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Block 1 - Fundamental Principles > Drugs > Flashcards

Drugs Flashcards

0
Q

Epoprostenol

A
  • PGI2 that vasodilates and inhibits platelet aggregation through GPCRs that increase cAMP
  • used in primary pulmonary hypertension
  • continuous IV infusion
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1
Q

Alprostadil

A
  • PGE1 used to maintain patency of ductus arteriosis in congenital heart defects until surgery
  • alleviates ED - topical option available, especially useful in patients taking nitrates that can’t take Viagra
  • administered by IV infusion
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2
Q

Treprostinil

A

Newer version of epoprostenol that has longer half life and can be given subcutaneously

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3
Q

Latanoprost

A
  • PGF2alpha that increases uveoscleral outflow of aqueous humor
  • used in glaucoma
  • topical - drops applied once daily
  • synergistic effect with beta blockers that decrease synthesis of aqueous humor
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4
Q

Misoprostol

A
  • PGE minimizes risk of GI bleeding and ulceration in high risk patients taking NSAIDs
  • used to expel blastocyst - do NOT use in pregnant women until inducing labor
  • tablet - only oral pg preparation
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5
Q

Carboprost

A
  • PGF2alpha used to produce uterine contractions to induce absorption and control postpartum hemorrhage
  • higher incidence of arrhythmias than dinoprostone
  • intramuscular injection
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6
Q

Dinoprostone

A
  • PGE2 - also used to produce uterine contractions to induce abortions and control postpartum hemorrhage
  • vaginal suppository - used more than carboprost because less risk of arrhythmia
  • also used to prepare cervix for dilation
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7
Q

Zafirlukast

A
  • leukotriene receptor antagonist
  • for asthma and airway inflammation
  • twice daily oral admin
  • effective after 3 days but maximal effect may take weeks to months
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8
Q

Montelukast

A
  • leukotriene receptor antagonist used for asthma
  • approved for children more than 1 year old and adults
  • maximal effects may take weeks to months
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9
Q

Zileuton

A
  • selective inhibitor of 5-lipoxygenase that blocks leukotriene formation
  • approved for asthma but can be used in RA or ulcerative colitis
  • administered four times daily
  • effective in about two hours
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10
Q

Indomethacin

A

Drug for gout
Non selective cox inhibitor
Older drug used to close patent ductus arteriosus (now use ibuprofen)

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11
Q

Propionic acids

A

NSAIDs - also as analgesics and antipyretics
Ibuprofen
Naproxen

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12
Q

Diclofenac sodium

A

Drug for RA that concentrates in synovial fluid

NSAID

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13
Q

Ketorolac

A

P.o or I.m for postoperative pain

NSAID

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14
Q

Cox2 specific agents

A

Fewer bleeding side effects, risk of thrombosis leading to MI and stroke
Celecoxib
Piroxicam - decreases PMN migration and lymphocyte activation - once a day admin

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15
Q

Methotrexate

A

Therapy for RA
Immunosuppressant
Slows progression of disease
Nausea and mucosal ulcers are common side effects

16
Q

Glucocorticoids

A

Drug for RA
Prednisone
Blocks production of cytokines, induction of cox2 and production of arachidonic acid
Acutely effective but long term side effects
Prednisone Also used to treat gout

17
Q

Anti TNFalpha agents

A

Drugs for RA
Infliximab - monoclonal antibody to it
Adalimumab - monoclonal antibody
Etanercept - fusion protein of TNFalpha receptor ligand binding domain with IgG Fc

18
Q

Abatacept

A

Interrupts T cell co-stimulatory signal through CD28-CD80/CD86 pathway
Drug for RA because T cells mediate RA

19
Q

Rituximab

A

Anti cd20 monoclonal antibody

Drug for RA

20
Q

Anti IL-1beta drugs

A

Anakinra - IL 1 receptor antagonist
Rilonacept - soluble IL 1 receptor
Drugs for RA

21
Q

Leflunomide

A

Reduces rUMP in lymphocytes leading to block of cell cycle progression
Drug for RA

22
Q

Azathioprine

A

Nucleic acid synthesis inhibitor

Drug for RA

23
Q

Hydroxychloroquine

A

Drug for RA

Anti inflammatory but doesn’t slow disease progression

24
Q

Sulfasalazine

A

Drug for RA

25
Q

Colchicine

A

Drug for gout

Decreases neutrophil migration into joint by disrupting micro tubules

26
Q

Uricosuric agents

A

Increase excretion of urate by decreasing reabsorption from tubular fluid - used in gout
Probenecid - prolongs penicillin by decreasing tubular secretion
Sulfinpyrazone
Should not be used in conjunction with salicylates

27
Q

Drugs to lower uric acid formation

A

Allopurinol - Inhibits xanthine oxidase to reduce formation of uric acid
Drugs for gout
Febuxostat - does the same thing but better tolerated
Both have severe drug interaction with azathioprine

28
Q

Rasburicase

A

Prevents renal failure and reduces need for transfusions in patients with tumor lysis syndrome
Drug for gout
Antibodies will develop and limit use

29
Q

Prednisone

A

Prophylactically used before transplant

Used in graft vs host disease

30
Q

Calcineurin inhibitors

A

Cyclosporine, oral and IV
Tacrolimus - 100x more potent, only oral
Both hydrophobic - bind to cyclophilins in cytoplasm - inhibition of calcineurin prevents dephosphorylation of NFAT which prevents formation of IL2
Don’t affect humoral response
Any inducer or inhibitor of c. P450 is a drug interaction
Possible risk of nephrotoxicity
Used in organ transplantation, RA, and dermatology

31
Q

Sirolimus

A

Anti-proliferative drug
Inhibits mTOR to block T cell response to cytokines and proliferation
Oral, metabolized by c.p450
No renal toxicity
Used in renal transplant and usually in combo with cyclosporine

32
Q

Mycophenolate mofetil

A

Anti-proliferative drug
Converted to mycophenolic acid by plasma esterases
Inhibits IMP dehydrogenase to block de novo purine synthesis - specifically targets lymphocytes
Oral, limited drug interactions
GI and hematologic toxicity
Prophylaxis in transplant rejection

33
Q

Azathioprine (as immunosuppressant)

A

Anti proliferative drug
Converted to 6-Mercaptopurine - inhibits production of purine nucleotides and blocks DNA synthesis
Oral admin
Combined with cyclosporine and prednisone for suppression of organ rejection
High incidence of complications so only used when other drugs don’t work

34
Q

Daclizumab

A

Anti IL2 receptor antibody
Binds receptor on activated but not resting T cells
Used to prevent organ rejection

Block 1 - Fundamental Principles (6 decks)

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