Other 1-Liners Flashcards
NSAID avoided in gout because low doses increases uric acid levels
Aspirin
The selective agents lose their selectivity at
high doses
Routes of administration of heparin
IV and subQ
Common side effect of hypnotic agents
Sedation
Anti-seizure medication also used in the prevention of migraines
Valproic acid
Another pneumonic for anticholinergic toxicity
“dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat”
Clinical response that may fluctuate in tx of Parkinson’s dx
“On-off-phenomenon”
Antidote used for carbon monoxide poisoning
100% O2 and hyperbaric O2
Usual time needed for full effect of antidepressant therapy
2 to 3 weeks
Period of time of therapy after which GC therapy will need to be tapered
5-7 days
Pyrimidine analog that causes “Thiamine-less death” given with leucovorin rescue
5-flouracil (5-FU)
Analog of hypoxanthine, needs HGPRTase for activation
6-mercaptopurine (6-MP)
Block glycoprotein IIb/IIIa involved in platelet cross-linking
Abciximab, tirofiban and eptifibatide
Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome
Abstinence syndrome
Alpha-glucosidase inhibitor associated with elevation of LFT’s
Acarbose
Examples of alpha-glucosidase inhibitors (AGI)
Acarbose, miglitol
Inhibit angiotensin-converting enzyme (ACE)
ACE inhibitors
These beta blockers are less lipid soluble
Acebutolol and atenolol
This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis
Acetazolamide
Carbonic anhydrase inhibitor
Acetazolamide
Mechanism of action (MOA) utilizes ligand gated ion channels
Acetylcholine, nicotine
Clinical use for H2 blockers
Acid reflux disease, duodenal ulcer and peptic ulcer disease
Drugs available in combination with metformin
Acroplus Met progutazone and metformin, Janumet and Janumet XR Sitagliptin and Metformin, Glyburide, glipizide, and rosiglitazone
MOA of AGI’s
Act on intestine, delay absorption of glucose
Adenosine’s MOA
Activates acetylcholine sensitive K+ channels in SA and AV node
Barbiturates may precipitate this hematologic condition
Acute intermittent porphyria
The most common type of drug interaction of sedative hypnotics with other depressant medications
Additive CNS depression
DOC for paroxysmal supraventricular tachycardia (PSVT)
Adenosine
Anti-arrhythmic with <10 second duration of action
Adenosine
Neurotoxicity with isoniazid (INH) prevented by
Administration of Vit. B6 (pyridoxine)
MOA for Valproic acid at high doses
Affect calcium, potassium, and sodium channels
Strength of interaction between drug and its receptor
Affinity
Carbamazepine may cause
Agranulocytosis
Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis
Albuterol
Agent that is teratogen and causes a fetal syndrome
Alcohol
Rate limiting step of alcohol metabolism
Aldehyde dehydrogenase
Enzyme that metabolizes acetaldehyde to acetate
Aldehyde dehydrogenase
Available bisphosphonates
Alendronate, etidronate, risedronate, pamidronate, tiludronate, and zoledronic acid
Method to reduce salicylate intoxication
Alkalinize urine, dialysis
MOA of cisplatin
Alkylating agent
Some cell cycle non-specific drugs
Alkylating agents (eg., mechlorethamine, cyclophosphamide), antibiotics (doxorubicin, daunorubicin), cisplatin, nitrosourea
Drug used concurrently with toxic anticancer agents to reduce renal precipitation of urates
Allopurinol
Benzodiazepines that are the most effective in the treatment of panic disorder
Alprazolam and Clonazepam
MOA of gold salts
Alter activity of macrophages and suppress phagocytic activity of PMNs
Enhances dopaminergic neurotransmission SE’s include CNS excitation, acute toxic psychosis and livedo reticularis
Amantadine
Antidote for thrombolytics
Aminocaproic acid
Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis
Aminoglutethimide
Class III antiarrhythmic that exhibits properties of all 4 classes
Amiodarone
Antiarrhythmic effective in most types of arrhythmia
Amiodarone
TCA used in chronic pain, a hypnotic, and has marked antimuscarinic effects
Amitriptyline
Antidepressant associated with neuroleptic malignant syndrome
Amoxapine
Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction
Amphetamines
Tolerance is marked and abstinence syndrome occurs
Amphetamines
Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects
Amrinone and milrinone
Neurologic SE of benzodiazepines
Anterograde amnesia
Toxicity of anticholinergics
Anti-DUMBBELSS
Four main actions of NSAIDS
Anti-inflammatory, analgesia, antipyretic and antiplatelet activity
SE for Felbamate
Aplastic anemia and acute hepatic failure
SE of penicillamine
Aplastic anemia and renal
Selective alpha agonists that decreases aqueous secretion
Apraclonidine, brimonidine
Primary endogenous substrate for Nitric Oxidase Synthase
Arginine
Nitroprusside vasodilates
Arteries and veins
Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons
Ascending pathways
Agent used to treat MI and to reduce incidence of subsequent MI
Aspirin
Cutaneous flush due to niacin can be reduced by pretreatment with
Aspirin
Irreversible, nonselective COX inhibitor
Aspirin (or other salicylates)
Difference between aspirin and other NSAIDS
Aspirin irreversibly inhibits cyclooxygenase
Drugs used in the management of angina
Aspirin, Nitrates, CCB, and Beta blockers
Beta-blockers should be used cautiously in
Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease
Agent undergoing Hofmann elimination (breaking down spontaneously)
Atracurium
Digoxin is used in
Atrial fibrillation and CHF
Treatment of muscarinic symptoms in organophosphate overdose
Atropine
A class of endogenous substances that include histamine, serotonin, prostaglandins, and vasoactive peptides that work in autocrine or paracrine manner
Autacoids
Drug of choice for Legionnaires’ disease
Azithromycin (or macrolides)
HIV med used to reduce transmission during birth
AZT (zidovudine)
Lactam that can be used in PCN allergic patients
Aztreonam
Class II antiarrhythmics are
B-blockers
Anti-arrhythmics that decrease mortality
B-blockers
GABA agonist in the spinal cord
Baclofen
Site of action for zaleplon and zolpidem
Benzodiazepine receptor BZ1 (although are not considered benzodiazepines)
Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects
Benztropine
Antidote for severe CV toxicity of theophylline
Beta blockers
Clinical uses of these agents include treatment of HTN, angina, arrhythmias, and chronic CHF
Beta blockers
Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF, signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)
Beta blockers
Used for the symptomatic treatment of thyrotoxicosis by blocking cardiac adverse effects
Beta-blockers such as propranolol and esmolol
These agents increase blood flow and may be beneficial in treatment of acute heart failure and some types of shock
Beta1 agonists
Long acting GC’s
Betamethasone, dexamethasone, and paramethasone
Decrease intestinal absorption of cholesterol
Bile acid-binding resins
Cholestyramine and colestipol are
Bile acid-binding resins
MOA of nystatin
Bind ergosterol in fungal cell membrane
The fraction of unchanged drug that reaches systemic circulation after administration
Bioavailability (F)
SE of both warfarin and heparin
Bleeding
Some cell cycle specific anti-cancer drugs
Bleomycin, vinca alkaloids, antimetabolites (eg., 5-FU, 6-MP, methotrexate, etoposide)
MOA of penicillin
Block cell wall synthesis by inhibiting transpeptidase and block peptidoglycan cross-linkage
MOA of local anesthetics (LA’s)
Block voltage-dependent sodium channels
Side effect of demeclocycline
Bone marrow and teeth discoloration for children under 8 years of age
Peptide causing increased capillary permeability and edema
Bradykinin and histamine
Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia
Bromocriptine
Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal
Buprenorphine
Agent that is a partial agonist for the 5-HT1A receptor
Buspirone
Drug of choice for generalized anxiety disorder, NOT effective in acute anxiety
Buspirone
Withdrawal from this drug causes lethargy, irritability, and headache
Caffeine
Used especially in postmenopausal women, dosage should be 1500 mg
Calcium
Block L-type calcium channel
Calcium channel blockers
MOA of class IV antiarrhythmics
Calcium channel blockers
MOA for Ethosuximide
Calcium channels
Used for prevention of postmenopausal osteoporosis in women
Calcium reguators Bisphosphonates: alendronate, risedronate, ibandronate, Estrogen (HRT-Hormone replacement therapy)
Anti-seizure drugs used also for Trigeminal neuralgia
Carbamazepine
Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida
Carbamazepine
Anti-seizure drugs used as alternative drugs for mood stabilization
Carbamazepine, gabapentin, lamotrigine, and valproic acid
PCN active against pseudomonas
Carbenicillin, piperacillin and ticarcillin
This is combined with L-dopa, inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE’s (GI distress, postural hypotension, and dyskinesias)
Carbidopa
Agent similar to cisplatin, less nephrotoxic, but greater myelosuppression
Carboplatin
Lithium is associated with this congenital defect
Cardiac anomalies and is contraindicated in pregnancy or lactation
Nitrosoureas with high lipophilicity, used for brain tumors
Carmustine (BCNU) and lomustine (CCNU)
Reason fluoroquinolones are contraindicated in children and pregnancy
Cartilage damage
Agent used in CHF that is a selective alpha and nonselective beta blocker
Carvedilol
Cephalosporins able to cross the BBB
Cefixime (2nd) and 3rd generation
Cephalosporin causes kernicterus in neonates
Ceftriaxone or cefuroxime
Drug that selectively inhibits COX 2
Celecoxib
Newer NSAIDs that selectively inhibit COX-2
Celecoxib
Class of antibiotics that have 10% cross sensitivity with penicillins
Cephalosporins
SE of tPA
Cerebral hemorrhage
Major SE of bisphosphonates
Chemical esophagitis
Drug that causes gray baby syndrome and aplastic anemia
Chloramphenicol
Longer acting benzodiazepines used in the management of withdrawal states of alcohol and other drugs
Chlordiazepoxide and Diazepam
1st generation antihistamine that is least sedating
Chlorpheniramine
Sulfonylurea NOT recommended for elderly because of very long half life
Chlorpropamide
First generation sulfonylurea
Chlorpropamide, tolbutamide, tolazamide, etc.
During Phase I these agents worsen the paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine
Cholinesterase inhibitors
Reversal of blockade by neuromuscular blockers
Cholinesterase inhibitors
Regimen used for non-Hodgkin’s lymphoma
CHOP (cyclophosphamide, oncovin(vincristine), doxorubicin and prednisone), rituximab (rituxan)
Toxicities include nephrotoxicity and ototoxicity, leading to a severe interaction with aminoglycosides
Cisplatin
Except for these agents all SSRI have significant inhibition of CytP450 enzymes
Citalopram and its metabolite escitalopram
Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents
Class IC (flecainide, propafenone, moricizine)
Beta blockers are used for which type of anginal attack
Classic
The ratio of the rate of elimination of a drug to its plasma concentration
Clearance (CL)
Drug notorious for causing pseudomembranous colitis
Clindamycin
Antiestrogen drugs used for fertility and breast cancer respectively
Clomiphene and tamoxifen
TCA used in obsessive compulsive disorder (OCD), most significant of TCA’s for risk of seizure, weight gain, and neuropsychiatric signs and symptoms
Clomipramine
Example of three antidepressants that are indicated for obsessive compulsive disorder
Clomipramine, fluoxetine and fluvoxamine
Benzodiazepine that has efficacy against absence seizures and in anxiety states, such as agoraphobia
Clonazepam
Presynaptic Alpha 2 agonist used in HTN
Clonidine, and methyldopa
Effective in preventing TIA’s
Clopidogrel and ticlopidine
Regimen used for breast cancer
CMF (cyclophosphamide, methotrexate, and fluorouracil) and tamoxifen if ER+
Additive effects when Sedative-Hypnotics used in combination with these agents
CNS depressants
Most important toxic effects of most local anesthetics
CNS toxicity
Local anesthetic with vasoconstrictive property, favored for head, neck, and pharyngeal surgery
Cocaine
Commonly abused LA which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage, cardiac arrhythmias, and myocardial infarction
Cocaine
Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias, seizures, respiratory depression, or severe HTN (MI and stroke)
Cocaine “super-speed”
These LA’s have surface activity
Cocaine and benzocaine
Three C’s associated with TCA toxicity
Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)
Constant low dose of estrogen and increasing dose of progestin for 21 days (last 5 days are sugar pills or iron prep)
Combination oral contraceptives (OC)
Ability to bind reversibly to the same site as the drug and without activating the effector system
Competitive antagonist
Drugs that can be used for infantile spasms
Corticosteroids
Short acting GC’s
Cortisone and hydrocortisone (equivalent to cortisol)
Difference between COX 1 and COX 2
COX 1 is constitutive while COX 2 may be induced during inflammation, although COX 2 is constitutive in some tissues
Plasma concentration of a drug at a given time
Cp
Toxicity caused by nitroprusside and treatment
Cyanide toxicity treated with sodium thiosulfate
Agent used for acute muscle spasm
Cyclobenzaprine
Anticancer drug also used in RA, produces acrolein in urine that leads to hemorrhagic cystitis
Cyclophosphamide
H1 blocker that is also a serotonin antagonist
Cyproheptadine
Anti-androgen used for hirsutism in females
Cyproterone acetate
Drug used in neuroleptic malignant syndrome
Dantrolene
Drug of choice for leprosy
Dapsone
Most inhaled anesthetics SE
Decrease arterial blood pressure
MOA of metformin
Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity
Mechanism of action of tetracycline
Decreases protein synthesis by binding to 30S ribosome and prevent binding of tRNA to A site
Antidote used for iron salt toxicity
Deferoxamine
Chelating agent used in acute iron toxicity
Deferoxamine
Antivirals that are teratogens
Delavirdine, efavirenz, and ribavirin
An early generation tetracyclin that may be used for chronic persistant SIADH
demeclocycline
Common mechanism by which overdose result in death
Depression of medullary and cardiovascular centers
SE of gold salts
Dermatitis of the mouth aplastic anemia and agranulocytosis
Pungent inhaled anesthetic which leads to high incidence of coughing and vasospasm
Desflurane
ADH agonist used for central diabetes insipidus
Desmopressin (DDAVP)
Amphetamine agents
Dextroamphetamines and methamphetamine
These agents are used as antitussive
Dextromethorphan, Codeine
Benzodiazepine with useful relaxant effects in skeletal muscle spasticity of central origin
Diazepam
DOC for status epilepticus
Diazepam
Facilitates GABA presynaptic inhibition
Diazepam
Agents having active metabolites, long half lives, and a high incidence of adverse effects
Diazepam, Flurazepam, chlordiazepoxide, and clorazepate
Reduce transient hyper GI motility
Dicyclomine, methscopolamine
Anti-viral with a dose limiting toxicity of pancreatitis
Didanosine
Antidote for digoxin toxicity
Digibind
Antidote used for digitalis toxicity
Digibind (also need to d/c digoxin, normalize K+, and lidocaine if pt. Is arrhythmic)
Drug used supraventricular arrhythmias
Digoxin
H1 antagonist used in motion sickness
Dimenhydrinate and other 1st generation
Antidote for arsenic, mercury, and gold poisoning
Dimercaprol
Antidote for severe lead poisoning (with encephalopathy)
Dimercaprol AND CaEDTA (edetate calcium disodium)
Antidote used for lead poisoning (without encephalopathy)
Dimercaprol, Edetate calcium disodium, or succimer
Antihistamine that is indicated for allergies, motion sickness, and insomnia
Diphenhydramine
These agents are used as antidiarrheal
Diphenoxylate, Loperamide
Prevents thrombosis in patients with artificial heart valve
Dipyridamole
Agent used in the treatment of alcoholism, if alcohol is consumed concurrently, acetaldehyde builds up and results in nausea, headache, flushing, and hypotension
Disulfiram
Metronidazole SE if given with alcohol
Disulfiram-like reaction
Agents that inhibit aldehyde dehydrogenase
Disulfiram, metronidazole, certain sulfonylureas and cephalosporins
Beta 1 agonists used in acute CHF
Dobutamine and dopamine
5ht-3 antagonist that has been MOST associated with QRS and QTc prolongation and should not be used in patients with heart disease
Dolasetron
These agents are congeners of Amphetamine
DOM, STP, MDA, and MDMA “ecstasy”
TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep
Doxepin
Antiglaucoma organophosphate, indicated but not used much clinically anymore due to long duration of action
Echothiophate
Dose which produces therapeutic response in 50% of the poopulation
ED50
SE of Thiazolindinediones
Edema, mild anemia; interaction with drugs that undergo CytP450 3A4 metabolism; if used over one year, bladder Cancer; with CHF, may cause new or worsening CHF
Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis
Edrophonium
Population group especially sensitive to side effects of antidepressants
Elderly patients
Inhaled anesthetics are myocardial depressants
Enflurane and halothane
Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson’s dx and cause acute hepatic failure (monitor LFT’s)
Entacapone and Tolcapone
Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis
Ephedrine
This is the drug of choice for anaphylactic shock
Epinephrine
Nonselective alpha agonists that decrease aqueous production and increase aqueous outflow
Epinephrine, dipivefrin
Antidote used for beta agonist toxicity (eg. Metaproterenol)
Esmolol
This parenteral beta blocker is a short acting
Esmolol
Used intravenously for acute arrhythmias during surgery
Esmolol
Slightly increased risk of breast cancer, endometrial cancer, heart disease (questionable), has beneficial effects on bone loss
Estrogen
Antidote used for methanol and ethylene glycol toxicity
Ethanol
Agent that competes for alcohol dehydrogenase in the case of methanol overdose
Ethanol
Agent with zero-order kinetics
Ethanol, theophylline, tolbutamide, warfarin, aspirin, phenytoin
Estrogen mostly used in oral contraceptives (OC)
Ethinyl estradiol and mestranol
Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia
Etidronate
The most important sign of withdrawal syndrome
Excessive CNS stimulation (seizures)
