Term
|
Definition
Drug class
Loop Diuretics
MOA
Inhibitors of Na+-K+-2Cl– symport in the thick ascending limb of loop of henle
Uses
acute pulmonary edema
chronic congestive heart failure
Edema
Side effects/contraindications
Hypokalemia
Dehydration
Ototoxicity
Sulfa related |
|
|
Term
| Hydrochlorothiazide (HCTZ) |
|
Definition
Drug class
Thiazide diuretics
MOA
Inhibitors of Na+-Cl– symport in distal tubule
Uses
Edema
HTN
Side effects/contraindications
Hypokalemia
Dehydration
Sulfa related |
|
|
Term
|
Definition
Drug class
Potassium-sparing diuretics
MOA
Na+ channel blockade in late distal tubule
Uses
Major utility is in combination with other diuretics for edema or HTN
Side effects/contraindications
Hyperkalemia |
|
|
Term
|
Definition
Drug class
Aldosterone Antagonists, K+-Sparing Diuretics
MOA
Competitively inhibit the binding of aldosterone to the MR
Uses
Combination with other diuretics for edema or HTN
Hepatic cirrhosis
CHF
Side effects/contraindications
Hyperkalemia |
|
|
Term
|
Definition
Drug class
Angiotensin-Converting Enzyme Inhibitors
MOA
Inhibit the conversion of Ang I to the active Ang II
Uses
HTN, CHF, Post-MI, Diabetes Mellitus
Side effects/contraindications
Contraindicated African Americans for HTN use
Contraindicated pregnancy
Cough (Bradykinins)
Hyperkalemia
Hypotension
Acute Renal Failure
Angioedema |
|
|
Term
|
Definition
Drug class
Angiotensin II Receptor Antagonists
MOA
Bind to the AT1 receptor with high affinity
Uses
HTN
CHF
Diabetes mellitus
Side effects/contraindications
Angioedema and cough with ARBs is less than that with ACE inhibitors
Contraindicated pregnancy |
|
|
Term
|
Definition
Drug class
Direct Renin Inhibitors
MOA
Binds the active site of renin to block conversion of angiotensinogen to Ang I
Uses
HTN |
|
|
Term
|
Definition
Drug class
Organic Nitrates
MOA
NO-dependent relaxation of vascular smooth muscle leads to vasodilation
Uses
Acute Angina
CHF
Side effects/contraindications
Headache
Hypotension
Interaction of Nitrates with PDE5 Inhibitors (ED) |
|
|
Term
|
Definition
Drug class
Organic Nitrates
MOA
NO-dependent relaxation of vascular smooth muscle leads to vasodilation
Uses
Chronic Angina
Side effects/contraindications
Headache
Hypotension
Interaction of Nitrates with PDE5 Inhibitors (ED) |
|
|
Term
|
Definition
Drug class
Ca2+ Channel Antagonists (CCB)
MOA
Relax arterial smooth muscle
Uses
Prinzmals angina
HTN
Raynauds phenomenon
Side effects/contraindications
Edema
GERD |
|
|
Term
|
Definition
Drug class
Ca2+ Channel Antagonists (CCB)
MOA
Depress the rate of the sinus node pacemaker and slow AV conduction
Uses
Supraventricular tachyarrhythmias
Side effects/contraindications |
|
|
Term
|
Definition
Drug class
b Adrenergic Blockers
MOA
Slow the heart rate and decrease myocardial contractility
Uses
Unstable angina, MI, CHF, HTN, Performance anxiety
Hyperthyroidism, Glaucoma – drops, Migraine prevention
Contraindications
Asthma and COPD
b2 receptor blockades
Raynaud’s syndrome, Depression, Severe PVD, Sinus bradycardia
AV block, Diabetes, Anaphylaxis Hx
Side effects
Fatigue
Erectile dysfunction |
|
|
Term
|
Definition
Drug class
a1 Adrenergic Receptor Antagonists
MOA
Blockade of a1 adrenergic receptors inhibits vasoconstriction induced by endogenous catecholamines
Uses
HTN
Benign Prostatic Hypertrophy (BPH)
Side effects/contraindications
Marked postural hypotension and syncope sometimes occur
“Floppy” cataract with tamsulosin (Flomax) |
|
|
Term
|
Definition
Drug class
a2-Selective Adrenergic Receptor Agonists
MOA
Activation of a2 receptors in the cardiovascular control centers of the CNS suppresses the outflow of sympathetic nervous system activity
Uses
HTN (Pregnancy first-line, HTN crisis)
ADHD side effects |
|
|
Term
|
Definition
Drug class
Vasodilators
MOA
Directly relaxes arteriolar smooth muscle
Uses
HTN
Side effects/contraindications
headache,
nausea,
flushing,
hypotension,
drug-induced lupus syndrome |
|
|
Term
|
Definition
Drug class
Cardiac Glycosides
MOA/Uses
Inhibition of the plasma membrane Na+, K+-ATPase in myocytes
A positive inotropic effect on the failing myocardium (CHF)
Suppression of rapid ventricular rate response in CHF-associated atrial fibrillation
Regulation of downstream deleterious effects of sympathetic nervous system over-activation
Side effects/contraindications
Digoxin Toxicity |
|
|
Term
|
Definition
Drug class
Class 1 Anti-Arrhythmic
MOA
Na+ channel block |
|
|
Term
|
Definition
Drug class
Class 2 Anti-Arrhythmic
MOA
b blockade |
|
|
Term
|
Definition
Drug class
Class 3 Anti-Arrhythmic
MOA
action potential prolongation (usually by K+ channel block) |
|
|
Term
|
Definition
Drug class
Class 4 Anti-Arrhythmic
MOA
Ca2+ channel block |
|
|
Term
|
Definition
Drug class
Statins
MOA
Inhibition of HMG-CoA reductase decreases the bodies de novo synthesis of cholesterol primarily in the liver.
