Abbreviated Pharm Flashcards
Decrease angiotensin II (potent vascoconstrictor) and have SE of angioedema (severe), acute RF, and persistent dry cough
Ace-Inhibitors
Lisinopril and Ramipril
Lisinopril depletes
zinc
Alpha-2-agonist that decreases vasoconstriction and CO
Clonidine
AntiHTN
Alpha-1-antagonist: decease NE; used to tx HTN and BPH
Doxazosin
Terazosin
Do not use these AntiHTN drugs with African Americans
ARBs
Losartan, Irbesartan, Valsartan
Major ADR of ARBs
HYPERkalemia
Selective (B1) Antagonists
Atenolol
Metoprolol
Nonselective (B1 and B2) Antagonists
Carvedilol
Propanolol
Timolol
_______ BB crosses the BBB and has more SE
Propanolol
Which BB is commonly used in CHF?
Carvedilol
Which antihypertensive drugs are NOT 1st line for CHF?
CCB
CCB
Amlodipine
Diltiazem
Verapamil
Amlodipine depletes
Potassium
Verapamil depletes
Vitamin E
Potassium wasting diuretic that inhibits Na+ and Cl- at the ascending loop
Furosemide
Loop diuretic
Furosemide SE
hypokalemia, ototoxicity, and nutrient depletion
Furosemide is CI in
allergy to sulfonamides
Potassium wasting diuretic that inhibits NaCl transporter in distal tubule
Hydrochlorothiazide
Thiazide diuretic
Hydrochlorothiazide SE
hypokalemia and hyperglycemia
Hydrochlorothiazide is CI in
allergy to sulfonamides
Potassium sparing diuretics
Spironolactone
Triamterene
Spironolactone and Triamterene are weak diuretics with SE of ______
HYPERkalemia
Aldosterone antagonist that works at the distal convoluted tubule
Spironolactone
What does hydralazine do?
Antihypertensive
unknown MOA, peripheral vasodilation
Major SE of NTG
HA
NTG C/I
Sildenafil (w/in 24 hrs)
Prophylactic vasodilator w/ a slower action than NTG
Isosorbide mononitrate
sympathomimetic with vasoconstriction via alpha-1 and bronchodilation via beta-2
Epinephrine
increases HR and contractility
This antiarrhythmic has a narrow therapeutic window
Potassium chloride
Potassium chloride SE
Hyperkalemia
Sodium channel blockers
Class I anti-arrhythmics: Lidocaine and Flecainide
BBW for Class I anti-arrhythmics: Lidocaine and Flecainide
increased mortality
*use as a last resort in hospital setting
Class II anti-arrhythmics
BB (-olol)
Potassium channel blockers
Class III anti-arrhythmics: Amiodarone
70% of pt on amiodarone have ADR, including:
pulmonary fibrosis, heart block, hypotension, hypo/hyperthyroidism, hepatotoxicity, coronary/skin deposits
Class IV anti-arrhythmics
CCB: Amlodipine, Diltiazem, Verapamil
anti-arrhythmics that inhibits N/K/ATPase
Digoxin (Class V)
Which anti-arrhythmics can be used for LHF (palliative) and A flutter, but must be monitored d/t narrow therapeutic window
Digoxin
Combining digoxin w/ diuretics increases the risk of
hypokalemia
fatigue, mm. weakness, agitation, anorexia, and yellow halos around vision are sx of _______ toxicity
Digoxin
Bile acid sequestrant used to tx T2DM, familial hypercholesterolemia and hyperlipidemia
Colesevelam
Colesevelam SE
wastes nutrients when bile is sequestered
Colesevelam C/I
bowel obstruction or TG > 500
Cholesterol absorption inhibitor
Ezetimibe
Ezetimibe C/I
active liver dz
fibrate drug used to tx triad of low HDL, high LDL, high TG (Type IV and V)
Gemfibrozil
Gemfibrozil interacts with
Warfarin and statins (inc SE of LV DZ)
Gemfibrozil SE
gallstones, elevated liver enzymes, enhances anticoagulants, myositis/rhabdomyolysis
HMG-CoA reductase inhibitors
Atorvastatin and Simvastatin
Statins interact with
fibrates and niacin
Statin SE
elevated LFT, myositis, rhabdomyolysis - d/c if pt has muscle pain
______ should always be given with statins
75-100 mg CoQ10
Best drug in anaphylaxis
Epinephrine
antitussive that suppresses cough reflex at source (i.e. anesthetizes respiratory passage)
Benzonatate
it’s actually an ester local anesthetic
antitussive that works at cough center in medulla
Dextromethorphan
Which antitussive can cause serotonin syndrome?
