All Drugs Flashcards
Diphenhydramine, dimenhydrinate, chlorpheniramine
1) Use: Allergy, motion sickness, sleep aid 2) Class/MOA: H1 blockers 1st generation/ Reverisble inhibitors of H1 histamine receptors 3) Side effects/ADEs: sedation, antimuscarinic, anti alpha andrenergic 4) Fun Facts: Names contain “-en/-ine” or “-en/-ate”
Leuprolide
1) Use: Infertility (Pulsatile), Prostate Cancer (continuous + flutamide), uterine fibroids (continuous), precocious puberty (continuous) 2) Class/MOA: GnRH analog, pulsatile use=agonist properties, continous use=antagonist properites because downregulates GnRH receptor in pituitary causing decrease FSH/LH 3) Side effects/ADEs: Antiandrogen, N/V 4) Fun Facts Leuprolide can be used in lieu of GnRH
Mannitol
1) Use: Shock, drug overdose 2) Class/MOA: Osmotic diuretic 3) Side effects/ADEs: Pulmonary edema, dehydration, CHF, contraindicated in anuria 4) Fun Facts:
Trifluoperazine
1) Use: Positive symptoms of schizophrenia, psychosis, mania, tourrettes 2) Class/MOA: High potency, typical, antipsychotic. Block D2 receptor 3) Side effects/ADEs: Mostly EPS (dyskinesia) b/c high potency 4) Fun Facts: Neurolepic malignant syndrome is dangerous toxicity of all antipsychotic
Methotrexate (MTX)
1) CA: leukemia, lymphoma, choriocarcinoma, sarcoma; non-CA: abortion, ectopic preg, rheumatoid arthritis, psoriasis 2) folate analog: inhibits DHFR –> decr dTMP –> decr DNA + protein syn 3) myelosuppression (reverse w/ leucovorin); macrovesicular fatty liver change; mucositis; teratogenic 4) S-phase specific
Epinephrine (in Neurology)
1) Use: Glaucoma 2) Class/MOA: alpha agonist, decreases aqueous humor synthesis due to vasoconstriction 3) Side effects/ADEs: Mydriasis, stinging: do not use in closed glaucoma 4) Fun Facts
Aspirin
1) Use: Low dose (s syndrome in children with viral infections. 4) Fun Facts
Cimetidine
1) peptic ulcer, gastritis, mild esophageal reflux 2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell 3) potent cyt P450 inhibitor (Rx interactions); anti-androgenic effects (prolactin release, gynecomastia, impotence, decr libido in males); can X BBB (confusion, dizziness, HA) + placenta; decr renal exretion of Cr 4) N/A
Lispro
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia 2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen -Muscle: increase glycogen and protien synthesis and K+ uptake -Fat: aids in TG storage 3)Hypoglycemia, very rarely hypersensitivy rxns 4)Rapid-acting
Antimicrobial
-azole, -cillin, -cycline, -navir
Nifedipine
1) HTN, angina, Prinzmetal’s angina, Raynaud’s 2)Ca2+ Channel Blockers/Block voltgae dependent L-type Ca2+ channel of cardiac and smooth muscle and thereby reduce muscle contractility -more vascular sm. muscle effects 3)Cardiac depression, AV block, peripheral edema, flushing, dizziness, constipation
Bethanchol
1) Activates Bowel and Bladder smooth m. Post-op and neurogenic ileus and urinary retention. 2) Direct Cholinomimetic. 4) Resistant to AchE.
Mineral/Vitamin: Ferrous Sulfate
1) Use: Iron defiecnt anemia 2) Class/MOA: 3) Side effects/ADEs: Constipation 4) Fun Facts
Heparin
1) immediate anticoag for PE, ACS, MI, DVT (pregnancy safe) 2) Anti-thrombin: antithrombin cofactor –> decr thrombin* + decr factor Xa 3) toxicity: bleeding, HIT, osteoporosis, Rx interactions; protamine sulfate antidote (pos charge molec that binds neg charge heparin) 4) short 1/2 life
Penicillin G
1) Gram-positive organisms (S. pneumoniae, S. pyogenes, Actinomyces) & syphillis; Bactericidal for gram-positive cocci, gram-positive rods, gram-negative cocci, & spirochetes; Not penicillinase resistant 2) IV Penicillin (Prototype Beta-lactam abx;Non-penicillinase resistant); Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes 3) Hypersensitivity rxns; Hemolytic anemia 4) Resistance: Beta-lactamases cleave Beta-lactam ring
Immunosuppressants
Cyclosporine Tacrolimus (FK-506) Sirolimus (rapamycin) Azathioprine Muromonab-CD3 (OKT3)
Tox: Acetaminophen
Rx: N-acetylcysteine (replenishes glutathione)
Loratadine, fexofenadine, desloratadine, cetirizine
1) Use: Allergy 2) Class/MOA: H1 blockers 2nd generation/reversible inhibitors of H1 histamine receptors 3) Side effects/ADEs: Less sedating than 1st generation because of decreased entry into CNS 4) Fun Facts: Name usually ends in “-adine”
Testosterone, methyltestosterone
1) Use: Hypogonadism, development secondary sex characteristics, stimulates anabolism to promote recovery after burn or injury 2) Class/MOA: Agonist at androgen receptor 3) Side effects/ADEs: Masculinization in females, reduces intratesticular testoerone b/c inhibit relase of LH causing gonadal atropy, premature closing epiphyseal plate, increase LDH, decrease HDL
Acetazolamide
1) Use: Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness 2) Class/MOA: Carbonic anhydrase inhibitor, prevents bicarb reabsorption in PCT 3) Side effects/ADEs: hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy 4) Fun Facts: ACIDazolamide causes ACIDosis
Fluphenazine
1) Use: Positive symptoms of schizophrenia, psychosis, mania, tourrettes 2) Class/MOA: High potency, typical, antipsychotic. Block D2 receptor 3) Side effects/ADEs: Mostly EPS (dyskinesia) b/c high potency 4) Fun Facts: Neurolepic malignant syndrome is dangerous toxicity of all antipsychotic
5-fluorouracil (5-FU)
1) colon CA, basal cell carcinoma (topical) 2) pyrimidine analog bioactivated to 5F-dUMP (covalently complexes folate) –> complex inhibits thymidylate synthase –> decr dTMP –> decr DNA + protein syn 3) myelosuppression (not reversible w/ leucovorin); OD rescue w/ thymidine; photosensitivity 4) S-phase specific
Brimonide (in neurology)
1) Use: Glaucoma 2) Class/MOA: Alpha agonist, decreases aqueous humor synthesis 3) Side effects/ADEs: no pupillary of vision changes 4) Fun Facts
NSAIDs (Ibuprofen, naproxen, indomethacin, ketorolac)
1) Use: Antipyretic, analgesic, anti-inflammatory. Indomethacin is used to close a PDA. 2) Class/MOA: Reversibly inhibits cycooxygenase (both COX-1 and COX-2). Block prostaglandin synthesis. 3) Side effects/ADEs: Renal damage, fluid retention, aplastic anemia, GI distress, ulcers. 4) Fun Facts
Ranitidine
1) peptic ulcer, gastritis, mild esophageal reflux 2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell 3) decr renal exretion of Cr 4) N/A
Aspart
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia 2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen -Muscle: increase glycogen and protien synthesis and K+ uptake -Fat: aids in TG storage 3)Hypoglycemia, very rarely hypersensitivy rxns 4)Rapid-acting
-azole
Antifungal Ex: Ketoconazole
Verapamil
1) HTN, angina, arrhythmias, Prinzmetal’s angina, Raynaud’s, nodal arrhythmias (SVT) 2)Anti-arrhythmics: Ca2+ Channel Blockers(Class IV)/Block voltgae dependent L-type Ca2+ channel of cardiac and smooth muscle and thereby reduce muscle contractility -more heart effects – decrease conduction velocity, increase ERP and PR interval 3)Cardiac depression, AV block, peripheral edema, flushing, dizziness, constipation
Carbachol
1) Glaucoma, pupillary contraction, and relief of intraocular pressure. 2) Direct Cholinomimetic. 4) Carbon copy of Ach
Mineral/Vitamin: Iron dextran = Iron sucrose
1) Use: FE Deficency Anemia 2) Class/MOA: 3) Side effects/ADEs: anaphalazis 4) Fun Facts
Enoxaparin
1) immediate anticoag for PE, ACS, MI, DVT (pregnancy safe) 2) LMWH antithrombin: act more on factor Xa 3) toxicity but less risk than heparin: bleeding, HIT, osteoporosis, Rx interactions; no antidote 4) compared to heparin: better bioavail, 2~4x longer 1/2 life; sub-Q; no need to monitor
Penicillin V
1) Gram-positive organisms (S. pneumoniae, S. pyogenes, Actinomyces) & syphillis; Bactericidal for gram-positive cocci, gram-positive rods, gram-negative cocci, & spirochetes; Not penicillinase resistant 2) PO Penicillin (Prototype Beta-lactam abx;Non-penicillinase resistant); Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes 3) Hypersensitivity rxns; Hemolytic anemia 4) Resistance: Beta-lactamases cleave Beta-lactam ring
Cyclosporine
- Post-transplant immunosuppression; select autoimmune disorders 2. Binds to cyclophilins. Complex blocks differentiation and activation of Tcells–> inhibiting calcineurin–> preventing production of IL-2 and its receptor 3. Nephrotoxicity, hypertension, hyperlipidemia, hyperglycemia, tremor, gingival hyperplasia, hirsutism 4. Think old man with diabetes who wants to look good for his date so he put in dentures and got hair plugs: old (renal failure, HTN, cholesterol), diabetes (hyperglycemia), dentures (gum hyperplasia), hair plugs (hirsutism, and he is taking the drug because of his hair transplant)
Tox: Salicylates
Rx: NaHCO3 (alkalinize urine), dialysis
Albuterol
1) Use: Asthma, acute exacerbation 2) Class/MOA: Beta 2 agonist, relaxes broncial smooth muscle 3) Side effects/ADEs: 4) Fun Facts
Finasteride
1) Use: BPH, hair growth male pattern baldness 2) Class/MOA: Antiandrogen/5alpha reductase inhibitor (decrease conversion of testosterone to DHT) 3) Side effects/ADEs: Female breast growth
Furosemide
1) Use: Edema (CHF, cirrhosis, nephrotic syndrome, pulmonary edema), HTN, hypercalcemia 2) Class/MOA: Loop diuretic. Inhibits cotransport system (Na, K, 2Cl) of thick ascnding limb, preventing solutes from entering medulla. Prevents concentration of urine. Stimulates PGE release for vasodilation. Increases calcium release. 3) Side effects/ADEs: OH DANG! (Ototoxicity, hypokalameia, dehydration, allergy-sulfa, nephritis, gout) 4) Fun Facts: Inhibited by NSAIDS
Haloperidol
1) Use: Positive symptoms of schizophrenia, psychosis, mania, tourrettes 2) Class/MOA: High potency, typical, antipsychotic. Block D2 receptor 3) Side effects/ADEs: Mostly EPS (dyskinesia) b/c high potency 4) Fun Facts: Neurolepic malignant syndrome is dangerous toxicity of all antipsychotic
Cytarabine (arabinofuranosyl cytidine)
1) leukemia, lymphoma 2) pyrimidine analog –> inhibit DNA polymerase 3) leukopenia, thrombocytopenia, megaloblastic anemia 4) S-phase specific
Timolol, betazolol, carteolol (in neurology)
1) Use: Glaucoma 2) Class/MOA: Beta blocker, decreases aqueous humor secretion 3) Side effects/ADEs: no pupillary or vision changes 4) Fun Facts
COX-2 Inhibitor (celecoxib)
1) Use: Rheumatoid and osteoarthritis; patients with gastritis or ulcers. 2) Class/MOA: Reversibly inhibits the cycooxygenase (COX) isoform 2, which is found in inflammatory cells and vascular endothelium and mediates inflammation and pain; spares COX-1, which maintains the gastric mucosa. Thus, should not have the corrosive effects of other NSAIDs on the GI lining. 3) Side effects/ADEs: Increased risk of thrombosis. Sulfa allergy. Less toxicity to GI mucosa (lower incidence of ulcers, bleeding than NSAIDs). 4) Fun Facts
Famotidine
1) peptic ulcer, gastritis, mild esophageal reflux 2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell 3) decr renal exretion of Cr 4) N/A
Glulisine
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia 2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen -Muscle: increase glycogen and protien synthesis and K+ uptake -Fat: aids in TG storage 3)Hypoglycemia, very rarely hypersensitivy rxns 4)Rapid-acting
-cillin
Penicillin Ex: Methicillin
Diltiazem
1) HTN, angina, arrhythmias, Prinzmetal’s angina, Raynaud’s, nodal arrhythmias (SVT) 2)Anti-arrhythmics: Ca2+ Channel Blockers (Class IV)/Block voltgae dependent L-type Ca2+ channel of cardiac and smooth muscle and thereby reduce muscle contractility -more heart effects – decrease conduction velocity, increase ERP and PR interval 3)Cardiac depression, AV block, peripheral edema, flushing, dizziness, constipation
Pilocarpine
1) Potent stim of sweat, tears, saliva. Contracts ciliary m of eye (open angle) and pupillary sphincter (narrow angle) 2) Direct Cholinomimetic 4) Resistant to AchE
Mineral/Vitamin: Folic Acid
1) Use: PND, traumatic cardiac hemolytic anemia, folate defiency (alcoholism) 2) Class/MOA: 3) Side effects/ADEs: 4) Fun Facts
Dalteparin
1) immediate anticoag for PE, ACS, MI, DVT (pregnancy safe) 2) LMWH antithrombin: act more on factor Xa 3) toxicity but less risk than heparin: bleeding, HIT, osteoporosis, Rx interactions; no antidote 4) compared to heparin: better bioavail, 2~4x longer 1/2 life; sub-Q; no need to monitor
Methicillin
1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site) 2) PNC-Resistant PNCs; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group 3) Hypersensitivity rxns; Interstitial nephritis (Methicillin specific)
Tacrolimus (FK-506)
- Post- organ transplant immunosuppression; POTENT 2. Binds to FK protein->inhibiting calcineurin->preventing IL-2 3. Nephrotoxicity, hypertension, hyperlipidemia, hyperglycemia, tremor 4. Think old with diabetes who is nervous because he is super sick: old (renal failure, HTN, cholesterol), diabetes (hyperglycemia), nervous (tremor), super sick (strong immunosuppressant)
Tox: Amphetamines (basic)
Rx: NH4Cl (acidify urine)
Salmeterol, formoterol
1) Use: Asthma, prophylaxis 2) Class/MOA: Beta 2 agonist, relaxes bronchial smooth muscle, long acting 3) Side effects/ADEs: Tremor, arrhythmia 4) Fun Facts
Flutamide
1) Use: Prostate carcinoma 2) Class/MOA: Antiandrogen/ nonsteroidal competitive inhibitor of androgesn at testosterone receptor
Ethacrynic acid
1) Use: Diuresis for people with sulfa allergies 2) Class/MOA: Phenoxyacetic acid derivative. Inhibits Na, K, Cl cotransporter in ascending limb 3) Side effects/ADEs: OH DANG! (Same as furosemide) 4) Fun Facts: Same MOA as furosemide. Can be used in hyperuricemia
Chlorpromazine
1) Use: Positive symptoms of schizophrenia, psychosis, mania, tourrettes 2) Class/MOA: Low potency, typical, antipsychotic. Block D2 receptor 3) Side effects/ADEs: blocking muscarinics (dry mouth), from blocking alpha 1 (hypotension), from blocking histamine (sedation), Neuroloeptic malignant syndromey 4) Fun Facts: Neurolepic malignant syndrome is dangerous toxicity of all antipsychotic
Azathioprine
1) leukemias 2) purine (thiol) analog –> decr de novo purine syn 3) BM, GI, liver; metabolized by xanthine oxidase so incr toxicity w/ allopurinol 4) S-phase specific; activated by HGPRT
Acetazolamide (in Neurology)
1) Use: Glaucoma 2) Class/MOA: Diuretic, decreases aqueous humor secretion due to decreased HCO3- (via inhibition of carbonic anhydrase) 3) Side effects/ADEs: No pupillary or vision changes 4) Fun Facts
Acetaminophen
1) Use: Antipyretic, analgesic, but lacking anti-inflammatory properties. Used instead of aspirin to prevent Reye’s syndrome in children with viral infections. 2) Class/MOA: Reversibly inhibits cycooxygenase, mostly CNS. Inactivated peripherally. 3) Side effects/ADEs: Overdose produces hepatic necrosis, acetaminophen metabolite depletes glutathione and forms toxic tissue adducts in the liver. N-aceylcystine is antidote - regenerates glutathione. 4) Fun Facts
Nizatidine
1) peptic ulcer, gastritis, mild esophageal reflux 2) H2 blocker: reversibly blocks histamine H2 receptor –> decr H+ secretion by parietal cell 3) decr renal exretion of Cr 4) N/A
Regular
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia 2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen -Muscle: increase glycogen and protien synthesis and K+ uptake -Fat: aids in TG storage 3)Hypoglycemia, very rarely hypersensitivy rxns 4)Short-acting
-cycline
Antibiotic, protein synthesis inhibitor Ex: Tetracycline
Amlodipine
1) HTN, angina, arrhythmias, Prinzmetal’s angina, Raynaud’s 2)Ca2+ Channel Blockers/Block voltgae dependent L-type Ca2+ channel of cardiac and smooth muscle and thereby reduce muscle contractility -more vascular smooth muscle effects 3)Cardiac depression, AV block, peripheral edema, flushing, dizziness, constipation
Methacholine
1) Challenge test –> dx of asthma. 2) Direct Cholinomimetic, stim muscarinic r in airway
Mineral/Vitamin: Vitamin B12
1) Use: Pernicious Anemia 2) Class/MOA: 3) Side effects/ADEs: 4) Fun Facts
Lepirudin
1) immediate anticoag for pts w/ HIT 2) antithrombin 3) N/A 4) deriv of hirudin (leeches)
Nafcillin
1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site) 2) PNC-Resistant PNCs; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group 3) Hypersensitivity rxns 4) Use naf for staph!
