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67 Cards in this Set
- Front
- Back
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Acetaminophen
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•Hepatic toxicity
•#1 cause of acute hepatic failure •Multiple OTC drugs with acetaminophen – can lead to dose error •10-15 mg/kg/dose q 4-6 hrs •No more than 5 doses in 24 hr •MAX dose 80mg/kg/dy •Usually safe with asthma pts due to weak COX 1/COX2 inhibitor •Can have liver toxicity in high doses or with 3+ drinks •Okay in pregnancy |
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Acetylsalicylate
(ASPIRIN) |
•Salicylates
o At 1-2g/day antagonize renal tubular secretion of uric acid and worsens the condition of gout o Also antagonize uricosuric action of Rx probenecid and sulfinpyrazone o Analgesic with anti-inflammatory effects |
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Albuterol
(Proventil) |
• Short-acting BETA-2 adrenergic receptor agonist
• Used for relief of bronchospasm in ASTHMA and COPD |
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Aldosterone
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• Mineralcorticoid
• Acts of distal tubules and collecting ducts of the kidney to increase reabsorption of Na+ and increase excretion of K+ and H+ • Similar actions in the colon, salivary glands and sweat glands • Overall effect is increased extracellular fluid volume, hypokalemia and alkalosis • Secreted by the adrenal gland and controlled by two mechs 1. Renin-angiotension system (angiotensin II stimulates aldosterone secretion) 2. Plasma potatssium levels (High K+ increases secretion) |
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Alendronate
(Fosamax) |
• Bisphosphonate (2nd generation 10-100x) used for tx of PAGET'S DISEASE & OSTEOPOROSIS
• Absorbed poorly in intestine • Must be taken after an overnight fast with a full glass of H2O • Inhibitor of bone resorption • Nonhydrolyzable analogs of inorganic pyrophosphates • Complications include: o Osteonecrosis of jaw o Bone under teeth is exposed o Swelling, loosening of teeth o Mainly in pts with cancer after prolonged tx |
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Arachidonic Acid
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• Omega-6-fatty acid
• Essential fatty acid that is present in phospholipids and cell membranes |
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Aspirin
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• NSAID
• Don't give to children due to Reye's syndrome • Blood thinning characteristics |
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Atorvastatin
(Lipitor) |
• Hypolipidemic Agent
• HMG-CoA Reductase Inhibitor – STATINS • Most effective drugs for lowering plasma LDL and total chlesterol and reduce TAG • Specific inhibition of HMG-CoA reductase, the rate limiting enzyme for cholesterol synthesis – leads to increased production of LDL receptors • Each doubling of dose decreases plasma cholesterol by 10% • Major side effects: o Liver damage (transminases) o Myalgia o Myopathy and thabdomyelosis, sometimes leading to kidney failure |
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Brompheniramine
(Dimetane) |
• Antihistamine with sedating effects
• Propylamine class • Tx for symptoms of common cold and allergic rhinitis • Antagonist of histamine H1 receptors |
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Calcium/Sodium EDTA
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• Can increase CNS lead levels (oral drugs)
• Used only in conjugation with dimercaprol • Renal toxicity: maintain adequate hydration |
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Carbon Monoxide
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• Binds to hemoglobin, reducing O2 carrying capacity
• Headache, dizziness, N/V, swizures, coma • Tx: 100% Oxygen |
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Chlorpheniramine
(Chlor-Trimeton) |
• First generation antihistamine
• Weak sedative compared to other 1st generation • Has some antidepressant properties, inhibiting reuptake of neurotransmitter serotonin |
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Cholesterol
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• Takes 180 ATP to make- very expensive to make
• 27 carbons • enzyme HMG-CoA Reductase converts HMG-CoA to Mevatonate which is inhibited by STATINS • Total body cholesterol should be <200mg/dL |
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Cimetidine
(Tagamet) |
• Tx for heartburn – H2 antagonist
• Inhibition of NOCTURNAL & BASAL rather than meal-stimulated acid secretion • Lower than prescription strength o Ineffective for relief of PUD or GERD • Most common reported side-effects: nausea, diarrhea, headache, dizziness • Increase gastric pH may decrease bioavailability of other drugs • Cimetidine >> Ranitidine inhibits Cytochrome P450 non-selectively o May increase toxicity of concurrent drugs |
