Drugs Flashcards
1
Q
block cell wall synthesis by inhibition of peptidoglycan cross-linking
A
penicillin, methicillin, ampicillin, pipercillin, cephalosporins, aztreonam, imipenem
2
Q
block peptidoglycan synthesis
A
bacitracin, vancomycin
3
Q
block nucleotide synthesis by inhibiting folic acid synthesis
A
sulfonamides, trimethoprim
4
Q
block DNA topoisomerases
A
fluoroquinolones
5
Q
block mRNA synthesis
A
rifampin
6
Q
damage DNA
A
metronidazole
7
Q
block protein synthesis at 50S ribosomal subunit
A
chloramphenicol, macrolides, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid
8
Q
block protein synthesis at 30S ribosomal subunit
A
aminoglycosides, tetracyclins
9
Q
structural analog of D-ala D-ala
A
penicillin
10
Q
penicillin MOA
A
bind transpeptidases, block transpeptidase cross-linking of peptidoglycan, activate autolytic enzymes
11
Q
penicillin use
A
gram + (S. pneumonia, S. pyogenes, Actinomyces), N. meningitidis, Treponema pallidum, bactericidal for gram+ cocci, rods, gram - cocci, spirochetes
12
Q
penicillin toxicity
A
hypersensitivity, hemolytic anemia
13
Q
penicillin resistance
A
beta lactamases cleave beta lactam ring
14
Q
D-ala D-ala
A
a.a. sequence on peptidoglycan precursor molecules that is recognized by enzyme transpeptidase
15
Q
oxacillin, nafcillin, dicloxacillin MOA
A
narrow spectrum, penicillinase resistant )bulky R group blocks access of beta-lactamase to beta lactam ring)
16
Q
oxacillin, nafcillin, dicloxacillin use
A
S. aureus (except MRSA–>altered penicillin-binding protein target site)
17
Q
oxacillin, nafcillin, dicloxacillin toxicity
A
hypersensitivity, interstitial nephritis
18
Q
ampicillin, amoxicillin MOA
A
wider spectrum, penicillinase sensitive; combine with clavulanic acid to protect against beta-lactamase; amoxicillin has greater oral bioavalability
19
Q
ampicillin, amoxicillin use
A
HELPSS kill enterococci
H. influenza, E. coli, Listeria, Proteus, Salmonella, Shigella, enterococci
20
Q
ampicillin, amoxicillin toxicity
A
hypersensitivity, ampicillin rash, pseudomembranous colitis
21
Q
ampicillin, amoxicillin resistance
A
beta-lactamases cleave beta-lactam ring
22
Q
ticarcillin, pipercillin MOA
A
extended spectrum
23
Q
ticarcillin, pipercillin use
A
pseudomonas, gram - rods, susceptible to penicillinase, use with clavulanic acid
24
Q
ticarcillin, pipercillin toxicity
A
hypersensitivity
25
beta-lactamase inhibitors
CAST
| clavulanic acid, sulbactam, tazobactam
26
cephalosporins MOA
inhibit peptidoglycan synthesis through blockage of transpeptidation enzymes; bactericidal
27
organisms not covered by cephalosporins
LAME
| Listeria, atypicals (chlamydia, mycoplasma), MRSA, enterococci. ceftaroline covers MRSA
28
1st generation cephalosporins
cefazolin, cephalexin
29
1st generation cephalosporins use
gram + cocci;
PEcK
proteus, e. coli, klebsiella.
