quinolones
SE: psychosis, renal dysfx, increase QTc, C.Diff, cartilege dysfx, photosensitivity
Linezolid
(Zyvox), MAO-i
SE: optic neuritis, BMS-W,T (esp>14d)
SMZ/TMP
(Septra, Bactrim)
SE: BMS-W,T, photosens, rash, SJS, periph. neuropathy
DI: 3A4, 2C9, 2C19
Metronidazone
(Flagyl), #1 tx for C.Diff
SE: Disulfiram, peripheral neuropathy
HF Treatment
#1: Loops
#2: ACEi/ARBs
#3: BB (Bisoprolol, Carvedilol, Metoprolol succ.)
#4: K-sparing
#5: Hydralazine/NTG (BiDil) --> Af. Ams
#6: Digoxin
Digoxin
MOA: blocks NE, Na/K ATPase pump, blocks AV node
Toxic >2ng/mL
SE: halo, color change, hallucinations, arrhythmias, heart block, N/V/D, rash
Antidote: Digibind
Type Ia
Quinidine (Quinidex, Quinaglute) IV, IM, PO
Procainamide (Pronestyl, Procan, Procanbid) IV, IM
Disopyramide (Norpace) PO
Type Ib
Lidocaine (Xylocaine) IV, IO, ET
Mexiletine (Mexitil) PO
Type Ic
Flecainide (Tambocor) PO
Propafenone (Rhythmol) PO
Type II
Metoprolol (Toprol, Lopressor) IV, PO
Esmolol (Brevibloc) IV
Atenolol (Tenormin) PO
Type III
Amiodarone (Cordarone) IV, PO
Dofetilide (Tikosyn) PO
Sotalol (Betapace, Sorine) PO
Ibutilide (Covert) IV
Dronedarone (Multaq) PO
Type IV
Verapamil (Calan, Covera, Isoptin, Verelan) IV, PO
Diltiazem (Cardizem, Cartia, Dilacor, Taztia) IV, PO
Azoles
DI: 3A4, 2C9, 2C19
Fluconazole
(Diflucan)
Candida, cryptococcus
SE: hep, BMS-W, rash
Itraconazole
(Sporanox)
Candida, Mold
PK: Caps with food, Solution w/o food
SE: visual disturb, tinnitis, IV neg inotrope, hep, SJS, peripheral neuropathy
Voriconazole
(Vfend)
Candida, molds-->broadest and strongest azole
Dosing: LD--> MD
SE: visual disturb, hallucinations, hep, rash
Ketoconazole
(Nizoral)
Echinocandins
Caspofungin (Cancidas)
Micafungin (Mycamine)
SE: hep, rash, SJS
Amphotericin B
Amp-B deoxycholate: gold standard for yeast and molds but increase SEs, give with a lot of fluids
SE: tachypnea, decrease BP, BMS-T,W, decrease K/Mg, infusion rxns (500cc NS before and after)
Lipid formulations decrease SEs
- Amphotec, Abelcet, AmBisome
Flucytosine
(Ancoban)
Terbinafine
(Lamisil)
Ganciclovir
(Cytovene)
Use for CMV (retinitis)
SE: seizures, retinal detachment, hep, BMS-T,W, rash, phlebitis, renal dysfx, bone marrow suppression (w/ Zidovudine)
Amantadine
(Symmetrel)
DA agonist
SE: psychosis
Rimantadine
(Flumedine)
Oseltamivir
(Tamiflu)
Zanamivir
(Relenza) Inhaler
SE: bronchospasms