2nd Semester Pharm Final Flashcards
Epinephrine (Adrenalin)
Direct acting adrenergic agonist DOC for life threatening anaphylaxis (to fix hypotension, cause bronchodilation, and increase HR) often administered thru pen injection (1:1000) or IV (1:10,000), can cause tremor/palpitations/other sympathetic effects
Albuterol
B2 selective short acting bronchodilater adrenergic agonist working primarily on bronchial smooth muscle allowing for dilation usually well tolerated with minimal ADR’s required as a rescue inhaler in all asthma patients (sometimes its all they need)
Xopenex (Levabuterol)
Just a different form of albuterol with same properties and principles
Loratadine (claritin or alavert)
2nd gen H1 antagonsist (antihistamine) used for allergic rhinitis or mild allergies (has to be taken prophylactically) that does NOT cause sedation but can cause some GI disturbance as an ADR
Certirizine (zyrtec)
2nd gen H1 antagonist (antihistamine) used for seasonal allergic rhinitis (has to be taken prophylactically) that does not cause sedation but can cause some GI upset as an ADR
Fexofenadine (allegra)
2nd gen H1 antagonist (antihistamine) used for seasonal allergic rhinitis (has to be taken prophylactically) that does not cause sedation but can cause some mild GI upset as an ADR
Diphenhydramine (benadryl)
1st gen H1 antagonist (antihistamine) used for allergies and insomnia (has to be taken prophylactically) that has several ADR’s including sedation/anticholinergic effects (dry mouth)
Ipratropium bromide (atrovent/nasal spray)
Short acting antimuscarinic antagonist anticholinergic agent that decreases mucus secretions in those with excessive watery rhinorrhea and allows for bronchodilation for quick relief of acute asthma exacerbation can cause transient nasal dryness and epistaxis and some concern to use if presence of CV disease
Pulmicort flexhaler/rhinocort nasal spray (budesonide)
Common glucocorticoid inhaler used to treat persistent asthma or relieve allergies when in a nasal spray, most effective treatment for asthma and relatively safe without causing severe systemic effects, concern for impact on growth in children and development of candida infection
Pseudoephedrine (sudafed)
a1 agonist used as a decongestant to clear a runny nose often due to allergy, common cold, or rhinitis but can cause hypertension or necrosis at site of administration due to microvasospasm
Fluticasone (flonase)
Nasal spray glucocorticoid used to treat seasonal allergies by bringing relief but can cause nasal dryness or bleeding as ADR’s
Montelukast (singulair)
Leukotriene receptor antagonist used to treat asthma (exercise induced) and allergic rhinitis with almost no ADR’s as it has very few interactions
Cromolyn
Mast cell stabilizer preventing release of histamine used as alternative asthma treatment to glucocorticoids in mild cases when inhaled, is the safest of all antiasthma medications with no ADR’s
Epoetin alfa (epogen, procrit)
Erythropoeitic growth factor used to reverse anemia brought on by chronic renal failure, not efficient at decreasing fatigue or delaying renal deterioration but reduces need for transfusions
ferrous sulfate (feosol)
Least expensive PO iron replacement therapy, to be taken between meals without food for max absorption, DOC for iron deficient anemia, ADR’s can include nausea/bloating/etc.
Fe dextran
IV iron for those who cannot take it orally
Lovenox (enoxaprin)
SubQ low molecular weight heparin approved for treatment (or prophylaxis) of DVT and PE, is as effective as standard heparin but can be given on a fixed dose/schedule and doesn’t require IV or aPTT monitoring while still being as effective as standard heparin
Clopidogrel (plavix)
Oral antiplatelet that prevents aggregation of platelets that is usually well tolerated UNLESS patient has to go to cath lab
Dabigatran etexilate (pradaxa)
Direct thrombin inhibitor that acts directly on thrombin (opposed to acting thru antithrombin) that has immediate onset, lowered risks of major bleeds, and does not require aPTT or PT/INR monitoring
Rivaroxaban (xarelto) and apixaban (eliquis)
Direct factor Xa inhibitors that prevent the formation of thrombin from prothrombin, frequently used to prevent stroke in patients with afib
Heparin
IV quick acting anticoagulant preferred during pregnancy, PE, stroke, DVT, and MI by activating antithrombin and binding it to thrombin creating the complex for inactivation, requires aPTT monitoring and can result in hemorrhaging in some patients
Warfarin (coumadin)
Vit K antagonist anticoagulant that works by blocking vit K synthesis and thus inactivation of the vit k dependant clotting factors II VII IX and X taking days to see effect (2-5) used to prevent PE often in afib patients, monitored via PT/INR and can cause hemorrhage or purple toe syndrome
Furosemide (lasix)
A Loop diuretic that is the most effective available, acts at the ascending loop of henle blocking absorption of Na+ and Cl- preventing the passive absorption of water that would follow even with severe renal impairment, reserved for times where rapid fluid mobilization is needed or in uncontrolled hypertension, ADR’s include dehydration, hypotension, hypokalemia, and ototoxicity
Hydrochlorothiazide (thiazide diuretic)
Blocks reabsorption of Na+ and Cl- early in the distal convoluted tubule preventing passive absorption of water that would follow but only in patients with preserved GFR’s, drug of choice for hypertension in nonblack and black patients, ADR’s include hypotension, hypokalemia
Spironolactone
K+ sparing diuretic that moderately increases diuresis without drastically decreasing K+ levels by blocking action of aldosterone (to retain Na+ in exchange for K+ loss in distal tubule) thus causing Na+ loss and water following, drug of choice for primary aldosteronism and can be used in hypertension, 2 big ADRs are hyperkalemia and endocrine effect due to steroid nature of drug
Elperenone (Inspra)
Same as spironolactone but without endocrine side effects