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Codeine
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• Opiate – antitussive
• Direct action on the cough center of the medulla • Suppression achieved at lower doses than those producing analgesia • Drying effct and increase viscosity of respiratory secretions • NO well controlled studies demonstrate efficacy o Ped death have been reported o Drowsiness, confusion and dizziness. Headache, nervousness, sleep disturbances, dysphoria, euphoria, lightheadedness, alterations of mood |
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Corticosterone -
Corticosteroid |
• Direct effects on mood, behavior and brain excitabililty – very immediate
• 21 carbon steroid hormone produced in adrenal glands • regulates fuel metabolism, immune rxns, and stress response |
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Deferoxamine
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• DOC for IRON INTOXICATION; most effective as IV
o ~8mg of iron is bound by 100mg o does not effectively chelate other important trace minerals • excreted in urine and bile and gives urine a red discoloartion • adverse effects o tachycardia, hypotension, and shock o abdominal discomfort, N/V, diarrhea o flushing and fever |
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Dextromethorphan
(Delsyn) |
• Non-narcotic antitussive
• Binds to different receptors in cough center o Not blocked by Naloxane • Serotonergic effects in XS dosing • Adverse effects include confusion, excitement, nervousness, restlessness, irritability, N/V and dysarthria • In toxicity stupor, ataxia, nystagmus, hyperexcitability, seizures, dystonia, coma, hallucinations and respiratory depression • Frequently implicated in pediatric overdosage |
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Diethylstilbestrol
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• Synthetic nonsteroidal estrogen that can cause malformation of embryo if given to pregnant women
• Been used in prostate cancer therapy and birth control |
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Dimercaprol
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• ARSENIC and MERCURY tx
• Formulated in peanut oil for IM injection o PROB: hypersensitivity; G-6-PD deficiency; concurrent iron supplementation therapy • May be nephrotoxic, abscess at injection site, burning sensation around mouth, etc |
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Diphenylhydramine
(Bendaryl) |
• 1st generation H1 antagonist
o based on the structure of histamine o often short lived o multiple dosing o highly sedative o anticholinergic side-effects o attenuation of motion sickness and vertigo • ether or ethanolamine derivative |
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Doxylamine
(Unisom) |
• One of the main sedating antihistamines used for sleep aid
• Ethanolamine • One the active ingredients in NyQuil |
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Esidrix
(HCTZ) |
• Diurectic used as anti-hypertensive drug
• Affects distal tubular electrolyte absorption • Drug-interactions – ETOH and narcotics may potentiate orthostatic hypotension, dose may require adjustment if on oral hypoglycemics, corticisteroids increase electrolyte depletion and may lead to hypokalemia, NSAIDS may reduce diurectic effects |
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Estrogen
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• Can be synthesized from androstenedione and/or testosterone by AROMATASE
• 70% bound to sex hormone binding Globulin, also to albumin • acts through nuclear receptors o ERA - located in female repro (uterus, vagina and ovary) o ERB - located primarily in prostate gland and ovary. • Coordinate the systemic responses during the ovulatory cycle o Reproductive o Pituitary o Breasts and other tissues • Increase HDL and lowers LDL cholesterol • Breast development • Hastens bone maturation and closure of epiphyseal plates of long bones • Antagonizes bone resorption (osteoporosis) • Shapes pelvis • Increases muscle in myometrium • Increases libido • Increases synthesis TBG, transcortin, SHBG and clotting factors • Stim the progression of endometrial and breast tumors, but used in tx of prostate cancer • Osteoblasts and –clasts have estrogen receptors • Major effect on bone is to decrease the numbers and activity of osteoclasts |
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Ezetimibe
(Zetia) |
• Newest class of lipid-lowering agents
• Inhibits the intestinal cholesterol transporter without affecting FA uptake • NOT A BILE ACID SEQUESTRANT • Effectively lowers LDL-C • Side effects of: tiredness, stomach pain when used alone, myalgia in combo with statin |
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Famotidine
(Pepcid-AC) |
