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Drugs not in LANGE flashcards

1
Q

Raltegravir, Elvitegravir

A

Integrase inhibitors – HIV drug

Inhibit HIV genome integration into host cell chromes by reversibly inhibiting HIV integrate

Toxicity: Increases creatine Kinase

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2
Q

Enfuvirtide

A

HIV drug
Binds gp41 – inhibits viral entry

Toxicity – skin reactions at site of injection
+ epenseive

  • reserved for any drug resistant HIV strains
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3
Q

Maraviroc

A

HIV drug
Binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120

The problem: obviously can only be used in patients with functional CCR-5 receptor

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4
Q

Anidulafungin
Caspofungin
Micafungin

A

class: Echinocandins Antifungals

Mechanism: inhibit cell wall synthesis by inhibiting synthesis of beta-glucan

Clinical use: invasive aspergillosis, Candida

Toxicity = GI upset, flushing (via histamine release)

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5
Q

what are the 5 drug classes that can be used to treat glaucoma?

A 
alpha agonists
Beta blockers
Cholinomimetics
diuretics 
Prostaglandins (PGF-2)
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6
Q

What is the treatment for diverticulitis?

A

Metronidazole (anaerobes)

Fluoroquinolones (gram neg) or TMP-SMX

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7
Q

Cinacalcet

A

mechanism: Sensitizes Ca2+- sensing receptor (CaSR) in parathyroid

Clinical use: hypercalcemia due to primary or secondary hyperparathyroidism

Toxicity = hypocalcemia

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8
Q

Drugs that cause methemoglobinemia

A

Recall the methemoglobin – Fe3+ state (oxidized)

Nitrates 
Antimalarial drugs ( Primaqine, Chloroquine)
Dapsone
Sulfonamides
Local anesthetics ( Lidocaine)
metoclopimide
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9
Q

Drugs that can cause a long QT (cardiac)

A

ABCDE

anti-Arrythmics ( Ia, III)
AntiBiotics (macrolides)
Anti "C"ycotics (haloperidol)
Anti Depressants ( TCAs)
Anti Emetics (ondansetron)
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10
Q

How do you treat Torsades de pointes

A

Magnesium sulfate

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11
Q

How do you treat Wolff-Parkinson-White syndrome?

A 
Procainamide
- avoid beta blockers or calcium channel blockers ( can use class IA/C... others block AV node and facilitate passage through the accessory pathway.----> SVT
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12
Q

How do you treat atrial fibrillation?

A

Class IC or III anti-arrythmetics

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13
Q

What is the preferred treatment for atrial flutter?

A

catheter ablation

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14
Q

How do you treat an acute heart attack

A
  1. ABC
  2. MONA – morphine, O2 (if hypoxic), Nitroglycerine, Aspirin)
  3. Beta-blocker (but not if there is a sign of heart failure)
  4. Statin
  5. Anti-platelet – Clopidogrel/ticagrelor
  6. Anti-coagulant– heparin and enoxaparin
  7. K+> 4, Mg >2
  8. STEMI – CATH/ Fibrinolysis
  9. NSTEMI – Cath
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15
Q

What drugs decrease the oxygen demand of the heart?

A
  1. Beta blockers (decrease contractility & HR)
  2. Nitrates (decrease preload)
  3. ACE/ ARB ( decrease afterlood)
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16
Q

treatment for hair-pulling disorder (Trichotillomania)

A

Fluoxetine (SSRI) or Clomipramine (TCA)

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17
Q

Atomoxetine ( Strattera)

A

Norepinephrine reuptake inhibitor (SNRI)

ADHD - attention deficit hyperactivity disorder

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18
Q

Dextroamphetamine

A

(aka Adderall)

CNS stimulants
Cause release of catecholamines at the synaptic cleft

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19
Q

How do you treat intractable tics? (Tourette syndrome)

A

Behavioral therapy
Fluphenazine
Pimozide
Tetrabenzaine

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20
Q

Treatment of Bulimia Nervosa

A

(SSRI) Fluoxetine + psychotherapy

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21
Q

what is the treatment for DTs (Delirium Tremens)