cefazolin used prior to surgery to prevent S. aureus infection of wound
30
2nd generation cephalosporins
cefoxitin, cefaclor, cefuroxime
31
2nd generation cephalosporins use
gram + cocci
HEN PEcKS
H. influenza, enterobacter, neisseria, proteus, e. coli, klebsiella, serratia
32
3rd generation cephalosporins
ceftriaxone, cefotaxime, ceftazidime
33
3rd generation cephalosporins use
gram - infections resistant to other beta-lactams
ceftriaxone: meningitis and gonorrhea
ceftazidime: pseudomonas
34
4th generation cephalosporins
cefepime
35
4th generation cephalosporins use
increased activity against pseudomonas and gram +
36
cephalosporins toxicity
hypersensitivity, vitamin K deficiency, low cross-reactivity with penicillins, increase nephrotoxicity of aminoglycosides
37
aztreonam MOA
monobactam resistant to beta-lactamases
prevents peptidoglycan cross-linking by binding PBP3, synergistic with aminoglycosides, no cross-allerginicity with penicillins
38
aztreonam use
gram - rods only
| for penicillin-allergic pts and those with renal insufficiency who can't tolerate aminoglycosides
39
aztreonam toxicity
occasional GI upset
40
imipenem/cilastatin, meropenem MOA
imipenem: broad-spectrum, beta-lactamase resistant cerbapenem, always administered with cilastatin (inhibitor of renal dehydropeptidase I)
41
imipenem/cilastatin, meropenem use
gram + cocci, gram - rods, anaerobes
| meropenem: reduced risk of seizures, stable to dehydropeptidase I
42
imipenem/cilastatin, meropenem toxicity
GI distress, skin rash, CNS (seizures)
43
vancomycin MOA
inhibits cell wall peptidoglycan formation by binding D-ala D-ala; bactericidal
44
vancomycin use
gram + only; MRSA, enterococci, C. difficile
45
vancomycin toxicity
NOT (does not have many problems)
| nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome (pretreat with antihistamines and slow infusion rate)
46
vancomycin resistance
D-ala D-ala change to D-ala D-lac
47
daptomycin MOA
lipopeptide antibiotic limited to gram + (including MRSA)
| causes depolarization of bacterial cellular membrane and inhibition of DNA, RNA, amd protein synthesis
48
daptomycin toxicity
increased CPK levels and increased incidence of myopathy
49
30S inhibitors
aminoglycosides (bactericidal), tetracyclines (bacteriostatic)
50
50S inhibitors
chloramphenicol, clindamycin (bacteriostatic)
erythromycin (bacteriostatic)
linezolid (s.e. thrombocytopenia, optic neuritis)
51
aminoglycosides MOA
bactericidal; inhibit formation of initiation complex and cause misreading of mRNA; block translocation; require O2 for uptake (ineffective against anaerobes)
52
aminoglycosides use
severe gram - rod infections; synergistic with beta-lactams
| neomycin for bowel surgery
53
aminoglycosides toxicity
nephrotoxicity (especially with cephalosporins), neuromuscular blockade, ototoxicity (especially with loop diuretics), teratogen
54
aminoglycosides resistance
transferase enzymes: acetylation, phosphorylation, adenylation
55
tetracyclines MOA
bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA, limited CNS penetration
doxycycline for pts with renal failure
do not take with milk, antacids, iron-containing preps because divalent cations inhibit absorption
56
demeclocycline use
ADH antagonist; diuretic in SIADH
57
tetracyclines use
borrelia burgdorferi, M. pneumonia; ability to accumulate intracellularly--
58
tetracyclines toxicity
GI, discoloration of teeth, inhibition of bone growth in children, photosensitivity. contraindicated in pregnancy
59
tetracyclines resistance
decreased uptake into cells or increased efflux by plasmin-encoded transport pumps
60
macrolides MOA
inhibit protein synthesis by blocking translocation; bind to 23S rRNA of 50S; bacteriostatic
61
macrolides use
atypical pneumonia (mycoplasma, chlamydia, legionella), chlamydia, gram + cocci (strep infections in pts allergic to penicillin)
62
macrolides toxicity
MACRO
motility issues, arrhythmia (prolonged QT), acute cholestatic hepatitis, rash, eosinophilia; increase serum concentration of theophyllines, oral anticoagulants
63
macrolides resistance
methylation of 23S rRNA
64
chloramphenicol MOA
blocks peptidyltransferase at 50S; bacteriostatic
65
chloramphenicol use
meningitis (H. influenza, neisseria, strep pneumonia)
66
chloramphenicol toxicity
anemia (dose dependent), aplastic anemia (dose independent), gray baby syndrome (lack liver UDP-glucuronyl transferase)