Dextromethorphan
it is C/I to use MAO-I w/in 14 days of dextromethorphan
Opioid antitussive(s)
Codeine
Hydrocodone
Mucolytic, expectorant
Guaifenesin
1st generation anti-histamines that cross BBB and cause sedation
Diphenhydramine
Hydroxyzine
Promethazine
2nd generation anti-histamines that do not cross BBB (thus do not cz sedation)
Cetirizine
Fexofenadine
Loratadine
Dose of diphenhydramine during anaphylaxis
50 mg IM
The anti-histamine _____ is used as an anxiolytic
Hydroxyzine
The anti-histamine _______ is used as an antipsychotic
Promethazine
Antihistamines that are used for allergies/asthma are ____ antagonists
H1
Loratadine SE
QT prolongation
sympathomimetic nasal spray (mostly alpha-adrenergic)
Phenylephrine
decongestant
sympathomimetic decongestant (alpha and beta)
Pseudoephedrine
Pseudoephedrine C/I
MAO-I: phenelzine (HTN crisis)
Decongestants
Phenylephrine (nasal spray), Pseudoephedrine, Epinephrine
mast cell stabilizer that inhibits histamine release
Cromolyn sodium
Albuterol onset is ___ and lasts ____
onset: 15 min
lasts: 3-4 hrs
Albuterol C/I
MAO-I (phenelzine), TCA, sympathomimetic
Long-acting B2 agonist that lasts 12-24 hr
Salmeterol
usu. used in combo w/ glucocorticoids
Salmeterol C/I ______ and ADR _____
C/I: acute asthma
ADR: prolonged QT
Salmeterol BBW
may increase asthma-related death
Inhaled steroids
Fluticasone, Mometasone, Beclomethasone, Budesonide
leukotriene antagonist used for prophylaxis and maintenance of persistent asthma, aspirin-induced asthma, and exercise-induced asthma
Montelukast
Montelukast SE
Churg-strauss syndrome, hypereosinophilia
antimuscarinic bronchodilator that inhibits ACh in smooth muscle of respiratory tract and is used for maintenance therapy in COPD
Tiotropium bromide
antimuscarinic bronchodilator that is shorter acting
Ipratropium bromide
Procoagulant that stimulates factors II, VII, IX, X
Vitamin K1
drug that inhibits ADP-induced platelet aggregation and is often used in pt that are aspirin intolerant
Clopidogrel
drugs that inhibits COX and inhibits platelet aggregation
Aspirin
Aspirin increases which drug?
Phenytoin (seizure drug)
Aspirin C/I
kids < 12 y/o (Reye’s syndrome) and G6PD deficiency
inhibits synthesis of vitamin K-dependent factors but has no effect on established thrombus
Warfarin
has a narrow therapeutic window and requires monitoring of PT/INR
Warfarin
Drugs that can increase effects of Warfarin
Acetaminophen, Androgens, BB, Corticosteroids, Omeprazole, Phenytoin
xanthine derivative that reduces blood viscosity and is used in intermittent claudication and peripheral vascular dz
Pentoxifylline
Factor X inactivator that binds anti-thrombin III to prevent conversion of fibrinogen to fibrin (intrinsic pathway)
Heparin
Low molecular weight heparin (factor X inactivator)
Enoxaparin
Factor Xa inactivator that inhibits platelet activation and fibrin clot formation
Rivaroxaban
direct thrombin inhibitor that inhibits free and fibrin-bound thrombin
Dabigatran
Iron chelator used to tx chronic iron overload, hemochromatosis, routine transfusions
Deferoxamine
chelator of mercury, gold, arsenic
DMPS
chelator of mercury, lead, antimony, and arsenic
DMSA
oral version of DMPS so it has less severe ADR
chelator of lead, mercury, iron; also acts as anti-coagulant in blood tubes
Edetate calcium disodium (EDTA)
chelator of copper and other heavy metals; used to tx Wilson’s dz
Penicillamine
drug used in anemia of chronic dz because it stimulates erythropoiesis
Epoetin alfa
Antibacterial classes that inhibit cell wall synthesis
Penicillins, Glycopeptides, Cephalosporins
Antibacterial classes that inhibit protein synthesis
Tetracyclines, Macrolides, Lincosamides, Aminoglycosides
Antibacterial classes that inhibit DNA synthesis
Fluoroquinolones
Antibacterial classes that inhibit RNA synthesis
Synthetase inhibitors (Mupirocin), Monoxycarbolic acid agents (Rifaximin, Nitrofurantoin)
Antibacterial classes that act as PABA analogue/dihydrofolate reductase inhibitors
Sulfamethoxazole-trimethorpim
C/I in KIDDOS
B-lactam drug used to tx dental abscesses, recurrent rheumatic fever, recurrent strep cellulitis in lymphedema but has SE of anaphylaxis and black hairy tongue
Penicillin G/VK
i.e. natural penicillin
synthetic B-lactam drugs that are 1st choice for uncomplicated ENT infx
Ampicillin, Amoxicillin, Amoxicillin + clavulanate
What is clavulanate?
B-lactamase inhibitor (added to B-lactam drug Ampicillin)
Are the synthetic penicillin drugs (ampicillin, amoxicillin, and amox + clavulanate) safe in Pg?
Yes
glycopeptide drugs that is IV only and used to tx MRSA
Vancomycin
Cephalosporins
Cefdinir
Cefuroxime
Ceftriaxone
Cephalexin
10-15% of pt that are hypersensitive to penicillins will also reach to ________
Cephalosporins
cefdinir, cefuroxime, ceftriaxone, cephalexin
Cephalosporins (cefdinir, cefuroxime, ceftriaxone, cephalexin) tx
cellulitis
broad-spectrum antibiotics that can have ADR of photosensitivity and tooth discoloration/bone effects in kids < 8
Tetracyclines (minocycline, doxycycline)
_________ antibiotics should be taken on an empty stomach, where as ______ antibiotics should be taken with food
Empty = tetracyclines
Food = macrolides
Are macrolides safe in pregnancy?