• Histamine H2 receptor antagonist
• Inhibits stomach acid production • Tx of peptic ulcers and gastroesophageal reflux disease (GERD) •~ antacid • 30x more active than cimetidine |
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FSH
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Follicle stimulating Hormone
• Secreted from anterior pituitary gland • Leads to ovulation • Critical in men for spermatogenesis |
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Glycogen
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• Storage of glucose form in liver
• Polysaccharide of glucose which functions as the primary short term energy storage in liver and muscles |
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Guaifenesin
(Mucinex) |
• Expectorant used for tx of COPD
• An ingredient contained in many combination OTC cough and cold products • Available as a single agent and in combo • Only FDA approved OTC agent • Nomal dose (200-400 mg q 4hr) • Prescription dose 600-1200mg q 4hr • High dose effects include nausea, vomiting, dizziness, hadache, rash, etc |
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Inderal
(Propanolol) |
• Nonselective B-blocker
• Uses o HPT, antiarrythmic, anti-tremor, migraine o Decreases chronotropic and ionotropic activity, vasodilator • Contras- bronchospatic disease, be careful with CA channel blockers |
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Insulin
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• Secreted by Beta cells in pancreatic Islet
• Peptide made of 2 chains |
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Stimulants of Insulin
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o Glucose, mannose
o Vagal stimulation o Sulfonyl ureas |
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Amplifiers of Insulin
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o Cholecystokinin, secretin, gastrin
o Neural stimulation(beta adrenergic) |
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Inhibitors of Insulin
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o Somatostatin
o Diazoxide o Catecholamines |
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Actions of Insulin in LIVER
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o Stim conversion of glucose to gylcogen
o Stim converstion of glucose to fatty acids and TAG |
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Actions of Insulin in ADIPOSE TISSUE
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o Stim transport of glucose into cells
o Stim conversion of glucose to fatty acids and TAG o Inhibit release of free fatty acids |
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Actions of Insulin in SKELETAL & CARDIAC MUSCLE
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o Stim transport of glucose into cells
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Lasix
(Furosamide) |
• Antihypertensive/Diuretic
• Uses-CHF, renal disease, HPT • Concerns-hypokalemia (exaggerated by steroids and digitalis), blood glucose levels may increase in DM • Drug interactions – avoid lithium, potentiates other HPT drugs |
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LH
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LEUTINIZING HORMONE
• Controls production of testosterone by Leydid Cells • increased secretion can lead to ovulation along with FSH • made in anterior lobe of pituitary |
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Loratidine
(Alavert) |
• 2nd generation H1-antagonist
• antiasthmatic – b/c doesn’t have anticholinergic effect then can be taken with asthmatic pts…generally NOT sedative • marketed as “non-sedating” • if you push dose too high, CNS effects will occur |
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Metformin
(Glucophage) |
• More potent of Biguanides
• Used for tx of type II diabetes • Does NOT affect insulin secretion, NO hypoglycemia • Decreased hepatic glucose production • Absorbed from GI tract. Little metabolism |
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Methanol
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• Simplest alcohol
• ~natural gas • highly volatile - poisonous |
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Montelukast
(Singulair) |
• Leukotriene receptor antagonist
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Niacin
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• B vitamin with a MDR of 15 mg, but hypolipidemic dose is about 3g
• Dose must be increased slowly. Start at 100 mg and increase by 500 mg each wk. can produce severe flushing, major cause of failure • Inhibits hormone sensitive lipase in adpiose tissue so FA release is secreasd, liver TG synthesis and VLDL syn are decreased • Comes in prescription form and as dietary supplements-must not be used as a substitute for prescription niacin-not regulated by FDA |
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Nizatidine
