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435 Cards in this Set
- Front
- Back
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alpha 2 agonist
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decrease SANS outflow , AE- edema and CNS dep , DI- TCA decrease antiHTN effects
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clonidine
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alpha 2 agonist, opiate withdrawal
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methyldopa
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alpha 2 agonist, HTN in preg women , AE- + coombs
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reserpine
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intereferes with storage vesicles, SEVERE DEPRESSION, increased GI secretions , depletes NE, 5HT, DA
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guanethidine
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inhibits NE release, AE- TCA block reuptake
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alpha 1 blocker
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decrease arteriloar ad venous resiscntace, reflexc tachycarida, -zosin, USE- HTN and BPH, AE- orthostatic hypotention and urinary incon, good lipid profile
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B blockers
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CI- diabetics, vasopsoams, asthma
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hydralazine
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decrease TPR via arteriolrar dilation,SLE like syn, use for pregnancy , act via NO2
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nitroprusside
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AE- CN toxicity, use- HTN emergecy , act via NO2
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minoxidil
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arteriolar vasoldation, open K channles , USE- male baldness(rogaine) AE- diabetogenic(decreases insulin)
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CCBs
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antiartyhmic, HTN, angina, AE- ginigival hyperplasia(dipines), verampil
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verampil
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CCB that works on hrt , AE- constipation
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DIPINE
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CCB that works on blood vessel
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dialtezam
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CCB that can work on hert and blood vessel
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captopril
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ACEI, blocks form of Ang II, AE- dry cough, hyperkalemia, ARF, angioedema , USE- mild to mod HTN, CHF
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losaratan
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block AT1 receptor, no dry cough , USE- mild to mod HTN, CHF
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aliskerin
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renin inhibitors, no dry cought, USE- mild to mod HTN
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ANTI HTN in angina
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B blockers, CCBs
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ANTI HTN in diabetes
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ACEI, ARBs
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ANTI HTN in HF
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ACEI, ARBs, Beta blockers
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ANTI HTN in post MI
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B blockers
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ANTI HTN in BPH
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alpha blockers
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ANTI HTN in dyslpipidemia
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alpha blockers, CCBs, ACEI/ ARB
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Bosetan
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vasoconstrictior, CI- pregnancy ,USE- pu; HTN
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epoprosteronol
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infusion pump for pul HTN
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sildenafil
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PDE inh, increased cGMP, USE- pul HTN
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methoxamine
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paraxysmal atrial tachycarida through vagal refelx
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isoproteronol
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B1 and B3 agonist, USE- bronchospasm and AV block, AE0 flushing
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Dobutamine
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B1 agonsit, USE- CHF
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selevctive B2
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salemterol, albuterol, terbutaline used in asthma
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methy phenidate
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use in narcolepsy and ADHD, displaces NE from mobile pool
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reuptake inhibitor
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cocaine and TCA
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mirtazapine
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selective alpha 2 blocker, used as antidepressent, increases appetite- USE- anorexia
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timolol
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glaucoma , blocks action of NE, decrease aqueosu humor formation, for open glucoma
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propranol
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thyrotoxicosis, performance anxiety, essential tremor , essential trempor, agoraphobia, social phobia
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sotalol
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K channel blocking and B blocking , slows phase III, B 1 blockage, USE- life threatening ventricular arrthmias
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pilocarpine
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increases aqueous humor outflow, for glaucoma , M3- ocntraction of cilirary muscle
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Quinidine