Class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins
Ezetimibe (Zetia)
Agent to treat hypochromic microcytic anemias
Ferrous sulfate
5 alpha-reductase inhibitor used for benign prostatic hyperplasia (BPH) and male pattern baldness
Finasteride (Proscar and Propecia respectively)
Generation of antihistamine that has the most CNS effects
First generation due to being more lipid-soluble
Constant percentage of drug metabolized per unit time
First order kinetics
The elimination of drug that occurs before it reaches the systemic circulation
First pass effect
SE of AGI’s
Flatulence (do not use beano to tx), diarrhea, abdominal cramps
Mineralocorticoids
Fludrocortisone and deoxycorticosterone
Toxic to the liver, kidney, lungs, bone marrow, peripheral nerves, and cause brain damage in animals, sudden death has occurred following inhalation
Fluorocarbons and Industrial solvents
Antibacterials for optimal treatment of acute pyelonephritis
Fluoroquinolones (ciprofloxacin, levofloxacin), trimethoprim-sulfamethoxazole
SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx
Fluoxetine
SSRI’s less likely to cause a withdrawal syndrome
Fluoxetine
SSRI indicated for premenstrual dysphoric disorder
Fluoxetine (Sarafem)
Anti-psychotics available in depot preparation
Fluphenazine and haloperidol
Anti-androgen used for prostate cancer
Flutamide (Eulexin)
Drug that inhibits alcohol dehydrogenase and is used in ethylene glycol exposure
Fomepizole
Ability of a drug to produce maximal response after binding to the receptor
Full agonist
Agent used neutropenia especially after chemotherapy
G-CSF (filgrastim) and GM-CSF (sargramostim)
MOA for benzodiazepines and barbiturates
GABA-related targets
DOC for CMV retinitis
Ganciclovir
Antivirals associated with neutropenia
Ganciclovir, zidovudine, saquinavir, and interferon
GnRH antagonist with more immediate effects, used for infertility
Ganirelix
COX 2 inhibitors may have reduced risk of
Gastric ulcers and GI Bleeding
Pneumonic for 3 zones of adrenal cortex
GFR
SE of phenytoin
Gingival hyperplasia
Ultra long acting insulin, has over a day duration of action
Glargine (Lantus)
Epinephrine and dipivefrin are used for
Glaucoma
3 zones of adrenal cortex and their products
Glomerulosa (mineralocorticoids), fasciculata (glucocorticoid=GC), and reticularis (adrenal androgens)
Antidote for beta-blocker overdose and hypoglycemia
Glucagon
Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation
Glucagon
Used for Addison’s disease, Congenital Adrenal Hyperplasia (CAH), inflammation, allergies, and asthma (as a local inhalation)
Glucocorticoids
Name 3 Phase II conjugation reactions
Glucuronidation, acetylation, glutathione conjugation, glycine conjugation, sulfation, methylation, water conjugation
Important in synthesis of glucose to glycogen in the liver
GLUT 2
Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation
GLUT 4
Second generation sulfonylurea
Glyburide, glipizide, glimepiride, etc.
SE seen only in men with administration of ketoconazole
Gynecomastia
SE of ergot alkaloids
Hallucinations resembling psychosis
Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker
Haloperidol
Antipsychotic having the weakest autonomic effects
Haloperidol
Agents used in Tourette’s dx
Haloperidol or pimozide
Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis
Halothane
Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents
Halothane and methoxyflurane
Anticoagulant of choice in pregnancy
Heparin
SE of heparin
Heparin induced thrombocytopenia (HIT)
Main route of metabolism for benzodiazepines
Hepatic
Most frequent route of metabolism
Hepatic enzymes
Reason troglitazone was withdrawn from market
Hepatic toxicity
SE of acetaminophen
Hepatotoxicity
Most commonly abused in health care professionals
Heroin, morphine, oxycodone, meperidine and fentanyl
Ganglion blockers that were indicated (but not anymore) for severe hypertension
Hexamethonium, trimethaphan
Drugs that have a high margin of safety is indicated by
High therapeutic index
Common SE of tamoxifen and raloxifene
Hot flashes
Direct vasodilator of arteriolar smooth muscle
Hydralazine
Prevention of cyclophosphamide induced hemorrhagic cystitis
Hydration and mercaptoethanesulfonate (MESNA)
Interferes with activity of T-lymphocytes
Hydroxychloroquine
Anti-malarial drug used in rheumatoid arthritis (RA)
Hydroxychloroquine
This may antagonize activity of local anesthetics
Hypercalcemia
This may enhance activity of local anesthetics
Hyperkalemia
Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)
Hypertensive crisis
SE of minoxidil
Hypertrichosis
Major side effect of insulin
Hypoglycemia
Common SE of sulfonylureas, repaglinide, and nateglinide
Hypoglycemia
Digoxin toxicity can be precipitated by
Hypokalemia
Major nutritional side effect of bile acid-binding resins
Impair absorption of fat soluble vitamin absorption (A,D,E,K)
Barbiturates MOA
Increase the DURATION of GABA-mediated chloride ion channels
MOA for benzodiazepines
increase the FREQUENCY of GABA-mediated chloride ion channel opening
Major drug interaction with Quinidine
Increases concentration of Digoxin
Shock due to septicemia or myocardial infarction is made worse by
Increasing afterload and tissue perfusion declines
MOA of Cardiac glycosides (eg. digoxin)
Indirectly increase intracellular calcium and cardiac contractility by inhibit Na+/K+ ATPase
NSAID used in gout
Indomethacin, ibuprofen
MOA of corticosteroids
Induce lipocortins to 1. inhibit phospholipase A2, 2. repress COX-2 gene and enzyme expression, 3. repress cytokines that activate COX-2
Atropine fever is the most dangerous effect and can be lethal in this population group
Infants
Contraindications to use of atropine
Infants, closed angle glaucoma, prostatic hypertrophy
Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)
Infliximab and etanercept
These drugs strongly potentiate and prolong effect of neuromuscular blockade (NMB)
Inhaled anesthetics, especially isoflurane, aminoglycosides, and antiarrhythmic
Mechanism of action of spironolactone
Inhibit mineralocorticoid receptor and inhibit Na/K-ATPase and ENaC synthesis
Mechanism of action of thiazide diuretics
