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PCM1 > DERS Drugs > Flashcards

DERS Drugs Flashcards

1
Q

AlOH

A

Antacid

AE: Constipation

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2
Q

MgOH

A

Antacid

AE: Osmotic diarrhea

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3
Q

Calcium Carbonate

A

Antacid

AE: Belching, metabolic alkalosis (milk alkali)

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4
Q

Cimetidine

A

H2 Receptor Antagonist

Prototype with many AEs

AE: Gynecomastia, galactorrhea, male impotence, confusion, dizziness, headaches, CYP450 inhibition.

Inc serum concentration of Warfarin, Diazepam, Phenytoin.

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5
Q

Famotidine

A

H2 Receptor Antagonist

AE: B12 deficiency and myelosuppression with long term use.

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6
Q

Nizatidine

A

H2 Receptor Antagonist

AE: B12 deficiency and myelosuppression with long term use.

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7
Q

Famotidine

A

H2 Receptor Antagonist

AE: B12 deficiency and myelosuppression with long-term use.

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8
Q

Omeprazole

A

Proton Pump Inhibitors

AE: Diarrhea, abdominal pain, headache, Vit B12 deficiency, hypomagnesemia, osteopenia, inc risk of C Diff colitis, CYP450 inhibitor, CYP2C19 Inhibitor.

Inc serum concentration of Warfarin, Diazepam, Phenytoin, decrease effectiveness of Clopidogrel.

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9
Q

Esomeprazole

A

Proton Pump Inhibitors

AE: Diarrhea, abdominal pain, headache, Vit B12 deficiency, hypomagnesemia, osteopenia, inc risk of C Diff colitis, CYP2C19 Inhibitor.

Decrease effectiveness of Clopidogrel.

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10
Q

Lansoprazole

A

Proton Pump Inhibitors

AE: Diarrhea, abdominal pain, headache, Vit B12 deficiency, hypomagnesemia, osteopenia, inc risk of C Diff colitis, CYP2C19 Inhibitor.

Decrease effectiveness of Clopidogrel.

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11
Q

Pantoprazole

A

Proton Pump Inhibitors

AE: Diarrhea, abdominal pain, headache, Vit B12 deficiency, hypomagnesemia, osteopenia, inc risk of C Diff colitis.

Minimal inhibition of CYP2C19. Preferred in pt taking Clopidogrel.

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12
Q

Rabeprazole

A

Proton Pump Inhibitors

AE: Diarrhea, abdominal pain, headache, Vit B12 deficiency, hypomagnesemia, osteopenia, inc risk of C Diff colitis.

Minimal inhibition of CYP2C19. Preferred in pt taking Clopidogrel.

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13
Q

Misoprostol

A

PGE1 Analog

PUD treatment.

Bings EP3 receptor, decreases acid secretion, increases mucus and bicarb secretion.

Treat NSAID-induced ulcers.

Pregnancy: Widely used to treat post-partum hemorrhage. Abortifacient in combination with mifepristone. Can be used for cervical ripening but not FDA approved for this.

AE: Diarrhea, abdominal pain, cramps.

CI in pregnancy.

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14
Q

Sucralfate

A

PUD treatment.

Sucrose salt + Sulfated AlOH

Paste that binds to ulcers. Initial management of GERD in pregnancy.

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15
Q

Bismuth Subsalicylate

A

Suppress H Pylori, neutralize gastric acid, treat dyspepsia & acute diarrhea. Decrease fluid secretion in enteric tract. Anti-diarrheal and anti-acid.

AE: Harmless blackening of stool. Salicylate poisoning in combination with other salicylate products.

CI: Renal failure.

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16
Q

Erythromycin

A

Prokinetic

Antibiotic, agonist at motilin receptor.

Indication: Diabetic gastroparesis.

Use limited to short term.

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17
Q

Cisapride

A

Prokinetic

5HT4 agonist, 5HT3 antagonist. Direct muscle stimulant.