67
chloramphenicol resistance
plasmid-encoded acetyltransferase
68
clindamycin MOA
blocks peptide transfer at 50S; bacteriostatic
69
clindamycin use
anaerobic infections (bacteroides fragilis, C. perfringens) in aspiration pneumonia or lung abscess, gram + cocci
70
clindamycin toxicity
pseudomembranous colitis, fever, diarrhea
71
sulfonamides MOA
PABA antimetabolites inhibit dihydropteroate synthase; bacteriostatic
72
sulfonamides use
gram +, gram -, nocardia, chmamydia; triple sulfas or SMX for simple UTI
73
sulfonamides toxicity
hypersensitivity, hemolysis of G6PD deficient, nephrotoxicity (tubulointerstitial nephritis), photosensitivity, kernicterus in infants, displace other drugs from albumin (warfarin)
74
sulfonamides resistance
altered bacterial dihydroproteroate synthase, decreased uptake, increased PABA synthesis
75
trimethoprim MOA
inhibits bacterial dihydrofolate reductase; bacteriostatic
76
trimethoprim use
in combo with sulfonamides causing sequential block of folate synthesis; combo used for UTI, shigella, salmonella, pneumocystis jirovecii
77
trimethoprim toxicity
TMP: treats marrow poorly
| megaloblastic anemia, leukopenia, granulocytopenia (may alleviate with supplemental folinic acid: leucovorin rescue)
78
fluoroquinolones MOA
inhibit DNA gyrase (topoisomerase II) and topoisomerase IV; bactericidal; must not be taken with antacids
79
fluoroquinolones use
gram - rods of urinary and GI tracts (pseudomonas), neisseria, some gram +
80
fluoroquinolones toxicity
GI, superinfections, skin rashes, headaches, dizziness, tendonitis, myalgias; contraindicated in pregnant women and children; prolonged QT; may cause tendon rupture in pts taking prednisone
81
fluoroquinolone resistance
chromosome-encoded mutation in DNA gyrase, plasmid-mediated resistance, efflux pump
82
metronidazole MOA
forms free radical toxic metabolites that damage DNA; bactericidal; antiprotozoal
83
metronidazole use
GET GAP
giardia, entamoeba, trichomonas, gardenella vaginalis, anaerobes, with proton pump inhibitor and clarithromycin against H. pylori
84
metronidazole toxicity
disulfiram-like reactions with alcohol (inhibits alcohol oxidizing enzymes), headache, metallic taste, GI
85
M. TB prophylaxis
isoniazid
86
M. TB treatment
RIPE
| rifampin, isoniazid, pyrazinamide, ethambutol
87
M. avium intracellulare prophylaxis
azithromycin
88
M. avium intracellulare treatment
azithromycin, rifampin, ethambutol, streptomycin
89
M. leprae treatment
tuberculoid form: dapsone and rifampin
| lepromatous form: add clofazimine
90
isoniazid MOA
decreased synthesis of mycolic acids; bacterial catalase peroxidase (KatG) needed to convert INH to active metabolites
91
isoniazid use
M. TB; different half-lives in fast vs slow acetylators
92
isoniazid toxicity
neurotoxicity, hepatotoxicity. Pyridoxine can prevent neurotoxicity, lupus
93
rifampin MOA
inhibits DNA-dependent RNA polymerase
94
rifampin use
M. TB, delays resistance to dapsone, meningococcal and H. influenza type B prophylaxis
95
rifampin toxicity
hepatotoxicity; enhances P-450, orange body fluids
96
pyrazinimide MOA
acidify intracellular environment via conversion of pyrazinoic acid
97
pyrazinimide use
M. TB
98
pyrazinimide toxicity
hyperuricemia, hepatotoxicity
99
ethambutol MOA
decrease carbohydrate polymerization of mycobacterial cell wall by blocking arabinosyltrabsferase
100
ethambutol use
M. TB
101
ethambutol toxicity
optic neuropathy (red-green color blindness)
102
meningococcal prophylaxis
ciproflaxacin, rifampin for children
103
gonorrhea prophylaxis
ceftriaxone
104
syphilis prophylaxis
benzathine penicillin G
105
recurrent UTIs prophylaxis
TMP-SMX
106
endocarditis with surgical or dental procedures
penicillins
107
pregnant woman carrying group B strep
ampicillin
108
prophylaxis of strep pharyngitis in a child with prior rheumatic fever
oral penicillin
109
prevention of post-surgical infection due to S. aureus
cefazolin
110
prevention of gonococcal or chlamydial conjunctivitis in newborn
erythromycin ointment
111
CD4<200 prophylaxis
TMP-SMX, pneumocystis
112
CD4<100 prophylaxis
TMP-SMX, pneumocystis and toxoplasmosis
113
CD4<50prophylaxis
mycobacterium avium complex
114
MRSA treatment
vancomycin
115
VRE treatment
linezolid and streptogramins (quinupristin/dalfopristin)
116
amphotericin B MOA
binds ergosterol and forms membrane pores
117
amphotericin B use