Sirolimus (rapamycin)
- Immunosuppression post-KIDNEY transplant (Give with cyclosporine); used with drug-eluting stents 2. Inhibits mTOR. Decreased cell proliferation in response to IL-2 3. Hyperlipidemia, thrombocytopenia, leukopenia 4. SIROlimus= SERIOUS complications: immunosuppression
Tox: AchE inhibitors, organophosphates
Rx: Atropine, Pralidoxime
Ipratropium
1) Use: asthma, COPD (tiotropium) 2) Class/MOA: Long Acting muscarinic antagonist/ competeitve block of muscarinic receptors, prevents bronchoconstriction 3) Side effects/ADEs: 4) Fun Facts
Ketoconazole
1) Use: Polycystic ovarian syndrome to prevent hirsutism 2) Class/MOA: Antiandrogen/ inhibits 17,20 desmolase and inhibits steroid synthesis 3) Side effects/ADEs: Gynecomastia and amenorrhea
Hydrochlorothiazide
1) Use: HTN, CHF, idiopathic hypercalciuria, nephrogenic DI 2) Class/MOA: Inhibits NaCl reabsorption in early DCT, limiting diluting capacity. Decrease calcium excretion. 3) Side effects/ADEs: HyperGLUC (hyperglycemia, hyperlipidemia, hyperuricemia, hpercalcemia). Hypokalemic matabolic alkalosis, hyponatremia, sulfa allergy. 4) Fun Facts:
Thioridazine
1) Use: Positive symptoms of schizophrenia, psychosis, mania, tourrettes 2) Class/MOA: Low potency, typical, antipsychotic. Block D2 receptor 3) Side effects/ADEs: blocking muscarinics (dry mouth), from blocking alpha 1 (hypotension), from blocking histamine (sedation), Neuroloeptic malignant syndromey 4) Fun Facts: Neurolepic malignant syndrome is dangerous toxicity of all antipsychotic
6-mercaptopurine (6-MP)
1) leukemias 2) purine (thiol) analog –> decr de novo purine syn 3) BM, GI, liver; metabolized by xanthine oxidase so incr toxicity w/ allopurinol 4) S-phase specific; activated by HGPRT
Direct Cholinomimetics (pilocarpine, carbachol) or Indirect Cholinomimetics (physostigmine, ecchothiophate)
1) Use: Glaucoma 2) Class/MOA: Cholinomimetics, increases the outflow of the aqueous humor; contract ciliary muscle and open trabecular meshwork; use pilocarpine in emergencies, very effective at opening meshwork into canal of Schlemm 3) Side effects/ADEs: Miosis, cyclospasm 4) Fun Facts
Bisphosphonates (Etidronate, pmidronate, alendronate, risedronate, zoledronate (IV))
1) Use: Maligancy associated hypercalcemia, Paget’s diseases of the bone, postmenopausal osteoproposis. 2) Class/MOA: Inhibit osteoclastic activity; reduces both formation and resorption of hydroxyapatite. 3) Side effects/ADEs: Corrosive esophagitis (except zoledronate), nausea, diarrhea, osteonecrosis of the jaw. 4) Fun Facts
Omeprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
NPH
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia 2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen -Muscle: increase glycogen and protien synthesis and K+ uptake -Fat: aids in TG storage 3)Hypoglycemia, very rarely hypersensitivy rxns 4)Intermediate
-navir
Antibiotic, protease inhibitor Ex: Saqyubavir
Hydralazine
1)Severe HTN (pregnancy), CHF, reflex tachycardia (w/ beta-blocker) 2)Increase cGMP to cause sm. muscle relaxation -vasodilates arterioles > veins -Afterload reduction 3) Compensatory tachycardia, fluid retention, nausea, headache, angina, lupus-like syndrome 4) Contraindicated in angina and CAD
Neostigmine
1) Post-op and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular jxn blockade (post-op). 2) Indirect Cholinomimetic; increases Ach. 4) No CNS penetration
Desferrioxamine (Deferoozamine or Desferal)
1) Use: Thalasemias, or other disease with regular blood transfusions - helps avoid iron overload (causes cirrhosis, CHF, DM) 2) Class/MOA: IRON CHELATOR (NOT ORAL!) 3) Side effects/ADEs: 4) Fun Facts
Bivalirudin
1) immediate anticoag for pts w/ HIT 2) antithrombin 3) N/A 4) deriv of hirudin (leeches)
Dicloxacillin
1) S. aureua (except MRSA; resistant d/t altered PNC-binding protein target site) 2) PNC-Resistant; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Narrow spectrum; Penicillinase resistant b/c of bulkier R-group 3) Hypersensitivity rxns
Azathioprine
- Immunosuppression post-KIDNEY transplant; autoimmune disorders (including glomerulonephritis and hemolytic anemia) 2. Antimetabolite. Blocks 6-mercaptopurine synth-> decreased synthesis of nucleic acids. Toxic to proliferating lymphocytes. 3. Bone marrow suppression. 4. Active metabolite (mercaptopurine) is metabolized by xanthine oxidase so more toxic when given with allopurinol
Tox: Antimuscarinic, anticholinergic agents
Rx: Physostigmine salicylate, control hyperthermia
Beclomethasone, fluticasone
1) Use: 1st line for chronic asthma 2) Class/MOA: Corticosteroid/ inhibits the synthesis of virtually all cytokines. Inactivates NFkB transcription factor for production of TNF alpha, among other inflammatory agents 3) Side effects/ADEs: 4) Fun Facts
Sprionolactone
1) Use: Polycytic ovarian syndrome prevent hirsuitsm 2) Class/MOA: Antiandrogen/inhibits steroid binding 3) Side effects/ADEs: Gynecomastia and amenorrhea
Spironolactone
1) Use: Hyperaldosteronism, K+ depletion, CHF 2) Class/MOA: K+ sparing diuretic. Spironolactone is a competitive aldosterone receptor antagonist in cortical collecting duct. 3) Side effects/ADEs: Hyperkalemia (arrhythmias), endocrine effects (gynecomastia and other androgen effects) 4) Fun Facts: The K+ STAys (Spironolactone, triamterene, amiloride)
Olanzapine
1) Use: Pos and negative schizoprenia symptoms. Bipolar, OCD, anxiety disorder, depression, mania, tourette’s 2) Class/MOA: Atypical antipsychotic. Varied effect on 5-HT2, dopamine, alpha and H1 receptors 3) Side effects/ADEs: Fewer EPS and anticholinergics than typicals. Olanzapine specific: weight gain 4) Fun Facts:
6-thioguanine (6-TG)
1) leukemias 2) purine (thiol) analog –> decr de novo purine syn 3) BM, GI, liver; metabolized by xanthine oxidase so incr toxicity w/ allopurinol 4) S-phase specific; activated by HGPRT
Latanoprost (PGF 2 alpha)
1) Use: Glaucoma 2) Class/MOA: Prostaglandin, increase the outflow of aqueous humor 3) Side effects/ADEs: darkens color of iris (browning) 4) Fun Facts
Chronic Gout Drug (Probenecid)
1) Use: Chronic Gout (urate lowering therapy) 2) Class/MOA: Inhibits resorption of uric acid in the PCT (also inhibits secretion of penicillin) 3) Side effects/ADEs: 4) Fun Facts
Lansoprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Glargine
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia 2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen -Muscle: increase glycogen and protien synthesis and K+ uptake -Fat: aids in TG storage 3)Hypoglycemia, very rarely hypersensitivy rxns 4)Long-acting
CNS
-triptan, -ane, -caine, -operidol, -azine, -barbital, -zolam, -azepam, -etine, -ipramine, -trptyline
Nitroprusside
1)Malignant HTN 2)Increases cGMP via direct release of NO; short acting 3) Cyanide toxicity
Pyridostigmine
1) Myasthenia gravis (long acting) 2) Indirect Cholinomimetic; increases Ach, increases strength. 4) No CNS penetration
Deferasirox (EXJADE)
1) Use: Thalasemias, or other disease with regular blood transfusions - helps avoid iron overload (causes cirrhosis, CHF, DM) 2) Class/MOA: Iron Cheltors ORAL 3) Side effects/ADEs: 4) Fun Facts
Warfarin (Coumadin)
1) chronic anticoag: post STEMI, VTE prophylaxis, prevent stroke in afib (teratogenic) 2) antiplt: interfere w/ nl syn + carboyxlation of vit-K clotting factors (1972: X, IX, VII, II) + proteins C, S 3) bleeding, teratogenic, skin/tissue necrosis*, Rx interactions; give vit K for OD, give FFP for severe OD 4) cyt P450 met; incr PT (extrinsic path); long 1/2 life; follow PT/INR; PO
Ampicillin
1) Extended-spectrum PNC–Haemophilus influenza, E. Coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci (HELPSS kill enterococci) 2) AminoPNCs; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Wider spectrum; Penicillinase sensitive. Also combine w/ clavulonic acid to protect against Beta-lactamase. 3) Hypersensitivity rxs; Ampicillin rash; Pseudomemranous colitis 4) Resistance: Beta-lactamases cleave Beta-lactam ring
Muromonab-CD3 (OKT3)
- Immunosuppression post-KIDNEY transplant 2. Monoclonal antibody to CD3 on T-cells. Blocks interaction with CD3 responsible for T-cell signal transduction 3. Cytokine release syndrome, hypersensitivity reaction 4. Antibodies= hypersensitivity, hypersensitivity= cytokine release -nab= monocolonal antibody therapy (usually)
Tox: B-blockers
Rx: Glucagon
Montelukast, zafirlukast
1) Use: Block Asthma, especially aspirin induced 2) Class/MOA: Antileukotrienes/block leukotriene receptor 3) Side effects/ADEs: 4) Fun Facts
Estrogens (ethinyl estradiol, DES, mestranol)
1) Use: Hypogonadism, ovarian failure, menstural abnormalities, HRT postmenopausal, men with androgen dependent prostate cancer 2) Class/MOA: Binds estrogen receptors 3) Side effects/ADEs: Increase risk endometrial cancer, bleed postmenopausal, vaginal clear cell adenocarcinoma if exposed to DES in utero, increase risk thormbi 4) Fun Facts: contraindicated if ER positive breast cancer or history of DVTs
Triamterene
1) Use: Hyperaldosteronism, K+ depletion, CHF 2) Class/MOA: K+ sparing diuretic. Triamterene and amiloride block Na channel in CCT. 3) Side effects/ADEs: Hyperkalemia (arrhythmias), endocrine effects (gynecomastia and other androgen effects) 4) Fun Facts: The K+ STAys (Spironolactone, triamterene, amiloride)
Clozapine
1) Use: Pos and negative schizoprenia symptoms. Bipolar, OCD, anxiety disorder, depression, mania, tourette’s 2) Class/MOA: Atypical antipsychotic. Varied effect on 5-HT2, dopamine, alpha and H1 receptors 3) Side effects/ADEs: Fewer EPS and anticholinergics than typicals. Clozapine specific: weight gain, agranulocytosis and seizures. 4) Fun Facts: Must monitor WBC. Must watch clozapine clozely
Dactinomycin (actinomycin D)
1) Wilm’s tumor, Ewin’s sarcoma, rhabdomyosarcoma; peds tumors 2) intercalates in DNA 3) myelosuppression 4) N/A
Opiod Analgesics (morphine, fentanyl, codeine, heroine, methandone, meperidine, dexomethophan diphenoxylate)
1) Use: Pain, cough suppression (dextromethophran), diarrhea (loperamide and diphenoxylate), acute pulmonary edema, maintenance program for addicts (methadone). 2) Class/MOA: Acts as agonists at opioid receptors (mu = morphine, delta = enkephalin, kappy = dynorphin) to modulate synaptic transmission - open K+ channels, close Ca2+ channels = decrease in synaptic transmission. Inhibit release of ACh, NE, 5-HT, glutamate, substance P. 3) Side effects/ADEs: Addiction, respiratory depression, constipation, miosis (pinpoint pupils), addictive CNS depression with other drugs. Tolerance does not develop with miosis and constipation. Toxicity treated with nalazone or naltrexone (opiod receptor antagonist). 4) Fun Facts
Chronic Gout Drug (Allopurinol)
1) Use: Chronic Gout (urate lowering therapy) 2) Class/MOA: Inhibits xanthine oxidase, decreases conversion of xanthine to uric acid. Also used in lymphoma and leukemia to prevent tumor lysis-associated urate nephropathy. Increases concentration of azathioprine and 6-MP (both normally metabolized by xanthine oxidase). 3) Side effects/ADEs: Do not dive salicylates; all but the highest dosages depress uric acid clearance. Even high doses (5-6 g/day) have only minor uricosuric activity. 4) Fun Facts
Esomeprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Detemir
1)Type I DM, Type II DM, gestational DM, life-threatening hyperkalemia, stress-induced hyperglycemia 2)Insulin/Bind insulin receptor (tyrosine kinase activity) -Liver: increase glucose stored as glycogen -Muscle: increase glycogen and protien synthesis and K+ uptake -Fat: aids in TG storage 3)Hypoglycemia, very rarely hypersensitivy rxns 4)Long-acting
-triptan
5-HT 1B/1D agonists (for migranes) Ex: Sumatriptan
Fenoldopam
1)Malignant HTN 2)Dopamine (D1) receptor agonist -leads to coronary, peripheral, renal, and splanchnic vasodilation -decreases BP and increases naturesis
Edrophonium
1) Diagnosis of myasthenia gravis (short acting). 2) Indirect Cholinomimetic; increases endogenous Ach
Epoeitin
1) Use: anemia 2) Class/MOA: GROWTH FACTOR EPO = increases RBC 3) Side effects/ADEs: 4) Fun Facts
Alteplase (tPA)
1) early MI, early ischemic stroke, direct thrombolysis of severe PE 2) thrombolytic: aid plasminogen –> plasmin to cleave thrombin + fibrin clots 3) bleeding (contraindicate in active bleed, intracranial bleed hx, recent sx, known bleed diathese, severe HTN); tx toxicity w/ aminocaproic acid (inhibits fibrinolysis) 4) incr PT, PTT; no change in plt ct
Amoxicillin
1) Extended-spectrum PNC–Haemophilus influenza, E. Coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, enterococci (HELPSS kill enterococci) 2) AminoPNCs; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Wider spectrum; Penicillinase sensitive. Also combine w/ clavulonic acid to protect against Beta-lactamase. 3) Hypersensitivity rxs; Ampicillin rash; Pseudomemranous colitis 4) Resistance: Beta-lactamases cleave Beta-lactam ring; AmOxicillin has greater Oral bioavailability vs Ampicillin
Tox: Digitalis
Rx: Normalize K+, Lidocaine, Anti-dig Fab fragments, Mg2+
Zileuton
1) Use: Asthma 2) Class/MOA: Antileukotrienes/5 lipoxygenase pathway inhibitor, blocks conversion of arachidonic acid to leukotrienes 3) Side effects/ADEs: 4) Fun Facts
Clomiphene
1) Use: Infertility and PCOS 2) Class/MOA: Selective estrogen receptor modulator (SERMs)/ partial agonist at estrogen receptors in hypothalamus, prevents normal feedback inhibition and increases relase of LH and FSH from pituitary and stimulates ovulaiton 3) Side effects/ADEs: Hot flashes, ovarian enlargement, multiple simultaneous pregnancies, visual disturbances 4) Fun Facts: Remember, infertile, take clomiphene have twins, seeing double
Amiloride
1) Use: Hyperaldosteronism, K+ depletion, CHF 2) Class/MOA: K+ sparing diuretic. Triamterene and amiloride block Na channel in CCT. 3) Side effects/ADEs: Hyperkalemia (arrhythmias), endocrine effects (gynecomastia and other androgen effects) 4) Fun Facts: The K+ STAys (Spironolactone, triamterene, amiloride)
Ziprasidone
1) Use: Pos and negative schizoprenia symptoms. Bipolar, OCD, anxiety disorder, depression, mania, tourette’s 2) Class/MOA: Atypical antipsychotic. Varied effect on 5-HT2, dopamine, alpha and H1 receptors 3) Side effects/ADEs: Fewer EPS and anticholinergics than typicals. Ziprasidone prolongs QT interval.
Doxorubicin (Adriamycin)
1) solid tumors, leukemias, lymphomas 2) makes ROS; non-covalently intercalate in DNA –> breaks DNA –> decr replication 3) cardiotoxicity* (dilated cardiomyopathy; use dexrazoxane, Fe chelator, to prevent), myelosuppression, alopecia; toxic to tissues following extravasation 4) N/A
Butorphanol
1) Use: Pain; causes less respiratory depression than dull agonists 2) Class/MOA: Partial agonist at opiod mu receptors, agonist at kappa receptors. 3) Side effects/ADEs: Causes withdrawal if on full opiod agonist. 4) Fun Facts
Chronic Gout Drug (Febuxostat)
1) Use: Chronic Gout (urate lowering therapy) 2) Class/MOA: Inhibits xanthine oxidase 3) Side effects/ADEs: 4) Fun Facts
Pantoprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Metformin
1)First-line therapy in Type II DM, can be used in pts w/o islet function 2)Biguanide/ Exact MOA unknown –> decreases gluconeogenesis, increases glycolysis, increases peripheral glucose uptake (insulin sensitivity) 3)GI upset, lactic acidosis (most serious) 4)Contraindicated in renal failure
-ane
Inhalational general anesthetic Ex: Halothane
Nitroglycerin, isosorbide dinitrate
1)Angina, pulmonary edema 2)Vasodilator – release of NO in sm. muscle –> increases cGMP and sm muscle relaxation -dilates veins >> arteries (decreases preload) 3) reflex tachycardia, hypotension, flushing, headache 4) “Monday Disease” –> devleop tolerance during the week and loss of tolerance during weekend resulting in side effects
Physostigmine
1) Anticholinergic toxicity 2) Indirect Cholinomimetic; increases Ach. 4) crosses BBB
Filgrastim (G-CSF; Neupogen); Sargramostim (GM-CSF; Leukine); Peg-Filgrastim (Neulasta)
1) Use: GROWTH FACTOR any chemo that causes neutropenia; meylosuppressive therapy 2) Class/MOA: stimulates proliferation, matruation and efficacy of NEUTROPHILS via JAK/STAT tyrosine kinase pathway 3) Side effects/ADEs: 4) Fun Facts: same as G-CSF
Reteplase (rPA)
1) early MI, early ischemic stroke, direct thrombolysis of severe PE 2) thrombolytic: aid plasminogen –> plasmin to cleave thrombin + fibrin clots 3) bleeding (contraindicate in active bleed, intracranial bleed hx, recent sx, known bleed diathese, severe HTN); tx toxicity w/ aminocaproic acid (inhibits fibrinolysis) 4) incr PT, PTT; no change in plt ct
Ticarcillin
1) Pseudomonas spp. & gram-negative rods; Susceptible to penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase) 2) Antipseudomonals; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Extended spectrum 3) Hypersensitivity rxns 4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)–Takes Care of Pseudomonas
Recombinant Cytokines
Aldesleukin (interleukin-2) Epoetin alfa (erythropoietin) Filgrastim (CSF-G) Sargramostim (CSF-GM) Alpha-Interferon Beta-Interferon Gamma-Interferon Oprelvekin (interleukin-11) Thrombopoietin
Tox: Iron
Rx: Deferoxamine, deferasirox
Omalizumab
1) Use: Allergic asthma resistant to inhaled steroid and long acting beta agonists 2) Class/MOA: Monoclonal anti IgE antibody, binds mosly unbound serum IgE 3) Side effects/ADEs: 4) Fun Facts
Tamoxifen
1) Use: Treat and prevent recurrence ER positive breast cancer 2) Class/MOA: SERM/Antagonist on breast tissue
Captopril
1) Use: HTN, CHF, diabetic renal disease, prevent heart remodeling from HTN 2) Class/MOA: Inhibit ACE to reduce angiotensin II/bradykinin and vasodilation. Renin release increases 3) Side effects/ADEs: CAPTOPRIL (Cough, Angioedema, Proteinuira, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower ATII) Hyperkalemia. Avoid with bilateral renal artery stenosis becauase ACE inhibitors reduce GFR. 4) Fun Facts: ATII receptor blockers (sartans) are similar to these without the cough.
Quetiapine
1) Use: Pos and negative schizoprenia symptoms. Bipolar, OCD, anxiety disorder, depression, mania, tourette’s 2) Class/MOA: Atypical antipsychotic. Varied effect on 5-HT2, dopamine, alpha and H1 receptors 3) Side effects/ADEs: Fewer EPS and anticholinergics than typicals.
Daunorubicin
1) solid tumors, leukemias, lymphomas 2) makes ROS; non-covalently intercalate in DNA –> breaks DNA –> decr replication 3) cardiotoxicity* (dilated cardiomyopathy; use dexrazoxane, Fe chelator, to prevent), myelosuppression, alopecia; toxic to tissues following extravasation 4) N/A
Tramadol
1) Use: Chronic pain 2) Class/MOA: Very weak opiod agonist; also inhibits serotonin and NE reuptake (works on multiple neurotransmitters - “tram it all” in) 3) Side effects/ADEs: Similar to opiods. Decreases seizure threshold. 4) Fun Facts
Acute Gout Drug (Colchicine)
1) Use: Acute Gout (urate lowering therapy) 2) Class/MOA: Binds and stabilizes tubulin to inhibit polymerization, impairing leukocyte chemotaxis and deregulation. 3) Side effects/ADEs: GI side effects, especially if given orally (note: Indomethacin is less toxic, also used in acute gout). 4) Fun Facts
Dexlansoprazole
1) peptic ulcer, gastritis, esophageal reflux, Zollinger-Ellison syn 2) proton pump inhibitor: irreversibly inhibits H+/K+ ATPase in stomach parietal cells 3) incr risk fo C. difficile infct + pneumonia; hip fractures; decr serum Mg2+ w/ long-term use 4) N/A
Tolbutamide
1)Type II DM –stimulate endogenous insulin release 2)Sulfonylureas (1st generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx 3)Disulfiram-like effects 4)Useless in Type I DM b/c requires some islet cell function
-caine
Local anesthetic Ex: Lidocaine
Lovastatin
1)Lipid-lowering agent (sig. decrease of LDL and slight decrease of triglycerides, increase HDL) 2)HMG-CoA Reductase Inhibitors/ Inhibits conversion of HMG-CoA to mevalonate (cholesterol precursor) 3)Hepatotoxicity (increase LFTs), rhabdomyolysis
Donepezil
1) Alzheimers 2) Indirect Cholinomimetic; increases Ach
IL-11 (Oprelvekin, Neumega) Rx: thrombocytopenia
1) Use: GROWTH FACTOR thrombocytopenia 2) Class/MOA: stimulates the growth of primative MEGAKARYOCYTE progenitors - increase megakaryocytes, increase peripheral platelets 3) Side effects/ADEs: fatigue, headache, CVE 4) Fun Facts:
Tenecteplase (TNK-tPA)
1) early MI, early ischemic stroke, direct thrombolysis of severe PE 2) thrombolytic: aid plasminogen –> plasmin to cleave thrombin + fibrin clots 3) bleeding (contraindicate in active bleed, intracranial bleed hx, recent sx, known bleed diathese, severe HTN); tx toxicity w/ aminocaproic acid (inhibits fibrinolysis) 4) incr PT, PTT; no change in plt ct
Carbenicillin
1) Pseudomonas spp. & gram-negative rods; Susceptible to penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase) 2) Antipseudomonals; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Extended spectrum 3) Hypersensitivity rxns 4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)–Takes Care of Pseudomonas
Aldesleukin
- Renal cell carcinoma Metastatic Melanoma 2. Cytokine: Interleukin-2 MOA: increases helper, cytotoxic, and regulatory T cells
Tox: Lead
Rx: CaEDTA, dimercaprol, succimer, penicillamine
Theophylline
1) Use: Asthma 2) Class/MOA: Methylxanthines/ causes bronchodilation by inhibiting phosphodiesterase, thereby decreasing cAMP hydrolysis, blocks adenosine 3) Side effects/ADEs: cardiotoxicity, neurotoxicity, metabolized by P450 these limit use 4) Fun Facts
Raloxifene
1) Use: Osteoporosis 2) Class/MOA: SERM/Agonist on bone, reduces resorption of bone
Enalapril
1) Use: HTN, CHF, diabetic renal disease, prevent heart remodeling from HTN 2) Class/MOA: Inhibit ACE to reduce angiotensin II/bradykinin and vasodilation. Renin release increases 3) Side effects/ADEs: CAPTOPRIL (Cough, Angioedema, Proteinuira, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower ATII) Hyperkalemia. Avoid with bilateral renal artery stenosis becauase ACE inhibitors reduce GFR. 4) Fun Facts: ATII receptor blockers (sartans) are similar to these without the cough.
