Term
|
Definition
| absorption impeded by food, except for amoxicillin; excreted via kidney |
|
|
Term
| Penicillin G (IM*) and V (oral): spectrum |
|
Definition
| Gram positives, Neisseria and spirochetes |
|
|
Term
| Dicloxacillin, Nafcillin, oxacillin |
|
Definition
| penicillinase-resistant penicillins --> given orally to treat resistant staph* |
|
|
Term
|
Definition
Spectrum now includes many gram negatives; given orally
Ampicillin to tx Listeria
Amoxicilin - BE prophylaxis |
|
|
Term
| Carbenicillin, Ticarcillin, Pipercillin |
|
Definition
| anti-pseudomonas and proteus; given IV |
|
|
Term
|
Definition
| tx klebsiella and pseudomonas |
|
|
Term
| 1st generation cephalosporins* |
|
Definition
| gram positive cocci, Proteus, E coli, Klebsiella (PEcK) |
|
|
Term
| 2nd generation cephalosporins* |
|
Definition
| some gram +, PEcK, and Haemophilus, Enterobacter, Neisseria |
|
|
Term
| 3rd generation cephalosporins* |
|
Definition
| Haemophilus, Bacteroides fragilis and pseudomonas; more resistant to B-lactamase |
|
|
Term
|
Definition
| 1st gen IM for surgical prophylaxis |
|
|
Term
|
Definition
| 2nd gen IV for anaerobes, B. fragilis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 3rd gen IV for H flu and gonorrhea; excreted in BILE |
|
|
Term
|
Definition
| 3rd gen IV for Pseudomonas |
|
|
Term
|
Definition
| Hypersensitivity, GI disturbances (if PO), renal impairment, thrombophlebitis, and Bleeding (give vit K) |
|
|
Term
| Cephalosporin indications |
|
Definition
| UTIs, Klebsiella, resistant staph, Gram neg sepsis (combined with aminoglycoside) |
|
|
Term
|
Definition
| Carbapenems that bind PBP-2 and transpeptidase |
|
|
Term
|
Definition
| Broad spectrum (gram+, gram-, pseudomonas, Bacteroides); Resistance (E. faecium, MRSA, C. dificile); IV, can penetrate CNS; coadminister w/ Cilastatin to increase availability |
|
|
Term
|
Definition
| binds 50s* ribosome (b-static*); Tx Gram+*, corynebacterium, pneumonia; very acid labile; increased penetration w/ inflammation; Liver metabolism |
|
|
Term
|
Definition
| Inhibits CYP3A4; GI IRRITATION* (#1 problem) |
|
|
Term
|
Definition
| Acid stable macrolide with less GI disturbances but still inhibits p450 |
|
|
Term
|
Definition
| Acid stable macrolide with no major toxicity or interactions; more potent too |
|
|
Term
| Ketolides (telithromycin) |
|
Definition
| Use for macrolide-resistant bacteria as it has higher affinity for ribosome and less for efflux pump; inhibits p450 |
|
|
Term
|
Definition
| Mycoplasma pneumoniae, Legionnaires, pregnancy chlamydia, Diphtheria |
|
|
Term
|
Definition
| 50s ribosome so antagonistic w/ macrolides; gram+, bacteroides, anaerobes (clostridium always resistant); liver metabolism |
|
|
Term
|
Definition
| AAC (pseudomembranous colitis) |
|
|
Term
|
Definition
| B-cidal by binding D-ala-D-ala; tx resistant Gram+ only esp in soft tissue and bone; tx MRSA and AAC |
|
|
Term
|
Definition
| Ototoxicity (2gm/day max dose), nephrotoxicity |
|
|
Term
|
Definition
| B-static for staph and B-cidal for strep; binds 50s subunit; Tx MRSA and VRE |
|
|
Term
|
Definition
|
|
Term
| Tetracyclines (doxy-, mino-, tige-) |
|
Definition
| Gram+/- and rickettsiae, chlamydia, spirochetes*, and mycoplasma; binds 30s ribosome*, b-static; major resistance via efflux pump* (plasmid); DC and MOC best orally though affected by divalent cations; only TC and MOC excreted renally (use TGC,DC in renal failure) |
|
|
Term
|
Definition
| very broad spectrum (MRSA, VRE), IV only, long half life, non renal |
|
|
Term
|
Definition
| Hypo-mineralization of bone*, teeth pigmentation + enamal hypoplasia, FATAL hepatotoxicity in preggers (TC,DC) |
|
|
Term
|
Definition
| Passive diffusion via porins then active transport (O2 mediated), binds S12 of 30s ribosome*, B-cidal*; active against enteric gram- and aerobes; IV use, distributes extracellularly; renal excretion |
|
|
Term
| Aminoglycosides (Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin) toxicity* |
|
Definition
| Give once daily due to many side effects: Ototoxicity* (vestibular via Genta-, auditory via Kana-), nephrotoxicity (Neo- esp*), and Neuromuscular blocking action* |
|
|
Term
|
Definition
| Serious life threating infections that are refractory to other antibiotics (pseudo, ecoli, proteus, klebsiella, enterobacter) |
|
|
Term
| Quinolones* (Ciprofloxacin, trovafloxacin) |
|
Definition
| Inhibits topoisomerase II*, B-cidal*; tx anthrax and orally for pseudomonas + gram- |
|
|
Term
|
Definition