A

Peaks 2-4 days after last drink

Benzodiazepines

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22
Q

What is used to treat alcoholic hallucinations

A

visual hallucination 12-48 hours after last drink

Long-acting benzodiazepines
chloridazepoxide, lorazepam, diazepam

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23
Q

Drug for Lyme disease or Rocky Moutain Spotted fever

A

Tetracyclines

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24
Q

Used to treat Giardia lamblia

A

Metronidazole

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25
Treatment for gram negative rods in patients with renal insufficiency
Meropenem/ imipenem with TMPX, Dapsone then Pentamiine
26
Propholaxis in Aids patients against P. jirovecii pneumonia
Cilastatin
27
Used as prophylaxis against TB
Isoniazid
28
Which antibiotics are safe during pregnancy
``` Penicillins and aminopenicillins Piperacillin Cephalosporins Macrolides (erythromycin, azithromycin) Metronidazole (after 1st trimester) Nitrofurantoin ```
29
which medication inhibits dihydrofolate reductase
Enzymes plays role in pyrimidine synthesis Methotrexate, Trimethoprim, pyrimethamine
30
which drug inhibits thymidylate synthase
Enzymes plays role in pyrimidine synthesis 5-FU 5- Fluorouracil
31
Inhibits nosine monophosphate dehydrogenase
Mycophenolate, Ribavirin
32
Inhibits PRPP amidotransferase
6-Mercaptopurine (6-MP) and it's prodrug azathioprine
33
Etoposide
Inhibits eukaryotic topoisomerase Treats cancer of the testicles and small cell lung cancer in combination with other medicines.
34
Alpha-amanitin
Toxin Found in Amanita phalloids (death cap mushrooms) and it inhibits RNA polymerase II (eukaryotes -- recall prokaryotes only have 1 polymerase). Can cause SEVERE HEPATOTOXICITY if ingested.
35
Drugs that cause Disulfiram-like reactions
Metronidazole Certain cephalosporins Procarbazine (Hodgkin lymphoma) 1st generation sulfonylureas (tolbutamide)
36
Who are the low potency neuroleptics?
Chlorpromazine, Thioridazine
37
Who are the high potency neuroleptics?
``` Haloperidol Fluphenazine Loxapine Thiothixene Trifluoperazine ```
38
Who are the atypical antipsychotics?
``` olanzapine quetiapine Risperidone apipiprazole clozapine ```
39
Methylphenidate Dextroamphetamine Methamphentamine - mechanism - clinical use? - toxicity?
Atypical antidepressant Stimulates release of norepinephrine and dopamine into synaptic cleft ADHD, narcolepsy, apetite control toxicity: sedation, increase appetite, weight gain, dry mouth
40
Trazodone - mechanism - clinical use? - toxicity
Atypical antidepressant blocks 5-HT2 and alpha-1 adrenergic receptors Primarly used for insomnia (works well with SSRIs and increases REM sleep) Toxicity: sedation, nausea, PRIAPISM (painful persistent penile erection), postural hypotension
41
Bupropion - mechanism - clinical use? - toxicity
Atypical antidepressant increases NE and dopamine by inhibiting its uptake Smoking cessation Toxicity: stimulant effects (tachycardia, insomnia) -- dont take drug before going to sleep - headaches, seizures in anorexic or bulimic patients benefit: NO SEXUAL SIDE EFFECTS
42
Nitrofuration mechanism Indication SE
mechanism: bacteriocidal Reduced by bacterial proteins to a reactive intermediate that inactivates bacterial ribosomes * has to be in presence of bacteria to be active Indication: UTI cystitis by E.coli or staph saprophyticus SE: rarely nausea, HA, diarrhea Safe in pregnancy
43
why should beta blockers not be used during cocaine intoxication
beta blockers can lead to severe hypertension from unopposed alpha 1 activation
44
How do you treat nephrogenic diabetes insipidus
Hydrochlorothiazide Amiloride (lithium toxicity) Indomethacin
45
Who are the short acting benzodiazepines?
"ATOM" Alprazolam Triazolam Oxazepam Midazolam
46
What are the drugs associated with Nephrotoxicity/ototoxicity
Vancomycin Aminoglycosides Loop diuretics Cisplatin and Carboplatin
47
Mnemonic for treating testicular cancer:
"Eradicate ball cancer" Etoposide Bleomycin Cisplatin Or: Etoposide Ifosfamide Cisplatin
48
Brimonidine what is it used for? receptor it targets? mechanism? Side Effects:
Glaucoma drug -- FA 494 (alpha 2) - decreases aqueous humor synthesis Blurry vision, ocular hyperemia, foreign body sensation, ocular allergic reactions, ocular parities
49
