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Details

Heidi Drug Chart
Comlex drugs
514
Medical
Professional
06/12/2013

Additional Medical Flashcards

 


 

Cards

Term
Nitrates (mechanism, use, toxicity)
Definition
Cause NO release -> vasodilation (veins >>> arteries); used in angina; fast tolerance, hypotension, flushing, headache
Term
Adverse effects of statins
Definition
Hepatoxicity and muscle breakdown
Term
Niacin (mechanism, use, toxicity)
Definition
Inhibits lipolysis and reduces VLDL secretion, lowering LDL and raising HDL; hyperlipidemia; flushing and hyperuricemia
Term
Cholestyramine, colestipol, colesevelam (mechanism, use, toxicity)
Definition
Inhibits reabsorption of bile acids -> lower LDL with slight increase in HDL; unpigmented gallbladder stones and malabsorption
Term
Ezetimibe
Definition
Prevents cholesterol reabsorption -> lower LDL
Term
Fibrates (gemfibrozil + -fibrates) (mechanism, use, toxicity)
Definition
Upregulates LPL -> lower triglycerides, slightly inc. HDL and slightly dec. LDL; myositis and hepatoxicity
Term
Digoxin and digitoxin (mechanism, use, toxicity)
Definition
Inhibits Na/K ATPase -> indirectly inhibits Na/Ca exchanger -> inc. calcium levels -> inc. contractility; stimulates the vagus; causes cholinergic symptoms and hyperkalemia
Term
Class 1A antiarrhythmics
Definition
Quinidine, procainamide, and disopyramide; inc. AP duration and QT interval; can cause torsades de pointes, cinchonism (qunidine), procainamide (drug-induced lupus)
Term
Class 1B antiarrhythmics
Definition
Lidocaine, mexiletine, and tocainide; dec. AP duration especially in depolarized/ischemia tissue; best following MI
Term
Class 1C antiarrhythmics
Definition
Flecainide, propafenone; no effect on AP, used in ventricular tachycardias; do not use post-MI due to risk for arrhythmias
Term
Class 1 antiarrhythmics (general mechanism and toxicity)
Definition
Blocks Na channels, decreasing the slope of phase 0 depolarization; toxicity exacerbated by hyperkalemia
Term
Class 2 antiarrhythmics
Definition
Beta-blockers; reduces cAMP, slowing SA and AV node activity, increases PR interval; adverse effects include impotence, asthma exacerbation, sedation
Term
Class 3 antiarrhythmics
Definition
Amiodarone, ibutilide, dofetilide, sotalol; K channel blockers; inc. AP duration and QT interval
Term
Toxicity of amiodarone
Definition
Pulmonary fibrosis, hepatotoxicity, thyroid dysfunction
Term
Class 4 antiarrhythmics
Definition
Ca channel blockers; verapamil and diltiazem; dec. conduction velocity and inc. PR interval; cause constipation, flushing, and edema
Term
Adeosine (mechanism, use, toxicity)
Definition
Inc. K efflux, hyperpolarizing the cell; used in supraventricular tachycardias; can cause flushing, hypotension, and chest pain
Term
Magnseium (mechanism, use, toxicity)
Definition
Used in torsades de pointes and digoxin toxicity
Term
Treatment for prolactinoma
Definition
Bromocriptine or cabergoline (dopamine agonists)
Term
Treatment of secondary hyperaldosteronism
Definition
Spironolactone (or other AT2 antagonist)
Term
Treatment of carcinoid syndrome
Definition
Octreotide (somatostatin analogues)
Term
Rapid-acting insulins (3)
Definition
Lispro, aspart, and glulisine
Term
Short-acting insulin (1)
Definition
Regular
Term
Intermediate-acting insulin (1)
Definition
NPH
Term
Long-acting insulins (2)
Definition
Glargine and detemir
Term
Metformin (mechanism, use, toxicity)
Definition
Biguanide; unknown mechanism; increases insulin sensitivity and glycolysis and decreases gluconeogenesis; can cause lactic acidosis (don't use in renal failure patients)
Term
Tolbutamide, chlorpropamide (mechanism, use, toxicity)
Definition
First-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes disulfuram-like effects
Term
Glyburide, glimepiride, glipizide (mechanism, use, toxicity)
Definition
Second-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes hypoglycemia
Term
Pioglitazone, rosiglitazone (mechanism, use, toxicity)
Definition
Thiazolidinediones; activates PPAR-gamma, increasing insulin sensitivity and adiponectin levels; causes weight gain, hepatotoxicity, and heart failure
Term
Acarbose, miglitol (mechanism, use, toxicity)
Definition
Alpha-glucosidase inhibitors; prevent sugar hydrolysis and absorption, reducing blood sugar levels
Term
Pramlintide (mechanism, use, toxicity)
Definition
Amylin analog; reduces glucagon secretion; causes hypoglycemia
Term
Exenatide, liraglutide (mechanism, use, toxicity)
Definition
GLP-1 analogues; increase insulin, decrease glucagon secretion; causes pancreatitis
Term
Linagliptin, saxagliptin, sitagliptin (mechanism, use, toxicity)
Definition
DPP-4 inhibitors; increase insulin, decrease glucagon secretion; causes mild urinary/respiratory infections
Term
Propylthiouracil (mechanism, use, toxicity)
Definition
Blocks thyroid peroxidase and 5'-deiodinase; used to treat hyperthyroidism; causes agranulocytosis, aplastic anemia, hepatotoxicity
Term
Methimazole (mechanism, use, toxicity)
Definition
Blocks thyroid peroxidase; used to treat hyperthyrodism; teratogenic
Term
Levothyroxine, triiodothyronine (mechanism, use, toxicity)
Definition
Thyroid hormone analogs; causes thyrotoxicosis
Term
Oxytocin (mechanism, use, toxicity)
Definition
Used to control uterine hemhorrage
Term
Demeclocycline (mechanism, use, toxicity)
Definition
ADH antagonist used to treat SIADH; can cause photosensitivty and bone/teeth abnormalities
Term
Glucocorticoids (mechanism, use, toxicity)
Definition
Inhibits phospholipase A2 activity and expression of COX-2; used for immune suppression; can cause Cushing's syndrome, adrenal insufficiency (if withdrawn quickly)
Term
Cimetidine and ranitidine (mechanism, use, toxicity)
Definition
H2 antagonists; used to treat hyperchloridia; cimeditine is a P-450 inhibitor and has antiandrogenic effects, both reduce creatinine secretion
Term
-prazoles (mechanism, use, toxicity)
Definition
Irreversibly inhibit the H/K pump; used to treat hyperchloridia; increased risk of C. difficile infection and hypomagnesemia
Term
Bismuth, sucralfate (mechanism, use, toxicity)
Definition
Coats ulcer base and protects underlying tissue
Term
Misoprostol (mechanism, use, toxicity)
Definition
PGE1 analog that decreases acid production and increases bicarb production; used to prevent NSAID ulcers; abortifacient
Term
Octreotide (mechanism, use, toxicity)
Definition
Somatostatin analog; used to treat VIPoma and carcinoid syndrome
Term
Toxicity of long-term antacid use
Definition
Hypokalemia
Term
Infliximab (mechanism, use, toxicity)
Definition
Anti-TNF; used to treat IBD and RA; can cause activation of latent microbes
Term
Sulfasalazine (mechanism, use, toxicity)
Definition
Combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory); used to treat IBD; causes oligospermia
Term
Ondansetron (mechanism, use, toxicity)
Definition
5-HT3 antagonist; used as an antiemetic
Term
Metoclopramide (mechanism, use, toxicity)
Definition
D2 antagonist; used to increase gut muscle activity and as an antiemetic; causes parkinson signs
Term
Can be used to prevent mast cell degranulation
Definition
Cromolyn sodium
Term
Treatment of lead poisoning
Definition
Dimercaprol and EDTA, succimer in kids
Term
Heparin (mechanism, use, toxicity)
Definition
Activates antithrombin, which inactivates thrombin and Xa; used for immediate coagulation and in pregnant women; some patients develop antibodies to platelet factor 4 (HIT)
Term
Enoxaparin, dalteparin (mechanism, use, toxicity)
Definition
Same actions as heparin, but has a longer half-life, does not have to be monitored as closely, and has a reduced risk of HIT
Term
Warfarin (mechanism, use, toxicity)
Definition
Inactivated gamma-carboxylation of factors II, VII, IX, X, C, and S; used for long-term and non-immediate anticoagulation; can cause tissue necrosis, teratogenic
Term
Alteplase, reteplase, tenecteplase (mechanism, use, toxicity)
Definition
Converts plasminogen to plasmin; used as a thrombolytic
Term
Aspirin (mechanism, use, toxicity)
Definition
Irreversibly inhibits COX-1 and COX-2; anti-platelet and anti-inflammatory; gastric ulcers, tinnitus, Reye's syndrome in childhood viral infections
Term
Clopidogrel, ticlodipine, prasugrel, ticagrelor (mechanism, use, toxicity)
Definition
Irreversibly blocks ADP receptors on platelets, preventing degranulation; used for acure coronary syndrome; ticlodipine causes neutropenia
Term
Cilostazol, dipyridamole (mechanism, use, toxicity)
Definition
Phosphodiesterase inhibitor, increases cAMP and decreases ADP, preventing platelet degranulation; nausea, headache, facial flushing, hypotension
Term
Abciximab, eptifibatide, tirofiban (mechanism, use, toxicity)
Definition
GPIIb/IIIa inhibitors, preventing platelet aggregation; bleeding, thrombocytopenia
Term
Methotrexate (mechanism, use, toxicity)
Definition
Inhibits dihydrofolate reductase, inhibiting DNA synthesis; myelosuppression, macrovesicular fatty change in liver
Term
5-fluorouracil (mechanism, use, toxicity)
Definition
Pyrimidine analog that is activated and inhibits thymidylate synthase, inhibiting DNA synthesis; myelosuppression, photosensitivity
Term
Cytarabine (mechanism, use, toxicity)
Definition
Pyrimidine analog that inhibits DNA polymerase; leukopenia, thrombocytopenia, megaloblastic anemia
Term
Azathioprine, 6-mercaptopurine, 6-thioguanine (mechanism, use, toxicity)
Definition
Purine analogs that are activated by HGPRT and inhibit purine synthesis; toxicity is increased with allopurinol, causes bone marrow, GI, and liver toxicity
Term
Dactinomycin (actinomycin D) (mechanism, use, toxicity)
Definition
DNA intercalator; used for childhood tumors; myelosuppression
Term
Doxorubicin (Adriamycin), daunorubicin (mechanism, use, toxicity)
Definition
Generates free radicals that cause DNA strand breaks; dilated cardiomyopathy(Dexrazoxone, an iron chelator, prevents this), myelosuppression, alopecia
Term
Bleomycin (mechanism, use, toxicity)
Definition
Generates free radicals that cause DNA strand breaks; pulmonary fibrosis with minimal myelosuppression
Term
Cyclophosphamide, ifosfamide (mechanism, use, toxicity)
Definition
Crosslinks DNA (must be activated by liver); myelosuppression, hemhorragic cystitis (can be minimized with mesna)
Term
Carmustine, lomustine, semustine, streptozocin (mechanism, use, toxicity)
Definition
Used to treat CNS tumors
Term
Busulfan (mechanism, use, toxicity)
Definition
Alkylates DNA; pulmonary fibrosis, hyperpigmentation
Term
Vincristine, vinblastine (mechanism, use, toxicity)
Definition
Block microtubule polymerization; vincristine causes neurotoxicity, vinblastine causes bone marro suppression
Term
Paclitaxel (mechanism, use, toxicity)
Definition
Blocks microtubule breakdown; myelosuppression
Term
Cisplatin, carboplatin (mechanism, use, toxicity)
Definition
Crosslinks DNA; nephrotoxicity (minimize with chloride diuresis, amifostine), acoustic n. damage
Term
Etoposide, teniposide (mechanism, use, toxicity)
Definition
Inhibits topoisomerase II; myelosuppression, GI upset, alopecia
Term
Hydroxyurea (mechanism, use, toxicity)
Definition
Inhibits ribonucleotide reductase and increases HbF; used in cancers and HbSS disease; bone marrow suppression
Term
Prednisone (mechanism, use, toxicity)
Definition
Unknown but may trigger apoptosis in dividing cells; Cushingoid symptoms
Term
Tamoxifen, raloxifene (mechanism, use, toxicity)
Definition
Prevents estrogen receptor binding; used in breast cancer and prevention of osteoporosis; tamoxifen increases the risk of endometrial cancer due to agonist effects. Raloxifene = no increase in endometrial cancer.
