Final all Drugs Flashcards
Peroxisome proliferator-activated receptor-a (PPAR-a) agonists
Upregulate apo A-I, A-II
Downregulate apo C-III
lowers LDL
increases HDL
Gemfibrozal
Fenofibrate
“fibrates”
HMGcoA reductase inhibitors
upregulate hepatocyte LDL receptors
decrease triglycerides
statins
Decreases catabolism of apo AI and reduces VLDL secretion
Niacin
Binds bile acids in gut –> excretion
Liver takes more cholesterol out of circulation to make more bile
lower LDL
Colestipol
Blocks sterol transporter NPC1L1 in intestine brush border
decreases cholesterol absorbed
lower LDL
Ezetimibe
irreversible COX I and II inhibitor. Stops the synthesis of thromboxane, which is responsible for platelet activation.
aspirin
***Baby ASA preferentially inhibits TXA production, leading to an overall vasodilatory effect (PGI2 is vasodilatory and is not inhibited at 81mg dose).
o MOA: activation of K+ channels and inhibition of L-type Ca2+ channels
Used for converting SVT
Adenosine
Inhibits Na+/K+/ATPase pump
reverses NCX pump –> increased intracellular Ca2+
increased contractility, SV, CO
decreased HR
Digoxin
selective peripheral vascular Ca2+ blockers
relax VSM
risk of reflex tachycardia
dihydropyridines
”—pine”
selective myocardial Ca2+ blocker
reduce mycordial O2 demand
Tx: angina, arrhythmias
Verapamil
blocks both VSM and myocardial Ca2+ channels
Diltiazem
Binds P.B.P. and blocks transpeptidation of
peptidoglycan in bacterial cell walls.
Ceftriaxone
Binds D-ala-D-alanine to prevent NAM/NAG-peptide subunits into peptidoglycan. BLOCKS TRANSGLYCOSYLATION
Vancomycin
Beta-Lactam: Binds P.B.P. and blocks transpeptidation of
peptidoglycan in bacterial cell walls.
Penicillin G
AMINO-Beta-Lactam: Binds P.B.P. and blocks transpeptidation of peptidoglycan in bacterial cell walls.
Amoxicilin
Converts plasminogen to plasmin thus increasing breakdown of fibrin clots
t-PA
Alteplase
Acts on mu receptors in three locations
analgesic
Morphine
Forms free radical NO
Nitroglycerin
Blocks ADP receptors on platelets
inhibits platelet activation
Clopidogrel
increases Activity of antithrombin III
Heparin
Binds GPIIb/IIIa receptor on activated platelets
inhibits binding of fibrinogen
Eptifibitide
Suppresses RAAS system by inhibiting conversion of Angiotensin I to Angiotensin II.
lisinopril
enalapril
ACE inhibitors
Same mechanism as nitroglycerine – longer half life
isosorbide dinitrate
Increases NO synthesis in endothelium.
Hydralazine
Inhibits NKCC2
diuretic
Furosamide
Blocks aldosterone action.
