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Drugs Flashcards

1
Q

Terbinafine

A

Antifungal

Inhibits squalene epoxidase (necessary for formation of lanosterol which then becomes ergosterol)

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2
Q

Azoles

A

Antifungal

Inhibits 14a-demethylase (converts lanosterol to ergosterol)

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3
Q

Flucytosine

A

Antifungal
Inhibits nucleic acid synthesis in fungal cells
Causes bone marrow suppression

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4
Q

Amphotericin B

A

Antifungal
Forms membrane pores in fungal cells (“ters” holes in the membrane)
Causes hypotension, renal toxicity, IV phlebitis, fever/chills

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5
Q

Echinocandins

A

Antifungal

Inhibits B glucan synthesis and disrupts the cell wall

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6
Q

Griseofulvin

A

Antifungal (used for nail fungal infections)

Interferes with microtubule function and disrupts mitosis

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7
Q

Acyclovir

A

Antiviral (used for herpes virus infections)

Viral dependent nucleoside
Converted to monophosphate form by viral kinase and then to triphosphate form by host cell kinase –> inhibits DNA polymerase and causes chain termination
**Resistance occurs when there is an absence of viral thymidine kinase

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8
Q

Ganciclovir

A

Antiviral (used for herpes virus infections)
specifically used for CMV infection

Viral dependent nucleoside
Converted to monophosphate form by viral kinase and then to triphosphate form by host cell kinase –> inhibits DNA polymerase and causes chain termination
**Resistance occurs when there is an absence of viral thymidine kinase

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9
Q

Valacyclovir

A

Antiviral (used for herpes virus infections)
Used to prevent reactivation of HSV

Viral dependent nucleoside
Converted to monophosphate form by viral kinase and then to triphosphate form by host cell kinase –> inhibits DNA polymerase and causes chain termination
**Resistance occurs when there is an absence of viral thymidine kinase

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10
Q

Cidovir

A

Antiviral (herpes virus)

Only needs to be activated by host cell kinases to be activated–> inhibits DNA polymerase and causes chain termination

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11
Q

Tenofovir

A

Antiviral (herpes virus)

Only needs to be activated by host cell kinases to be activated–> inhibits DNA polymerase and causes chain termination

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12
Q

Zidovudine

A

Antiviral (herpes virus)

Cell dependent nucleoside
Only needs to be activated by host cell kinases to be activated–> inhibits DNA polymerase and causes chain termination

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13
Q

Lamivudine

A

Antiviral (herpes virus)

Cell dependent nucleoside
Only needs to be activated by host cell kinases to be activated–> inhibits DNA polymerase and causes chain termination

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14
Q

Celecoxib

A

Irreversible COX-2 inhibitor
Prevents AA –> prostaglandins (normally sensitize pain fibers)

Has decreased side effects than other NSAIDs but has increased cardio risks

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15
Q

Aspirin

A

Irreversible COX 1/2 inhibitor
Prevents AA –> prostaglandins (normally sensitize pain fibers)

GI irritation, GERD, GI ulcers
Do not give to kids with the flu –> can cause Reyes syndrome (encephalitis, fatty liver, liver failure) because it uncouples oxidative phosphorylation and disrupts the proton gradient along the e- transport chain

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16
Q

Ibuprofen

A

Reversible COX 1/2 inhibitor
Prevents AA –> prostaglandins (normally sensitize pain fibers)

GI irritation, GERD, GI ulcers

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17
Q

Diclofenac

A

Reversible COX 1/2 inhibitor
Prevents AA –> prostaglandins (normally sensitize pain fibers)

GI irritation, GERD, GI ulcers

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18
Q

Indomethacin

A

Reversible COX 1/2 inhibitor
Prevents AA –> prostaglandins (normally sensitize pain fibers)

GI irritation, GERD, GI ulcers

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19
Q

Ketorolac

A

Reversible COX 1/2 inhibitor
Prevents AA –> prostaglandins (normally sensitize pain fibers)

GI irritation, GERD, GI ulcers

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20
Q

Naproxen

A

Reversible COX 1/2 inhibitor
Prevents AA –> prostaglandins (normally sensitize pain fibers)

GI irritation, GERD, GI ulcers

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21
Q

Corticosteroids (Prednisone, Dexamethasone, Betamethasone, etc)

A

Inhibit phospholipase A2 (via increase of lipocortin) to prevent formation of arachidonic acid

Causes immunosuppression, Cushing’s syndrome, thinning of skin (if used topically)

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22
Q

What is the first line drug for absence seizures?

A

Ethosuximide

“It SUX to have Silent Seizures”

Blocks Ca2+ channels

Side effects: EFGHIJ
Ethosuximide causes Fatigue, GI distress, Headache, Itching, and stevens-Johnson syndrome

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23
Q

What is the first line drug for control of tonic clonic seizures?

A 
Phenytoin (inc Na channel inactivation)
Carbamazepine (inc Na channel inactivation)
Valproic Acid (inc Na channel inactivation, inc GABA by inhibiting GABA transaminase)
24
Q

What drug do you give for acute status epilepticus?

A

Benzodiazepines (Diazepam, Lorazepam)

Inc GABA action by inc frequency of Cl channel opening

25
Q

Side effects of Valproic Acid

A

Rare but fatal hepatotoxicity

Neural tube defects (teratogen)

26
Q

What is a severe but uncommon side effect of Carbamazepine

A

Blood dyscrasias (agranulocytosis, aplastic anemia)

27
Q

What do you use to treat eclampsia?