Used for GERD, gastroparesis.

No longer available due to causing ventricular arrhythmia.

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18
Q

Metoclopramide

A

Prokinetic

5HT4 agonist. Vagal + central 5HT3 antagonist. D2 antagonist in upper digestive tract.

Indication: Gastroparesis, Anti-emetic, GERD.

AE: Extrapyramidal syndrome, galactorrhea.

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19
Q

Scopolamine

A

Antimuscarinic antiemetic

Treat postop N/V and motion sickness.

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20
Q

Diphenhydramine

A

H1 Antagonist antiemetic

Treat postop N/V and motion sickness.

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21
Q

Meclizine

A

H1 Antagonist antiemetic

Treat postop N/V and motion sickness.

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22
Q

Cyclizine

A

H1 Antagonist antiemetic

Treat postop N/V and motion sickness.

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23
Q

Promethazine

A

Weak D2 antagonist at chemotaxic zone. Antiemetic.

Treat CINV

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24
Q

Droperidol

A

Central D2 antagonist. Anti-emetic.

AE: Extrapyramidal syndrome, QT prolongation.

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25
Q

Ondansetron

A

5-HT3 Antagonist (prototype). Anti-emetic

DOC for prophylaxis of acute CINV. Effective against hyperemesis gravidarum. Well tolerated.

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26
Q

Granisetron

A

5-HTS Antagonist. Anti-emetic

DOC for prophylaxis of acute CINV. Effective against hyperemesis gravidarum. Well tolerated.

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27
Q

Dexamethasone

A

Anti-emetic: Effective adjuvants against nausea in metastatic cancer. Suppress peritumoral inflammation & prostaglandin production.

Acute adrenal insufficiency: Dexamethasone given to treat if AAI is suspected but not yet diagnosed. Allows for immediate treatment that doesn’t impede diagnostic cortisol assays.

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28
Q

Methylprednisolone

A

Anti-emetic: Effective adjuvants against nausea in metastatic cancer. Suppress peritumoral inflammation & prostaglandin production.

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29
Q

Aprepitant

A

NK1 antagonist ORAL. Anti-emetic

Prophylaxis against delayed CINV.

Extensive CYP3A4 metabolism- affect metabolism of warfarin and OCP

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30
Q

Fosaprepitant

A

NK1 antagonist PARENTERAL. Anti-emetic.

Prophylaxis against delayed CINV.

Extensive CYP3A4 metabolism- affect metabolism of warfarin and OCP

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31
Q

Benzodiazepines

A

Lorazepam, Alprazolam, Diazepam. Anti-emetics.

Anti-anxiety adjuncts. Facilitate GABA action.

AE: CNS depression, addiction.

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32
Q

Dronabinol

A

Delta-9-tetrahydrocannabinol. Anti-emetic.

Stimulates CB1 receptors.

Prophylaxis in patients with chemo when other drugs ineffective.

AE: Palpitations, Hypotension, Tachycardia, Vasodilation, Conjunctival injection.

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33
Q

Methylcellulose

A

Bulk-forming laxative

Non-digestible colloid, absorbs water, forms a bulky jelly that distends colon and promotes peristalsis.

CI: Immobile pt or on long-term opioids.

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34
Q

Psyllium

A

Bulk-forming laxative

Non-digestible colloid, absorbs water, forms a bulky jelly that distends colon and promotes peristalsis.

Use: Constipation predominant IBS.

CI: Immobile pt or on long-term opioids.

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35
Q

Bran

A

Bulk-forming laxative

Non-digestible colloid, absorbs water, forms a bulky jelly that distends colon and promotes peristalsis.

CI: Immobile pt or on long-term opioids.

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36
Q

Bisacodyl

A

Stimulant laxative

Directly stimulates enteric NS to increase motility.

Minimal systemic absorption, safe for acute & long-term use.