Inhibit Na+/Cl- cotransport
MOA of NSAIDS
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
Mechanism of action of macrolides (erythromycin, clarithromycin)
Inhibit protein synthesis by binding to domain V of 23S rRNA of 50S ribosome subunit
MOA of Leflunomide (newer agent)
Inhibiting Dihydroorotate Dehydrogenase which leads to decreased pyrimidine synthesis
MOA of lovastatin (STATIN)
inhibits HMG COA reductase
Mechanism of action of loop diuretics
inhibits Na+/K+/2Cl- cotransporter
MOA of Bisphosphonates
Inhibits osteoclast bone resorption
MOA of both generations
Insulin release from pancreas by modifying K+ channels
MOA of repaglinide
Insulin release from pancreas; faster and shorter acting than sulfonylurea
Used for hairy cell leukemia; it stimulates NK cells
Interferon alpha
Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy
Interleukin 11 (oprelvekin)
Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism
Iodide salts (potassium iodide)
MOA of aspirin
Irreversibly blocks COX1 and COX2
Beta cells are found
Islets of Langerhans
Inhaled anesthetic causes peripheral vasodilation
Isoflurane
This route is associated with rapid tolerance and psychologic dependence
IV administration
Drugs of choice for status epilepticus
IV diazepam (or lorazapam) followed by phenytoin
This produces “dissociative anesthesia”, is a cardiovascular stimulant which may increases intracranial pressure, and hallucinations occur during recovery
Ketamine
5HT2 antagonist mediate synaptic excitation in the CNS and smooth muscle contraction
Ketanserin, cyproheptadine, and ergot alkaloids (partial agonist of alpha and serotonin receptors)
Antifungal agent used for inhibition of all gonadal and adrenal steroids
Ketoconazole
NSAID available orally, IM, IV, nasally, and ophthalmically
Ketoralac
NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
Ketoralac
SE of colchicine
Kidney and liver toxicity, diarrhea, myelosuppression
Major route of elimination for Lithium
Kidneys
Converts asparagine to aspartate and ammonia, denies cancer cells of essential AA (asparagine)
L-asparaginase
Agent used in drug therapy of Parkinson’s instead of Dopamine which has low bioavailability and does not cross the BBB
L-dopa
Combined alpha and beta blocking agents that may have application in treatment of CHF
Labetalol and carvedilol
Most important potential SE of metformin
Lactic acidosis
Dose which is lethal to 50% of the population
LD50
Alternative anticoagulant used if HIT develops
Lepirudin
Antidote for methotrexate toxicity
Leucovorin
GnRH agonist used for infertility or different types of CA depending on pulsatile or steady usage respectively
Leuprolide
Anti-Parkinson’s drug which increases intraocular pressure and is contraindicated in closed angle glaucoma
Levodopa
An isomer of T3 which may be used in myxedema coma
Liothyronine (T3)
Very rapid acting insulin, having fastest onset and shortest duration of action
Lispro (Humalog)/Apidra (glulisine)
Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetics property
Liver enzyme INDUCTION
Major SE of zileuton
Liver toxicity
SE of mirtazapine
Liver toxicity, increased serum cholesterol
Target plasma concentration times (volume of distribution divided by bioavailability)
Loading dose (Cp*(Vd/F))
Constant proportion of cell population killed rather than a constant number
Log-kill hypothesis
Treatment of withdrawal syndrome involves
Long-acting sedative-hypnotic or a gradual reduction of dose, clonidine or propranolol
Diuretic used in hypertensive patients with renal failure
Loop diuretics (furosemide, ethacrynic acid, butmetanide)
Benzodiazepine that undergo extrahepatic conjugation (which are useful in older or hepatically impaired)
Lorazepam, oxazepam, and temazepam
Orthostatic hypotension and QT prolongation
Low potency and risperidone
Drugs that have a narrow margin of safety is indicated by
Low therapeutic index
Reduced seizure threshold
Low-potency typical antipsychotics and clozapine
Antidote useful for some drug induced Torsade de pointes
Magnesium sulfate
Agent to treat torsades de pointes
Magnesium sulfate
Concentration in the plasma times (clearance divided by bioavailability)
Maintenance dose (Cp*(CL/F))
Insecticide organophosphate
Malathion, parathion
Antidepressant associated with seizures and cardiotoxicity
Maprotiline
Important drug interaction with chloral hydrate
May displace coumadin from plasma proteins
Alkylating agent, vesicant that causes tissue damage with extravasation
Mechlorethamine
MOPP regimen used in Hodgkin’s disease (HD)
Mechlorethamine+ oncovorin (vincristine)+ procarbazine, and prednisone
All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction
Meperidine
Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI’s can lead to serotonin syndrome
Meperidine
Biguanide
Metformin
Treatment for opioid addiction
Methadone, followed by slow dose reduction
Penicillins active against penicillinase secreting bacteria
Methicillin, nafcillin, and dicloxacillin
Thioamide agents used in hyperthyroidism
Methimazole and propylthiouracil (PTU)
Causes bone marrow suppression
Methotrexate
Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency
Methoxyflurane
Used for Cushing’s syndrome (increased corticosteroid) and sometimes for adrenal function test
Metyrapone
Benzodiazepine that is used for anesthesia
Midazolam
Benzodiazepine used adjunctively in anesthesia
Midazolam
Chronic orthostatic hypotension can be treated with
Midodrine
Antiprogestin used as potent antagonist of GC receptor
Mifepristone
Anti-progesterone used as abortifacient
Mifepristone (RU-486)
Inversely related to potency of anesthetics
Minimum alveolar anesthetic concentration (MAC)
Oral antibiotic of choice for moderate inflammatory acne
Minocycline
Arterial vasodilator that works by opening K+ channels
Minoxidil
Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating
Mirtazapine
Non-depolarizing antagonist has short duration
Mivacurium
Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression
Monamine oxidase inhibitors
Opioids used in anesthesia
Morphine and fentanyl
Strong opioid agonists
Morphine, methadone, meperidine, and fentanyl