| GI, CNS disturbances, Inhibits p450 pathway, Avoid in preggers and kids |
|
|
Term
|
Definition
| broader spectrum including anaerobes such as B. fragilis; still excreted in bile |
|
|
Term
| Sulfonamides-trimethoprim |
|
Definition
| Blocks folic acid synthesis*; tx UTI, pneumonia, MRSA, PCP, shigellosis, H flu |
|
|
Term
|
Definition
| decomposes at pH <5.5 in urine to produce formaldehyde; given orally and metabolized in liver; some GI problems |
|
|
Term
|
Definition
| same as methenamine but used just for drug-resistant E. coli; BIRTH DEFECTS |
|
|
Term
|
Definition
| Anaerobes only (and trichomonas) can reduce nitro group to give metabolite* that inhibits DNA replication; taken orally, distributes well |
|
|
Term
|
Definition
| Disulfiram reaction with alcohol, GI troubles |
|
|
Term
|
Definition
| with 2 first line agents: ethionamide, quinolone, capreomycin, PAS |
|
|
Term
|
Definition
| Avoid Pyrazinamide, aminoglycosides, quinolones, ethionamide |
|
|
Term
|
Definition
| Pyrazinamide, ethionamide, isoniazid |
|
|
Term
|
Definition
| Most active; B-cidal; gets into CSF; Toxicity is hepatitis*, give pyridoxine |
|
|
Term
|
Definition
| B-cidal both intra/extracellular; binds beta-subunit of RNA polymerase*; Toxicity: Orange secretions, hepatitis*, thrombocytopenia, rash, drug interactions with oral contraceptives (p450 inducer is rifampin)* |
|
|
Term
|
Definition
| Rifampin contraindicated in HIV patients use Rifabutin (less potent p450 inhibitor |
|
|
Term
|
Definition
| B-static; blocks arabinosyl transferases; synergistic wtih rifampin; poor penetration of cns; excreted in urine; Toxicity is loss of visual acuity and R/G color blindness*; dont give to children |
|
|
Term
|
Definition
| B-cidal for extracellular* TB; toxicity is ototoxicity and nephrotoxicity |
|
|
Term
|
Definition
| Intracellular* TB; B-cidal*; toxicity is hepatitis |
|
|
Term
|
Definition
| blocks mycolic acid synthesis; GI and neuro toxicity --> dont give to preggers |
|
|
Term
|
Definition
|
|
Term
| Clarithromycin* (macrolides) to treat TB |
|
Definition
| Activity against MAC and rapid growers |
|
|
Term
|
Definition
| phenazine dye that may alter DNA fxn; Leprosy drug; anti-inflammatory + prevents development of erythema nodosum; toxicity is red-black discoloration of skin |
|
|
Term
|
Definition
| amikacin, quinolone, clarithromycin*, rifabutin |
|
|
Term
| Tx for chronic wound infection MOTTs* |
|
Definition
| Amikacin, cephalosporins, imipenem |
|
|
Term
|
Definition
| Sulfa-related drug; disrupts folate synthesis; excreted in urine; combo treat leprosy w/ rifampin and clofazimine; toxicity is hemolysis + methemoglobinemia |
|
|
Term
|
Definition
| Binds to ergosterol* leading to cell death*; IV for systemic disease but poorly for CNS penetration; broad spectrum for candida, crypto, histo, blasto, coccidio |
|
|
Term
|
Definition
| Renal impairment (dec perfusion, dec EPO, RTA), abnormal liver fxn, infusion related toxicity |
|
|
Term
|
Definition
| binds ergosterol for cell death; ONLY topical for oral thrush and vaginal thrush; too toxic |
|
|
Term
|
Definition
| Imi- have more side effects, Tri- slower metabolism; Reduce ergosterol byosynthesis*; f-static*, inhibit p450 |
|
|
Term
|
Definition
| Oral, inhibits adrenal and gonadal steroid synthesis*, p450 alteration; teratogenic; NOT USED anymore |
|
|
Term
|
Definition
| reduces ergosterol biosynthesis*; Oral, NO p450 effect; tx dermatophytoses and onchomycoses; aspergillus, histo, blasto, sporo |
|
|
Term
|
Definition
| Good CNS penetration, most water soluble; Used for Cryto meningitis and prophylactically for bone marrow disease |
|
|
Term
|
Definition
| similar to itra-; Excellent activity against candida |
|
|
Term
|
Definition
| topical; lozenges for oral and vaginal thrush |
|
|
Term
|
Definition
| topical for athletes foot |
|
|
Term
|
Definition
| deamidated to 5-FU which blocks DNA/RNA synthesis*; f-static*; high resistance, used to treat crypto meningitis with Ampho B; Tox: antineoplastic, bone marrow damage |
|
|
Term
|
Definition
| Orally as a suspension to treat dermatophytic infections*; disrupts mitotic spindle esp polymerized microtubles and keratin |
|
|
Term
|
Definition
| inhibits squalene epoxide interfering with ergosterol biosynthesis; f-cidal; orally to treat nail fungus but takes 3 months |
|
|
Term
|
Definition
| inhibits B-glucan preventing formation of fungal cell wall; for severe refractory candidiasis and aspergillosis; Toxicity includes phlebitis, fever, chills, teratogenic |