Risperadone
1) Use: Pos and negative schizoprenia symptoms. Bipolar, OCD, anxiety disorder, depression, mania, tourette’s 2) Class/MOA: Atypical antipsychotic. Varied effect on 5-HT2, dopamine, alpha and H1 receptors 3) Side effects/ADEs: Fewer EPS and anticholinergics than typicals.
Bleomycin
1) testicular CA, Hodgkin’s lymphoma 2) ROS formation –> causes breaks in DNA strands 3) pulm fibrosis*, skin changes; minimal myelosuppression 4) N/A
Phenytoin
1) Use: Epilepsy drug, used in: partial simple, partial complex, 1st line for generalized tonic clonic, 1st line for prophylaxis of generalized status seizures. Also a class IB antiarrhytimic. 2) Class/MOA: Increases Na+ channel inactivation, I.E. use-dependent blockade of Na+ channels: increase refractory period, inhibition of glutamate release from excitatory presynaptic neuron 3) Side effects/ADEs: Nystagmus, diplopia, ataxias, sedation, teratogenesis (fetal hydantion syndrome), SLE-like syndrome, induction of cytrocrome P-450. Chronic use produces gingival hyperplasia in children, peripheral neuropathy, hirtuim, meglobastic anemia (decrease in folate absorption). 4) Fun Facts: fosphentoin for parenteral use
Acute Gout Drug (NSAIDs)
1) Use: Acute Gout (urate lowering therapy) 2) Class/MOA: Naproxen. 3) Side effects/ADEs: 4) Fun Facts
Bismuth
1) incr ulcer healing, traveler’s diarrhea 2) bind ulcer base to provide physical protection + let HCO3- secretion re-establish pH gradient in mucus layer 3) N/A 4) N/A
Chlorpropamide
1)Type II DM –stimulate endogenous insulin release 2)Sulfonylureas (1st generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx 3)Disulfiram-like effects 4)Useless in Type I DM b/c requires some islet cell function
-operidol
Butyrophenone (neuroleptic) Ex: Haloperidol
Pravastatin
1)Lipid-lowering agent (sig. decrease of LDL and slight decrease of triglycerides, increase HDL) 2)HMG-CoA Reductase Inhibitors/ Inhibits conversion of HMG-CoA to mevalonate (cholesterol precursor) 3)Hepatotoxicity (increase LFTs), rhabdomyolysis
ADE of all Cholinomimetics
Exacerbation of COPD, asthma, and peptic ulcers
Growth Factor: Romiplostim (Nplade) - Thrombopoeitin analog - Rx for chronic ITP
1) Use: GROWTH FACTOR thrombocytopenia 2) Class/MOA: same as IL-12: stimulates growth of primative megakarycytic progenitors, increasing megakaryocytes, increasing platelets 3) Side effects/ADEs: fatigue, headache, CVE 4) Fun Facts
Aspirin (ASA)
1) antipyretic, analgesic, anti-infl, anti-plt (decr aggregation) 2) irreversibly inhibits COX-1 (and -2) via covalent acetylation –> decr TxA2 + prostaglandins 3) gastric ulcer, tinnitus (CN VIII); chronic use: acute renal failure, interstitial nephritis, upper GI bleed; Reye’s syn in kids w/ viral infct; OD: respir alkalosis + met acidosis 4) plts can’t syn new COX so effect lasts until new plts made; incr bleeding time; no effect on PT, PTT
Piperacillin
1) Pseudomonas spp. & gram-negative rods; Susceptible to penicillinase; Use w/ Clavulonic acid (to protect against Beta-lactamase) 2) Antipseudomonals; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). Extended spectrum 3) Hypersensitivity rxns 4) TCP (Ticarcillin, Carbenicillin, & Piperacillin)–Takes Care of Pseudomonas
Epoetin alfa
- Anemias (esp in renal failure) 2. Cytokine: Erythropoietin MOA: Stimulates Erythrocyte replication
tox: Mercury, arsenic, gold
Rx: Dimercaprol (BAL), succimer
Guaifenesin
1) Use: Expectorant 2) Class/MOA: Thins respiratory secreitons, doesn’t suppress cough reflex 3) Side effects/ADEs: 4) Fun Facts
Hormone Replacement Therapy
1) Use: Relief/prevent menopausal symptoms (hot flashes, vaginal atrophy) and osteoporosis 2) Class/MOA: 3) Side effects/ADEs: Unopossed estrogen replacement therapy (ERT) causes increase endometrial cancer so add progesterone, possible increase in CV risk
Lisinopril
1) Use: HTN, CHF, diabetic renal disease, prevent heart remodeling from HTN 2) Class/MOA: Inhibit ACE to reduce angiotensin II/bradykinin and vasodilation. Renin release increases 3) Side effects/ADEs: CAPTOPRIL (Cough, Angioedema, Proteinuira, Taste changes, hypOtension, Pregnancy problems, Rash, Increased renin, Lower ATII) Hyperkalemia. Avoid with bilateral renal artery stenosis becauase ACE inhibitors reduce GFR. 4) Fun Facts: ATII receptor blockers (sartans) are similar to these without the cough.
Aripiprazole
1) Use: Pos and negative schizoprenia symptoms. Bipolar, OCD, anxiety disorder, depression, mania, tourette’s 2) Class/MOA: Atypical antipsychotic. Varied effect on 5-HT2, dopamine, alpha and H1 receptors 3) Side effects/ADEs: Fewer EPS and anticholinergics than typicals.
Cyclophosphamide
1) solid tumors, leukemia, lymphoma, some brain CAs 2) alkylating agent: covalently X-link DNA at guanine N-7 3) myelosuppression; hemorrhagic cystitis (partly prevent w/ mesna, thiol grp of mesna binds toxic metabolite) 4) need liver bioactivation
Carbamazepine
1) Use: Epilepsy drug, used in: first line in partial simple, partial complex & generalized tonic clonic seizures 2) Class/MOA: Increases Na+ channel inactivation 3) Side effects/ADEs: Diplopia, ataxia, blood dyscrasias (agranulocytosis, aplastic anemia), liver toxicity, teratogenesis, induction of cytrochrome P-450, SIADH, Steven’s-Johnson syndrome 4) Fun Facts: fist line for trigeminal neuralgia
The alpha inhibitors (Entanercept)
1) Use: Rheumatoid arthritis, psoriasis, ankylosing spondylitis. 2) Class/MOA: Recombinant form of human TNF receptor that binds TNF. 3) Side effects/ADEs: All TNF alpha inhibitors predispose to infection including reactivation of latent TB since TNF blockade prevents activation of macrophages and destruction of phagocytosed microbe. 4) Fun Facts: EntanerCEPT is a TNF decoy reCEPTor.
Sucrafate
1) incr ulcer healing, traveler’s diarrhea 2) bind ulcer base to provide physical protection + let HCO3- secretion re-establish pH gradient in mucus layer 3) N/A 4) N/A
Glyburide
1)Type II DM – stimulates endogenous insulin release 2)Sulfonylureas (2nd generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx 3)Hypoglycemia 4)Useless in Type I DM b/c requires some islet cell funciton
-azine
Phenothiazine (neuroleptic, antiemetic) Ex: Chlorpromazine, compazine
Simvastatin
1)Lipid-lowering agent (sig. decrease of LDL and slight decrease of triglycerides, increase HDL) 2)HMG-CoA Reductase Inhibitors/ Inhibits conversion of HMG-CoA to mevalonate (cholesterol precursor) 3)Hepatotoxicity (increase LFTs), rhabdomyolysis
Organophosphate poisoning (e.g. Parathion)
Irreversibly inhib AchE. (DUMBBELSS) Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal m and CNS, Lacrimation, Sweating, and Salivation
Asprinin
1) Use: PLATELET INHIBITOR 2) Class/MOA: Actylates and irreversibly inhibits COX-1 and COX-2 to prevent conversion of arachadonic acid to thromboxane A2 3) Side effects/ADEs: increase BT, no effect on PT, PTT | Gastric ulcertation, bleeding, hyperventilation, Reye’s Syndr
Clopidogrel
1) ACS, coronary stenting, decr incidence + recurr of thrombotic stroke 2) ADP R inhibitor: inhibit plt aggregation by irreversibly blocking ADP R; inhibit fibrinogen binding via Gp IIb/IIIa 3) N/A 4) N/A
Clavulonic Acid
1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase) 2) Beta-lactamase inhibitor 3) – 4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)
Filgrastim
- Recovery of bone marrow 2. GM-CSF (Granulocyte Colony Stimulating Factor)
Tox: Copper, arsenic, gold
Rx: Penicillamine
N-acetylcysteine
1) Use: Expectorant, CF patients, antidote for acetaminophen overdose 2) Class/MOA: Mucolytic, loosen mucous plugs (CF patients) 3) Side effects/ADEs: 4) Fun Facts
Anastrozole/ exemestane
1) Use: Postmenopausal women with breast cancer 2) Class/MOA: Aromatase inhibitor
What do all diuretics do to serum/urine NaCl?
Increase NaCl in urine. Decrease NaCl in serum
Lithium
1) Use: Bipolar, SIADH 2) Class/MOA: Not established. Related to phosphoinositol cascade (?) 3) Side effects/ADEs: Movement, Nephrogenic DI, hypOthyroidism, Pregnancy (LMNOP) 4) Fun Facts: May cause fetal cardiac defects, excreted by kidneys
Ifosfamide
1) solid tumors, leukemia, lymphoma, some brain CAs 2) alkylating agent: covalently X-link DNA at guanine N-7 3) myelosuppression; hemorrhagic cystitis (partly prevent w/ mesna, thiol grp of mesna binds toxic metabolite) 4) need liver bioactivation
Gabapentin
1) Use: Epilepsy drug, used in: partial simple, partial complex & generalized tonic clonic seizures 2) Class/MOA: Designed as a GABA analog, but primarily inhibits HVA Ca2+ channels 3) Side effects/ADEs: sedation, ataxia 4) Fun Facts: also used for peripheral neuropathy and bipolar disorder
The alpha inhibitors (Infliximab)
1) Use: Chron’s disease, rheumatoid arthritis, ankylosing spondylitis. 2) Class/MOA: Anti-TNF antibody 3) Side effects/ADEs: All TNF alpha inhibitors predispose to infection including reactivation of latent TB since TNF blockade prevents activation of macrophages and destruction of phagocytosed microbe. 4) Fun Facts INFLIimab INFLIX pain on TNF
Misoprostol
1) prevent NSAID-induced peptic ulcers; maintenance of patent ductus arteriosus; also induce labor (ripens cervix) 2) PEG1 analog: incr production + secretion of gastric mucus barrier; decr acid production 3) diarrhea; contraindicated in women of childbearing age (abortifacient) 4) N/A
Glimepiride
1)Type II DM – stimulates endogenous insulin release 2)Sulfonylureas (2nd generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx 3)Hypoglycemia 4)Useless in Type I DM b/c requires some islet cell funciton
-barbital
Barbituate Ex: Phenobarbital
Atorvastatin
1)Lipid-lowering agent (sig. decrease of LDL and slight decrease of triglycerides, increase HDL) 2)HMG-CoA Reductase Inhibitors/ Inhibits conversion of HMG-CoA to mevalonate (cholesterol precursor) 3)Hepatotoxicity (increase LFTs), rhabdomyolysis
Rx for Organophosphate poisoning
Atropine + Pralidoxime = regenerate active AchE
Ticlopidine, Clopidogrel (Plavix)
1) Use: PLATELET INHIBITOR 2) Class/MOA: Inhibit platelet aggregation by irreversibly blocking ADP RECEPTORS | inhibit fibrinogen binding by preventing glycoprotein Iib/I
Ticlopidine
1) ACS, coronary stenting, decr incidence + recurr of thrombotic stroke 2) ADP R inhibitor: inhibit plt aggregation by irreversibly blocking ADP R; inhibit fibrinogen binding via Gp IIb/IIIa 3) neutropenia (unique) 4) N/A
Sulbactam
1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase) 2) Beta-lactamase inhibitor 3) – 4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)
Sargramostim (CSF-GM)
- Recovery of bone marrow 2. GM-CSF (Granulocyte-Macrophage Colony Stimulating Factor)
Tox: Cyanide
Rx: Nitrite + thiosulfate, hydroxocobalamin
Bosentan
1) Use: Pulmonary arterial hypertension 2) Class/MOA: Compeitively antagonizes endothelin 1 receptors, decreasing pulmonary vascular resistance 3) Side effects/ADEs: 4) Fun Facts
Progestins
1) Use: OCP, Mirena IUD, treatment of endometrial cancer and abnormal uterine bleeding 2) Class/MOA: Binds progesterone receptors, reduce growth and increase vascularizaiton of endometrium 4) For OCP have to take at same time everyday so not as effective contraceptive
What do all diuretics do to serum/urine K?
Increase urine K. Decrease serum K
Buspirone
1) Use: Generalized anziety disorder 2) Class/MOA: Stimulates 5-HT1A receptor. 3) Side effects/ADEs: No sedation, addiction or tolerance 4) Fun Facts: No interactions with barbituates or benzodiazepines
Carmustine
1) brain tumors (incl glioblastoma multiforme) 2) alkylating agent: nitrosourea 3) CNS toxicity: dizziness, ataxia 4) needs bioactivation; X’s BBB –> CNS
Topiramate
1) Use: Epilepsy drug, used in: partial simple, partial complex & generalized tonic clonic seizures 2) Class/MOA: Blocks Na+ channels, increases GABA action 3) Side effects/ADEs: Sedation, mental dulling, kidney stones, weight loss. 4) Fun Facts
The alpha inhibitors (Adalimumab)
1) Use: Psoriasis, rheumatoid arthritis, ankylosing spondylitis 2) Class/MOA: Anti-TNF antibody 3) Side effects/ADEs: All TNF alpha inhibitors predispose to infection including reactivation of latent TB since TNF blockade prevents activation of macrophages and destruction of phagocytosed microbe. 4) Fun Facts
Octreotide
1) acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors 2) long-acting somatostatin analog 3) nausea, cramps, steatorrhea 4) N/A
Glipizide
1)Type II DM – stimulates endogenous insulin release 2)Sulfonylureas (2nd generation)/Close K+ channel in beta cell membrane so cell depolarizes –> triggers insulin release via Ca2+ influx 3)Hypoglycemia 4)Useless in Type I DM b/c requires some islet cell funciton
-zolam
Benzodiazepine Ex: Alprazolam
Rosuvastatin
1)Lipid-lowering agent (sig. decrease of LDL and slight decrease of triglycerides, increase HDL) 2)HMG-CoA Reductase Inhibitors/ Inhibits conversion of HMG-CoA to mevalonate (cholesterol precursor) 3)Hepatotoxicity (increase LFTs), rhabdomyolysis
Atropine Use/MOA
1) Blocks Organophosphate poisoning. Used to treat bradycardia and opthalmic applications 2) Muscarinic antagonist.
Abciximab (Rheopro), Eptidibatide (Integrilin) and Tirofibiban (Aggrastat)
1) Use: PLATELET INHIBITOR 2) Class/MOA: Monoclonal antibody that binds to the GLYCOPROTEIN RECEPTOR Ib/IIIa on activated platelets, preventing aggregation 3) Side effects/ADEs: bleeding, thrombocytop
Prasugrel
1) ACS, coronary stenting, decr incidence + recurr of thrombotic stroke 2) ADP R inhibitor: inhibit plt aggregation by irreversibly blocking ADP R; inhibit fibrinogen binding via Gp IIb/IIIa 3) N/A 4) N/A
Tazobactam
1) Often added to PNC abxs to protect the abx from destruction by Beta-lactamase (penicillinase) 2) Beta-lactamase inhibitor 3) – 4) CAST (Clavulonic Acid, Sulbactam, & Tazobactam)
Alpha-Interferon
- Hepatitis B and C Kaposi’s Sarcoma Leukemia Malignant Melanoma 2. Inhibit viral protein synthesis and activates NK cells to kill virally infected cells
Tox: Methemoglobin
Rx: Methylene blue, vit C
Dextromethorphan
1) Use: antitussive=cough suppressant 2) Class/MOA: Antagonizes glutamate recptors, synthetic codeine analog 3) Side effects/ADEs: Mild opioid effect when used in excess, mild abuse potential 4) Fun Facts: Naloxone can be given for overdose
Mifepristone (RU 486)
1) Use: Terminiation of pregnancy +misoprostol (PGE1) 2) Class/MOA: Competitive inhibitor of progestins at progesterone receptors 3) Side effects/ADEs: Heavy bleeding, GI effects (nausea, vomiting, anorexia), abdominal pain
What do all loop diuretics vs thiazides do to urine calcium?
Loop diuretics increase it. thiazides decrease it from enhanced paracellular calcium reabsorption in PCT and loop of henle.