Receptors for serotonin (5HT-1) are located
Mostly in the brain, and they mediate synaptic inhibition via increased K+ conductance
Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)
Muscarinic blockers
SE for ganciclovir
Myelosuppression
This beta blocker is the longest acting
Nadolol
Anabolic steroid that has potential for abuse
Nandrolone and stanozolol
Most common SE of fibrates
Nausea
Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure
Nefazodone
Carbamate with intermediate action and used as off-label for postoperative paralytic ileus and urinary retention
Neostigmine
Common toxicities of cisplatin
Nephro and ototoxicity
Two toxicities of aminoglycosides
nephro and ototoxicity
Toxicity of amphotericin
Nephrotoxicity
Agent used in acutely decompensated CHF resembling natriuretic peptide
Nesiritide (Natrecor)
State of analgesia and amnesia produced when fentanyl is used with droperidol and nitrous oxide
Neuroleptanesthesia
Structurally related to acetylcholine, used to produce muscle paralysis in order to facilitate surgery or artifical ventilation. Full doses lead to respiratory paralysis and require ventilation
Neuromuscular blocking drugs
SE for ticlopidine
Neutropenia and agranulocytosis
Anti-viral agents associated with Stephen Johnson syndrome
Nevirapine, amprenavir
W/D from this drug causes anxiety and mental discomfort
Nicotine
CCB with predominate effect on arteriole dilation
Nifedipine
Drug used in Chagas disease
Nifurtimox
Antidote used for cyanide poisoning
Nitrites, sodium thiosulfate, hydroxocobalamin (cyanokit)
Antibacterials for optimal treatment of acute uncomplicated cystitis
Nitrofurantoin, trimethoprim-sulfamethoxazole, fosfomycin
Nitrate used for acute anginal attacks
Nitroglycerin sublingual tablets
IV Drug used Hypertensive Crisis
Nitroprusside
Drug used in ergot alkaloids overdose, ischemia and gangrene
Nitroprusside
Inhaled anesthetic with a low blood/gas partition coefficient
Nitrous oxide
Inhaled anesthetics, less likely to lower blood pressure than other agents, and has the smallest effect on respiration
Nitrous oxide
Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia
Nitrous oxide
Inhalant anesthetics
NO; chloroform; and diethyl ether
Ability to bind irreversibly to the active site or bind to a site distinctly separate from the agonist binding site
Noncompetitive antagonist
Tubocurarine is the prototype; pancuronium; atracurium; vecuronium are newer short acting agent; produce competitive block at end plate nicotinic receptor; causing flaccid paralysis
Nondepolarizing Neuromuscular Blockers
These prevent the action of Ach at the skeletal muscle endplate to produce a “surmountable blockade;” effect is reversed by cholinesterase inhibitors (ex. neostigmine or pyridostigmine)
Nondepolarizing type antagonists
Prototypical drug is atropine
Nonselective Muscarinic Antagonists
Neurotransmitters affected by the action of antidepressants
Norepinephrine and serotonin
Endogenous insulin
Normal C-peptide
Secondary amines that have less sedation and more excitation effect
Nortriptyline; Desipramine
Class of drugs that reversibly inhibit COX
NSAIDS
Somatostatin (SRIF) analog used for acromegaly; carcinoid; glucagonoma and other GH producing pituitary tumors
Octreotide
Newer atypical antipsychotic used for bipolar disorder; known to cause weight gain; and adversely affect diabetes
Olanzapine
Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation
Olanzapine and aripiprazole
Extrapyramidal dysfunction is more common with these agents; which block this subtype of dopamine receptor
Older antipsychotic agents; D2 receptors
Antipsychotics that reduce positive symptoms only
Older antipsychotics
SE of these drugs include dependence; withdrawal syndrome; sedation; euphoria; respiratory depression nausea and vomiting; constipation; biliary spasm; increased ureteral and bladder tone; and reduction in uterine tone
Opioid Analgesics
Route of administration of warfarin
Oral
Nitrate used to prevent further attacks
Oral and transdermal forms of nitroglycerin
Treatment of resistant pseudomembranous colitis
ORAL vancomycin
Cause dizziness; tachycardia; hypotension; and flushing
Organic nitrites
Oral contraceptive available in a transdermal patch
Ortho-Evra
Uses of bisphosphonates
Osteoporosis; Paget’s disease; and osteolytic bone lesions; and hypercalcemia from malignancy
Aminoglycosides used with loop diuretics potentiate this adverse effect
Ototoxicity
Different steps of Phase I
Oxidation; reduction; hydrolysis
Cystitis; postoperative bladder spasms; or incontinence
Oxybutynin; dicyclomine
Agent can blocking muscarinic receptors
Pancuronium
Some of SSRIs’ therapeutic effects beside depression
Panic attacks; social phobias; bulimia nervosa; and PMDD premenstrual dysphoric disorder); OCD
Ability to produce less than maximal response after binding to the receptor
Partial agonist
Most dangerous of the currently popular hallucinogenic drugs; OD leads to nystagmus; marked hypertension; and seizures; presence of both horizontal and vertical nystagmus is pathognomonic
PCP
Antidote used in Wilson’s disease (copper poisoning)
Penicillamine
Chelating agent used in Wilson’s disease
Penicillamine
Methylxanthine derivative used as a remedy for intermittent claudication
Pentoxifylline
SE of INH
Peripheral neuritis and hepatitis
Approved for use in severe pulmonary HTN
PGI2 (epoprostenol)
DOC for febrile seizures
Phenobarbital
Nonselective alpha-blocking drug; long acting and irreversible; and used to treat pheochromocytoma. Blocks 5-HT; so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis
Phenoxybenzamine
Non-selective Alpha1blockers use to treat pheochromocytoma
Phenoxybenzamine
Nonselective alpha-blocking drug; short acting and reversible; used for rebound HTN from rapid clonidine withdrawal; and Raynaud’s phenomena
Phentolamine
For rebound HTN from rapid clonidine withdrawal
Phentolamine
Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy; it does not cause cycloplegia
Phenylephrine
DOC for digoxin induced arrhythmias
Phenytoin