Mannitol
Osmotic diuretic injected IV that is pharmacologically inert but used to create osmotic force in nephron that drives fluid out of body and into urine, ADR’s are edema and heart failure
Acetazolamide (diamox)
Carbonic anhydrase inhibitor that causes increased diuresis after days of therapy primarily used for glaucoma and mountain sickness because not very strong diuretic
Aliskiren (tekturna)
Direct renin inhibitor blocking cleavage of angiotensinogen to angiotensin I and thus II and aldosterone are decreased as well, used to reduce BP similar to ACE or ARB but is new and thus not well studied, does cause same fetal harm as ACEs and ARBs and are thus contraindicated in pregnancy
Permethrin/malathion
Agent of choice for mites, scabies, and lice, toxic them to their ova killing them by paralysis but causing minimal effects to host
Finasteride (propecia)
5a reductase inhibitor indicated to prevent hair loss in men by inhibiting testosterone conversion to DHT
Erythromycin + benzoyl peroxide
Macrolide antibiotic in topical ointment for treatment of acne functions by decreasing the # of P. acnes organisms on the face
Tretinoin topical (Retin-A)
Retinoid (derivative of vit A) cream approved for mild to moderate acne acting by removing existing comedones and preventing formation of new ones
Isotretinoin (accutane)
Retinoid (derivative of vit A) oral pill approved for treatment of severe cystic nodular acne, ADR’s include UV sensitivity, psychological effects, teratogenic effects, and it can interact with tetracyclines or vit A
Dapsone (aczone)
Topical alternative for those who cannot tolerate benzoyl peroxide
Metronidazole cream
Antibiotic cream useful in treating rosacea
Mupirocin (bactroban)
Bactericidal agent against MRSA used to treat impetigo or intranasal elimination of S Aureus
Fluconazole (diflucan) derm
Azole (antifungal) that in cream form can be used to treat fungal infections on the skin
Ketoconazole
Azole antifungal cream and shampoo for seborrheic dermatitis (dandruff)
Nystatin cream
Nonazole antifungal that in cream form can be used to treat fungal infections on the skin
Lisinopril
ACE inhibitor that prevents conversion of angiotensin I to II, causing vasodilation to lower blood pressure and reduces aldosterone conc. resulting in less Na+ retention and as a result fluid loss, ADR’s include hypotension, cough due to bradykinin level buildup, and teratogenic effects on pregnancy, used as first line management of hypertension alongside others in nonblack patients only, (ACEI not as effective in black patients but can be employed in those with chronic kidney disease alongside others) as well as post MI and nephropathy
Metoprolol
B1 adrenergic antagonist (B-blocker) acting primarily on B receptors in cardiac tissue for treatment of hypertension, angina pectoris, and heart failure but ADR’s include bradycardia, AV heart block, and exercise intolerance
Diovan/cozaar (ARB’s)
Angiotensin receptor blockers, prevent angiotensin II from acting on blood vessels causing dilation and thus prevent activation of aldosterone reducing conc. resulting in less Na+ retention and as a result fluid loss, can be used to treat hypertension, diabetic nephropathy, and MI without causing the cough but can cause hypotension or teratogenic effects on pregnancy, less effective than ACEI in heart failure because does not increase levels of bradykinin (which helps vasodilation)
Propranolol
A B blocker that can be administered orally and crosses the BBB easily making it useful for things such as prevention against stage fright
Amlodipine (norvasc) and nifidipine
Dihydropyridine Ca2+ channel blockers that act primarily on smooth muscle vasculature and are thus primarily used for hypertension but MUST be taken alongside a B blocker to prevent reflex tachycardia
Verapamil (calan, covera HS, verelan)
Phenylalkamine Ca2+ channel blocker that acts at the blood vessels and the heart used to treat hypertension, arrhythmia, and angina, contraindicated in those with AV block
Dilitiazem (cardizem, dilacor, dilitia XT, tiazac)
Benzothiazapine Ca2+ channel blocker that acts on blood vessels and the heart used to treat angina, arrhythmia, and hypertension
Nitroglycerin
Smooth muscle relaxant drug of choice for patients experiencing angina attacks, can NOT give if on sildenafil
Atropine (atropen)
Anticholinergic muscarinic antagonist that prevents endogenous Ach activating muscarinic receptors, can treat a cholinergic crisis all the way down to just decreasing salivation, can treat bradycardia but ADRs is dry mouth or urinary retention
Clomiphene (clomid)
Inertility treatment agent
Bethanechol (urecholine)
Direct acting muscarinic agonist used to treat urinary retention or GI paralysis
Pilocarpine
A topical cholinergic agonist that functions to topically treat close angle glaucoma until surgery or treat dry mouth due to sjogrens
Donepezil
Cholinesterase inhibitor used in treatment (delay of progression) of alzheimers
Dopamine (incor)
Can stimulate kidneys at low doses, inotropic effect at intermediate doses, and vasoconstriction at high
Dobutamine
Catecholamine with selective activation of B1 adrenergic receptors preferred for short term treatment of acute HF by IV
Amiodarone
Class III antiarrhythmics that blockade K+ channels delaying repolarization, big ADR is that it is thyrotoxic
Digoxin and adenosine
2 drugs that do not fit into any other classes of antiarrhythmics, both drugs decrease conduction thru AV node and reduce automaticity in SA node
Phenytoin (dilantin)
Antiseizure drug used to treat digoxin induced arrhythmia primarily (not used for tonic clonic seizures anymore)
Quinidine
Drug most commonly used to treat supraventricular tach and atrial flutter/fib, blockades sodium channels, slows impulse of conduction delaying depolarization, strongly anticholinergic blocking vagal imput on heart and thus must be pre-treated with AV conduction suppressant such as verapamil, or B blocker