Fluoxetine
1) Use: Depression, GAD, panic disorder, OCD, bulimia, PTSD, social phobias 2) Class/MOA: SSRI 3) Side effects/ADEs: GI stress, sexual dysfunction, serotonin syndrome (when combined with MAO inhibitors or TCAs) 4) Fun Facts: Takes 4-8 weeks to have an effect
Lomustine
1) brain tumors (incl glioblastoma multiforme) 2) alkylating agent: nitrosourea 3) CNS toxicity: dizziness, ataxia 4) needs bioactivation; X’s BBB –> CNS
Phenobarbital
1) Use: Epilepsy drug, used in: partial simple, partial complex & generalized tonic clonic seizures 2) Class/MOA: increased GABAA 3) Side effects/ADEs: Sedation, tolerance, dependence, induction of cytrochrome P-450 4) Fun Facts: 1st line in pregnant women, children
Aluminum hydroxide
1) esophageal reflux dz’s 2) antacid 3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; constipation + hypophosphatemia; proximal musc weakness; osteodystrophy; seizures 4) N/A
Pioglitazone
1)Monotherapy in Type II DM or in combination therapy 2)Glitazone/Thiazolidinedione: Incraeses insulin sensitivity in peripheral tissue;, binds PPAR-gamma nuclear transcription regulator 3)Weight gain, edema, hepatoxicity, heart failure
-azepam
Benzodiazepine Ex: Diazepam
Niacin (B3)
1)Lipid-lowering agent (decreases LDL and TG, sig increases HDL) 2)Inhibits lipolysis in adipose tissue, reduces hepatic VLDL secretion into circulation 3)Red flushed face, hyperglycemia (acanthosis nigrans), hyperuricemia (excerbates gout)
Atropine ADE
3) Increase body temp, rapid pulse, dry mouth, dry/flushed skin, cycloplegia, constipation. Can cause acute angle-glaucoma in elderly, urinary retention in men with BPH, hyperthermia in infants
Dipyridamole
1) Use: PLATELET INHIBITOR 2) Class/MOA: increase cAMP = decrease ADENOSINE uptake/cyclic nucleotide PDE = decreased aggregation 3) Side effects/ADEs: serious bleeding risk 4) Fun Facts
Ticagrelor
1) ACS, coronary stenting, decr incidence + recurr of thrombotic stroke 2) ADP R inhibitor: inhibit plt aggregation by irreversibly blocking ADP R; inhibit fibrinogen binding via Gp IIb/IIIa 3) N/A 4) N/A
Cefazolin
1) Gram-positive cocci, Proteus mirabilis, E. Coli, Klebsiella pneumoniae. **Cefazolin–used prior to surgery to prevent S. aureus wound infections. 2) Beta-lactam, 1st Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptible to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Orgs covered by 1st Generation=PEcK–Proteus mirabilis, E. Coli, Klebsiella pneumoniae; Orgs typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Beta-Interferon
Multiple Sclerosis
Tox: CO
Rx: 100% O2, Hyperbaric O2
Pseudoephedrine, phenylephrine
1) Use: Nonprescription nasal decongestants: Reduce hyperemia, edema and nasal congestion, obstructed eustachian tubes 2) Class/MOA: Sympathomimetic alpha antagonistic 3) Side effects/ADEs: Hypertension, CNS stimulaiton/anxiety (pseudoephedrine) 4) Fun Facts: also used as a stimulant and to make meth
Oral contraception (synthetic progestins, estrogen)
1) Use: Prevent pregnancy 2) Class/MOA: Estrogen and progestins inhibit LH/FSH and prevent estrogen surges so no LH surge and no ovulaiton. Progestins cause thickenign of cervical mucus, limiting access of sperm to uterus. Also inhibits endometrial proliferation, making endometirum less suitable for implanation of embryo 3) Side effects/ADEs: Contraindicated in smokers >35 yo becuase increase risk of DVT and CV events, patients with history of thormoembolism and storke or estrogen dependent tumor
Paroxetine
1) Use: Depression, GAD, panic disorder, OCD, bulimia, PTSD, social phobias 2) Class/MOA: SSRI 3) Side effects/ADEs: GI stress, sexual dysfunction, serotonin syndrome (when combined with MAO inhibitors or TCAs) 4) Fun Facts: Takes 4-8 weeks to have an effect
Semustine
1) brain tumors (incl glioblastoma multiforme) 2) alkylating agent: nitrosourea 3) CNS toxicity: dizziness, ataxia 4) needs bioactivation; X’s BBB –> CNS
Valproid acid
1) Use: Epilepsy drug, used in: partial simple, partial complex, 1st line in tonic clonic generalized seizures and in absence generalized seizures. 2) Class/MOA: Increases Na+ channel inactivation, increases GABA concentration 3) Side effects/ADEs: GI distress, rare but fatal hepatotoxicity (measure LFT), neural tube defects in fetus (spinal bifida), tremor, weight gain. Contraindicated in pregnancy. 4) Fun Facts: Also used for myoclonic seizures
Magnesium hydroxide
1) esophageal reflux dz’s, constipation 2) antacid; osmotic laxative: provide osmotic load to draw out H2O 3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; diarrhea; hyporeflexia; hypotension; cardiac arrest; diarrhea, dehydration 4) may be abused by bulimics
Rosiglitazone
1)Monotherapy in Type II DM or in combination therapy 2)Glitazone/Thiazolidinedione: Incraeses insulin sensitivity in peripheral tissue;, binds PPAR-gamma nuclear transcription regulator 3)Weight gain, edema, hepatoxicity, heart failure
-etine
SSRI Ex: Fluoxetine
Cholestyramine
1)Lipid-lowering agents (decrease LDL, slightly increase TG and HDL 2)Bile Acid Resins/Prevent intestinal reabsorption of bile acids (liver has to make more) 3)Bad taste, GI discomfort, decreases absorption of fat-soluble vitamins, cholesterol gallstones
Homatropine
1) Produce mydriasis and cycloplegia 2) Muscarinic antagonist
Heparin
1) Use: immediate ANTICOAG for PE, stroke, ACS, MI, DVT | used during pregnancy | follow PTT 2) Class/MOA: INHIBITS THROMBIN ACTION | cofactor for activation of ANTI-THROMBIN, decrease thrombin and Xa, short 1/2 life 3) Side effects/ADEs: Bleeding, thrombocytopenai (HIT),
Cilostazol
1) intermittent claudication, coronary vasodilation, prevent stroke/TIAs (w/ ASA), angina prophylaxis 2) PDE III inhibitor –> incr cAMP in plts –> inhibit plt aggregation; vasodilator 3) nausea, HA, facial flush, hypotension, ab pain 4) N/A
Cephalexin
1) Gram-positive cocci, Proteus mirabilis, E. Coli, Klebsiella pneumoniae 2) Beta-lactam, 1st Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptible to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Orgs covered by 1st Generation=PEcK–Proteus mirabilis, E. Coli, Klebsiella pneumoniae; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Gamma-Interferon
- Chronic Granulomatous disease 2. Activates macrophages and Th1 cells Suppresses Th2 cells. 4. (G)amma = (G)ranulomatous
Tox: Methanol, ethylene glycol (antifreeze)
Rx: Fomepizole> ethanol, dialysis
Methacholine
1) Use: Asthma challenge testing 2) Class/MOA: Muscarinic receptor agonist 3) Side effects/ADEs: 4) Fun Facts
Terbutaline
1) Use: Reduces premature uterine contraction 2) Class/MOA: B2 agonist that relaxes the uterus
Sertraline
1) Use: Depression, GAD, panic disorder, OCD, bulimia, PTSD, social phobias 2) Class/MOA: SSRI 3) Side effects/ADEs: GI stress, sexual dysfunction, serotonin syndrome (when combined with MAO inhibitors or TCAs) 4) Fun Facts: Takes 4-8 weeks to have an effect
Streptozocin
1) brain tumors (incl glioblastoma multiforme) 2) alkylating agent: nitrosourea 3) CNS toxicity: dizziness, ataxia 4) needs bioactivation; X’s BBB –> CNS
Ethosuximide
1) Use: Epilepsy drug, used in: 1st line in generalized absence seizure 2) Class/MOA: Blocks thalamic T-type Ca2+ channels 3) Side effects/ADEs: GI distress, fatigue, headache, urticaria, Steven’s-Johnson syndrome (EFGH- Ethosuximide, Fatigue, GI, Headache) 4) Fun Facts
Calcium carbonate
1) esophageal reflux dz’s 2) antacid 3) can affect absorption, bioavail or urinary excretion of other Rx by altering gastric + urinary pH or by delaying gastric emptying; hypokalemia; hypercalcemia; rebound incr in acid 4) can chelate + decr effectiveness of other Rx (ie, tetracycline)
Acarbose
1)Monotherapy in Type II DM, or in combination therapy 2)Alpha-glucosidase Inhibitor/ Inhibits intestinal brush-border alpha-glucosidases –> get delayed sugar hydrolysis and glucose absorption -decreases postprandial hyperglycemia 3)GI disturbances
-ipramine
TCA Ex: Imipramine
Colestipol
1)Lipid-lowering agents (decrease LDL, slightly increase TG and HDL 2)Bile Acid Resins/Prevent intestinal reabsorption of bile acids (liver has to make more) 3)Bad taste, GI discomfort, decreases absorption of fat-soluble vitamins, cholesterol gallstones
Tropicamide
1) Produce mydriasis and cycloplegia 2) Muscarinic antagonist
Enoxaparin (LMWH, Lovenox)
1) Use: Anticoagulation 2) Class/MOA: Cofactor for activation of ANTITHROMBIN and Xa (work better on Xa), better bioavailibilty and 2-4 times longer 1/2 life - can be administered subQ and without lab monitoring 3) Side effects/ADEs: can’t reverse esily
Dipyridamole
1) intermittent claudication, coronary vasodilation, prevent stroke/TIAs (w/ ASA), angina prophylaxis 2) PDE III inhibitor –> incr cAMP in plts –> inhibit plt aggregation; vasodilator 3) nausea, HA, facial flush, hypotension, ab pain 4) N/A
Cefoxitin
1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens 2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Orgs covered by 2nd Generation=HEN PEcKS–Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Oprelvekin
- Thrombocytopenia 2. IL-11
Tox: Opiods
Rx: Naloxone/naltrexone
What is bronchoconstriction mediated by?
1 ) Inflammatory processes 2) prasympathetic tone so therapy is direct at these 2 pathways
Tamsulosin
1) Use: BPH 2) Class/MOA: Alpha 1 antagonist, inhibits smooth muscle contraction. Selective for alpha 1 A,D receptors on prostate (not vascular alpha 1B receptor)
Citalopram
1) Use: Depression, GAD, panic disorder, OCD, bulimia, PTSD, social phobias 2) Class/MOA: SSRI 3) Side effects/ADEs: GI stress, sexual dysfunction, serotonin syndrome (when combined with MAO inhibitors or TCAs) 4) Fun Facts: Takes 4-8 weeks to have an effect
Busulfan
1) CML; also to ablate BM before BMT 2) alkylating agent 3) pulm fibrosis*; hyperpigmentation 4) N/A
Benzodiazepines for epilepsy (diazepam or lorazepam)
1) Use: Epilepsy drug, used in: 1st line for acute generalized status seizures 2) Class/MOA: Increases GABAA action 3) Side effects/ADEs: sedation, tolerance, dependence 4) Fun Facts: also used for seizures of eclampsia (1st line is MgSO4)
Magnesium citrate
1) constipation 2) osmotic laxative: provide osmotic load to draw out H2O 3) diarrhea, dehyration 4) may be abused by bulimics
Miglitol
1)Monotherapy in Type II DM, or in combination therapy 2)Alpha-glucosidase Inhibitor/ Inhibits intestinal brush-border alpha-glucosidases –> get delayed sugar hydrolysis and glucose absorption -decreases postprandial hyperglycemia 3)GI disturbances
-triptyline
TCA Ex: Amitriptyline
Colesevelam
1)Lipid-lowering agents (decrease LDL, slightly increase TG and HDL 2)Bile Acid Resins/Prevent intestinal reabsorption of bile acids (liver has to make more) 3)Bad taste, GI discomfort, decreases absorption of fat-soluble vitamins, cholesterol gallstones
Benztropine
1) Rx for Parkinsons. 2) Muscarinic Antagonist
Lepirudin, Bilirudin
1) Use: 2) Class/MOA: Hirudin derivatives; directly INHIBITS THROMBIN 3) Side effects/ADEs: 4) Fun Facts: used as an alternative to heparin for anticoagulating patients with HIT
Abciximab
1) ACS, PTCA 2) Gp IIb/IIIa inhibitor: bind R on activated plts –> prevent aggregation 3) bleeding, thrombocytopenia 4) made from monoclonal ab Fab fragments (unique)
Cefaclor
1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens 2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Orgs covered by 2nd Generation=HEN PEcKS–Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Thrombopoietin
Thrombocytopenia
Tox: Benzodiazepines
Rx: Flumazenil
Sildenafil, vardenafil
1) Use: Erectile dysfunction 2) Class/MOA: Inhibits phosphodiesterase 5, increase cGMP, smooth muscle relaxaiton in corpus cavernosum, increase blood flow and penile erection 3) Side effects/ADEs: Headache, flushing, dyspepsia, impaired blue green color vision, risk of life threatening hypotension in patients taking nitrates “Hot and sweath” but then Headace, Heartburn, Hypotension 4) Fun Facts: DON’T USE WITH NITRATES
Venlafaxine
1) Use: Depression. Venlafaxine also in GAD, panic disorders. 2) Class/MOA: SNRI, Inhibit serotonin and NE reuptake 3) Side effects/ADEs:Increased BP
Vincristine
1) solid tumors, leukemias, lymphomas 2) microtubule inhibitor: alkaloid that binds to tubulin in M phase + blocks polymerization so mitotic spindle can’t form 3) neurotoxicity: areflexia, periph neuritis; paralytic ileus 4) N/A
Benzodiazepines for neurological problems (diazepam, lorazepam, triazolam, temazepam, oxzepam, midazolam, chlodiazepoxide, alprazolam))
1) Use: anxiety, spacticity, status epileptics (lorazepam and diazepam), detoxification (especially in alcohol DTs-DTs), night terrors, sleepwalking, general anesthetic (amnesia, muscle relaxation), hypnotic (insomnia) 2) Class/MOA: Facilitate GABAA action by increasing frequency of Cl- channel opening, decreasing REM sleep. Most have long half-lives and active metabolites. FREnzodiazepines (Increase FREquency), short acting = TOM thumb (Triazolam, Oxzepam, Midazolam … also has the highest addictive potential). Benzos, barbs, and EtOH all bind GABA(A)-R which is a ligand-gated chloride channel. 3) Side effects/ADEs: dependence, additive CNS depression effects with alcohol. Less risk of respiratory depression and coma than with barbiturates. 4) Fun Facts: treat overdose with flumazenil (competitive antagonist at GABA benxodiazepine receptor)
Polyethylene glycol
1) constipation 2) osmotic laxative: provide osmotic load to draw out H2O 3) diarrhea, dehyration 4) may be abused by bulimics
Pramlinitide
1)Type I and II DM 2)Amylin Analog/ Decreases glucagon 3)Hypoglycemia, nausea, diarrhea
Autonomic
-olol, -terol, -zosin,
Ezetimibe
1) Lipid-loweing agents (decrease LDL) 2) Cholesterol Absorption Blockers/Prevent cholesterol reabsorption at small intestine brush border 3) Rare increase in LFTs, diarrhea
Scopolamine
1) Motion sickness. 2) Muscarinic antagonist
Argatroban
1) Use: HIT, patient with kidney dysfunction 2) Class/MOA: directly INHIBITS THROMBIN 3) Side effects/ADEs: falsely elevates INR levels 4) Fun Facts: irreversible
Eptifibatide
1) ACS, PTCA 2) Gp IIb/IIIa inhibitor: bind R on activated plts –> prevent aggregation 3) bleeding, thrombocytopenia 4) N/A
Cefuroxime
1) Gram-positive cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens 2) Beta-lactam, 2nd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Orgs covered by 2nd Generation=HEN PEcKS–Haemophilus influenzae, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens; Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Tox: TCAs
Rx: NaHCO3 (plasma alkalinization)
Danazol
1) Use: Endometriosis and hereditary angioedema 2) Class/MOA: Synthetic androgen acts as partial agonist at andorgen recpetors 3) Side effects/ADEs: Weight gain, edema, acne, hirsutism, masculinizaiton, decrease HDL levels, hepatotoxicity
Duloxetine
1) Use: Depression, diabetic peripheral neuropathy. 2) Class/MOA: SNRI, Inhibit serotonin and NE reuptake (greater effect on NE than other SNRI-venlafaxine). Toxicity: Convulsions, coma, cardiotoxicity (treat with NaBicarb) 3) Side effects/ADEs:Increased BP
Vinblastine
1) solid tumors, leukemias, lymphomas 2) microtubule inhibitor: alkaloid that binds to tubulin in M phase + blocks polymerization so mitotic spindle can’t form 3) BM suppression (VinBLASTine BLASTS Bone Marrow) 4) N/A
Tiagabine
1) Use: epilepsy drug, used in: partial simple and partial complex seizures 2) Class/MOA: inhibits GABA reuptake 3) Side effects/ADEs: 4) Fun Facts
Lactulose
1) constipation; hepatic encephalopathy 2) osmotic laxative: provide osmotic load to draw out H2O; gut flora degrades this Rx into metabolites (lactic acid, acetic acid) that promote nitrogen excretion as NH4+ 3) diarrhea, dehyration 4) may be abused by bulimics
Exenatide
1)Type II DM 2)GLP-1 Analog/ Increase insulin and decrease glucagon release 3)Nausea, vomiting, pancreatitis
-olol
B-antagonist Ex: Propranolol
Gemfibrozil
1)Lipid-lower agents (sig decrease TGs, slightly decrease LDL, increase HDL) 2)Fibrates/Upregulates LPL –> increases TG clearance 3)Myositis, hepatotoxicity (increase LFTs), cholesterol gallstones
Tiotropium
1) Rx for COPD, Asthma. 2) Muscarinic antagonist
Warfarin
1) Use: Chronic anticoagulation | not used in pregnat women | follow PT/INR values 2) Class/MOA: interfears with normal synthesis of K depedent clotting factors through blocking | INHIBIT THROMBIN GENERATION 3) Side effects/ADEs: bleeding, teratogenic,
Tirofiban
1) ACS, PTCA 2) Gp IIb/IIIa inhibitor: bind R on activated plts –> prevent aggregation 3) bleeding, thrombocytopenia 4) N/A
Ceftriaxone
1) Serious gram-negative infections resistant to other Beta-lactams; **Ceftriaxone–meningitis & gonorrhea 2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Theraputic Antibodies
Muromonab-CD3 (OKT3 Digoxin Immune Fab Infliximab Adalimumab Abciximab Trastuzumab (Herceptin) Rituximab Omalizumab
Tox: Heparin
Rx: Protamine
Amitriptyline
1) Use: Major depression, fibromyalgia 2) Class/MOA: 3rd generation tricyclic antidepression. Block NE and serotonin 3) Side effects/ADEs: Alpha blocking side effects (postural hypotension), anticholinergic effects (tachycardia, urinary retention, dry mouth), Sedation. Toxicity: Convulsions, coma, cardiotoxicity (treat with NaBicarb) 4) Fun Facts: Third generation TCAs have more anticholinergic side effects
Paclitaxel
1) ovarian + breast carcinomas 2) microtubule inhibitor: hyperstabilizes polymerized microtubules in M phase so mitotic spindle can’t break down (blocks anaphase) 3) myelosuppression, hypersensitivity 4) N/A
Vigabatrin
1) Use: epilepsy drug, used in: partial simple and partial complex seizures 2) Class/MOA: Irreversibly inhibits GABA transaminase - increases GABA 3) Side effects/ADEs: 4) Fun Facts
Infliximab
1) Crohn’s dz, ulcerative colitis, rheumatoid arthritis 2) monoclonal ab to TNF-alpha 3) infct (including reactivation of latent TB); fever; hypotension 4) N/A
Liraglutide
1)Type II DM 2)GLP-1 Analog/ Increase insulin and decrease glucagon release 3)Nausea, vomiting, pancreatitis
-terol
B2-agonist Ex: Albuterol
Clofibrate
1)Lipid-lower agents (sig decrease TGs, slightly decrease LDL, increase HDL) 2)Fibrates/Upregulates LPL –> increases TG clearance 3)Myositis, hepatotoxicity (increase LFTs), cholesterol gallstones
Ipratropium
1) Rx for COPD, Asthma. 2) Muscarinic antagonist
Alteplase (tPA)
1) Use: CVA, acute MI, PE 2) Class/MOA: converts plasminogen to plasmin and helps cleave fibrin mesh TPA 3) Side effects/ADEs: bleeding 4) Fun Facts
Cefotaxime
1) Serious gram-negative infections resistant to other Beta-lactams 2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Muromonab-CD3 (OKT3)
- Immunosuppression post-KIDNEY transplant 2. Monoclonal antibody to CD3 on T-cells. Blocks interaction with CD3 responsible for T-cell signal transduction 3. Cytokine release syndrome, hypersensitivity reaction 4. Antibodies= hypersensitivity, hypersensitivity= cytokine release -nab= monocolonal antibody therapy (usually)
Tox: Warfarin
Rx: Vit K, FFP
Nortriptyline
1) Use: Major depression, fibromyalgia 2) Class/MOA: 2nd generation tricyclic antidepression. Block NE and serotonin 3) Side effects/ADEs: Alpha blocking side effects (postural hypotension), anticholinergic effects (tachycardia, urinary retention, dry mouth), Sedation. Toxicity: Convulsions, coma, cardiotoxicity (treat with NaBicarb) 4) Fun Facts: Second generation TCAs have fewer anticholinergic side effects
Cisplatin
1) testicular, bladder, ovary, lung carcinomas 2) X-links DNA 3) nephrotoxicity (prevent w/ amifostine, ROS scavenger), acoustic nerve damage, chloride diuresis 4) N/A
Levetiracetam
1) Use: epilepsy drug, used in: partial simple and partial complex seizures and in generalized tonic-clonic seizures 2) Class/MOA: Unknown, may modulate GABA and glutamate release 3) Side effects/ADEs: 4) Fun Facts
Sulfasalazine
1) ulcerative colitis, Crohn’s dz 2) combo of sulfapyridine (antibacterial) + 5-aminosalicylic acid (5-ASA, anti-inflammatory); activated by colonic bacteria (cleaves bond) 3) malaise; nausea; sulfonamide toxicity; reversible oligospermia 4) N/A
Linagliptin
1)Type II DM 2)DPP-4 Inhibitors/ Increase insulin and decrease glucagon release 3)Mild urinary or respiratory infections
-zosin
Alpha1-antagonist Ex: Prazosin
Bezafibrate
1)Lipid-lower agents (sig decrease TGs, slightly decrease LDL, increase HDL) 2)Fibrates/Upregulates LPL –> increases TG clearance 3)Myositis, hepatotoxicity (increase LFTs), cholesterol gallstones
Oxybutynin
1) Reduce urgency in mild cystitis and reduce bladder spasms. 2) Muscarinic Antagonist
Protamine Sulfate
1) Use: REVERSES HEPRIN 2) Class/MOA: 3) Side effects/ADEs: 4) Fun Facts
Ceftazidime
1) Serious gram-negative infections resistant to other Beta-lactams; **Ceftazidime–Pseudomonas. 2) Beta-lactam, 3rd Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Digoxin Immune Fab
Target: Digoxin Use: Antidote for Digoxin toxicity
Tox: tPA, Streptokinase, Urokinase
Rx: Aminocaproic acid
Imipramine
1) Use: Major depression, fibromyalgia, bedwetting 2) Class/MOA: Tricyclic antidepression. Block NE and serotonin 3) Side effects/ADEs: Alpha blocking side effects (postural hypotension), anticholinergic effects (tachycardia, urinary retention, dry mouth), Sedation. Toxicity: Convulsions, coma, cardiotoxicity (treat with NaBicarb) 4) Fun Facts: use for bedwetting is imipramine specific.