Uses
Hyperlipidemia
Side effects/contraindications
liver dysfunction
rhabdomyolysis
Extreme caution with combination statin and fibrate |
|
|
Term
| Cholestyramine (Questran) |
|
Definition
Drug class
Resins
MOA
sequester bile acids and bile salts from being absorbed by the ileum and are consequently eliminated in the feces
Uses
Hyperlipidemia
Bile salt–induced diarrhea
Side effects/contraindications
Upset GI
Decreased absorption of drugs and fat soluble vitamins |
|
|
Term
|
Definition
Drug class
Niacin
MOA
Niacin impairs of the release and synthesis of VLDL by the liver
Uses
Hyperlipidemia
Side effects/contraindications
Cutaneous flush |
|
|
Term
|
Definition
Drug class
Fibrates
MOA
increase in lipolysis and decrease in VLDL levels by acting as ligands for the peroxisome proliferator-activated receptor (PPAR).
Uses
Hyperlipidemia
Side effects/contraindications
liver dysfunction
rhabdomyolysis
Extreme caution with combination statin and fibrate |
|
|
Term
|
Definition
Drug class
Absorption Inhibitors
MOA
decrease the intestinal uptake of dietary and liver excreted cholesterol.
Uses
Hyperlipidemia |
|
|
Term
| Albuterol (Ventolin) (inhaled) |
|
Definition
Drug class
Short acting B2-agonist
MOA
relax airway smooth muscle and cause a prompt increase in airflow and reduction of symptoms
Uses
Acute asthma – first line
Side effects/contraindications
Tachycardia |
|
|
Term
| Ipratropium bromide (inhaled) |
|
Definition
Drug class
Anticholinergics
MOA
Reverse vagally mediated bronchospasm but not allergen- or exercise-induced bronchospasm
Uses
Acute COPD – first line |
|
|
Term
|
Definition
Drug class
Inhaled corticosteroid
MOA
reduce both acute and chronic inflammation
Uses
Preventative asthma – first line
Preventative COPD – second line
Side effects/contraindications
Mouth washing after use decreases local side effects (cough, dysphonia, oropharyngeal candidiasis) and systemic absorption
Systemic effects may occur with high-dose inhaled corticosteroid therapy. |
|
|
Term
| Cromolyn sodium (inhaled) |
|
Definition
Drug class
Mediator inhibitors
Uses
Exercised-induced asthma |
|
|
Term
|
Definition
Drug class
Long acting B2 agonist
MOA
bronchodilation for up to 12 hours after a single dose
Uses
Preventative COPD - First-line but more effective as combination with inhaled steroid
Preventative asthma when used with inhaled steroid
Side effects/contraindications
NEVER use alone for preventative asthma |
|
|
Term
|
Definition
Drug class
Phosphodiesterase inhibitors
MOA
mild bronchodilation
anti-inflammatory and immunomodulatory properties,
enhances mucociliary clearance,
strengthens diaphragmatic contractility
Uses
Preventative Asthma – last resort
Preventative COPD – last resort
Side effects/contraindications
narrow toxic-therapeutic range
Many side effects |
|
|
Term
| Montelukast (Singulair) (oral) |
|
Definition
Drug class
Leukotriene modifiers
MOA
Leukotriene receptor antagonists
Uses
Preventative asthma – 2nd or 3rd line
Allergic rhinitis |
|
|
Term
| Tiotropium (Spiriva) (inhaled) |
|
Definition
Drug class
Anticholinergics
Uses
Preventative COPD – first line |
|
|
Term
|
Definition
Drug class
Systemic corticosteroids
MOA/Uses
Metabolic
Anti-inflammatory
Immunosuppressive
Side effects/contraindications
diabetes-like state due to increases in blood glucose
fat deposition and redistribution to face and trunk
muscle wasting/weakness
ulceration/PUD
osteoporosis (increased osteoclast activity)
increase susceptibility to infection (immune suppression)
decrease wound healing
glaucoma/cataracts (due to impaired aqueous humor flow)
Acne, HTN
Additional
Must be tapered if past 7-10 days of treatment |
|
|
Term
|
Definition
Drug class
Estrogen/progesterone oral HRT
MOA
replace estrogen in blood stream
decrease bone resorption
Uses
amelioration of vasomotor symptoms
the prevention of bone fractures
prevention of urogenital atrophy.