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37
Q

Senna

A

Stimulant laxative

Directly stimulates enteric NS to increase motility.

Melanosis coli with chronic use- harmless brown pigmentation of colonic mucosa.

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38
Q

Castor oil

A

Stimulant laxative. Broken down into ricinoleic acid in SI.

Directly stimulates enteric NS to increase motility.

Required on a long-term basis for neurologically impaired and bed-bound patients.

CI: Pregnancy (stimulates contraction)

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39
Q

Docusate

A

Stool softener. Laxative

Surfactant that allows water and lipids to penetrate and soften stool.

Use: Constipation predominant IBS

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40
Q

Glycerin

A

Stool softener. Laxative

Surfactant that allows water and lipids to penetrate and soften stool.

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41
Q

Mineral Oil

A

Lubricant Laxative

Coats fecal material, preventing water reabsorption.

CI: Docusate will negate action of mineral oil by absorbing it into the stool (can’t coat stool)

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42
Q

Lactulose

A

Osmotic Laxative

AE: Flatus with abdominal cramping

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43
Q

Magnesium Salts

A

Osmotic Laxative

MgOH and MgSO4

CI: Prolonged use in pt with renal insufficiency can cause hypermagnesemia

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44
Q

Polyethylene Glycol

A

Osmotic Laxative

No systemic absorption, high osmotic pressure. No flatus or cramping.

Use: Complete bowel prep before GI endoscopy. Management of chronic constipation. Constipation predominant IBS.

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45
Q

Lubiprostone

A

Laxative

Stimulates Cl channels in SI

Use: Chronic constipation, IBS with predominant constipation.

AE: Diarrhea

CI: Children

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46
Q

Alvimopan

A

Laxative

Selective mu-opioid receptor antagonist

Do not cross BBB

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47
Q

Methylnaltrexone

A

Laxative

Selective mu-opioid receptor antagonist

Do not cross BBB

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48
Q

Loperamide

A

Antidiarrheal Opioid Agonist.

Presynaptic mu-opioid receptors inhibit ACh release and decrease gut peristalsis.

Doesn’t cross BBB- no analgesic properties or addiction potential.

Use: Diarrhea predominant IBS

CI: Children, severe colitis.

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49
Q

Diphenoxylate

A

Antidiarrheal Opioid Agonist

Presynaptic mu-opioid receptors inhibit ACh release and decrease gut peristalsis.

Can cross BBB- high prolonged doses can cause opioid dependence.

CI: Children, severe colitis.

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50
Q

Octreotide

A

Somatostatin Analog

Synthetic Octapeptide with longer half-life.

Antidiarrheal: Treat diarrhea due to neuroendocrine tumors, vagotomy, short bowel syndrome, dumping syndrome, AIDS.

AE: Reduce pancreatic exocrine function –> steatorrhea, fat-soluble vitamin deficiency. Reduce gallbladder contractility –> gallstones.

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51
Q

Alosetron

A

Afferent 5-HT3 antagonist. Anti-diarrheal.

Reduce noxious visceral sensations such as bloating, nausea, pain

Use: Diarrhea predominant IBS.

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52
Q

Hyoscyamine

A

Anticholinergic antidiarrheal

Anti-spasmodic affects on GI tract. Limited to short term relief of acute diarrhea due to unpleasant side effects from cholinergic blockade.

Used in Diarrhea predominant IBS

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53
Q

Dicyclomine

A

Anticholinergic antidiarrheal

Anti-spasmodic affects on GI tract. Limited to short term relief of acute diarrhea due to unpleasant side effects from cholinergic blockade.

Used in Diarrhea predominant IBS

54
Q

Glycopyrrolate

A

Anticholinergic antidiarrheal

Anti-spasmodic affects on GI tract. Limited to short term relief of acute diarrhea due to unpleasant side effects from cholinergic blockade.