Term
Trastuzumab (mechanism, use, toxicity)
Definition
Antibody against HER-2 receptor; cardiotoxicity
Term
Imatinib (mechanism, use, toxicity)
Definition
Antibody against bcr-abl tyrosine kinase
Term
Rituximab (mechanism, use, toxicity)
Definition
Antibody against CD20; used to treat non-Hodgkin's lymphoma and rheumatoid arthritis
Term
Vemurafenib (mechanism, use, toxicity)
Definition
B-raf kinase inhibitor (V600 mutation); used in metastatic melanoma
Term
Bevacizumab (mechanism, use, toxicity)
Definition
Antibody against VEGF
Term
Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac (mechanism, use, toxicity)
Definition
Reversible COX inhibitor; gastric ulcers, renal ischemia (due to constriction of afferent arteriole)
Term
Celecoxib (mechanism, use, toxicity)
Definition
Reversible COX-2 inhibitor; anti-inflammatory without damage to gastric mucosa; sulfa allergy, thrombosis
Term
Acetominophen (mechanism, use, toxicity)
Definition
COX inhibitor in the CNS (not anti-inflammatory); causes hepatic necrosis
Term
Alendronate (mechanism, use, toxicity)
Definition
Pyrophosphate analog that inhibits osteoclasts; used to treat osteoporosis, hypercalcemia, and Paget's disease; corrosive esophagitis
Term
Allopurinol (mechanism, use, toxicity)
Definition
Xanthine oxidase inhibitor, reduces production of uric acid
Term
Febuxostat (mechanism, use, toxicity)
Definition
Xanthine oxidase inhibitor
Term
Probenecid (mechanism, use, toxicity)
Definition
Inhibits reabsorption of uric acid in PCT
Term
Colchine (mechanism, use, toxicity)
Definition
Inhibits microtubule polymerization, preventing neutrophil extravasation
Term
Etanercept (mechanism, use, toxicity)
Definition
TNF-alpha receptor that binds free TNF-alpha
Term
Infliximab, adalimumab (mechanism, use, toxicity)
Definition
Anti-TNF-alpha antibody
Term
Latanoprost (mechanism, use, toxicity)
Definition
PGF2 analog that increases the outflow of aqueous humor; can cause darkening of the iris
Term
Morphine, fentanyl, cofeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate (mechanism, use, toxicity)
Definition
Mu opioid agonists that open K channels and close Ca channels, inhibting synaptic transmission; addiction, respiratory depression, constipation, miosis
Term
Butorphanol (mechanism, use, toxicity)
Definition
Mu opioid partial agonist; used to treat severe pain; causes withdrawal if being treated with full agonist
Term
Tramadol (mechanism, use, toxicity)
Definition
Weak opioid agonist that inhibits serotonin and NE reuptake; increases risk for seizures
Term
First-line therapy for simple partial seizures
Definition
Carbamazepine
Term
First-line therapy for complex partial seizures
Definition
Carbamazepine
Term
First-line therapies for tonic-clonic seizures (3)
Definition
Carbamazepine, phenytoin, valproate
Term
First-line therapy for absence seizures
Definition
Ethosuximide
Term
Phenytoin (mechanism, use, toxicity)
Definition
Increases Na channel inactivation and inhibits glutamate release; used for simple, complex, and tonic-clonic seizures and status epilecticus prophylaxis; nystagmus, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenic, drug-induced lupus, P450 inducer
Term
Carbamazepine (mechanism, use, toxicity)
Definition
Increases Na channel inactivation; first-line for simple, complex, and tonic-clonic seizures and trigeminal neuralgia; agranulocytosis, aplastic anemia, P450 inducer, SIADH, liver toxicity
Term
Lamotrigine (mechanism, use, toxicity)
Definition
Blocks Na channels; used for simple, complex, and tonic-clonic seizures; Steven-Johnson syndrome
Term
Gabapentin (mechanism, use, toxicity)
Definition
Inhibits Ca channels; used for simple, complex, and tonic-clonic seizures, migraine prophylaxis, peripheral neuropathy, bipolar disorder; ataxia
Term
Topiramate (mechanism, use, toxicity)
Definition
Blocks Na channels and increases GABA secretion; used for simple, complex, and tonic-clonic seizures and migraine prevention; mental dulling, kidney stones, weight loss
Term
Phenobarbital (mechanism, use, toxicity)
Definition
Increases GABA channel action; first-line for simple, complex, and tonic-clonic seizures in children; P450 inducer
Term
Valproate (mechanism, use, toxicity)
Definition
Increases Na channel inactivation and increases GABA levels; first-line for tonic-clonic seizures, used for simplex, complex, tonic-clonic, and myoclonic seizures; hepatotoxicity, neural tube defects, weight gain, tremor
Term
Ethosuximide (mechanism, use, toxicity)
Definition
Blocks thalamic Ca channels; first-line for absence seizures; GI distress, Steven-Johnson syndrome
Term
Benzodiazepines (mechanism, use, toxicity)
Definition
Increases frequency of GABA channel opening; first-line for status epilepticus (diazepam, lorazepam), used for eclampsia seizures (diazepam, lorazepam), anxiety, alcohol withdrawl, sleep walking, night terrors; sedation
Term
Tiagabine (mechanism, use, toxicity)
Definition
Inhibits GABA reuptake; used for simple and complex seizures
Term
Vigabatrin (mechanism, use, toxicity)
Definition
Irreversibly inhibits GABA transaminase, increasing GABA concentration; used for simple and complex seizures
Term
Levetriacetam (mechanism, use, toxicity)
Definition
Unknown mechanism; used for simple, complex, and tonic-clonic seizures
Term
Phenobarbital, pentobarbial, thiopental, secobarbital (mechanism, use, toxicity)
Definition
Increase duration of GABA channel opening; induction of anesthesia, sedative; CNS depression, P450 inducer, contraindicated in patients with porphyrias
Term
Triazolam, oxazepam, midazolam (mechanism, use, toxicity)
Definition
Short-acting benzodiazepines; more addictive potential
Term
Barbituates vs. benzodiazepines (mechanism)
Definition
Increase duration vs. increase frequency
Term
Zolpidem, zaleplon, eszopiclone (mechanism, use, toxicity)
Definition
BZ1 subtype GABA channel agonists; used to treat insomnia
Term
Ketamine (mechanism, use, toxicity)
Definition
Blocks NMDA receptor; used as an anesthetic; increases cardiac activity, hallucinations, bad dreams
Term
Order of sensory loss when using local anesthetics
Definition
Pain -> temperature -> touch -> pressure
Term
Succinylcholine (mechanism, use, toxicity)
Definition
ACh receptor agonist, produces sustained depolarization and desensitization; used as a paralytic; hypercalcemia, hyperkalemia, malignant hyperthermia
Term
Tubocurarine, -curium drugs (mechanism, use, toxicity)
Definition
ACh antagonists; used as paralytics
Term
Dantrolene (mechanism, use, toxicity)
Definition
Inhibits release of Ca from sarcoplasmic reticulum and skeletal muscle; used to treat malignant hyperthermia and neuroleptic-malignant syndrome
Term
Levodopa/carbidopa (mechanism, use, toxicity)
Definition
Converted to dopamine by dopa decarboxylase in CNS/inhibits peripheral dopa decarboxylase activity; used to treat parkinson symptoms; can cause arrhythmias and "on/off" phenomenon
Term
Selegiline (mechanism, use, toxicity)
Definition
MAO-B (prefers dopamine for breakdown) inhibitor, inhibits dopamine breakdown; used to treat parkinson symptoms; enhances adverse effects of levodopa
Term
Donepezil, galantamine, rivastigmine (mechanism, use, toxicity)
Definition
ACh esterase inhibitors; used to treat Alzheimer's disease; cholinergic symptoms
Term
Sumatriptan (mechanism, use, toxicity)
Definition
Agonist at 1B/1D serotonin receptors; used to treat acute migraines and cluster headaches; coronary vasospasm
Term
Trifluoperzine, fluphenazine, haloperidol (mechanism, use, toxicity)
Definition
High potency antipsychotics that antagonize D2 receptors; used to treat schizoprehnia, psychosis, mania, and Tourette's; hyperprolactinemia, anti-cholinergic symptoms (dry mouth, constipation), extrapyramidal effects (dyskinesia), neuroleptic malignany syndrome, tardive dyskinesia (haloperidol)
Term
Chlorpromazine, thioridazine (mechanism, use, toxicity)
Definition
Low potency antipsychotics that antagonize D2 receptors; used to treat schizophrenia, psychosis, mania, and Tourette's; corneal deposits (chlorpromazine), retinal desporits (thioridazine)
Term
Olanzapine, clozapine, quetiapine, risperidone, aripripazole, ziprasidone (mechanism, use, toxicity)
Definition
Atypical antipsychotics with unknown mechnism; used for schizophrenia, bipolar disorder, OCD, and others; weight gain (olanzapine, clozapine), agranulocytosis (clozapine), seizures (clozapine), prolonged QT (ziprasidone)
Term
Lithium (mechanism, use, toxicity)
Definition
Unknown mechanism; used for bipolar disorder and SIADH; tremor, sedation, edema, hypothyroidism, polyuria