Side effects/contraindications
adverse cardiovascular effects, including hypertension, myocardial infarction, hemorrhagic or ischemic stroke in presence of risk factors
venous thrombosis and embolism
breast, hepatocellular, and cervical cancers in presence of risk factors
gallbladder disease
Additional
Combination must be used if uterus still present
Estrogen-only acceptable if complete hysterectomy |
|
|
Term
|
Definition
Drug class
Estrogen/progesterone combination OCP
MOA
Prevent ovulation by suppressing FSH and LH – 99.9% effective
Uses
Birth control
Ovarian cysts
Acne
Dysmenorrhea & menorrhagia
Side effects/contraindications
adverse cardiovascular effects, including hypertension, myocardial infarction, hemorrhagic or ischemic stroke in presence of risk factors
venous thrombosis and embolism
breast, hepatocellular, and cervical cancers in presence of risk factors
gallbladder disease
decrease lactation in nursing mothers
Benefits
Reduced endometrial and ovarian cancer |
|
|
Term
|
Definition
Drug class
Progesterone-only OCP
MOA
Prevent ovulation by suppressing FSH and LH
Thickening of cervical mucus, which decreases sperm penetration,
Endometrial alterations that impair implantation;
Uses
Birth control – good choice for nursing mothers
Progestin challenge test in amenorrhea
Side effects/contraindications
Break through bleeding
Mood changes
Weight gain
Headaches
Decrease HDL and increase LDL |
|
|
Term
|
Definition
Drug class/MOA
muscarinic receptor antagonists
Uses
Overactive bladder
Enuresis in children
Increase bladder capacity in spastic paraplegia
Side effects
Red as a beat
bronchodilation
Dry as a bone
dry mouth, dry red hot skin, dry eyes
Mad as a hatter
CNS confusion, delirium, hallucinations and seizures
Blind as a bat
dilated pupils (mydriasis) and cycloplegia (paralysis of accommodation),
Contraindications
urinary tract obstruction,
GI obstruction,
uncontrolled (or susceptibility to attacks of) angle-closure glaucoma
BPH (caution) |
|
|
Term
|
Definition
Drug class
Antitussive
MOA
centrally active N-methyl-D-aspartate (NMDA) receptor antagonist.
Uses
Cough – not effective – OTC
Interactions with dextromethorphan
Triptans
MAOI’s
SSRI’s (Fluoxetene &Paroxetine)
Memantine (Namenda) |
|
|
Term
| BENZONATATE (Tessalon pearls) |
|
Definition
Drug class
Antitussive
MOA
A local anesthetic, acts peripherally by anesthetizing the stretch receptors located in the respiratory passages, lungs, and pleura
Uses
Cough
Side effects/contraindications
Caution with children
Ester-type anesthetic (tetracaine) hypersensitivity with benzonatate |
|
|
Term
| Guaifenesin (Robitussin/Mucinex) |
|
Definition
Drug class
Expectorant
MOA
increase secretions, reduce viscosity and help to expel sputum
Uses
Help loosen phlegm and thin bronchial secretions to make coughs more productive
Side effects
Nausea, vomiting and diarrhea
Runny nose
Drowsiness, dizziness and headache
Contraindications or Caution:
Persistent or chronic cough
Asthmatics (prone to bronchospasm)
CV disease and HTN
Pregnancy & lactation |
|
|
Term
| Pseudoephedrine (Sudafed) |
|
Definition
Drug class
Decongestant
MOA/Uses
Constrict blood vessels in the respiratory tract, resulting in shrinkage of swollen mucous membranes and helping open the nasal airway passages
Directly stimulates alpha 1-adrenergic receptors of respiratory mucosa causing vasoconstriction;
Directly stimulates beta-adrenergic receptors causing bronchial relaxation, increased heart rate and contractility
Side effects
Anxiety, nervousness, tremor and seizures, Palpitations, Headache, Cerebral hemorrhage
Reduced cardiac and reduced urine output
Dizziness, Excitability, Insomnia, Restlessness
Elevated blood pressure
Contraindications or extreme caution:
CV disorders, Hyperthyroid or Diabetes
Older adults – especially those with glaucoma or BPH
Pregnancy or lactation & Hypertension
Use with caution in patients with
asthma, bowel obstruction/narrowing & elderly |
|
|
Term
| Diphenhydramine (Benadryl) |
|
Definition
Drug class/MOA
First generation H1 antagonist (ethanolamines)
Uses
Allergic diseases & pruritus
Sedation/Insomnia
Anxiety
Motion sickness
Side effects
Sedation
Contraindications/caution
COPD and asthma
Persons operating machinery or driving
Older adult patients (extended half life)
CV disorders
BPH
Infants
Seizure disorders |
|
|
Term
| Hydroxyzine (Vistaril or Atarax) |
|
Definition
Drug class/MOA
First generation H1 antagonist (piperazines)
Uses
Allergic diseases & pruritus
Sedation/Insomnia
Anxiety
Side effects
Sedation
Contraindications/caution
COPD and asthma
Persons operating machinery or driving
Older adult patients (extended half life)
CV disorders
BPH
Infants, pregnancy, lactation
Seizure disorders |
|
|
Term
|
Definition
Drug class/MOA
First generation H1 antagonist (piperazines)
Uses
Motion sickness
Vertigo
Side effects
Sedation
Contraindications/caution
COPD and asthma
Persons operating machinery or driving
Older adult patients (extended half life)
CV disorders
BPH
Infants, pregnancy, lactation
Seizure disorders |
|
|
Term
|
Definition
Drug class/MOA
First generation H1 antagonist (phenothiazines)
Anticholinergic activity
Uses
Motion sickness
Nausea/emesis
Vertigo
Side effects
Sedation
Anticholinergic side effects
Contraindications/caution
COPD and asthma
Persons operating machinery or driving
Older adult patients (extended half life)
CV disorders
BPH
Infants, pregnancy, lactation
Seizure disorders |
|
|
Term
|
Definition
Drug class/MOA
Second generation H1 antagonist (piperazines)
Non-drowsy
Uses
Allergic rhinitis
Side effects/contraindications
Caution in infants, pregnancy and nursing mothers
May still cause sedation |
|
|
Term
|
Definition
Uses
Hypoxia
Heart and lung disease
Carbon monoxide poisoning
CNS conditions with resp. difficulty/failure
Side effects
Hypoventilation (particularly with COPD)
May cause CO2 retention and acidosis
Confusion
Changes in the alveoli of the lungs
Blindness (in premature infants)
Cautions:
Patients with COPD (high O2 conc. May cause hypoventilation or apnea)
Danger of fire |
|
|
Term
|
Definition
Drug class
Extended-Spectrum Penicillins
MOA
peptidoglycan synthesis is inhibited in the cell wall resulting in cell lysis
Uses
Bacterial infection
Gram + and some gram –
NOT for staph aureus
Side effects/contraindications
The frequency of IgE cross-allergy between cephalosporins and penicillins approximates 5–10%. |
|
|
Term
| Amoxicillin/clavulanic acid (Augmentin) |
|
Definition
Drug class
Penicillins Combined with B-Lactamase Inhibitors
MOA
peptidoglycan synthesis is inhibited in the cell wall resulting in cell lysis
b-lactamase inhibitor
Uses
Bacterial infection
Gram + and some gram –
Staphylococcus aureus, H influenzae, Moraxella catarrhalis, and B fragilis.