Anti-seizure agent that exhibits non-linear metabolism; highly protein bound; causes fetal hydantoin syndrome; and stimulates hepatic metabolism
Phenytoin
Enzyme which theophylline inhibits
Phosphodiesterase
Antidote used for anticholinergic poisoning
Physostigmine
Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect; which may lead to convulsions
Physostigmine
Muscarinic that is very lipid soluble and used in glaucoma
Pilocarpine
Muscarinic used to treat dry mouth in Sjögren’s syndrome
Pilocarpine or Cevimeline
Cholinomimetics that increase outflow; open trabecular meshwork; and cause ciliary muscle contraction
Pilocarpine; carbachol; physostigmine
Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma
Pindolol and acebutolol
Thiazolidinediones
Pioglitazone; Rosiglitazone; Troglitazone (withdrawn/d from market)
Aspirin reduces mortality in unstable angina by
Platelet aggregation inhibition
Type of resistance found with vancomycin
Point mutation
SE of methyldopa
Positive Comb’s test; depression
Activation of these receptors open K+ ion channels to cause membrane hyperpolarization
Postsynaptic Mu receptors
SE of nitrates
Postural hypotension; reflex tachycardia; hot flashes; and throbbing headache due to meningeal artery dilation
MOA of class III antiarrhythmics
Potassium channel blockers
Amount of drug necessary to elicit a biologic effect compared with another drug
Potency
The reason why aspirin is contraindicated in children with viral infection
Potential for development of Reye’s syndrome
This agent competes for phosphorylated cholinesterase enzyme and regenerates enzyme if organophosphate-enzymes complex has not “aged”
Pralidoxime
Non ergot agents used as first-line therapy in the initial management of Parkinson’s
Pramipexole and ropinirole
COX 2 inhibitors should be used cautiously in pts with
Pre-existing cardiac or renal disease
Drug used in cancer therapy causes Cushing-like symptoms
Prednisone
Intermediate acting GC’s
Prednisone; methylprednisolone; prednisolone; oaramethasone; fluprednisone and triamcinolone
HMG CoA reductase inhibitors are contraindicated in
Pregnancy
Fibrates are contraindicated in
Pregnancy
Warfarin is contraindicated in
Pregnancy
LA causing methemoglobinemia
Prilocaine
Drug used in exoerythrocytic cycle of malaria
Primaquine
CCB are DOC for
Prinzmetal’s angina
Agent used to treat chronic gout by increasing uric acid excretion through inhibition of URAT1 anion transporter
Probenecid
Alkylating agent that produces disulfiram-like reaction with ethanol
Procarbazine
Alpha cells in the pancreas
Produce glucagon
Beta cells in the pancreas
Produce insulin
Delta cells in the pancreas
Produce Somatostatin
Specific pharmacokinetic characteristic of amiodarone
Prolonged half-life; up to six weeks
Side effect of sotalol
prolongs QT and PR interval
Produces both rapid anesthesia and recovery; has antiemetic activity and commonly used for outpatient surgery; may cause marked hypotension
Propofol
Weak opioid agonist; poor analgesic; its overdose can cause severe toxicity including respiratory depression; circulatory collapse; pulmonary edema; and seizures
Propoxyphene
This beta blocker is highly lipid soluble and may account for side effects such as nightmares
Propranolol
Non-selective Beta-blocker also used for migraine prophylaxis
Propranolol
Agent effective in physiologic and essential tremor
Propranolol
This agent cause increased aqueous outflow
Prostaglandin PGF2a (latanoprost; travoprost; unoprostone)
Chronic high dose abuse of nicotine leads to
Psychotic state; overdose causes agitation; restlessness; tachycardia; hyperthermia; hyperreflexia; and seizures
Treatment with cancer chemotherapy at high doses every 3-4 weeks; too toxic to be used continuously
Pulse therapy
Treatment of myasthenia gravis and sometimes used prophylactically for organophosphate poisoning in chemical warfare
Pyridostigmine
Increased risk of developing cataracts
Quetiapine
Permanently cures thyrotoxicosis; patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy
Radioactive iodine
Recombinant uricases that enhance uric acid metabolism
rasburicase; pegloticase
SE of clonidine
Rebound HTN; sedation; dry mouth
Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma
Reduce aqueous synthesis
Sedative-Hypnotics action
Reduce inhibition; suppress anxiety; and produce relaxation
Often mixed with local anesthetic to
Reduce the loss from area of injection
Diuretics work in CHF by
Reducing preload
Beta blockers work in CHF by
Reducing progression of heart failure (never use in acute heart failure)
Rapid acting; crystalline zinc insulin used to reverse acute hyperglycemia
Regular (Humulin R)
Major effect of benzodiazepines on sleep at high doses
REM is decreased
Meglitinide
Repaglinide
Toxic effect of anticancer drug can be lessened by rescue agents
Rescue therapy
The most important cause of acute deaths in cholinesterase inhibitor toxicity
Respiratory failure
SE of hydroxychloroquine
Retinal destruction and dermatitis
Concurrent use of fibrates and statins increases risk of
Rhabdomyolysis
SE of HMG COA reductase inhibitors
Rhabdomyolysis and Hepatotoxicity
Atypical antipsychotic causing high prolactin levels
Risperidone
Long acting beta 2 agonist used in asthma
Salmeterol
Longer acting Beta 2 agonists is recommended for prophylaxis of asthma
Salmeterol
Most common side effect of 1st generation antihistamines
Sedation; anticholinergic
SE of imipenem
Seizures
MOA of Colchicine (used in acute gout)
Selective inhibitor of microtubule assembly
Inhibitor of MAO type B which metabolizes dopamine; used adjunct to levodopa or as sole agent in newly diagnosed pt’s
Selegiline
GHRH analog used as diagnostic agent
Sermorelin
MAOI should not be administered with SSRI’s or potent TCA’s due to development of this condition
Serotonin syndrome
Laboratory value required to be monitored for patients on valproic acid
Serum ammonia and LFT’s
Side effect of Mitomycin
SEVERE myelosuppression
All antidepressants have roughly the same efficacy in treating depression; agents are chosen based on these criterion
Side-effect profile and prior pt response
Beta 1 agonist toxicity
Sinus tachycardia and serious arrhythmias
