Gen Pharm - drugs Flashcards
Acetazolamide (Diamox)
Carbonic Anhydrase Inhibitor (Diuretic) –po, inhibits CA enzyme, alkalinization of urine (increased HCO3- in urine), diuretic effect only lasts a few to several days, tx for alkalosis
-decrease in H+ for exchange w/Na+ results in Na+ loss (stops Na+ reabsorption)
-sulfa sensitivity!
Brinzolamide (Azopt)
topical Carbonic anhydrase inhibitor - glaucoma drop, decreases aqueous humor production and CSF
-orange cap
Dorzolamide (Trusopt)
topical Carbonic anhydrase inhibitor - glaucoma drop, decreases aqueous humor production and CSF
-orange cap
Methazolamide (Neptazane)
Carbonic anhydrase inhibitor - po, tx glaucoma, decreases aqueous humor production and CSF
Furosemide (Lasix)
Loop Diuretic - blocks the Na+/K+/2Cl- transporter in the thick ascending limb of the loop of Henle, induces kidney prostaglandins (vasodilation) can be used to tx HTN
-causes loss of Ca2+ and Mg2+, also Cl- and K+
-tx for heart failure (edema), and pulmonary edema, tx hypercalcemia
-can cause hypokalemic metabolic alkalosis, hyperuricemia, irreversible ototoxicity, NSAID interference
Ethacrynic acid (Edecrin)
Loop Diuretic
-used only when patient has sulfa allergy and can’t be given furosemide
-more likely to have irreversible ototoxicity side effect with aminoglycosides
-blocks the Na+/K+/2Cl- transporter in the thick ascending limb of the loop of Henle, induces kidney prostaglandins (vasodilation), causes a loss of Ca2+ and Mg2+, also Cl- and K+
-tx for heart failure (edema), and pulmonary edema, tx hypercalcemia
-can cause hypokalemic metabolic alkalosis, hyperuricemia, NSAID interference
Hydrochlorothiazide (Esidrix)
Thiazide, most used diuretic, also a common DOC for HTN (C/I for DM pt!)
-inhibits Na+ reabsorption at distal tubule -causes decrease of Na+, CO, decrease in blood volume and so decrease in BP
-increase in ATP-dependent K+ channel opening, causes hyperpolarization (vasodilation in smooth muscle) and also decreases insulin
Chlorothiazide (Diuril)
Thiazide diuretic, also a common DOC for HTN (C/I for DM pt!)
-inhibits Na+ reabsorption at distal tubule -causes decrease of Na+, CO, decrease in blood volume and so decrease in BP
-increase in ATP-dependent K+ channel opening, causes hyperpolarization (vasodilation in smooth muscle) and also decreases insulin
C/I for thiazides
causes dry eye, hyperglycemia (C/I for DM pts), hyperlipidemia, lithium toxicity, digitalis toxicity, hepatic coma in cirrhotic pts, hypokalemic metabolic alkalosis, hyperuricemia! (tell pts to stop thiazide before having a surgical procedure)
Diuretic drug that can be used for patients with a sulfa allergy
Ethacrynic acid (Edecrin)
Amiloride (Midamor)
Potassium-sparing Diuretic
-reduces the K+ loss caused by the other diuretics, used in combination as they are weak on their own
-inhibit Na+/K+ exchange independently of aldosterone
C/I for burn patients (already hyperkalemic!)
Triamterene (Dyrenium)
Potassium-sparing Diuretic
-reduces the K+ loss caused by the other diuretics, used in combination as they are weak on their own
-inhibit Na+/K+ exchange independently of aldosterone
C/I for burn patients (already hyperkalemic!)
Spironolactone (Aldactone)
Potassium-sparing Diuretic - competitive inhibitor of aldosterone (anti-androgen)
-tx edema w/HF, hyperaldosteronism, hirsutism, PMS
-SE: occasional hyperkalemia w/ACEI and ARBs
-C/I: liver damage, renal insufficiency
Mannitol (Osmitrol)
Osmotic Diuretic
IV only, keeps water in tubules, large amount of water diuresis, keeps water flowing and protects kidney, can be used as prophylaxis of acute renal failure
-decreases IOP and ICP quickly
-SE: cellular dehydration, edema
-C/I: DON’T USE WITH HF pts!
What is the order of effectiveness for diuretic drugs?
Loops»_space; thiazides»_space;> K+ sparing drugs
Sodium nitroprusside (Nitropress)
Antihypertensive - acts through nitric oxide to cause vasodilation
IV only, rapid (minutes), decreases BP for HTN emergencies
-SE: cyanide accumulation
Hydralazine
Antihypertensive - acts through nitric oxide to cause vasodilation - used during pregnancy for long-term tx of severe HTN in combo with other BP-lowering meds and as a last resort
-SE: Lupus!