|
|
Term
|
Definition
| DOC for most plasmodium; interferes with heme detoxification by plasmodium*; little toxicity if oral |
|
|
Term
|
Definition
| DOC for hypnozoites from vivax and ovale; oral; toxicity is hemolytic anemia in |
|
|
Term
|
Definition
| Chloroquine resistant P falciparum; synergistic relationship; oral; Toxicity: low dose (cinchonism- visual hearing disturbances), high dose (GI, CV, dermal) |
|
|
Term
|
Definition
| tx chloroquine resistant malaria; Atovaquone inhibits mitochondrial fxn; proguanil inhibits DHFR |
|
|
Term
|
Definition
| chloroquine-resistant malaria; well tolerated |
|
|
Term
|
Definition
| Always given with sulfa b/c it also inhibits DHFR; toxicity is skin rash and depression of hematopoesis |
|
|
Term
|
Definition
| tx for malaria, cyclospora*, toxoplasma; toxicity is agranulocytosis, aplastic anemia |
|
|
Term
| Iodoquinol + Metronidazole |
|
Definition
| Tx amebiasis; Iodoquinal treats only LUMINAL trophozoites; Toxicity includes anorexia, metallic taste* |
|
|
Term
|
Definition
| Tx Cryptosporidium; prodrug for tizoxanide which inhibits pyruvate:ferredoxin oxidoreductase pathway; well tolerated |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Metronidazole for parasites |
|
Definition
|
|
Term
|
Definition
| Larval tapeworms, Cysticercosis, hydatid (pork/dog tapeworms) and adult tapeworms, and larva migrans; inhibits tubulin polymerization by binding to Beta tubulin; also inhibits glucose uptake |
|
|
Term
|
Definition
| DOC* for Ascaris, hookworm, pinworms and whipworms, both larval and adult; binds to free B-tubulin* and inhibits glucose uptake |
|
|
Term
|
Definition
| Strongyloides stercoralis; inappropriate release of GABA* |
|
|
Term
|
Definition
| Schistosomiasis*; Cell membrane permeability to Calcium resulting in paralysis* |
|
|
Term
|
Definition
| Topical for Scabies; inhibits insect neuronal activity |
|
|
Term
|
Definition
| Pyrethrin plus piperonyl butoxide; pyrethrin is similar to DDT by inhibiting neuronal activity; piperonyl butoxide is a p450 inhibitor which increases pyrethrin levels |
|
|
Term
|
Definition
| guanosine analog; requires 3 phosphorylations w/ thymidine kinase performing the initial one*; acts as both chain terminator and DNApol inhibitor*; Tx VZV and genital herpes |
|
|
Term
|
Definition
| prodrug of acyclovir; greater bioavailability |
|
|
Term
|
Definition
| converted to penciclovir; same mechanism as acyclovir; acute zoster, genital herpes and mucocutaneous HSV |
|
|
Term
|
Definition
| same as acyclovir; effective against Life-threating CMV (retinitis, pneumonitis)*; Toxicity: hematologic myelosuppression* additive w/ AZT |
|
|
Term
|
Definition
| Deoxycytodine analog activated by cellular enzymes and inhibits DNApol; long intracellular half-life; treats CMV retinitis by IV; Toxicity: renal(give probenacid) |
|
|
Term
|
Definition
| pyrophosphate analog, blocks its binding site in DNApol*; Tx acyclovir-resistant HSV,VZV* and CMV retinitis*; Toxicity: renal, metabolic, CNS, anemia |
|
|
Term
| Idoxuridine, Trifluridine |
|
Definition
| Thymidine analogs used topically in eye for HSV keratitis |
|
|
Term
|
Definition
| Antisense oligonucleotide* complementary to CMV nucleic acid inhibiting replication; Injected into eye for CMV retinitis; Toxicity: uveitis, glaucoma |
|
|
Term
|
Definition
| guanosine analog, inhibits DNA/RNA synthesis; administered by aerosol; Tx RSV pneumonitis and HCV; Toxicity: hemolytic anemia and precipitates in ventilators |
|
|
Term
|
Definition
| cyclic amines that target influenza A m2 protein adn prevent uncoating*; tx type A; Toxicity: GI intolerance, CNS effects (amantadine) |
|
|
Term
| Zanamivir(IN), Oseltamivir(oral) |
|
Definition
| neuraminidase inhibitors*; Tx type A&B; can be used prophylactically |
|
|
Term
| 2 classes of HIV tropic receptors |
|
Definition
| CD4 and Chemokine (CCR5-macrophage, CXCR4-Tcell |
|
|
Term
|
Definition
| reduced expression speeds progression to AIDS |
|
|
Term
|
Definition
| homozygous delta 32 deletion delays HIV progression*, though promotor region mutation increases susceptibility |
|
|
Term
|
Definition
| Promoter mutation delays the onset of AIDS |
|
|
Term
|
Definition
| suppressive chemokine; those w/ lower gene copy number have increased susceptibility |
|
|
Term
|
Definition
| NRTI: thymidine analog, requires 3 phophorylations to competitively inhibit RT and DNA chain formation*; Toxicity: Macrocytic anemia, neutropenia, leukopenia*; lactic acidosis and severe hepatomegaly w/ steatosis |