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cinchonism(GI, ocular dysfunction, CNS exlciation), torsades, DI- hyperkalemia, toxic with digoxin, Class IA
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procainamide
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IA antiarrthmic, AE- SLE like syn, torsades , hematoxcity, thrombocytopenia
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IA antiarrthmic
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block open or activated state Na channels
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IB antiarrthmic
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preference for damaged tissue, prefers partially depoalzied tissue, lidocaine, mexiletene
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lidocaine
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IB, post MI, AE- sexiures, less cardiotxoicity
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mexiletine
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IB antiarrthmic
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flecainadie
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IC, increased sudden death,
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esmolol
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IV, acute SVTs, beta blocker
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B blocker as antiarthmcis
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prophylasix post MI, SVTs , decrease slope of phase 4 of AP in SA node
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Ventricular arrthmias
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IA, III
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SVTs
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II, IV
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III antiarthmics
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decreas IK(delayed rectified) sloe down phase 3, amiodarone, sotalol
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amiodarone
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I, II, III, IV, long half life, AE- pul fibrosis, hepatoxicity, thyroid dysnfcion, blue skin( high Vd)
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adenosine
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DOC for paroxysmal supraventricualr tachycardias and AV nodal arrythmias, short half life
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Magnesium
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USE- torsades
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digoxin
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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
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inamironone and milrinoine
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increase cAMP in hrt, increased ionotropy, increased cAMP in smooth muscle--> decreased TPR
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Nesiritide
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recomb BNP, increased cGMP , use for acute decompensated CHF
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nitroglycerin
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AE- orthostatic hypertension, tachyphylaxis, cadiotox with digoxin, USE- angina
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nefidipine
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CCB used for vaspospastic angina
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carvedilol
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angina of effort
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ranolazine
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blocks late inward Na current in cardiac myocytes decreasing Ca acculumation( Ca accumulates in ischemic tissue to due increased Na)
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theophylline
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PDE inhibitors, tx for status epilepticius, AE- carditoxicity
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Acetazolamide
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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
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Mannitol
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inhbits water reabsortions through out the tubule, increased urine volumne
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Ethacrinic acid
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loop diurecti, no allergies to sulfanamide, INCREASED Ca in urine
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Furosemide
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loop diurecti, allergies to sulfanamide, INCREASED Ca in urine , USE- acute pul edema
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Thiazides
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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
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Spironolactone
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early collecting duct , aldosterone antagonist, uSE- antiandrogenic, CHF, AE- hyperkalemia+acidosis
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Amiloride and triamterone
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Na channel blockers, USE-LI induced nephrogenic diabetes(amiloride), AE- hyperkalemia+acidosis
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Loops
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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
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lovastatin
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HMG CoA reductase, MOA- decreased VLDL synthesis and decreased LDL, AE- rhabdomyolysis, hepatoxicity, DI with gemfibrozil(increased rhabdomyolsis), increased toxcitiy with CYP 450 inh
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cholestryamine and colestipol
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bile acid sequenstrant, increaed LDL expression, AE- increased VLDL and TAGs, MALABSORPTION OF FAT SOLUBLE VITAMINS , CI- hypertriglycerderimia
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niacin
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inhibition of VLDL syntehsis, decreased VLDL, AE- intesse PRURITIS made better with aspirin
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gemfibrozil, fenofibrate
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fibrates, bind to PPAR alpha and increase expression of lipoprotein lipases, increases HDL in most pts, USE- hypertriglycedemia, AE- gall stones, myositis
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ezetimibe
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prevents intestinal reabsorption of cholestrol