Minoxidil (Loniten)
Antihypertensive - acts through opening potassium channels (hyperpolarizes membrane) to cause vasodilation
SE: Hypertrichosis
Nifedipine (Procardia)
Calcium Channel Blocker - Dihydropiridine type
-strong vasodilator, more vascular effects, increases HR
Amlodipine (Norvasc)
Calcium Channel Blocker - Dihydropiridine type
Felodipine (Plendil)
Calcium Channel Blocker - Dihydropiridine type
Verapamil (Calan)
Calcium Channel Blocker - strong cardiac effect, decreases HR
Diltiazem (Cardizem)
Calcium Channel Blocker - effects in between Verapamil and Dihydropiridines
Captopril (Capoten)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Enalapril (Vasotec)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Quinapril (Accupril)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Lisinopril (Zestril)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Benazepril (Lotensin)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Losartan (Cozaar)
Angiotensin receptor blocker - anti HTN
blocks AT1 receptor but not AT2 (difference from ACEIs)
Valsartan (Diovan)
Angiotensin receptor blocker - anti HTN
blocks AT1 receptor but not AT2 (difference from ACEIs)
Clonidine (Catapres)
Alpha 2 agonist, sympatholytic, anti-HTN
Methyldopa (Aldomet)
Alpha 2 agonist, sympatholytic, anti-HTN
-used in pregnancy
Prazosin (Minipress)
Alpha 1 adrenergic blocker, anti-HTN
also good for tx BPH
Doxazosin (Cardura)
Alpha 1 adrenergic blocker, anti-HTN
Terazosin (Hytrin)
Alpha 1 adrenergic blocker, anti-HTN
Propranolol (Inderal)
nonspecific Beta-blocker, anti-HTN
-reduces sympathetic vasomotor tone but doesn’t cause vasodilation unless with NO
-SE: bronchoconstriction, decreased insulin release, increase of lipids and atherogenesis, masks hypoglycemia
-C/I: asthmatics, DM, hypercholesterolemia, heart block end stage HF
Carvedilol (Coreg)
Combined alpha and beta blocker to tx HTN
Labetalol (Trandate)
Combined alpha and beta blocker to tx HTN, used in pregnancy, HTN emergencies
-SE: hepatotoxicity
Metoprolol (Lopressor)
Cardio specific or B1 blocker for treating HTN
Nebivolol (Bystolic)
Cardio specific or B1 blocker for treating HTN, has NO (vasodilation)
Atenolol (Tenormin)
Cardio specific or B1 blocker for treating HTN
Nitroglycerin
DOC for tx acute anginal attack
Isosorbide dinitrate (Isordil)
tx angina, decreases oxygen demand
SE: headaches, tolerance
Sildenafil (Viagra)
phosphodiesterase type 5 (PDE5) inhibitor
tx - ED, pulmonary HTN
C/I: Nitrates
CYP3A4 interactions
Vardenafil (Levitra)
phosphodiesterase type 5 (PDE5) inhibitor - faster onset than sildenafil
Tadalafil (Cialis)
phosphodiesterase type 5 (PDE5) inhibitor - longer duration
Lovastatin (Mevacor)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Atorvastatin (Lipitor)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Rosuvastatin (Crestor)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Pravastatin (Pravachol)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Simvastatin (Zocor)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Fluvastatin (Lescol)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Cholestyramine (Questran)
bile acid binding resins, very safe but can inhibit other drug absorption
Niacin (Nicotinic acid, Vitamin B3)
impairs synthesis of lipoproteins, effective at increasing HDL and treating hypercholesterolemia
Gemfibrozil (Lopid)
fibric acid derivative - increases catabolism of VLDL, effective at treating hypertriglyceridemia
Fenofibrate (Tricor)
fibric acid derivative - increases catabolism of VLDL, effective at treating hypertriglyceridemia
Warfarin (Coumadin)
clotting factor synthesis inhibitor - anticoagulant, prevention of emboli development
-INR(2-3)
Heparin sodium (Liquaemin)
immediate onset anticoagulant, high-molecular weight heparin
PTT 2-2.5
Enoxaparin (Lovenox)
low molecular weight heparin, anticoagulant
Dabigatran (Pradaxa)
direct thrombin inhibitor, anticoagulant
-antidote: Idarucizumab (Praxbind)
Rivaroxaban (Xarelto)
direct inhibitor of factor Xa, anticoagulant
Apixaban (Eliquis)
direct inhibitor of factor Xa, anticoagulant
Protamine sulfate
binds and inhibits heparin
Idarucizumab (Praxbind)
antidote to Dabigatran (a direct inhibitor of thrombin)
Factor Xa (Andexxa)
needed for clot formation - antidote to factor Xa inhibitors: rivaroxaban (Xarelto) and apixaban (Eliquis)
Alteplase / t-PA (Activase)
fibrinolytic - converts plasminogen to plasmin to lyse clots
Aminocaproic acid (Amicar)
inhibits tPA, treatment for bleeding disorders (pro-clotting) can be used for hemophilia
Aspirin
inhibitors of prostaglandin production, antiplatelet agent
-secondary prevention of CV events
Clopidogrel (Plavix)
inhibitor of ADP-induced platelet aggregation, irreversible, used for pts with aspiring allergy
-interacts w/omeprazole
-DOC after coronary stent sx
Ticlopidine (Ticlid)
inhibitor of ADP-induced platelet aggregation, irreversible, used for pts with aspiring allergy
-interacts w/omeprazole
-DOC after coronary stent sx
Abciximab (ReoPro)
decreases platelet aggregation by inhibiting GPIIb/IIa receptor
Dipyridamole
coronary vasodilator, combine with aspirin
Esmolol (Brevibloc)
Beta 1 selective blocker drug, short acting, IV
Betaxolol (Betoptic)
beta 1 selective blocker, can be used topically in eye to tx glaucoma
Carteolol (Cartol)
partial agonist, beta-blocker, can be used in eye
said to have intrinsic sympathetic activity
Tamsulosin (Flomax)
Alpha 1 adrenergic blocker, little effect on BP but used to tx BPH
Phentolamine (Regitine)
alpha-receptor blocker
can be used to prevent necrosis after accidental NE injection
Phenoxybenzamine (Dibenzyline)
alpha-receptor blocker, irreversible, very long acting
Leuprolide (Lupron)
GnRH agonist, suppresses LH/FSH release (long term), DOC for endometriosis, IVF, precocious puberty, etc.