Carboplatin
1) testicular, bladder, ovary, lung carcinomas 2) X-links DNA 3) nephrotoxicity (prevent w/ amifostine, ROS scavenger), acoustic nerve damage, chloride diuresis 4) N/A
Barbiturates (Phenobarbital, Phenobarbital, thiopental, secobarbital)
1) Use: sedative for anxiety, seizures, insomnia, induction of anesthesia (thiopental) 2) Class/MOA: facilitate GABAA action by increasing duration of Cl- channel opening, thus decreasing neuron firing (barbiDURATe - increase DURATion). 3) Side effects/ADEs: dependence, additive CNS depression effects with alcohol, respiratory or cardiovascular depression (can lead to death), drug interactions owing to induction of liver microsomal enzymes (cytrochrome P-450) 4) Fun Facts: treat overdose with symptom management (assist respiration, increase blood pressure). Contraindicated in porphyria.
Ondansetron
1) control vomiting postoperatively + in pts undergoing CA chemo 2) 5-HT3 antagonist; powerful central-acting antiemetic 3) HA, constipation 4) N/A
Saxagliptin
1)Type II DM 2)DPP-4 Inhibitors/ Increase insulin and decrease glucagon release 3)Mild urinary or respiratory infections
Cardio
-oxin, -pril, -afil
Fenofibrate
1)Lipid-lower agents (sig decrease TGs, slightly decrease LDL, increase HDL) 2)Fibrates/Upregulates LPL –> increases TG clearance 3)Myositis, hepatotoxicity (increase LFTs), cholesterol gallstones
Glycopyrrolate
1) Parenteral: preop –> reduce airway secretions. PO: Rx for drooling, peptic ulcer 2) Muscarinic Antagonist
DDAVP (Desmopressin)
1) Use: vWF disease 2) Class/MOA: RELEASES vWF stored in endothelium 3) Side effects/ADEs: 4) Fun Facts
Cefepime
1) Increase activity against Pseudomonas & gram-positive orgs 2) Beta-lactam, 4th Generation Cephalosporins; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Infliximab
Target: TNF-alpha Use: Crohn’s Disease, Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis
Tox: Theophylline
Rx: B-blocker
Desipramine
1) Use: Major depression, fibromyalgia. 2) Class/MOA: Ttricyclic antidepression. Block NE and serotonin 3) Side effects/ADEs: Alpha blocking side effects (postural hypotension), anticholinergic effects (tachycardia, urinary retention, dry mouth), Sedation. Toxicity: Convulsions, coma, cardiotoxicity (treat with NaBicarb) 4) Fun Facts: Less sedating, higher seizure threshold. .
Etoposide
1) solid tumors, leukemias, lymphomas 2) topo II inhibitor –> incr DNA degradation 3) myelosuppression, GI irritation, alopecia 4) N/A
Nonbenzodiazepine hypnotics (zolpidem aka ambien, zaleplon, eszopiclone)
1) Use: Insomnia 2) Class/MOA: act via the BZI receptor subtype and are reversed by flumazenil 3) Side effects/ADEs: Atazia, headaches, confusion. Short duration because of rapid metabolism by liver enzymes. Unlike older sedative-hypnotics, cause only modest day-after psychomotor depression and few amnesic effects. Lower dependence risk than benzodiazepines. 4) Fun Facts
Metoclopramide
1) DM, post-sx gastroparesis, antiemetic 2) D2 receptor antagonist: incr resting tone, contractility, LES tone, motility; doesn’t influence colon transport time 3) incr parkinsonian effects; restlessness; drowsiness; fatigue; depression; nausea; diarrhea; contraindicated in pts w/ small bowel obstruction or Parkinson’s dz 4) Rx interaction w/ digoxin + DM agents
Sitagliptin
1)Type II DM 2)DPP-4 Inhibitors/ Increase insulin and decrease glucagon release 3)Mild urinary or respiratory infections
-oxin
Cardiac glycoside (inotropic agent) Ex: Digoxin
Digoxin
1)CHF (increase contractility), A.fib (decrease conduction at AV node, depression of SA node) 2)Cardiac Glycoside/Direct inhibition of Na+/K+ ATPase leads to indirect inhibtion of Na+/Ca2+ exchanger/antiport –> increases Ca2+ concentration(positive inotropy) -stimulates vagus nerve to decrease HR 3)Cholinergic –> N/V/D, blurry yellow vision, EKG changes (increased PR, decrased QT, ST scooping, T-wave inversion, arrhythmia, AV block), hyperkalemia -Factors predisposing to toxicity –> renal failure, hypokalemia, quinidine (decreases clearance) 4)Antidote –> slowly normalize K+, lidocaine, cardiac pacer, anti-digoxin Fab fragments, Mg2+
Epinephrine
1) Anaphylaxis, glaucoma (open angle), asthma, hypotension 2) Sympathomimetics; A1, A2, B1, B2. LOW dose selective for B1
Vitamin K
1) Use: REVERSES Warfarin 2) Class/MOA: 3) Side effects/ADEs: 4) Fun Facts
Ceftaroline
1) **Only Cephalosporin that covers MRSA 2) Beta-lactam, **Newest Generation Cephalosporin; Beta-lactam rx that inhibits cell wall synthesis but are less susceptibl to penicillinases. Bactericidal 3) Hypersensitivity rxns, Vit K deficiency. Low cross-reactivity w/ Penicillins. Increased nephrotoxicity of Aminoglycosides. 4) Organisms typically not covered by Cephalosporins are LAME: Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA & Enterococci. (Exception= Ceftaroline-covers MRSA)
Adalimumab
Target: TNF-alpha Use: Crohn’s Disease, Rheumatoid arthritis, psoriatic arthritis
Rxn: Coronary vasospasm
Rx: Cocaine, sumatriptan, ergot alkaloids
Clomipramine
1) Use: Major depression, fibromyalgia. First line OCD. 2) Class/MOA: Ttricyclic antidepression. Block NE and serotonin 3) Side effects/ADEs: Alpha blocking side effects (postural hypotension), anticholinergic effects (tachycardia, urinary retention, dry mouth), Sedation. Toxicity: Convulsions, coma, cardiotoxicity (treat with NaBicarb)
Teniposide
1) solid tumors, leukemias, lymphomas 2) topo II inhibitor –> incr DNA degradation 3) myelosuppression, GI irritation, alopecia 4) N/A
Inhaled anesthetics (halothane, enflurane, isoflurane, sevodlurane, methoxyflurane, NO)
1) Use & Effects: Anesthetic - myocardial depression, respiratory distress, nausea/emesis, increase cerebral blood flow (decrease cerebral metabolic demand 2) Class/MOA: mechanism unknown 3) Side effects/ADEs: Hepatotoxicity (halothane), nephrotoxicity (methoxyflurane), proconvulsant (endlurane), malignant hyperthermia (rare), expansion of trapped gas (NO) 4) Fun Facts
Propylthiouracil
1)Hyperthyroidism 2)Block peroxidase inhibiting organificatoin of iodide anda coupling of thyroid hormone synthesis -also blocks 5’-deiodinase –> decreases peripheral conversion of T4 to T5 3)Skin rash, agranulocytosis (rare), aplastic anemia, hepatotoxicity
-pril
ACE inhibitor Ex: Captopril
Quinidine
1)Atrial and ventricular arrhythmias – re-entrant and ectopic supraventricular, ventricular tachycardia 2)Anti-arrhythmics:Na+ Channel Blocker (Class IA)/ Slow or block conduction – increase AP duration, ERP and QT interval 3)Cinchonism – headache, tinnitus; thrombocytopenia, Torsades de Pointes (increased QT), hyperkalemia causes increased toxicity
NE
1) Hypotension (but low renal perfusion) 2) Sympathomimetics; A1, A2 > B1
Novo VII
1) Use: potent means to stop bleeding! 2) Class/MOA: BASICALLY FACTOR VII | binds activated platelets and catalysex X-> Xa, which turns activated factor II -> Iia (thrombin) 3) Side effects/ADEs: thrombosis 4) Fun Facts
Ertapenem
1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening infections, or after other drugs have failed. 2) Beta-lactam, **Newer** Carbapenem; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC) 3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma levels
Abciximab
Target: Glycoprotien IIb/IIIa Use: Prevent cardiac ischemia in unstable angina and patients treated with percutaneous coronary intervention MOA: Prevents platelet aggregation by inhibiting the platelet-GIIb/IIIa-fibrinogen bonds
Rxn: Cutaneous flushing
Rx: Vancomycin, Adenosine, Niacine, Ca2+ channel, blockers
Doxepin
1) Use: Major depression, fibromyalgia. 2) Class/MOA: Ttricyclic antidepression. Block NE and serotonin 3) Side effects/ADEs: Alpha blocking side effects (postural hypotension), anticholinergic effects (tachycardia, urinary retention, dry mouth), Sedation. Toxicity: Convulsions, coma, cardiotoxicity (treat with NaBicarb)
Hydroxyurea
1) melanoma, CML, sickle cell dz (incr HbF) 2) inhibits ribonucleotide reductase –> decr DNA syn (S-phase specific) 3) BM suppression, upset GI 4) N/A
Intravenous anesthetic: Barbiturate (thiopental)
1) Use & Effects: intravenous anesthetic, used for induction of anesthesia and short surgical procedures. Effect terminated by rapid redistribution into tissue (I.e. skeletal muscle) and fat. Decrease in cerebral blood flow. 2) Class/MOA: high potency, high lipid solubility, rapid entry into the brain 3) Side effects/ADEs: 4) Fun Facts:
Methimazole
1)Hyperthyroidism 2)Block peroxidase inhibiting organificatoin of iodide anda coupling of thyroid hormone synthesis 3)Skin rash, agranulocytosis (rare), aplastic anemia 4)Possible teratogen
-afil
Erectile Dysfunction Ex: Sildenafil
Procainamide
1)Atrial and ventricular arrhythmias – re-entrant and ectopic supraventricular, ventricular tachycardia 2)Anti-arrhythmics:Na+ Channel Blocker (Class IA)/ Slow or block conduction – increase AP duration, ERP and QT interval 3)Reversible SLE-like syndrome, thrombocytopenia, Torsades de Pointes (increased QT),hyperkalemia causes increased toxicity
Isoproterenol
1) Torsade de pointes (tachycardia decr low QT interval), bradyarrhythmias (but can worsen ischemia) 2) Sympathomimetics; B1=B2
Aminocaproid Acid (AMICAR)
TREATMENT OF BLEEDING all anti fibrinolytic - a drug to stop a clot from breaking down
Doripenem
1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening infections, or after other drugs have failed. 2) Beta-lactam, **Newer** Carbapenem; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC) 3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma levels
Trastuzumab (Herceptin)
Target: HER2 Use: HER2 overexpressing breast cancer
Rxn: Dilated cardiomyopathy
Rx: Doxorubicin (Adriamycin), daunorubicin
Amoxapine
1) Use: Major depression, fibromyalgia. 2) Class/MOA: Ttricyclic antidepression. Block NE and serotonin 3) Side effects/ADEs: Alpha blocking side effects (postural hypotension), anticholinergic effects (tachycardia, urinary retention, dry mouth), Sedation. Toxicity: Convulsions, coma, cardiotoxicity (treat with NaBicarb)
Prednisone
1) CA chemotx: CLL, non-Hodgkin’s lymphomas; immunosuppressant (autoimmune dz) 2) glucocorticoid; may trigger apoptosis; may work on non-dividing cells 3) Cushing-like sx’s; immunosuppression, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis 4) N/A
Intravenous anesthetic: Benzodiazepines (Midazolam)
1) Use: intravenous anesthetic, used for endoscopy; used adjunctively with gaseous anesthetics and narcotics 2) Class/MOA: 3) Side effects/ADEs: may cause severe postoperative respiratory distress, decrease in blood pressure (treat overdose with flumazenil) and amnesia. 4) Fun Facts
Levothyroxine
1)Hypothyroidism, myxedema 2)THyroxine replacement 3)Tachycardia, heat intolerance, tremors, arrhythmias
Disopyramide
1)Atrial and ventricular arrhythmias – re-entrant and ectopic supraventricular, ventricular tachycardia 2)Anti-arrhythmics:Na+ Channel Blocker (Class IA)/ Slow or block conduction – increase AP duration, ERP and QT interval 3)Heart failure, thrombocytopenia, Torsades de Pointes (increased QT), hyperkalemia causes increased toxicity
Dopamine
1) Shock (renal perfusion), heart failure 2) Sympathomimetic; D1 (low dose) >B (medium dose) >A (high dose), inotropic and chronotropic
Cyclophoasphamide, Ifosphasmide
1) Use: NHL, breast/ovarian carcinomas | immunosupressant 2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Covalently links X-link (intrastrand) DNA at guanine N-7 | requires bioactivation by the liver 3) Side effects/ADEs: Myelosupression, hemor
Aztreonam
1) Gram-negative rods only–No activity against gram-positives or anaerobes. For penicllin-allergic pts & those w/ renal insufficiency who cannot tolerate aminoglycosides 2) Beta-lactam, Monobactam; Resistant to Beta-lactamases. Prevents peptidoglycan cross-linking by binding to PBP3. Synergistic w/ Aminoglycosides. No cross-allergenicity w/ Penicillins. 3) Usually nontoxic; Occasional GI upset
Rituximab
Target: CD20 Use: B-cell non-Hodgkin’s lymphoma
Rxn: Torsades de pointes
Rx: Class III (Sotalol) and class IA (quinidine) anti-arrhyth
Tranylcypromine
1) Use: Atypical depression, anxiety, hypochondriasis 2) Class/MOA: Nonselective MAO inhibitor. Increases levels of Ne, serotonin and dopamine (all amine NTs) 3) Side effects/ADEs: Hypertensive crisis, CNS stimulation. Serotonin syndrome (with SSRI, TCA, St. John’s wort, meperidine, dextromethorphan) 4) Fun Facts: MAO Takes Pride In Shanghai (tranylcypromine, phenelzine, isocarboxazid, selegilint)
Prednisolone
1) CA chemotx: CLL, non-Hodgkin’s lymphomas; immunosuppressant (autoimmune dz) 2) glucocorticoid; may trigger apoptosis; may work on non-dividing cells 3) Cushing-like sx’s; immunosuppression, cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis 4) N/A
Intravenous Anesthetic: Arylcyclohexylamines (Ketamine)
1) Use: intravenous anesthetic 2) Class/MOA: PCP analogs that act as dissociate anesthetics, blocks MNDA receptors. 3) Side effects/ADEs: cardiovascular stimulant, causes disorientation, hallucination and bad dreams, increases cerebral blood flow. 4) Fun Facts
Triiodothyronine
1)Hypothyroidism, myxedema 2)THyroxine replacement 3)Tachycardia, heat intolerance, tremors, arrhythmias
-tropin
Pituitary hormone Ex: Somatotropin
Lidocaine
1)Acute ventricular arrhythmias (esp post-MI), digitalis-induced arrhythmias 2)Anti-arrhythmics:Na+ Channel Blocker (Class IB)/ Slow or block conduction –decrease AP duration 3)Local anesthetic, CNS stimulation/depression, cardiovascular depression 4)Preferentially affects ischemic or depolarized Purkinje and ventricular tissue, hyperkalemia causes increased toxicity
Dobutamine
1) Heart failure, cardiac stress testing 2) Sympathomimetic; B1>B2, inotropic and chronotropic)
Busulfan
1) Use: CML - ablate bone marrow before BM transplant 2) Class/MOA: ANTINEOPLASTIC AGENT | ALYKATING AGENT | lkylates DNA 3) Side effects/ADEs: Pulmonary fibrosis, hyperpigmentation 4) Fun Facts
Meropenem
1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening infections, or after other drugs have failed. **Meropenem, however, has a reduced risk of seizures & is stable to dehydropeptidase I. 2) Beta-lactam, Carbapenem; Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC) 3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma levels
Omalizumab
Target: IgE Use: Additional treatment for severe asthma
Rxn: Agranulocytosis
Rx: Clozapine, Carbamazepine, Colchicine, Propylthiouracil, Methimazole, Dapsone
Phenelzine
1) Use: Atypical depression, anxiety, hypochondriasis 2) Class/MOA: Nonselective MAO inhibitor. Increases levels of Ne, serotonin and dopamine (all amine NTs) 3) Side effects/ADEs: Hypertensive crisis, CNS stimulation. Serotonin syndrome (with SSRI, TCA, St. John’s wort, meperidine, dextromethorphan) 4) Fun Facts: MAO Takes Pride In Shanghai (tranylcypromine, phenelzine, isocarboxazid, selegilint)
Tamoxifen
1) breast CA tx + prophylaxis; prevent osteoporosis 2) SERM: R antagonist in breast + agonist in bone; block estrogen binding to ER+ cells 3) partial agonist in endometrium –> incr endometrial CA risk; “hot falshes” 4) compare toxicity to raloxifene
Intravenous Anesthetic: Opiates (morphine, fentanyl)
1) Use: used with other CNS depressants during general anesthesia 2) Class/MOA: 3) Side effects/ADEs: 4) Fun Facts
GH
1)GH deficiency, Turner’s Syndrome
-tidine
H2 antagonist Ex: Cimetidine
Mexiletine
1)Acute ventricular arrhythmias (esp post-MI), digitalis-induced arrhythmias 2)Anti-arrhythmics:Na+ Channel Blocker (Class IB)/ Slow or block conduction –decrease AP duration 3)Local anesthetic, CNS stimulation/depression, cardiovascular depression 4)Preferentially affects ischemic or depolarized Purkinje and ventricular tissue, hyperkalemia causes increased toxicity
Phenylephrine
1) Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant) 2) Sympathomimetic; A1>A2
Bendamustine
1) Use: Refractory CLL, low NHL 2) Class/MOA: ANTINEOPLASTIC AGENT | Alkylating agent - Nitrogen Mustard 3) Side effects/ADEs: NO allopecia, liver irritation, fatigue, rash 4) Fun Facts
Imipenem (w/ Cilastatin)
1) Gram-positive cocci, gram-negative rods, & anaerobes. Wide spectrum, but the significant side effects limit use to life-threatening infections, or after other drugs have failed. *Meropenem, however, has a reduced risk of seizures & is stable to dehydropeptidase I. 2) Beta-lactam, Carbapenem; *Imipenem–broad-spectrum, Beta-lactamase-resistant carbapenem. Bind PNC-binding proteins; Block transpeptidase cross-linking of peptidoglycan; Activates autolytic enzymes (=Same MOA as PNC). **Always administered w/ Cilastatin (inhib of renal dehydropeptidase I) to decrease inactivation of drug in renal tubules. 3) GI distress, Skin rash, & CNS toxicity (seizures) at high plasma level
Rxn: Aplastic anemia
Rx: Chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole
Isocarboxazid
1) Use: Atypical depression, anxiety, hypochondriasis 2) Class/MOA: Nonselective MAO inhibitor. Increases levels of Ne, serotonin and dopamine (all amine NTs) 3) Side effects/ADEs: Hypertensive crisis, CNS stimulation. Serotonin syndrome (with SSRI, TCA, St. John’s wort, meperidine, dextromethorphan) 4) Fun Facts: MAO Takes Pride In Shanghai (tranylcypromine, phenelzine, isocarboxazid, selegilint)
Raloxifene
1) breast CA tx + prophylaxis; prevent osteoporosis 2) SERM: R antagonist in breast + agonist in bone; block estrogen binding to ER+ cells 3) no incr in endometrial carcinoma b/c it’s an endometrial antagonist 4) compare toxicity to tamoxifen
Intravenous Anesthetics: Propofol
1) Use: rapid anesthesia induction and short procedures. 2) Class/MOA: Potentates GABAA receptors. 3) Side effects/ADEs: Less postoperative nausea than thiopental. 4) Fun Facts: Not recommended for home use by pop stars
Somatostatin (octretodie)
1)Acromegaly, carcinoid, gastrinoma, glucagonoma, espohageal varices
Tocainide
1)Acute ventricular arrhythmias (esp post-MI), digitalis-induced arrhythmias 2)Anti-arrhythmics:Na+ Channel Blocker (Class IB)/ Slow or block conduction –decrease AP duration 3)Local anesthetic, CNS stimulation/depression, cardiovascular depression 4)Preferentially affects ischemic or depolarized Purkinje and ventricular tissue, hyperkalemia causes increased toxicity
Albuterol
1) Acute asthma 2) Sympathomimetic; Selective B2-agonist (B2>B1)
Nitrosoureas (BCNU - Carmustine) & (CCNU - Lomustine)
1) Use: Brain tumors (including glioblastoma multifome) 2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Require bioactivation | cross BBB = CNS 3) Side effects/ADEs: CNS tocicity (dizziness, ataxia) 4) Fun Facts
Vancomycin
1) Gram-positive only–serious, amultidrug-resistant orgs, including MRSA, enterococci, & C. difficile (oral dose for pseudomembranous colitis) 2) Antimicrobial; Inhib cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors. Bactericidal. 3) Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing–red man syndrome (can largely prevent by pretreatment w/ antihistamines & slow infusion rate). Well tolerated in general (–does NOT have many problems) 4) Resistance: Occurs w/ amino acid change of D-ala D-ala to D-ala D-lac. [“Pay back 2 D-alas (dollars) for VANdalizing (VANcomycin)]
Rxn: Direct Coombs + hemolytic anemia
Rx: Methyldopa, PCN
Selegiline
1) Use: Atypical depression, anxiety, hypochondriasis 2) Class/MOA: Nonselective MAO inhibitor. Increases levels of Ne, serotonin and dopamine (all amine NTs) 3) Side effects/ADEs: Hypertensive crisis, CNS stimulation. Serotonin syndrome (with SSRI, TCA, St. John’s wort, meperidine, dextromethorphan) 4) Fun Facts: MAO Takes Pride In Shanghai (tranylcypromine, phenelzine, isocarboxazid, selegilint)
Trastuzumab (Herceptin)
1) HER-2 (+) breast CA 2) monoclonal ab against HER-2 (c-erbB2), a tyrosine kinase –> kill breast CA cells taht overexpress HER-2 (ab-dependent cytotoxicity) 3) cardiotoxicity 4) N/A
Local Anesthetics (esters: procaine, cocaine, tetracain; amides-lidocaine, mepivaciane, bupicacaine - amides have 2 I’s in each name)
1) Use: Minor surgical prodeedures, spinal anestheia. If allergic to esters, give amides. 2) Class/MOA: block Na+ channels by binding to specific receptors on inner portion of channel. Perferentially bind to activated Na+ channels, so most effective in rapidly firig neurons. 3 degree amine local anesthetics penetrate membrnae in uncharged form, then bind to ion channel as charged form. 3) Side effects/ADEs:CNS excitation, severe cadiovascular toxifity (bupivacaine), hypertension, hypotension and arrhthmias (cocaine). 4) Fun Facts/Principle: 1) in infected (acidic) tissue, alkaline anesthetics are charged and can’t penetrate membranes effectivly. More anestetic is needed in these cases. 2) order of nerve blockage- small diamaeter fibers > large diameter. Mylinated fibers > unmylinated fibers. Overall, size factor predominates over myelination such that small myelinated fibers >small unmylinated fibers > large mylinated fibers > large unmylinated fibers. Order of loss - pain (lose first) > temperature > touch > pressure (lose last). 3) Except for cocain, given with vasoconstrictors (usually epinephrine) to enhance local action - decreases bleeding, increases anesthesia by decreasing systemic contraction.