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drug for increased cholestrol
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cholestryamine, colestipol, ezetimibe
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drug for increased TAG
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gemfibrozil
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drug for increased cholestrol and triglycerides
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statins, niacin, ezetimibe
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alprozolam
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anxiety, panic phobias
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diazepam
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anxiety, muscle relaxant
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lorazepam
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anxiety, status epilepticus , not metabolized by liver
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midazolam
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preop sedation, anesthesia , anterograde amnesia(BZ2)
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teazepam and oxazepam
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sleep disorder benzo , not metabolized by liver
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phenobarbitol
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barbituate, DOC for epilepsy during pregnancy
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thiopental
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short acting, anesthesia, barbituate , works on GABA A(Cl), complex I inhibitor
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zolpidem and zaleplon
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BZ1 receptor agonist, sleep disorders(less effect on cognition)
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barbituates
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CYP inducer, CI in porphyria
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busipirone
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5HTA partial agonist, used for GAD
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methanol
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results in formaldehyde- irreversible tisue damage, ocular damage, resp failure
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ethylene glycol
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reumts in production of oxalic acid, nephrotoic acid, CNS depression
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ethanol
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results in acetic acid, acetaldehyde combines with folate to inactivate it, combies with thiamine to decrease availability
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disulfiram
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inhibits acetaldehyde dehydrogenase, similar rxn with- metronidazole, griseofulvin, cefoperazone, cefotetan, chlorpropramide
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chronic alcoholism
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msucle wasting, gout, fatty liver, hypoglycemia
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Phenytoin
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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)
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Carbamazepine
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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)
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valproic acid
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GABA transaminas inibitor, blcokage of T type Ca channels, USE- migraine prophylaxis, mania of bipolar disorders, AE- pancreatitis, alopecia, TERATOGEIC( spina bifida)
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Ethosuximide
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blockage of T type Ca, USE- absence seizure, AE- decreased efficacy of oral contraceptives via CYP induction
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felbamate and lamitrigine
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block Na channels and glutamate receptors , AE- hepattoxcitiy and aplastic anemia(felbamate), steven johnson( lamotrigine)
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gabapentin
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increased GABA effects, USE- neuropathic pain
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NO2
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diffusion hypoxia, spon abortion, low blood gas, rapid onset and recovery, high MAC
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halothate
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low MAC, higher blood gas ratio, malignant hyperthermia, cardiac arrythmias
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profol
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antiemetic, anesthesia- initation and maitaines
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fentanyl
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opiate, anesteha
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ketamine
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dissociative anethesia, NMDA receptor antagonist, hallucination, increased ICP, vivid nightmares
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felbamate
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anesthetic blocking NMDA receptor
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tetrodotoxin
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puffer fish. Block inactivated Na channels, decreased Na influex
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ciguatoxin
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bind to activated Na channle, cause inactvation, prolong Na influx, desesensitixe and inactivate
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esters
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procaine, cocaine, cause allergeis due to PABA(paraaminobenzoic acid)
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amides
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lidocaine, bupivacaine
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local analgesics
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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
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cocaine
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vasocontiction by blocking NE uptake
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tubocurarine
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competitive, non depol, reversible with AcHE, no CNS effects