Side effects/contraindications
Most commonly associated with diarrhea
The frequency of IgE cross-allergy between cephalosporins and penicillins approximates 5–10%. |
|
|
Term
|
Definition
Drug class
Antistaphylococcal Penicillins
MOA
peptidoglycan synthesis is inhibited in the cell wall resulting in cell lysis
Uses
Bacterial infections
Staph aureus
group A streptococci in skin and soft tissue infections
NOT effective against other gram + bacteria
Side effects/contraindications
The frequency of IgE cross-allergy between cephalosporins and penicillins approximates 5–10%. |
|
|
Term
|
Definition
Drug class
1st generation cephalosporin
MOA
inhibition of cell wall synthesis,
activation of autolytic enzymes in the cell wall
Uses
Bacterial infections
Gram + mostly
Staph aureus
Group A hemolytic streptococci
E coli, Klebsiella pneumoniae
NOT H influenzae or penicillin-resistant streptococci
Side effects/contraindications
The frequency of IgE cross-allergy between cephalosporins and penicillins approximates 5–10%. |
|
|
Term
|
Definition
Drug class
2nd generation cephalosporin
MOA
inhibition of cell wall synthesis,
activation of autolytic enzymes in the cell wall
Uses
Bacterial infections
Gram + with some extended coverage to gram –
NOT Pseudomonas aeruginosa
Side effects/contraindications
The frequency of IgE cross-allergy between cephalosporins and penicillins approximates 5–10%. |
|
|
Term
|
Definition
Drug class
3rd generation cephalosporin
MOA
inhibition of cell wall synthesis,
activation of autolytic enzymes in the cell wall
Uses
Bacterial infections
Mostly gram – with some gram +
Inhibit most streptococci
Staph aureus (not as good as 1st generation)
Gonorrhea
Side effects/contraindications
The frequency of IgE cross-allergy between cephalosporins and penicillins approximates 5–10%. |
|
|
Term
|
Definition
Drug class
Macrolides
MOA
Inhibit protein synthesis by binding to the 50S subunit of bacterial ribosomes.
Uses
Bacterial infections
streptococcal and pneumococcal disease
Legionella, Mycoplasma, and Chlamydia |
|
|
Term
|
Definition
Drug class
Macrolides
MOA
Inhibit protein synthesis by binding to the 50S subunit of bacterial ribosomes.
Uses
Bacterial infections
streptococcal and pneumococcal disease
Legionella, Mycoplasma, and Chlamydia
Side effects/contraindications
prolongation of the QT interval and torsades de pointes
increase the effects of oral anticoagulants, digoxin, theophylline, and cyclosporine by inhibiting cytochrome P450
must stop Statin while taking |
|
|
Term
|
Definition
Drug class
Tetracyclines
MOA
inhibitors of protein synthesis
Uses
Bacterial infections
Many gram + and gram –
Staph aureus, including MRSA (second choice)
Antipneumococcal & H influenzae activity
Chlamydia
Acne
Side effects/contraindications
absorption is impaired by dairy products and aluminum hydroxide gels (antacids)
photosensitization
avoid at bedtime due to the risk of esophageal erosion.
should not be given to pregnant or nursing women
teeth discoloration
children under 8 years of age |
|
|
Term
|
Definition
Drug class
Aminoglycosides
MOA
inhibit the function of the 30S subunit of the bacterial ribosome
Uses
Bacterial infections
Topical, ear, and eye
Side effects/contraindications
ototoxic
nephrotoxic
not absorbed from the gastrointestinal tract |
|
|
Term
| Trimethoprim/sulfamethoxazole (Bactrim DS or Septra DS) |
|
Definition
Drug class
Sulfonamides
MOA
structural analogs of p-aminobenzoic acid (PABA) and compete with PABA to block its conversion to dihydrofolic acid.
Organisms that utilize PABA in the synthesis of folates and pyrimidines are inhibited
Uses
Bacterial infections
Gram –
E. coli
Staph aureus including MRSA (1st choice)
Side effects/contraindications
Because of the risk of Stevens-Johnson syndrome, patients with a previous rash after trimethoprim-sulfamethoxazole should not receive the drug again |
|
|
Term
| Mupirocin (Bactroban) topical |
|
Definition
MOA
inhibits protein synthesis by binding to bacterial isoleucyl-tRNA synthetase.
