Extra's Flashcards
Peptic Ulcer Disease (Helicobacter Pylori, gastric acid, pepsin, NSAID) - PPI
Decrease acid production (1st line: PPI, then H2B)
proton pump inhibitors (more effective)
-Omeprazole
-Lansoprazole
-Rabeprazole
-Pantoprazole
-Esomeprazole
-Dexlansoprazole
generally overused
increase incidence of aspiration pneumonia
-decrase effectivenss of clopidogrel
-causes sucralfate to be less effective
-increased osteoporosis risk
-blurred vision
oxymetazoline
DECONGESTANTSADRENERGIC AGONISTS
finasteride & dutasteride “asteride”
DNA SYNTHESIS INHIBITORS“FLUOROQUINOLONES
Bactericidal; inhibit DNA gyrase and topoisomerase IV.
2nd Generation: Ciprofloxacin, Ofloxacin
3rd Generation: Levofloxacin
4th Generation: Moxifloxacin, Gatifloxacin
“5th” Generation: Besifloxacin w/ Durasite®
*The most commonly used class of antibiotics
*Newer generations provide greater gm + coverage over and above the excellent gm - coverage
*All FDA approved for bacterial conjunctivitis, not bacterial keratitis; resistance to conjunctival S epidermidis develops rapidly w/ repeated use
*Nalidixic acid is the original (NegGram)
-1st gen fluoroquinolone
-not used in eyecare
-Intracranial hypertension
*Ciprofloxacin
-is available as an ointment also;
-the solution has no age restrictions
*Moxifloxacin
-is the only topical antibiotic lacking a preservative! BAK preservatives are criticized for corneal toxicity;
-originally sold as Vigamox (tid), it is now packaged in a new vehicle under the name Moxeza (bid) since the patent expired in June 2012
*Gatifloxacin,
-originally sold as Zymar (0.3%) was recently replaced with a 0.5% formula called Zymaxid: as a concentration dependent antibiotic
*Levo/Moxi/Gati
-100% effective in vitro when used for the most common pediatric ocular infections: Haemophilus influenzae and Streptococcus pneumonia
*Besifloxacin
-only topical suspension; the Durasite mucoadhesive vehicle requires only 2-3 vigorous shakes before instillation;
-longer retention permits TID lacks a systemic counterpart along with Gatifloxacin (d/c’d in 2008)
-Note: in contrast to other FQ’s, Besifloxacin demonstrates promising MRSA sensitivity but is ineffective for coagulase neg staph
AE
*Tendonitis (Black Box) & aggravation of myasthenia gravis
*QT prolongation
*Reduced levels in combination w/ antacids, Fe, Zn
*Convulsions (po)
*Ciprofloxacin
-White corneal precipitates
-Reduced metabolism of theophylline
Contraindications
*<18 yrs of age (po) due to inhibition of bone growth and damage to cartilage
*Pregnancy (arthropathy)
Succinylcholine
sucralfate
misoprostol
local anesthetics
zinc oxide
chymotrypsin
Chymotrypsin is a digestive enzyme that promotes proteolysis, or the breakdown of proteins and polypeptides. It is a serine protease synthesized in the pancreas and vital to pancreatic juice. Like most proteolytic enzymes, chymotrypsin is activated from its inactive zymogen precursor, chymotrypsinogen
Chymotrypsin is the most abundant pancreatic protease that represent up to 10-20% of the total protein synthesized by the exocrine pancreas
PDE-5 Inhibitors
tea tree oil
antimicrobial*
prochlorperazine
Dopamine antagonist
“Nausea and Vomiting
-antiemetic therapy”
AE
prolong QTc segment
Diclofenamide
Diclofenamide is a sulfonamide and a carbonic anhydrase inhibitor of the meta-disulfamoylbenzene class. Dichlorphenamide as a carbonic anhydrase inhibitor is used for the treatment of acute angle closure glaucoma
tolterodine
Anti-cholinergic M3 receptor Antagonist for Overactive Bladder
OB = Increased urinary frequency, urgency, or urge incontinence due to overaction of the parasympathetic system on the bladder.
Anticholinergic drugs decrease the parasympathetic response
block acetylcholine from binding to M3 receptors in the bladder , decrease bladder contractions
Constipation Treatment: Laxatives
fluorouracil
Cytotoxic Drugs
Cell cycle-specific, meaning they act during a specific phase of the cell cycle
methotrexate
Cytotoxic Drugs
Cell cycle-specific, meaning they act during a specific phase of the cell cycle
epinephrine
Catecholamines: biogenic amines derived from phenylalanine/tyrosine including dopamine, epinephrine and norepinephrine; produced from tyrosine in the adrenal medulla and postganglionic fibers of the sympathetic nervous system
Alpha-1 blockers end in “-osin”
doxazosin (Cardura)
prazosin (Minipress)
terazosin (Hytrin)
tamsulosin (Flomax)
Indirect agents (acetylcholine esterase inhibitors)
digoxin
Cardiac Glycoside
Mechanism of Action:
* Inhibit Na/K/ATPase on heart
* Na/K/ATPase is a key enzyme that actively pumps Na out and K into the cell. Inhibiting this enzyme:
* IncreaseinintracellularCa2+in heart - increase force of heart contraction (+ inotropy), without increasing heart rate
- Very long half-life & narrow therapeutic index
- Too high of levels can lead to toxicity (life threatening arrythmias)
- Because of long-half life if levels get too high/become toxic it can take days to decrease back down to safe levels!
- Blood levels monitored * Lots of drug interactions
- NSAIDs (ibuprofen)
MacuHealth
Ocuvite
dialysis vitamins
- Have greater need for B vitamins and some vitamin C
- Nephrocaps
- Renal vitamins usually contain vitamins B1, B2, B6, B12, folic acid, niacin, and a low dose of vitamin C
- The fat soluble vitamins (A, D, E and K) are more likely to build up, so these are avoided
- Vitamin C supplements are recommended in lower doses (60 to 100 mg)
- Higher doses are a problem
- Can cause a buildup of oxalate, which can deposit in bones and soft tissues
H2 Antagonists/Blockers
Polysporin
metoclopramide
theophylline
topiramate
BUDESONIDE
TOPICAL STEROIDS: Moderate/Maximum Strength
trifluridine
B Vitamins
