Term
| Hormone Replacement Therapy |
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Definition
Estrogen Therapy
MECH: decreased osteoclast activity; increased apoptosis of osteoclast/blast/cytes
SE: Venous thromboembolism, vaginal bleeding breast tenderness/cancer |
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Term
| Selective Estrogen Receptor Modulators (SERMs) |
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Definition
Ralxifene
MECH: Agonist effect in bones. Antagonist effect in breast and uterine tissue
BENEFIT: decreased vertebral fracture/LDL/total cholesterol/risk of breast cancer
SE: Hot flashes, leg cramps, venous thromboembolism |
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Term
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Definition
"Dronates" and Z-Acid
MECH: Decreased osteoclast activity and bone turnover
ADMIN: Pamidronate and Z-Acid IV for 2* osteoporosis; Z-Acid 1X/Yr Injxn for osteoporosis
BENEFIT: decreased risk of fractures
CLIN: osteoporosis, hypercalcemia of malignancy, Paget's Dz
SE: GI disturbance, hypokalemia, decreased renal fxn |
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Term
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Definition
Calcitonin-Salmon
MECH: Exogenous calcitonin
ADMIN: SC Injxn and Nasal Spray
BENEFIT: Decreased incidence of new vertebral fracture
CLIN: Osteoporosis, Paget's Dz
SE: Rhinitis, Irritation, Epistaxis, HA, arthralgia |
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Term
| Phosphate Binders: Calcium Containing |
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Definition
Ca Acetate and Ca Carbonate
MECH: Take with meals to bind dietary PO4. Can limit further complications from chronic renal Dz
BENEFIT: Tx hypocalcemia. CHEAP
CLIN: Hyperphosphotemia associated with chronic renal Dz
SE: HYPERcalcemia, GI disturbance |
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Term
| Phosphate Binder: Non-Calcium Containing |
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Definition
Sevelamer HCL and Sevelamer Carbonate
MECH: With meals to bind dietary PO4. Limit complications associated with renal Dz
CLIN: Hyperphosphotemia --> use when Calcium-Phosphate factor is >55; Decreased LDL and Increased HDL
SE: HYPOcalcemia, GI Disturbance |
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Term
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Definition
Calcitriol, Paracalcitol, Doxercalciferol
MECH: Decreased PTH Synth = Decreased PTH serum; Increase Ca++ absorption = Decreased PTH secretion
CLIN: 2* Hyperparathyroidism, Hypocalcemia (Calcitrol ONLY)
SE: Hypercalcemia, Edema, N/V/D |
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Term
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Definition
Cinacalcet
MECH: Binds to Ca++ receptor on Parathyroid gland causing a negative feedback suppression of PTH secretion
CLIN: 2* Hyperparathyroidism, Hypercalcemia associated with parathyroid carcinoma
SE: Hypocalcemia, N/D
CONTRA: Do NOT give if Ca++ <8.4 mg/dl |
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Term
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Definition
Epoetin Alfa and Darbapoetin
MECH: induces erythropoeisis
ADMIN: EA: 80-120 SQ (INPT); DARB: .45 (OUTPT)
CLIN: Chronic Anemias, Transfusion reduction associated with Surgery (give large doses)
SE: HTN , MI, stroke |
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Term
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Definition
G-CSF Filgastrim, PEG-G-CSF Pegfilgastrim, GM-CSF Sargramostin
MECH: CSF increased production and fxn of target cells
ADMIN: FIL: 5 SQ Daily; PEG: 6 SQ ONCE; SAR: 5 SQ Daily
-Start CSF 24-72 hours after chemo. Tx until ANC >10K
CLIN: Decreased ANC
SE: Bone pain, fever |
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Term
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Definition
Recombinant Human IL-11
MECH: Causes Dose-Dependent increase in platelet count and in megakaryocytes in the bone marrow
ADMIN: 50 SQ daily; 6-24 wks after chemo started; TX until count is <50K; >12 not recommended
CLIN: Prevention of severe thrombocytopenia in chemo pts
SE: Edema, SOB< Tachy, caution in pts with CHF/Arrhythmias |
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Term
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Definition
Hydroxyurea
MECH: Increased HgbF --> Dilutes abnormal HgbS
ADMIN: Requires several months of therapy to get effect
CLIN: Tx of Sickle Cell Dz; hemolytic anemias, polycythemia vera
SE: Myelosuppression of WBCs and PLTs |
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Term
| 1st Generation: H1 AntiHistamines |
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Definition
"Amines and Azines"
MECH: Inverse Agonist; does NOT effect histamine formation or release
PHARM: Readily crosses BBB
CLIN: Rhinitis, urticaria, conjunctivitis, pruritus, insomnia, allergic rxn, motion sickness, N/V
SE: Sedation/Sleepiness, Anticholinergic effects |
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Term
| 2nd Generation: H1 AntiHistamines |
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Definition
"TAdines and Razines"
MECH: Inverse Agonist; does NOT influence histamine formation/release
PAHRM: Longer duration; Doesn't cross BBB
