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Drugs Flashcards

1
Q

Dexamethasone

A

•Decadron
•glucocorticoid
Also used for lupus, organ transplant, asthma
•MOA: increase levels of lipocortin that inhibits phospholipase A2, decreasing inflammatory mediators
•oral
•Side Effects: immunosuppressive and cushingoid (central obesity, moon face, hyperglycaemia, osteoporosis etc…), mood swings

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2
Q

Triamcinolone

A
  • Aristocort, Nasacort
  • glucocorticoid
  • MOA: increase levels of lipocortin that inhibits phospholipase A2, decreasing inflammatory mediators
  • oral, topical, injectable
  • Side Effects: immunosuppressive and cushingoid (central obesity, moon face, hyperglycaemia, osteoporosis etc…), mood swings
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3
Q

Budesonide

A
  • Entocort, Symbocort+formoterol
  • MOA: increase levels of lipocortin that inhibits phospholipase A2, decreasing inflammatory mediators
  • inhaled
  • Side Effects: immunosuppressive and cushingoid (central obesity, moon face, hyperglycaemia, osteoporosis etc…), mood swings
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4
Q

Hydrocortisone

A
  • Cortisol
  • glucocorticoid
  • MOA: increase levels of lipocortin that inhibits phospholipase A2, decreasing inflammatory mediators
  • topical
  • Side Effects: increased risk of infection, severe allergic reactions and skin irritation, psychosis, increased hair growth
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5
Q

Teraparatide

A
  • Forteo
  • osteoporosis medication
  • anabolic agents (increase bone density)
  • MOA: recombinant truncated form of parathyroid hormone, binds to PTH receptors on osteoblasts to stimulate RANK ligand release
  • Side Effects: JOINT ACHES, nausea, leg cramps, allergic reaction, slight chance of developing osteosarcoma in rats
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6
Q

Denosumab

A
  • XGEVA, Prolia
  • osteoporosis medication
  • antiresorptive
  • MOA: human monoclonal antibody designed to inhibit RANKL therefore inhibiting the maturation of osteoclasts, hence a decrease in osteoclasts
  • Side Effects: infections of the respiratory and urinary tracts, cataracts, constipation, rashes and joint pain, contraindicated in patients with hypocalcemia
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7
Q

Raloxifene

A
  • Evista
  • osteoporosis medication
  • selective estrogen receptor modulators (SERMs)
  • MOA: mixed agonist/antagonist for estrogen receptors, agonist for estrogen receptors in bone - enhancing osteoblasts activity
  • Side Effects: increased risk for endometrial cancer, hot flashes, flushing, fatty liver, risk of blood clots
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8
Q

Alendronate

A
  • Fosamax
  • osteoporosis medication
  • bisphosphonate/ antiresorptive
  • MOA: a pyrophosphate that lines the bone, is absorbed by the osteoclast and kills the osteoclast by blocking an enzyme for cholesterol synthesis
  • Side Effects: ulceration of the eso-Hague’s, eso-Hague’s cancer, necrosis of the jaw, skin rash, uveitis
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9
Q

Zolendronic

A
  • Zometa
  • osteoporosis medication
  • bisphosphonate/ antiresorptive
  • MOA: a pyrophosphate that lines the bone, is absorbed by the osteoclast and kills the osteoclast by blocking an enzyme for cholesterol synthesis
  • Side Effects:fatigue, anemia,muscle aches, necrosis of the jaw
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10
Q

Ustekinumab

A
  • Stelara
  • arthritis medication, also used to treat plaque psoriasis
  • biologic DMARD, IL-12 inhibitor
  • MOA: monoclonal antibody that inhibits IL-12 and IL-23, decreasing T-Cell activation
  • Side Effects: SERIOUS INFECTIONS including TB, upper respiratory tract infection, fatigue
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11
Q

Guselkumab

A
  • Tremfya
  • arthritis medication, also used to treat plaque psoriasis
  • biologic DMARD, IL-23 inhibitor
  • MOA: monoclonal antibody that inhibits IL-23
  • Side Effects: SERIOUS INFECTION including TB, upper respiratory tract infection, fatigue
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12
Q

