GU pharm chart Flashcards
what are the two PDE5 inhibitors
Sildenafil
Tadalafil
what is the PDE5 inhibitors MOA
inhibits PDE5 to incr [NO] leading to corpus cavernosum relaxation & inflow of blood to cause erection
what is the indication of the PED5 inhibitors
ED
Pulm artery hypertension [Adcirca]/ [Revatio]
what is the 5α-reductase inhibitor
Finasteride
what is the MOA of Finasteride
decreases prostatic tissue growth sec to inhibiting conversion testosterone to dihydrotestosterone
reduce static factor & induce apoptosis glandular cells;
what is the indicaiton of Finasteride
2nd line for Mod to Severe BPH (AUA scores)
what is the α1 adrenergic antagonist
3rd Generation
Tamulosin
MOA of Tamulosin
relax bladder neck, prostatic urethra, prostatic sm muscle
indication of Tamulosin
Mod to Severe BPH (AUA scores)
reduce dynamic factor (neurologic inhibition)
what is the herbal drug currently not recommended
Saw Palmetto
what are the Anti-androgen
Anti-neoplastic
Leuprolide
Flutamide
what si the MOA of Leuprolide
GnRH agonist;
agonist of LHRH
what is the indications of Leuprolide
palliative Rx prostate cancer;
endometriosis
MOA of Flutamide
nonsteroidal anti-androgen that inhibits androgen binding in target tissues
indications of Flutamide
metastatic prostate cancer w/ LHRH agonist
what is a sex hormone androgen drug
testosterone
what is the MOA of testosterone
replacement
what is the indication of testosterone
hypogonadism
what are the two M3 antimuscarinic
Oxybutinin
Tolterodine
MOA of M3 antimuscarinic
selective antagonist of bladder muscarinic receptors decr detrussor muscle pressure, incr residual urine volume
indication of M3 antimuscarinic
overactive bladder,
urge incontinence
what is the Beta-3 Agnoist
Mirabegron
MOA of Mirabegron
activates beta-3 adrenergic receptors in bladder relaxing detrussor muscle during urine storage phase
indication of Mirabegron
Overactive bladder w/ sxs of urinary frequency, urgency, or urge UI
what is the Tricyclic
Antidepressant
Imipramine
MOA of Imipramine
incr synaptic [serotonin, norepinephrine]; down regulation of ß-andrenergic receptors; anti-cholinergic effect
indication of Imipramine
depression;
off label for anticholinergic impact in UI
Anti-hypertensive:
Central alpha-adrenergic inhibitor
Alpha2-adrenergic agonist
Methyldopa
MOA of Methyldopa
central alpha-adrenergic inhibition decrease sym outflow to heart, kidneys, peripheral vasculature
indications of Methyldopa
HTN in PG
Anti-hypertensive:
Non-selective Alpha1 & Beta Receptor Blocker
Beta blocker w/alpha activity
Labetalol
MOA of Labetalol
Blocks α-, β1-, β2-adrenergic receptors
Indications of Labetalol
HTN in PG
Folic Acid is in what drug class
Vitamin
Water Soluble
MOA of Folic Acid
Folate required for formation of multiple co-enzymes in protein synthesis
indications of Folic Acid
supplement to prevent neural tube defects
Vitamin B6
Anti-Nauseant w/ Doxylamine
Pyridoxine
MOA of Pyridoxine
With Doxylamine use:
inhibits CRTZ; diminishes vestibular stimulation; depresses labyrinthine function; sedating
indications of Pyridoxine
N/V of pregnancy
Antihistamine
Anti-Nauseant w/ Pyridoxine
Doxylamine
Don’t confuse w/ Doxycycline abx
MOA of Doxylamine
With Doxylamine use:
inhibits CRTZ; diminishes vestibular stimulation; depresses labyrinthine function; sedating
Indications fo Doxylamine
N/V of pregnancy
Other alternatives for N/V
metaclopromide, diphenhydramine
Tocolytic Agents
Magnesium Sulfate
MOA of
Magnesium Sulfate
decr acetylcholine in motor nerve terminals;
slows rate S-A node impulse formation; relaxation of bronchial smooth muscle
Indications of
Magnesium Sulfate
premature labor/eclampsia; seizure; torsade de pointes; severe Mg deficiency; unresponsive status asthmaticus (in children)
Antiretroviral agent
RTI (nucleoside & nucleotide)
Tenofovir/ Emtricitabine
MOA of Tenofovir/ Emtricitabine
each interferes with DNA polymerase function resulting in viral inhibition
indications of Tenofovir/ Emtricitabine
HIV1, PrEP;
Unlabeled: Hep B (in patients w/ antiviral resistant ds or co-infection w/ HIV)
Miscellaneous PG Meds:
Opioids
o Codeine, hydrocodone, oxycodone, meperidine
o Heart defects – studies retrospective, case-control so ? causation?