Yes (Cat. B)
Macrolides
“-romycin”
Azithromycin
Clarithromycin
Erythromycin
alternative antibiotic for people w/ penicillin allergy
Clindamycin
antibiotic that is used topically for acne
Clindamycin
Clindamycin ADR
C. diff super infx (pseudomembranous colitis)
topical aminoglycoside antibiotic used for ocular infx
Gentamicin
1st line drug for UTIs
Ciprofloxacin and Levofloxacin
Fluoroquinolones
Ciprofloxacin and Levofloxacin BBW
tendon rupture
Ciprofloxacin and Levofloxacin C/I
< 18 y/o (can arrest growth plate)
topical antibiotic for MRSA and impetigo
Mupirocin
Monoxycarbolic acid agent used to tx SIBO, traveler’s diarrhea, IBS, hepatic encephalopathy
Rifaximin
“everything inhibitor” used to tx acute uncomplicated UTIs
Nitrofurantoin
Nitrofurantoin C/I
G6PD deficiency, lactation, and 3rd trimester of Pg (can cz hemolysis of newborn)
Give _____ with Sulfamethoxazole-trimethorpim
Folate
Sulfamethoxazole-trimethorpim SE
photosensitivity and megaloblastic anemia
Sulfamethoxazole-trimethorpim interactions
OCPs
Triple Antibiotic Ointment
Bacitracin + Neomycin + Polymyxin B
B: inhibits cell wall synth
N: aminoglycoside
PB: cell wall permeability
Triple Antibiotic Ointment SE
allergic contact derm and SNHL (neomycin)
Neomycin SE
permanent SNHL
aminoglycoside drug
Anti-tuberculosis drugs
Isoniazid and Rifampin
Note: use both drugs together for active infx
can be used to tx latent and active TB but is also hepatotoxic
Isoniazid
Rifampin SE
red tears/saliva/urine, hepatotoxic
anti-fungals that penetrate into all body fluids
Fluconazole and Ketoconazole
Triazoles
Fluconazole and Ketoconazole interactions
Warfarin, phenytoin, others
Anti-fungal used for onychomycosis
Terbinafine
Terbinafine SE
hepatotoxic, SJS, neutropenia
anti-fungal that disrupts cell wall formation and only works topically (even in GI it works as topical agent)
Nystatin
Malaria prophylaxis
Hydroxychloroquine
anti-helminthic drugs that destroy microtubules and block glucose uptake
Albendazole and Mebendazole
topical application for lice, ticks, mites; 1st line tx scabies
Permethrins
anti-parasitic for roundworms, lice, scabies
Ivermectin
anti-protozoel for anaerobic infx, C. diff, H. pylori ulcers, BV, trichomonas, and giardia
Metronidazole
Metronidazole C/I
EtOH (disulfiram rxn)
guanosine analogue that inhibits viral DNA polymerase and tx actively replicating HSV
Acyclovir and Valacyclovir
reverse transcriptase inhibitor; drug accumulates in all dividing cells
Zidovudine
Parkinson’s drugs that can also tx Influenza A
Amantadine
no longer recommended for influenza A
tx influenza A and B; prevents release of virus
Oseltamivir
tx chronic HBV and HCV
interferon-a-2
alkylating agent used to tx metastatic testicular and ovarian tumors and adv bladder CA
Cisplatin
Cisplatin BBW
renal toxicity, myelosuppression, ototoxicity
alkylating agent used to tx leukemia, lymphoma, and many other CA
Cyclophosphamide
anthracycline drug used to tx Kaposi’s sarcoma, ovarian CA, multiple myeloma
Doxorubicin
Doxorubicin SE
life-threatening heart damage
Doxorubicin C/I
cardiac dz
drug used to tx Her-2+ breast CA
Trastuzumab
Trastuzumab BBW
fatal heart/lung problems and fetal harm
folic acid antagonist used to tx many CA and to induce abortion
Methotrexate
anti-microtuble drug used to tx Hodgkin’s, testicular CA, and Kaposi’s sarcoma
Vinblastine (IV only)
Vinblastine is derived from
Vinca rosea (periwinkle)
aromatase inhibitor used reduce serum estradiol in breast CA pt post-surgery and for METS
Anastrozole
GnRH analogue; testosterone antagonist used to tx metastatic prostate CA
Bicalutamide
Bicalutamide C/I
women, pregnancy (X)
GnRH analogue; suppression of ovarian/testicular steroidogenesis for prostate CA, endometriosis, uterine fibroids
Leuprolide
mitotic inhibitor that binds tubulin and affects rapidly dividing cells
Paclitaxel
drug used to tx advanced ovarian CA, non-small cell lung CA, ovarian/breast CA METS unresponsive to 1st line drugs
Paclitaxel
pyrimidine analogue use to tx many CA
5-Fluorouracil
5-Fluorouracil is used topically to tx
BCC
SERM used prophylactically for postmenopausal osteoporosis
Raloxifine
SERM that competes with E2 for E-receptor proteins and is used to tx E+ CA
Tamoxifen
Tamoxifen BBW
uterine malignancies, stroke, PE
cytokine inhibitor (TNF-alpha); circulating receptor fusion protein used to tx RA, jRA, PsA, AS, plaque psoriasis
Etanercept
Etanercept BBW
incr risk of serious infx and CA
TNF-a inhibitor used to tx inflammatory dz (RA, PsA, IBD)
Adalimumab
Adalimumab BBW
incr risk of serious infx and CA
Infliximab BBW
incr risk of serious infx and CA
*can also cz HF, pancytopenia, and demyelinating dz
Cytokine/TNF inhibitors
Etanercept, Adalimumab, Infliximab
DMARD used to tx SLE and RA
Hydroxychloroquine
DMARD used to tx CA, RA, severe psoriasis, ectopic pg (abortifacient)
Methotrexate
DMARD used RA (also a copper chelating agent)
Penicillamine
