Drugs - Mechanisms I Flashcards
methotrexate
inhibits dihydrofolate reducatase in humans
Class IC antiarrhythmic contraindication
ischemic and structural heart disease
amiodarone
Class III antiarrhythmic (K channel)
-navir drugs
protease inhibitors
Tizanidine
alpha 2
Pilocarpine
mimics ACh (but AChE resistant) –> constricts ciliary muscle
Ethambutol
blocks arabinosyltransferase –> decreased carbohydrate polymerization in cell wall
Cylcosporine
binds cyclophilin –> Calcineurin inhibition –> no IL-2
-glitazone
thiazolidinediones, activate PPAR gamma –> increase insulin sensitivity and adiponectin levels
Sacubitril
neprilysin inhibitor –> prevents degradation of bradykinin, ANP, BNP, A2
Milrinone
PDE3 inhibitor (used in acute decomp HF with shock)
2,4-dinitrophenol
increased mitochondrial membrane permeability –> uncoupling
Solifenacin
antimuscarinic (bladder)
Carbapenems
block peptidoglycan cross linking
Tacrolimus
binds FK506 –> caclineurin inhibition –> no IL-2
Norepinephrine
alpha 1 > alpha 2 > beta 1 –> increased BP –> reflex decreased HR
Terbinafine
blocks Lanosterol synthesis (squalene epoxidase)
phentolamine
reversible nonselective alpha blocker
Carvedilol anf Labetalol
non selective alpha and beta antagonists
NPH
intermediate acting insulin
Sirolimus (Rapamycin)
mTOR inhibitor, binds FKBP –> no IL-2 response
Class IB antiarrhythmics
Weak Na channel blockade –> preferentially decrease AP duration in ischemic tissue (use post MI)
Glucocorticoids
inhibit NF-kappaB –> decreased cyokines and increase T cell apoptosis
Niacin
inhibits lipolysis in adipose tissue and reduces hepatic VLDL synthesis –> LDL down, HDL up, TG somewhat down
Enfuvirtide
binds gp40 –> blocks HIV viral fusion
Cephalosporins
block peptidoglycan cross linking
Class IC antiarrhythmics
Strong Na channel blockade –> selectively prolongs AP ERP in AV node and accessory tracts
edrophonium
anticholinesterase
Echinocandins
blocks fungal cell wall synthesis (beta-glucan)
detemir
long acting insulin
Ipratropium
antimuscarinic
Foscarnet
DNA pol inhibitor
PCSK9 inhibitors
block LDL receptor degradation –> removal of LDL from bloodstream (and some tg)
Acyclovir
guanosine analog
metformin (a biguanide)
inhibits mGDP –> inhibits hepatic gluconeogenesis
increases glycolysis and insulin sensitivity
Dantrolene
blocks Ca release from sarcoplasmic reticulum
Dapsone
block PABA –> DHF (folate synthesis)
Monobactams (aztreonam)
block peptidoglycan cross linking
Chloroquine
blocks heme –> hemozoin detoxification –> heme is toxic to plasmodia
febuxostat
xanthine oxidase inhibitor
Name the bile acid resins
cholestyramine, colestipol, colesevelam
Carbachol
mimics ACh (but AChE resistant)
Dipyradimole
inhibits platelet aggregation (nonspecific PDE inh)
Ribovirin
blocks guanine synthesis
Class II antiarrhythmics
beta blockers –> decrease cAMP and Ca in SA and AV nodes
Palivizumab
anti RSV F protein monoclonal
trimethoprim
inhibits dihydrofolate reducatase in bacteria
Oligomycin
ETC complex V (ATPsynthase) inhibitor
Secukinumab
anti IL-17 monoclonal
Methacholine
Cholinomimetic –> activates muscarinics in the airway
galantamine
anticholinesterase
regular insulin is…
short acting
Linezolid
Targets 50S subunit
Daptomycin
disrupts membrane integrity (gram +)
antiarrhythmic channel target pneumonic
they’re in order of molecular number (1, 3, 4 = Na, K, Ca)
Isoproterenol
beta 1 = beta 2 –> decreased BP, increased HR and CO (can worsen ischemia)
Pembrolizumab
anti PD-1 monoclonal
Omalizumab
anti IgE monoclonal
Oxybutynin
antimuscarinic (bladder)
-tegravir drugs
integrase inhibitors
Clindamycin
Targets 50S subunit
glycopyrrolate
antimuscarinic
Lispro
Rapid insulin
Verapamil
nondihydropyridine Ca channel blocker –> acts on heart (Type IV anti-arrhythmic)
Phenylephrine
alpha 1 > alpha 2 –> increased BP –> decreased HR
Sulfonamides
block PABA –> DHF (folate synthesis)
Dofetilide
Class III antiarrhythmic (K channel)
Rifampin
inhibits RNA pol
epinephrine
low dose: beta > alpha –> increased HR and CO
high dose: alpha > beta –> increased BP
(stronger beta 2 than norepi)
Theophyline
nonspecific PDE inhibitor –> increased cAMP –> smooth muscle relaxation –> bronchodilation
Quinidine
Class IA antiarrhythmic (moderate Na channe block)
leflunomide
inhibits dihydroorotate dehydrogenase –> blocks pyrimidine synthesis
Ibutilide
Class III antiarrhythmic (K channel)
Lidocaine
Class IB antiarrhythmic (weak Na channel block)
Rotenone
ETC complex I inhibitor
Fibrates
activate PPAR-alpha –> upregulate LPL –> increased TG clearance (also LDL loss and HDL synthesis)
Mirtazapine
selective alpha 2 blocker
Roflumilast
PDE4 inhibitor –> increased cAMP (used in COPD)
Eculizumab
anti Complement C5 monoclonal
Ezetimibe
Prevents cholesterol absorption at the brush border