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Exam 3
Gene Therapy, pharmacogenomics, geriatrics, pregnancy, calcium & bone drugs, female steroids & HRT, contraceptives, other ob/gyn drugs, androgens, drugs of abuse
191
Pharmacology
Professional
03/08/2012

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Cards

Term
Calcium carbonate brand names
Definition
Tums, Os-Cal (oral)
Term
Calcium Carbonate %Ca
Definition
40% Ca
Term
calcium carbonate indications
Definition
most common oral prep for mild hypocalcemia, osteomalacia, rickets osteoporosis, renal osteodystrophy
Term
calcium carbonate PK
Definition
not absorbed well without HCl, take with food
Term
calcium carbonate side effects
Definition
more GI effects than other preps, mild alkali syndrome leading to hypercalcemia, decreased PTH, hyperphosphatemia, kidney stones, renal failure
Term
calcium citrate brand name
Definition
Citracal (oral)
Term
calcium citrate %
Definition
21% Ca
Term
calcium citrate PK
Definition
more soluble, better BA, can be taken without food
Term
dibasic calcium phosphate
Definition
supplies both calcium and phosphate (oral)
Term
oral calcium salt side effects
Definition
GI: constipation, intestinal bloating, gas (esp calcium carb)
Term
oral calcium salt interactions
Definition
decreased absorption of fluoride, iron, zinc, beta blockers, salicylates, phenytoin, bisphosphanates, tetracyclines, ciprofloxacin
Term
oral calcium salt new concerns
Definition
possible increased heart attack risk (no definitive evidence)
Term
calcium gluconate route of admin and % Ca
Definition
IV or oral, 9% Ca
Term
calcium gluconate indication
Definition
drug of choice for IV therapy in acute hypocalcemic tetany (least irritating to veins, infuse slowly to avoid arrhythmias)
Term
calcium gluceptate route of admin, % Ca, unique characteristic
Definition
IV or IM, 22% Ca, only one that is not irritating on IM injection
Term
cholecalciferol, route of admin, brand, and what is it?
Definition
oral tablets, Delta-D, pure D3
Term
ergocalciferol, route of admin, brands, what it is
Definition
oral or IM, calciferol, drisdol, pure D2
Term
dihydrotachysterol, brands, what it is, route of admin
Definition
DHT, Hytakerol, Roxane; reduced form of D2, oral
Term
dihydrotachysterol indication, for what population
Definition
hyperparathyroidism secondary to renal failure, safer drug with renal failure (does not require renal 1-hydroxylation)
Term
doxercalciferol; brand, what it is
Definition
Hectoral, newer synthetic oral analog, doesn't require 1-hydroxylation (similar to dihydrotachysterol)
Term
calcifediol; brand, what population is it used in, route of admin
Definition
Calderol, does not require liver 25-hydroxylation, safer in liver disease, oral capsules
Term
Calcitriol, what it is, route of admin
Definition
1,25 OH2-D3, the final active hormone, no activation required, clinically most important, oral or injection
Term
paricalcitol and maxicalcitol; used for, route of admin
Definition
suppress excess PTH production without causing hypercalcemia; used in treating hyperparathyroidism but not for enhancing Ca abosrption, adminstered IV
Term
calcipotriene and calcitriol ointment; used for
Definition
skin ointment preps approved for treatment of psoriasis (vitamin D3 analog)
Term
cinacalcet; brand, what it is, indication, advantage
Definition
Sensipar, new group of "calcium sensor mimetics", decreases amount of Ca needed to supress PTH release, used for hyperparathyroidism, normalizes serum calcium without altering bone density
Term
Calcitonin; what it is, MOA
Definition
32 aa polypeptide secreted from thyroid when hypercalcemic, decreases calcium release from bone (inhibits osteoclasts), stimulates calcium and phosphate excretion by kidneys, acts as agonist on calcitonin receptors (GPCRs that increase cAMP)