systemic mycoses, cryptococcus, blastomycoses, hitoplasma, candida. supplement K and Mg because of altered renal tubule oermeability
118
amphotericin B toxicity
fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis
hydration reduces nephrotoxicity
liposomal amphotericine reduces toxicity
119
nystatin MOA
same as amphotericin; topical form
120
nystatin use
oral candidiasis, diaper rash, vaginal candidiasis
121
azole MOA
inhibit fungal ergosterol synthesis by inhibiting P-450 that converts lanosterol to ergosterol
122
azoles use
fluconazole: chronic suppression of cryptococcal meningitis in AIDS and candidal infections
itraconazole: blastomyces, coccidiodes, histoplasma
clotrimazole and miconazole for topical fungal infections
123
azoles toxicity
testosterone synthesis inhibition (gynecomastia, esp ketokonazole); liver dysfunction
124
flucytosine MOA
inhibits DNA and RNA synthesis by conversion to 5-fluorouracil by cytosine deaminase
125
flucytosine use
systemic fungal infections (Esp Cryptococcus) in combination with amphotericin B
126
flucytosine toxicity
bone marrow suppression
127
capsofungin, micafungin MOA
inhibits cell wall synthesis by inhibiting synthesis of beta glucan (polysaccharide)
128
capsofungin, micafungin use
invasive asperigillosis, candida
129
capsofungin, micafungin toxicity
GI, flushing (histamine release)
130
terbinafine MOA
inhibits squalene epoxidase--> decreases ergosterol synthesis
131
terbinafine use
dermatophytoses (esp. onychomycosis)
132
terbinafine toxicity
abnormal LFT, visual disturbances
133
griseofulvin MOA
interferes with microtubule function; disrupts mitosis; deposits in keratin-containing tissues
134
griseofulvin use
oral treatment of superficial infections, inhibits growth of dermatophytes
135
griseofulvin toxicity
teratogenic, carcinogenic, confusion, headaches, encahnces P-450 and warfarin metabolism
136
anti-toxoplasmosis therapy
pyrimethamine
137
anti-trypanosoma brucei therapy
suramin and melarsoprol
138
anti-T. cruzi therapy
nifurtimox
139
anti-leishmaniasis therapy
sodium stibogluconate
140
chloroquine MOA
blocks detoxification of heme into hemozoin-->heme accumulates and is toxic to plasmodia
141
chloroquine use
treatment of plasmodium species other than P. falciparum
142
chloroquine resistance
membrane pump
143
chloroquine toxicity
retinopathy
144
P. falciparum treatment
artemether/lumifantrine or atovaquone/proguanil; for life-threatening use quinidine or artisunate
145
schistosoma treatment
praziquantel
146
zanamivir, oseltamivir MOA
inhibit influenza neuraminidase, decreasing the release of progeny virus
147
zanamivir, oseltamivir use
treatment and prevention of influenza A and B
148
rebavirin MOA
inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase
enhances TH1 and decreased TH2 responce
149
rebaririn use
RSV, chronic hepatitis C
150
ribavirin toxicity
hemolytic anemia, teratogen
151
acyclovir MOA
monophosphorylated by HSV/VZV thymidine kinase; guanosine analog; triphosphate formed by cellular enzymes; preferentially inhibits viral DNA polymerase by chain termination
152
acyclovir use
HSV and VZV, weak against EBV, no activity against CMV; genital lesions, encephalitis
valacyclovir: prodrug, better oral bioavailability
153
acyclovir toxicity
can cause crystalline nephropathy if adequate hydration is not provided
154
acyclovir resistance
mutated viral thymidine kinase
155
herpes zoster treatment
famciclovir
156
ganciclovir MOA
5-monophosphate formed by CMV viral kinase; guanosine analog; triphosphate formed by cellular kinases; preferentially inhibits viral DNA polymerase
157
gancilcovir use
CMV
| valganciclovir: prodrug, better oral bioavailability
158
ganciclovir toxicity
leukopenia, neutropenia (increased with zidovudine), thrombocytopenia, renal toxicity
159
ganciclovir resistance
mutated CMV DNA polmerase or lack of viral kinase
160
fascarnet MOA
viral DNA polymerase inhibitor that binds to pyrophosphate-binding site; does not require activation by viral kinase
161
foscarnet use
CMV retinitis in immunocompromised when ganciclovir fails; acycloovir-resistant HSV
162
fascarnet toxicity
nephrotoxicity; electrolyte abnormalities (can lead to hypocalcemia and hypomagnesemia, generalized seizures)
163
foscarnet resistance
mutated DNA polymerase
164
cidofovir MOA
preferentially inhibits viral DNA polymerase; doesn't require phosphorylation by viral kinase
165
cidofovir use