Goserelin (Zoladex)
GnRH Agonist
Estradiol (Estraderm)
estrogen given in cream/patches
Ethinyl estradiol
estrogen used in oral contraceptives (not available individually)
Premarin
conjugated estrogens, used for HRT
Tamoxifen (Novaldex)
Antiestrogen - SERM (selective estrogen receptor modulator) tx. pre-menopausal breast cancer, AE: can cause crystalline retinopathy
Raloxifene (Evista)
Antiestrogen, SERM, tx: osteoporosis
Clomiphene (Clomid)
Antiestrogen, SERM, used for fertility but can cause multiple pregnancies
Anastrozole (Arimidex)
aromatase inhibitors (stops conversion to estrogen) tx: postmenopausal breast cancer
Progesterone (generic)
Progestins - used in contraceptives
Medroxyprogesterone (Provera)
progestin
Levonorgestrel (Plan B)
progestin
Mifepristone (RU 486, Mifeprex)
anti-progestin, taken to terminate a pregnancy
Danazol (Danocrine)
anti-progestin, can treat endometriosis but not DOC
Drospirenone/ethinyl estradiol (Yasmin, Yaz)
combination oral contraceptive, the only one approved to treat PMDD
Testosterone (generic, Testoderm transdermal)
Androgen
Flutamide (Eulexin)
Anti-androgen (androgen receptor antagonist) tx: prostate cancer w/GnRH agonist
Finasteride (Propecia)
5a-reductase inhibitor (stops conversion to DHT) tx: BPH and male pattern baldness
Insulin lispro (Humalog)
Rapid-acting insulin - IV
Insulin, inhaled (Afrezza)
Rapid-acting insulin
Regular insulin (Novolin R, Humulin R)
Short-acting insulin, IV
NPH Insulin (Humulin N, Novolin N, isophane)
Intermediate-acting insulins
Insulin glargine (Lantus)
Long-acting insulins
Insulin detemir (Levemir)
Long-acting insulins
Metformin
a biguanide, oral, DOC, only used in type 2 DM, decreases glucose levels (euglycemia), does not increase weight, decreases risk of CV events
C/I: renal failure
AE: lactic acidosis, diarrhea
Exenatide (Byetta)
glucagon-like peptide-1 receptor agonist (GLP-1 RA), incretin mechanism, stimulates pancreas beta cells, causes weight loss
AE/caution w/pancreatitis
injected
Sitagliptin (Januvia)
dipeptidyl-peptidase-IV (DPP-4) inhibitor, inhibits DPP-4 so glucose gets to beta cells better, no effect on weight
Canagliflozin (Invokana)
SGLT-2 inhibitor, oral, weight loss, decrease risk of CV events
AE: UTIs
C/I: renal impairment
Pioglitazone (Actos)
thiazolidinedione derivative, increases insulin sensitivity
AE: edema, increased heart failure risk, macular edema
Acarbose (Precose)
Miglitol (Glyset)
alpha-glucosidase inhibitors, delays carb absorption, causes gas and GI issues, no effect on weight
Glyburide, Glipizide, Glimepiride, Tolbutamide, Chlorpropamide
Sulfonylureas, stimulate insulin release from pancreas beta cells. AE: weight gain, hypoglycemia
C/I: sulfa allergy
Repaglinide
meglitinides - bind K+ channels, increases insulin release
Pramlintide (Symlin)
amylin-like peptide (synthetic analogue), only used as an insulin adjunct, can be used in Type 1 DM, injected, causes weight loss
Glucagon injection
hyperglycemic agent to treat hypoglycemia in patients with sufficient glycogen stores, increases glucose levels. produced by alpha cells (pancreas)