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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
Side effects of Valproic Acid
Rare but fatal hepatotoxicity | Neural tube defects (teratogen)
26
What is a severe but uncommon side effect of Carbamazepine
Blood dyscrasias (agranulocytosis, aplastic anemia)
27
What do you use to treat eclampsia?
MgSO4 is first line. Can also use benzodiazepines
28
Local anesthetics (amides)
Blocks Na channels | Loss of 1) pain 2) temperature 3) touch 4) pressure
29
Succinylcholine
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
Rocuronium, pancuronium
Neuromuscular blocker : used for muscle paralysis in surgery or mechanical ventilation Competes with ACh for receptors Reverse with Neostigmine
31
Dantrolene
Given to correct malignant hyperthermia Prevents release of Ca2+ from the sarcoplasmic reticulum of skeletal muscle
32
What drugs can cause gynecomastia?
"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
Treatment of Parkinsons
``` BLASTA Bromocriptine Levodopa (with carbidopa) Amantadine Selegiline Tolcapone Antimuscarinics ```
34
Bromocriptine
Tx of Parkinson's | Dopamine agonist
35
Amantadine
Tx of Parkinson's Inc dopamine availability (inc dopamine release and dec dopamine reuptake)
36
Levodopa/Carbidopa
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
Selegiline
Tx of Parkinson's and atypical depression | Prevents breakdown of dopamine by inhibiting MAO
38
Tolcapone
Tx of Parkinson's | Prevents breakdown of dopamine by inhibiting COMT
39
Benztropine
Tx of Parkinson's "Park your mercedes benz" Antimuscarinic: improves tremor and rigidity but has little effect on bradykinesia
40
Tetrabenazine
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
Haloperidol
Tx of Huntington's | D2 receptor antagonist (prevents dopamine from turning off the indirect pathway --> leads to dec movement)
42
Treatment of Myasthenia Gravis
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
Which antidepressant does not have sexual side effects?
Buproprion "Able to have proper sex"
44
What drug can cause priapism in men? What is it normally used for?
Trazodone (think trazobone) Used to tx insomnia- blocks serotonin and a1 adrenergic receptors
45
Venlafaxine, duloxetine
SNRIs (Serotonin-NE reuptake inhibitors) Used to tx depression, anxiety, panic disorder, and PTSD Can cause HTN Duloxetine: dual (Serotonin and NE)
46
SSRIs
Fluoxetine Paroxetine Sertraline Citalopram
47
Side effect of Bupropion in anorexic/bulemic patients
Seizures
48
What drugs can you use to treat bipolar disorder?
Valproate (valproic acid) Lithium Atypical psychotics
49
Tx of Narcolepsy
Modafinil (sounds like daffodil- allows them to dream of daffodils) Amphetamines
50
Tx of PTSD
Therapy | SSRI
51
Treatment of delirium tremens
Benzodiazepines are first line | Diazepam, Chlordiazepoxide
52
What can cause lithium toxicity in a bipolar patient
Use of thiazide diuretic
53
Clozapine side effects
Important to monitor neutrophil levels because it can cause agranulocytsis
54
Acetaminophen
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
Triptans
Sumatriptan USed to treat acute migraines Serotonin agonist that inhibit trigeminal nerve activation, prevent vasoactive peptide release, and induce vasoconstriction
56
Naltrexone vs Disulfiram for treatment of alcoholism
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
Digoxin
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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