Used in Diarrhea predominant IBS

55
Q

Methscopolamine

A

Anticholinergic antidiarrheal

Anti-spasmodic affects on GI tract. Limited to short term relief of acute diarrhea due to unpleasant side effects from cholinergic blockade.

Used in Diarrhea predominant IBS

56
Q

Sulfasalazine

A

Aminosalicylate. IBD treatment.

Active ingredient: 5-ASA: Modulation of COX & LOX pathways. Inhibition of NF-kB. Inhibition of cellular immunity mechanism. ROS scavenging.

Maintain IBD remission, treat Mild IBD.

2ndary ingredient: Sulfapyridine

AE: Nausea, GI upset, Headache, Arthalgia, Myalgia, BM suppression, hypersensitivity reactions.

57
Q

Balsalazide

A

Aminosalicylate. IBD treatment.

Active ingredient: 5-ASA: Modulation of COX & LOX pathways. Inhibition of NF-kB. Inhibition of cellular immunity mechanism. ROS scavenging.

Maintain IBD remission, treat Mild IBD.

2ndary ingredient: Inert carrier molecule

58
Q

Mesalamine

A

Aminosalicylate. IBD treatment.

Active ingredient: 5-ASA: Modulation of COX & LOX pathways. Inhibition of NF-kB. Inhibition of cellular immunity mechanism. ROS scavenging.

Maintain IBD remission, treat Mild IBD.

Extended release/pH sensitive 5-ASA

59
Q

Prednisone

A

Glucocorticoid

IBD Treatment: Induce remission of acute IBD exacerbation. Oral corticoid. Used for Moderate IBD.

60
Q

Prednisolone

A

Glucocorticoid

IBD Treatment: Induce remission of acute IBD exacerbation. Oral corticoid. Used for Moderate IBD.

61
Q

Budesonide

A

Glucocorticoid

IBD Treatment: Induce remission of acute IBD exacerbation. Oral corticoid that acts topically. Used for Mild IBD.

62
Q

Mercaptopurine (6-MP)

A

Purine analog, Immunosuppressant.

IBD: Treat moderate IBD. Induction & maintenance of IBD remission. Steroid sparing effect.

AE: N/V, BM sup, Hepatotoxicity. Allopurinol increases serum concentration and thus AE.

63
Q

Azathioprine

A

Purine analog, Immunosuppressant.

IBD: Treat moderate IBD. Induction & maintenance of IBD remission. Steroid sparing effect.

AE: N/V, BM sup, Hepatotoxicity. Allopurinol increases serum concentration and thus AE.

64
Q

Methotrexate

A

Folate Analog, Immunosuppressant

IBD: Treat moderate IBD

Pregnancy: Used off-label for early abortion.

AE: BM sup, megaloblastic anemia (need folate supplementation), mucositis

65
Q

Cyclosporine

A

Calcineurin inhibitor, Immunosuppressant

Forms complex with cyclophillin, inhibits calcineurin, reduces activation of NFAT.

IBD: Treat severe IBD.

AE: Nephrotoxic, neurotoxic, htn, gingival hyperplasia, hirsutism, hyperkalemia, GI disturbance, hyperglycemia, osteoporosis.

66
Q

Infliximab

A

Anti-TNFa, Immunosuppressant

IBD: Treat moderate-severe IBD. Acute & Chronic treatment.

AE: BM suppression, hypersensitivity reactions. Inc risk of hepatic failure, CHF.

67
Q

Adalimumab

A

Anti-TNFa, Immunosuppressant

IBD: Treat moderate-severe IBD. Acute & Chronic treatment.

AE: BM suppression, hypersensitivity reactions. Inc risk of hepatic failure, CHF.

68
Q

Natalizumab

A

Anti-integrin, Immunosuppressant.

IBD: Treat severe IBD.

AE: Infusion reactions, immunosuppression, reactivation of human polyomavirus (JC virus) resulting in progressive multifocal leukoencephalopathy.