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Atracurium
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nondepol blocker, safe in hepatic and renal impariment because spon inactiavation to laudanosine( this could cause seizures)
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mivacurium
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short duration nondepol blockers
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succinylcholine
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nicotinic agonist, noncome depol blocker, no effect of AchE when desenstivzed, AE- malignant hyperthermia, hyeperkalemia, genetic polymorphism(slow metabs could be problematic)
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baclofen
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GABA B receptors, use for spasticity
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dantrolene and bromocriptine
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tx for malig hyperthermia
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MAC
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lower MAC- more potennt
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blood gas ratio
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high- slower onset and slower recovery
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IV anethetics
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thiopental, midozolam, propodol, fentanyl, ketamine
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dantrolene
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blocks Ca release from muscle SR, tx for NMS
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CI in opids use
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head injuries, pul dysfunction(except pul edema), hepatic and renal dysfucntion, adrenal or thyroid def, pregnancy
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meripridine
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opioid full agnosit, antimuscardinic, met to normepridine-->serotonin syndrome and seziures
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methadone
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maintains opioid addiction
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codeine
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cough supressant
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dextromorphan
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opid related, cough supressant
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loperamide
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opoid rel, diarrhea
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opidoid management of withdrawal
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methadone and clonidine(decreases NE release)-->decreases SANs response
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opoid mgmt of acute txocitiy
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IC nalazone
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opoid withdrawal
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yawning, lacrimation, salivation, rhinorea, CNS origin, pain, anxiety, sweating, G I coulple, u- strongest
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nalbuphine and pentazocine
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K agonist- spinal analgesia and dysphoria, u antagonist- preciptation of withdrawal
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naloxone
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opoid antagonist, IV, reverse resp dep
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naltrexone
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decrease craving of alc and opiate addiction
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methylnaltrexone
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opioid anatgonist, opioid rel constipation
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DA agonist
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dyskinesia(hyper movement)
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DA antagonist
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pseudoparkinsosm(nigrostriatal) , gynecopastia, amenoreha/galactorreha (tuveroinfedibular)
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mesolimbic pathway
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cell bodies in midbrain, reiforcement of behavior increased DA in nucelus accumbens
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amporphine
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DA agonsit, emetic
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D1
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Gs
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D2
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Gi
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D2A
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nigrostriatal
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D2C
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mesolimbic , clozapine
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levodopa
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prodrug, converted by decarbozylase, give with carbidopa(inhbits peripheral decarboxylase) AE- dyskinesia, psychosis, hypotension
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tolcapone and entacapone
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inhibit COMT and enhances uptake and effciacy, tolcapone- hepatoxic
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seleginine
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MAO B selective inhbitor, NO TYRAMINE INTERACTION AE- dyskeniea, psychosis, amnesia(met by aphetamine- will test + in drug test)
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bromocriptine
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hyperprolactinoma and acromegaly , DA receptor acgonist , AE- psychosis and dyskinesia
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pramipexole and ropinirole
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DA receptor agonist
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benztropine, trihexyphenydyl, diphenhydramine
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decreases Ach function, muscarinic blocker, decreases tremor and rigidity, AE- antimuscarinic(atropine like)
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amantidine
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antiviral, blocks muscarinin increased DA release, AE- LIVEDO RETICULARIS
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antimuscarinic use in psychosis