CMV retinitis in immunocompromised; acyclovir-resistant HSV; long half-life
166
cidofovir toxicity
nephrotoxicity (coadminister with probenecid and IV saline)
167
medication-induced body fat redistribution syndrome
associated with HIV protease inhibitors and glucocorticoids
168
HAART
initiated when pts have CD4<500 or high viral load
| 2 NRTI + NNRTI or protease inhibitor or integrase inhibitor
169
protease inhibitors
-navir (lopinavir)
170
protease inhibitors MOA
prevent maturation of new viruses
| ritonavir: inhibits P-450
171
protease inhibitors toxicity
hyperglycemia, GI, lipodystrophy, nephropathy, hematuria (indinavir)
172
NRTIs
tenofovir, abacavir, emtricitabine, lamivudine, zidovudine, stavudine, didanosine
173
NRTIs MOA
competitively inhibit nucleotide binding to reverse transcriptase and terminate DNA chain
tenofovir: nucleotide analog, doesn't have to be activated (others are nucleoside analogs and need to be phosphorylated)
ZDV (zidovudine): used for general prophylaxis and during pregnancy
174
NRTIs toxicity
bone marrow suppression (Can be reversed with G-CSF an erythropoietin), peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), anemia (ZDV)
ZDV: can inhibit mamalian cellular and mitochondrial beta and gamma DNA polymerases
didanosine: pancreatitis
175
NNRTIs
nevirapine, efavirenz, delavirdine
176
NNRTIs MOA
bind to reverse transcriptase; do not require phosphorylation
177
NNRTIs toxicity
same as NRTIs
| nevirapine and efavirenz: Steven-Johnson syndrome and toxic epidermal necrolysis
178
integrase inhibitors
raltegravir
179
integrase inhibitors MOA
inhibits HIV genome integration into host chromosome by reversibly inhibiting HIV integrase
impaired mRNA transcription
180
integrase inhibitors toxicity
hypercholesterolemia
181
intefrerons MOA
glycoproteins synthesized by virus infected cells; block replication of DNA and RNA viruses
182
interferon alpha use
chronic hepatitis B and C, Kaposi's sarcoma
183
interferon beta use
MS
184
interferon gamma use
NADPH oxidase deficiency
185
interferons toxicity
neutropenia, myopathy
186
enfuviritide MOA and use
prevents viral entry into target cells
antiretroviral fusion inhibitor
used for HIV
187
antibiotics to avoid in pregnancy
SAFe Children Take Really Good Care
| sulfonamides, aminoglycosides, fluoroquinolones, clarithromycin, tetracyclines, ribavirin, griseofulvin, chloramphenicol
188
sulfonamides during pregnancy
kernictures
189
aminoglycosides during pregnancy
ototoxicity
190
fluoroquinolones during pregnancy
cartilage damage
191
clarithromycin during pregnancy
embryotoxic
192
tetracyclines during pregnancy
discolored teeth, inhibition of bone growth
193
ribavirin during pregnancy
teratogenic
194
griseofulvin during pregnancy
teratogenic
195
chloramphenicol during pregnancy
gray baby
196
direct cholinergic agonists
bethanecol, carbachol, pilocarpine, methacoline
197
bethanecol MOA
activates bowel and bladder smooth muscle; resistant to AChE
198
bethanecol use
postoperative ileus, neurogenic ileus, urinary retention
199
carbachol MOA
carbon copy of ACh
200
carbachol use
glaucoma, pupillary contraction, relief of intraocular pressure
201
pilocarpine MOA
contracts ciliary muscle of eye (open angle glaucoma), pupillary sphincter (closed-angle glaucoma), resistant to AChE
202
pilocarpine use
stimulator of sweat, tears, and saliva
| open and closed-angle glaucoma
203
methacoline MOA
stimulates muscuranic receptors in airway when inhaled
204
methacoline use
challenge test for diagnosis of asthma
205
indirect cholinergic agonists
neostigmine, pyridostigmine, edrophonium, physostigmine, donepezil
206
neostigmine MOA
increases endogenous ACh
| no CNS penetration
207
neostigmine use
postoperative and neurologic ilues, urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade
208
pyridostigmine MOA
increases endogenous ACh, increases strength
209
pyridostigmine use
myasthenia gravis (long-acting), doesn't penetrate CNS
210
edrophonium MOA
increases endogenous ACh
211
edrophonium use
diagnosis of myasthenia gravis (extremely short-acting)
212
physostigmine MOA
increases endogenous ACh, fixes atropine overdose
213
physostigmine use
anticholinergic toxicity (crosses BBB)
214
donepezil MOA
increases endogenous ACh
215
donepezil use
alzheimers
216
cholinomimetic agents possible exacerbation
COPD, asthma, peptic ulcers
217
can you use beta blockers in cardiogenic shock?