|
|
Term
|
Definition
| NRTI: deoxyadenosine analog; rapidly degraded if oral; Toxicity: pancreatitis, peripheral neuropathy |
|
|
Term
|
Definition
| NRTI: deoxycytidine analog; Toxicity: peripheral neuropathy, pancreatitis |
|
|
Term
|
Definition
| NRTI: thymidine analog; 2nd line therapy; Toxicity is peripheral neuropathy, pancreatitis |
|
|
Term
| Lamivudine, Emtricitibine |
|
Definition
| NRTI*: cytidine analog; 1st line with zidovudine; less toxicity but some pancreatitis |
|
|
Term
|
Definition
| NRTI*: guanosine analog, DNA chain terminator; hypersensitivity reaction is toxicity |
|
|
Term
|
Definition
| NRTI: acyclic nucleoside phophonate (doesnt need to be phosphorylated); 1st line (some GI complaints) |
|
|
Term
| NNRTIs: nevirapine, delavirdine, efavirenz: MOA |
|
Definition
| direct binding and inhibition of RT at allosteric sites, inhibits DNA-dependent DNApol |
|
|
Term
|
Definition
| NNRTI, rash that resolves |
|
|
Term
|
Definition
| NNRTI, Liver toxicity but given to preggers |
|
|
Term
|
Definition
| NNRTI, AVOID in preggers; significant CNS toxicity |
|
|
Term
| Protease inhibitors (-navir) |
|
Definition
| Inhibit HIV aspartic protease blocking processing of gag,pol*; Toxicity: GI problems, diabetes, lypodystrophy; p450 inhibitor |
|
|
Term
|
Definition
| Strong inhibitor of p450 so used at low levels with other PIs to increase effects |
|
|
Term
|
Definition
| only PI where cross resistance does NOT develop very rapidly |
|
|
Term
|
Definition
| synthetic peptide that binds gp41 and inhibits fusion |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| blocks viral transcription and translation; injected SC; Tx HBV,HCV,HPV |
|
|
Term
| 5 things that increase insulin secretion |
|
Definition
| sulfonylureas, B2 agonists, prostaglandins, ACh, Calcium |
|
|
Term
| 5 things that DECREASE insulin secretion |
|
Definition
| somatostatin, a-agonists, diazoxide, thiazide diuretics, verapamil |
|
|
Term
| Sulfonylureas and Meglitinides |
|
Definition
| Oral agents for type II; increase sensitivity of B-cell to glucose; weight gain common; Low Toxicity: decreases Iodide uptake, GI reaction (only sulfonylureas); teratogenic |
|
|
Term
|
Definition
| sulfonylurea, increased CV related deaths |
|
|
Term
|
Definition
| sulfonylurea, once day dosing |
|
|
Term
|
Definition
| sulfonylurea, use with caution in elderly* due to risk of hypoglycemia |
|
|
Term
|
Definition
| sulfonylurea, ADH-like effect and used with caution in elderly* |
|
|
Term
| Sulfonylureas and drug interactions |
|
Definition
| ASA (displaces), NSAIDS (displace and inhibit metabolism), Warfarin (displace and inhibit metabolism), Chloramphenicol (inhibits metabolism) |
|
|
Term
|
Definition
| decrease hepatic glucose output and increase insulin sensitivity of periphery*; no risk of hypoglycemia or weight gain; Toxicity: GI disturbances, lactic acidosis |
|
|
Term
| Thiazolidinediones (rosiglitazone, pioglitazone) |
|
Definition
| increase number of glucose transporters, reduces plasma glucose, insulin and triglycerides*; weight gain edema and MI (only Rosiglitazone) |
|
|
Term
|
Definition
| synthetic GLP-1 for injection; causes weight loss; tox: NVD; teratogenic |
|
|
Term
|
Definition
| inhibits DPP-4 protease that degrades GLP-1; Oral |
|
|
Term
|
Definition
| Meglitinide; excreted in bile, weight gain |
|
|
Term
|
Definition
| meglitinide; excreted in urine, weight gain |
|
|
Term
| INCREASE of OPL/OPG (osteoclastic activity) |
|
Definition
| IL-11, IL-6, IL-1, PGE1, PTH |
|
|
Term
|
Definition
| TGF-B, estradiol, calcitonin |
|
|
Term
|
Definition
| PTH analog; Tx osteoporosis or diaagnose pseduohypoparathyroidism; Injection but only for 2 years maximum, Tox: nausea, dizziness, leg cramps, altered mood, osteosarcomas |
|
|
Term
|
Definition
| derived from salmon; decreases calcium turnover in bone by increasing cAMP*; used leads to excretion of Ca*,PO4,Mg,CL,K; tx Paget's disease*, hyper-PTH, osteoporosis |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 25OH-D3, circulating form |
|
|
Term
|
Definition
| 1,25OH-D3, active form; used for emergency situations |
|
|
Term
| 5 inducers of 1-hydroxylase in kidney |
|
Definition
| low Ca, PTH, low Phos, Estradiol, Prolactin |
|
|
Term
|
Definition
|
|
Term
|
Definition
| 1,25OH-D2; IV Tx hyper-PTH in patients with renal failure on dialysis; works b/c it doesnt affect Ca/P levels |
|
|
Term
|
Definition
| 1,25OH-D2; given orally for hyper-PTH secondary to renal failure |
|
|
Term
|
Definition