A

MgSO4 is first line. Can also use benzodiazepines

28
Q

Local anesthetics (amides)

A

Blocks Na channels

Loss of 1) pain 2) temperature 3) touch 4) pressure

29
Q

Succinylcholine

A

Neuromuscular blocker : used for muscle paralysis in surgery or mechanical ventilation

Strong ACh agonist: causes unregulated release of Ca2+ from the sarcoplasmic reticulum

Can cause malignant hyperthermia, hypercalcemia, or hyperkalemia

30
Q

Rocuronium, pancuronium

A

Neuromuscular blocker : used for muscle paralysis in surgery or mechanical ventilation

Competes with ACh for receptors

Reverse with Neostigmine

31
Q

Dantrolene

A

Given to correct malignant hyperthermia

Prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle

32
Q

What drugs can cause gynecomastia?

A

“Some Drugs Create Awesome Knockers”
Spironolactone: diuretic, blocks Na/K channel in collecting duct
Digoxin:
Cimetidine: H2 antagonist (Peptic ulcer disease)
Alcohol
Ketoconazole: antifungal that prevents ergosterol synthesis

33
Q

Treatment of Parkinsons

A 
BLASTA
Bromocriptine
Levodopa (with carbidopa)
Amantadine
Selegiline 
Tolcapone
Antimuscarinics
34
Q

Bromocriptine

A

Tx of Parkinson’s

Dopamine agonist

35
Q

Amantadine

A

Tx of Parkinson’s
Inc dopamine availability
(inc dopamine release and dec dopamine reuptake)

36
Q

Levodopa/Carbidopa

A

Tx of Parkinson’s
Levodopa is a precursor to dopamine and can cross the BBB. Administered with Carbidopa to prevent levodopa from turning into dopamine before it crosses the BBB (bc dopamine cannot cross the BBB)

Long term use can lead to dyskinesias and off/on phenomenon

37
Q

Selegiline

A

Tx of Parkinson’s and atypical depression

Prevents breakdown of dopamine by inhibiting MAO

38
Q

Tolcapone

A

Tx of Parkinson’s

Prevents breakdown of dopamine by inhibiting COMT

39
Q

Benztropine

A

Tx of Parkinson’s
“Park your mercedes benz”

Antimuscarinic: improves tremor and rigidity but has little effect on bradykinesia

40
Q

Tetrabenazine

A

Tx of Huntingtons
Blocks the reuptake of dopamine into vesicles via VMAT and results in degradation of dopamine

Can lead to depression due to dec. dopamine

41
Q

Haloperidol

A

Tx of Huntington’s

D2 receptor antagonist (prevents dopamine from turning off the indirect pathway –> leads to dec movement)

42
Q

Treatment of Myasthenia Gravis

A

Neostigmine/physostigmine: cholinesterase inhibitor

Myasthenia gravis has autoantibodies to ACh receptors - by keeping ACh in the synaptic cleft for a longer period of time, it is more likely to outcompete the autoantibodies

43
Q

Which antidepressant does not have sexual side effects?

A

Buproprion

“Able to have proper sex”

44
Q

What drug can cause priapism in men? What is it normally used for?

A

Trazodone (think trazobone)

Used to tx insomnia- blocks serotonin and a1 adrenergic receptors

45
Q

Venlafaxine, duloxetine

A

SNRIs (Serotonin-NE reuptake inhibitors)
Used to tx depression, anxiety, panic disorder, and PTSD
Can cause HTN

Duloxetine: dual (Serotonin and NE)

46
Q

SSRIs

A

Fluoxetine
Paroxetine
Sertraline
Citalopram

47
Q

Side effect of Bupropion in anorexic/bulemic patients

A

Seizures

48
Q

What drugs can you use to treat bipolar disorder?

A

Valproate (valproic acid)
Lithium
Atypical psychotics

49
Q

Tx of Narcolepsy

A

Modafinil (sounds like daffodil- allows them to dream of daffodils)

Amphetamines

50
Q

Tx of PTSD

A

Therapy

SSRI

51
Q

Treatment of delirium tremens

A

Benzodiazepines are first line

Diazepam, Chlordiazepoxide

52
Q

What can cause lithium toxicity in a bipolar patient

A

Use of thiazide diuretic

53
Q

Clozapine side effects

A

Important to monitor neutrophil levels because it can cause agranulocytsis

54
Q

Acetaminophen

A

Cox1/Cox2 inhibitor

Can cause hepatotoxicity
During metabolism, forms a reactive intermediate called NAPQ1 that can cause necrosis. GSH normally converts this to a nontoxic form, however when there is a lot of NAPQ1 formed (ex. alcohol use) then GSH is overwhelmed

Give N-acetylcysteine to limit liver injury

55
Q

Triptans

A

Sumatriptan

USed to treat acute migraines
Serotonin agonist that inhibit trigeminal nerve activation, prevent vasoactive peptide release, and induce vasoconstriction

56
Q

Naltrexone vs Disulfiram for treatment of alcoholism

A

Naltrexone: blocks the mu opioid receptor, blocks the rewarding and reinforcing effects of alcohol which can reduce cravings
Nal = null cravings

Disulfiram: inhibits aldehyde dehydrogenase and has an aversive mechanism of action (N/V. sweating, HA, dyspnea) but does not reduce cravings

57
Q

Digoxin

A

Used for chronic HF (does not improve survivability)

Blocks the Na/K ATPase, which indirectly blocks the Na/Ca Exchanger – leading to inc intracellular calcium and inc contractility

Antidote: Anti-digoxin Fab fragments

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