Oxytocin
1)Stimulate labor, uterine contractions, milk let-down, controls uterine hemorrhage
Flecainide
1)V.tach that progress to V.fib, intractable SVT, last resort in refractory tachyarrhythmias 2)Anti-arrhythmias: Na+ Channel Blocker (Class IC)/ Slow or block conduction – no effect on AP duration 3)Pro-arrhythmic (esp post-MI), prolongs refractory period in AV node 4)Contraindicated post-MI and in pts with structural abnormalities, hyperkalemia causes increased toxicity
Salmeterol
1) Long-term treatment of asthma or COPD control 2) Sympathomimetic; Selective B2-agonist (B2>B1)
Cisplatin (& mesna), Carboplatin
1) Use: Testicular, bladder, ovary and lung carcinomas 2) Class/MOA: ANTINEOPLASTIC AGENT | ALKYLATING AGENT | Cross-link DNA 3) Side effects/ADEs: Nephrotoxicity and acoustic nerve damage 4) Fun Facts
Streptomycin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs. 2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet) 3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen. 4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. 4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
-azole
Antifungal Ex: Ketoconazole
Rxn: Gray baby syndrome
Rx: Chloramphenicol
Bupropion
1) Use: Smoking cessation. Depression 2) Class/MOA: Atypical antidepressant. Increase NE/dopamine via unknown mechanism 3) Side effects/ADEs: Toxicity: tachycardia, insomnia, headache, seizures in bulimics 4) Fun Facts: No sexual side effects
Imatinib (Gleevec)
1) CML, GI stromal tumors 2) Ph chr bcr-abl tyroxine kinase inhibitor 3) fluid retention 4) N/A
Neuromuscular Blocking Drugs, Depolarizing (Succynlcholine)
1) Use: for muscle paralysis in surgery or mechanical ventilation. Selective for motor (vs. autonomic) nicotinic receptor. 2) Class/MOA: 3) Side effects/ADEs: hypercalcemia and hyperkalemia 4) Fun Facts: for reversal of blockage: Phase I) prolonged depolarization: no antidote. Block potential by cholinesterase inhibitors. Phase II) repolarized by blocked: antidote consists of cholinesterase inhibitors (e.g. neostigmine).
ADH (Desmopressin)
1)Central DI
Propafenone
1)V.tach that progress to V.fib, intractable SVT, last resort in refractory tachyarrhythmias 2)Anti-arrhythmias: Na+ Channel Blocker (Class IC)/ Slow or block conduction – no effect on AP duration 3)Pro-arrhythmic (esp post-MI), prolongs refractory period in AV node 4)Contraindicated post-MI and in pts with structural abnormalities, hyperkalemia causes increased toxicity
Terbutaline
1) Reduce premature uterine contractions 2) Sympathomimetic; Selective B2-agonist (B2>B1)
Methotrexate - Leucivorin (Folinic Acid)
1) Use: Cancers (leukemias, lymphomas, choriocarcinoma, sarcoma) non-neoplastics (abortion, ectopic pregancy, RA, psoriasis) 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | FOLIC ACID ANALOG that inhibits dihydroredutase = decrease in dTMP = decrea
Tobramycin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs. 2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet) 3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen. 4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. 4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
-cillin
Penicillin Ex: Methicillin
Rxn: Hemolysis in G6PD-defic pts
Rx: Isoniazid (INH), Sulfonamides, Primaquine, ASA, Ibuprof, Nitrofurantoin
Mirtazapine
1) Use: Depression. 2) Class/MOA: Atypical antidepressant. Alpha2 antagonist (increases NE and serotonin), potent 5-HT2 and 5-HT3 antagonist 3) Side effects/ADEs: Toxicity: sedation, increase in appetite, weight gain, dry mouth 4) Fun Facts: May be used in anorexics due to side effect of weight gain
Rituximab
1) non-Hodgkin’s lymphoma, rheumatoid arthritis (w/ MTX) 2) monoclonal ab against CD20 (found on most B-cell neoplasms) 3) N/A 4) N/A
Neuromuscular blocking drugs, Nondepolarizing (tubocuraine, atracurium, mivacurium, pancuronium, vecronium, rocuronium).
1) Use: for muscle paralysis in surgery or mechanical ventilation. Selective for motor (vs. autonomic) nicotinic receptor. 2) Class/MOA: Competitive, compete with Ach for receptors 3) Side effects/ADEs: 4) Fun Facts: reversal of blockage: neostigmine, edrophonium and other cholinesterase inhibitors.
Demeclocycline
1)SIADH 2)Tetracycline/ ADH antagonist 3)Nephrogenic DI, photosensitivity, abnormalities of bone and teeth
Metoprolol
1)V.tach, SVT, slowing ventricular rate during a.fib and a.flutter 2)Anti-arrhythmics: Beta-Blockers (Class II)/ Decrease cAMP and Ca2+ currents to decrease SA and AV nodal activity – suppress abnormal pacemakers by decreasing slope of phase 4 3)Impotence, exacerbation of asthma, CV effects (bradycardia, AV block, CHF), CNS (sedation, sleep alterations), mask signs of hypoglycemia, dyslipidemia 4)Treat overdose with glucagon
Ritodrine
1) Reduces premature uterine contractions 2) Sympathomimetic; B2
6-mercaptopurine and 6-thioguanine
1) Use: Leukemias, lymphomas (not CLL or HD) 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PURINE ANALOG | Purine analog = decreased de novo purine syntehsis | activated by HGPRTas 3) Side effects/ADEs: BM, GI, Liver | metabolized by xanthene ox
Amikacin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs. 2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet) 3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen. 4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. 4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
-cycline
Antibiotic, protein synthesis inhibitor Ex: Tetracycline
Rxn: Megaloblastic anemias
Rx: Phenytoin, Methotrexate, Sulfa drgs
Maprotiline
1) Use: Depression. 2) Class/MOA: Blocks NE reuptake. 3) Side effects/ADEs: Orthostatic hypotension, sedation
Vemurafenib
1) metastatic melanoma 2) small molec inhibitor of B-Raf kinases that have V600E mute 3) N/A 4) N/A
Dantrolene
1) Use: used in the treatment of malignant hypertension, which is caused by inhalation anesthetics (except N2)) and succinylcholine. Also used to treat neuropleptic malignant syndrome (a toxicity of antipsychotic drugs) 2) Class/MOA: Prevents release of Ca2+ from sarcoplasmic reticulum of skeletal muscle 3) Side effects/ADEs: 4) Fun Facts
Hydrocortisone
1)Addison’s Disease, inflammation, immune suppression, asthma 2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression 3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic) 4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Propranolol
1)V.tach, SVT, slowing ventricular rate during a.fib and a.flutter 2)Anti-arrhythmics: Beta-Blockers (Class II)/ Decrease cAMP and Ca2+ currents to decrease SA and AV nodal activity – suppress abnormal pacemakers by decreasing slope of phase 4 3)Impotence, exacerbation of asthma, CV effects (bradycardia, AV block, CHF), CNS (sedation, sleep alterations), mask signs of hypoglycemia 4)Exacerbate vasospasm in Prinzmetal’s angina
Amphetamine
1) Narcolepsy, obesity, ADD 2) Indirect Sympathomimetic/general agonist, releases stored catecholamines
5-Flurouracil
1) Use: Colon cancer and other solid tumors, basal cell carcinoma (topical), synergy with MTX 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANALOG | bioactivated to 5F-dUMP, which covalently complexes folic acid | this complex inhibits
Neomycin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs.; *Neomycin–for bowel surgery 2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet) 3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen. 4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. 4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
-navir
Antibiotic, protease inhibitor Ex: Saqyubavir
Rxn: Thrombotic complications
Rx: OCPs (estrogens)
Trazodone
1) Use: Depression (at high doses). Insomina primarily. 2) Class/MOA: Atypical antidepression 3) Side effects/ADEs: Sedation, nausea, priapism, postural hypotension 4) Fun Facts: Called trazoBONE due to male specific side effect
Bevacizumab
1) solid tumors 2) monoclonal ab against VEGF –> inhibits angiogenesis 3) N/A 4) N/A
Bromocriptine (ergot), pramipexole, ropinirole (non ergot, preferred)
1) Use: Parkinson’s 2) Class/MOA: agonize dopamine receptors 3) Side effects/ADEs: 4) Fun Facts
Prednisone
1)Addison’s Disease, inflammation, immune suppression, asthma 2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression 3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic) 4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Esmolol
1)V.tach, SVT, slowing ventricular rate during a.fib and a.flutter 2)Anti-arrhythmics: Beta-Blockers (Class II)/ Decrease cAMP and Ca2+ currents to decrease SA and AV nodal activity – suppress abnormal pacemakers by decreasing slope of phase 4 3)Impotence, exacerbation of asthma, CV effects (bradycardia, AV block, CHF), CNS (sedation, sleep alterations), mask signs of hypoglycemia 4)Very short-acting
Ephedrine
1) Nasal decongestion, urinary incontinence, hypotension 2) Indirect sympathomimetic/general agonist, releases stored catecholamines
5-azacitidine
1) Use: MDS 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANALOG, also restore function of tumor supressor gene 3) Side effects/ADEs: 4) Fun Facts
Gentamicin
1) Severe gram-negative rod infections. Synergistic w/ Beta-lactam Abs. 2) Aminoglycoside; Bactericidal. Inhibits formation of initiation complex & cause misreading of mRNA. Also block translocation. Req O2 for uptake; therefore, ineffective against anaerobes. (A “initiates” the Alphabet) 3) Nephrotoxicity (esp when used w/ Cephalosporins), Neuromuscular blockade, Ototoxicity (esp when used w/ Loop diuretics). Teratogen. 4) Resistance: Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. 4) Aminoglycoside Rxs & ADES: “MEAN”=(aMINoglycosides) GNATS caNNOT kill anaerobes–Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin, Nephrotox, Neuromuscular blockade, Ototoxicity, Teratogen
Rxn: Cough
Rx: ACE-i
Amatadine
1) Use: Parkinson’s, also used as a antiviral against influenza A and rubella; toxicity = ataxia 2) Class/MOA: Increase dopamine 3) Side effects/ADEs: 4) Fun Facts
Triamcinolone
1)Addison’s Disease, inflammation, immune suppression, asthma 2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression 3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic) 4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Amiodarone
1)When other anti-arrhythmics fail 2)Anti-arrhythmics: K+ Channel Blockers (Class III)/ Decrease cAMP and Ca2+ currents to decrase SA and AV nodal activity –increase AP, ERP, and QT interval 3)Pulmonary fibrosis, hepatotoxicity, hypothyroidism/hyperthyroidism, corneal deposits, skin deposits (blue/grey) – cause photodermatitis, neurologic effects, constipation, cardiovascular effects (bradycardia, heart block, CHF) – **check PFTs, LFTs, TFTs** 4) Has Class I, II, III and IV effects – alters the lipid membrane
Cocaine
1) Causes vasoconstriction and local anesthesia 2) Indirect sympathomimetic/general agonist. Uptake inhibitor. 4) People use this to get high. Don’t give B-blockers if cocaine intoxication suspected.
Cytarabine (Ara-C)
1) Use: AML, ALL, high grade non-Hodgkin’s lymphoma 2) Class/MOA: ANTINEOPLASTIC AGENT | ANTIMETABOLITE | PYRIMIDINE ANTAGONIST inhibition of DNA polymerase 3) Side effects/ADEs: Leukopenia, thrombocytopenia, megaloblastic anemia 4) Fun Facts
Minocycline
1) Borrelia burgdorferi, M. pneumoniae. Drug’s ability to accumulate intracellularly makes it very effective against Rickettsia & Chlamydia. 2) Tetracycline; Bacteriostatic. Bind to 30S & present attachment of aminoacyl-tRNA; Limited CNS penetration. Do not take w/ milk, antacids, or iron-containing preparations b/c divalent cations inhib its absorption in the gut 3) GI distress, Discoloration of teeth & inhib of bone growth in children, Photosensitivity. Contraindicated in pregnancy. 4) Resistance: Decreased uptake into cells or Increased efflus of cell by plasmid-encoded transport pumps.
-triptan
5-HT 1B/1D agonists (for migranes) Ex: Sumatriptan
Rxn: Pulm fibrosis
Rx: Bleomycin, Amiodarone, Busulfan
L-dopa/carbidopa
1) Use: Parkinson’s 2) Class/MOA: increase dopamine, converted to dopamine in the CNS. Unlike dopamine, L-dopa can cross the blood brain barrier and is converted by dopa decarboxylase in the CNS to dopamine. 3) Side effects/ADEs: Arrhythmias from peripheral conversion to dopamine. Long term use can cause dysskinesia following administration, akinesia between doses. Carbidopa, a peripheral decarboxylase inhibitor is given with L-dopa to increase the bioavailability of L-dopa in the brain and to limit peripheral side effects. 4) Fun Facts
Dexamethasone
1)Addison’s Disease, inflammation, immune suppression, asthma 2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression 3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic) 4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Ibutilide
1)When other anti-arrhythmics fail 2)Anti-arrhythmics: K+ Channel Blockers (Class III)/ Decrease cAMP and Ca2+ currents to decrase SA and AV nodal activity –increase AP, ERP, and QT interval 3)Torsades de Pointes
Clonidine
1) HTN esp w renal disease (no decr in blood flow to kidney) 2) Sympathoplegics. Centrally acting A2-agonist. Decr central sympathetic outflow
Dactinomycin (Antinomycin D)
1) Use: Wilms tumor, Ewig’s sarcoma, rahbdo, childhood tumors (kids ACT out!) 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Intercalates in DNA 3) Side effects/ADEs: Myelosupression 4) Fun Facts
Demeclocycline
1) Acts as diuretic in SIADH; *Rarely used as antibiotic (Role of abx= Borrelia burgdorferi, M. pneumoniae. Drug’s ability to accumulate intracellularly makes it very effective against Rickettsia & Chlamydia.) 2) Tetracycline; MOA in SIADH tx=ADH antagonist; MOA as abx=Bacteriostatic. Bind to 30S & present attachment of aminoacyl-tRNA; Limited CNS penetration. Do not take w/ milk, antacids, or iron-containing preparations b/c divalent cations inhib its absorption in the gut 3) GI distress, Discoloration of teeth & inhib of bone growth in children, Photosensitivity. Contraindicated in pregnancy. 4) Resistance: Decreased uptake into cells or Increased efflus of cell by plasmid-encoded transport pumps.
-ane
Inhalational general anesthetic Ex: Halothane
Rxn: Acute cholestatic hepatitis, jaundice
Rx: Erythromycin
Selegiline
1) Use: Adjunctive agent to L-dopa in treatment of Parkinson’s disease. 2) Class/MOA: prevent dopamine breakdown, selective MAO type B inhibitor, which preferentially metabolizes dopamine over NE and 5-HT, thereby increasing the availability of dopamine. 3) Side effects/ADEs: may enhance adverse effects of L-dopa 4) Fun Facts
Beclomethasone
1)Addison’s Disease, inflammation, immune suppression, asthma 2)Glucocorticoid/Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and COX-2 expression 3)Iatrogenic Cushing’s –> buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, bruise easily, osteoporosis, adrenocortical atrophy, peptic ulcers, DM (if chronic) 4)Can see adrenal insufficiency when drug is stopped abruptly after chronic use
Dofetilide
1)When other anti-arrhythmics fail 2)Anti-arrhythmics: K+ Channel Blockers (Class III)/ Decrease cAMP and Ca2+ currents to decrase SA and AV nodal activity –increase AP, ERP, and QT interval
Alpha-methyldopa
1) HTN esp w renal disease (no decr in blood flow to kidney) 2) Sympathoplegics. Centrally acting A2-agonist. Decr central sympathetic outflow
Doxorubicin (Adriamycin), Daunorubicin
1) Use: HD, myelomas, sarcomas and solid tumors 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Generates free radicles | noncovalently intercalates in DNA = BREAKS IN DNA = decreased replicatoin 3) Side effects/ADEs: cardiotoxicity; myelosupress
Doxycycline
1) Borrelia burgdorferi, M. pneumoniae. Drug’s ability to accumulate intracellularly makes it very effective against Rickettsia & Chlamydia. 2) Tetracycline; Bacteriostatic. Bind to 30S & present attachment of aminoacyl-tRNA; Limited CNS penetration. *Doxycycline is fecally eliminated & can be used in pts w/ renal failure. Do not take w/ milk, antacids, or iron-containing preparations b/c divalent cations inhib its absorption in the gut 3) GI distress, Discoloration of teeth & inhib of bone growth in children, Photosensitivity. Contraindicated in pregnancy. 4) Resistance: Decreased uptake into cells or Increased efflus of cell by plasmid-encoded transport pumps.
-caine
Local anesthetic Ex: Lidocaine
Rxn: Focal-massive hepatic necrosis
Rx: Halothane, Amanita phalloides, Valproic acid, Acetaminophen
Entacapone, tolcaptone
1) Use: Parkinson’s 2) Class/MOA: prevent dopamine breakdown, COMT inhibitor - prevent L-dopa degradation, thereby increasing dopamine availability 3) Side effects/ADEs: 4) Fun Facts
Sotalol
1)When other anti-arrhythmics fail 2)Anti-arrhythmics: K+ Channel Blockers (Class III)/ Decrease cAMP and Ca2+ currents to decrase SA and AV nodal activity –increase AP, ERP, and QT interval 3)Torsades de Pointes, excessive beta-block
Phenoxybenzamine
1) Pheochromocytoma (b4 removing tumor) 2) Irreversible, Nonselective alpha blocker 3) Orthostatic hypotension, reflex tachycardia
Bleomycin
1) Use: Testicular cancer, HD 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL AGENT | Induces free radical formation; which causes BREAKS IN DNA strands 3) Side effects/ADEs: Pulomonary firbosis, skin changes, minimal myelosupression 4) Fun Facts
Tetracycline
1) Borrelia burgdorferi, M. pneumoniae. Drug’s ability to accumulate intracellularly makes it very effective against Rickettsia & Chlamydia. 2) Tetracycline; Bacteriostatic. Bind to 30S & present attachment of aminoacyl-tRNA; Limited CNS penetration. Do not take w/ milk, antacids, or iron-containing preparations b/c divalent cations inhib its absorption in the gut 3) GI distress, Discoloration of teeth & inhib of bone growth in children, Photosensitivity. Contraindicated in pregnancy. 4) Resistance: Decreased uptake into cells or Increased efflus of cell by plasmid-encoded transport pumps.