| Increase Ca and PO4; induces calcium transport proteins in intestine (ECa2, Calbindin, PMCA1b atpase)*; increases renal reabsorption of both*; stimulates Ca mobilization in bone*; potentiates action of PTH on bone*; increases number of osteoclasts*; decreases lymphoid cells, induces osteocalcin/osteopontin |
|
|
Term
|
Definition
| Vit D derivative used to tx psoriasis |
|
|
Term
|
Definition
| Vit D2 derivative that only needs to be modified by liver to tx hypocalcemia (good for renal patients) |
|
|
Term
|
Definition
| pyrophosphate analogs which bind directly to hydroxyapatite crystals in bone impairing resorption; VERY POOR oral absorption |
|
|
Term
|
Definition
| Non-nitrogenous bisphosphonate that is internalized by osteoclasts impairing functions and leading to apoptosis*; tx Pagets, neoplasms, trauma; Toxicity: GI bleeds, diarrhea, osteomalacia |
|
|
Term
| Alendronate*, Ibandronate |
|
Definition
| aminobisphophonates; block farnesyl diphosphate synthase which impairs post-translation modification of regulator proteins such as Ras,Rho,Rac*; also induces apoptosis; NO osteomalacia or reflux; TOXICITY: osteonecrosis of jaw |
|
|
Term
|
Definition
| IV bisphos once/year; reduce hip,wrist,vertebrae fracture; Toxicity: nausea and severe bone pain, osteonecrosis of jaw |
|
|
Term
|
Definition
| SERM (bone liver agonist) (uterus brain antagonist); strong bones, good LDL, hot flashes, procoagulant |
|
|
Term
|
Definition
| slow release stimulates bone formation highly but bone has less mechanical strength |
|
|
Term
|
Definition
| stimulate bone formation in post-menopausal osteoporosis; can cause nausea, diarrhea, headache, dermatitis |
|
|
Term
|
Definition
| Estrogen used primarily in contraceptives |
|
|
Term
| Estradiol and conjugated equine estrogens |
|
Definition
| used primarily in menopausal HRT |
|
|
Term
| Anastrazole* and exemestane |
|
Definition
| aromatase inhibitors used to treat breast cancer; toxicity: hot flashes, long term bone/chol effects |
|
|
Term
| Progesterone, Medroxyprogesterone acetate |
|
Definition
|
|
Term
| Northindrone, Norgesterol |
|
Definition
| 19-nor steroids used in contraceptives with some androgenic side effects |
|
|
Term
|
Definition
| tx hot flashes (Estrogen), Maintenance of bone (E), vaginal dryness (E); Side effects: endometrial cancer*(E so give P), risk of breast cancer and stroke |
|
|
Term
|
Definition
| Block ovulation at hypothalamus* (19norP), decrease dysmenorrhea, anemia, ovarian/uterine cancer*; Toxicity: stroke, VTE, breast cancer risk |
|
|
Term
|
Definition
| either low dose 19-norP or medroxyprogesterone injection; can cause menstrual irregularities |
|
|
Term
|
Definition
| high dose Progesterone; N/V and possibly teratogenic if already preggers |
|
|
Term
|
Definition
| blocks ER in breast cancer tumor cells; Toxicity: endometrial cancer*, VTE*, hot flashes; good for lipids |
|
|
Term
|
Definition
| Inhibits estrogen inhibition at pituitary to enhance FSH*; increases ovulation |
|
|
Term
|
Definition
| Anti-progestin at receptors (causes detachment) used wtih a PG for medical abortion |
|
|
Term
|
Definition
| 17-alkyl substituted compound; causes Hepatic toxicity* |
|
|
Term
|
Definition
| Anti-andrgoen receptor antagonist to treat prostate cancer |
|
|
Term
|
Definition
| GnRH analog, continuous administration to shut down the pituitary |
|
|
Term
|
Definition
| Systemic, short duration, can cause hypertension |
|
|
Term
|
Definition
| partially stystemic, prolonged activity, can lead to acid rebound (via gastrin) and kidney stones |
|
|
Term
|
Definition
| local, rapid onset, cause diarrhea |
|
|
Term
|
Definition
| local, rapid onset, cause constipation, deplets phosphate* leads to bone destruction |
|
|
Term
| Anti-muscarinics (propantheline, isopropamide, pirenzepine) |
|
Definition
| block ACh mediated motility and secretions but cause systemic anti-Ach effects (Pirenzipine is more selective of M1 so less effects) |
|
|
Term
|
Definition
| decrease acid secretion by all stimuli though high relapse rates |
|
|
Term
|
Definition
| H2 antagonist; bad in elderly, renal pts, prolonged thereapy can cause mental confusion, increased creatinine, hematologic changes; anti-androgen effects in high doses; inhibits p450* |
|
|
Term
|
Definition
| H2 antagonist with less p450 effects and does NOT bind androgen receptor |
|
|
Term
|
Definition
| H2 antagonist with no p450 effects and no other side effects |
|
|
Term
|
Definition
| H2 antagonist with rare hepatic toxicity but no p450 or androgen effects |
