Drugs - Midterm 3 Flashcards
Tamoxifen
- partial estrogen antagonist
- blocks the actions of estrogen in the breast
- used to treat breast cancers
Mifepristone
- morning-after contraception
- blocks progesterone and glucocorticoid receptors (99% effective if used within 3 days)
- prevents implantation of the fetus
Danazol
- suppresses ovarian function
- has a masculinizing effect
Clomiphene
- “Clomid”
- partial estrogen agonist
- ovulation-inducing
- promotes fertilization and pregnancy
- increased risk of multiple births (twins)
ketoconazole
- antifungal drug
- inhibits steroid synthesis
- used to treat prostate carcinoma in males
oxytocin
- induces/augments labor
metoclopramide
- dopamine D2 receptor antagonist that stimulates prolactin and lactation
aspirin
- NSAID
- non selective COX 1/2 inhibitor
ibuprofen
- NSAID
- non selective COX 1/2 inhibitor
naproxen
- NSAID
- non selective COX 1/2 inhibitor
celecoxib
- NSAID
- selective COX 2 inhibitor
adverse effects of all NSAIDs
- CNS (tinnitus)
- CVS (hypertension)
- GI (nausea, ulcers, bleeding)
- Hepatic (altered liver functions)
- Pulmonary (asthma)
- Skin (rashes)
- Renal (insufficiency, and failure in sever cases)
uses of NSAIDs
- decrease pain and inflammation
- COX 1 inhibition (GI, bleeding, and kidney side effects)
- COX 2 inhibition (MI, stroke, and hypertension side effects)
uses and side effects of glucocorticoids
- rapidly acting, dramatic effect on inflammation, slows bone erosions, and treats rheumatoid arthritis
- side effects: loss of muscle mass, osteoporosis, diabetogenesis, peptic ulcers, round face, buffalo hump
dexamethasone
- glucocorticoid (long acting)
cortisone
- short to medium acting glucocorticoid
prednisone
- short to medium acting glucocorticoid
uses and side effects of disease-modifying anti-rheumatic drugs (DMARDs)
- decrease inflammation and slow bone damage in rheumatoid arthritis
- potentially more toxic than other options
- sever hepatotoxicity
- stomatitis
- immunosuppression
methotrexate
- DMARD
sulfasalazine
- DMARD
etanercept
- DMARD
- anti-rheumatic/anti-autoimmune disease
- inhibits inflammation by blocking TNF
infliximab
- DMARD
- antibody that blocks TNF
- used to treat inflammatory diseases
salicylic acid (for acne)
- topical keratolytic
- removes keratin layer and opens sebaceous glands
- can be used as wart removers
benzoyl peroxide
- topical keratolytic
- removes keratin layer and opens sebaceous glands
- can be used as wart removers
erythromycin
- antibiotic
- used for acne; eliminates the bacteria that cause the infection and inflammation associated with acne
- can be topical or systemic; drugs concentrate in the skin
tetracycline
- antibiotic
- used for acne; eliminates the bacteria that cause the infection and inflammation associated with acne
- can be topical or systemic; drugs concentrate in the skin
clindamycin
- antibiotic
- used for acne; eliminates the bacteria that cause the infection and inflammation associated with acne
- can be topical or systemic; drugs concentrate in the skin
Retinoids
- Vitamin A derivatives
- side effects: dry skin, sores
Tretinoin
- topical retin A
- Vitamin A derivative
isotretinoin
- “Accutane”
- systemic
- side effects: dry skin, sores, major birth defects**
non-drug treatments for acne
- UV phototherapy (acne-causing bacteria are photosensitive)
Antispasmolytics
- muscle relaxants
- reduce muscle stretch reflex
- enhance levels of inhibition, usually via GABA systems in CNS
Diazepam
- can be used as a muscle relaxant
Baclofen
- muscle relaxant
- GABA B agonist
Dantrolene
- muscle relaxant
- affects Ca2+ trafficking
Carisoprodol
- “Soma”
- muscle relaxant/sedative
- may have some dependence problems
D-turbocurarine
- non-depolarizing neuromuscular blocker
- blocks ganglionic nicotinic receptor
- reversed by acetylcholinesterase inhibitors
succinylcholine
- depolarizing neuromuscular blocker
- blocks ganglionic nicotinic receptors by desensitizing/overstimulating them?