Term
Buspirone (mechanism, use, toxicity)
Definition
Agonizes 1A serotonin receptors; used for generalized anxiety disorder; no side effects, but takes 1-2 weeks for improvement
Term
Fluoxetine, paroxetine, sertraline, citalopram (mechanism, use, toxicity)
Definition
Block reuptake of serotonin from the synaptic cleft; depression and others; sexual dysfunction, sertonin syndrome (hyperthermia, myoclonus, flushing, diarrhea, seizures)
Term
Venlafaxine, duloxetine (mechanism, use, toxicity)
Definition
Block reuptake of NE and serotonin from synaptic cleft; depression, diabetic neuropathy (duloxetine); hypertension
Term
-iptyline, -ipramine, doxepin, amoxapine (mechanism, use, toxicity)
Definition
TCAs, block reuptake of NE and serotonin; depression, bewetting (imipramine), OCD (clomipramine); convulsions, coma, arrhythmias, sedation, hypotension, anti-cholinergic effects
Term
Tranylcypromine, phenelzine, isocarboxazid, selegiline (mechanism, use, toxicity)
Definition
Inhibit breakdown of NE, serotonin, and dopamine; used for atypical depression, anxiety, and hypochondriasis; hypertensive crisis (tyramine in wine/cheese), don't use with other serotonin agonists
Term
Bupropion (mechanism, use, toxicity)
Definition
Increases NE and dopamine; used for smoking sensation, depression; seizures
Term
Mirtazapine (mechanism, use, toxicity)
Definition
Alpha-2 antagonist, increases NE and serotonin release, and serotonin receptor agonist; used for depression; sedation, increased appetite with weight gain;
Term
Maprotiline (mechanism, use, toxicity)
Definition
Blocks NE reuptake; used for depression; sedation, hypotension
Term
Trazodone (mechanism, use, toxicity)
Definition
Inhibits serotonin uptake; used for insomnia; pripism
Term
Mannitol (mechanism, use, toxicity)
Definition
Osmotic diuretic; used to treat drug overdose and increased ICP; pulmonary edema, CHF
Term
Acetazolamide (mechanism, use, toxicity)
Definition
Carbonic anhydrase inhibitor; used for glaucoma, metabolic alklalosis; hyperchloremic metabolic acidosis, ammonia toxicity, sulfa allergy
Term
Furosemide (mechanism, use, toxicity)
Definition
Inhibits NKCC channel, preventing urine concentration; used in hypertension, CHF, hypercalcemia; ototoxicity, hypokalemia, hypocalcemia, nephritis, gout, sulfa allergy
Term
Ethacrynic acid (mechanism, use, toxicity)
Definition
Inhibits NKCC channel; used in patients with furosemide (sulfa) allergy; hyperuricemia
Term
Hydrochlorothiazide (mechanism, use, toxicity)
Definition
Inhibits NaCl reabsorption in DCT and increases Ca reabsorption; hypertension and hypercalcinuria; hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy
Term
Spironolactone, eplerenone (mechanism, use, toxicity)
Definition
Aldosterone receptor antagonists; hyperaldosteronism, CHF, hypokalemia; hyperkalemia (arrhythmias), antiandrogen effects with spironolactone
Term
Triamterene, amiloride (mechanism, use, toxicity)
Definition
Block sodium channels in cortical collecting duct; hyperaldosteronism, CHF
Term
Captopril, enalapril, lisinopril (mechanism, use, toxicity)
Definition
ACE inhibitor, leads to reduced angiotensin II levels and decreases GFR; prevents heart remodeling, hypertension, CHF; cough, angioedema, transient creatinine increase, hyperkalemia
Term
Losartan, valsartan (mechanism, use, toxicity)
Definition
Angiotensin II receptor antagonists; similar to ACE inhibitors, but do not cause cough due to normal metabolism of bradykinin
Term
Leuprolide (mechanism, use, toxicity)
Definition
GnRH analog that acts as an agonist in pulsatile doses and an antagonist in continuous doses; used as an agonist for infertility and an antagonist for prostate cancer, fibroids, and precocious puberty; antiandrogenic
Term
Finasteride (mechanism, use, toxicity)
Definition
5-alpha reductase inhibitor; used for BPH and male-pattern baldness
Term
Flutamide (mechanism, use, toxicity)
Definition
Testosterone receptor antagonist; used in prostate cancer
Term
Ketoconazole (mechanism, use, toxicity)
Definition
Inhibits 17,20-desmolase, stopping sex steroid synthesis; used to treat polycystic ovarian syndrome
Term
Clomiphene (mechanism, use, toxicity)
Definition
Partial estrogen agonist in the hypothalamus, increases release of LH and FSH, stimulating ovulation; used for infertility and PCOS
Term
Tamoxifen (mechanism, use, toxicity)
Definition
Estrogen receptor antagonist at the breast; used for breast cancer; partial agonist at the uterus, can cause endometrial hyperplasia
Term
Raloxifene (mechanism, use, toxicity)
Definition
Estrogen receptor agonist at bone, inhibits osteoclast activity and stimulates osteoblast activity; used to treat osteoporosis
Term
Anastrozole, exemestane (mechanism, use, toxicity)
Definition
Aromatase inhibitors; used in breast cancer
Term
Mifepristone (mechanism, use, toxicity)
Definition
Progesterone receptor antagonist, given with misoprostol for abortion; abortifacient; bleeding, abdominal pain
Term
Terbutaline (mechanism, use, toxicity)
Definition
Beta-2 agonist, inhibits uterine contractions
Term
Tamsulosin (mechanism, use, toxicity)
Definition
Alpha-1 antagonist; used to treat BPH
Term
Sildenafil, vardenafil (mechanism, use, toxicity)
Definition
Phosphodiesterase 5 inhibitors, causing inc. cGMP levels and smooth muscle relaxation; used in erectile dysfunction; impaired blue-green vision, contradindicated with nitrates
Term
Danazol (mechanism, use, toxicity)
Definition
Partial androgen receptor agonist; used to treat endometriosis and hereditary angioedema; weight gain, acne, hirsutism, low HDL, hepatoxicity
Term
Treat methemoglobinemia with
Definition
Methylene blue
Term
Diphenhydramine, dimenhydrinate, chlorpheniramine (mechanism, use, toxicity)
Definition
(First generation) H1 antagonists; used in allergies, motion sickness, insomnia; sedation, antiadrenergic, antiserotonergic, and antimuscarinic effects due to CNS penetration
Term
Loratadine, fexofenadine, desloratadine, cetrizine (mechanism, use, toxicity)
Definition
H1 antagonists, 2nd gen; used in allergies; less fatigue than 1st gen antihistamines due to decreased CNS penetration
Term
Albuterol (mechanism, use, toxicity)
Definition
Short-acting beta-2 agonist; asthma
Term
Salmeterol, formoterol (mechanism, use, toxicity)
Definition
Long-acting beta-2 agonist; asthma; tremor, arrhythmias
Term
Theophylline (mechanism, use, toxicity)
Definition
Phosphodiesterase inhibitor, increases cAMP and causes bronchodilation; asthma; cardiotoxicity, neurotoxicity
Term
Ipratropium (mechanism, use, toxicity)
Definition
Muscarinic antagonist, prevents bronchoconstriction; asthma and COPD
Term
Beclomethasone, fluticasone (mechanism, use, toxicity)
Definition
Inhibit cytokine synthesis, reducing inflammation due to asthma; 1st line for chronic asthma
Term
Montelukast, zafirlukast (mechanism, use, toxicity)
Definition
Leukotriene receptor antagonists; especially useful in aspirin-induced asthma
Term
Zileuton (mechanism, use, toxicity)
Definition
Inhibits activity of 5-lipoxygenase, inhibiting leukotriene production; reduces inflammation
Term
Omalizumab (mechanism, use, toxicity)
Definition
Anti-IgE antibody; used in refractory allergic asthma
Term
Guaifenesin (mechanism, use, toxicity)
Definition
Thins respiratory secretions
Term
N-acetylcysteine (mechanism, use, toxicity)
Definition
Loosens mucus plugs; used in CF patients and as an antidote to acetominaphen posioning
Term
Bosentan (mechanism, use, toxicity)
Definition
Antagonizes endothelin-1 receptors, reducing vascular resistance in the pulmonary vessels; used in pulmonary hypertension
Term
Dextromethorphan (mechanism, use, toxicity)
Definition
Antagonizes NMDA receptors, inhibiting coughing; produces opioid effects in large doses and carries mild abuse potential
Term
Pseudoephedrine, phenylephrine (mechanism, use, toxicity)
Definition
Alpha-1 agonists that reduce edema and nasal congestion; rhinitis; hypertension, quick tolerance (recurrence of symptoms despite continued treatment)
Term
Difference in competitive vs noncompetitve inhibitors?
Definition
competitive = decrease potency, noncompetitive = decrease efficacy.
Term
What is Km?
Definition
Inverse relation of affinity of enzyme for its substrate.
Term
What is Vmax?
Definition
Direct proportion to enzyme concentration
Term
What is bioavailability?
Definition
Fraction of administered drug that reaches systemic circulation unchanged.
Term
Time to steady state depends on?
Definition
depends on half-life. Does not depend on frequency or size of dose.