Term
Calcitonin uses
Definition
acute hypercalcemia, hyperphosphatemia, Paget's, osteoporosis
Term
bisphosphanates; structure and mechanism
Definition
analogs of pyrophosphate, bind bone matrix, inhibit osteoclasts, decrease bone turnover
Term
bisphosphanates; uses, advantages/disadvantages
Definition
Paget's, hypercalcemia, osteoporosis; oral, non-antigenic, cheaper, may decrease bone formation
Term
bisphosphanates PK
Definition
poorly abosrbed, esp with food, should be taken on empty stomach, excreted by kidney (avoid renal), persist in bone for months/years
Term
bisphosphanate side effects
Definition
abdominal pain, nausea, diarrhea, vomiting, osteonecrosis of jaw (ONJ), femur fractures, esophageal cancer
Term
oral bisphophonate directions
Definition
overnight fast, take while upright, lots of water, no food for 30 min, remain upright 30 minutes
Term
Oral bisphosphanates (3)
Definition
alendronate (generic), risedronate (delayed release prep), tiludronate, ibandronate (oral or IV)
Term
zolendronate
Definition
IV use for prevention and treatement, once per year or every other year injection, risk for renal impairment
Term
ibandronate
Definition
oral (daily or monthly) or IV (every 3 months)
Term
teriparatide; brand, what is it, indications
Definition
Forteo, synthetic human PTH [1-34], hypoparathyroidism, osteoporosis with high fracture risk or glucocorticoid-induced
Term
teriparatide uniqueness
Definition
first drug that clearly increases bone formation, daily injection stimulates bone (chronic presence decreases bone), daily SC injection, short action
Term
teriparatide side effects
Definition
nausea, cramps, headache, bone cancer concern
Term
denosumab; properties and mechanism
Definition
monoclonal antibody (peptide injection) against RANK-L (a cytokine that activates osteoclasts, promotes resorption), denosumab bind RANK-L and prevents RANK activtion (decreasing bone degradation)
Term
denosumab indication/dose
Definition
injection given twice per year for postmenopausal women with osteoporosis with history or high risk of fracture or failed other therapy, also to treat bone metastases
Term
denosumab concerns
Definition
long-term suppression: ONJ, fracture, delayed fracture healing
side effects: back, muscle, bone pain, elevated cholesterol, urinary bladder infections
Term
denosumab contraindication
Definition
patients with hypocalcemia
Term
gallium nitrate
Definition
inhibits bone resorption, quite toxic, 3rd choice after calcitonin, bisphosphonates for hypercalcemia, Paget's, osteoporosis
Term
Plicamycin (aka mithramycin)
Definition
cytotoxic antibiotic that decreases plasma Ca by osteoclast toxicity, bone marrow suppression makes it useful in cancer, last resort for hypercalcemia, Paget's, osteoporosis; Useful for hypercalcemia of malignancy
Term
prednisone and other glucocorticoids
Definition
decrease hypercalcemia by inhibiting gut Ca absorption and toxic to immune cells, danger of osteoporosis with long-term use
Term
fluoride mechanism
Definition
stimulates osteoblasts, increases bone formation, increases bone fragility at higher doses
Term
fluoride disadvantages
Definition
narrow therapeutic window, highly toxic due to inhibition of respiratory and glycolytic enzymes
Term
therapy of hypocalcemia
Definition
IV Ca salts for acute tetany
Oral Ca salts for longer-term therapy
Vitamin D preparation plus adequate dietary Ca
Term
therapy of hypercalcemia
Definition
treat cause - hyperparathyroidism, adrenocorticall deficiency
Acute hypercalcemia: furosemide plus IV saline for diuresis and calciuresis
Vitamin D toxicity, sarcoidosis: glucocorticoids
hypercalcemia of malignancy: glucocorticoids, calcitonin, bisphosphonates, gallium nitrate, plicamycin
Term
therapy of osteoporosis
Definition
replacement sex steroids plus Ca
bisphosphonates
calcitonin