Uses
Bacterial infections
Gram +
Staph aureus including MRSA
Most streptococci |
|
|
Term
|
Definition
Uses
Bacterial infections
Gram +
Most anaerobes
S pneumoniae
Group A streptococci,
S aureus including MRSA (2nd choice) |
|
|
Term
|
Definition
Uses
Bacterial infections
anaerobic gram-negative bacilli
minimal activity against anaerobic gram-positive
Protozoal infections
Side effects/contraindications
EtOH
Ingestion of alcohol results in a disulfiram reaction
Reversible peripheral neuropathy
Decrease the metabolism of warfarin (Coumadin) |
|
|
Term
|
Definition
Uses
Bacterial infections
Broad spectrum (“big guns”)
Oral for antibiotic-associated enterocolitis
Side effects/contraindications
not absorbed from the gastrointestinal tract
hyperemia ("red man syndrome") from rapid infusion
pretreating with H1 antagonist can help |
|
|
Term
|
Definition
Drug class
Quinolones
MOA
inhibition of bacterial DNA synthesis by blocking the enzyme DNA gyrase
Uses
Bacterial infections (Broad spectrum)
Gram – with limited gram +
Pseudomonas aeruginosa
Side effects/contraindications
Prolong the QT interval
Decrease the metabolism of warfarin (Coumadin)
Not to be used in children
Black Box warnings
Tendinitis/Tendon rupture
Avoid in Myasthenia Gravis |
|
|
Term
|
Definition
Drug class
Quinolones
MOA
inhibition of bacterial DNA synthesis by blocking the enzyme DNA gyrase
Uses
Bacterial infections (Broad spectrum)
Gram – with good gram +
Pseudomonas aeruginosa
NOT MRSA or Chlamydia (due to resistance)
Side effects/contraindications
Prolong the QT interval
Decrease the metabolism of warfarin (Coumadin)
Not to be used in children
Black Box warnings
Tendinitis/Tendon rupture
Avoid in Myasthenia Gravis |
|
|
Term
| Nitrofurantoin (Macrobid) |
|
Definition
Uses
Bacterial infections (urinary only)
UTI |
|
|
Term
|
Definition
Drug class
Antifungal
Uses
Superficial candidal infections
Thrush
Diaper rash
Intertrigo
Side effects/contraindications
drug is not absorbed from mucous membranes or the gastrointestinal tract |
|
|
Term
|
Definition
Drug class
Antifungal
Uses
Fungal infections
Side effects/contraindications
Monitor liver function
Must stop Statin while taking |
|
|
Term
|
Definition
Drug class
Antifungal
MOA
inhibit synthesis of ergosterol, resulting in inhibition of membrane-associated enzyme activity, cell wall growth, and replication.
Uses
Fungal infections
Seborrheic dermatitis
Side effects/contraindications
Monitor liver function
Must stop Statin while taking |
|
|
Term
|
Definition
Drug class/MOA
Neuraminidase inhibitors
Uses
prevention and treatment of influenza A and B |
|
|
Term
|
Definition
Drug class
Antiviral
MOA
selectively active against viral DNA polymerase and thus inhibits virus proliferation
Uses
herpes simplex virus
varicella-zoster virus |
|
|
Term
|
Definition
Drug class
Proton Pump Inhibitors
MOA
Inhibit the gastric H+, K+-ATPase (proton pump)
Uses
GERD, gastritis, gastric ulcer
Side effects/contraindications
Can interact adversely with clopidogrel (Plavix) |
|
|
Term
|
Definition
Drug class
H2 Receptor Antagonists
MOA
inhibit acid production by reversibly competing with histamine for binding to H2 receptors on the basolateral membrane of parietal cells
Uses
GERD, gastritis, gastric ulcer
Allergic disease |
|
|
Term
|
Definition
Drug class
Prokinetic Agents
MOA
serotonin (5-HT)-4 receptor agonist
vagal and central 5-HT3 antagonism
dopamine-2 receptor antagonist
Uses
Gastroparesis
Nausea/emesis
Side effects/contraindications
Extrapyramidal effects (Parkinsonian symptoms)
Dystonias and parkinsonian-like symptoms are reversible upon discontinuation of metoclopramide
Tardive dyskinesia also can occur with chronic treatment (months to years) and may be irreversible. |
|
|
Term
|
Definition
Drug class/MOA
5-HT3 Receptor Antagonists
Uses
Chemotherapy-induced nausea
Nausea secondary to upper abdominal irradiation
Hyperemesis of pregnancy
Postoperative nausea |
|
|
Term
| Prochlorperazine (Compazine) |
|
Definition
Drug class
Dopamine-Receptor Antagonists
MOA
D2 receptor antagonism at the CTZ
Uses
Nausea/emesis |
|
|
Term
|
Definition
Drug class
Bulk forming agents
MOA
Absorb water and increase fecal bulk.
Increase colonic bacterial mass through fermentation
Uses
Constipation
Side effects/contraindications
Bloating
Avoid in obstruction and megacolon |
|
|
Term
|
Definition
Drug class
Stool softeners
MOA
Lowers the surface tension of the stool to allow mixing of aqueous and fatty substances, softening the stool and permitting easier defecation.