Diuretic
Spirinolactone
Eplerenone
Alteplase
thrombolytic
plaminogen –> plasmin
NTG
vasodilator
Clopidogrel
anti-coagulant
blocks ADP receptors
heparin
anti-coagulant
activates anti-thrombin III
Eptifibitide
anti-coagulant
binds GIIb-IIIa
Lisinopril
ACE inhibitor
Enalapril
ACE inhibitor
-statins
HMG-CoA reductase inhibitors
decrease LDL
Metoprolol
selective B-1 blocker
Propanolol
non-selective Beta blocker
Isosorbide dinitrate
long acting nitro
vasodilation
Hydralazine
increases NO
more effect on ARTERIOLES
furosamide
diuretic
inhibits NKCC pump
eplerenone
angiotensin receptor blocker (ARB)
spironolactone
ARB
Digoxin
Na+/K+/ATPase pump inhibitor
increased intracellular Ca2+ –> inc. contractility
decreased HR
cocaine
blocks NE reuptake
axoplasmic pump
Imipramine
blocks NE reuptake
axoplasmic pump
Reserpine
inhibits accumulation of catecholamines in vesicles
Guanethidine
releases NE from vesicles –> degraded by MAO
pargyline
MAO inhibitor
tyramine
releases catecholamines
cheese, wine, beer
dobutamine
selective B-1 agonist
positive inotrope
used in CHF/MI with HF
dopamine
positive inotrope at B-1
vasodilation in renal and mesenteric vessels at low dose
a1 agonist at high dose
used in shock
phenylephrine
a1 agonist
metaproterenol
B-2 selective agonist
bronchodilation
terbutaline
B-2 selective agonist
delays labor
albuterol
selective B-2 agonist
bronchodilation
ritodrine
selective B-2 agonist
delays labor
salmeterol
selective B-2 agonist
bronchodilation
isoproterenol
non-selective Beta agonist
vasodilates at B-2
tachycardia at B-1
norepinephrine
vasoconstricts at a1
increased HR at B-1
epinephrine
vasoconstricts at a1
bronchodilation at B-2
increased HR at B-1
terazosin
a1 blocker
amphetamine
releases NE from nerves
ephedrine
releases NE
indirect activation of a1, B1
also vasodilates at B2 (direct effect)
pseudoephedrine
similar to ephedrine
guanadrel
releases NE from vesicles for degradation by MAO
procaiamide
Class IA
slows upstroke of AP (Na+ blocker), prolongs ERP (non-specific K+ blockade)
can cause:
torsades
lupus
quinidine
Class IA
has anti-muscarinic (anti-PNS) effects
can cause:
torsades
disopyramide
Class IA
NO loading doses –> precipitates HF
Lidocaine
Class IB
treats Vtach and Vfib after cardioversion
NO prophlaxis
mexiletine
Class IB
oral version of lidocaine
chronic pain too
Tocainide
Class IB
lidocaine analog
flecainide
Class IC
slow unblocking kinetics (but does not prolong AP or QT)
propafenone
Class IC
weak Beta blocker
moricizine
Class IC
not sold in US so prob not on test
propanolol
non-selective Beta blocker
don’t give if asthma (B2 block–> bronch spasm)
treats SVT w/o AV blocks (can exacerbate)
Acebutolol
non-selective Beta blocker
treats HTN and SVTs
esmolol
short acting, selective B-1 blocker
sotalol
Beta blocker at low dose
K+ antiarrhythmic at high dose
enoxaparin
low molecular weight heparin
amiodarone
Class III (and I, II, IV)
treats Vtach, Vfib, Afib, Aflutter
PULM toxicity
LOOONG half life
iodine buildup
dofetilide
Class III
very selective K+ blocker
Contraindicated in long QT, bradycardia, hypokalemia
ibutilide
Class III
K+ blocker and slow inward Na+ ACTIVATOR
dihydropyridines
Class IV
smooth muscle Ca2+ channel selective
**reflex tachycardia, don’t use in angina
verapimil
Class IV
cardio selective Ca2+ blocker–preference for frequently firing tissue
treats angina and arrhythmia
reduces myocardial O2 demand
don’t use in WPW!!!
Diltiazem
Class IV
BOTH cardiac depressant and vasodilatory
no reflex tachycardia
adenosine
activates K+
inhibits Ca2+
hyperpolarization and suppression of Ca2+ dependent APs (SA and AV tissue)
used for SVTs
don’t use in 2 and 3 AV block
nifedipine
Class IV dihydropyridine
vaso seletive Ca2+ blockage
used in angina
also HTN
gemfibrozil
PPAR-a agonist
decreases VLDL secretion
fenofibrate
PPAR-a agonist
decreases VLDL secretion
niacin
Blocks adipocyte lipolysis.
Decreases catabolism of apo AI and reduces VLDL secretion.
colestipol
binds bile acid
ezetimibe
Blocks sterol transporter NPC1L1 in intestinal brush border