teriparatide
Term
therapy of Paget's disease
Definition
bisphosphonates, calcitonin, plicamycin
Term
estradiol PK
Definition
rapid first pass metabolism in liver when given orally
Term
slow-release depot forms of estradiol
Definition
estradiol valerate, estradiol cypionate
Term
estradiol indications
Definition
mainly used in HRT and hypogonadism
Term
conjugated estrogens
Definition
most common of several natural estrogen preps, contains estrone and estriol isolated from pregnant mare urine (Premarin)
Term
conjugated estrogen indications
Definition
major use is in HRT
Term
ethinyl estradiol and mestranol (prodrug)
Definition
synthetic estradiol analog, ethinyl group slows metabolism, increases potency, oral effectiveness, commonly used in oral contraceptives and some use in HRT
Term
diethylstilbestrol (DES, Stilphostrol)
Definition
non-steroidal estrogen, oral, very potent, toxic, use in cancer
Term
low dose estrogens used for
Definition
growth stimulation
Term
higher dose estrogens used for
Definition
epiphysial closure, sexual development, gonadotropins for fertility
Term
oral contraceptives, HRT, oophorectomy treatment
Definition
estrogen in combination with progestin
Term
estrogens; minor side effects
Definition
nausea, edema most common, breast tenderness, hyperpigmentation
Term
estrogens; more significant side effects
Definition
migraine, cholestasis, insulin resistance, liver/gall bladder disease, thrombophlebitis, endometrial hyperplasia (cancer, decreased by including progestins), gynecomastia, teratogenesis, metabolic changes
Term
progesterone
Definition
IM, creams, suppositories, slow release IUD, micronized oral prep, safer than synthetic progestins for long term HRT use
Term
medoxyprogesterone acetate, hydroxyprogesterone caproate, megestrol acetate
Definition
synthetic progestin, structurally related to progesterone (21 carbons), exert mainly progesterone-like effects, for HRT, cancer, contraception
Term
norethindrone acetate, norgestrel, ethynodiol
Definition
synthetic progestin, structurally related to testosterone (18 carbons), aka impeded androgens, usually used in oral contraceptive
Term
drospirenone
Definition
synthetic progestin, anti-androgenic and anti-mineralocorticoid, used in most popular new oral contraceptives
Term
Progestin uses
Definition
combo with estrogens for contraception/HRT, uterine bleeding due to endometrial hyperplasia, edometriosis, metastatic endometrial and breast cancer, diagnostic for estrogen secretion and endometrial responsiveness
Term
Progestin adverse effects
Definition
androgenic progestins: acne, weight gain, masculinization, altered libido, decreased HDL, increased LDL
All progestins: menstrual changes, nausea, bloating, teratogenesis
Term
Raloxifene
Definition
SERM, orally effective, used for agonist effect on bone (osteoporosis), no risk of cancer/uterine cancer because antagonist at these receptors, causes menopause symptoms and clotting
Term
Tamoxifen
Definition
SERM, orally effective, long used as anti-estrogen, found to be agonist on some receptors, antagonist on breast (used for breast cancer prevention), uterine cancer risk, thrombosis risk, causes menopause symptoms, decrease osteoporosis and heart disease risk
Term
fulvestrant
Definition
first and only pure estrogen antagonist for breast cancer
Term
shared properties of combination oral contraceptive pills
Definition
most widely used contraceptives, all contain ethinyl estradiol or mestranol (few) plus a "19-nor" progestin (norethindrone, norgestrel/levonorgestrel, norgestimate, drosperinone), most are fixed combos (some employ sequential changes)
Term
norgestimate
Definition
not androgenic or estrogenic used in combo with ethinyl estradiol
Term
Seasonale
Definition
84 days of active pills, 7 days of inactive pill (1 period every 3 months)