Uses
Constipation |
|
|
Term
| polyethylene glycol 3350 (Miralax) |
|
Definition
Drug class
Osmotic laxative
MOA
osmotically mediated water retention, which then stimulates peristalsis
Uses
Constipation
Bowel prep (electrolyte version)
Side effects/contraindications
Electrolyte imbalance with large doses |
|
|
Term
| magnesium hydroxide (Milk of magnesia) |
|
Definition
Drug class
Saline osmotic laxative
MOA
Osmotically mediated water retention, which then stimulates peristalsis
Uses
Constipation
Side effects/contraindications
Electrolyte imbalance
Caution
renal insufficiency,
cardiac disease,
preexisting electrolyte abnormalities,
patients on diuretic therapy |
|
|
Term
|
Definition
Drug class
Stimulant laxative
MOA
direct effects on enterocytes, enteric neurons, and GI smooth muscle
Uses
Constipation
Side effects/contraindications
Electrolyte imbalance
“cathartic colon” |
|
|
Term
|
Definition
MOA
enhance fluid secretion by acting locally on ion channels in the colonic epithelium to promote secretion
prostanoid activator of Cl– channels
Uses
Constipation |
|
|
Term
|
Definition
MOA
anti-secretory,
anti-inflammatory,
antimicrobial effects
Uses
Diarrhea
Nausea and GI cramps
Side effects/contraindications
Dark stools
Black staining of the tongue
Avoid
Salicylate allergy
Children due to Reye syndrome |
|
|
Term
|
Definition
Drug class
Anti-diarrheal (Opioid agonists)
MOA
Increases small intestinal and mouth-to-cecum transit times.
Increases anal sphincter tone
Uses
Diarrhea
Side effects/contraindications
Avoid in active inflammatory bowel disease due to toxic megacolon |
|
|
Term
| Diphenoxylate/atropine (Lomotil) |
|
Definition
Drug class
Anti-diarrheal (Opioid agonists)
MOA
Increases small intestinal and mouth-to-cecum transit times.
Increases anal sphincter tone
Uses
Diarrhea
Side effects/contraindications
Avoid in active inflammatory bowel disease due to toxic megacolon
In high doses, these drugs cause CNS effects as well as anticholinergic effects from the atropine (dry mouth, blurred vision, etc.) |
|
|
Term
|
Definition
Drug class
ANTI-SPASMODICS
MOA
Nonspecific antagonists of the muscarinic receptor
Uses
IBS |
|
|
Term
|
Definition
Drug class
SSRI
MOA
blocks reuptake of 5HT by SERT and results in enhanced and prolonged serotonergic neurotransmission.
Uses
Depression
Generalized anxiety,
Panic attack
Social anxiety,
Obsessive-compulsive disorder
Premenstrual dysphoric syndrome (PMDD)
Vasovagal symptoms in post-menopausal women
Side effects/contraindications
Black Box warning increased suicide risk in adolescents
Serotonin syndrome
ED/decreased libido
Taper when discontinuing
Avoid use with Triptans (migraine) and tramadol |
|
|
Term
|
Definition
Drug class
SNRI
MOA
inhibit both SERT and NET
Uses
Depression
Anxiety
Pain (fibromyalgia, nerve pain)
Off label uses
stress urinary incontinence (duloxetine)
Side effects/contraindications
Black Box warning increased suicide risk in adolescents
Serotonin syndrome
ED/decreased libido
Cymbalta unlikely to cause ED
Taper when discontinuing
Avoid use with Triptans (migraine) and tramadol |
|
|
Term
|
Definition
MOA
Appears to inhibit NET
It also blocks the DAT (dopamine)
Uses
depression,
smoking cessation (ZYBAN brand).
Side effects/contraindications
Black Box warning
1. increased suicide risk in adolescents
2. Serious neuropsychiatric events, especially with smoking cessation
Seizures at high doses
Does NOT cause ED |
|
|
Term
|
Definition
Drug class
TRICYCLIC ANTIDEPRESSANTS
MOA
Inhibit both SERT and NET
Uses
Depression
Insomnia (low doses)
Pain (low doses)
Side effects/contraindications
sedation
cognitive dulling
blurred vision,
dry mouth,
tachycardia,
constipation,
difficulty urinating
orthostatic hypotension
weight gain
seizure
cardiac conduction abnormalities |
|
|
Term
|
Definition
Drug class
Benzodiazepines (intermediate-acting)
MOA
enhance the inhibitory effects of the neurotransmitter
Uses
acute anxiety
sedative/insomnia
Side effects/contraindications
sedation
impair cognitive performance and memory,
adversely affect motor control,
slowed reaction time (which may lead to accidents)
potentiate the effects of other sedatives including alcohol
habit-forming
withdrawal symptoms if not tapered
caution with elderly
Controlled substance
Schedule IV |
|
|
Term
|
Definition
Drug class
Benzodiazepines (quick-acting)
MOA
enhance the inhibitory effects of the neurotransmitter GABA
Uses
acute anxiety
muscle relaxant
Side effects/contraindications
sedation
impair cognitive performance and memory,
adversely affect motor control,
slowed reaction time (which may lead to accidents)
potentiate the effects of other sedatives including alcohol
habit-forming
withdrawal symptoms if not tapered
caution with elderly
Controlled substance
Schedule IV |
|
|
Term
|
Definition
MOA
Selective partial agonists at 5-HT1A receptors.