Beta 2 agonist toxicity
Skeletal muscle tremor
Antidote used for tricyclic antidepressants (TCA)
Sodium bicarbonate
Mechanisms of action for Phenytoin; Carbamazepine; Lamotrigine
Sodium blockade
Antidote for hyperkalemia
sodium polystyrene sulfonate (Kayexalate)
Somatotropin (GH) analog used in GH deficiency (dwarfism)
Somatrem
Antiarrhythmic that exhibits Class II and III properties
Sotalol
Agents acting in the CNS or in the skeletal muscle; used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease
Spasmolytic drugs
Selectivity of a drug for its receptor
Specificity
Well-tolerated and are first-line antidepressants
SSRI’s; bupropion; and venlafaxine
Disease caused by excess ergot alkaloids
St. Anthony’s Fire
When the rate of drug input equals the rate of drug elimination
Steady state
Causes acne; premature closure of epiphyses; masculinization in females; hepatic dysfunction; MI; and increases in libido and aggression
Steroids
SE for Lamotrigine
Stevens-Johnson syndrome
MOA of thiazolindinediones
Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism
MOA of nateglinide
Stimulates rapid and transient release of of insulin through closure of the ATP-sensitive K+ channel
Thrombolytic that can cause allergic reaction
Streptokinase
Aminoglycoside that is least ototoxic
Streptomycin
Only member of depolarizing neuromuscular blocker; causes fasciculation during induction and muscle pain after use
Succinylcholine
One depolarizing blocker that causes continuous depolarization and results in muscle relaxation and paralysis; causes muscle pain postoperatively and myoglobinuria may occur
Succinylcholine
Anti-rheumatic agent also used for ulcerative colitis
Sulfasalazine
Class of drugs that may cause cross-sensitivity with thiazide diuretics
Sulfonamides
Triptan available in parenteral and nasal formulation
Sumatriptan
Drug used for African sleeping sickness
Suramin
Dose which is toxic in 50% of the population
TD50
Beta 2 agonist used to suppress premature labor; but cardiac stimulatory effects may be hazardous to mother and fetus
Terbutaline
Agents having higher sedation and antimuscarinic effects than other TCA’s
Tertiary amines
Agents used in Huntington’s Disease
Tetrabenazine (amine depleting drug); Haloperidol (antipsychotic)
Longer acting local anesthetics which are less dependent on vasoconstrictors
Tetracaine and bupivacaine
Drug causes teeth discoloration
Tetracycline
Drug increases the renal clearance hence decreases levels of lithium
Theophylline
Window between therapeutic effect and toxic effect
Therapeutic index
Diuretic used as first line for treatment of hypertension
Thiazides
Anti-thyroid drugs
Thioamides (methimazole; propylthiouracil); potassium iodide; radioactive iodine (131I)
Barbiturate used for the induction of anesthesia
Thiopental
IV barbiturate used as a pre-op anesthetic
Thiopental
Only phenothiazine not exerting antiemetic effects; can cause visual impairment due to retinal deposits; and high doses have been associated with ventricular arrhythmias
Thioridazine
SE of amrinone
Thrombocytopenia
Other side effects of Quinidine
Thrombocytopenic purpura; and CINCHONISM
SE of Amiodarone
Thyroid dysfunction; photosensitivity; skin (blue smurf syndrome); corneal deposits; liver damage and pulmonary fibrosis
Antiplatelet drug reserved for patients allergic to aspirin
Ticlopidine
SE of salicylates
Tinnitus; GI bleeding
Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA
Tissue plasmin activator
Similar to clonidine and may cause hypotension
Tizanidine
Nitrate free intervals are needed due to
Tolerance
Occurs when sedative hypnotics are used chronically or at high doses
Tolerance
Agents used for SIADH
Tolvaptan and conivaptan
Topical DOC in impetigo
Topical mupirocin (Bactroban)
Antidepressant also used for sleep that causes priapism
Trazodone
Sedation is a common side effect of these drugs; they lower seizure threshold; uses include BAD; acute panic attacks; phobias; enuresis; and chronic pain and their overdose can be deadly
Tricyclic antidepressants (TCA)
Agent with long duration of action and is sost likely to cause histamine release
Tubocurarine
MOA of general anesthetics
Unclear; thought to increase the threshold for firing of CNS neurons
Removal of PCP may be aided
Urinary acidification and activated charcoal or continual nasogastric suction
Major indication for H1 receptor antagonist
Use in IgE mediated allergic reaction (allergic rhinitis; urticaria)
Reason ergot alkaloids are contraindicated in pregnancy
Uterine contractions
Agent that inhibits hepatic metabolism; is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress
Valproic acid
Anti-seizure drugs used also for bipolar affective disorder (BAD)
Valproic acid; carbamazepine; phenytoin and gabapentin
Antibiotic causing red-man syndrome; and prevention
Vancomycin; can be prevented by infusion
at a slow rate and antihistamines
Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity
Vasodilation
Antidepressant having stimulant effects similar to SSRI’s and can increase blood pressure
Venlafaxine
Antidepressant inhibiting norepinephrine; serotonin; and dopamine reuptake
Venlafaxine
Microtubule inhibitor that causes peripheral neuropathy; foot drop (eg. ataxia); and “pins and needles” sensation
Vincristine
Agent used for neurological deficits in megaloblastic anemia
Vitamin B12
Vitamin given with calcium to ensure proper absorption
Vitamin D
Antidote to reverse actions of warfarin
Vitamin K or fresh frozen plasma
Relates the amount of drug in the body to the plasma concentration
Volume of distribution (VD)
Vitamin K dependent anticoagulant
Warfarin (PT)
Selective Alpha 2 blocker used for impotence (controversial effectiveness)
Yohimbine
Inhibitor of leukotrienes (LTD4) receptors and used in asthma
Zafirlukast and montelukast
Constant amount of drug metabolized per unit time
Zero order kinetics
Syndrome of hypersecretion of gastric acid and pepsin usually caused by gastrinoma; it is associated with severe peptic ulceration and diarrhea
Zollinger-Ellison Syndrome
Good hypnotic activity with less CNS SE than most benzodiazepines
Zolpidem; zaleplon