Term
Seasonique
Definition
similar to Seasonale but contains low ethinyl estradiol in final 7 pills
Term
Yaz
Definition
similar to Yasmin (has drosperinone as progestin) but has lower ethinyl estradiol and 24 active pills per 28 day cycle
Term
Loestrin 24 Fe
Definition
24 instead of 21 active pills per 28 day cycle, ethinyl estradiol dose now only 10ug (lowest ever)
Term
Lybrel
Definition
first continuous combo contraceptive, low dose ethinyl estradiol plus levonorgestrel, eliminates menstruation after some breakthrough spotting, similar to progestin-only pills
Term
Ortho-Evra
Definition
first combo contraceptive transdermal patch worn for 3 weeks, off for 1 week
Term
Nuvaring
Definition
new 3 week combo controceptive vaginal ring, ethinyl estradiol plus etonogestrel (a new progestin)
Term
Femcon Fe
Definition
new chewable combo contraceptive
Term
Natazia
Definition
new four-phase pill oral estrogen (estradiol valerate) and new progestin (dienogest), estrogen alone on days 1-2 and 25-26
Term
Contraceptive MOA
Definition
inhibits ovulation by disrupting cyclical release of gonadotropins (example of feedback suppressive therapy)
Term
Combination Contraceptive pill adverse effects - minor
Definition
estrogen effects: nausea, irritability, headache, fluid retention, cyclic weight gain, breast enlargement/tenderness, menstrual changes, altered libido
Progestin effects: Nausea, bloating, menstrual changes, depression, fatigue
Term
Combo contraceptives serious adverse effects
Definition
hypertension, lipid changes, clotting, stroke, MI, endometriosis (combos decrease), ovarian cancer, breast cancer, glucose intolerance, liver/gall bladder disease, teratogenesis
Term
Combo contraceptives contraindications
Definition
Absolute: pregnancy, estrogen-responsive tumor
Relative: thromboembolic disease, HTN, diabetes, liver disease, smoking in older women
Term
OCs decrease response to these drugs
Definition
acetaminophen, warfarin, thyroxine, antidiabetic drugs
Term
OCs increase response to these drugs
Definition
cyclosporine, imipramine, theophylline, corticosteroids, BNZ
Term
OC efficacy reduced by these drugs
Definition
ampicillin, tetracycline, neomycin, rifampin, barbs, phenytoin, carbamazepine
Term
OCs efficacy increased by these drugs
Definition
vitamin C, acetaminophen
Term
norethindrone (Micronor) or norgesterel (Ovrette)
Definition
progestin only "mini-pills", avoid estrogen adverse effects, but less effective (99.5%), taken daily, lack of regular bleeding, ovulation still occurs, used when estrogens contraindicated (breast feeding, breast cancer, migraine, HTN, older smokers, liver/gall bladder disease, thrombotic disease)
Term
medroxyprogesterone acetate (Depo-Provera)
Definition
IM injections every 3 months, concern due to possible toxicity, delayed recovery of fertility (not good for those that still desire pregnancy later)
Term
etonorgestrel (Implanon)
Definition
single-rod implant inside upper arm, effective for 3 years, risk of irregular bleeding
Term
Plan B
Definition
emergency contraceptive containing levonorgestrel only, 2 pills within 72 hrs
Term
Next Step
Definition
emergency contraceptive, contains levonorgestrel only, 2 pills 12 hr apart within 72 hrs
Term
Ella
Definition
emergency contraceptive, contains ulipristal (progesterone mixed agonist/antagonist related to mifepristone, an anti-progestin), can be taken up to 5 days after intercourse
Term
RU 486 - Mifepristone (Mifeprex)
Definition
abortefactient, progesterone receptor antagonist, disrupts maintenance of endometrium, also increases prostaglandin levels stimulating uterine contraction (induce safe abortion)
Term
Mifepristone regimen
Definition
3 x 200 mg tablets in single dose on first day, if no abortion take 2 x 200 ug misoprostol tablets in single dose, on day 14 return visit to confirm termination (95% effective)