Ciprofloxacin

A
  • Cipro
  • antibacterial, broad spectrum Gram - and Gram + bacteria
  • fluorquinilone
  • MOA: inhibits DNA gyrase (a type of II and IV topoisomerase)
  • Side Effects: TENDON DAMAGE/RUPTURE, muscle weakness, GI disturbances, headache, dizziness
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13
Q

Azithromycin

A
  • Zithromax
  • macrolide
  • antibacterial, broad spectrum against aerobic and anaerobic, Gram - and Gram + bacteria
  • MOA: inhibits protein synthesis by binding to the 50S subunit of the bacterial ribosome
  • Side Effects: GI disturbances, rash
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14
Q

Tetracycline

A
  • Sumycin, Tetracyn, Panmycin
  • polyketide
  • antibacterial, Ricketsia, B. burgdorferi, chylamidia, H. pylori, broad spectrum Gram - and Gram + bacteria
  • MOA: bacteriostatic, inhibits protein synthesis, binds the 30S ribosomal unit (inhibits RNA translation to protein)
  • Side Effects: stain developing teeth, liver toxicity, GI disturbances, photosensitivity, decrease in bone growth in foetus
  • Doxycycline
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15
Q

Nafcillan

A
  • Cubicin
  • antibacterial, Gram + bacteria, used for Staph, but NOT MRSA
  • MOA: beta lactam containing ring that inhibits the synthesis of the Gram + bacterial cell wall
  • Side Effects: allergic reactions, GI disturbances, hypokalemia, abdominal pain, yeast infections
  • Dicloxacillan
  • Methicillan
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16
Q

Clindamycin

A
  • Cleocin, Clindacin, Clindagel, ClindaMax, Clindesse, Evoclin
  • lincosamide
  • antibacterial, anaerobic, streptococcal, staphylococcal bacteria
  • MOA: bacteriostatic, binds 50S subunit and interferes with transpeptidation reaction, disrupting protein synthesis
  • Side Effects: GI disturbance, including increased risk of Clostridium difficile colitis, allergic reaction, Stevens Johnson Syndrome
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17
Q

Sulfamethoxazole

A
  • Bactria, Septrin, Septra
  • sulfonamides
  • antibacterial, Gram + bacteria
  • MOA: bacteriostatic, competitive inhibitor of dihydropteroate synthase - blocking folic acid production- hence blocking DNA synthesis
  • Side Effects: GI disturbances, allergic reactions, Stevens Johnson Syndrome, can cause crystal formation in kidney and bladder, photosensitivity
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18
Q

Ketoconazole

A
  • Nizoral, Xolegel
  • antifungal
  • azole
  • used for topical fungal infections and found in shampoos to treat dandruff
  • MOA: inhibit fungal sterol (ergosterol) synthesis
  • Side Effects: inhibition of testosterone synthesis (gynecomastia), LIVER DYSFUNCTION by inhibiting cyp450
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19
Q

Clotrimazole

A
  • Desenex
  • antifungal
  • azole
  • topical for tinea (ringworm)
  • MOA:inhibit fungal sterol (ergosterol) synthesis
  • Side Effects: inhibition of testosterone synthesis (gynecomastia), liver dysfunction by inhibiting cyp450
20
Q

Fluconazole

A
  • Diflucan
  • antifungal
  • azole
  • oral or IV, often used for candida infections
  • MOA: inhibit fungal sterol (ergosterol) synthesis
  • Side Effects: rash, GI issues, LIVER DYSFUNCTION by inhibiting CYP2C19, CYP3A4
21
Q

Amphotericin B

A
  • Ambisome, Abelcet
  • antifungal
  • polyene
  • oral treatment of candidiasis resistant to azole, histoplasmosis, coccidiomycosis, aspergillosis, cryptococcosis
  • MOA: binds ergosterol, forms membrane pores
  • Side Effects: chills, fever, vomiting, NEPHROTOXICITY, bone marrow suppression
22
Q

Nystatin

A
  • Nyamyc, Nystop
  • antifungal
  • polyene
  • topical treatment of oral, vaginal and cutaneous candidiasis, diaper rash, thrush
  • MOA: binds ergosterol, forms membrane
  • Side Effects: hypersensitivity, rash, SJS
23
Q