Uses
Chronic anxiety – GAD only |
|
|
Term
|
Definition
Drug class
Atypical antipsychotics
MOA
Blockade of dopamine receptors in the mesolimbic area
Uses
Schizophrenia, Mania (Bipolar), Treatment-resistant depression as an add-on
Obsessive compulsive disorder (OCD) , Post-traumatic stress disorder (PTSD)
Tourette’s - relates to reduced D2 neurotransmission in basal ganglia sites)
Huntington’s disease, Autism
Side effects/contraindications
Black Box warning
1. increased suicide risk in adolescents
2. Elderly patients with dementia-related psychosis treated with antipsychotics are at an increased risk of death
Extrapyramidal effects (EPS) (Parkinsonism)
Akathisia, Tardive dyskinesia risk, Hyperprolactinemia, Sedation
Weight gain to appetite stimulation, Orthostatic hypotension, Dyslipidemia
Impairments in glycemic control, Ventricular arrhythmias and sudden cardiac death
(Less for newer atypicals), Seizure, Neuroleptic malignant syndrome
Mainly just typicals |
|
|
Term
|
Definition
Uses
Bipolar
Side effects/contraindications
Toxic at high doses – requires routine labs
Hand tremor
Seizures
Significant weight gain
Renal damage from long term use
Thyroid dysfunction
Allergic skin rash has been associated with Lithium use
Interactions
Diuretics
ACE inhibitors
NSAIDS |
|
|
Term
|
Definition
Drug class
Insomnia - Imidazopyridine
MOA
effects on the benzodiazepine site of the GABAA receptor
Uses
Insomnia
NOT anxiety
Side effects/contraindications
“Morning hangover” |
|
|
Term
|
Definition
Drug class
Salicylates (NSAIDS)
MOA
inhibiting the prostaglandin synthase enzymes, colloquially known as the cyclooxygenases (COXs)
irreversibly inhibits COX activity
Uses
antipyretic,
analgesic,
anti-inflammatory
anti-platelet
Side effects/contraindications
GI ulcer
Ototoxic
Contraindicated in children and young adults <20 years of age with viral illness–associated fever
Due to Reye syndrome |
|
|
Term
| Ibuprofren (Motrin, Advil) |
|
Definition
Drug class
NSAIDS
MOA
inhibiting the prostaglandin synthase enzymes, colloquially known as the cyclooxygenases (COXs)
Uses
antipyretic,
analgesic,
anti-inflammatory
Side effects/contraindications
Black box warning
1. GI ulcer
2. Increased heart attack and stroke
renal and renovascular adverse events
NEPHROPATHY |
|
|
Term
|
Definition
Drug class
COX-2 inhibitor NSAID
MOA
inhibiting the prostaglandin synthase enzymes, colloquially known as the cyclooxygenases (COXs)
COX-2 only with minimal to no COX-1
Uses
antipyretic,
analgesic,
anti-inflammatory
Side effects/contraindications
Black box warning
1. GI ulcer
2. Increased heart attack and stroke
renal and renovascular adverse events
NEPHROPATHY |
|
|
Term
| Acetaminophen (APAP) (Tylenol) |
|
Definition
MOA
inhibiting the prostaglandin synthase enzymes, colloquially known as the cyclooxygenases (COXs)
Only 50%
Uses
antipyretic,
analgesic,
Side effects/contraindications
Acute liver failure |
|
|
Term
|
Definition
MOA
Some activity at opioid receptor
Somewhat inhibits 5HT and NE reuptake
Uses
Pain control
Side effects/contraindications
Increased suicide risk in adolescents
Seizures
Dependence may occur
Avoid SSRI, SNRI, and triptans (migraines)
NOT controlled substance |
|
|
Term
|
Definition
Drug class
Opioid agonist (very strong)
MOA
Binds to various opioid receptors, producing analgesia and sedation
Uses
Pain control
Side effects/contraindications
May cause QT prolongation
Taper chronic use
Nausea/emesis
Constipation
Respiratory depression
Sedation
Avoid driving or operating machinery
Cardiovascular side effects
Controlled substance
Schedule II |
|
|
Term
|
Definition
Drug class
Opioid agonist (very strong)
MOA
Binds to various opioid receptors, producing analgesia and sedation
Uses
Pain control
Side effects/contraindications
Taper chronic use
Nausea/emesis
Constipation
Respiratory depression
Sedation
Avoid driving or operating machinery
Cardiovascular side effects
Controlled substance
Schedule II |
|
|
Term
| Oxycodone/APAP (Percocet) |
|
Definition
Drug class
Opioid agonist (moderate strength)
MOA
Binds to various opioid receptors, producing analgesia and sedation
Uses
Pain control
Side effects/contraindications
Taper chronic use
Nausea/emesis
Constipation
Respiratory depression
Sedation
Avoid driving or operating machinery
Cardiovascular side effects
Controlled substance
Schedule II |
|
|
Term
| Hydrocodone/APAP (Vicodin) |
|
Definition
Drug class
Opioid agonist (Mild strength)
MOA
Binds to various opioid receptors, producing analgesia and sedation
Uses
Pain control
Side effects/contraindications
Taper chronic use
Nausea/emesis
Constipation
Respiratory depression
Sedation
Avoid driving or operating machinery
Cardiovascular side effects
Controlled substance
Schedule III |
|
|
Term
| Codeine/APAP (Tylenol #3) |
|
Definition
Drug class
Opioid agonist (Weakest)
MOA
Binds to various opioid receptors, producing analgesia and sedation
Uses
Pain control
Side effects/contraindications
Taper chronic use
Nausea/emesis
Constipation
Respiratory depression
Sedation
Avoid driving or operating machinery
Cardiovascular side effects
Controlled substance
Schedule III |
|
|
Term
| Cyclobenzaprine (Flexeril) |
|
Definition
Drug class
Muscle relaxants
MOA
Centrally active muscle relaxant – possible through sedation effects