Term
Mifepristone/misoprostol adverse effects
Definition
vaginal bleeding, severe abdominal pain, transient nausea, vomiting, diarrhea, headache
Term
methotrexate plus misoprostol
Definition
not approved for abortion but effective and used, folic acid antagonist and cytotoxic to trophoblast
Term
bromocriptine (Parlodel)
Definition
induce ovulation, dopamine agonist, orally effective, inhibits prolactin secretion by activating pituitary DA receptors
Term
danazol (Danocrine)
Definition
induce ovulation, weak androgen, orally effective, anti-estrogen to inhibit gonadotropin secretion, some progestin activity, used when ovulation prob due to endometriosis
Term
clomiphene (Clomid, Serophene)
Definition
induce ovulation, non-steroidal anti-estrogen, orally effective, reduces estrogen feedback inhibition of gonadotropin release, stimulates ovaries, also partial estrogen agonist, induces ovulation in 80%, 10% multiple births, causes ovary enlargement, menopause symptoms, used for oligospermia in males
Term
Human chorionic gonadotropin (hCG) (Profasi, APL)
Definition
peptide (IM), induce ovulation when pituitary defect, similar activity to LH, longer duration, from urine of preg women, also treat male infertility, hypogonadism in both sexes
Term
Menotropins (human menopausal gonadotropins, hMG, Pergonal)
Definition
peptide, induce ovulation when pituitary defect, LH and FSH activity, urine of postmeno women, used with hCG
Term
Ovulation induction regimen
Definition
low doses of menotropins plus hCG for 9-12 days for follicular development, then large dose of hCG alone for LH surge, induce ovulation (multiple births common), used in vitro fertilization, spermatogenesis
Term
FSH preparations
Definition
peptides, IM or SC (Urofollitropin, recombinant follitropin alpha subunit or beta subunit)
Term
gonadorelin (Lutrepulse)
Definition
synthetic GnRH, pulsatile admin (mimic physio release pattern), when hypothalamus is defective
Term
oxytocin (Pitocin, Syntocinon)
Definition
augmentation of labor or induction (high dose), small peptide hormone from posterior pituitary, agonist at GPCR, stimulates uterine SM contraction, stimulates PG production
Term
Oxytocin caution
Definition
fetal HR closely monitored, too much uterine contraction can reduce fetal circulation, may need B2-adrenergic agonist
Term
PGE2, PGE1, PGF
Definition
uterine contraction, small AA metabolites, act on GPCR to increase calcium, muscle contraction, induce cervical ripening at low doses
Term
dinoprostone, carboprost, misoprostol
Definition
prostaglandins, misoprostol has less GI effects and fever
Term
PG indications
Definition
second trimester abortions, often used together with other agents, local application of dinoprostone for cervical ripening
Term
Excess PGs
Definition
mediate painful contractions during dysmenorrhea (indomethacin, PG synthesis inhibitor effective therapy)
Term
Ergot alkaloids
Definition
plant compounds, increase frequency/force of uterine contractions, contraindicated in HTN
Preps include: ergonovine, methylergonovine
Used for: post-partum or after abortion to control bleeding, maintain contraction
Term
Tocolytic agents
Definition
inhibit uterine motility, delay/prevent premature delivery, examples include: terbutaline, magnesium salts, nifedipine, nicardipine, indomethacin
Term
terbutaline (Brethine)
Definition
most commonly used B2-adrenergic agonist for premature labor, IV to stop labor, then oral for maintenance, reflex tachycardia, increase cardiac output, hyperglycemia
Term
Mg salts
Definition
eclamptic seizures (Mg sulfate), IV to inhibit uterine motility, Mg gluconate oral for maintenance, high concentrations can cause respiratory depression and cardiac arrest
Term
Nifedipine and nicardipine
Definition