69
Q

Pancrelipase

A

Pancreatic enzyme supplement. Treat pancreatic exocrine deficiency.

AE: Diarrhea, abdominal pain, renal stones, colonic strictures, hyperuricosuria.

70
Q

Insulin Lispro

A

Rapid-acting Insulin

Given SC or IV. 15 minutes before a meal.

71
Q

Insulin Aspart

A

Rapid-acting Insulin

Given SC or IV. 15 minutes before a meal.

72
Q

Insulin Glulisine

A

Rapid-acting Insulin

Given SC or IV. 15 minutes before a meal.

73
Q

Regular Insulin

A

Short-acting Insulin- Soluble crystalline zinc insulin

Given SC or IV. 30 minutes before a meal. Insulin of choice for emergencies.

74
Q

Neutral protamine Hagedorn

A

aka Isophane Insulin. Intermediate-acting insulin.

Suspension of crystalline zinc insulin with protamine. Cloudy.

Given only SC. Used for basal control.

75
Q

Insulin Glargine

A

Long-acting insulin

Used for basal control, given once daily.

Given SC.

76
Q

Insulin Degludec

A

Long-acting insulin

Used for basal control, given once daily.

Given SC.

77
Q

Insulin Detemir

A

Long-acting insulin

Used for basal control, given once daily.

Given SC.

78
Q

Chlorpropamide

A

1st Gen Sulfonylurea

Binds SUR1 receptor, block ATP-sensitive K channel, depolarization, insulin release.

AE: Hypoglycemia, weight gain, hyperemic flush, SIADH (potentiates ADH).

CI: Elderly, hepatic or renal insufficiency.

79
Q

Glyburide

A

2nd Gen Sulfonylurea

Binds SUR1 receptor, block ATP-sensitive K channel, depolarization, insulin release.

AE: Hypoglycemia (highest risk), weight gain, rapid tolerance (tachyphylaxis).

80
Q

Glipizide

A

2nd Gen Sulfonylurea

Binds SUR1 receptor, block ATP-sensitive K channel, depolarization, insulin release.

AE: Hypoglycemia, weight gain, rapid tolerance (tachyphylaxis).

81
Q

Glimepiride

A

2nd Gen Sulfonylurea

Binds SUR1 receptor, block ATP-sensitive K channel, depolarization, insulin release.

AE: Hypoglycemia (lowest risk), weight gain, rapid tolerance (tachyphylaxis).

82
Q

Repaglinide

A

Meglitinide

Binds SUR1 receptor (different site from sulfonylurea), block ATP-sensitive K channel, depolarization, insulin release.

Less effective at reducing BGL & HbA1C than sulfonylurea.

Used in pt with sulfonylurea or sulfur allergy.

AE: Hypoglycemia (higher risk), weight gain.

83
Q

Nateglinide

A

Meglitinide

Binds SUR1 receptor (different site from sulfonylurea), block ATP-sensitive K channel, depolarization, insulin release.

Less effective at reducing BGL & HbA1C than sulfonylurea.

Used in pt with sulfonylurea or sulfur allergy.

AE: Hypoglycemia, weight gain.

84
Q

Metformin

A

Biguanide

Activates AMPK –> alters gene expression –> reduces gluconeogenesis, increases glucose utilization.

Equal to sulfonylurea in reducing BGL & HbA1c. Also reduces plasma triglycerides & body weight.

First-line drug against Type 2 DM.

AE: GI upset. B12 deficiency. Lactic acidosis.

CI: Renal disease, hepatic disease, hypoxia, alcoholism.

85
Q

Pioglitazone

A

Thiazolidinedione (TZD)

Binds PPAR-y receptor –> alters gene expression –> increases glucose uptake.

Acts over weeks-months.

AE: Fluid retention, weight gain, edema. LFT needs to be monitored. Osteoporosis.

CI: Heart failure.