Uses
Muscle spasms
Side effects/contraindications
Sedation
Avoid driving and operating machinery
Respiratory depression
NOT controlled substance |
|
|
Term
| Levothyroxine (Synthroid) |
|
Definition
Drug class
Thyroid replacement
MOA
Replaces thyroid hormone thyroxine (T4)
Uses
Hypothyroidism
Depression (off-label)
Side effects/contraindications
Cholestyramine, iron, fiber, antacids all decrease absorption of levothyroxine |
|
|
Term
|
Definition
Drug class
Anti-thyroid medications
MOA
inhibits TH synthesis by preventing oxidation of iodide and preventing the coupling of iodinated tyrosines into MIT and DIT
PTU also prevents peripheral conversion of T4 into T3
Uses
Hyperthyroidism
Preferred for pregnancy-related hyperthyroidism |
|
|
Term
|
Definition
Drug class
Sulfonylurea
MOA
Closes K+ channel in b-cell which stimulates insulin release from pancreas
Uses
Diabetes mellitus type 2
Side effects/contraindications
Hypoglycemia
Weight gain – due to normal insulin physiology
Caution in elderly |
|
|
Term
|
Definition
Drug class
Biguanide
MOA
primary action is on the liver, reducing hepatic gluconeogenesis
Improves peripheral receptor sensitivity to insulin
Uses
Diabetes mellitus type 2
Side effects/contraindications
Lactic acidosis
Caution in kidney disease
Stop when using IV contrast
GI disturbances (constipation or diarrhea) |
|
|
Term
|
Definition
Drug class
Thiazolidinediones (TZDs)
MOA
sensitize peripheral tissues to insulin by up-regulating GLUT 4 receptors in the periphery by activating PPARg
Uses
Diabetes mellitus type 2
Side effects/contraindications
Edema
Macular edema
Contraindicated in CHF |
|
|
Term
|
Definition
Drug class
Incretins
MOA
GLP-1 receptor agonist that stimulates insulin release and decreases glucagon
Uses
Diabetes mellitus type 2
Side effects/contraindications
Weight loss
Nausea
Hypoglycemia (low risk)
Severe pancreatitis |
|
|
Term
|
Definition
Drug class
Incretins
MOA
DPP-4 inhibitor prolonging the action of endogenously released GLP-1which increases insulin release and decreases glucagon
Uses
Diabetes mellitus type 2
Side effects/contraindications
Nasopharyngitis
Severe pancreatitis |
|
|
Term
|
Definition
Drug class
Short-acting insulin
MOA
10-15 minute onset with peak 1 hour and duration 5-6 hours
Uses
Diabetes mellitus requiring insulin
Side effects/contraindications
Hypoglycemia |
|
|
Term
|
Definition
Drug class
Long-acting insulin
MOA
3-4 hour onset, 8-10 hour peak (no real significant peak), and duration of 18-22 hours
Uses
Diabetes mellitus requiring insulin
Side effects/contraindications
Hypoglycemia (rare, if clinically possible) |
|
|
Term
|
Definition
Drug class
Topical corticosteroid (low strength)
MOA
Immunosuppressive and anti-inflammatory
Uses
Eczema
Pruritus
Contact dermatitis
Seborrheic dermatitis
Side effects/contraindications
Thinning of the skin
Avoid on open wounds
No prolonged use
Avoid occlusion |
|
|
Term
|
Definition
Drug class
Topical corticosteroid (medium strength)
MOA
Immunosuppressive and anti-inflammatory
Uses
Eczema
Pruritus
Contact dermatitis
Seborrheic dermatitis
Side effects/contraindications
Thinning of the skin
Avoid on open wounds
No prolonged use
Avoid occlusion |
|
|
Term
| Fluocinonide (Lidex) cream |
|
Definition
Drug class
Topical corticosteroid (high strength)
MOA
Immunosuppressive and anti-inflammatory
Uses
Eczema
Psoriasis
Seborrheic dermatitis
Side effects/contraindications
Thinning of the skin
Avoid on open wounds
No longer than 2 week use
Avoid face, groin, axilla
Avoid occlusion |
|
|
Term
| Halobetasol (Ultravate) cream |
|
Definition
Drug class
Topical corticosteroid (ultra-high strength)
MOA
Immunosuppressive and anti-inflammatory
Uses
Psoriasis
Seborrheic dermatitis
Side effects/contraindications
Thinning of the skin
Avoid on open wounds
No longer than 1 week use
Avoid face, groin, axilla
Avoid occlusion |
|
|
Term
| TRETINOIN (Retin A) topical |
|
Definition
Drug class
Topical Retinoids
MOA
Correct
abnormal follicular keratinization,
reduce P. acnes counts,
reduce inflammation,
Uses
Acne
Fine wrinkles
Dyspigmentation
Side effects/contraindications
photosensitivity
erythema,
desquamation,
burning,
stinging
avoid during pregnancy
Benzoyl peroxide inactivates tretinoin and should not be applied simultaneously |
|
|
Term
|
Definition
Drug class
MOA
interferes with insect sodium transport proteins, causing neurotoxicity and paralysis
Uses
Head lice
Scabies
Side effects/contraindications
Slight local irritation, rash or conjunctivitis
Dermatitis with frequent application |
|
|
Term
| Silver sulfadiazine (Silvadene) (SSD) |
|
Definition
|
|
Term
| Proparacaine (Alcaine) gtts |
|
Definition
Drug class
Topical Anesthetic Agents
Uses
Measuring intraocular pressure
Performing superficial surgery
Evaluating a painful eye
Side effects/contraindications
Never Rx topical anesthetics
Corneal ulcer with prolong use and delayed healing |
|
|
Term
|
Definition
Drug class
Prostaglandin (PG) analog
Uses
Glaucoma (first-line) |
|
|
Term
|
Definition
Drug class
synthetic DMARD
Uses
Rheumatoid arthritis – first-line
Side effects/contraindications
Stomatitis
Cytopenia
Hepatotoxicity
Avoid EtOH and liver disease
Side effects reduced by taking folate
Avoid pregnancy – BOTH male and female |
|
|