|
|
Term
|
Definition
| PGE1 derivative, opposes cAMP in ECL cells (decreases acid secretion), increases bicarb, mucus, blood flow; tx high risk patients on NSAIDs; Toxicity: bloating and diarrhea, preggers |
|
|
Term
| Proton pump inhibitors (omeprazole, lansoprazole, rabeprazole, esomeprazole) |
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Definition
| Weak bases that get trapped and activated in secretory canaliculi irreversibly inhibiting H/K atpase*; Toxicity: inc infxns, osteoporosis, CI with clopidogrel, hypergastrinemia |
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Term
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Definition
| sucrose+AlOH, in acid polymerizes to create a barrier, H. pylori suppressive; stimulates PGE, inhibits pepsin |
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Term
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Definition
| stimulates mucus and scavenges free radicals; tx ulcers |
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Term
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Definition
| stiulates mucus secretion |
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Term
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Definition
| promot mucus secretion, adherence, adn antibacterial |
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Term
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Definition
| inhibits AChE increasing ACh; increases GI motility and stomach emptying; Toxicity: SLUDS* rarely used |
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Term
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Definition
| D2 antagonist which increases ACh; increases LES tone, esophageal clearance, gastric emptying, bowel motility; Toxicity: somnolence, nervousness, dystonia, increased prolactin |
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Term
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Definition
| 5HT4 agonist* increasing ACh activity; promotes gastric emptying, increases LES tone and esophageal clearance; Toxicity: increased bowel movements and FATAL cardiac effects |
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Term
| Erythromycin and role in GI motility |
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Definition
| binds motilin receptors; tx diabetic gastroparesis; Toxicity: abdominal cramps |
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Term
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Definition
| natural bile acid; inhibits HMG-CoA reductase; tx for up to years for gallstone dissolution; Toxicyt: diarrhea, liver dysfunction, LDL increase |
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Term
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Definition
| hydrophylic bile acid taht does not inhibit 7a-hydroxylase (dec diarrhea,LDL, liver problems); still requires up to 2 years and CI in chronic liver disease |
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Term
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Definition
| Infused directly into gallbladder; is a solvent for lipids |
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Term
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Definition
| semi synthetic veggie oil that is infused into common bile duct for 7-21 days |
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Term
| Psyllium, methyl-cellulose, bran |
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Definition
| Bulk forming laxatives (increase water) and least SEs |
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Term
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Definition
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Term
| Magnesium salts and sodium phosphates |
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Definition
| stimulate bowel contractions; Toxicity: Mg (accumulates w/ renal failure), Phosphates (htn) |
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Term
| Bisacodyl, sennasoids, castor oil |
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Definition
| secretory laxatives (induce mild irritant injury to mucosa); Castor oil can reduce absorption of lipid soluble vitamins |
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Term
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Definition
| 5HT4 partial agonist*; works presynaptically in bowel to promote transit; Toxicity: CARDIAC problems |
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Term
