Exam 4 Flashcards
Drugs
Heparin
Anti-coagulant. Enhances antithrombin activity (1000x) which inhibits Xa and thrombin. Reversed by protamine sulfate.
LMW heparin
Anti-coagulant, enhances antithrombin and is more specific for factor Xa inactivation.
Fondaparinux
Anti-coagulant, increases antithrombin. The least efficacious.
Protamine sulfate
Reversal agent for heparin.
Hirudin/ Lepirudin
Anti-coagulant. Derived from leeches also can be made recombinantly. Binds to both active and substrate sites on thrombin.
Argatroban
Direct thrombin inhibitor.
Dabigatran
Bind to thrombin active sites.
Warfarin
Direct thrombin inhibitor. Prevents synthesis of factors 2, 7, 9 ,10 via tampering with redox metabolism of vitamin K. Reversed by vitamin K, factor 9, FFP
Rivaorxaban
Factor Xa inhibitor.
Apixaban
Factor Xa inhibitor.
tPA
Fibrinolytic. Rapidly lyses thrombi. Treatment for ischemic strokes.
Streptokinase
Fibrinolytic
Urokinase
Fibrinolytic
Aspirin
COX inhibitor. Acetylation of Serine 529 residue irreversibly modifies COX1 enzyme from binding with arachidonic acid to form prostaglandins and TXA2. Less platelet aggregation and has some anti-inflammatory effects. High incidence of GI ulcers.
Clopidogrel
ADP inhibitor. Anti-platelet aggregation.
Abiciximab
Mab anti-platelet aggregation.
vitamin K
For warfarin overdose. Helps replenish factors.
Fresh frozen plasma
To replenish factors. For hemophilia.
Aminocaproic acid
Fibrinolytic inhibitor. Targets plasminogen pathway. Clot stabilizer. Used post-operatively.
Tranexamic acid
Anti-fibrinolytic used for massive hemorrhage/ trauma to help stop bleeding.
Lispro and Aspart
Rapid acting insulin
Humulin
Short acting insulin
Neutral Protamine Hagedorn
intermediate acting insulin
Glargine and Detemir
Long acting insulin
Metformin
Biguanides. Inhibits gluconeogenesis.
Sulfonylureas
Insulin secretagogue. Blocks the K+ channel in the beta cells causing insulin release. Black box warnings for increased cardiovascular events.
Thiazolidinediones (TZD’s)
Decreases insulin resistance by increasing insulin signal transduction.
Acarbose
Alpha-glucosidase inhibitor. Blocks digestion of complex carbs.
Bile acid binding resin
Sticks to cholesterol and glucose in bile acids and excretes them.
Amylin
Made by beta cells, suppresses glucagon release from the alpha cells
Semaglutide
GLP-1 agonist, which increases insulin release and decreases glucagon release.
Statin
HMG-CoA reductase inhibitor. Side effects: muscle pain.
Gliflozin
SGLT2 inhibitor. Prevents glucose reabsorption in the proximal convoluted tubule.
Sitagliptin
(Januvia) combination therapy in NIDDM. DPP4 inhibitor (DPP4 inhibits GLP-1).
Niacin
Inhibits VLDL from leaving the hepatocytes. Side effects: flushing, itching, dry skin.
Gemfibrozil
A fibrate. Increases lipolysis in the liver. Decreases VLDL and LDL a little.
Ezetimibe
Blocks uptake of dietary cholesterol.
Evolocomab
PCSK9 inhibitor. Allows more receptors to get recycled to pull more LDL out of the blood. Very effective when used with a statin.
Celecoxib
COX2 selective inhibitor, no effect on constitutive COX1
Meloxicam
COX2 selective inhibitor. Less effective than celebrex.
Diclofenac
COX and LOX inhibitor. Can be given topically for arthritic pain.
Ibuprofen
NSAID. Used for pain and to decrease inflammatory response. COX1 and COX2 inhibition. Causes less GI upset than aspirin.
Indomethacin
COX and LOX inhibitor. Used for arthritis, gout, and patent ductus arteriosus.
Ketorolac
Toradol. COX inhibitor. Used for severe pain in sports medicine. Helps decrease need for opioids.