DMARD used to tx IBD and RA that is C/I in people with sulfonamide/salicylate allergy
Sulfasalazine
JAK inhibitor used to tx RA when it’s refractive to methotrexate
Tofacitinib
*new on NPLEX
Tofacitinib BBW
incr risk of serious infx and CA
used for prophylaxis during organ transplant and for dry eyes
Cyclosporine
transplant drug that has BBW of incr risk of serious infx and CA
Tacrolimus
drug used to tx leprosy and multiple myeloma
Thalidomide
Thalidomide C/I
pregnancy (X)
4x stronger than cortisol and longer acting than hydrocortisone
Prednisone
non-selective COX inhibitor used to tx fever, pain, inflamm, and platelet agg
Aspirin
Salicylism
dose-dependen reversible vertigo, vomiting, tinnitus, hearing loss
(aspirin toxicity - max dose = 4g)
Diclofenac gel
non-selective COX inhibitor for inflammation; NSAID
non-selective COX inhibitor that decreases cartilage synthesis
Ibuprofen
Ibuprofen interacts with
Aspirin
do not combine
Indomethacin
non-selective COX inhibitor for inflammation
non-selective COX inhibitor use for moderate-severe pain only; IV or IM
Ketorolac
Ketorolac C/I
use > 5 days and in peds
Naproxen
non-selective COX inhibitor for inflammation
Naproxen sodium
greater absorption and faster onset than Naproxen (NSAID)
non-selective COX inhibitor used for post-cataract surgery
Nepafenac
Selective Cox-2 inhibitor
Celecoxib
Celecoxib has less ______ than aspirin, but increased risk of _______
less: GI distress
incr: risk of serious thrombosis
Celecoxib C/I
perioperative pain from CABG
Muscle relaxants for acute use (1-2 wks)
Carisoprodol
Cyclobenzaprine
Diazepam (benzo)
Methocarbamol
muscle relaxants C/I
CNS depressants
Methocarbamol SE
black/blue/green urine
you need to taper this drug that is used to tx mm. spasticity, spinal cord injury, and rheumatic d/o
Baclofen
alpha-2 agonist used for mm. spasticity
Tizanidine
inhibits ACh release and causes flaccid paralysis
Botulinum toxin
bisphosphonate drug that inhibits osteoclasts
Alendronte
_______ must be taken on an empty stomach with 6-9 oz water and remain upright for 30 min
Alendronte
Alendronte SE
esophageal erosion, osteonecrosis of jaw
Alendronte C/I
hypocalcemia
hormone used to inhibit osteoclasts and tx osteoporosis (not prevention)
Calcitonin
monoclonal antibody use to tx osteoporosis
Denosumab
SQ q 6 mo
SERM used for postmenopausal osteoporosis prophylaxis
Raloxifene
Raloxifene C/I
past VTE, pregnancy (X)
centrally acting analgesic that inhibits prostaglandin synthesis for pain and fever; not anti-inflammatory
Acetaminophen
Acetaminophen interactions
EtOH
3 drinks/day + 3 g can shut down the liver
Acetaminophen max dose
1 drug to OD on
4 g in 24 hours
xanthine oxidase inhibitor used in prevention of further gouty attacks (decreases uric acid production)
Allopurinol
drug used in acute gouty attacks; microtubule inhibitor that prevents neutrophils causing gout sx
Colchicine
______ is used to tx acute gout, whereas ______ is used to prevent further gout attacks
Acute = colchicine
Prevention = allopurinol
rubefacient used as a counter-irritant for pain, vasodilation, and blocks substance P
capsaicin
kappa and mu receptor activities
Codeine Fentanyl Hydrocodone Morphine Oxycodone Tramadol
*all are class II except hydrocodone, which is class III
strongest non-synthetic opiate
morphine
Tramadol SE
seizure risk
synthetic opioid agonist for addiction and detox
Methadone
partial opioid agonist/antagonist for addiction
Buprenorphine
competitive opioid antagonist for addiction that is C/I in pt taking opiates
Naltrexone
competitive opioid antagonist for acute OD
Naloxone
immunosuppressant and ocular emulsant; used to tx keratoconjunctivitis sicca (Sjogrens, scleroderma)
Cyclosporine
aminoglycoside, bacteriocidal eye drops
Gentamicin
bacteriostatic drug used for conjunctivitis, superficial ocular infx
Sulfacetamide
macrolide used for superficial ocular infx that has a SE of eye irritation
Erythromycin
BB for ocular HTN and open-angle glaucoma
Timolol
prostaglandin analog that reduces IOP by increasing outflow of aqueous humor
Latanoprost
Latanoprost SE
iris darkening
cholinergic agonist causing miosis (constriction) and decreased pressure in open-angle glaucoma or ocular HTN; also used in acute-open angle glaucoma
Pilocarpine
anticholinergic drug used to dilate eyes for exam (mydriatic agent)
Atropine
NSAID for cataract surgery to decrease pain and inflammation
Nepafenac
Nepafenac SE
increased bleeding time, delayed healing, corneal ulcers
ophthalmic antihistamine used in tx allergies
Olopatadine
sympathomimetic decongestants that cause rebound congestion (aka rhinitis medicamentosa)
Oxymetazoline
Phenylephrine
Oxymetazoline and Phenylephrine C/I
use > 3 days, glaucoma, MAO-I
topical antibacterial and steroid for swimmer’s ear, superficial bacterial infx of external auditory canal
Neomycin/Polymyxin B/Hydrocortisone
cholinesterase inhibitors used to tx dementia
Donepezil
Rivastigmine