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for acute EPS( pseduoparkinsonism, akathesia, dystonia)
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atypical antipsychotic
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chronic EPS for tardive dyshyemia
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antipyschotic AE
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EPS, dysphoria(decreases compliance), endocrine( NMS, increased prolactin, wt gain) , hypotnesion due to alpha blockage
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Typicals
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chlorpromazine, thioridazine, fluphenazile, haloperidol
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atypicals
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clozapine, olanzapine, risperidone, aripiprazole
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thioridiazine
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better antimusacrin, incrased sedation, increased alpha blockate, cardiac toxicity(quinidine like), retinal deposits, allergies , typical antipsych
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haloperidol
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NMS and TD, typical antipsych
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clozapine
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block D2C and 5HT2, AE- agranulocystosis, NO TD, increased salivation(due to serotnin) , seziures(due to antimuscarinic) , atypical antipsychotic
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olanzapie and risperidone
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atypical, blocks 5HT2 improves negative symptoms
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aripiprazole
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partial agonist of D2, blocks 5HT2 receptors
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phenelzine and tranylcypromine
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MAOI , use- atypical depression, AE- HYPERTENSIVE CRISSI, DI with tyramine, TCA, levodopa, alpha 1 agonist, SEROTONIN SYN
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serotonin syn
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sweating, rigidity, myoclonus, hyperthermia, ANS instabiliy, seizures , Drugs- SSRI, TCA, meperidine
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TCA
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amitriptiline, imipramine, clomipramine, non specific block of 5HT and NE, DI- hypertensive crisis with MAOI, seronin syn, AE- 3 Cs(coma, convusion, cardiotoxic)
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clomipramine
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TCA for OCD
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amytriptyline
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TCA for neuropathic pain, can also use carbemazepine
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imipramine
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decreased slow wave sleep, works on phase IV of sleep, night terrors
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fluoxetine, paroxetine, sertraline, citalopram, fluvoxamine
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slective blockade of 5HT reuptake , USE- depression, anxiety, DI- CYP inh(fluvoxamine and fluxetine), benzo
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citalopram
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safe for interactions
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trazodone
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5HT agonist, AE- arrthmias, pirapism
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venlafazine
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nonselective reuptake blocker devoid of ANS effects
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buproprion
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DA reuptake blocker, used in smoking cessation
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Mirtazapine
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alpha 2 antagonist, wt gain and anorexia
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lithium
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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)
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methylphenidate
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amphetatime like, AE- cardio toxicity, use- ADHD
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atomoxetine
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selective NE reuptake inhibitor, USE- ADHD
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amphetamine
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block reuptake of NE and DA, relase amines from mobule pool
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benzo toxcitiy
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tx with flumazenil, cant use for barbituate toxcitiy
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benzo MOA
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potnetiate GABA with GABA A (BZ1 and BZ2)
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barbituate+ alcohol
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lif threatening seziure
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marijuana
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interact of CB 1 and CB2
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PCP
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NMDA antagonist, AE- rhabdomylosysi, convulsions and edeath
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ketamine
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hallucinations, glutamate receptro antagonist
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MDMA
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5HT, excstasy, raves
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inhanats
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solvent abuse, multiple organ damage
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macrolides
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erythromycin, azithromycin clarithromycin, USE- g+, atypicals, C jejuni, MAC, H pylori, CYP inh, AE- stim gut motilin
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clarithromycin
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macroline with less GI symptosm
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azitrhomycin
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macrolide with least CYP inh , H pyroli
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telitrhomycin