o Pain treatment: APAP drug of choice (avoid NSAIDS)
Miscellaneous PG Meds: Antipsychotics
o Potential risk of extrapyramidal signs & withdrawal symptoms in neonate
Miscellaneous PG Meds:
Anti-depressants
o Paxil – Cat D (other SSRI’s are PG Cat C)
o Fluoxetine
Miscellaneous PG Meds:
Anti-seizure drugs
o Topiramate, phenytoin, carbamazepine, valproate – all PG Cat D
Combo Oral Contraceptive:
Monophasic
Loestrin Fe 1/20
norethindrone acetate, ethinyl estradiol
MOA of all COMBO ORAL CONTRACEPTIVES
suppression of FSH, LH with suppression of ovulation (~90%) & reduced implantation (~10%);
thickening cervical mucus, decr tubal motility
Indications of Loestrin Fe 1/20
Contraception, etc
Combo Oral Contraceptive:
Biphasic
Lo Loestrin Fe
norethindrone acetate 1mg/ ethinyl estradiol 10, 10 mcg
indications of Lo Loestrin Fe
Contraception, etc
Combo Oral Contraceptive:
Triphasic
Triphasil
levonorgestrel / ethinyl estradiol 0.05mg/30mcg, 0.075mg/40mcg, 0.125mg/30mcg
indications of Triphasil
Contraception, etc
Peri-menopause
Combo Oral Contraceptive(OC):
Quadriphasic
Natazia
Dionogest/ Estradiol valerate 0mg/3mcg, 2mg/2mcg, 3mg/1mcg; 0mg/1mcg
indications of Natazia
Contraception, etc
Peri-menopause
Progestin-only OC
Ovrette
norgestrel 0.075mg
MOA of Ovrette
prevent mid-cycle FSH/LH surge,
inhibit ovulation (less than COC) & implantation,
thicken cervical mucus, slow tubal transport
indications of Ovrette
contraception; contraception in women where COC is C/I
Extended Cycle OC
Lybrel
levonorgestrel / EE 0.09mg/ 0.02mg
MOA of Lybrel
prevent mid-cycle FSH/LH surge,
inhibit ovulation & implantation,
thicken cervical mucus, slow tubal transport
indications of Lybrel
contraception; women w/ menstral related sxs: (HA, menorrhagia, anemia, endometriosis-related pain)
Ascending Dose Extended Cycle OC
Quartette
Levonorgestrel/ EE 0.15mg/0.02mg (42 days);
0.15mg/ 0.025mg (21 days); 0.15mg/0.03mg (21 days);
EE 0.01mg
(7 days
MOA of Quartette
prevent mid-cycle FSH/LH surge,
inhibit ovulation & implantation,
thicken cervical mucus, slow tubal transport
indications of Quartette
contraception; women w/ menstral related symptoms (HA, menorrhagia, anemia, endometriosis-related pain)
what is the drug class of Ethinyl Estradiol and Conjugated Equine Estrogen CEE
Estrogen
MOA of estrogen drugs
Estrogen supplement
indications of estrogen drugs
Moderate to severe vasomotor symptoms
Vaginal mucosal atrophy
Hypogonadism
Depo MPA is what drug class
Progestogen
MOA of MPA
prevent mid-cycle FSH/LH surge,
inhibit ovulation (less than COC) & implantation,
thicken cervical mucus, slow tubal transport
indications of MPA
contraception; esp woman who have contra- for EE
what are the two names of the IUD’s
Levonorgestre 1 IUD (mirena)
Copper IUD
indications of Levonorgestrel IUD
contraception for 5 years
indications of Copper IUD
contraception for 10 years
which drug is under the class Mixed 5-HT1AAgonist/ 5-HT2A Antagonist
Flibanserin
MOA of Flibanserin
Not known although is known to be an agonist at 5-HT1A and antagonist at 5-HT2A receptors;
moderate activity at other CNS receptors (5-HT2B and 5-HT2C, D4)
indications of Flibanserin
Acquired, generalized hypoactive sexual desire disorder in premenopause females