Terbinafine

A
  • Lamisil
  • antifungal
  • polyene
  • oral use for onychomycosis or widespread tinea, fungal nail
  • MOA: inhibits fungal enzyme squalene epoxidase inhibiting infections, athlete’s foot, “jock itch”
  • Side Effects: GI disturbance, HEPATOTOXICITY, headaches, vertigo
24
Q

Griseofulvin

A
  • Gris-PEG
  • antifungal
  • polyene
  • oral treatment of superficial fungal infections unresponsive to topical agents or involving scalp or nails
  • MOA: interferes with microtubule function, disrupts mitosis, deposits in keratin containing tissues
  • Side Effects: TERATOGENIC, CARCINOGENIC, confusion, headaches, increased CYTP450 and Warfarin metabolism
25
Q

Acyclovir

A
  • antiviral
  • nucleic acid synthesis inhibitor
  • MOA: guanosine analog, preferentially inhibits viral DNA polymerase by chain termination
  • Side Effects: NEPHROPATHY if not adequately hydrated
26
Q

Famciclovir

A
  • antiviral
  • nucleic acid synthesis inhibitor
  • MOA: is converted to penciclovir, which is converted to the triphosphate form, which selectively inhibits viral DNA polymerase by competing with deoxyguanosine triphosphate
  • Side Effects: headache, nausea
27
Q

Benzoyl peroxide

A

•antiseptic
•MOA: is thought to have a three fold activity in treating acne - sebostatic, comedolytic and inhibits growth of C. Acnes
Side Effects: bleaching, local irritation

28
Q

5-fluorouracil

A
  • anti-metabolite
  • MOA: a thymidylate synthase (TS) inhibitor; interrupting the action of this enzyme blocks synthesis of the pyrimidine thymidine, which is a nucleoside required for DNA replication
  • Side Effects: topical, dramatic inflammation at site of application
29
Q

Isotetinoin

A
  • Acutane
  • MOA: shrinks sebaceous glands, redefines the pilosebaceous unit
  • Side Effects: teratogenicity, depression, dry skin
30
Q

Permethrin

A
  • biologic
  • MOA: disrupt the sodium channel current in insect nerve cells that regulates the polarisation of the membrane
  • Side Effects: local irritation
31
Q

Spironolactone

A
  • biologic
  • MOA: aldosterone antagonist
  • Side Effects: gynecomastia, ED
32
Q

Tacrolimus

A
  • Sirolimus
  • biologic
  • MOA: calcineurin inhibitor
  • Side Effects: topical, local irritation
33
Q

Lidocaine

A
  • pain medication - local aesthetic
  • MOA: blockade of voltage gated sodium channels (VGSC)
  • use dependent
  • medium acting
  • side effects: death due to the blockade of respiration, cardiovascular problems, depression of smooth muscle contraction, seizures
34
Q

Morphine

A
  • pain medication - opiod
  • MOA: acts at my GPCR to cause opening of K+ channels and block VGSC
  • side effects: CONSTIPATION, nausea, emesis, sedation, somnolence, pruritic, respiratory depression, abuse potential
35
Q

Methotrexate

A
  • Rheumatrex, Trexall
  • arthritis medication, also used for ANCA associated vasculitis
  • traditional DMARD
  • MOA: inhibits, irreversibly, Dihydrofolate Reductase (DHFR) - an enzyme involved in the metabolism of folic acid, inhibits the synthesis of DNA, RNA and proteins, supressing the immune system
  • side effects: STOMATITIS (inflammation of mucus linings), alopecia, GI upset, major but rare - hepatic cirrhosis, PNEUMONITIS and severe myelosuppression
36
Q

Leflunomide

A
  • Arava
  • arthritis medication
  • traditional DMARD
  • MOA: inhibits pyrimidines by inhibiting the enzyme dihydrorotate dehydrogenase and also inhibits inflammation
  • side effects: LIVER DAMAGE (HEPATITIS, NECROSIS, CIRRHOSIS), intestinal pneumonitis, alopecia, severe myelosuppresion- making patients more susceptible to infection
37
Q

Azathioprine

A
  • Azasan, Imuran
  • arthritis medication, also used for lupus and ANCA associated vasculitis
  • traditional DMARD
  • MOA: inhibits synthesis of purines (adenine and guanine), suppressing the immune system
  • side effects: GI disturbances, fatigue, alopecia, rash, myelosuppression
38
Q