drug that blocks NMDA-R and decreases excitotoxicity for moderate to severe Alzheimers
Memantine
GABA analogue used as adjunct in epilepsy tx
Gabapentin
Pregabalin
sodium channel blocker used to tx partial seizures, bipolar mania, and trigeminal neuralgia
Carbamazepine
Carbamazepine SE
ataxia
sodium channel blocker seizure drug that has SE of gingival hyperplasia and suicidal ideation
Phenytoin
Phenytoin SE
- P: peripheral neuropathy
- H: hyperplasia of gingiva, hirsutism, hypersensitivity
- E: enlarged LN
- N: nystagmus
- y
- T: teratogenicity
- O: osteomalacia
- I: inhibition of insulin
- N: nausea
benzodiazepine use in seizure tx
Diazepam
Diazepam C/I
CNS depressants
seizure drugs with SE of sudden unexplained death and suicidal ideation
Lamotrigene
Topiramate
Valproate
PD drugs that is a dopamine precursor
Levodopa/carbidopa
inhibits peripheral degradation of levodopa but has no effect if used alone
carbidopa
Levodopa/carbidopa SE
tolerance over time
Levodopa/carbidopa interaction
B5 (increases peripheral DA catabolism)
dopamine agonist used to tx PD, acromegaly, and hyperprolactinemia
Bromocriptine
Bromocriptine SE
pulmonary fibrosis
dopamine agonist for tx PD that is s/t used to delay starting Levodopa
Pramipexole
anticholinergics for dyskinesia (in PD)
Benztropine
Scopolamine
Diphenhydramine
drug used to levodopa-induced dyskinesia
Amantadine
sphingosine-1-phosphate-R modulator used to tx MS; it decreases inflammation
Fingolimod
immune modulator used to tx MS, that activates suppressor T-cells to decrease inflammation
Glatiramer acetate
interferon used to reduce MS exacerbations
Interferon-beta-1
drugs used to spasticity related to MS
Tizanidine (mm. relaxant)
Baclofen (unknown MOA)
Botulinum toxin
drug used for postherpetic neuralgia, epilepsy, and bipolar mania
Gabapentin
drug used for neuropathic pain, fibromyalgia, and postherpetic neuralgia
Pregabalin
5HT-1 agonist, potent vasoconstriction of cranial aa., take at onset of migraine or cluster HA
Sumatriptan
Sumatriptan CI
ischemic heart dz, history of MI or stroke
tx for chronic migraines that blocks ACh release
Botulinum toxin
Topiramate and Valproate can both be used to tx
migraines and seizures
Amides are metabolized
by the liver
Esters are metabolized
in peripheral plasma to PABA
Lidocaine is an
amide (liver)
Bupivacaine is an
amide (liver)
Procaine is an
ester (peripheral plasma)
Lidocaine onset and duration
onset: 1-10 min
duration: 30-60 min
Bupivacaine
onset: 8-12 min
duration: 3-4 hr
Which type of nerve block agent is more likely to cause allergic rxn?
Esters
i.e. procaine
the nerve block agent _______ acts topically, and ______ does not act topically
Lidocaine
Procaine
Procaines has a _____ onset, and ______ duration as Lidocaine
slower onset same duration (30-60 min)
NMDA receptor antagonist used in pain/procedures
Ketamine
Ketamine C/I
psychosis
1st generation antihistamines that are somnorific
Diphenhydramine
Hydroxyzine
Promethazine
non-benzo GABA potentiator - strong sedative, minor anxiolytic, rapid onset but short duration of hypnotic action
Zolpidem
Zolpidem SE
rebound insomnia (must taper)
anti-convulsant drugs used to tx mania in bipolar d/o
Lamotrigine
Valproate
Carbamazepine
Carbamazepine blocks ____ channels
sodium
drugs that block 5HT and DA
Atypical anti-psychotics: Risperidone Aripiprazole Quetiapine Clozapine
The atypical anti-psychotic ______ is used to tx irritability in autism
Risperidone
Aripiprazole SE
dysglycemia (caution with DM)
drug used to tx mania that has a narrow therapeutic window and must be monitored
Lithium
Lithium SE
hypothyroidism, hyponatremia
_____ are first line anxiolytic for MDD, OCD, GAD, and eating d/o
SSRIs:
Escitalopram
Fluoxetine
Paroxitine
SSRIs (Escitalopram, Fluoxetine, Paroxitine) C/I
MAO-I (serotonin syndrome)
Benzodiazepines
Alprazolam
Diazepam
Benzodiazepine (Alprazolam, Diazepam) SE
anterograde amnesia, must taper
Benzodiazepine (Alprazolam, Diazepam) C/I
CNS depressants
long-acting benzo used to tx epilepsy, EtOH w/drawal, and mania
Diazepam
antipsychotic that blocks D2, some H1, some cholinergic, some alpha-adrenergic and has LOTS of SE
Haloperidol
Haloperidol C/I
severe CNS depression, dementia-related psychosis
anti-psychotic used to tx psychosis and vomiting
Phenothiazines:
Prochlorperazine
Promethazine
Phenothiazines (Prochlorperazine, Promethazine) SE
tardive dyskinesia
Phenothiazines (Prochlorperazine, Promethazine) C/I
CNS or bone marrow depression
atypical antipsychotic used in treatment-resistant schizophrenia and suicide risk reduction
Clozapine
Clozapine BBW
severe neutropenia
Quetiapine
atypical antipsychotic used to tx mania
amphetamine agents used to tx narcolepsy
Dextroamphetamine
Methylphenidate
non-amphetamine CNS stimulation used to tx narcolepsy
Modafinil
Modafinil SE
SJS
Anorexiants (used to suppress appetite)
Phentermine
Dextroamphetamine
Is Phentermine safe in pregnancy?