Term
What is rate of elimination in zero order kinetics?
Definition
constant amount eliminated per time.
Term
Give three drugs that are zero order eliminated.
Definition
PEA - phenytoin, Ethanol, Aspirin.
Term
What is the rate of elimination for first order kinetics?
Definition
A constant FRACTION is eliminted, variable by concentration!
Term
How does ionization relate to urine pH?
Definition
Ionzied species are trapped in urine and not resorbed. Neutral can be resorbed.
Term
How do you treat overdose of weak acid? Give drug examples.
Definition
Treat with Bicarb to make neutral. Exp: phenobarbital, methotrexate, aspirin.
Term
How do you treat overdose of weak base? Give drug examples.
Definition
Treat with ammonium chloride. exp: amphetamines.
Term
What is phase I drug metabolism? What pt. population loses this?
Definition
Reduction, Oxidation, hydrolysis with CYP450. Often gives neutral products. Geriatrics lose this phase.
Term
What is phase II metaboloism? What population depend on this?
Definition
Conjugation (Glucuronidation, Acetylation, and Sulfation.) Gives charged products. Geriatrics depend on this, old people have GAS.
Term
What is efficacy?
Definition
maximal effect a drug can produce.
Term
What is potency?
Definition
amount of drug needed for the same effect.
Term
What happends to efficacy when a partial agonist and full agonist are mixed?
Definition
DECREASED efficacy. fight for same binding site, full agonist cant exert full effect.
Term
What is therapetuic index?
Definition
LD50/ED50. Median lethal dose divded by median effective dose. Safer drugs have a higher TI.
Term
What is a therapeutic window?
Definition
Minimum effective dose to minimum toxic dose. Think of it as range of use.
Term
What are the two types of Nicotonic receptors? What kind of messenger do they use?
Definition
1. Nicotinic - Ligang gated Na/K channels. Two nicotinic types: Nm(NMJ) and Nn(autonomic ganglia. 2. Muscarinic - G-proteins. 5 types, M1-M5.
Term
Alpha-1 sympathetic receptor (G-protein class, major function)
Definition
q, increase: vasc. smooth muscle contraction, pupillary dilator muscle contraction, intestinal and bladder sphincter contaction.
Term
Alpha-2 sympathetic receptor(G-protein class, major function)
Definition
i, decrease: sympathetic outflow, insulin release, lipolysis. increase: platlet aggregation.
Term
Beta-1 sympathetic receptor(G-protein class, major function)
Definition
s, increase: heart rate, contractilty, renin release, lipolysis
Term
Beta-2 sympathetic receptor(G-protein class, major function)
Definition
s, vasodilation, brochodilation, increase: heart rate, contractility, lipolysis, insulin release, aqueous humor production. decrease: uterine tone, ciliary muscle tone.
Term
M-1 Parasymp receptor(G-protein class, major function)
Definition
q, CNS, enteric nervouse system.
Term
M-2 Parasymp(G-protein class, major function)
Definition
i, decease: heart rate, contractility of atria
Term
M-3 parasymp(G-protein class, major function)
Definition
increase: exocrine gland secretion (tears, gastric, etc), gut peristalsis, bladder contraction, bronchoconstriction, pupillary spinchter contraction, cilliary muscle contraction.
Term
What receptor is responsible for miosis and accomadation?
Definition
Parasympathetic M-3.
Term
What receptor is responsbile for mydriasis?
Definition
Sympathetic Alpha-1.
Term
Dopamine D-1 receptor(G-protein class, major function)
Definition
s, relaxes renal vascular smooth muscle
Term
Dopamine D-2 receptor(G-protein class, major function)
Definition
i, modulates transmitter release especially in brain.
Term
Histamine H-1 receptor(G-protein class, major function)
Definition
q, increase: mucus production, contraction of bronchioles, pruritus, pain.
Term
histamine H-2 receptor(G-protein class, major function)
Definition
a, increase gastric acid secretion
Term
vasopression V-1 receptor(G-protein class, major function)
Definition
q, increase: vascular smooth muscle contraction
Term
vasopression V-2 receptor(G-protein class, major function)
Definition
s, increase water permeability and reabsorption in kidneys. (V2 found in 2 kidneys).
Term
Which receptors work via Gq -> Phospholipase C ->Pip2->DAG + IP3?
Definition
H1,Alpha1,V1,M1,M3. (remember HAVe 1 M&M)
Term
DAG causes activation of what?
Definition
Protein Kinase C.
Term
IP3 causes increase in what?
Definition
Calcium -> smouth muscle contraction
Term
Which receptors work via Gi->Adenyly cyclase ->cAMP ->Protein Kinase A?
Definition
M2, Alpha2, D2. (remember MAD 2's.)
Term
Which receptors work via Gs->adenylyate cyclase ->cAMP->Protein Kinase A?
Definition
Beta1, Beta2, D1, H2,V2.
Term
What does protein kinase A do?
Definition
increase calcium release in heart and blocks myosin light chain kinase.
Term
What are the two classes of cholinomimetics?
Definition
1. direct agonsts 2. indirect agonists (anticholinesterases).
Term
Bethanechol(mechanism,use,toxicity)
Definition
Direct cholinomimetic. Postop or neurogenic ileus, urinary retention. COPD+asthma exacerbation, peptic ulcers.
Term
Carbachol(mechanism,use,toxicity)
Definition
Direct Cholinomimetic. Identical to Ach. Glaucoma, pupillary contraction, relief of IOP. COPD+asthma exacerbation, peptic ulcers.
Term
Pilocarpine(mechanism,use,toxicity)
Definition
Direct Cholinomimetic. Stimulates tears, salvia, sweat. Open and closed-angle glaucoma.COPD+asthma exacerbation, peptic ulcers.
Term
methacholine(mechanism,use,toxicity)
Definition
Direct Cholinomimetic. challenge test of asthma diagnosis. COPD+asthma exacerbation, peptic ulcers.
Term
Neostigmine(mechanism,use,toxicity)
Definition
Indirect cholinomimetic agonist. NO cns penetration. Postop and neurogenic ileus, myasthenia gravis, reversal of NMJ block. COPD+asthma exacerbation, peptic ulcers.
Term
pyridostigmine(mechanism,use,toxicity)
Definition
indirect cholinomimetic agonist. Long acting myasthenia gravis treatment. COPD+asthma exacerbation, peptic ulcers.
Term
edrophonium(mechanism,use,toxicity)
Definition
indirect cholinomimetic agonist. Short acting, for myasthenia gravis diagnosis. COPD+asthma exacerbation, peptic ulcers.
Term
Physostigmine(mechanism,use,toxicity)
Definition
indirect cholinomimetic agonist. for anti-cholinergic overdose, crosses BBB. COPD+asthma exacerbation, peptic ulcers.
Term
Donepezil(mechanism,use,toxicity)
Definition
indirect cholinomimetic agonist. Alzheimers disease. COPD+asthma exacerbation, peptic ulcers.
Term
signs of cholinesterase inhibitor poisoning. treatment.
Definition
DUMBBELSS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle +CNS, lacrimation, sweating, salvia.) tx: atropine + pralidoxime.
Term
Parathion(mechanism, treatment)
Definition
Irreversible cholinesterase inhibitor, ACH overdose. Tx: atropine + pralidoxime.
Term
Atropine, homatropine, tropicamide (mechanism, use, toxicity).
Definition
Muscarinic antagonist. produces mydriasis and cycloplegia. (Atropine also used for bradycardia). Causes hot as a hare, dry as bone, red as beet, blind as bat, mad as a hatter.
Term
Benztropine(mechanism,use,toxicity)
Definition
Muscarinic antagoist. Parkinsons disease (park my benz). Can be used in haloperiodal O.D, whihc causes torticolliosis. Causes hot as a hare, dry as bone, red as a beet, blind as a bat, mad as a hatter.
Term
Scopolamine(mechanism,use,toxicity)
Definition
Muscarinic antagonist. Motion sickness. causes hot as a hare, dry as a cone, red as a beet, blind as a bat, mad as a hatter.
Term
Ipratropium,tiotropium (mechanism, use, toxicity)
Definition
Muscarinic antagonist. COPD, Asthma. Causes hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.
Term
Oxybutynin(mechanism,use,toxicity)
Definition
Muscarinic anatagonist. reduces urgency in mild cystitis and reduce bladder spasms. causes hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.
Term
Glycopyrrolate(mechanism,use,toxicity)
Definition
Muscarinic anatagonist. IP: given in preop to reduce airway secretions. oral:reduce drooling, peptic ulcer. Can cause hot as a hare, dry as a bone red as a beet, blind as a bat, mad as a hatter.
Term
Jimson Weed(mechanism, toxicity)
Definition
muscarinic antagonist, causes gardner's pupil (mydriasis).
Term
Epinephrine(Mechanism, receptors bound, use, toxicity)
Definition
Direct Sympathomemetic. A1,A2,B1,B2. Anaphylaxis, open angle glaucoma, asthma, hypotension.
Term
Norepinephine(Mechanism, receptors bound, use, toxicity)
Definition
direct sympathomemetic. A1,A2, some B1. used in hypotension but it decrease renal perfusion.
Term
Isoproterenol(Mechanism, receptors bound, use, toxicity)
Definition
Direct sympathomemetic. B1, B2. Used in Torsade de pointe and bradyarryhmia. Can cause tachycardia and worsen cardiac ischemia.
Term
dopamine(Mechanism, receptors bound, use, toxicity)
Definition
Direct sympathomimetics. Receptors depend on dose. low = D1, med = D1,B2,B1, high = A1,A2,B1,B2,D1. Used in shock and heart failure (ionotropic and chronotropic).
Term
dobutamine(Mechanism, receptors bound, use, toxicity)
Definition
Direct sympathomimetic. Mostly B1, little a1,a2,b2. Used in heart failure and cardiac stresstest (ionotrpic and chronotropic)
Term
Phenylephrine(Mechanism, receptors bound, use, toxicity)
Definition
Direct sympathomimetic. A1, A2. Used in hypotension, to cause mydriasis, and rhinitis (decongestant).
Term
Albuterol, salmetrol, terbutaline (Mechanism, receptors bound, use, toxicity)
Definition
Direct sympathomimetic. Mostly B2, some b1. Sal = long term ashtma or copd. Albuterol for short term asthma. Terbutaline for to reduce premture uterine contractions.