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Definition
| Activates local Cl- channels; tx idiopathic chronic constipation |
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Term
| Morphine, codeine, opium tincture |
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Definition
| natural opiates, SE include constipation and CNS effects |
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Term
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Definition
| synthetic opiate; Little abuse but does cross BBB so give with atropine |
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Term
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Definition
| synthetic opiate; does NOT cross BBB, NO abuse |
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Term
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Definition
| muscarinic antagonists; reduce secretion and colonic peristalsis*, primarily relieve cramping |
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Term
| Kaolin, pectin, attapulgite |
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Definition
| Hydrated aluminum silicate clays, act as absorbants/protectants; not used |
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Term
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Definition
| binds abcterial toxins, prevents PG production, some antibacterial activity; Tx travelers diarrhea; Toxicity: avoid ASA use, turns tongue/stool black |
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Term
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Definition
| Increase Na/K atpase in intestinal lumen thus increasing absorption; delayed effect; tx chronic diarrhea |
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Term
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Definition
| Decrease secretions, can cause hypotension |
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Term
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Definition
| somatostatin analog*; inhibits GI hormones, decreases blood flow, reduces motility, increases absorption; *Tx carcinoid and VIPomas and AIDS patients; give parenterally |
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Term
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Definition
| increases absorption along dextrose-sodium cotransport system; tx acute childhood diarrhea |
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Term
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Definition
| non-absorbable antibiotic used to tx travelers diarrhea and some IBS |
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Term
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Definition
| broken down to sulfapyridine and 5-ASA; used for mild to moderate ulcerative colitis |
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Term
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Definition
| active agent; remains in colon inhibiting AA metabolism esp preventing leukotriene B4 production and can scavenge free radicals; give as enema for active ulcerative colitis |
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Term
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Definition
| completely absorbed; commonly causes NV, headache, abdominal discomfort, malaise, arthralgia, anorexia |
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Term
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Definition
| covalent dimer of 5-ASA* which is activated by bacteria in colon, taken orally |
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Term
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Definition
| can be given via enema for severe ulcerative colitis |
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Term
| Azothioprine, 6-mercaptopurine |
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Definition
| purine anti-metabolites that inhibit lymphocyte production; tx ibd |
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Term
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Definition
| inhibits purine and thymidine synthesis, promotes Tcell apoptosis; tx Crohn's in remission |
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Term
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Definition
| tx flare-ups in ulcerative colitis unresponsive to steroids |
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Term
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Definition
| TNFa chimeric monoclonal antibody; can cause serum sickness, lymphoma, CNS demyelination |