- fast acting (get an initial twitch before paralysis
- NOT reversed by acetylcholinesterase inhibitors
acyclovir
- “Zovirax”, “Denavir” ointments
- viral thymidine kinase-dependent medication (some viruses are becoming resistant)
- most effective for HSV 1 and 2
- less effective for VZV
- most effective if used early in infection
- some topical forms available
famciclovir
- effective against VZV virus and shingles, also for herpes viruses
- longer acting than acyclovir
- most effective if used early in infection
foscarnet
- non-thymidine kinase dependent (less resistance issues)
magnesium salts
- antacid (neutralizes gastric HCl)
- can cause diarrhea
bicarbonate
- antacid
- can cause gas
calcium carbonate
- antacid
- can cause constipation
- is chalky
aluminum salts
- antacid
- not very effective
H2 receptor blockers
- not effective at H1 receptors
- reduce gastric secretions
Cimetidine
- “Tagamet”
- H2 blocker
- tx of GERD
Ranitidine
- “Zantac”
- H2 blocker
- tx of GERD
Famotidine
- Pepcid
- H2 blocker
- tx of GERD
Proton pump inhibitors
- disrupts hydrogen exchange for potassium in gastric parietal cells which blocks the production and release of HCl into the gut
- side effects: diarrhea, interferes with digestion, increases food allergies, oral sores/ulcers
- often combined with H2 blockers or with antacids
Omeprazole
- “Prilosec”
- proton pump inhibitor
Lansoprazole
- “Prevocid”
- proton pump inhibitor
Esomeprazole
- “Nexium”
- proton pump inhibitor
Prevpac
- combination of lansoprazole (PPI) and antibiotics (amoxicillin and clarithromycin)
- used to treat peptic ulcer disease caused by H. pylori infection
Milk of Magnesium
- can kill H. pylori and be used to treat corresponding peptic ulcer disease
bisacodyl
- laxative (tx of constipation)
- stimulant of smooth muscles in the gut (can cause cramps)
- fast acting
- OTC
- suppository or oral administraitons
docusate
- causes more water retention in the stool (softens the stool)
- OTC (“Dulcolax”)
loperamine
- “Immodium”
- tx of diarrhea
- mild opioid agonist
bismuth subsalicylate
- “Pepto-bismol”
- tx of diarrhea
atropine (for GI issues)
- tx of diarrhea
- anti-cholinergic that slows intestinal motility
linaclotide
- “linzess”
- only FDA approved drug for treatment of IBS with constipation
- guanylate cyclase C agonist that cuases increased bowel movement and fluid secretion to reduce pain
- side effects: diarrhea and gas
mesalamine
- topical anti-inflammatory for treatment of IBD (i.e. Crohn’s disease or ulcerative colitis)
- corticosteroids may be used systemically to treat IBD
metronidazole (for GI issues)
- used to treat Crohn’s disease/IBD/ulcerative colitis
- may have a mechanism that affects the flora of the gut
pilocarpine
- cholinomimetic drug that causes contraction of the ciliary muscle of the eye
- increases outflow of aqueous humor (tx of glaucoma)
timolol
- beta blocker
- decreases aqueous humor production (tx of glaucoma)
lantanoprost
- prostaglandin
- increases outflow of aqueous humor (tx of glaucoma)
epinephrine
- alpha agonist
- increases outflow and decreases production of aqueous humor (tx of glaucoma)
acetazolamide
- carbonic anhydrase inhibitor
- reduces the secretion of aqueous humor (tx of glaucoma)
pharmacological options of macular degeneration
- vit. C or zinc oxide (antioxidants)
- benefit is minimal
meclizine
- “Antivert”
- H1 blocker, anti-cholinergic activity, CNS depressant
- anti-motion sickness medication used in tx of Meniere’s disease
- can cause xerostomia
diazepam
- anxiolytic
promethazine
- H1 blocker, anti-cholinergic
- anti-nausea, anti-motion sickness
- can cause xerostomia
dexamethasone (for ear issues)
- tx of Meniere’s disease
- long-acting steroid
hydrochlorthiazide
- diuretic
- regulates fluid volume and pressure in the inner ear
- tx of Meniere’s disease
treatment of otitis media
- antibiotics (amoxicillin, amoxicillin + clavulanate, or ceftriaxone)
cyclophosphamides
- alkylating agents used to treat cancers
- used to treat lymphomas (Hodgkin’s and non-Hodgkin’s), leukemias, breast cancers, and multiple myeloma
- causes alkylations of the DNA
- adverse effects: nausea/vomiting, damage to rapidly growing tissues (bone marrow, GI tract, oral mucosa), carcinogenic in nature
Procarbazine
- nitrosurea (the metabolites are alkylating agents)
- highly lipophilic (can cross the BBB)
- used with Decarbazine to treat Hodgkin’s lymphoma
Decarbazine
- nitrosurea (the metabolites are alkylating agents)
- highly lipophilic (can cross the BBB)
- tx of melanomas, lymphomas, and soft tissue sarcomas
Cisplatin
- platinum analog for tx of cancers
- used for a broad range of solid tumors
Methotrexate
- antimetabolite used to treat cancers and rheumatoid arthritis
- folic acid analog (interferes with formation of DNA and key proteins; inhibits tetrahydrofolate
- tx of head and neck cancers, breast cancer
- can cause mucositis and diarrhea
5-fluorouracil
- antimetabolite used to treat cancers (head, neck and GI cancers; also good for basal cell carcinoma)
- inhibits thymidine synthesis
Vinblastine or Vincristine
- vinca alkaloids (natural chemotherapeutic agents)
- inhibits tubulin polymerization to inhibit cell division –> tumor cells die
- toxicities: mucositis and alopecia
Etoposide
- semisynthetic chemotherapeutic agent from the mandrake plant
- inhibits topoisomerase II which interferes with DNA structuring
doxorubicin or bleomycin
- anthacyclines (anti-tumor antibiotics)
- used to treat breast cancer and Hodgkin’s lymphoma
Erlotineb
- antagonize epidermal growth factor receptors
- tx of cancer
Imatinib
- “Gleevac”
- inhibits oncogenes
- blocks a form of tyrosine kinase enzyme
- tx of chronic myeloid leukemia
- “great story”