Term
Ritodrine(Mechanism, receptors bound, use, toxicity)
Definition
Direct sympathomimetic. B2 only. Used to reduce premature uterine contractions.
Term
Amphetamine (mechanism, use)
Definition
indirect sympathomimetic. Releases stored catecholamines. Used for narcolepsy, obesity, ADD.
Term
Epinephrine(Mechanism, use, toxicity)
Definition
indirect sympathomimetic. Releases stored catecholamines. Used for nasal decongestion, urinary incontience, hypotension.
Term
Cocaine (mechanims, use).
Definition
direct sympathomimetic. Reuptake inhibitor. Causes vasoconstriction and local anesthesia.
Term
Why must B-Blockers be avoided in suspected cocaine intoxication?
Definition
mixing them can lead to unopposed A1 activation and extreme hypertenion.
Term
How does norepinephrine cause reflex bradycardia?
Definition
stimulates A1>B2. Causes increased vasoconstrciton -> increased BP. This causes reflex bradycardia and slowing of HR.
Term
How does isoproterenol cause reflex tachycardia?
Definition
Stimulates B2>A1. This cause vasodilation and dropping of BP. B1 is stimulated and causes tachycardia.
Term
Clonidine, alpha-methyldopa(Mechanism, receptors bound, use)
Definition
Centrally acting alpha-2 agonists, this causes LESS peripheral sympathetic release.Used in hypertension, especially renal disease due to no increase in renal blood flow!
Term
Phenoxybenzamine(Mechanism, receptors bound, use, toxicity)
Definition
IRREVERSIBLE nonslective alpha blocker. Used in pheochromosytoma BEFORE surgery! toxic: orhtostatic hypotension, reflec tachycardia.
Term
phentolamine(Mechanism, receptors bound, use, toxicity)
Definition
REVERSBILE nonselective alpha blocker. give to patients on MAOI who each tyramine contraining foods.
Term
Prazosin, Terazosin, Doxazosin,Tamsulosin(Mechanism, receptors bound, use, toxicity)
Definition
Alpha-1 blocker. Used in hypertension, urinary rentention in BPH. tox:orthostatic hypotension, dizziness, headache.
Term
Mirtazapine (mechanism, use, toxicity)
Definition
Alpha-2 blocker. Used in depression. tox: sedation, hypercholesterolemia, increased apetite.
Term
Describe what occurs when you alpha-blockade epi vs. phenylephrine.
Definition
Before blockade: Both epi and phen RAISES BP. After alpha blockade: only epi raises, no change in phenyl. Why: Epi has B binding, phenyl does NOT.
Term
Give 6 applications of Beta-blockers in general.
Definition
Angina - decreases HR and contractility, decreasing oxygen use. MI - decrease mortality. SVT - decrease AV duction. Hypertension - decrease CO and renin secretion. CHF - slows progression. Glaucoma - decrease secretion of aqueous humor.
Term
give general toxicites of b-blockers
Definition
impotence, asthma exacerbation, bradycardia, seizures, sedation, hides hypoglycemia.
Term
What are the B1 selective b-blockers? When are they useful?
Definition
A BEAM. acebutolol, betaxolol, Esmolol, Atenolol, Metoprolol. Useful in comorbid pum. disease.
Term
What are the nonselective ( b1 = b2) b-blockers?
Definition
Please Try Not Being Picky. Propranolol, Timolol, Nadolol, Pindolol. B = B-blocker.
Term
what are the nonselective a and b-antagonists?
Definition
Carvedilol, labetalol.
Term
What are the partial B-agonists?
Definition
Pindolol, Acebutolol.
Term
Give treatment for acetaminophen overdose.
Definition
N-Acetylcysteine (replenishes glutathione).
Term
Give treatment for salicylates overdose.
Definition
NaHCO3 (alkalinize urine)
Term
give treatment for amphetamines overdose
Definition
NH4Cl (acidify urine)
Term
Give treatment for antimuscarinic and anticholinergic overdose.
Definition
Phygostigmine and control the hyperhermia.
Term
Give treatment for b-blocker overdose
Definition
Glucagon
Term
Give treatment for digitalis overdose
Definition
(KLAM) normalize K, Lidocaine, Anti-dig fab fragments, Mg2
Term
give treatment for iron overdose.
Definition
deFEroxamine, deFErasirox.
Term
give treatment for lead overdose
Definition
CaEDTA, dimercaprol, succimer, penicillamine
Term
give treatment for mercury, arsenix, gold overdose
Definition
Dimercaprol, succiner
Term
give treatment for copper, arsenic, gold overdose
Definition
penillamine
Term
give treatment for cyanide
Definition
nitrite + thiosulfate, hydroxocobalamin
Term
give methemoglobin treatment
Definition
Methylene blue, vitamin c
Term
Give Carbon monocide treatment
Definition
100% oxygen or hyperbaric oxygen
Term
give treatment for methanol, ethylene glycol overdose
Definition
Fomepizole>Ethanol, dialysis
Term
give treatment for opiods overdose
Definition
naloxone/naltrexone
Term
give treatment for benzodiazepine overdose
Definition
flumazenil
Term
give treatment for TCA overdose
Definition
NaHCO3 (alkalinize plasma)
Term
give treatment for heparin overdose
Definition
protamine
Term
give treatment for warfarin overdose
Definition
Vitamin K, fresh frozen plasma
Term
give treatment for tPA, Streptokinase, urokinase overdose
Definition
aminocaproic acid
Term
give treatment for theophylline overdose
Definition
B-Blockers
Term
give treatment for acetylcholinesterase inhibitors
Definition
atropine + pralidoxime
Term
causes coronary vasospam
Definition
cocaine, sumatriptan, ergots
Term
causes cutaneous flushing
Definition
(VANC) Vancomycin, Adenosine, Niacin, Ca blocker
Term
causes dilated cardiomyopathy
Definition
doxorubicin, daunorubicin
Term
causes torsades de pointes
Definition
class III (sotalol) and class Ia (quinidine)
Term
causes agranulocytoisis
Definition
Clozapine, Carbamazepine, Colchine, Propylthiouracil, Methimazole, Dapsone
Term
causes aplastic anemia
Definition
chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole
Term
causes direct coombs positive hemolytic anemia
Definition
methyldopa, penicillin
Term
causes gray baby syndomr
Definition
chloramphenicol
Term
causes hemolysis in G6PD-defiect patients
Definition
(hemolysis IS PAIN)isoniazid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin
Term
causes megaloblastic anemia
Definition
(females with PMS are on full BLAST mode) Phenytoin, Methotrexate, Sulfa drugs
Term
Causes thrombotic complications
Definition
OCPs like estrogen
Term
Causes cough
Definition
ACE inhibitors
Term
causes pulmonary fibrosis
Definition
Bleomycin, amiodarone, Busulfan
Term
causes acute cholestatic hepatits, jaundice
Definition
erthryomycin
Term
causes focal to massice hepatic necrosis
Definition
Halothane, Amanita Phalloides, Valrpoic acid, Acetaminophen
Term
causes hepatits
Definition
isoniazid
Term
can lead to pseudomembranous colitis
Definition
clindamycin, ampicillin
Term
can lead to adrenocortical insufficiency
Definition
glucocorticoid withdrawl via HPA suppression
Term
can causes gynecomastia
Definition
`(Some drugs create awkward knockers) spironolactone, digitalis, cimetidine, chronic alcohol use, ketoconazole
Term
causes hot flashes
Definition
estrogen, clomophene
Term
causes hypergylcemia
Definition
niacin, tacrolimus, protease inhibitor, HCTZ, corticosteriods
Term
causes hypothyroidism
Definition
lithium, amiodarone, suldonamides
Term
causes fat redistribution
Definition
glucocoricoids, protease inhibitors
Term
causes gingival hyperplasia
Definition
phenytoin, verpamil
Term
causes gout
Definition
furosemide, thiazides, niacin, cyclosporine
Term
causes myopathies
Definition
fibrates, niacin, colchine, hydroxychloroquine, interferon-alpha, penicillamine, statins, glucocorticoids
Term
causes osteoporosis
Definition
corticosteroids, heparin
Term
causes photosensitivty
Definition
(SAT for a PHOTO) Sulfonamides, amiodarone, tetracycline
Term
causes rash/SJS
Definition
penicillin, ethosuximide, carbamazepine, sulfa drugs, lamotrigine, allopurinol, phenytoin, phenobarbital
Term
cause drug induced lupus
Definition
Hydralazine, isonizid, procainamine, phenytoin
Term
causes teeth problems
Definition
tetracyclines
Term
causes tendonitis, tendon rupture, tooth damage
Definition
fluoroquinolones
Term
causes diabetes insipidus
Definition
lithium, demeclocycline
Term
causes fanconi's syndome
Definition
expired tetracycline
Term
causes hemorrhagic cystits
Definition
Cyclophosamide, ifosfamide
Term
causes interstital nephritis
Definition
methicllin, NSAID, furosemide
Term
causes SIADH
Definition
carbamazepine, cyclophosamide
Term
causes cinchonism
Definition
Quinidine, qunine
Term
causes parkinson-like syndome
Definition
antipsychotics, resperine, metoclopramide
Term
causes seizures
Definition
(with seizures, I BITE My tongue) isoniazid, Buproprion, imipenem, Tramadol, Enflurane, Metoclopramide
Term
causes tardive dyskinesia
Definition
antipsychotics
Term
acts like an anti-muscarinic
Definition
Atropine, TCA, H1-blocker, neuoleptics
Term
can cause a disulfiram like reaction
Definition
metronidazole, some cephalosporins, procarbazine, 1st gen sulphonoureas
Term
can cause nephro/ototoxicity
Definition
aminoglycosides, vancomycin, loop dieuetics, cisplatin
Term
list p450 inducers
Definition
(Momma Barb Steals Phen-phen and Refuses Greasy Carbs Chronically)Modafinil, Barbiturates, St. John wart, phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol use.
Term
list p450 inhibitors
Definition
(MAGIC ROCKS in GQ) Macrolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir actue alcohol use, ciprofloxacin, ketoconazole, sulfonamides, gemfibrozil, quinidine.
Term
lists the sulfa drugs
Definition
(Popular FACTSSS) probenacid, furosemide, acetazolamide, celecoxib, thiazide, sulfonamide antibiotics, sulfaasalazine, sulfonylureas
Term
Difference between peniciliin G and V.