(Axid-AR) |
• Histamine H2-receptor antagonist
• Inhibits stomach acid production • Tx of peptic ulcers and GERD |
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Olopatadine
(Patanol) |
• Acts as a relatively selective H1-antagonist
• Inhibits the release of histamine from mast cells • May block the activities of some additional mediators of ophthalmic infammation by inhibiting the release of typtase and prostaglandin D2 from inflammatory cells • Selectiviy for the H1 receptor is greater than that of other ocular antihistamines, including ketotifen, levocabastine, antazoline, and pheniramine. • Prevents or reduces ocular inflammation rxns induced by common allergens |
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Omalizumab
(Xolair) |
• ONLY monoclonal antibody
• Prophylaxis of moderate to sever aeroallergen associated asthma • SC injection q 2-4 wks • 2nd line therapy in pts >12yrs • potential side effects: new or recurrent cancer and severe allergic rexns/anaphylaxis • Black box WARNING • Should only be administered under direct medical supervision • Anaphylaxis, presenting as bronchospasm, hyotension, syncope, urticaria, and/or angioedema of the throat or tongue |
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Omeprazole
(Prilosec) |
• Proton pump inhibitor
• Tx: dyspepsia, peptic ulcer, GERD • NOT intended for immediate relief o 14-day course • Interactions: warfarin, anti-fungal and yeast agents, diazepam, digoxin • Side Effects: headache, GI upset, cough, cold, dizziness, rash |
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Orlistat
(Alli) |
• GI lipase (covalent) inhibitor for obesity management
o Block the absorption of dietary fat o Decrease caloric intake – negative energy balance and weight loss • Minimal systemic absorption • Adverse effects esp with >30% fat calories o Flatulence with discharge, fecal urgency of incontinence, stearorrhea, oily spotting, oily evacuation, o Pts should adhere to recommended diet plan o Psyllium fiber adjunct can reduce some GI side effects o Hypovitaminosis may be prevented through the use of a daily multivitamin supplement that contains fat-soluble vitamins |
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Penicillamine
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• Chelator of copper, iron, lead and mercury
• Inactive breakdown of penicillin • Used for tx of rheumatoid arthritis and wilson’s disease • Declined use due to toxicity o Fatal thrombocytopenia, agranulocytosis, aplastic anemia, pancytopenia, and sideroblastic anemia o Exertional dyspnea, cough, or wheezing o Renal failure o Neurologic effects o Tinnitus, neuropathy, optic neuritis, agitation, anxiety, dystonia o N/V, anorexia, abdominal pain, and occasional diarrhea o Drug hypersensitivity - Erythematous or maculopapular rash |
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Pioglitazone
(Actos) |
• Thiazolidiediones used for oral hypoglycemics
• Bind specifically to peroxisome proliferators-activated receptor-gamma • Increase insulin sensitivity • Increase glucose transport into muscles, adipose tissue • Absorbed from GI tract. Little metabolism |
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Prednisone
(Deltasone) |
• Glucocorticoid
• Can be used to tx hypercalcemia • Tx for o Rheumatic disorders o Renal disease o Chronic ulcerative colitis o Crohn’s Disease o Hepatic disease • Clinical Correlations (Weeda) o Uses - Hypoadrenalsim, rheumatic, collagen, and dermatiologic disorders, allergic states o Contraindications – fungal infections o Warnings – adrenal crisis, may mask signs of infection, fluid/electrolyte imbalance o 4-5x as potent as cortisol |
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Procardia
(Nifedipine) |
• Ca channel blocker
• Uses o Coronary artery spasm, vasospastic angina, HPT o Decreases coronary oxygen utilization and peripheral resistance • Precautions o Hypotension, peripheral edema, gingival enlargement • Drug interactions: increases digitalis levels, cimetadine increases levels of procardia dramatically • Causes GINGIVAL HYPERPLASIA |
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Progesterone
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• Precursor to estrogen, androgens and adrenocortical steroids
• Synthesized in the ovary, adrenal gland, and testis. • Released in large amts by the placenta during pregnancy • Responsible for the alveolobular development of the secretory apparatus in the breast • Modulates estrogen action on the uterus • Aids in the maintenace of pregnancy • Inhibits uterine contraction [therefore blocking could cause induced labor] • Alters carb metabolism (increases basal insulin levels, promotes glycogen storage) • Decreases HDL levels and stim LDL production [birth control can lead to heart attack] • Stim lipoprotein lipase (fat transfer from lipoproteins to tissues) • Body temp increase at ovulation ~ 1 • May have depressant and hypnotic effects on the brain |