86
Q

Rosiglitazone

A

Thiazolidinedione (TZD)

Binds PPAR-y receptor –> alters gene expression –> increases glucose uptake.

Acts over weeks-months.

AE: Fluid retention, weight gain, edema. LFT needs to be monitored. Osteoporosis.

CI: Heart failure.

87
Q

Acarbose

A

a-glucosidase inhibitor

Inhibits upper intestinal carb absorption. Decreases postprandial hyperglycemia & hyperinsulinemia.

AE: Flatulence diarrhea abd pain, hypoglycemia (in combo with metformin), reversible hepatic enzyme elevation.

CI: IBS or any intestinal condition worsened by gas and distension.

88
Q

Exenatide

A

GLP-1 Analog

Enhances glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, decreases appetite.

AE: N/V, diarrhea, acute pancreatitis.

CI: Gastroparesis.

89
Q

Sitagliptin

A

DPP-4 inhibitor

Increases GLP-1 and insulin levels.

AE: Predispose to URTI, hypersensitivity, pancreatitis.

90
Q

Pramlintide

A

Injectable Amylin Analog

Inhibits food intake, gastric emptying, glucagon secretion.

AE: N/V, anorexia.

CI: Gastroparesis.

91
Q

Colesevelam

A

Oral Bile Acid Sequestrant

Lowers LDL-C. Unknown mechanism for treating DM.

Hyperthyroidism: Reduce enterohepatic recycling of thyroid hormone.

92
Q

Canagliflozin

A

Oral SGLT2 inhibitor.

Increases renal glucose excretion.

AE: Inc risk of UTI, volume depletion, hyperkalemia, hyperMg, hyperPO4, hypotension, increased creatinine.

93
Q

Levothyroxine

A

Synthetic T4 Analog

Treat hypothyroidism. Decreased effectiveness in presence of CYP450 Inducer.

94
Q

Propylthiouracil

A

Blocks Thyroid Peroxidase. Blocks peripheral deiodination of T4.

Preferred in severe hyperthyroid states or thyroid storm. Preferred in first trimester of pregnancy.

AE: Pruritic rash, agranulocytosis, severe hepatitis.

95
Q

Methimazole

A

Blocks Thyroid Peroxidase.

DOC for Graves disease.

AE: Pruritic rash, agranulocytosis

CI: First trimester of pregnancy.

96
Q

Amiodarone

A

Can cause hypo & hyperthyroidism.

Hypothyroidism- drug contains iodine, blocks TH synthesis. Usually in pt with autoimmune thyroiditis.

Hyperthyroidism Type 1: Inc T3, T4 synthesis from iodine. Usually in pt with pre-existing goiter

Type 2: Direct toxic effect of Amiodarone on Thyroid follicles causes excess T3/T4 release.

97
Q

Hydrocortisone

A

Cortisol preparation

Short-acting, diffuses well across mucus membranes, some salt retaining effects

98
Q

Fludrocortisone

A

Synthetic mineralocorticoid (aldosterone analog)

Increase expression of Na/K ATPase & ENaC.

Given in hypo-aldosteronism. Given in acute adrenal insufficiency when hydrocortisone dosage is reduced to below 50mg/day.

AE: Hypokalemia, metabolic alkalosis, Hypertension.

99
Q

Betamethasone

A

Synthetic glucocorticoid

Reduced salt-retaining effects compared to hydrocortisone/cortisol.

Given IM to mother in pre-term labor to induce fetal lung surfactant production prior to birth.

100
Q

Mifepristone

A

Glucocorticoid & Progesterone Receptor Antagonist

Use: Inoperable Cushing’s syndrome

Can be given with Misoprostol to induce early abortion.

101
Q

Spironolactone

A

Aldosterone Antagonist

Use: Treat Hyperaldosteronism, Treat hirsutism in women (androgen antagonist effects), K-sparing diuretic.