Definition
G = IV and IM. V = oral.
Term
Penicillin(mechanism,use,toxicity)
Definition
Bind penicillin-binding proteins(transpeptidases), block cross linking of peptidoglycans;most effective on G+, also N. Meningitidis, Treponema;hypersensitivy reaction, hemolytic anema.
Term
Oxacillin,Naficillin,Dicloxacillin(mechanism,use,toxicity)
Definition
bind transpeptidases, penicillanse resistant due to bukly r-group blocking B-Lactamse; S. Aureus, except MRSA; hypersensitivity and interstitial nephritis.
Term
Ampicillin, amoxicillin(mecanism,use,toxicity)
Definition
bind transpeptidases, wide spectrum and more penicillinase sensitive. combo with claculanic acid to protect from B-lactams;kills enterococci(HELPSS)H.iB, E.coli,Listera,Proteus,Salmonella,Shigella,enterococci;hypersensitivity reaction,rash,pseudomemrane colitis.
Term
Which has better bioavailibility; amoxicllin or ampicillin?
Definition
amOxicllin has better Oral bioavilability.
Term
What does clavulanic acid do?
Definition
B-lactamse inhibitor
Term
Ticarcillin,piperacillin(mechanism,use,toxicity)
Definition
transpeptidase inhibitor but extended spectrum;pseduomonas and g- rods, use with claculanic acid due to B-lactamse suspectibilty; hypersensitivity reaction.
Term
List the B-lactamse inhibitors
Definition
(CAST) Clavulanic Acid, Sulbactam,Tazobactem.
Term
Cephalosporin(mechanism,use,toxiciity)
Definition
inhibit cell wall synthesis but are less susceptible to B-lactamases, are bactericidal;use depends on generation, there are four;hypersensitivty reactions, vitamin K defiency, increased nephrotoxicity of aminoglycosides.
Term
give use of cefazolin, cephalexin.
Definition
1st generation cephalosporins. PEcK. Proteus, E.coli,Klebsiella. Cefazolin used preop to prevent A.aureus infections.
Term
give use of cefoxitin, cefaclor,cefuroxime`
Definition
2nd generation cephalosporins. HEN PEcKs. H.ib, Enterbacter, Neisseria, Proteus, E.coli,Klebsiella, Serratia.
Term
give use of ceftriaxone, cefotaxime,ceftazidime
Definition
3rd gen. cephalosporins. Serious gram - infections. Ceftriaxone = meningitis and gonorrhea. Ceftazidime = pseudomonas.
Term
give use of cefepime.
Definition
increased activity against pseudomonas and G+ bugs.
Term
Aztreonam(mechanism,use,toxicty)
Definition
a monobactem resistant to B-lactamases, prevents binding to PBP3 and is synergistic with aminoglycosides;gram - rods only;very nontoxic, some GI upset.
Term
what transpeptidase inhibitor can be used in penicillin allergy?
Definition
aztreonam.
Term
imipenem/cilastatin,meropenem,etrapenem,doripenem(mechanism,use,toxicity)
Definition
broad spectrum, B-lactamase resistent but imipenem needs cilastatin to inhibit renal dehydropeptidase. later carbepenems do not;G+ cocci,G- rods, anerobes. used only in life threating events;skin rash, CNS toxicity, seizures.
Term
Vancomycin(mechanism,use,toxicty)
Definition
inhibits cell wall binding peptidoglycan formation by binding D-ala percursors, is bacterialcidal; G+ only, especially for multidrug resistant onces;NOT - nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome.
Term
How is redman syndrome prevented in vancomycin use?
Definition
slow infusion and rate and antihistamines.
Term
How does vancomycin resistant occur?
Definition
amino acid change of D-ala D-ala to D-ala D-lac.
Term
List antibiotic protein synthesis inhibitors
Definition
AT 30, CCEL at 50. 30S = Aminoglycosides, Tetracyclines. 50S = Chloramphenicol, Clindamycin, Erythromycin, Linezolid.
Term
Gentamicin, neomycin, amikacin,tobramycin,streptomycin(mechanism,use,toxicity)
Definition
aminoglycosides, bacterialcidal, block translocation but require oxygen for uptake;ineffective in anaerobes,use in gram - rod infections and before bowel surgery; nephrotoxicty, NMJ block, ototoxicity, teratogen.
Term
how does resistenace to aminoglycosides occur?
Definition
transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.
Term
tetracycline, doxycycline, demecycline,minocycline(mechanism, use, toxicity)
Definition
bacteriostatic, prevents aminoacyl-tRNA binds;Borrela, M. Pneuomo, Rickettsia, Chlamysia; can't take with milk, antacids, iron because ions bind it, GI distress, discoloration of teeth, inhibition of bone growth, contraindication in pregnancy.
Term
how does resistance to tetracyclines occur?
Definition
decrease uptake into cells or increased efflux by pumps.
Term
Azithromycin, clarithromycin, erythromycin(mechanism,use,toxicity)
Definition
bacteriostatic, blocks translocation; atypical pneumonias, chlamydia, gram + cocci; MACRO: increased Motility, arrhythmia, Cholestatic hepatitis, Rash, eOsinophilia.
Term
how does resitance to macrolides occur?
Definition
methylation of 23s rRNA binding site.
Term
Chloramphenicol(mechanism,use,toxicity)
Definition
Bacterialstatic, blocks peptidlytransferase; Meningitis in adults, used in power countries due to being cheap; dose dependent anemia, dose independent aplastic anemia, gray baby syndrome.
Term
what causes grey baby syndrome?
Definition
use of chloramphenicol in premature infants, they lack UDO-glucuronyl-transferase.
Term
How does resistance to chloramphenicol occur?
Definition
plasmid-encoded acetyltransferase.
Term
clindamycin(mechanism,use,toxicity)
Definition
Bacteriostatic. Blocks peptide transfer; anaerobic infections in lung infections and oral anerobes; C. Diff infection, fever, diarrhea.
Term
Sulfamethoxazole(SMX), sulfisoxazole, sulfadiazine(mechanism, use, toxicity)
Definition
Bacteriostatic, PABA metabolites inhibit dihydropteroate synthase; Gram +, G-, Nocardia, Chlamydia, UTI; hypersensitivty, hemolysis in G6PD, nephrotoxic, kernicterus, displaces other drugs from albumin.
Term
how does resistance to sulfonamides occur?
Definition
altered bacterial dihydropteroate or increased PABA synthesis.
Term
Trimethoprim(mechanism,use,toxicity)
Definition
Bacteriostatic, inhibits bacterial dihydrofolate reductase, blocks folate synthesis; used in UTI, PCP (prophylacis and treatment), shigella, salmonella; megaloblastic anemia, leukopenia, granulocytopenia.
Term
ciprofloxacin, norfloxacin, levofloxacin, etc...(mechanism, use, toxicity)
Definition
bactericidal, inhibits DNA gyrase(topo II and IV);G- rods of urinary and GI tracts, Neisseria, some G+;( lones hurt the bones) tenonitis and tendon rupture, superinfections, don't give to kids or pregnant women due to cartilage damage.
Term
how does resistance to fluroquinolones occur?
Definition
mutation in DNA gyrase or efflux pumps.
Term
What groups are susceptible to fluorquinolone tendon rupture?
Definition
older than 60 or taking prednisone
Term
Metronidazole(mechanism, use, toxicity)
Definition
bacterialcidal, forms free radical toxic metabolites that damge bacterial DNA damage; (GET GAP) Giardia, Entamoeba, trichomonas, Gardnerella, Anaerobes, Pylori; causes disulfiram like reaction, headache, metallic taste.
Term
Isoniazid(mechanism,use,toxicity)
Definition
decrease synthesis of mycolic acids, bacterial catalase peroxidase(KatG) must activate INH; TB drug, only one used as prophylaxis and in latent TB; peripheral neuropathy, hepatoxic, lupis like drug interaction, pyridoxine antagonist.
Term
Rifampin(mechanism,use,toxicity)
Definition
inhibits DNA-dependent RNA polymerase; TB, Leprosy, prophylaxis in meningococcus and Hib type B; hepatotox, p450 inducer, orange body fluids.
Term
Pyrazinamide(mechanism, use, toxicity)
Definition
unknown; TB; hyperuricemia, hepatotoxic.
Term
Ethambutol(mechanism,use,toxicity)
Definition
decreased carbohydrate polymerization of TB cell wall, blocks arabinosyltransferase; TB; optic neuropathy(red-green color blindness_
Term
Amphotericin B(mechanism, use, toxicity)
Definition
binds fungal ergosterol, causes holes in membranes; use in systemtic and CNS mycoses infections; fever/chills, hypotension, arrythmias, nephrotoxic, IV phlebitis, must supplement K and MG.
Term
nystatin(mechanism,use,toxicty)
Definition
binds fungal ergosterol;topical only due to high toxicity, used for oral thrush and topical diaper rash or vaginal candidiasis.
Term
Fluconazole, ketoconazole, clotrimazole, itraconazole, voriconazole(mechanism, use,toxicity)
Definition
inhibits fungal ergosterol synthesis by binding p450;Fluconazole for suppression of cryptococcus in AIDs patients, itraconazle for blasto, coccio, histo.
Term
Flucytosine(mechanism, use, toxicity)
Definition
inhibits fungal DNA and RNA synthesis by conversion to 5FU; used in systemic fungal infections, especially cryptococcus; bone marrow suppression.
Term
Caspofungin, micafungin(mechanism, use, toxicity)
Definition
inhibits fungal cell wall synthesis by inhibiting B-glucan synthesis; invasive aspergillosis, candida; flushing via histamine releae.
Term
terbinafine(mechanism,use,toxicity)
Definition
inhibits fungal squalene epoxidase; treat dermatophytes - toe nail infection especially;abnormal LFT, visual disturbances.
Term
Griseofulvin(mechanism,use,toxicity)
Definition
interferes with microtubules, stops mitosis in fungi;deposits in keratin so used in superficial infections, stops dermatophytes; teratogenic, carcinogenic, confusion, p450 inducer.