Acetaminophen
COX2 inhibition in the CNS. Can be used for headache (vasoconstriction in the brain) and fever (peripheral vasodilation).
Glucocorticoids
Suppress inflammation. Increase Annexin 1, SLP-1, IL-10 and decrease NFkB.
Morphine
Phenanthrene opioid strong agonist
Dilaudid
Phenanthrene opioid strong agonist
Codeine
phenanthrene opioid moderate agonists
Oxycodone
moderate agonist phenanthrene opioid
Percocet
Moderate opioid agonist. Combination of acetaminophen and oxycodone.
Methadone
Phenylheptylamine opioid strong agonist
Fentanyl
Strong agonist phenylpiperadine opioid
Meperidine
Phenylpiperadine opioid strong agonist
Tramadol
Phenylpiperadine opioid moderate agonist
Buprenorphine
Partial opioid agonist used for opioid abuse
Butorphanol
Partial opioid agonist used for post-op shivering
Dextromethorphan
Partial opioid agonist. An antitussive
Naloxone
Opioid antagonist. Used for opioid toxicity reversal.
Naltrexone
Opioid antagonist used for alcohol withdrawal
Naloxegol
Opioid antagonist used to increase GI motility when taking opioids.
Penecillin
Inhibits cell wall synthesis by inserting beta lactam ring into enzyme responsible for peptidoglycan synthesis. More useful for gram + bacteria. Allergies are common.
Ampicillin
Antibiotic that targets cell wall synthesis. More useful for gram + bacteria.
Amoxicillin
Antibiotic that targets cell wall synthesis. More useful for gram + bacteria.
Cephalosporin
Antibiotic that targets cell wall synthesis. More useful for gram + bacteria.
Vancomycin
Antibiotic that targets cell wall synthesis. Resistant to beta lactamase. Drug of “last resort.” Lots of toxicity reactions.
Polymixin
Antibiotics that disrupt cell membrane by attaching to phospholipids and acting as detergents. Especially effective for gram - bacteria.
Daptomycin
Antibiotics that disrupt cell membrane by attaching to phospholipids and acting as detergents. Especially effective for gram - bacteria.
Tetracycline
Antibiotics that inhibit protein synthesis. Bacteriostatic. Most broad spectrum. Can cause severe GI disorders.
Erythromycin
Antibiotics that inhibit protein synthesis. Macrolide. Broad spectrum.
Azithromycin
Antibiotics that inhibit protein synthesis. Macrolide. Broad spectrum.
Neomycin
Antibiotics that inhibit protein synthesis. Macrolide. Broad spectrum. Topical.
Rifamycin
Antibiotic that targets DNA/RNA synthesis by binding to bacteria RNA polymerase and inhibiting mRNA synthesis.
Ciprofloxacin
Antibiotic that targets nucleic acid synthesis. Fluoroquinolone. Inhibit bacterial DNA gyrase. Useful for UTIs and bone infections. Excellent gram - activity.
Sulfonamide
Antibiotics that inhibit folic acid synthesis by competitively inhibiting PABA.
Trimethoprim
Antibiotics that inhibit folic acid synthesis by competitively inhibiting PABA.
Ketoconazole
Antifungal.
Lamisil
Antifungal.
Hydroxychloroquine
Antiprotozoal treatment for malaria.
Metronidazole
Antiprotozoal treatment for giardia and trichomonas. Side effect: black “hairy” tongue.
Niclosamide
Treatment for parasitic worms (tapeworms)
Acyclovir
Antiviral that inhibits viral DNA polymerases and therefore viral DNA synthesis. Used to treat HSV and Varicella.
Azidothymidine (AZT)
anti-retroviral used to treat HIV. Part of Highly Active Anti-Retroviral Therapy “HAART”
Lamivudine
anti-retroviral used to treat HIV. Part of Highly Active Anti-Retroviral Therapy “HAART”
Interferon
Produced by the body to signal for cell suicide. Can also be made recombinantly as an antiviral. Activate MHC-1 receptors to signal for CD8+ “T-killer” cells.
Tamiflu
For the flu can decrease flu symptoms by a day. PO.
Relenza
For the flu can decrease flu symptoms by a day. Inhaled powder.
Xofluza
For the flu can decrease flu symptoms by a day. Not recommended for pregnant or breastfeeding women.
