Drugs 2

Front 1

Three major conditions that require treatment

Back 1

Hypertension
Congestive heart failure
Coronary artery insufficiency with angina

Front 2

when use diuretics?

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high risk situation (as with a diabetic patient, or one with heart disease) the first class of drugs we use is the diuretics (so-called water pills)

Front 3

These reduce blood pressure by decreasing blood volume through increased urine production.
All these enhance water and sodium secretion.
Their effect on other ions depends on the drug, but most diuretics lower body potassium and calcium, and the patient is often put on potassium and calcium supplements

Back 3

diuretics

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the main side effect of most diuretics (such as Diuril) is

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low serum potassium and calcium

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spironolactone (Aldactone) and Dyrenium (turns urine blue!).
are?

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Potassium sparing diuretics

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Alpha and Beta Sympathetic Blocking drugs: these agents are widely used to treat

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hypertension

Front 7

Relax the blood vessels and lower pressure. These drugs relax smooth muscles all over the body, also improving urine flow in men with prostate enlargement

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Alpha blockers

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for high blood pressure
alpha blocker

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Minipress

Front 9

for urinary stream blockage
Alpha blocker

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Flomax

Front 10

This class of drugs slows the heart rate and force of contraction, thereby also reducing blood pressure

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Beta blockers

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Examples include propanolol (Inderal), metoprolol (Lopressor) and bisoprolol (Zebeta)

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beta blockers

Front 12

These medicines also reduce the risk of some abnormal heart rhythms
reduce signs and symptoms of heart failure and improve heart function

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beta blockers

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the standard drug for heart failure for a long time

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Digitalis

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first described in the medical literature in 1785 by William Withering

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Digitalis
is herb
aka fox glove

Front 15

Increases the force of contraction of myocardial muscle cells by its effects on increasing calcium and sodium in the heart muscle cells

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digoxin

Front 16

bradycardia, and an irritable heart muscle that is prone to arrhythmias are side effects of what drug

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Digitalis side effects

Front 17

Digitalis
Beta blockers
Strong diuretics, such as Lasix
Calcium channel blockers
Renin-angiotensin system drugs:
are classes of drugs to treat what?
ACE inhibitors (angiotensin converting enzyme inhibitors)
Angiotensin II receptor blockers
Renin inhibitors

Back 17

Classes of drugs to treat heart failure

Front 18

This class of drugs slows the heart rate and reduces blood pressure.
Examples include propanolol (Inderal), metoprolol (Lopressor) and bisoprolol (Zebeta)

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Beta blockers

Front 19

for heart failure include furosemide (Lasix) and bumetanide (Bumex).
Nothing else is as powerful as these two drugs in getting unwanted fluid out of the body.
These drugs also decrease fluid in the lungs, so the patient can breathe more easily

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Diuretics

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These drugs include spironolactone (Aldactone) and eplerenone (Inspra).

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Potassium-sparing diuretics

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These drugs also have a role in treating hypertension, but their main usage is in treating heart disease.
They block the release of calcium from the muscle cell channels (where it resides when it is inactive) which is an all important step in smooth and cardiac muscle contraction

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Calcium Channel Blockers

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These drugs are especially useful in patients (often young men and women) who suffer from episodes of PAT (also known as SVT: supra-ventricular tachycardia).

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calcium channel blockers

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nifedipine (Procardia®) and diltiazem (Cardizem®)

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Other calcium channel blockers

Front 24

__________ may be used in conjunction with a beta blocker in treating heart disease. The cardiologist can individualize such treatment.

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calcium channel blockers

Front 25

These block the formation of angiotensin II, so there is less vasoconstriction. This is helpful when the heart is struggling to pump blood against a high pressure in the systemic circulation.
Examples include enalapril (Vasotec), lisinopril (Prinivil, Zestril) and captopril (Capoten)

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Angiotensin-converting enzyme (ACE) inhibitors

Front 26

These drugs block the receptors in the smooth muscle cells that surround the blood vessels
Examples are losartan (Cozaar) and valsartan (Diovan)

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Angiotensin II receptor blockers

Front 27

A new class of drugs that block the action of renin on angiotensinogen so it does not get converted to angiotensin I.
Example: Aliskirin (Tekturna), remikirin

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Renin inhibitors

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Nitroglycerin remains the most commonly used agent for

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angina

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Side effects are few, but sometimes include hypotension, with the possibility of rebound tachycardia because of falling blood pressure, which can then make the angina worse