AE: Hyperkalemia, cardiac arrhythmia, impotence, menstrual abnormalities, gynecomastia, GI upset, rashes, sedation, headaches.

102
Q

Ketoconazole

A

Non-selective inhibitor of adrenal & gonadal steroid synthesis.

Use: DOC for Cushing’s syndrome. Prostate Cx.

AE: Hepatotoxicity, irregular menses, decreased libido, impotence, gynecomastia.

103
Q

Aminoglutethimide

A

Inhibitor of all steroid hormone synthesis by blocking pregnenolone synthesis from cholesterol

Use: Cushing’s syndrome due to adrenal carcinoma

AE: Lethargy & skin rash

104
Q

Metyrapone

A

Inhibitor of 11-hydroxylase: Inhibits cortisol synthesis

Use: Test adrenal function. DOC for Cushing’s in pregnancy.

AE: Hirsutism, salt/water retention.

105
Q

Dinoprostone

A

PGE2 Analog

Ripens Cervix. Vaginal Insert & Cervical Gel.

106
Q

Oxytocin

A

Induce Labor. DOC to treat post-partum hemorrhage.

Activates Gq receptor –> PLC –> SM contraction
also activates MAPK –> cPLA2 –> increased prostaglandin synthesis.

Given IV or IM.

AE: Excess uterine contractions. Vasopressin activation (SIADH).

107
Q

Methylergonovine

A

Ergot Alkaloid

Partial agonist at a-adrenergic & some 5-HT receptors. Stimulates uterine contraction.

Use: treat post-partum bleeding.

AE: Htn, headache, seizures, N/V, chest pain, SOB, leg cramps.

CI: Angina pectoris, MI, pregnancy, hx of CVA/TIA/Htn.

Can be found in breast-milk so don’t use too long –> can give nursing infant ergot poisoning (gangrene)

108
Q

Carbaprost Tromethamine

A

PGF2a analog. Given IM.

Helps treat post-partum bleeding.

109
Q

Magnesium Sulfate

A

Uterine Relaxant

Inhibits myometrial action potential.

AE: Maternal flushing, nausea, headache, drowsiness, blurred vision. In both maternal & fetus: respiratory depression & cardiac arrest at doses that are way too high.

Given IV continuously.

110
Q

Indomethacin

A

NSAID- Prostaglandin inhibitor. Uterine relaxant.

AE: Can cross placenta and cause oligohydraminos by decreasing fetal renal blood flow if used for more than 48 hours. Can cause premature ductus arteriosus closing if pregnancy over 32 weeks.

CI: Pregnancy after 32 weeks gestation.

Given orally or rectally.

111
Q

Nifedipine

A

Ca Channel Blocker. Uterine Relaxant.

AE: Maternal tachycardia, palpitations, flushing, headaches, dizziness, nausea.

Given orally.

112
Q

Atosiban

A

Competitive Antagonist at oxytocin receptor. Uterine relaxant.

Not available in USA.

113
Q

Terbutaline

A

B2 agonist. Uterine relaxant.

AE: Palpitations, hyperglycemia, hypokalemia, hypotension. Serious: Pulm edema, cardiac insufficiency, arrhythmia, MI, maternal death.

Oral terbutaline no longer used.

IV terbutaline limited to 72 hours.

114
Q

Ethinyl Estradiol

A

Estrogen component of oral contraceptive, transdermal patch, contraceptive ring.

Works through preventing ovulation.

Increases risk of thromboembolic events. Melasma.

Activated through enterohepatic circulation.

Rifampin can decrease levels of EE in the blood by reducing enterohepatic circulation.

115
Q

Mestranol

A

Estrogen component of oral contraceptive.

Works through preventing ovulation.

Is converted to ethinyl estradiol in the liver.

Increases risk of thromboembolic events. Melasma.

Activated through enterohepatic circulation.

Rifampin can decrease levels of EE in the blood by reducing enterohepatic circulation.