Paxlovid
PO treatment for COVID. Approved for emergency use only.
Remdesivir
Treatment for COVID (IV therapy).
Dexamethasone
Useful treatment for COVID by targeting inflammatory response and suppressing cytokine release.
Carbidopa
Given in conjunction with Levodopa. Inhibits COMT and dopa decarboxylase which increases the amount of L-dopa, so more can cross BBB (up to 10%).
Levodopa
Given to increase dopamine. Only about 3% of L-dopa can cross BBB, but can be useful for treatment of PD.
Primavanserin
(Nuplazid) antipsychotic that is an inverse agonist for the serotonin receptors in the visual cortex. Used to treat delusions and hallucinations associated with levodopa/carbidopa use.
Pramipexole
Dopamine receptor agonist. Binds receptor freeing up more dopamine.
Selegiline
MAO-B inhibitor used to increase dopamine. Beneficial for movement disorders like Parkinson’s.
Tolcapone
COMT inhibitor to decrease degradation of dopamine. Beneficial for movement disorder’s like PD.
Apomorphine
A morphine derivative. Dopamine agonist.
Baclofen
Muscle relaxant can be used for symptom management with cerebral palsy
Tetrabenazine
Depletes dopamine. Used to treat Huntington’s symptoms which are the result of decreased GABA inhibition.
Haloperidol
Dopamine receptor blocker. Treatment adjunct for Huntington’s disease.
Riluzole
Na+ channel blocker used for ALS treatment (progressive loss of motorneurons)
Tacrine
AChesterase inhibitor. A palliative drug for Alzheimer’s disease.
Memantine
NMDA receptor antagonist. A palliative drug for Alzheimer’s disease.
Echinacea
Used for immunity support. Increases WBC and cytokines. Can decrease cold symptoms by about a day.
Garlic
inhibits HMG-CoA reductase. Can reduce cholesterol. Can also have some anti-platelet effects.
Gingko biloba
Can increase scavenging of free radicals, and increase blood flow. Claims to help reduce incidence of dementia, good for memory.
St. John’s Wort
For mild depression. CPY450 inducer.
Ginseng
For memory, and immune system.
Milk Thistle
For hepatotoxicity.
Saw Palmetto
For BPH.
Kava kava
Anti-toxicity.
Kombucha
For blood pressure control, anti-cancer and good gut health.
Aloe
Laxative and burn ointment
Black cohosh
For menstrual discomfort.
Cyclophosphamide
Alkylating agent. Works by alkylating DNA or interdigitates itself in between DNA stands. Nitrogen mustards. Good for neoplastic and non-neoplastic conditions for immunosuppression.
Chlorambucil
Alkylating agent. Nitrogen mustard. Drug of choice for chronic lymphocytic leukemia. Well-tolerated.
Nitrosoureas
Alkylating agents. Very lipid soluble and can cross BBB. Used for meningeal tumors.
Cisplatin
Platinum analog. Intercalating agent to prevent replication of DNA and inhibits cell proliferation. Does not cross BBB.
Methotrexate
Inhibits dihydrofolate reductase. Interferes with DNA and RNA synthesis. Cytotoxic and immunosuppressive. Do NOT take if pregnant!
Antimetabolites
Anti-cancer drugs that include: folate antagonists, purine and pyrimidine antagonists.
Vincristine
Vinca alkaloid derived from the periwinkle plant. Anti-cancer plant-based drug. Prevents mitotic spindle from forming cannot form new daughter cells.
Paclitaxel (Taxol)
Plant-based anti-cancer drug that stabilizes the mitotic spindle preventing split of two new daughter cells.
Dactinomycin
Intercalating agent. Antitumor antibiotic.
Doxorubicin
Antitumor antibiotic. Intercalating agent.
Bleomycin
Antitumor antibiotic. Intercalating agent.
Corticosteroids
Interfere with hormonal signaling. Can be useful anti-cancer drugs. Especially for leukemias and lymphomas.
Tamoxifen
Antitumor antibiotic. Intercalating agent.
Fulvestrant
Anti-cancer drugs. Interfere with hormone signaling. Estrogen receptor down regulator.
Tamoxifen
Anti-cancer drugs. Interfere with hormone signaling. Estrogen receptor modulator.