Term
Pyrimethamine use
Definition
toxoplasmosis
Term
suramin and melarsoprol use
Definition
trypanosoma brucei
Term
nifurtimox use
Definition
trypanosoma cruzi
Term
sodium stibogluconate use
Definition
leshmaniasis
Term
Chloroquine(mechanism,use,toxicity)
Definition
blocks formation of heme into hemozoin. Heme accumulates and is toxic to plasmodia;used on all species but falciparum(too much resitance); retinopathy
Term
quinidine use
Definition
lifethreatening malaria
Term
artemether/lumifantrine use
Definition
p. falciparum killing
Term
Zanamivir,oseltamivir(mechanism,use)
Definition
inihibits influenza neuraminidase, stops progeny release; treamt of influenze a and b
Term
Ribavarin(mechanism,use,toxicity)
Definition
inhibits sythesis of guanine nucleotides by competitvely inhibiting IMP dehydrogenase; RSV, chronic hep C; hemolytic anemia, severe teratogen
Term
Acyclovir,valacyclovir(mechanism, use, toxicity)
Definition
Guanosine analog, inhibits viral DNA polymerase; monophosphorylated by thymidine kinase in HSV/VZV so active in lesions and encephalitis, good for prophylaxis,
Term
Famciclovir use
Definition
used in herpes zoster active infections
Term
mechanism for resistance to acyclovir
Definition
mutated viral thymidine kinase
Term
Ganciclovir,valgangciclovir(mechanism,use,toxicity)
Definition
guanosine analog, 5'-monophosphate formed by CMV viral kinase, inhibits viral DNA polymerase;CMV infections;leukopenia,neutopenia,thrombocytopenia,renal toxicity
Term
mechanism for resistance to acyclovir
Definition
mutated CMV DNA polymerase or lack of viral kinase
Term
Foscarnet(mechanism,use,toxicity)
Definition
viral DNA polymerase inhibitor, binds to pyrofosphate binding site, doesn't need viral kinase activation;CMV retinitis when ganciclovir fails and acyclovir restitant HSV; nephrotoxic
Term
mechanism for resistance to foscarnet
Definition
mutated DNA polymerase
Term
cidofovir(mechanism,use,toxicity)
Definition
inhibits DNA polymerase, doesn't require activiation by viral kinase; CMV retenitis, acyclovir resistant HSV; nephrotoxic(coadminister with probenacid and IV saline to reduce toxicity).
Term
HAART consist of what?
Definition
[2 NRTI] +[1 NNRTI OR 1 protease inhibitor OR 1 integrase inhibitor]
Term
give mechanism and toxicity of protease inhibitors
Definition
all end in -NAVIR! stops HIV mRNA cleavage into functional parts; hyperglycemia, GI upset, lipodystrophy.
Term
Ritonavir does what to be a "booster"
Definition
inhibits cytochrome p-450, boosting concentration of other drugs.
Term
Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, didansoine, stavudine(mechanism,use,toxicity
Definition
(NRTI)competitively blocks binding of nucleotide to reverse transcriptase, only tenofovir doesn't need to be activated;all NRTIs, zidovidine used in pregnancy to reduce fetal transmision; bone marrow suppression, lactic acidosis, peripheral neuropathy.
Term
Nevirapine, Efavirenz, Delavirdine(mechanism,use,toxicity)
Definition
(NNRTI) bind at a site different from NRTIs, no don't require activation don't compete with nucleotides; bonow marrow suppression, peripheral neuropathy, lactic acidosis,
Term
Raltegravir(mechanism,use,toxicity)
Definition
inhibits integrase, which stops HIV integration into host cells;HIV;hypercholesterolemia
Term
Interferons(mechanism,use,toxicity)
Definition
glycoproteins synthesized my virus infected cells, block RNA and DNA virus replication; INFa- chronic hep b and c, Kaposi sarcoma, IFN-b -MS, INF-gamma -NADPH oxidase defiency; neutropenia, myopathy.
Term
What antibiotics must be avoided in pregnancy?
Definition
SAFe Children Take Really Good Care. sulfonamides(kericterus), aminoglycosides(ototox), fluoroquinolones(cartilage damage), Clarithromycin(embryotoxic), Tetracycline(teeth,bone damage),Ribavarin(teratogenic),Griseofulvin(teratogenic),Chloramphenicol(grey baby)
Term
cause direct toxicity to nerves
Definition
vincristine and paclitaxil
Term
By what mechanism does isoniazid cause B6(pyridoxine) loss?
Definition
isoniazid structurally similar to B6, which causes renal excretion of B6 and competes for B6 binding sites.
Term
What medications can be given before Amphotercin B infusion to lessen side effects?
Definition
antihistamines and antipyretics.
Term
Does digoxin cause hyper or hypokalemia? which states increases patient susceptibility to digoxin toxicity?
Definition
digoxin causes hyperkalemia. HOWEVER, a HYPOkalemic state increses patient susceptibility to digoxin toxicity.
Term
list signs of ammonia overdose
Definition
ataxia, slurred speech, somnolence, vomiting
Term
cause restrictive lung disease
Definition
bleomycin, busulfan, amiodarone, methotrexate
Term
Contrast urine Ca with loop diuretics and thiazides
Definition
loop diuretics: increased urine Ca via decreased reabsorption. thiazides: decreased urine Ca.
Term
What is a sensitive indicator of alcohol abuse?
Definition
Serum gamma-glutamyltransferase.
Term
What is the treatment for delirium tremens?
Definition
benzodiazepenes
Term
Why is the naloxone-buprenorphine combo used for heroin addiction treatment?
Definition
The naloxone is only active if inected, making it hard to abuse the combo.
Term
What is neuroleptic malignant syndrome? What is the treatment?
Definition
rigidity, myoglobinuria, autonomic instability. seen with antipsychotics overdose. treatment: dantrolene and bromocriptine (d2 agonist)
Term
What is tardive dyskinesa? Is it reversible?
Definition
sterotypical oral-facial movements, from long term antipsychotic use. often NOT reversible.
Term
What is serotonin syndrome? what is the treatment?
Definition
occurs with any drug that increases serotonin (MAO inhibitor, SNRI, TCA) hyperthermia, confusion, myoclonus, cardio collapse, flushing. tx: cyproheptadine (5ht antagonist)
Term
What can long term Phenactin use cause?
Definition
Translitional cell carcinoma of the bladder
Term
What are the teratogenic effects of ACE inhibitors?
Definition
renal damage
Term
What are the teratogenic effects of alkylating agents?
Definition
absence of digits, toes
Term
What are the teratogenic effects of aminoglycosides?
Definition
CV VIII toxicity
Term
What are the teratogenic effects of carbamazepine?
Definition
neural tube defects, craniofacial defects
Term
What are the teratogenic effects of diethylstilbestrol?
Definition
vaginal clear cell adenocarcinoma, congenital mullerian anomalies
Term
What are the teratogenic effects of folate antagonists?
Definition
neural tube defects
Term
What are the teratogenic effects of lithium?
Definition
ebstein's anomaly -> atrialized right ventricle
Term
What are the teratogenic effects of phenytoin?
Definition
fetal hydantoin syndrome->microcephaly,dysmorphic face
Term
What are the teratogenic effects of tetracyclines
Definition
discolored teeth
Term
What are the teratogenic effects of thalidomide
Definition
limb defects like flipper arms
Term
What are the teratogenic effects of valproate?
Definition
inhibitor of maternal folate absorption ->neural tube defects
Term
What are the teratogenic effects of warfarin?
Definition
bone deformities, fetal hemorrhage, abortion
Term
At what time period is a fetus most susceptable to teratogens?
Definition
3rd -8th week.
Term
What are the teratogenic effects of vitamin a?
Definition
extremely high risk for spontaneous abortion
Term
What are the teratogenic effects of cocaine?
Definition
placental abruption, developmental abnormalities
Term
What are the teratogenic effects of smoking?
Definition
preterm labor, placental problems, ADHD
Term
What drug is the leading cause of birth defects and mental retardation?
Definition
alcohol
Term
What are the toxicities of Loop diuretics?
Definition
(OH DANG) Ototox, hypokalemia, dehydration, allergy(sulfa), Nephritis, Gout
Term
What are the toxicites of HCTZ?
Definition
(hyperGLUC) hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia.
Term
By what mechanisms do thiazides and loop diutetics cause metabolic alkalosis?
Definition
1. Volume contraction ->AT II increases ->increased bicarb absorbed in PT. 2. K loss leads to K leaving all cells and thus H entering all cells. 3. in a low K state, H is exchanged instead of K for Na in the CCT leading to paradoxical aciduria.
Term
What drugs can stimulate prolactin secretion?
Definition
OCP and dopemaine antagonists (antipsychotics)
Term
What is a difference in the mechanism of PTU and methimazole?
Definition
PTU disables peroxidase AND 5'-deiodinase. Methimazole only inhibits peroxidase.
Term
Can sulfonylureas be used in type 1 DM?
Definition
NO, they require some islet function to release insulin. type 1 - those cells are dead.
Term
What drugs can be used to treat type 1 AND 2 DM?
Definition
Insulins, amylin analongs(pramlintide).
Term
What drug is used to prevent tumor lysis urate neuropathy?
Definition
allopurinol stops urate crystal collection -> no gout.
Term
List acute and chronic gout drugs.
Definition
acute: NSAID, indomethicin. Chronic: allopurinol, febuxostat, probenacid, colchicine
Term
probenacid(mechanism, use, tox)
Definition
used in chronic gout; inhibits reabsorption of uric acid in the proximal tubule; inhibits secretion of penicillin; do NOT use in renal dysfunction.
Term
febuxostat(use, mechanism)
Definition
used in chronic gout, inhibits xanthine oxidase.
Term
Polymixin B(mechanism, use, toxicity)
Definition
binds to G- cell membrane phospoholipids, disrupting them; only works in g-; peripheral neuropathy, dizziness, nsytagmus, nephrotoxicity.
Term
Methylphenidate, destroamphetamine, methamphetamine(mechanism, use)
Definition
increase catecholamines at synaptic cleft, especially NE + dopamine; ADHD, nacrolepsy, appetite control
Term
Phytonadione(use)
Definition
this is vitamin K, used in warfarin overdose
Term
Leucovorin(use,mechanism)
Definition
folinic acid, it is a metabolite of folic acid; given with methotrexate to replish the body's folate stores.
Term
Protamine sulfate (use, mechanism)
Definition
antidote to heparin overdose. Protamine is a postive ion that binds to negative heparin, inactivating it.
Term
What is tyramine crisis caused by?
Definition
When someone taking MAO inhibitors eats hard cheeses and drinks wine, causing a crisis.