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ketoline, macrolide resistn S pneumona
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clindamycin
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not macrolide but same mechanism and resistance, G+, b fragilis and anarobes, use in osteomylitis with g+, AE- C DIFFICLE COLITIS
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linezolid
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MOA- inhibits initation complex in bac translation, prevents formation of tRNA complex, USE- tx for VRSA and VRE, drug resist penumoccoa, 50 S
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quinupristin-Dalfopristin
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50S, like tetracycline, streptogramins, binding to 50S prevent interaction of amino acyl tRNA with acceptor site , USE- VRE, VRSA
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sulfonamides
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inhibit dihydropteroate synthetase , DON’T USE ALONE- resistance
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trimethoprim and pyrimethamine
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inhibit dihdrofolate reductase , Bone marrow suprresion, problemtatic in HIV pts
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sulfasalazine
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ulcertative coilitis and rheumatoid arthritis
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Ag sulfadiazine
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burns
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GI conjugases
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carbamezipine and phenytoin, allows for transport of folate
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cotrimoxazole
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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
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chloramphenicol
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bacteriostatic, met by hepatic glucorination, CYP inh, dose dep marrow supreesion, back up for salmonella and ricettksa, AE- GRAY BABY SYN
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Doxycyline
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lipid soluble, proststis(gonorhea+chlamydia, boreilla , hepatic met
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minocycline
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menigicoocal carrier state( rifampin more frequent- organge body fluids)
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Demeclocycline
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SIADH
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tigecycline
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MRSA and VRE skin and complicated infections
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ADH
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increased by carbamazepine, decreased by LI , decreased by demeclocyline
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tetracycline
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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)
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drugs that cause photoxicity
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tetracucline, sulfonamide, quinolones
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gentamicin, tobramycin, amikacin, streptomycin
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aminoglycosides, AE- nephrotoxicity(ATN) , otoxicity, NEUROMUSCLAR BLOCKADE , once daily dosing
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|
|
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
|
|
|
quinilones
|
ciprofloxacin, levofloxacin, MOA- bacteriacidal, interfere with DNA syntehsis, inhibit top II, USE- UTI res to cotromixazole, oral tx for gonnia(1 disoe), skin, soft tissue and bone infections, Diarreha resistant to cotrimixazole(salmonella, shigella, e coli, campylobacter, DONT take with meals, CI in pregnancy, AE- tenodinits, tendon rupture
|
|
|
metroniddazole
|
DOC for giardia, trichomonas, entamoeba, AE- metallic taste, disulfiram like effect
|
|
|
isoniazid
|
anti TB, inhibits mycolic acid syn(only in TB), resistance- del in katG, AE- hepatitis, peripheral neuricts(due to B6 def), SLE
|
|
|
rifampin
|
anti TB, inhibits DNA dep RNA pol, red orange metabolites, 450 induction
|
|
|
ethambutol
|
inhbits syn of arabinaglactan(cell wall comp), decreases red green visual acuity, anti TB
|
|
|
streptomycin
|
anti TB, AE- deafness, nepthroxic
|
|
|
ampoteracin B
|
interactis with ergosterol and forms pores in membres, disrupt membraine permeabiltiy, DOC for systemic infections fungal , IV, poor BBB penetration so need to use it intrathecally, slow clearlance, AE- nefphrotoxic(looks like CRF)
|
|
|
nyastatin
|
topically for local infeciotn, swish and swallow for candiasi, too toxicy for systemic
|
|
|
azoles
|
inhibits 14 alpha demytylase which converts lanestrol to ergosteron, preferred to amph when possible due to less toxicity, AE- gynecomastia, LFTs , CYP inhibitors
|
|
|
ketoconazole
|
DOC for histo para and balsto(preferrered to ampho due to less txocitiy) , decreased absoprtion by antacids
|
|
|
fluconazole
|
DOC for esophageal and invasive candiasis, crypotcoall meningits prohpylactic , CAN CROSS BBB
|
|
|
Itraconazole and voriconazole
|
DOC for blastomyces, sporotrichoses, aspergilloses , itra- increased absoprtion by food
|
|
|
flucytosine
|
cytosine deaminase to 5-FU, 5 FU forms 5Fd UMP which inhibits thymidylate synthase which decreases thymine
|
|
|
griseofulvin
|
acts only against dermatophytes, AE- disufliram rxn
|
|
|
terbinafine
|
only dermatphytes, inhibits squalene epoxidase
|
|
|
amantidine, enfuvirtide, maraviroc
|
block viral penetration/ uncoating
|
|
|
acyclovir, foscarnet, ganciclovir
|
inhibit viral DNA polymerases
|
|
|
foscarnet, ribavirin
|
inhibit viral RNA polymerases
|
|
|
zidovudine, didanosine, zalcitabine, lamivudine, stavudine, nerviapine, efavirenz
|
inhibit viral reverse transcriptase
|
|
|
idinavir, ritonavir, saquinivir, nelfinavir
|
inhibits viral asparate protease
|
|
|
zanamivir, oseltamivir
|
inhibits viral neuraminidase
|
|
|
acylovir
|
viral thymidine kinase, HSV, VZV, AE- NOT HEMATOXIC, neurotxic and crystalluria , chain termination because lacks OH group , res due to change in kianse
|
|
|
ganciclovir
|
viral specific thymidine kihase, phophotransferase(UL97) in CMV, causes chain termination, USE- mostly for CMV prophylacis for retinitis in AIDS and transplant pts , AE- DOSE LIMITING HEMATOXICITY , SEIZURES
|
|
|
Foscarnet
|