-operidol
Butyrophenone (neuroleptic) Ex: Haloperidol
Rxn: Hepatitis
Rx: INH
Benztropine
1) Use: 2) Class/MOA: Curb excess cholinergic activity, antimuscarinic; improves tremor and rigidity but has little effect on bradykinesia 3) Side effects/ADEs: 4) Fun Facts: Park your Mercedes-Benz
Adenosine
1)Diagnosing/abolishing SVT 2)Increase K+ removal from cell –> hyperpolarize the cell and decrease I(Ca), very short-acting 3)Flushing, hypotension, chest pain 4)Effects blocked by theophylline and caffeine
Phentolamine
1) Give to pts on MAO-i who eat tyramine-containing foods 2) Reversible, Nonselective alpha blocker
Vincristine, Vinblastine
1) Use: HD, Wilms, Choriocarcinoma 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT | Alkaloids that BIND TO TUBULIN in M-phase and block polyermization of MICROTUBULES so that mitotic spindle can’t form 3) Side effects/ADEs: neurotoxicity | Blast’s
Erythromycin
1) Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (for Chlamydia), & gram-positive cocci (Strep infections in pts allergic to penicillins) 2) Macrolide; Inhib protein synth by blocking translocation; Bind to 23S rRNA of 50S ribosomal subunit. Bacteriostatic. 3) Motility issues, Arrhythmia caused by prolonged QT, acute Cholecstatic hepatitis, Rash, eOsiniphilia (=MACRO). Increases serum concentration of theophyllines, oral anticoagulants. 4) Resistance: Methylation of 23S rRNA binding site.
-azine
Phenothiazine (neuroleptic, antiemetic) Ex: Chlorpromazine, compazine
Rxn: Pseudomembranous colitis
Rx: Clindamycin, ampicillin
Memantine
1) Use: Alzheimer’s drug 2) Class/MOA: NMDA receptor antagonist, helps prevent excitotocity (mediated by Ca2+) 3) Side effects/ADEs: Dizziness, confusion, hallucinations 4) Fun Facts
Mg2+
1)Torsades de Pointes, Digoxin toxicity
Prazosin
1) HTN, urinary retention in BPH 2) A1 blocker 3) 1st dose orthostatic hypotension, dizziness, HA
Etoposide
1) Use: Small Cell Cardinoma of the lung and prostate, testicular Carcinoma 2) Class/MOA: ANTINEOPLASTIC AGENT: NATURAL PRODUCT: Inhibits TOPOisomerase II = increase in DNA degradation 3) Side effects/ADEs: myelosupression, GI irritation, alopecia 4) F
Clarithromycin
1) Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (for Chlamydia), & gram-positive cocci (Strep infections in pts allergic to penicillins) 2) Macrolide; Inhib protein synth by blocking translocation; Bind to 23S rRNA of 50S ribosomal subunit. Bacteriostatic. 3) Motility issues, Arrhythmia caused by prolonged QT, acute Cholecstatic hepatitis, Rash, eOsiniphilia (=MACRO). Increases serum concentration of theophyllines, oral anticoagulants. 4) Resistance: Methylation of 23S rRNA binding site.
-barbital
Barbituate Ex: Phenobarbital
Rxn: Adrenocortical insuffic
Rx: Glucocorticoid w/drawal (HPA suppression)
Donepezil, falantamine, rivastigmine
1) Use: Alzheimer’s drug 2) Class/MOA: acetylcholinesterase inhibitor 3) Side effects/ADEs: Nausea, dizziness, insomnia 4) Fun Facts
Terazosin
1) HTN, urinary retention in BPH 2) A1 blocker 3) 1st dose orthostatic hypotension, dizziness, HA
Paclitaxel
1) Use: Ovarian and breast carcinomas 2) Class/MOA: ANTINEOPLASTIC AGENT | NATURAL PRODUCT hyperstablizes polymerized microtubules in M phase so that MITOTIC SPINDLE spindle can’t break down (anaphase can’t occur) 3) Side effects/ADEs: myelosuppresion
Azithromycin
1) Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), STDs (for Chlamydia), & gram-positive cocci (Strep infections in pts allergic to penicillins) 2) Macrolide; Inhib protein synth by blocking translocation; Bind to 23S rRNA of 50S ribosomal subunit. Bacteriostatic. 3) Motility issues, Arrhythmia caused by prolonged QT, acute Cholecstatic hepatitis, Rash, eOsiniphilia (=MACRO). Increases serum concentration of theophyllines, oral anticoagulants. 4) Resistance: Methylation of 23S rRNA binding site.
-zolam
Benzodiazepine Ex: Alprazolam
Rxn: Gynecomastia
Rx: Spironolactone, Digitalis, Cimeditine, chronic alcohol use, estrogens, Ketoconazole
Reserpine + tetrabenazine
1) Use: Huntington’s drug 2) Class/MOA: amine depleting 3) Side effects/ADEs: 4) Fun Facts
Doxazoin
1) HTN, urinary retention in BPH 2) A1 blocker 3) 1st dose orthostatic hypotension, dizziness, HA
Hydroxurea
1) Use: Melanoma, CML, sickle cell 2) Class/MOA: ANTINEOPLASTIC AGENT Inhibits RIBONUCULOTIDE REDUCTASE = decrease in DNA synthesis 3) Side effects/ADEs: BM supression, GI upset 4) Fun Facts
Chloramphenicol
1) Meningitis (Haemophius influenzae, Neisseria meningitidis, Streptococcus pneumoniae). Conservative use d/t toxicities but often still used in developing countries b/c of low cost 2) Protein Synthesis Inhib; Blocks peptidyltransfease at 50s ribosomal subunit. Bacteriostatic 3) Anemia (dose dep), Aplastic aneima (dose dep), Gray baby syndrome (in premature infants b/c lack liver UDP-glucuronyl transferase) 4) Resistance: Plasmid-encoded acetyltransferase that inactivates drug
-azepam
Benzodiazepine Ex: Diazepam
Rxn: Hot flashes
Rx: Tamoxifen, Clomiphene
Haloperidol
1) Use: Huntington’s drug 2) Class/MOA: dopamine receptor agonist 3) Side effects/ADEs: 4) Fun Facts
Tamsuolosin
1) HTN, urinary retention in BPH 2) A1 blocker 3) 1st dose orthostatic hypotension, dizziness, HA
Thalidomide and Lenolidamide
1) Use: MM 2) Class/MOA: ANTINEOPLASTIC AGENT | SUPRESS ANGIONEOGENESIS, immunomodulate, pro-apoptottic? 3) Side effects/ADEs: Birth defects 4) Fun Facts
Clindamycin
1) Anaerobic infections (e.g., Bacteroides fragilis, Clostridium perfringens) in aspiration pneumonia or lung abscesses. Also oroal infections w/ mouth anaerobes. 2) Protein Synthesis Inhib; Block peptide transfer (transpeptidation at 50s ribosomal subunit. Bacteriostatic. 3) Pseudomembranous colitis (C. dificile overgrowth), fever, diarrhea. 4) Clindamycin tx anaerobes ABOVE the diaphragm vs Metronidazole (which tx anaerobes BELOW the diaphragm)
-etine
SSRI Ex: Fluoxetine
Rxn: Hyperglycemia
Rx: Niacin, tacrolimus, protease-i, HCTZ, corticosteroids
Sumatriptan
1) Use: Acute migraine, cluster headache attacks. 2) Class/MOA: 5-HT 1B/1D agonist. Causes vasoconstriction, inhibition of trigeminal activation and vasoactive peptide release. Half-lifes angina), mild tingling. 4) Fun Facts: A SUMo wrestler TRIPs ANd falls on your head!
Mirtazapine
1) Depression 2) A2 blocker 3) Sedation, incr serum cholesterol, incr appetite
Tamoxifin, Raloxifene
1) Use: Breast cancer & osteoporosis 2) Class/MOA: SERM - receptor antagonists in the breast, and antagonist in bone | block the binding of estogren to estrogen receptor positive cells 3) Side effects/ADEs: T: increase risk of endometrial carcinoma via
Sulfadiazine
1) Gram-positive, gram-negative, Nocardia, Chlamydia. Triple sulfas or SMX for simple UTI. 2) Sulfonamides; PABA antimetabolites inhib dihydropteroate synthase. Bacteriostatic. 3) Hypersensitivity rxns, Hemolysis if G6PD deficient, Nephrotoxicity (tubulointerstitial nephritis), Photosensitivity, Kernicterus in infants, Displace other drugs from albumin (e.g. Warfarin) 4) Resistance: Altered enzyme (bacterial dihydropteroate synthase), Decreased uptake, or Increased PABA synthesis
-ipramine
TCA Ex: Imipramine
Rxn: Hypothyroidism
Rx: Lithium, Amiodarone, Sulfonamides
Acebutolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist (partial Beta-agonist) 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Anastrolzole
1) Use: postmenopausal women with breast cancer 2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONES : AROMATASE INHIBITOR 3) Side effects/ADEs: 4) Fun Facts
Sulfisoxazole
1) Gram-positive, gram-negative, Nocardia, Chlamydia. Triple sulfas or SMX for simple UTI. 2) Sulfonamides; PABA antimetabolites inhib dihydropteroate synthase. Bacteriostatic. 3) Hypersensitivity rxns, Hemolysis if G6PD deficient, Nephrotoxicity (tubulointerstitial nephritis), Photosensitivity, Kernicterus in infants, Displace other drugs from albumin (e.g. Warfarin) 4) Resistance: Altered enzyme (bacterial dihydropteroate synthase), Decreased uptake, or Increased PABA synthesis
-triptyline
TCA Ex: Amitriptyline
Rxn: Fat redistribution
Rx: Glucocorticoids, protease-i
Betaxolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Flutamide
1) Use: prostate carcinoma 2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONES a nonsteroidal competitive inhibitor of androgens at the testosterone inhibitor 3) Side effects/ADEs: 4) Fun Facts
Sulfamethoxazole (SMX)
1) Gram-positive, gram-negative, Nocardia, Chlamydia. Triple sulfas or SMX for simple UTI. 2) Sulfonamides; PABA antimetabolites inhib dihydropteroate synthase. Bacteriostatic. 3) Hypersensitivity rxns, Hemolysis if G6PD deficient, Nephrotoxicity (tubulointerstitial nephritis), Photosensitivity, Kernicterus in infants, Displace other drugs from albumin (e.g. Warfarin) 4) Resistance: Altered enzyme (bacterial dihydropteroate synthase), Decreased uptake, or Increased PABA synthesis
Rxn: Gingival hyperplasia
Rx: Phenytoin, Verapamil
Esmolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist (short acting) 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Fulvestrant
1) Use: advanced breast cancer 2) Class/MOA: ANTINEOPLASTIC AGENT | HORMONES | binds E receptor, accelerates destruction 3) Side effects/ADEs: E withdrawl, muscle wasting and gynecomastia 4) Fun Facts
Trimethoprim (TMP)
1) Used in combo w/ sulfonamides [trimethoprim-sulfamethoxazole (TMP-SMX)], causing sequential block of folate synth. This combination is used to tx: UTIs, Shigella, Salmonella, Pneumocystic jirovecii pneumonia (tx & prophylaxis) 2) Inhib bacterial dihydrofolate reductase. Bacteriostatic 3) Megaloblastic anemia, leukopenia, granulocytopenia. [May alleviate w/ supplemental folinic acid (=Leucovorin rescue)] 4) TMP–Treats Marrow Poorly
-olol
B-antagonist Ex: Propranolol
Rxn: Gout
Rx: Furosemide, Thiazides, NIacin, Cyclosporine
Atenolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Leuprolide
1) Use: Infertility, prostate cancer, uterine fibrosis 2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONE: GnRH analog with agonist properties when used in pulsatile fasion; antagonist properties wihen used in continous fashion 3) Side effects/ADEs: antiandrog
Ciprofloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
-terol
B2-agonist Ex: Albuterol
Rxn: Myopathies
Rx: Fibrates, Niacin, Colchicine, Hydroxychloroquine, Interferon-a, Penicillamine, Statins, Glucocorticoids
Metoprolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Beta1-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Ketoconazole
1) Use: PCOS to prevent hirtuism, 2) Class/MOA: ANTINEOPLASTIC AGENT: HORMONE inhibits STEROID syntehsis (inhibits desmolase) 3) Side effects/ADEs: Gynecomastia and amenorrhea 4) Fun Facts
Norfloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
-zosin
Alpha1-antagonist Ex: Prazosin
Rxn: Osteoporosis
Rx: Corticosteroids, heparin
Propanolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Non-selective B-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure sleep alteration). Use with caution in diabetics
Rituximab (Rituxan)
1) Use: NHL, RA (with MTX) 2) Class/MOA: ANTINEOPLASTIC AGENT: MONOCLONAL ANTIBODY TO CD-20, which is found on most B-cell neoplasms 3) Side effects/ADEs: 4) Fun Facts
Levofloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Rxn: Photosensitivity
Rx: Sulfonamides, Amiodarone, Tetracycline
Timolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Non-selective B-antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Ibritumomab Tiuxetan (Zevalin)
1) Use: HD 2) Class/MOA: ANTINEOPLASTIC AGENT | MONOCLONAL ANTIBODY 3) Side effects/ADEs: infusion reactions 4) Fun Facts
Ofloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
-oxin
Cardiac glycoside (inotropic agent) Ex: Digoxin
Rxn: Rash (SJS)
Rx: PCN, Ethosuximide, Carbamazepine, Sulfa drugs, Lamotrigine, Allopurinol, Phenytoin, Phenobarbital
Pindolol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Non-selective B-antagonist (partial B-agonist) 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Gemtuzumab Ogozamiin (Mylotarg)
Anti-CD33
Sparfloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
-pril
ACE inhibitor Ex: Captopril
Rxn: SLE-like syndrome
Rx: Hydralazine, INH, Procainamide, Phenytoin
Labetalol
1) HTN, Angina pectoris,MI, SVT, CHF, Glaucoma 2) Non-selective A and B antagonist 3) Impotence, exacerbations of asthma, cardio (bradycardia, AV blok, CHF), CNS (sedation, seizure, sleep alteration). Use with caution in diabetics
Trastuxumab (Herceptin)
1) Use: Metastatic breast cancer 2) Class/MOA: monoclonal Ab against HER-2 (erb-B2) helps kill breast cancer cells that overexpress HER-2, possibly through antibody dependent cytotoxicity 3) Side effects/ADEs: Cardiotoxicity 4) Fun Facts
Moxifloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
-afil
Erectile Dysfunction Ex: Sildenafil
Rxn: Teeth changes (kds)
Rx: Tetracyclines
Carvedilol
Non-selective A and B antagonist
Cetuzimab (Erbitux)
1) Use: Metestatic Breast Cancer 2) Class/MOA: ANTINEOPLASTIC AGENT MONOCLONAL ANTIBODY TO HER-2 (erb-B2) | helps kill breast cancer cells that overexpress HER-2 possibly through antibody-dependent cytotoxicity 3) Side effects/ADEs: cardiotoxicity 4) F
Gatifloxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
Rxn: Tendonitis, tendon rupture, cartilage dmge
Rx: Fluoroquinolones
Nadolol
Non-selective B antagonist
Bevacizumab (Avastin)
1) Use: Mets lung, colon, breast, renal cell, glioblastoma 2) Class/MOA: ANTINEOPLASTIC AGENT radioimmunotherapy, binds VEGF & prevents interaction with its R - decreased endothelial cell prolifeation and decreased new blood vessel formation 3) Side e
Enoxacin
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Fluoroquinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
-tropin
Pituitary hormone Ex: Somatotropin
Rxn: DI
Rx: Lithium, demeclocycline
Erlotinib (Tarceva)
1) Use: 2) Class/MOA: ANTINEOPLASTIC AGENT small molecule, inhibits EGFR - TK1 inhibitor, preents posphorylation, prevents phosphorylation of tyrosine kinase 3) Side effects/ADEs: Skin rash, fatigue, Diarrhea $$$ 4) Fun Facts
Nalidixic acid
1) Gram-negative rods of urinary & GI tracts (including Pseudomonas), Neisseria, some gram-positive orgs 2) Quinolone; Inhib DNA gyrase (topoisomerase II) & topoisomerase IV. Bacterocidal. Must not be taken w/ antacids. 3) GI upset, Super infections, Skin rashes, HA, Dizziness. Less comonly–tendonitis, tendon rupture, leg cramps, & myalgias. Contraindicated in–pregnant women & children b/c animal studies show damage to cartilage. Some may cause prolonged QT interal. May cause tendon rupture in ppl >60 yo & in pts taking Prednisone. 4) Resistance: Chromosome-encodede mut in DNA gyrase, plasmid-mediated resistance, efflux pumps
-tidine
H2 antagonist Ex: Cimetidine
Rxn: Fanconi’s
Rx: Expired tetraycline
Bortexomib (Velcade)
1) Use: MM 2) Class/MOA: ANTINEOPLASTIC AGENT Small molecule, PROTEASE inhibitor - decrased NFKB activation (cells explode because they ant breakdown proteins they contain 3) Side effects/ADEs: Neruropathy, htormbocytopenia, fever, diarrhea, $$$$ 4) Fun
Metronidazole
1) Txs Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Bacteroides, C. dificile). Used w/ proton pump inhib & Clarithromycin for “triple therapy” against H. Pylori (GET GAP on the Metro w/ metronidazole!) 2) Forms free radical toxic metabolites in the bacterial cell that damage DNA. Bactericidal, antiprotozoal 3) Disulfuram-like rxn w/ alcohol; HA, Metallic taste
Rxn: Hemorrhagic cystitis
Rx: Cyclophosphamide, Ifosfamide (prevent by coadministering with mesna)
Imatinib (Gleevec)
1) Use: CML, GI stromal tumors 2) Class/MOA: ANTINEOPLASTIC AGENT PHILDELPHIA CHRphilidelphia chromosome bcr-abl tyrosine kinase inhibitor 3) Side effects/ADEs: fluid retention 4) Fun Facts
Antimicrobial Drugs: Prophylaxis & Tx -M. tuberculosis -M. avium-intracelluare -M. leprae
Antimicrobial Drugs: Prophylaxis & Tx -M. tuberculosis–Prophylaxis=Isoniazid & Tx=Rifampin, Isoniazid, Pyrazinamide, Ethambutol (RIPE for tx) -M. avium-intracelluare–Prophylaxis=Azithromycin & Tx=Azithromycin, Rifampin, Ethanobutol, Streptomycin -M. leprae–Prophylaxis=N/A & Tx=Long-term tx w/ Dapsone & Rifampin for tuberculoid form. Add Clofazimine for lepromatous form.