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Progestin
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• Birth control – low dose – minipill
• Blocks ovulation in only 60 – 80 % of cycles • Impairs sperm transport by thickening the cervical mucus, decreases motility of ovules in the oviduct and alters endometrium to impair implantation. • Slightly higher failure rate that the combo pill |
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Ranitidine
(Zantac) |
• H2-receptor antagonist inhibits stomach acid production
• Tx: peptic ulcers and GERD |
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Repaglinide
(Prandin) |
• Meglitinides – oral hypoglycemic for tx of Type II diabetes
• Increase insulin secretion • Benzoic acid derivatives, NOT related to sulfonylureas • Very rapid GI absorption, short ½ life, • Metabolized in liver • Major side effect is hypoglycemia |
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Risedronate
(Actonel) |
• Bisphosphonate
• Nonhydrolyzable analogs of inorganic pyrophosphates • Inhibitors of bone resorption • Tx: Paget’s disease-mainly, osteoporosis |
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Salmeterol
(Serevent) |
• Beta 2 specific andrenergic receptor agonist: slow onset
• Tx: asthma, COPD • Available in metered-dose inhaler • Long lasting |
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Sodium Cromolyn
(Intal) |
• Mast cell stabilizer
• Prevents the release of inflammatory chemicals – histamine from mast cells • Tx: used as nasal spray for preventative management of asthma |
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Sodium Cyanide
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• Highly toxic chemical compound
• Cyanide Kit may be used for tx o Sodium nitrate + sodium thiosulfate + amyl nitrite o Small inhaled doses of amyl nitrite followed by IV sodium nitrite converts a portion hemoglobin into methmoglobin. Cyanide is more strongly drawn to methemoglobin than to cytochrome oxidase in cells. Once bound with the cyanide, methemoglobin becomes cyanmethemoglobin. The sodium thiosulfate and cyanmethahemoglobin become thiocyanate, releasing the hemoglobin, and thiocyanate for renal elimination. |
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Succimer
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• Tx of Arsenic and Mercury
• Licensed only for childhood lead poisoning but efficacious for arsenic o Bead-filled oral caps o Hypersensitivity; hydration important as renally excreted |
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Tamifoxen
(Nolvadex) |
• SERMS (Selective Estrogen Receptor Modulators)
• Drugs with tissue selective estrogenic activities where they are beneficial (bone, brain, and liver), but have no activity in breast or endometrium. • Used in breast and endometrial cancers b/c they block estrogen stim. Of tumor growth |
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Tetracycline
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• Bacteriostatic antibiotic that disrupts protein synthesis
• Avoid in last 6 months of pregnancy, and until age 8(shows in breast milk) • Problems: photosensitivity, renal impairment may lead to hepatotoxicity, rash, GI upset • Don’t take with antacids or milk (bivalent cations) |
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Theophylline
(Theo-Dur) |
• Methylxanthines- related to caffeine
• Effects disproportionate to bronchodiation o Immunomodulatory, anti-inflammatory and bronchoprotective effects • Inhibition of phosphodiesterases leading to: o Relaxation of smooth muscle o Reduction in eosinophil migration o Reduced response to histamine o Reduced leukotriene-mediated effects • Non-specific inhibition of adenosine receptors: o Increased ventilation during hypoxia o Decreased fatigue in diaphragmatic muscles o Reduced adenosine-stimulated mediator release from mast cells • Adverse effects related to serum concentration o <20 microg/mL: transient nausea, insomnia, irritablitiy o acute overdose: cardiac arrhythmias, hypotension o high microg/mL seizures, brain damage and death - Serum conc must be monitored by physician |
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Tolbutamide
(Orinase) |
• Oral Hypoglycemics – Sulfonylureas
• 2nd generation – 10 to 100x more potent • Increase insulin release, but not after long-term tx • Increase insulin sensitivity (inhance effect of insulin on glucose uptake) • Rapidly absorbed from GI • Extensively protein bound, metabolized in liver, excreted by kidney • NSAIDs ENHANCE HYPOGLYCEMIC ACTION!!! |
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Zoledronate
(Zometa) |
• Bisphosphonate
• Used in prevention of skeletal fractures in pts with cancers such as multiple myeloma and prostate cancer |