No (Cat. X)
ADD/ADHD meds
Dextroamphetamine
Methylphenidate
Clonidine
Clonidine MOA
alpha-2 agonist
methylxanthine, phosphodiesterase inhibitor
caffeine
CNS stimulant and local anesthetic that works by reducing Na+ permeability
cocaine
Nicotinic ACh-R partial agonist
Varenicline
Varenicline BBW
suicidal ideation
Nicotine interactions
BB
Bupropion is used to tx
smoking cessation
Bupropion C/I
seizure d/o, eating d/o
hallucinogen that affects 5HT release, increases catecholamines, inhibits parasympathetics
Cannabis
hallucinogen that is an NMDA receptor antagonist
Ketamine
anticholinergic used to tx bradycardia, organophosphate poisoning, and PD
Atropine
Atropine C/I
acute glaucoma
MOA inhibitor that increases NE, DA, 5HT - used in depression
Phenelzine
Phenelzine C/I
all antidepressants and any meds that affect catecholamines
tricyclic that increases NE and 5HT - used in depression
Amitriptyline
Amitriptyline C/I
MAO-I or SSRI
tetracycline drug used for MDD
Mirtazapine
the smoking cessation drug ______ can also be used to tx depression
Buproprion
although takes several wk for antidepressant effects
which anti-depressant has the fewest sexual SE
Buproprion
5HT antagonist and reuptake inhibitor (SARI) used off label to tx insomnia
Trazodone
SSRI used to tx MDD, OCD, GAD, eating d/o, panic attack
SSRI:
Escitalopram, Fluoxetine, Paroxetine
1st line tx for depression and panic d/o
Fluoxetine (SSRI)
drug used to social anxiety, MDD, OCD, panic d/o, GAD
Paroxetine
SNRI used to tx depression, GAD and diabetic neuropathy
Duloxetine
SNRI used to tx MDD
Venlafaxine
ADHD med, NE reuptake inhibitor
Atomoxetine
antibacterial used topically for acne that has SE of photosensitivity
Benzoyl peroxide
synthetic retinoid that reduces sebaceous gland size and sebum production
Isoretinoin
Isoretinoin SE and C/I
SE: chelitis, increased LFTs
C/I: pregnancy (X)
synthetic retinoid cream used for acne - reduces sebaceous gland size and sebum production
Tretinoin
blocks ACh release and can tx hyperhydrosis
Botulinum toxin
Topical steroids for eczema
Clobetasol propionate Fluocinonide Mometasone Fluticasone Triamcinolone Hydrocortisone
RNA synthesis blocker that tx staph infx
Mupirocin
synthetic calcitriol (Vit D) to aid in proliferation and differentiation of various cell types; used to tx psoriasis
Calcipotriol
Calcipotriol SE
hypercalcemia
tx tinea versicolor, seborrheic derm, and dandruff
selenium disulfide
used to tx actinic keratosis and external genital warts
Imiquimod
Imiquimod C/I
immunocompromised and kids with molluscum (ineffective)
tx diarrhea and ulcers; coats stomach; cytoprotective against H. pylori
Bismuth subsalicylate
Bismuth subsalicylate SE
black tongue, tarry stool
mast cell stabilizer that inhibits histamine release and can tx diarrhea
Cromolyn sodium
anti-diarrheal effect on circular smooth muscle of bowel; may prolong transit time
Diphenoxylate/atropine
Diphenoxylate/atropine C/I
pseudomembranous colitis, enterotoxin-producing bacteria
opioid analogue that inhibits peristalsis and prolongs transit time; tx diarrhea
Loperamide
Loperamide C/I
bloody diarrhea, high fever, infectious diarrhea, pseudomembranous colitis
somatostatin analog (inhibits GH, glucagon, insulin, LH, and VIP); tx vasoactive intestinal peptide tumors, acromegaly, and watery diarrhea
Octreotide
detergent agent that pulls more water into fecal matter
Docusate
Docusate interactions
mineral oil
Docusate C/I
obstruction
increase water into lumen and increase peristalsis; between softener and laxative
Oral osmotic agents: Lactulose
Milk of magnesium
PEG 3350
stimulant laxative that evacuates bowels 8 hr after taking
Bisacodyl
phosphoric acid salt that exerts osmotic effect and acts as a laxative/bowel evacuant
Sodium phosphate enema
binds prostaglandin R or parietal cells increasing HCO3-, decreasing pepsin, protecting tight jn, and thickening mucous layer; used for prevention of NSAID-induced ulcers
Misoprostal
Misoprostal C/I
pregnancy (X; abortifacient)
enhances mucosal barrier, adheres to “roughed up” gastric mucosa, little systemic absorption/no toxicity; powerful demulcent
Sucralfate
H2 blockers that inhibit gastric acid secretion by binding reversibly to H2-R in parietal cells, for short-term use
Cimetidine
Ranitidine
suppress gastric acid secretion by irreversible blocking H/K/ATPase at parietal cells
PPI:
Esomeprazole
Lansoprazole
Omeprazole
Are H2 blockers safe in Pg?