Rxn: Interstitial nephritis
Rx: Methicillin, NSAIDs, furosemide
Isoniazid (INH)
1) Mycobacteriium tuberculosis; Only drug used as solo prophylaxis against TB 2) Antimicrobial; Decreases synth of mycolic acids. Bacterial catalase-peroxidases (KatG) needed to convert INH to active metabolite 3) Neurotoxicity, Hepatotoxicity. Pyridoxine (vit B6) can prevent neurotoxicity, lupus (INH–Injures Neurons & Hepatocytes) 4) Different INH half-lives in fast vs slow acetylator
Rxn: SIADH
Rx: Carbamazepine, cyclophosphamide
Rifampin
1) Mycobacterium tuburculosis; Delays resistance to dapsone when used for leprosy. Used for meningococcal prophylaxis and chemoprophylaxis in contacts of children w/ Haemophilus influenzae type B 2) Antimicrobial; Inhib DNA-dep RNA polymerase 3) Minor hepatotoxicity & drug rxns (increased P-450); Orange body fluids (nonhazardous side effect) 4) 4 Rs–RNA polymerase inhib, Revs up microsomal P-450, Red/orange body fluids, Rapid resistance if used alone
Rxn: Cichoism
Rx: Quinidine, Quinine
Pyrazinamide
1) Mycobacterium tuberculosis 2) Antimicrobial; Mech unknown–thought to acidify intracellular env via conversion to pyrazinoic acid. Effective in acidid pH of phagolysosomes, where TB engulfed by macs is found 3) Hyperuricemia, Hepatotoxicity
Rxn: Parkinson-like syndrome
Rx: Antipsychotics, Reserpine, Metoclopramide
Ethambutol
1) Mycobacterium tuberculosis 2) Antimicrobial; Decreases carbohydrate polymerization of mycobacterum cell wall by blocking arabinosyltransferase 3) optic neuropathy (red-green color blindness)
Rxn: Seizures
Rx: Isoniazid, Bupropion, Imipenem/cilastatin, Tramadol, Enflurane, Metoclopramide
Antimicrobial Prophylaxis: -Meningococcal infection
-Ciprofloxacin (Rx of choice) -Rifampin for children
Rxn: Tardive dyskinesia
Rx: Antipsychotics
Antimicrobial Prophylaxis: -Gonorrhea
-Ceftriaxone
Rxn: Antimuscarinic
Rx: Atropine, TCAs, H1-blockers, Neuroleptics
Antimicrobial Prophylaxis: -Syphilis
-Benzathine penicllin G
Rxn: Disulfiram-like rxn
Rx: Metronidazole, certain Cephalosporins, Procarbazine, 1st-gen Sulfonylureas
Antimicrobial Prophylaxis: -History of recurrent UTIs
-TMP-SMX
Rxn: Nephrotoxicity/Ototoxicity
Rx: Aminoglycosides, Vancomycin, Loop diuretics, Cisplatin
Antimicrobial Prophylaxis: -Endocarditis w/ surgical or dental procedures
-Penicillins
Rxn: Serotonin Syndrome
Rx: Cryoheptadine (5-HT1/2 receptor antagonist, Antihistamine)
Antimicrobial Prophylaxis: -Pregnant woman carrying group B strep
-Ampicillin
P-450 Inducers
Modafinil Barbiturates St. John’s wort Phenytoin Rifampin Griseofulvin Carbamazepine Chronic alcohol use
Antimicrobial Prophylaxis: -Strep pharyngitis in child w/ prior rheumatic fever
-Oral penicllin
P-450 Inhibitors
Macrolides Amiodarone Grapefruit juice Isoniazid Cimetidine Ritonavir Acute alcohol abuse Ciprofloxacin Ketoconazole Sulfonamides Gemfibrozil Quinidine
Antimicrobial Prophylaxis: -Prevention of postsurgical infection due to S. aureus
-Cefazolin
Sulfa drugs
Probenicid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide Ab’s, Sulfasalazine, Sulfonylureas -Rxns: fever, UTI, pruritic rash, SJS, hemolytic anemia, thrombocytopenia, agranulocytosis, and urticaria (hives)
Antimicrobial Prophylaxis: -Prevention of gonococcal or chlamydial conjunctivitis in newborn
-Erythromycin ointment
HIV: Prophylaxis Tx & Infection -CD4 < 200 cells/mm3 -CD4 < 100 cells/mm3 -CD4 < 50 cells/mm3
HIV Prophylaxis Tx & Infection: -CD4 < 200 cells/mm3=*TMP-SMX; Pneumocytis pneumonia -CD4 < 100 cells/mm3=*TMP-SMX=Pneumocytis pneumona & Toxoplasmosis -CD4 < 50 cells/mm3=Azithromycin; Mycobacterium avium complex *Aerosolized Pentamidine–can be used if pt is unable to tolerate TMP-SMX, butt this may not prevent toxoplasmosis
Tx for highly resistant bacteria: -MRSA -VRE
-MRSA tx = Vancomycin -VRE tx =Linezolid & Streptogramins (quinupristin/dalfopristin)
Amphotericin B
1) Serious systemic mycoses, Cryptococcus (w or w/o Flucytosine for cryptococcal meningitis), Blastomyces, Coccidioides, Histoplasma, Candida, Mucor. Intrathecally for fungal meningitis. 2) Antifungal; Alters membrane fnx–Binds ergosterol (unique to fungi), forms membrane pores that allow leakage of electrolytes (AmphoTERicin “TEARs” holes in fungal membrane) 3) Fever/chills (“shake & bake”), Hypotension, Nephrotoxicity, Arrhythmias, Anemia, IV phlebitis (“AMPHOTERRIble); Hydration reduces nephrotoxicity (see line #4); Liposomal Amphotericin reduced toxicity 4) Supplement K & Mg b/c of altered renal tubule permeability
Nystatin
1) “Swish & swallow” for oral candidiasis (thrush); Topical for diaper rash or vaginal candidiasis 2) Antifungal; Same MOA as Amphotericin B [=Alters membrane fnx–Binds ergosterol (unique to fungi), forms membrane pores that allow leakage of electrolytes (AmphoTERicin “TEARs” holes in fungal membrane)]. Topical form b/c too toxic for systemic use
Fluconazole
1) Local & Less serious systemic mycoses; Floconazole specific=Chronic suppression of cryptoccal meningitis in AIDs pts & candida infection of all types 2) Antifungal-Azole; Inhib fungal sterol (ergosterol) synth by inhib P-450 enzyme that converts lanostrerol to ergosterol 3) Testosterone synth inhib (gynecomastia) Liver dysfnx (inhib cytochrome P-450)
Ketoconazole
1) Local & Less serious systemic mycoses 2) Antifungal-Azole; Inhib fungal sterol (ergosterol) synth by inhib P-450 enzyme that converts lanostrerol to ergosterol 3) Testosterone synth inhib (gynecomastia, esp Ketoconazole) Liver dysfnx (inhib cytochrome P-450)
Clotrimazole
1) Local & Less serious systemic mycoses; Clotrimazole (& Miconazole) specific=Topical fungal infections 2) Antifungal-Azole; Inhib fungal sterol (ergosterol) synth by inhib P-450 enzyme that converts lanostrerol to ergosterol 3) Testosterone synth inhib (gynecomastia) Liver dysfnx (inhib cytochrome P-450)
Miconazole
1) Local & Less serious systemic mycoses; Miconazole (& Clotrimazole) specific=Topical fungal infections 2) Antifungal-Azole; Inhib fungal sterol (ergosterol) synth by inhib P-450 enzyme that converts lanostrerol to ergosterol 3) Testosterone synth inhib (gynecomastia) Liver dysfnx (inhib cytochrome P-450)
Itraconazole
1) Local & Less serious systemic mycoses; Itraconazole specific=Tx for Bastomyces, Coccidiodes, & Histoplasma 2) Antifungal-Azole; Inhib fungal sterol (ergosterol) synth by inhib P-450 enzyme that converts lanostrerol to ergosterol 3) Testosterone synth inhib (gynecomastia) Liver dysfnx (inhib cytochrome P-450)
Voriconazole
1) Local & Less serious systemic mycoses 2) Antifungal-Azole; Inhib fungal sterol (ergosterol) synth by inhib P-450 enzyme that converts lanostrerol to ergosterol 3) Testosterone synth inhib (gynecomastia) Liver dysfnx (inhib cytochrome P-450)
Flucytosine
1) Tx of systemic fungal infections (esp. meningitis caused by Cryptococcus) in combo w/ Amphotericin B 2) Antifungal; Inhib DNA & RNA biosynth by conversion to 5-fluorouracil by cytosine deaminase 3) BM suppression
Caspofungin
1) Invasive aspergilliosis, Candida 2) Antifungal; Inhib cell wall synth by inhibiting synth of Beta-glucan 3) GI upset, flushing (by histasmine release)
Micafungin
1) Invasive aspergilliosis, Candida 2) Antifungal; Inhib cell wall synth by inhibiting synth of Beta-glucan 3) GI upset, flushing (by histasmine release)
Terbinafine
1) Tx dermatophytoses (esp onchomycosis=fungal infection of finger or toe nails) 2) Antifungal; Inhib fungal enzyme squalene epoxidase 3) Abn LFTs, Visual disturbances
Griseofulvin
1) PO tx of superficial infections; Inhib growth of dermatophytes (tinea, ringworm) 2) Antifungal; Interferes w/ microtubule fnx; Disrupts mitosis. Deposits in keratin-containing tissues (e.g. nails) 3) Teratogenic, Carinogenic, Confusion, HAs, Increase P-450 & warfarin metabolism
Pyrimethamine
1) Tx Toxoplasmosis 2) Antiprotozoan
Suramin
1) Tx Trypanosoma brucei 2) Antiprotozoan
Melarsoprol
1) Tx Trypanosoma brucei 2) Antiprotozoan
Nifurtimox
1) Tx Trypansoma cruzi 2) Antiprotozoan
Sodium stibogluconate
1) Tx Leishmaniasis 2) Antiprotozoan
Chloroquine
1) Tx of plasmodial species other than P. falciparium ( d/t high resistance; see line #4) 2) Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia 3) Retinopathy 4) P. falciparum mechanism of resistance: Membrane pump that decreases intracellular concentration of Chloroquine; Tx P. falciparum w/ Artemether/Lumifantrine OR Atovaquone/Proguanil; Tx life-threatening malaria w/ Quinidine in US (quinine elsewere) or Artisunate
Txs for P. falciparum
-Artemether/Lumifantrine OR Atovaquone/Proguanil -NOT Chloroquine (d/t resistance)
Txs for life-threatening malaria
-Quinidine in US (quinine elsewere) or Artisunate
Mebendazole
2) Antihelminthic therapy; Immobilize helminths
Pyrantel pamoate
2) Antihelminthic therapy; Immobilize helminths
Ivermectin
2) Antihelminthic therapy; Immobilize helminths
Diethylcarbamazine
2) Antihelminthic therapy; Immobilize helminths
Praziquantel
1) Tx for flukes (trematodes, e.g. Schistosoma) 2) Antihelminthic therapy; Immobilize helminths
Zanamivir
1) Tx and prevention of: Influenza A & B 2) Antiviral therapy; Inhib influenza neuraminidase, Decreasing the release of pogeny virus
Oseltmavir
1) Tx and prevention of: Influenza A & B 2) Antiviral therapy; Inhib influenza neuraminidase, Decreasing the release of pogeny virus
Ribavirin
1) RSV, Chronic hepatitis C 2) Antiviral therapy; Inhib synth of guanine nucleotides by competitively inhibiting IMP dehydrogenase 3) Hemolytic anemia, Severe teratogen
Acyclovir
1) HSV & ZVZ; Weak activity against EBV. No activity against CMV. Used for HSZ-induced mucocutaneous & genital lesions as well as encephalitis. Prophylaxis in immunocompromised pts. No effect on latent forms of HSZ & ZVZ. 2) Antiviral therapy; Monophosphorylated by HSV/VZV thymidine kinase. Guanosine analog. Triphosphate formed by cellular enzymes. Preferentially inihib viral DNA polymerase by chain termination 4) Mechanism of resistance: Mutated viral thymidine kinase
Valacyclovir
1) HSV & ZVZ; Weak activity against EBV. No activity against CMV. Used for HSZ-induced mucocutaneous & genital lesions as well as encephalitis. Prophylaxis in immunocompromised pts. No effect on latent forms of HSZ & ZVZ. 2) Antiviral therapy; **= a prodrug of Acyclovir, so has better oral bioavailability vs Acyclovir** Monophosphorylated by HSV/VZV thymidine kinase. Guanosine analog. Triphosphate formed by cellular enzymes. Preferentially inihib viral DNA polymerase by chain termination 4) Mechanism of resistance: Mutated viral thymidine kinase
Famciclovir
1) Herpes Zoster 2) Antiviral therapy; **Related to Acyclovir**
Ganciclovir
1) CMV, esp in immunocompromised pts. 2) Antiviral therapy; 5’-monophosphate formed CMV viral kinase Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhib viral DNA polymerase 3) Leukopenia, Neutropenia, Thrombocytopenia, Renal toxicity; More toxic to host enzymes vs Acyclovir 4) Mechanism of resistance: Mutated CMV DNA polymerase or lack of viral kinase
Valganciclovir
1) CMV, esp in immunocompromised pts. 2) Antiviral therapy; **a prodrug of Ganciclovir, so has better ora bioavailability vs Ganciclovir** 5’-monophosphate formed CMV viral kinase Guanosine analog. Triphosphate formed by cellular kinases. Preferentially inhib viral DNA polymerase 3) Leukopenia, Neutropenia, Thrombocytopenia, Renal toxicity; More toxic to host enzymes vs Acyclovir 4) Mechanism of resistance: Mutated CMV DNA polymerase or lack of viral kinase
Foscarnet
1) CMV retinitis in immunocompromised pts when Ganciclovir fails; Acyclovir-resistant HSV 2) Antiviral therapy; A pyrophosphate analog (Foscarnet=pyroFOSphate analog). Viral DNA polymerase inhib that binds to pyrophosphate-binding site of the enzyme. Does not req activation by viral kinase 3) Nephrotoxicity 4) Mechanism of resistance: Mutated DNA polymerase
Cidofovir
1) CMV retinitis in immunocompromised pts; Acyclovir-resistant HSV 2) Antiviral therapy; Preferentially inhib viral DNA polymerase. Does not req phosphorylation by viral kinase. Long t-1/2. 3) Nephrotoxicity (co-admin w/ Probenecid & IV saline to reduce toxicity)
HIV Therapy: -Name -When to initiate -Drug regimen
-Highly active antiretroviral therapy (HAART) -Initiate when pts present w/ AIDS-defining illness, low CD4+ cts (<500 cells/mm3), or high viral load -Regimen consists of (3) drugs to prevent resistance: –2 nucleoside reverse transcriptase inhib (NRTIs) + –1 non-nucleoside reverse transcriptase inhib (NNRTI) OR 1 protease inhib OR 1 integrase inhib
Lopinavir
1) HIV therapy 2) Protease inhib; Prevents maturation of new viruses by cleaving HIV-1 protease (Assembly of virions depends on HIV-1 protease, which cleaves polypeptide products of HIV mRNA into their functional parts) 3) Hyperglycemia, GI intolerance (N/D), Lipodystrophy, Nephropathy 4) All protease inhibitors end in -navir [Navir (never) tease a protease]
Atazanavir
1) HIV therapy 2) Protease inhib; Prevents maturation of new viruses by cleaving HIV-1 protease (Assembly of virions depends on HIV-1 protease, which cleaves polypeptide products of HIV mRNA into their functional parts) 3) Hyperglycemia, GI intolerance (N/D), Lipodystrophy, Nephropathy 4) All protease inhibitors end in -navir [Navir (never) tease a protease]
Darunavir
1) HIV therapy 2) Protease inhib; Prevents maturation of new viruses by cleaving HIV-1 protease (Assembly of virions depends on HIV-1 protease, which cleaves polypeptide products of HIV mRNA into their functional parts) 3) Hyperglycemia, GI intolerance (N/D), Lipodystrophy, Nephropathy 4) All protease inhibitors end in -navir [Navir (never) tease a protease]
Fosaprenavir
1) HIV therapy 2) Protease inhib; Prevents maturation of new viruses by cleaving HIV-1 protease (Assembly of virions depends on HIV-1 protease, which cleaves polypeptide products of HIV mRNA into their functional parts) 3) Hyperglycemia, GI intolerance (N/D), Lipodystrophy, Nephropathy 4) All protease inhibitors end in -navir [Navir (never) tease a protease]
Saquinavir
1) HIV therapy 2) Protease inhib; Prevents maturation of new viruses by cleaving HIV-1 protease (Assembly of virions depends on HIV-1 protease, which cleaves polypeptide products of HIV mRNA into their functional parts) 3) Hyperglycemia, GI intolerance (N/D), Lipodystrophy, Nephropathy 4) All protease inhibitors end in -navir [Navir (never) tease a protease]
Ritonavir
1) HIV therapy 2) Protease inhib; Prevents maturation of new viruses by cleaving HIV-1 protease (Assembly of virions depends on HIV-1 protease, which cleaves polypeptide products of HIV mRNA into their functional parts) 3) Hyperglycemia, GI intolerance (N/D), Lipodystrophy, Nephropathy 4) All protease inhibitors end in -navir [Navir (never) tease a protease]; Ritonavir specific=CYP450 inhib
Indinavir
1) HIV therapy 2) Protease inhib; Prevents maturation of new viruses by cleaving HIV-1 protease (Assembly of virions depends on HIV-1 protease, which cleaves polypeptide products of HIV mRNA into their functional parts) 3) Hyperglycemia, GI intolerance (N/D), Lipodystrophy, Nephropathy; Indinavir specific ADE=Hematuria 4) All protease inhibitors end in -navir [Navir (never) tease a protease]
Tenofovir (TDF)
1) HIV therapy 2) Nucleoside reverse transcriptase inhib (NRTI); Completely inhib nucleotide binding to reverse transcriptase & terminate te DNA chain (lack a 3’ OH group) 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy, Lactic Acidosis 4) Is a nucleotide analog, so does not have to be activated (vs other NRTIs, which are nucleoside analogs & therefore, req activation)
Emtricitabine (FTC)
1) HIV therapy 2) Nucleoside reverse transcriptase inhib (NRTI); Completely inhib nucleotide binding to reverse transcriptase & terminate te DNA chain (lack a 3’ OH group) 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Lactic acidosis 4) Must be phosphorylated to be activated (True of all NRTIs, except Tenofovir b/c it is a nucleotide vs nucleoside analog)
Abacavir (ABC)
1) HIV therapy 2) Nucleoside reverse transcriptase inhib (NRTI); Completely inhib nucleotide binding to reverse transcriptase & terminate te DNA chain (lack a 3’ OH group) 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Lactic acidosis 4) Must be phosphorylated to be activated (True of all NRTIs, except Tenofovir b/c it is a nucleotide vs nucleoside analog)
Lamivudine (3TC)
1) HIV therapy 2) Nucleoside reverse transcriptase inhib (NRTI); Completely inhib nucleotide binding to reverse transcriptase & terminate te DNA chain (lack a 3’ OH group) 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Lactic acidosis 4) Must be phosphorylated to be activated (True of all NRTIs, except Tenofovir b/c it is a nucleotide vs nucleoside analog)
Zidovudine (ZDV, formerly AZT)
1) HIV therapy 2) Nucleoside reverse transcriptase inhib (NRTI); Completely inhib nucleotide binding to reverse transcriptase & terminate te DNA chain (lack a 3’ OH group) 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Lactic acidosis; ZDZ specific ADE=Anemia 4) Used for general prophylaxis & during pregnancy to reduce risk of fetal transmission; Must be phosphorylated to be activated (the second statement is true of all NRTIs, except Tenofovir b/c it is a nucleotide vs nucleoside analog)
Didanosine (ddl)
1) HIV therapy 2) Nucleoside reverse transcriptase inhib (NRTI); Completely inhib nucleotide binding to reverse transcriptase & terminate te DNA chain (lack a 3’ OH group) 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Lactic acidosis 4) Must be phosphorylated to be activated (True of all NRTIs, except Tenofovir b/c it is a nucleotide vs nucleoside analog)
Stavudine (d4T)
1) HIV therapy 2) Nucleoside reverse transcriptase inhib (NRTI); Completely inhib nucleotide binding to reverse transcriptase & terminate te DNA chain (lack a 3’ OH group) 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Lactic acidosis 4) Must be phosphorylated to be activated (True of all NRTIs, except Tenofovir b/c it is a nucleotide vs nucleoside analog)
Nevirapine
1) HIV therapy 2) Non-nucleoside reverse transcriptase inhib (NNRTI); Bind to reverse transcriptase at site different from NRTIs (Nucleoside RTIs). Do not req phosphorylation to be active or compete w/ nucleotides 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Rash
Efazirenz
1) HIV therapy 2) Non-nucleoside reverse transcriptase inhib (NNRTI); Bind to reverse transcriptase at site different from NRTIs (Nucleoside RTIs). Do not req phosphorylation to be active or compete w/ nucleotides 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Rash
Delavirdine
1) HIV therapy 2) Non-nucleoside reverse transcriptase inhib (NNRTI); Bind to reverse transcriptase at site different from NRTIs (Nucleoside RTIs). Do not req phosphorylation to be active or compete w/ nucleotides 3) BM suppression (can be reversed w/ G-CSF & EPO), Peripheral neuropathy; Rash
Raltegravir
1) HIV therapy 2) Integrase inhib; Inhibits HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrase 3) Hypercholesterolemia
IFN-Alpha
1) Chronic hepatitis B & C; Kaposi’s sarcoma 2) Interferon; Glycoproteins synth by virus-infected cells; Blocks replication of both RNA & DNA viruses 3) Neutropenia, Myopathy
IFN-Beta
1) MS 2) Interferon; Glycoproteins synth by virus-infected cells; Blocks replication of both RNA & DNA viruses 3) Neutropenia, Myopathy
IFN-Gamma
1) NADPH oxidase deficiency 2) Interferon; Glycoproteins synth by virus-infected cells; Blocks replication of both RNA & DNA viruses 3) Neutropenia, Myopathy
Abx to avoid in pregnancy
Contraindicated in Pregnancy –> Adverse Effect: -Sulfonamides –> Kernicterus -Aminoglycosides –> Ototoxicity -Fluoroquinolones –> Cartolage damage -Clarithromycin –> Embryotoxic -Tetracyclines –> Discolored teeth, Inhib of bone growth -Ribavirin (antiviral) –> Teratogenic -Griseofulvin (antifungal) –> Teratogenic -Chloramphenicol –> “Gray baby” (SAFe Children Take Really Good Care)