Term
Why is phenoxybenzamine prefered over phentolamine for presurgery pheochromocytoma surgery?
Definition
it has a MUCH longer half life, plus it is irrversible while phentolamine is reversible
Term
Why is Lactulose fed to people with hepatic encephalopathy?
Definition
It is broken down in the gut into an acid. This acid acts as both as osmotic (draws out some ascites) and also it gets rid of excess ammonia, which is causing the encephalopathy.
Term
Eculizumab(mechanism, use)
Definition
Complement inhibitor, used in Paroxysmal Nocturnal Hemoglobinuria.
Term
Cladribine(mechanism, use)
Definition
adenosine analog, used in treatment of hairy cell leukemia
Term
Trans-retinoic acid(use)
Definition
Used in treating the M3, promyelocytic subtype of AML.
Term
Is an increase in serum creatinine normal after starting ACE inhibitors?
Definition
Yes, they lower GFP by stopping efferent arteriole constrinction. Creatinine can increase up to 30% and should peak by 1 weak. This can be BAD in renal artery stenosis, where ACE II is what is keeping the kidney alive.
Term
Daptomycin(mechanism, use, toxicity)
Definition
causes depolarization of cellular membrane; used in invasive MRSA; myopathy, raised CPK, inactivated by pulmonary surfactant
Term
Ondansetron acts on 5HT3 receptors in what location, in order to decrease nausea?
Definition
chemoreceptor trigger zone (area postrema), the solitary nucleus, and in the presynpatic vagus nerve.
Term
Why must mu agonists be avoided in suspected pancreatic or biliary pain?
Definition
They cause constriction of the spinchter of oddi -> increased billiary pressures -> billiary colic.
Term
What drugs inhibit dihydrofolate reductase?
Definition
trimethoprim, methotrexate, pyrimethamine.
Term
Varenicline(mechanism, use)
Definition
partial agonist for nicotinic aCh channels in CNS. fights with ciggeratte nicotine for channel. reduces nicotine withdrawl cravings while attenuating the rewarding effects.
Term
What class of drug can precipitate mania in those with bipolar disorder?
Definition
antidepressants
Term
What is the treatment for sleep enuresis?
Definition
Desmopression (sleep enuresis = bed wetting)
Term
In general, what is the best drug to use for edema of any kind?
Definition
furosemide. TAL of Henlee absorbs the most NA here compared to where over diuretics work. will reduce edema quickly.
Term
Which drug used for hyperthyroidism decreases peripheral T3->T3 conversion?
Definition
PTU does. Methimazole does NOT.
Term
Can atropine be used to block gastric secretions? why or why not?
Definition
NO. G cells are under vagal influence but they do not use ACh as a neurotransmitter. Instead, they use GRP.
Term
Fomepizole(mechanism, use)
Definition
Inhibits alcohol dehydrogenase; used as an antidote to methanol or ethylene glycol poisoning.
Term
Disulfiram(mechanism, use)
Definition
Inhibits acetaldehyde dehydrogenase, makes acetaldehyde accumulate leading to hanger; used in alcohol abuse.
Term
What can be given to those suffering from hyperammonia caused by a metabolic derangement?
Definition
Benzoate or Phenylbutyrate will bind amino acids and lead to excretion.
Term
What is first dose effect, typically seen in A1 blockers?
Definition
On first dose, patient gets severe hypotension. Correct this by starting with a small dose.
Term
Which nitrate can be given PO?
Definition
Isosorbide mononitrate can be swallowed. It has an almost 100% biavailability that way. Others cannot due to first pass metabolism.
Term
Colchine stops what specific cell to decrease gout symptoms?
Definition
Stops chemotaxis of neutrophils
Term
What is the first line drug used to treat hypertension in pregnancy?
Definition
methlydopa
Term
Why is MRSA resistant to Naficillin but normal S. Aureus is not?
Definition
All S. Aureus has Beta-lactamases. Naficillin fights this. But MRSA has this AND altered penicillin binding proteins, which prevents Naficillin from working in MRSA.
Term
Palizumab(mechanism, use)
Definition
antibody against F protein, prevents pneumonia from RSV in infants
Term
Rhogam(mechanism, use)
Definition
IgG anti-RH antibodies. given to mom at 28 weeks and also at birth, it sticks to the RH antigens in the MOM's blood, keeping her from developing antibodies.
Term
Entacapone, Tolcapone (mechanism, use, tox)
Definition
COMT blockers, which increase DOPA levels; Both stop peripheral methylation and only Tolcapone stops central methylation; tolcapone causes hepatotoxicity
Term
What opioid effect is most resistant to tolerance?
Definition
Constipation
Term
Aldesleukin (mechanism, use)
Definition
IL 2; used in RCC, metastaic melanoma
Term
Epoetin Alfa(mechanism, use)
Definition
erythropoietin; anemias, especially in renal failure
Term
Filgrastim, Sargramostim (mechanism, use)
Definition
Fil = GC-SF, Sar = GM-CSF; both used in recovery of bone marrow, aplastic anemia
Term
alpha-inerferon(use)
Definition
hepatitis B and C, Kaposi sarcoma, Leukemias, Malignany Melanoma
Term
B-Interferon(use)
Definition
Multiple sclerosis
Term
gamma-interferon(use)
Definition
Chronic Granulamatous disease
Term
Oprelvekin(mechanism, use)
Definition
IL-11; thrombocytopenia
Term
thromopoietin(use)
Definition
thrombocytopenia
Term
Muromonab-CD3 (mechanism, use)
Definition
antibody to CD3; used in acute transplant rejection
Term
Digoxin Immune Fab(mechanism, use)
Definition
antibody to digoxin; used as antidote to digoxin intoxication
Term
Rasburicase (mechanism, use)
Definition
Recombinat version of Urate oxidase, breaks uric acid down into allantoin; use in tumor lysis syndrome and gout
Term
denosumab(mechanism, use)
Definition
monoclonal anitbody that binds to RANKL and prevents its interaction with RANK, inhibiting osteoclasts; decreases bone loss in bone mets
Term
What keeps heparin from crossing the placental barrier?
Definition
It's high water solubility. Things with a high lipid solubility (unconjugated bilirubin) tend to cross the placenta while things with high water solubility(conjugated bilirubin) tend to not. binds albumin = probably lipid soluble
Term
cyclosporine(mechanism, use, toxicity)
Definition
Used in transplant anti-rejected, treatment of graft-vs-host disease, and psoriasis; binds calineurin on T cells, stopping IL2 from being expressed, lowering T cell response; nephtrotox and lymphomma risk
Term
Isotretinoin, tretinoin, Acitretin(mechanism,use,toxicity
Definition
a retinoid that has immunomodulatory effects, binds nuclear receptors; psorisias and acne; severe teratogen
Term
Calcipotrol(mechanism, use)
Definition
vitamin D analog; used in topical psoariasis treatment
Term
Orlistat(mechanism, use)
Definition
Inhibits intestinal lipase, decreasing fat absorption; used to treat obesity
Term
giving what drug 30 minutes before Niacin can help reduce flushing?
Definition
aspirin. Niacin increases prostaglandin D2. release. asprin blocks this release = lower flushing
Term
Paclitaxil or sirolimus are commonly used in cardiac stents. why?
Definition
Prevent growth of intima by inhibiting cellular growth = no restenosis
Term
What is the drug used for Pre-eclampsi and ecplamsia?
Definition
IV magnesium sulfate for seizures
Term
Bortezomib(mechanism,use, toxicity)
Definition
Protease inhibitor, proteases are overactive in some cancers and can destroy pro-apototic proteins; used in multiple myeloma; peripheral neuropathy
Term
What causes nitroprusside toxicity? What is the antidote?
Definition
Nitroprusside degrades into cyanide. Give thiosulfide to inactivate.
Term
Memantine(mechanism, use, toxicity)
Definition
blocks NMDA-type glutamate receptors; used in alzheimers; confusion
Term
What vitamin is used in alzheimer's treatment?
Definition
Vitamin E (generic name is alpha-tocopherol)
Term
In gas anesthesias, what is the lipid solubility and the blood solubility?
Definition
Lipid solubility = potency (MAC). Blood solubility = speed of induction.
Term
Calcitrol, calcipotriene, tacalcitol (mechanism, use)
Definition
topical vitamin D analogs, activate nuclear receptors that inhibit keratinocyte proliferation and enhance keratinocyte differentiation; psoriasis
Term
Usetekinumab(mechanism, use)
Definition
monoclocal antibody that binds IL-12 and IL-12 thus inhibiting activation of Th1 cd4+ t cells; used in psoriasis
Term
Why is it required to wait 14 days after stoping a MAO-i before starting an SSRI?
Definition
MAO-inhbitors (phenelzine) inactive the MAO-I enzymes. It takes 2 weeks for them to get re-synthesized. If both SSRI and MAO-I are active at the same time, serotonin syndrome could occur
Term
Lepirudin, Bivalirudin (mechanism, use)
Definition
from leeches, inhibit thrombin; used as an alternative to heparin in HIT.
Term
Ropinirole, Pramipexole (mechanism, use)
Definition
are D2 agonists that DON'T need to be activated like l-dopa does; used in parkinsons and restless leg syndrome
Term
what are the uses of amantidine for parkinsons?
Definition
indirect and direct D agonist, also some anticholingergic functions which reduces tremors
Term
What compound can cause sickling of sickle cell trait RBC's?
Definition
sodium metabisulite, found as a food additive and sanitizer
Term
How do atypical antipsychotics avoid causing parkinson's symptoms and tardive dyskinesia?
Definition
They act on D4 instead of D2 receptors -> no risk of tardive dyskinesia or parkinson's like symptoms
Term
Which anti-inflammatories will not impair platlet aggregation? why?
Definition
Celecoxib. It only impairs COX2. COX1 is predominate in platlets.
Term
Natalizumab(mechanism, use, toxicity)
Definition
binds alpha-4 integrin, which blocks movement of WBC into orgrans;used in crohns and MS; can cause PML and hepatotoxicity.
Term
What drugs are preferred in medication induced parkinson's treatment? why?
Definition
Anti-muscarinics (Benzotropine). Giving dopamine agonists would exacerbate psychosis.
Term
What defines induction and potency in gas anesthetics?
Definition
induction = lower solubility in blood, quicker induction. potency = higher with higher lipid solubility =1/MAC.
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