CLIN: Rhinitis, urticaria, conjunctivitis, pruritus, allergic rxn
SE: Anticholinergic effects |
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Term
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Definition
"TIdines" - Ranitidine, Famotidine, Cimetidine
MECH: H2 Receptor Antagonists; Inhibits histamine-induced gastric acid secretion
CLIN: GERD, heartburn, Stress ulcer pre-op, allergic rxns
SE: Thrombocytopenia |
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Term
| Leukotreine Pathway-Modifying Agents |
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Definition
Zileutin, Monteluckast, Zafirkulast
MECH: ZIL: Decreased biosynthesis of LTA4 and its active derivatives; MONT and ZAFIR: inhigition of cysteinyl leukotreine receptor CysTLI
PHARM: Check LFTs Q6mth
CLIN: Asthma
SE: Hepatotoxicity, HA, GI upset, Churg-Strauss Syndrome |
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Term
| Anti-IgE Antibodies (Monoclonal) |
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Definition
Omalizumab
MECH: Decreases quantity of circulating IgE
PHARM: Long HL (26 days)
CLIN: Asthma
SE: Injxn site rxn, urticaria, thrombocytopenia, anaphylaxis |
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Term
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Definition
"Tidines" - Ranitidine, Famotidine, Cimetidine, Nizatidine
MECH: Inhibits Histamine-Induced Gastric Acid secretion
PHARM: Rapidly absorbed from small intestine
CLIN: PUD, GERD, Stress Ulcer prophylaxis
SE: Thrombocytopenia, confusion/hallucination |
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Term
| Proton Pump Inhibitors (PPIs) |
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Definition
"Prazoles"
MECH: Bind the H+/K+ ATPase system. Suppres secretion of H+ into the gastric lumen. Requires 18 Hr for enzyme to resynthesize.
ADMIN: PO, IV (Acute GI bleed), Continuous Drip
CLIN: PUD, erosive esophagitis, GERD, stress ulcer prophylaxis, hypersecretory conditions, H Pylori Tx, Acute GI bleed
SE: Nausea, Ab!, Dirrhea, Vit B12 inhibition |
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Term
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Definition
Aluminum Hydroxide, Mg Hydroxide, Calcium Carbonate
MECH: Weak bases that attempt to neutralize acid - Decrease gastric acidity
CLIN: PRN for symptom relief
SE: Constipation, diarrhea, bind ABXs, Mg Toxicity, Aluminum toxicity |
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Term
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Definition
Sucralfate
MECH: Impairs diffusion of further HCL and prevents further degradation of cells. Stimulates prostaglandin release.
PHARM: Not systemically absorbed. Required acidic pH for activation
CLIN: Heals DUODENAL ulcers
SE: Constipation |
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Term
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Definition
Misoprostol
MECH: Inhibits secretion of HCL and stimulates secretion of Mucus and HCO3-; Cytoprotective effect
PHARM: Produces uterine contractions
CLIN: Prevention of NSAID-induced ulcers
SE: Ab!, Diarrhea |
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Term
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Definition
ASA, Ibuprofen, Naproxen, Indomethacin, Celoxib (COX-2 only)
MECH: inhibit cyclooxygenase enzymes. Decrease prostaglandin production, decrease levels of inflammatory mediators
CLIN: ACUTE Gout
SE: N/V, GI bleed, Renal injury, Cardiac problems
CONTRA: Renal Dz |
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Term
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Definition
MECH: Limits inflammatory response; decreased release of chemotactic factors, decreased motility and adhesion of neutrophils, decreased tyrosine phosphorylation of neutrophil proteins that decrease leukotreine synthesis
PHARM: rapidly absorbed. Secreted in bile via MDR protein
ADMIN: Q2 or til Pt has diarrhea
CLIN: ACUTE gout attack, prophylactic for chronic gout
SE: N/V/D, Ab!, myelosuppression |
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Term
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Definition
"Sones"
MECH: Down-Regulate expression of many inflammatory mediators; Anti-inflammatory and immunosuppressive effects
SE: Osteoporosis, Increased infxn risk, HTN, edema, peptic ulcer, glaucoma, increased appetite, emotional disturbance, hypokalemia, hirsutism
-Abrupt removal of glucos causes an Acute Adrenal Insufficiency Syndrome |
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Term
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Definition
Allopurinol
MECH: Decreases uric acid production
CLIN: CHRONIC gout
SE: Rash, GI disturbance
CONTRA: Do not administer during an ACUTE attack |
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Term
| Xanthane Oxidase Inhibitor |
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Definition
Febuxostat
MECH: Decreased uric acid
CLIN: CHRONIC gout
SE: rash, increased liver enzymes, acute gout flares |
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Term
| Proximal Tubule Anion Exchange Inhibitor |
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Definition
Probenecid
MECH: Increased Urate Secretion
CLIN: CHRONIC Gout
SE: GI disturbance, Kidney stones |
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