116
Q

Levonorgestrel

A

Progestin component of oral contraceptive. Main component in intrauterine system, Plan B or Next Choice emergency contraceptive.

Highest androgenic activity. Inc risk of Hirsutism & Acne.

Breakthrough bleeding. Insulin Resistance.

Works through thickening cervical mucus & preventing implantation.

117
Q

Norgestrel

A

Progestin component of oral contraceptive. Can be given as progestin-only pill.

Highest androgenic activity. Inc risk of Hirsutism & Acne.

Breakthrough bleeding. Insulin Resistance.

Works through thickening cervical mucus & preventing implantation.

118
Q

Drospirenone

A

Progestin component of oral contraceptive.

Anti-androgenic activity. Lower risk of Hirsutism & Acne.

Breakthrough bleeding. Insulin Resistance.

Works through thickening cervical mucus & preventing implantation.

119
Q

Norgestimate

A

Progestin component of oral contraceptive.

Lowest androgenic activity. Lower risk of Hirsutism & Acne.

Breakthrough bleeding. Insulin Resistance.

Works through thickening cervical mucus & preventing implantation.

120
Q

Desogestrel

A

Progestin component of oral contraceptive.

Lowest androgenic activity. Lower risk of Hirsutism & Acne.

Breakthrough bleeding. Insulin Resistance.

Works through thickening cervical mucus & preventing implantation.

121
Q

Norethindrone

A

Progestin component of oral contraceptive. Can be given as progestin-only pill.

Lower androgenic activity (than levonorgestrel & norgestrel). Lower risk of Hirsutism & Acne.

Breakthrough bleeding. Insulin Resistance.

Works through thickening cervical mucus & preventing implantation.

122
Q

DMPA

A

Depot-medroxyprogesterone acetate

Progestin. IM injection once every 3 months.

AE: Osteoporosis with long-term use.

123
Q

Nonoxynol-9

A

Spermicidal surfactant

Used in diaphragms or cervical caps

124
Q

Ulipristal acetate

A

Main ingredient of Ella emergency contraception

Selective progesterone modulator, mainly an antagonist. Inhibits or delays ovulation.

125
Q

Tamoxifen

A

Selective Estrogen Receptor Modulator

Antagonist in breast, agonist elsewhere.

Prevent & treat hormone-responsive breast cx.

AE: Hot flashes, nausea, endometrial hyperplasia, thromboembolism.

126
Q

Raloxifene

A

Selective Estrogen Receptor Modulator

Antagonist in breast & uterus, agonist in bone

Prevent hormone-responsive breast cx

Prevent & treat osteoporosis in postmenopausal women.

AE: Hot flashes, nausea, leg cramps, thromboembolism.

No risk of endometrial hyperplasia.

127
Q

Clomiphene

A

Selective Estrogen Receptor Modulator

Antagonist in hypothalamus. Prevents feedback inhibition.

Treatment of infertility associated with anovulatory cycles.

AE: Hot flashes, N/V, weight gain, breast tenderness, visual disturbances, ovarian hyperstimulation, multiple pregnancies.

128
Q

Fulvestrant

A

Selective Estrogen Receptor Degrader

Adjuvant treatment of hormone-receptor-positive metastatic breast cx that is resistant to first-line antiestrogen therapy.

AE: Hot flashes, arthralgia, myalgia.

129
Q

Anastrozole

A

Aromatase inhibitor

Adjuvant Treatment of Estrogen-receptor positive breast cx.

AE: Hot flashes, nausea, fatigue, alopecia, dermatitis.

130
Q

Flutamide

A

Androgen receptor antagonist

Treat prostate cx

AE: Gynecomastia, hot flashes, reversible hepatotoxicity

131
Q

Finasteride

A

5a-reductase inhibitor (decreases conversion of testosterone to DHT)

Use: Treat BPH & male-pattern baldness

AE: Imptence, gynecomastia

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