which drug is under the class: Selective Estrogen Receptor Modulator (SERM)
estrogen agonist/antagonist
Ospemifene
MOA of Ospemifene
selective activation/inhibition of estrogen pathways in different tissues;
agonistic effects on endometrium
indications of Ospemifene
Mod to severe dyspareunia due to vulvar and vaginal atrophy in postmenopausal females
which drug is in the class: Abortifactant
Mifepristone
MOA of Mifepristone
Inhibits progesterone receptors, antagonizing endometrial & myometrial effects
indications of Mifepristone
Early Pregnancy Termination
which drug is in the class: Post Exposure Contraception
Ulipristal
[Ella]
MOA of Ulipristal
[Ella]
progesterone agonist-antagonist
Indications of Ulipristal
[Ella]
Post Exposure Contraception
what are the five ABX?
Metrionidazole Ceftriaxone Azithromyocin Benzathine Penicillin C Doxycycline
MOA of Metrionidazole
Inhibits protein synthesis in susceptible organisms when chemical structure is reduced
indications of Metrionidazole
Trichomoniasis Bacterial Vaginosis
DOC for anaerobes in intra-abdominal infection. C.diff, Giardiasis, Amebiasis.
MOA of Ceftriaxone
In actively growing bacterial cells, interferes w/ transpeptidation of bacterial cell walls by binding to penicillin binding protein (PBP)
Indications of Ceftriaxone
Gonorrhea
Gram+, more Gram-
coverage; Acute OM, Sinusitis, LRTI, Meningitis; Empiric Rx of serious infections pending C&S
MOA of Azithromyocin
Reversibly bind to 50S subunit of bacterial ribosome & inhibit protein synthesis
Indications of Azithromyocin
Chlamydia
Penicillin substitute Atypical pneumonia, CAP, PID, Acute OM, Sinusitis, Pharyngitis, COPD, Pertussis
Indications of Benzathine Penicillin C
Syphilis
MOA of Doxycycline
Inteferes with bacterial 30S ribosome protein production
Indications of Doxycycline
Syphilis
CAP, Sinusitis, Lyme, Plague ricketssiae, rosacea, periodontitis, cholera
what drug is in the class: Anti- RETROviral RTI (nucleoside), RTI (nucleotide)
Tenofovir/Emtricitabine
MOA of Tenofovir/Emtricitabine
Inteferes w/DNA polymerase function resulting in viral inhibition
Indications of Tenofovir/Emtricitabine
HIV1, PrEp
Unlabeled: Hep B (in pts. w/antiviral resistant dz or co-
infection w/HIV)
what is the drug in this class: anti-viral
Valcyclovir
MOA of Valcyclovir
Inhibits DNA polymerase; incorporates into viral DNA
Indications of Valcyclovir
HSV, Herpes Zoster (shingles)
what is the drug in the class: anti-fungal
Clotrimazole Cream
MOA of Clotrimazole Cream
Alters fungal cell well permeability, and jacks up fungi in other ways.
Indications of Clotrimazole Cream
Candidiasis (vulvovaginal or breast)
Fungal infections, incl. vulvovaginal candidiasis (yeast
infection)
what drug is in the class Antibacterial?
Nitrofurantoin
MOA of Nitrofurantoin
inhibits several bacterial enzyme systems including acetyl coenzyme A interfering with metabolism and possibly cell wall synthesis
Indications of Nitrofurantoin
UTIs d/t susceptible E. coli, S. aureus, Enterococcus, Klebsiella, and Enterobacter
What class is Ibuprofen in?
NSAIDS
MOA of Ibuprofen
Analgesic and antipyretic effects through inhibition of prostaglandin synthesis
Indications of Ibuprofen
Pain, fever, HA, dysmenorrhea, rheumatoid arthritis