Yes
Are PPI safe in Pg?
Yes
-“prazole”
PPI (“-prazole”) SE
rebound hypersecretion (must taper)
spasmolytic drugs (dicyclomine, hyoscyamine, and scopolamine) C/I
glaucoma
spasmolytic, anticholinergic, tx diarrhea, IBS, spasms, PUD
Hyoscyamine
Dicyclomine
anticholinergic, parasympatholytic drug used for motion sickness prevention
Scopolamine
DMARD used to tx IBD and RA
Sulfasalazine
Sulfasalazine C/I
sulfa allergy
active metabolite of sulfasalazine (tx IBD)
Mesalazine
1st generation antihistamines used to prevent vestibular stimulation of vomiting center, prophylaxis for motion sickness
Diphenhydramine
Meclizine
blocks 5HT3-R, inhibits activation of vomiting reflex pathway; used for N/V with chemotherapy or surgery
Ondansetron
antipsychotics with anti-DA and anti-emetic effects
Prochlorperazine
Promethazine
Prochlorperazine and Promethazine SE and C/I
SE: extrapyramidal
C/I: kids <2 (fatal respiratory depression)
solubilizing agent for primary biliary cirrhosis; tx gallstonres
Ursodeoxycholic acid
Ursodeoxycholic acid C/I
biliary obstruction
progestin for anorexia/cachexia of AIDS
Megestrol acetate
Megestrol acetate C/I
pregnancy (X)
cholinergic, increased SLUDGE for dry mouth of Sjogren’s or chemotherapy
Pilocarpine
Pilocarpine C/I
glaucoma
dopamine R antagonist that tx N/V associated with chemo or radiation, GERD (2nd line), diabetic gastroparesis
Metoclopramide
Metoclopramide SE and C/I
SE: extrapyramidal
C/I: used > 12 wk
5-alpha reductase inhibitor, decreases serum DHT for BPH and male pattern baldness
Finasteride
Finasteride C/I
Pregnancy (X)
BPH drugs that block alpha-1 R around bladder neck
Doxazosin
Terazosin
Tamsulosin
(alpha-1-antagonists)
androgen that tx ED
Testosterone
Testosterone C/I
Pregnancy (X)
cGMP-PDE V Inhibitor, smooth muscle relaxation and inflow of blood to tx ED
Sildenafil
Sildenafil SE
HA (MC), sudden cardiac death
Sildenafil C/I
Nitrate use
prostaglandin analogue (PGE-1) that leads to vasodilation and platelet inhibition and tx ED; IM into corpus cavernosum or used as urethral suppository
Alprostadil
Alprostadil SE
curving of penis, priapism, testicular swelling/pain
Alprostadil C/I
pregnancy (X)
antimuscarinic drugs used to tx urinary incontinence
Oxybutynin
Solifenacin
Tolteridine
Antimuscarinic (Oxybutynin, Solifenacin, Tolteridine) C/I
glaucoma, gastric/urinary retention
block ACh release and tx urinary incontinence
Botulinum toxin
muscarinic agonist (structurally related to ACh) that acts as a parasympathomimetic and is used for acute post-op and postpartum urinary retention
Bethanechol
1st line tx for interstitial cystitis; also used to tx pain of UTI but does not tx infx
Phenazopyridine
Phenazopyridine SE
body fluids turn deep orange (will interfere with urinalysis results)
antibiotic that has high concentration in urine, for cystitis, uncomplicated UTIs, 1st line tx for E. coli UTI
Nitrofurantoin
Nitrofurantoin C/I
3rd trimester of pregnancy (can cz hemolysis of newborn)
HBV tx that inhibits reverse transcriptase and incorporates into viral DNA
Entecavir
Entecavir BBW
hepatitis B exacerbation if tx is d/c, HIV resistance (don’t use in pt w/ coinfx)
NSAID used to tx OA and RA
Meloxicam
precursor of progestogens, mineralcorticoids, glucocorticoids, androgens, and estrogens
Pregnenolone
used in Addison’s to replace mineralcorticoids
Fludrocortisone
Oral glucocorticoids
Hydrocortisone Prednisone Prednisolone Methyprednisolone Dexamethasone
Prednisone is ___ X stronger than hydrocortisone
4
Dexamethasone is ___ X stronger than hydrocortisone
30
Inhaled glucocorticoids
Fluticasone
Momentasone
Budesonide
Beclomethasone
Glucocorticoid topical creams/gels
Fluocinonide Triamcinolone Hydrocortisone Clobetasol propionate Dexamethasone
Glucocorticoid nasal sprays
Beclomethasone
Budesonide
Fluticasone
Mometasone
estrogen that is used for HT, prophylaxis of osteoporosis, naturally highest in postmenopausal F, and
Estrone
Estrone SE and C/I
SE: carcinogenic
C/I: pregnancy (X)
estrogen that is used for atrophic vaginitis, BrCA, osteoporosis, DUB/AUB
Estradiol
Estradiol SE and C/I
SE: clot formation
C/I: E+ tumor, pregnancy(X)
estrogen that is used for HT, atrophic vaginitis, and is highest during pregnancy
Estriol
Estriol C/I
pregnancy, thrombosis
estrogen used to tx atrophic vaginitis, F hypogonadism, osteoporosis, AUB
Conjugated Estrogen
from pregnant mare