effective tocolytic agents, calcium channel blockers, without reducing placental blood flow
Term
Indomethacin
Definition
tocolytic, PG synthetase inhibitor, fetal/neonatal toxicities limit use
Term
testosterone
Definition
rapid metabolism, limited parenteral effectiveness, not orally effective, topical preps effective
Term
Andro LA, Depo-testosterone
Definition
testosterone esters, IM injection lasting 2-4 wks
Term
methyltestosterone (Android)
Definition
modified 17 alkyl to decrease metabolism, orally effective, androgenic steroid, hepatotoxic, short half life
Term
testosterone uses
Definition
replacement therapy, anabolic effects, breast cancer, erythropoiesis in some types of anemia
Term
Danazol (Danocrine)
Definition
17 alkyl testosterone analog, used in hereditary angioneuretic edema (liver effect)
Term
testosterone adverse effects
Definition
adverse effects: masculinization, feminization in men, testicular atrophy, prostate enlargement, acne, liver disease (17 alkyl synthetics), lipid changes, salt/water retention, HTN
Term
Oxandrolone, oxymetholone, stanozolol
Definition
higher ratio of anabolic to androgenic effectiveness, less masculinizing side effects, used by athletes, SARMS?, all are schedule III
Term
testosterone-like dietary supplements
Definition
androstenedione, dehydroepiandrosterone (DHEA)
Term
leuprolide
Definition
anti-androgen, GnRH analog, modified synthetic peptide, long DOA, reduces gonadotropin release (initially increase by desensitization)
Term
leuprolide and flutamide
Definition
used together to treat prostate cancer and hirsutism, anti-estrogen effects in breast cancer
Term
abarelix (plenaxis)
Definition
new GnRH antagonist analog, anti-androgen for advanced prostate cancer, peptide
Term
medroxyprogesterone acetate
Definition
inhibit GnRH release, induce chemical castration for sex offenders
Term
flutamide
Definition
orally effective non-steroidal androgen receptor antagonist, for prostate cancer, useful early in course of GnRH agonist therapy
Term
spironolactone
Definition
orally effective antagonist at mineralocorticoid and androgen receptors, also inhibits androgen synthesis, used alone or with oral contraceptives to treat hirsutism
Term
finasteride (propecia, proscar)
Definition
orally effective 5a-reductase inhibitor, block conversion of testosterone to DHT, used for BPH, baldness
Term
retroviruses
Definition
class of viruses ssRNA that create dsDNA, HIV is example
Term
lentiviruses
Definition
class of viruses ssRNA that create dsDNA copies, most efficient vector for gene delivery
Term
adenoviruses
Definition
class of viruses with dsDNA, cause respiratory, intestinal and eye infections
Term
adeno-associated viruses
Definition
class of small, ssDNA, insert DNA on chromosome 19
Term
herpes simplex viruses
Definition
class of dsDNA viruses, impact neurons
Term
Leber's congenital amaurosis (LCA)
Definition
defect in RPE65, AAV used
Term
retrovirus, lentivirus
Definition
insert size 7.4 kb
Term
adenovirus
Definition
insert size 30 kb
Term
AAV
Definition
insert size 4.7 kb, high immune response
Term
HSV
Definition
insert size 50 kb
Term
retrovirus
Definition
integration occurs with this vector
Term
allovectin-7 contains
Definition
plasma/lipid complex contains DNA sequences encoding HLA-B7 and beta2 microglobulin, form a MCH Class I
Term
Allovectin-7 use
Definition
used by injecting directly into tumor lesion to direct an immune response against metastatic tumors
Term
fomivirsen
Definition
antisense phosphorothioate oligonucleotide, blocks replication of mRNA, 21 nucleotides long
Term
fomivirsen
Definition
complimentary to mRNA transcribed from major immediate-early transcriptional unit of CMV, inhibits replication, used for local treatment of CMV retinitis with AIDS
Term
P-glycoprotein
Definition
protein product of MDR1, functions as an efflux transporter for lipophilic xenobiotics