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Term
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Definition
| Integrin a4 receptor antibody; tx IBD; can cause PML and infections |
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Term
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Definition
| emetic used for acute poisoning; contains emetine which directly stimulates peripheral sensory afferents in stomach to induce reflex vomiting*, can also hit up CTZ; Toxicity: heart in large doses |
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Term
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Definition
| muscarinic antagonist, reduces transmission of vestibular system and depresses labyrinth receptors; synergistic with ephedrine; Tx motion sickness!; Toxicity SLUDS |
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Term
| Dimenhydrinate, Diphenhydramine |
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Definition
| H1 antagonists w/ antimuscarinc activity; block labyrinth neural pathways; tx motion sickness, postop nausea and vomiting; sluds |
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Term
| Metoclopramide, Chlorpromazine |
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Definition
| D2 receptor antagonists in CTZ and VC; inhibit vagal nerve stimulation; prokinetic drug; Tx mild cancer regimens, irradiation, post-op nausea; Toxicity: sedation, diarrhea, EPS, orthostatic hypotension, seizures, if chronic admin |
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Term
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Definition
| cannabinoid used for cancer chemotherapy, predictable side effects |
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Term
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Definition
| High dose IV bolus for chemo, oral for delayed nausea; often prescribed w/ ondansetron to block delayed emesis |
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Term
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Definition
| BZ, prevents anticipatory emesis and vertigo (NOT motion sickness) |
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Term
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Definition
| 5-HT3 antagonist*; DOC for acute nausea caused by chemo esp higher emotgenic potential, used postoperatively and during preggers |
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Term
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Definition
| High affinity antagonist of NK1 receptors in brain; blocks both acute and delayed chemo vomiting, very powerful; Toxicity: inhibits p450 |
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Term
| anti-emetogenic triple therapy |
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Definition
| Ondansetron, aprepitant, dexamethasone |
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Term
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Definition
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Term
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Definition
| similar to amphetamine, decrease appetite with less CNS effects |
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Term
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Definition
| similar to amphetamine, lower cns effects with increased insomnia |
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Term
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Definition
| similar to amphetamine (also inc 5HT); short lived effect; NO dependence and safer but still dont give to patients with bad hearts |
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Term
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Definition
| appetite suppresant; CB1 receptor blocker; may cause severe depression |
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Term
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Definition
| increases serotonin; promotes satiety; TOO TOXIC TO USE |
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Term
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Definition
| promotes satiety; inhibits NE/5HT reuptake; approved for long-term use; After cessation body weight rapidly regained |
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Term
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Definition
| inhibits pancreatic/intestinal lipases; not absorbed, use long term; causes flatulence, steatorrhea, fecal leakage |
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