inhibits viral DNA and RNA pol, dose limiting nephrotxicity, avoid pentamidine IV(increases nephrotoxicity and hypocalcemia- used for PCP) , USE- acyclovir res strains of HSV
|
|
|
NNRTs
|
do not reuqire metabolic activation- nevirapine and efavirenz, inibits RT at another site different from NRTI bidning
|
|
|
Zidovudine , AZT
|
phosphyrlated nonspecifically to triphospate that can inihibit RT, chain termination , AE- hematoxic, don’t use with stavudine
|
|
|
Didanosine , DDI
|
NRTI, AE- pnaacreatitis, don’t use with zalcitabine
|
|
|
zalcitabine , DDC
|
peripheral neurophaty , don’t use with diadanosine
|
|
|
stavudine, D4T
|
meylosuppresion and periphjeral nuerppathy , don’t use with zidovudine
|
|
|
lamivudine, 3TC
|
least toxic, active in Hep B
|
|
|
indinavir
|
protease inhibitor, cleaves precursor polypetides in HIV so mature portines cant form, resistance due to pt mutation in pol gene, AE- crystalluria
|
|
|
ritonavir
|
protease inhibhitor, induces and inhbits CYP, can lead to type II diabetes and cardiovasvual dsiease
|
|
|
raltegravir
|
integrase inhibitor , prevents integration of viral genome in host cell
|
|
|
enfuviritide
|
binds to gp41 and inhbits fusion of HIV1 and CD4
|
|
|
maraviroc
|
blocks CCR5 protein on macrophages to prevent viral entry
|
|
|
amantidine
|
blocks attachment, penetration and unconatinng of infleunza A, AE- livedo reticualris
|
|
|
zanamivir, oseltamivir
|
inhibits nueromainase A and B, propylaictic fro infleuncza
|
|
|
Ribivarin
|
inhibits viral RNA pol, RNA viruses(RSV, lasssa), AE- hematotxic
|
|
|
Antitumor interforms
|
kaposi(intf gamma)
|
|
|
Cyclophosphamide
|
antiCA, alkylating agent attacks guanine N 7, USE- NHL, breast ca, neurobasltoma, AE- hemoraggic cystitis(tx with mesna)
|
|
|
mesna
|
tx hemoragic cystitc causes by cyclophosphamide
|
|
|
cisplatin
|
anticCA, alkymates DNA, USE- testicular, ovarian, bladder, lung CA, AE- nephrotoxic and neurotoxic(use amifostine for kindesy)
|
|
|
amifostine
|
tx nephrotoxicity with cisplatin
|
|
|
procarbizine
|
antiCA, hodgkins
|
|
|
Doxirubucin
|
atti CA, MOA- antitumor antovdy, AE- cardiotoxcity, free radical gen, USE- HL, breast, lung, endomet, dilated cardiomyopathy
|
|
|
Methotrexate
|
DHF reducatase inh(S phase), USE- lymphoma and lukemia, RA and psoriasis, rescue with leucoverin
|
|
|
5-Flyroyracin
|
pyrimidine antimetabolite( S sphase) to inhibit thymidylate synthetase, colorectal CA
|
|
|
6-Mercaptopurine
|
purine antimetabolite, USE- ALL, increaed gout with allopurinol
|
|
|
Bleomycin
|
complexes with Fe and O2, G2 phase, USE- HL, testicular, head, neck, skin CA, pneumonitis, pul fibrosis
|
|
|
viblastin and vincristine
|
decrease microtubular polym( Mphase) , vinblastin- BMS, vincristine- neurotoxic, USE- vinblastic( HL, testicular, kaposi), Vincritine(HL, testicular, wilms)
|
|
|
ATRA
|
differentiating agent, t(15;17) differntiation syndrome(resp distress, plerual, pericardial effucsion)
|
|
|
Renal toxcitiy
|
cisplatin, methotrexate
|
|
|
pulmonary toxicity
|
bleomycin, busulfan, procarbizine
|
|
|
cardiac toxcitiy
|
doxarubicin, danurubicin
|
|
|
neurologic toxicitiy
|
vincristine, cisplatin
|
|
|
immunosuppressive
|
cyclophosphamide, methotrexate
|
|
|
Filgrastim
|
increased granulocytes
|
|
|
Sargromostin
|
increased granulocytes and macrophages , AE- CAPILLARY LEAKAGE SYN
|
|
|
imatinib
|
tyrosine kinase inhibitor, used for CML, inhibits bcr abl t(9,22)
|
|
|
ANTICA with no BMS
|
cisplatin, bleomycin, vincritine, asperginase
|
|
|
asperginase
|
AE- pancreatitis
|
|
|
lomustine, carmustine
|
crosses BBB, used for glioma
|
|
|
charcoal
|
AD for all other positings
|
|
|
vit K
|
AD for warfarn
|
|
|
atropine+pralidoxime
|
organophohphates , ACH2 inhibitors AD
|
|
|
Deforoxamine
|
AD for iron and salts
|
|
|
digoxin immun Fab
|
AD for digoxin
|
|
|
Dimercaprol
|
AD for Arshenic, gold, mercury, lead, oral succimer for milder lead and milder mercury toxicity
|
|
|
EDTA
|
AD for Cd, Cr, Co, Mn, Zn toxicity
|
|
|
Esmolol
|
AD for theyophyline, beta agonsits
|
|
|
Ethanol, fomepizole
|
AD for methoanol or ethylene glycol
|
|
|
flumanezil
|
AD for benzo
|
|
|
naloxone
|
AD for opoids
|
|
|
100% oxygen
|
AD for CO
|
|
|
pencillamine
|
AD for Cu
|
|
|
protamine
|
AD for Heparin
|
|
|
acetylcysteine
|
AD for acetaminophn
|
|
|
gingki
|
intermittent claudication and alzeimers, use in cuation with anticoags
|
|
|
saw palmetto
|
tx of BPH, 5 alpha reductase inhibitor and androgen receptor antagonist
|
|
|
St johns
|
serotonin syndrome, enhaces 5HT, interaction with antidepresants
|
|
|
abciximab
|
antagonist of IIb/IIIa receptors
|
|
|
infliximab
|
RA and CD , binds to TNF
|
|
|
trastuzumab
|
breast CA, ERB2(Her 2/neu)
|
|
|
rituximab
|
NHL, binds to surface protein
|
|
|
Interferon alpha
|
Hep B, C, lukemia, melanoma
|
|
|
Interferon beta
|
MS
|
|
|
Interferon gamma
|
CGD increases TNF
|
|
|
azithioprine
|
immunosupressant converted to 6- mercaptourine
|
|
|
cyclosporine
|
DOC for organ or tissue transplant , binds to cycophilin
|
|
|
Tacrolimus
|
alt to cylosporine , MOA- FK binding protein
|
|
|
alendronate
|
DOC for glucocroticoid induced ostoporosis
|
|
|
bisphonates
|
stabilzies hydroapatite, ends in ronate, for paget disease
|
|
|
teriparatide
|
recombinant DNA PTH analog, once daily, AE- continuous infusion stimulate osteoclast activity , increased risk of osteosarcoma
|
|
|
octreotide
|
somatostatin
|
|
|
somatropin
|
GH
|
|
|
cosyntropin
|
ACTH
|
|
|
leuprolide, nafarelin
|
GnRH
|
|
|
Propylthiouracil and methomazole
|
hyperthyroidism, PTU safer in pregnancy , inhibts oxidation, coupling, iodination, conversion of T3 to T 4
|
|
|
Flutamide
|
androgen receptor blocker for prostate CA
|
|
|
Leuprollide
|
GnRH analog, androgen receptor+ prostate cancer
|
|
|
Finasteride
|
5 alpha reductase inhibitor, USE- BPH and male pattern baldness
|
|
|
OCPs
|
increased risk of liver adenoma, complication- retroperitoneal bleeding
|
|
|
oxandrolone, nandrolone
|
androgens, male hypogonadism, use in atheles, AE- aggresion and cholestatic jaundice
|
|
|
norethindone
|
progestin, AE- hursuitisim
|
|
|
Raloxifene
|
no increased risk of endometrial cancer
|
|
|
clomiphene
|
fertility pill, decreases feedback inhnition, AE- multile births
|
|
|
Anastrazole
|
post menopausla breast CA
|
|
|
mifepristone
|
morning after pill, blocks glucocorticoid and progestin receptors
|
|
|
metyrapone, ketoconazole
|
blocks 11 hydroxylation
|
|
|
Exenatide
|
releases incretin, increases insulin secretion, GLP1 full agonist,
|
|
|
Sitagliptin
|
inhibits dipeptidyl peptidase, inhibits activaiton of GLP-1
|
|
|
pramilintide
|
synthetic version of amylin- slows rate of food absorption and decreases appetite
|
|
|
Pioglytazone and rosiglitazone
|