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Nitroglycerin

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counteract the firing of the beta fibers of the sympathetic nervous system which in an emergency cause the heart to beat faster
They are often used to treat PAT: paroxysmal atrial tachycardia, a condition commonly affecting young people, especially women in their teens and 20’s. It is also called PSVT
Inderol (propanolol)

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Beta Blockers for tachycardia

Front 31

New” wonder drugs for severe dyspepsia, ulcers, and GERD (gastroesophageal reflux disorder)
Inhibit the formation of HCL in the pareital cells of the stomach

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proton pump inhibitors

Front 32

Omeprazole: Prilosec®
Esomperasole: Nexium®
Omeprazole and sodium bicarbonate combination: Zegerid

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The most popular proton pump inhibitors

Front 33

Cimetadine: Tagamet: the first blockbuster drug
Also very popular:
Ranitidine: Zantac

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Histamine 2 receptor antagonists (sometimes called H2 receptors)

Front 34

H pylori (a bacteria) is present in virtually all

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peptic ulcers and also needs to be treated, with antibiotics, usually a combination of two of them:
Metronidazole: Flagyl
and
Doxycycline: Vibramycin

Front 35

bananas, rice, apple sauce, and tea

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BRAT diet

Front 36

Appropriate antibiotics are needed (often ciprofloxacin or doxycycline) for...

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Bacterial infectious diarrhea

Front 37

improves the penetration of water into the feces and causes increased bulk

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Colace

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lubricates the feces and helps with elimination

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Mineral oil

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gram positive staining bacteria

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purple

Front 40

gram negative bacteria

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pink

Front 41

Generally live on the skin
Staphlococcus, Streptococccus, and Pneumococcus
All cause soft tissue infections and pneumonia
Staph also causes infections everywhere else.
Staph causes abscesses, strep causes cellulitis (spreading infection)
what kind of bacteria

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Gram positive bacteria

Front 42

Generally live in the intestinal tract
E. coli, Pseudomonas, Aerobacter, Proteus, Salmonella, and Shigella
Often cause intestinal or urinary tract infections.

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Gram negative bacteria

Front 43

Causes nodular infections in the lungs and other areas of the body: Tuberculosis
They are slow-growing and require a long time for treatment (usually a year).
Prior to antibiotics tuberculosis was one of the greatest killers on earth.
Leprosy is also an ______ ______ bacteria

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Acid-fast bacteria: Mycobacterium tuberculosum

Front 44

More serious gram positive infections such as pneumonia or osteomylitis use these drugs

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IV Nafcillin and oral dicloxacillin.
Methacillin resistant staph infections (MRSA):
IV Vancomycin and Rocephin
Sulfa is sometimes used (it’s curious this would work!)

Front 45

used to treat otitis media and sinus infections, which if unchecked may lead to brain abscesses, especially in diabetic patients or the elderly

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Amoxacillin or Augmentin (amoxicillin plus clavulinic acid)

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For serious infections of this sort (upper urinary tract infections)

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third generation cephalosporins such as ceftriaxone are used IV, and have saved many lives

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for Chlamydia infections

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doxycycline

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moderate the severity of influenza and the bird flu virus

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Relenza and Tamiflu

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Acyclovir: Zovirax
Valcyclovir : Valtrex
Famcyclivir: Famvir

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Herpes genitalis and oralis

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Zidovudine: Retrovir
Lamivudine:Epivir
Abacavir: Ziagen
Plus many others, combined in a three-agent cocktail

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HIV and AIDS

Front 51

Chloroquine
Hydroxychloroquine
Mefloquine
Primaquine
They all have severe side effects, including GI disturbance, irreversible eye damage, dizziness, and shock in some cases

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for malaria

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Pinworms are common in school children, and can then infect the whole family... they are treated with......

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mebenazole (Vermox)

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Scabies, and head, body and pubic lice: treated with

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Lindane shampoo: Kwell

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It lowers fever, reduces inflammation, combats pain, and helps prevent blood clots, all at the same time.
It manages to do this because it blocks the enzyme cyclooxygenase

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aspirin

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Acetoaminophen (Tylenol)
Ibuprofen (Motrin, Advil)
Naproxen (Naprosyn, Aleve).
Celebrex (fewer GI side effects than the others above)

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non-steroidal anti-inflammatory drugs (NSAIDs)

Front 56

methotrexate
azathioprine (Imuran)
cyclophoasphamide (Cytoxan)
Newer agents that block the actions of TNF, the tumor necrosis factor: inflixamab (Remicaid), and etanercept (Enbrel)

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Drugs which suppress the activity of the immune system have been developed which are also widely used in autoimmune disorders