no
218
protective against diabetic nephropathy
ACE inhibitors
219
Ca channel blockers
nifedipine, diltiazem, verapamil, amlodipine
220
Ca channel blockers MOA
block voltage-dependent L-type Ca channels-->reduce muscle contractility
smooth muscle: amlodipine, nifedipine
geart: verapamil> diltiazem
221
Ca channel blockers use
hypertension, angina, antiarrhythmic (not nifedipine), Prinzmetal's angina, Raynaud's
222
Ca channel blockers toxicity
cardiac depression, AV block, peripheral edema, flushing, dizziness, constipation
223
hydralazine, diazoxide MOA
increase cGMP-->smooth muscle relaxation, vasodilates arterioles-->afterload reduction
224
hydralazine, diazoxide use
severe hypertension, CHF. 1st line for hypertension in pregnancy (with methyldopa). Often administered with beta blockers to prevent reflex tachycardia
225
hydralazine, diazoxide toxicity
compensatory tachycardia, fluid retention, nausea, headache, angina, SLE
226
nitroprusside MOA
short-acting
| increases cGMP via direct release of NO--> arterial and venous vasodilator
227
nitroprusside use
malignant hypertension
228
nitroprusside toxicity
cyanide (treat with sulfur)
229
fenoldopam MOA
D1 receptor agonist-->coronary, peripheral, renal, splanchnic vasodilation
230
fenoldopam use
malignant hypertension
| decreased BP and increases natriuresis
231
nitroglycerin, isosorbide dinitrate MOA
vasodilate by releasing NO-->increase in cGMP and smooth muscle relaxation
dilate veins, decrease preload
232
nitroglycerin, isosorbide dinitrate use
angina, pulmonary edema
233
nitroglycerin, isosorbide dinitrate toxicity
reflex tachycardia, hypotension, flushing
| pts taking daily nitrates need to have a nitrate-free period every day to avoid tolerance
234
isosorbide mononitrate
nearly 100% bioavailable when taken orally
235
partial beta agonists contraindicated in angina
pindolol, acebutolol
236
statins MOA
inhibit HMG-CoA reductase
inhibit conversion of HMG-CoA to mevalonate
pravastatin: not metabolized by P450
237
statins use
decrease LDL, increase HDL, decrease TG
238
statins toxicity
hepatotoxicity, rhabdomyolysis: can lead to acute renal failure
239
niacin use
increase HDL, decrease LDL, decrease TG
240
niacin MOA
inhibits lipolysis in adipose tissue, reduces hepatic VLDL secretion
potentiates effects of some anti-hypertensive meds
241
niacin toxicity
red, flushed face (decreased by aspirin or long-term), hyperglycemia, hyperuricemia
242
bile acid resins
cholestyramine, colestipol, colesevelam
243
bile acid resins MOA
prevent intestinal absorption of bile acids
244
bile acids use
decrease LDL, slightly increase HDL and TG
245
bile acids toxicity
pts hate it, decreases absorption of fat-solubel vitamins, cholesterol gallstones
246
ezetemibe MOA
prevent cholesterol reabsorption in small intestine
247
ezetemibe use
decreases LDL
248
ezetimibe toxicity
rare increase LFT, diarrhea
249
fibrates MOA
upregulates LPL-->increase TG clearance
250
fibrates use
decrease TG, decrease LDL, increase HDL
251
fibrates toxicity
myositis, hepatotoxicity, cholesterol gallstones
| combination with statins increases risk of myopathy
252
digoxin MOA
direct inhibition of Na/K ATPase-->indirect inhibition of Na/Ca exchanger-->increased intracellular Ca-->positive inotropy
decreases HR
253
digoxin uses
CHF, atrial fibrillation
254
digoxin toxicity
cholinergic: nausea, vomiting, diarrhea, blurry yeallow vision
increased PR, shortened QT, ST scooping, T-wave inversion, arrhythmia, AV block
hyperkalemia-->poor prognostic indicator
factors predisposing to toxicity: renal failure, hypokalemia, quinidine (displaces digoxin from tissue-binding sites)
