2nd year drug names (not ABX or psych) Flashcards by Øystein Rivrud

Strong mu agonists

Morphine, oxycodone, fentanyl, methadon, meperidine

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Weak mu agonists

Codeine, hydrocodone, tramadol, diphenoxylate, loperamide

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Mixed opioids

Buprenorphine - u-ago/k-antago

Nalbuphine - u-antago/k-ago

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Pure opioid antagonists

Naloxene, naltrexone

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Important NSAIDs

Ibuprofen - COX1>COX2
Aspirin - irreversible binding
Diclofenac - COX1 = COX2
Meloxican - long acting 20-70h

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Gout - drugs against acute flare

NSAIDs except aspirin

Specific

Colchicin
Canakinumab

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Gout prophylaxis

Inhibits uric acid synthesis

Allopurinol
Febuxostat

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Treatment options for neuropathic pain

Gabapentin, pregabilin (n-type Ca++ chn blockers)
tri/tetracyclic antidepressants
Duloxetin
8% capsaicin patch
Tramadol, cannabinoids

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Neuralgia treatment options

neurolysis

- tricyclic antidepressants, carbamezapine, gabapentin, clonezapam, NSAIDs

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ANTIMETABOLITES

6-MP (6-merkaptopurine) - purine analog that disrupts DNA production and nucleotide production - LEUKEMIAS; ALL CML

Cytarbine - pyrimidine analog - Leukemia, lymphoma

5-FU - pyrimidine analog - Solid tumors; colorectal, pancreatic, head/neck

Methotrexate - foleate analog - decreases DNA, RNA and protein prod. - leukemia, lymphoma, solid tumors

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Alkylating agents

Cyclophosphomide - leukemia, lymphoma, solid tumors; ovarian/breast cancer

Attach alkyl group to guanine base in DNA, damaging it and causing cell death

specific SE: SIADH

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Platinum meds

Not cell cycle specific - cross links between DNA strands

Cisplatin - solid tumors; osteosarcoma, lung cancer
Oxaliplatin - advanced colorectal cancer
Carboplatin - lung cancer, etc

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Anti-tumor ABX

Dactinomycin
Bleomycin - creates free oxygen radicals

interfere with DNA replication

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Topoisomerase inhibitors

Ironotecan - metastatic colon cancer

Etopside - solid tumors; testicular tumor, SmCc

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Microtubule inhibitors

Vincristine - acts in M phase - solid tumors, pediatric, leukemia
docetaxel - same

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Monoclonal AB (onco) and their targets

Trastuzumab - HER2
Bevacizumab - VegF
Rituximab - CD20 - activates compliment -> induces apoptosis

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Anasthetics, parenteral

Stimulates GABAr or increases sensitivity to GABA:
- Thiopental
- Propofol
- Etomidate
Rapid onset, best for induction

NMDAr blocker
- Ketamine

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Inhaled anasthetics

N2O - blocks NMDA; contraindication: pneumothorax (gas expansion)

Halogenated inhalational anesthetics - blocks NMDA; GABA agonists
- isoflurane
- desflurane
- sevoflurane
OBS! malignant hyperthermia due to Ca++ release in muscles

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Short acting benzo

Alprazolam

Midazolam

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Intermediate benzo

Clonazepam

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Long acting benzo

Diazepam

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Benzo antidote

Flumazenil

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Barbiturates

Enhances GABA effect by prolonging the Cl- channel opening
Also blocks AMPA receptors
- thiopental
- PhenoBarbital - first line treatment for neonatal seizures

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General/partial seizure drugs