Beta blockers that can be used in glaucoma?
Timolol, betaxolol, carteolol -- Beta blockers Decrease aqueous humor synthesis No pupillary or vision changes
50
Mnemonic to see if beta blockers are specific for B1 or are non selective:
A- M selective against B1 N to Z is non selective Carvedilol and labetalol are nonselective alpha and beta antagonists.
51
Carbachol
muscarnic and nicotinic receptor agonist. | M3 receptor
52
Drugs that cause SLE
``` Hydralazine Procainamide Isoniazid Minocycline Quinidine ```
53
What is the treatment for Wilson's disease
low ceruloplasmin tx: penicillamine
54
What is the anti protozoan therapy for toxoplasmosis
Pyrimethamine
55
What is the anti-protozoan therapy for trypanosome brucei
suramin and melarsoprol
56
What is the anti-protozoan therapy for T. cruzi
nifurtimox
57
What is the anti-protozoan therapy for leishmaniasis
Sodium stibogluconate
58
What are the anti-louse therapies
Permethrin (blocks Na+)--> neurotoxicity Malathion (AchE i) Lindane (blocks GABA) ---> neurotoxicity To treat Scabies and Pedicures and Pthirus (lice)
59
who are the agents used as antihelminthic therapy
Mebendazole, pyrantel pamoate, ivermectin, diethylcarbamazine, praziquantel
60
treatment of Von Willebrand disease
Desmopressin -- analog of vasopressin/ADH -- it is known that it increases vWF release from endothelial cells. however, severe vWF deficiency will not respond to desmopressin
61
what is the treatment for gestational diabetes if light exercise and diet have failed?
Insulin -- does not cross the placenta
62
how is hypoglycemia treated in medical setting vs. non medical setting
In medical setting -- IV dextrose (glucose) In non medical setting -- intramuscular glucagon
63
treatment of central DI?
Intranasal desmopressin acetate | Hydration
64
Treatment for nephrogenic DI?
- HCTZ (1st line) -- causes patient to become dehydrated: makes PCT work harder and so it reabsorbs more water so that by the time filtrate hits distal tubal, it is already a little more concentrated - Indomethacin (blocks prostaglandin, decrease renal blood flow, inhibit urine output) - Amiloride ( blocks Na+ channels that lithium use to enter principle cell) -- lithium induced DI. - hydration
65
Treatment for SIADH?
``` Fluid restriction IV hypertonic saline (NaCl > 0.9%) Conivaptan Tolvaptan Demeclocycline ```
66
Drugs that can cause seizures
- Bupropion (antidepressant -- especially bolemic/ anorexic) - Clozapine (antipsychotic at high doses) - Isoniazide ( anti-TB, give pyridoxine) - Ciproflaxin (antibiotic) - Imipenem (antibiotic)
67
treatment for ADHD? | - names and mechanism
stimulants : Methylphenidate, dextroamphetamine, methamphetamine mechanism: increase catecholamines in the synaptic cleft, especially NE and Dopamine
68
treatment for alcohol withdrawal
long-acting benzodiazepines | (chlordiazepoxide, lorazepam, diazepam_
69
treatment for bipolar disorder
- Lithium ( mood stabilizer) - Valproic acid - Atypical antipsyhcotics
70
treatment for Bulimia
SSRIs
71
treatment for Depression
SSRIs
72
treatment for generalized anxiety disorder
SSRIs, SNRIs
73
Treatment for obsessive compulsive disorder
SSRIs, clomipramine (tricyclic antidepressant - block reuptake of NE and 5-HT - serotonin)
74
treatment of panic disorder
SSRIs Venlafaxine (SNRI) benzodiazepines
75
treatment of PTSD
SSRIS | Venlafaxine (SNRI)
76
treatment of Schizophrenia
``` Atypical antipsychotics (olanzapine, clozapine, quetiapine, risperidone, aripiprazole, ziprasidone) ```
77
Treatment for social phobias
SSRIs, beta-blockers
78
Tourette Syndrome
Antipsychotics (fluphenazine, pimozide) tetrabenazine Clonidine
79
drugs with antimuscarinic effects:
``` Atropine TCA H1 antagonists neuro-eleptics Anti-parkinson meds ``` = flushing and myadriasis
80
who are the mood stabilizers? Are they used in combination with anything else?
Lithium Valproate ( Valproic Acid) carbamazepine Plus an atypical antisychotic (olanzapine)
81
treatment for essential tremors
nonspecific beta-adrenergic antagonist (like propranolol) | essential tremor is believed to be inherited as an autosomal dominant
82
Drug given for ALS
"Lou needed riLUzole" Riluzole -- decreases presynaptic glutamate release
83
treatment for bedwetting
Desmopressin
84
Treatment for night terrors and sleepwalking
benzodiazepines

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