Term
nelfinavir and efavirenz
Definition
MDR1 T/T mutation causes decreased concentrations of these chemotherapies
Term
suxamethonium
Definition
anesthesia, patients with plasma cholinesterase deficiency remain paralyzed for longer, dibucaine number used
Term
isoniazid
Definition
slow acetylator gets peripheral neuropathy, rapid acetylator has potential therapy failure
Term
procainamide
Definition
slow acetylator develops SLE, fast acetylator need higher doses
Term
benzidine
Definition
slow acetylator has more bladder cancer, slow acetylator has less bladder cancer
Term
CYP2D6
Definition
largest phenotypical variability among CYP family, more than 70 variant alleles
Term
normal cyp2d6 activity
Definition
CYP2D6*1
Term
no CYP2D6 activity
Definition
CYP2D6*3,*4,*5
Term
increased CYP2D6 activity
Definition
CYP2D6*2
Term
decreased CYP2D6 activity
Definition
CYP2D6*9,*10,*17
Term
Codiene
Definition
extensive 2D6 activity means more morphine, PM means less analgesia
Term
Haloperidol
Definition
EM 2D6 means mild side effects, PM means neurological problems
Term
Propranolol
Definition
EM 2D6 causes no change, PM causes no change
Term
CYP2C9 *2 and *3
Definition
2C9 most deficient activity alleles among ethnic groups, warfarin, tolbutamide and phenytoin
Term
debrisoquine
Definition
taken up by nerve cells by same mechanisms as noradrenaline, message is not passed on, muscles relax, blood vessels widen, decreases BP
Term
debrisoquine-4-hydroxylase
Definition
5-10% of caucasians are PM, caused by several mutant 2D6 alleles
Term
tamoxifen metabolic pathway
Definition
metabolized by 2D6 and multiple other enzymes
Term
frail patients
Definition
assumed to be more sensitive to mediaction, phase II metabolism appears to depressed
Term
liver metabolism in elderly
Definition
decreased phase I activity, CYP3A4 unchanged, 2D6/2C9/2C19/1A2 activities reduced
Term
barbs, diazepam, propranolol, verapamil
Definition
high extraction ratio drugs, hepatic clearance, reduce doses
Term
ethanol, prazosin, warfarin
Definition
low extraction ratio drugs, no change in dose
Term
cipro + olanzapine
Definition
1A2 inhibition, increased olanzepine, causes rigidity and falls, PK
Term
cipro and glibenclamide
Definition
synergistic hypoglycemia, causes falls and fatigue, PD
Term
tolterodine and donepezil
Definition
antagonism, causes decreased cognition, PD
Term
phenytoin and warfarin
Definition
3A4 induction, decreased warfarin, increased risk of strokes, PD
Term
ginkgo and aspirin
Definition
decreased platelet function, bleeding, herbal-drug interaction
Term
benzodiazepines and alcohol
Definition
synergistic CNS depression, falls
Term
thiazide
Definition
preferred antihypertensive, hypokalemia, hyperglycemia, hyperuricemia are more relevant due to arrhythmias, DM, and gout
Term
acetaminophen
Definition
drug of choice for anti-inflammatory
Term
acetaminophen
Definition
analgesic and atipyretic of choice during pregnancy
Term
cold medications with sympathomimetics
Definition
may lead to vascular-mediated congenital defects in the fetus
Term
penicillins and cephalosporins
Definition
safest for treatment of bacterial infections during pregnancy
Term
chloramphenicol
Definition
gray baby syndrome, phase II glucuronidation deficient
Term
carbamazepine and valproic acid
Definition
dietary suppl with folic acid recommended to prevent neural tube defects
Term
methyldopa and labetalol
Definition
preferred antihypertensives in pregnancy
Term
isotretinoin
Definition
for acne vulgaris, highly teratogenic!
Term
acitretin
Definition
for psoriasis, highly teratogenic!
Term
phenothiazines, metoclopramide and ondansetron
Definition
used for N/V during pregnancy
Term
loperamide
Definition
used for diarrhea during pregnancy, poorly absorbed
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