PHENYLTOIN - prophylaxis of status epelepticus

Carbamazipine
Phenobarbital
Valproate
Vigabitrine

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Absence seizures

``` Ethosuximide Valproate Lamotrigine Clonazepam Diazepam ```

Uterine stimulants

Oxytocin - labour induction - opens Ca++ chnls in ER - contraction Ergonovin - post partum hemorrhage treatment Misoprostol - abortion induction after giving mifepristone/methotrexate

Uterine relaxants

Labour supression against premature birth - selective B2r AGONISTS - Terbutaline OxytocinR antagonist - Atosiban

Antiemetics - H1 antagonists

Diphenhydramine Dimethydrinate Promethazine good for nausea of vestibular origin (motion sickness)

Antiemetics - «other»

Droperidol - antipsychotic, useful in kids

Antiemetics - benzoamides

Metoclopramide | - blocks 5HT3, stim. 5HT4 - causes extrapyramidal symptoms

Antiemetics - setrons

The strongest and most effective antiemetics together with NK1 antagonists, used in chemo and post-op vomiting - Ondangetron - Palonsetron

Antiemetics - NK1 antagonists

Boosts efficacy of 5HT3 antagonism - Aprepitant

Antiemetics - cannabinoids

- Dronabinol, nabilon | - THC

Laxatives - stool softeners

Parafin oil, glycerol

Laxatives - bulk laxatives

Plant fibers Expands bowel volume -> increases bowel motility

Osmotic laxatives

Keeps water retained in bowel Salts - MgSO4 Sugars - lactulose, glycerol Massive purgative action

Laxatives - bowel irritants

Stimulate electrolyte and water secretion, inhibits Na reabsorbtion - Castor oil: strongest ever, purgative as hell, rarely used, risin derived - Sennoside, aloe vera - Bisacodyl

Anti diarrhea - absorbents

Active charcoal

Anti diarrhea - adstringents

Forms protective layer so mucosa wont be irritated Bizmuth salts

Motility inhibitors

Loperamide - opioid agonist, used in IBS-D Diphenoxylate - opioid agonist both decreases ACh release

Appetizers - bile acids

Ursodeoxycholic acid (UDCA) - secondary bile acid IND: billiary cirrhosis, bily synth. problems

Appetizers - liver protective enzymes

Silmarin | Acetylcysteine (can be used against paracetamol OD)

HEPATOTOXIC DRUGS | 1. Dose dependent, predictable direct liver toxicity

Paracetamol iron CCl4

HEPATOTOXIC DRUGS | 2. Dose dependent, predicatble, cholestatic (indirect)

Rifampin | Sexual hormones

HEPATOTOXIC DRUGS | 3. Dose independent, direct:

Halothan, indometacin, valproate

HEPATOTOXIC DRUGS | 4. Dose independent cholestasis

Chloropromazine

HEPATOTOXIC DRUGS | 5. Other

Alcohol Benign liver tumors Amiodarone

Acid reducing agents - H2 R antagonists

«ToDine» Famotidine decreases acid secretion by 90%

PPI’s

«prazole» Oral: omeprazole I.V.: esmoprazole, pantoprazole Targets parietal cells, blocks H/K ATPase Can block 99%

Antacids

Magnesium oxide Aluminium hydroxide Symptomatic relief in GERD

Tyrosine kinase inhibitors (membrane bound)

-nib HER1/EGFR - Erlotinib, gefitinib VEGFR - Sunitunib HER1 + HER2 - Lapatinib ALK fusion - Crizotinib

Tyrosine kinase inhibitors (non-membrane bound)

BCR-ABL Imatinib - first ever Brutans TKI -iBrutinab RAF-kinase inh. -Dabrufinib MEK-inh. - Trametanib

immuno - calcineurin inhibitors

Blocks transcription of IL2 from Th2 - cyclosporin A only severe cases IND bone marrow transplant, GvH, RA, uveitis - Tacrolimus more potent

mTOR inh.

Sirolimus Blocks t-cell proliferative signal from IL-2 ind - kidney trx, GvH - drug coated stents

JAK inhibitors

Tofacitinib ind: RA, combine with MTX

Cytotoxic drugs (immuno)

Methotrexate - anti inf. oral, onco is I.V. and higher dose IND: RA, psoriasis, lupus, IBD - Leflunomide pyrimidine synth. block

Immunosupressive AB - IVIG

ATG - antithymocyte globulin | kills and blocks lymphocytes

Immunosupressive AB - Monoclonal AB

Rituximab | - anti B-cell - binds CD20 of malignant and normal B-cells

Anti TNFa

Infliximab Adlimumab IND RA, IBD

Anti IL-6 receptor

Tocilizumab IND RA

Anti IL-12/23 AB

Ustekinumab IL-23 -> Th17 -> IL-17: Psoriasis ind IL-12 -> Th1 -> IL-2: cell mediated damage

Cancer: hormonal agents

Progesterone - inh. of LH and FSH Tamoxifen - anti estrogen - breast cc Amastrozol - inh. estrogen synth Bicalutamide - testosterone R blocker Goserelin - GnRH agonist Degarelix - GnRH antagonist Prednisolone - used pallatively, decreases intercranial pressure in brain tumors

Neurodegenerative diseases - parkinsons

Early phase: MAO-B inhibitors - selegiline or DA agonists - pramipexole, ropinirole Start substitution therapy (levodopa) as late as possible In tremor dominant or drug induced Parkinsons: Anticholinergic drugs