Conjugated Estrogen C/I
pregnancy (X)
strong E, only E used in OCP
Ethinyl Estradiol (EE)
prevents endometrial hyperplasia in females with uterus with postmenopausal estrogen therapy
Progesterone
hormones used to tx amenorrhea, DUB, PMS, fibroids, insomnia (dose at night), and is used in OCP
Progesterone
IUD
Levonorgestrel
Levonorgestrel C/I
pregnancy (X)
contraception, endometriosis, IM q 3 months
Medroxyprogesterone acetate
Medroxyprogesterone acetate C/I
pregnancy (X)
progestin used in OCP - alone or in combo with ethinyl estradiol (EE); also used in menopause
Norethindrone
only OC that are safe in nursing moms
Progestin OC (Norethindrone)
they also have highest rate of unintended Pg
Norethindrone C/I
pregnancy (X)
Combo OCP
Drospirenone/Ethinyl Estradiol
Norelgestromin/Ethinyl Estradiol
Norgestimate/Ethinyl Estradiol
ovulatory stimulant used in ovulatory dysfn in F trying to become pregnant, PCOS, post-OCP amenorrhea, some 2’ amenorrhea
Clomiphene
Clomiphene SE
ovarian hyperstimulation syndrome, hepatic dysfn
Clomiphene C/I
pregnancy (X)
increases production of E and T, decreases cortisol
DHEA
DHEA C/I
breast/uterine CA, endometriosis, fibroids
hormone for tx male hypogonadism
Testosterone
only give if AM plasma T is < 3 ng/mL
Testosterone SE (males)
gynecomastia, transfer to partner, liver CA, BPH, prostate CA
Testosterone SE (female)
clitoral hypertrophy, hirsuitism, acne, amenorrhea
Testosterone C/I
pregnancy (X)
competitive antagonist at androgen R, decreases T and tx hirsuitism d/t PCOS
Spironolactone
Insulin interactions
BB
can mask sx of hypoglycemia and prolong recovery
very rapid onset insulin (1 hr), very short-acting (3-4 hr), bolus dosing with meals
Lispro
rapid onset insulin (2-3 hr), short-acting (5-7 hr)
Regular
slow onset insulin (12 hr), long-acting (24 hr)
Glargine
rescue of hypoglycemia; given IV, IM, SQ
Glucagon
Glucagon C/I
pheochromocytoma
synthetic ADH, tx diabetes insipidus, limits H2O eliminated in urine
Desmopressin
Desmopressin SE
seizures, hyponatremia
labor/let down/love
Oxytocin
IV or nasal spray, postpartum hemorrhage, labor induction, incomplete abortion
Oxytocin
Oxytocin C/I
pregnancy (X)
prolactin blocker, dopamine agonist; tx hyperprolactinemia or prolactin-secreting adenoma
Bromocriptine
GH agonist used to tx dwarfism, growth failure (peds), HIV cachexia
Somatropin
stimulates chondrocytes, protein synthesis, EPO
Somatropin
given with Octreotide for acromegaly
Bromocriptine
somatostatin analogue that tx acromegaly, VIP tumor, carcinoid tumor
Octreotide
Octreotide SE
hyper/hypoglycemia, cardiac conduction d/o
iodine replenisher, radiation protection, inhibits release of thyroid hormone (ST); can be used in tx of both hyper and hypothyroidism
Lugol’s sol’n
inhibits thyroid hormone synthesis, blocks TPO, safer than PTU
Methimazole
inhibits TPO, inhibits conversion of T4 to T3, preferred agent in thyroid storm
Propylthiouracil (PTU)
Propylthiouracil (PTU) SE
agranulocytosis, life-threatening hepatotoxicity
T4
Levothyroxine
Levothyroxine C/I
uncorrected adrenal deficiency
T3
Liothyronine
T4/T3 blend from desiccated pig thyroid
Thyroid USP
from C-cells, opposes PTH, decreases serum Ca++; tx Paget’s disease of bone, hypercalcemia, postmenopausal osteoporosis
Calcitonin
induces ovulation and tx infertility in F; increases sperm count in M and helps testes descend
hCG
hCG SE
ovarian hyperstimulation syndrome
hCG C/I
pregnancy (X)
powerful antioxidant that tx disturbed biorhythms and sleep d/o
Melatonin
increases # and affinity of insulin R in periphery, decreases hepatic glucose output
Metformin
Biguanide
Metformin SE
lactic acidosis, diarrhea, B12 deficiency
Metformin C/I
metabolic acidosis, T1DM
sulfonyluria that stimulates insulin release
Glyburide
Glyburide SE
hypoglycemia
Glyburide C/I
DKA, sulfa allergy
insulin sensitizer in periphery
Pioglitazone
Pioglitazone BBW
cause/worsen heart failure
Pioglitazone C/I
CHF and liver disease
GLP1 agonist; incretin mimetic to increase insulin secreted in elevated blood glucose, slows gastric emptying
Liraglutide
SGLT2 antagonist that lowers renal glucose threshold, leading to increase urinary glucose excretion
Canaglifozin
Canaglifozin SE
increased urination, vag/penis stuff
DPP-4 inhibitor that increases/prolongs incretin increasing insulin release and decreasing serum glucose
Sitagliptin