binds to PPAR increases sensitixation to isulin on genetic level, AE- less hypoglycemia than sufonynureas, wt gain, edema
|
|
|
acarbose
|
inhibits alpha glucosidase in brush borders of small intestince-->decreased absoprtion, AE- hepatoxic
|
|
|
metformin
|
increases tissue snesitivty to insulin and decreases hepatic gluconeogenesis, AE- lactic acidosis
|
|
|
repaglinide
|
stimuates insulin release from pancreatic beta cells
|
|
|
Acetohexamide, tolubutamide, chlorpromide
|
first generation sulfonylureas, chlorpomide(SIADH/disulfiram rxn)
|
|
|
glipizide, glyburide
|
second gen sulfonylureas
|
|
|
sulfonylureas
|
block K channles-->depolariozation-->insulin rlease, AE- hypoglycemia and wt gain, lots of DI(cimetidien, saliclylates, sulfonamides)
|
|
|
hypoglycema rxn
|
lip tonging, lethargy, confusion, sweats, tremors, coma, seizure
|
|
|
glargine
|
insulin analog with no peak
|
|
|
Abicimab, eptifibatide, tirofiban
|
Iib/IIIa antagonist, used for acute coronary syndrome (antiplatelet)
|
|
|
ticlopidine and clopidogrel
|
block ADP receptors on platelets, decreased activation (antiplatelet)
|
|
|
aspirin
|
prophylaxis for atrial arrthmias and TIAs, COX inh
|
|
|
streptokinase
|
thrombolytic, depetes circulating V and VIII
|
|
|
altepllase
|
trhomolytic clot specific
|
|
|
argatroban
|
used in HIT , direct thormbin inhibitors
|
|
|
Dabigatran
|
atrial fib
|
|
|
Bivalurudin
|
unstable angina
|
|
|
Warfarn
|
small, vit K deriv, oral, decreases hep syn of vit K factors, PT, fresh forozen plasma or vit K as tx, long term,AE- skin necrosis
|
|
|
Heparin
|
large, parenteral, PTT, tx- protamine sulfate, rapid, AE- HIT hypersensitivity
|
|
|
Theophylline
|
inhibits adenosine(prevents bronchoconstriction) and decreases PDE which increase cAMP and lead to bronchodilation
|
|
|
ipratropium
|
DOC for B blocker bronchospasm
|
|
|
cromolyn and nedocromil
|
prevents degran of pul mast cells and decreases release of histamine
|
|
|
lukasts
|
LTD4 antagonists, astham prophylactic
|
|
|
acute astham tx
|
B agonsits, theophylline
|
|
|
chronic astham tx
|
ipratropum, lukasts, zilueton
|
|
|
zileuton
|
selective LOX inhibitor
|
|
|
bexametasone, dexamethasone
|
glucocorticoids, decreases PGs and LTs, antiinf and immunisupression, AE- iatrogenic cushingoind syn, cortical atrophy, osteoporosis, electolyte imbalance
|
|
|
colchicine
|
binds to tubulie and decreases microtubular polyerzaiton
|
|
|
sulindac
|
NSAID with no renal effect, used for gout
|
|
|
allpurinol
|
prodrug that is converted by xanthine oxidase inhibits enzyme, decreases purine metablism decreases uric acid , AE- hypoxanthine stones, DI- inhinits 6-Mercaptopurine, used for chonic gout
|
|
|
probenecid
|
inhibits proximal tubular reabsorption of urate
|
|
|
acute gout
|
colchicine, NSAID, intracrutcalr steroids( cochilicine has lots of AE)
|
|
|
hydroxychloriquine
|
stabilizes lysosomes and decreases cehmostaxis, hemolysis in G6PD pts, used for RA
|
|
|
Methotrexate
|
cytotxoci to lymphocytes, hematoxicity
|
|
|
sulfasalazine
|
hemolysis in G6PD, for RA
|
|
|
RA drugs
|
hydroxychloruine, methotrexate, suflasalazine, glucocorticoids, gold salts, pencillamine, leflunamide, etanercept, inflixmab
|
|
|
glucocortioics
|
AE- cushoid syndrome, used for RA
|
|
|
gold salts
|
RA, AE- dermatatitis, hematoxicity, nephrotici
|
|
|
pencillamine
|
wilsons idsease, RA
|
|
|
leflunomide
|
inhibts DHOD, AE- alomeida, USE- RA
|
|
|
etanercept
|
binds TNF, infections, RA
|
|
|
anaakinra
|
IL1 receptor antagonist
|
|
|
RA drugs
|
NSAID initially(do not affect progresion just pain and inf) then put on DMARDs
|
|
|
metroniddazole
|
amebiasis, giardiasis, trichomoniasis, toxoplasmosis, leishmaniasis, trypanosomiasis
|
|
|
antimalarial prophylaixs
|
chloroquinine +primiquine( p vivax and povale)
|
|
|
leisbmaniasis
|
stibogluconate
|
|
|
trypnosmoasis
|
african(arsenicals) and nifurtomox(chagas disease)
|
|
|
chloroquin resistant mamalira
|
prophylkaxis- mefloquine, tx- quinine, AE- hemolytic anemia
|
|
|
mebendazole
|
nematodes , decreased glucose uptake and microtubular structure
|
|
|
praziquantel
|
tapeworms and flukes , increased Ca and increased vaculoization
|
|
|
pyratel pamoate
|
spastic paralysis
|
|
|
diphenhydramine
|
muscarnic blocker, sedatibe, antimotion
|
|
|
antihustamines
|
most block M receptors, are sedative and are antimition
|
|
|
loratidine and fexofenadie
|
antihismatines with NO CNS entry, no sedation and not anti mition sickess
|
|
|
H1 actication
|
capilalary dilation, increased permanility, decreased AV conduction
|
|
|
H2 activation
|
increased gastric acid secretion, increased SA node rate
|
|
|
cimetidine and ranitidine
|
H2 antagonists, supresses secretory resposnes to food, USE- PUD, GERD, ZE syndrome
|
|
|
cimetidine
|
H2 antaognist, CYP inh, gynecomastia and decreased libido
|
|
|
omeprazole
|
PPI, irreversible
|
|
|
misoprostol
|
PGE1 analog, increased mucus and bicarb secretion, decreased HCl secretion, NSAID induced ulcers, CI in pregnacy
|
|
|
sucralfate
|
protective gel like coating, antacids will interfere
|
|
|
bismuth subsalicylate
|
binds selectively to ulcer, coating and protecting it from acid and pepsin, BMT regimen
|
|
|
AlOH
|
antacid, constimation
|
|
|
MgOH
|
diarrhea
|
|
|
odansteron
|
5HT3 antagonist, antiemetic for chemo
|
|
|
antimetiec
|
5HT3 atnagaonsit, DA antagonist, H1 antagonist, muscarinic antagonsit, cabbinoids
|
|
|
apretipitant
|
NK receptor atntagonist, antiemetic
|
|
|
prochlorperazine, metoclopromide
|
DA antagonists , antiemetic
|
|
|
diphenhydramine, meclizine, promethazine
|
H1 antagonist , antiemetic
|
|
|
buspirone
|
partial agonsit at 5HT1a, GAD
|
|
|
sumatriptan
|
5HT1d decreases migraine pain
|
|
|
olanzapine
|
5HT2a antagonist, decreases symptoms of psychosis
|
|
|
cyproheptadine
|
5HT2 antagonist, used in carcinoid
|
|
|
ergotamine
|
partila agonist at alpha and 5HT2, vasoconstrctive, AE- abortion, gangene, ischemia
|
|
|
ergonovine
|
uterine smooth muscle contraction
|
|
|
carcinoid marker
|
5 HIAA- hydroxyindoleacetic acid
|
|
|
alrpostadil
|
mainatinas PDA, CI in pregnancy
|
|
|
dinoprostone
|
cervical rempening, abortifacient , PGE2
|
|
|
carboprost
|
PGF2alpha, abrotfacient
|
|
|
latanoprost
|
tx of glaucoma, decreased intraocular pressure
|
|
|
epoprostenol
|
PGI2, USE- pul HTN
|
|
|
aspirin
|
covalent bond via acetylation of a serine hyproxyl group near active site , antiplatetlet aggregiation- low dose, antiinfl- high dose, uncoupling of oxidative phosphryation, 0 order kinetics, alkanize urine , AE- reyes syndrome, angioedema, salycylism- vertigo, tinnitus, ringing,
|
|
|
celecoxib
|
cox 2 inhibitor , prothrombotic effects
|
|
|
acetaminophen
|
analgesic and antipyretic, hepatoxic, ethanol enhances liver toxicity , N acetylcysteine- antidote
|