Hydroxychloroquine

A
  • Plasquenil
  • arthritis medication, also used for lupus
  • traditional DMARD
  • MOA: block toll like receptors (TLR 9) on plasmacytoid dendritic cells (PDCs)
  • side effects: altered eye pigmentation, corneal deposits, significant vision difficulties, bleaching of hair, acne, anemia, stomatitis, GI upset
39
Q

Adalimumab (Humira)
Etanercept (Enbrel)
Infliximab (Remicade)

A

•arthritis medication, also used for ankylosing spondylitis
•biologic DMARD, ant-TNF
•MOA: inhibit TNF alpha/receptor interactions
•side effects: SERIOUS INFECTIONS including TB, viral, fungal, bacterial infections, drug induced lupus, lymphoma association, serious and sometime fatal blood disorders
-injection site reactions, cutaneous manifestations of infusion reactions, cutaneous infections, non melanoma skin cancer, psoriasis
-lupus like syndrome, SJS, EM, TENs

40
Q

Focilzumab

A
  • Actemra
  • arthritis medication
  • biologic DMARD, IL-6 inhibitor
  • MOA: inhibits IL-6 receptor/IL-6 interactions
  • side effects: RESPIRATORY TRACT infections, headaches, hypertension, elevation in liver enzymes
41
Q

Abatacept

A
  • Orencia
  • arthritis medication
  • biologic DMARD, co-stimulators blockade
  • MOA: T cell costimulatory blocker, block interactions between antigen presenting cells and T lymphocytes
  • side effects: SERIOUS INFECTIONS including TB, viral, fungal, bacterial infections, serious and sometime fatal blood disorders
42
Q

Rituximab

A
  • Rituxan
  • arthritis medication, also used for scleroderma
  • biologic DMARD, B cell depletion
  • MOA: monoclonal antibody that binds the CD20 on B cells decreasing cytokines release, T cell interactions and reduction in autoantibody levels
  • side effects: SERIOUS INFECTIONS including TB,hives, itching, swelling, difficulty breathing, fever, chills, and changes in BP
43
Q

Tofactinib

A
  • Xeljanz
  • arthritis medication
  • biologic DMARD, kinase inhibitor
  • MOA: Janus Kinase 3 (JAK3) inhibitor- interfering with the JAK-STAT signaling pathway
  • side effects: SERIOUS INFECTIONS including TB, viral, fungal, bacterial infections
44
Q

Allopurinol

A

•Zyloprim
•gout medication
•xanthine oxidase inhibitor —> urate lowering drug
•MOA: purine analog inhibiting xanthine oxidase, inhibiting purine synthesis
•side effects: SERIOUS INFECTIONS including TB, upper respiratory tract infections, fatigue
-allopuriol induced hypersensitivity is a life threatening cutaneous adverse reaction, associated with significant mortality
-fever, skin rash, systemic involvement (liver, kidney, pulmonary, cardia, eosinophilia, atypical monocytosis)
-several types of rash - TENs, SJS, EM, generalised maculopapular exanthema, generalized exfoliative dermatitis (GED), DRESS
•accepted indications and dose adjustment for renal dysfunction are the only ways to decrease the incidence of potentially fatal toxic effects

45
Q

Colchicine

A
  • gout medication
  • MOA: inhibits microtubule polymerisation, halting mitosis
  • side effects: ANEMIA, LEUKOPENIA, hair loss, GI upset
46
Q

DMARDs

A 
•disease modifying anti rheumatic drugs
•RA and inflammatory arthritis
•if NSAIDs don’t work, DMARDs are used
•traditional: try these first, if they don’t work, a combo of biologic + traditional or just biologic
-methotrexate, leflunomide, sulfasalazine, hydrochlorquine, —if those aren’t tolerated or are contraindicated —> azathioprine, minocycline, doxycycline, gold, cyclosporin
•biologic
-learn based on pathways
1)TNF inhibitors
-infliximab, etanercept, adalimumab, golimumab, certolizimab
2)costimulatory signal inhibitors
-abatacept
3)IL-6 inhibitors
-toculizumab, sarilumab
4)B cell depletion
-rituximab
5)Janus Kinase (JAK) inhibitors
-tofacinib, baricitinib

MSS (14 decks)

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