Pharm Drugs USMLE Flashcards
antineoplastic–inhibits thymidylate synthatase; inhibits RNA synthesis
I:used for colon and breast CA
SE: Delayed toxicity: nausea, oral and GI ulcers, bone marrow depression
5-Fluorouracil (5-FU)
Analgesic, antipyretic-unknown mechanism; not anti0inflammatory
I: Pain; fever
SE: Liver toxicity at high doses
Notes: Overdose treated with N-acetylcysteine
Acetaminophen [Tylenol]
Diuretic–carbonic anhydrase inhibitor on PCT and DCT; decreases production of aqueous humor in the eye
I: Diuresis; glaucoma; high altitude
SE: Metabolic acidosis
Acetazolamide [Diamox]
Muscarinic agonist
I: Eye sx (miotic)
contraindicated for patients with peptic ulcer, asthma, hyprthyroidism, or parkiinsonism
Acetylcholine
Anti-inflammatory, antipyretic, analgesic-acetylates COX irreversibly
I: Articular, msk pain, chronic pain; acute gout
SE: Irritates GI; inhibits platelet aggression; causes hypersensitivity rxns
notes: contraindicated in children with the flu (leads to Reye’s syndrome), gouty patients
Acetylsalicytic acid (aspirin)
Increases production of steroids by the adrenal gland (zona fasciculata)
ACTH (corticotropin)
Antiviral–guanosine analog; inhibits DNA polymerase
I: Herpes, varicella, EBV, CMV (at high doses)
SE: GI disturbances; CNS; renal problems; headache; tremor; rash
Adenosine
Bronchodilation – beta2agonist
I: Asthma
Albuterol
Acts at GABA receptor
I: Sedative; hypnotic; depressive action on brain
Alcohol (EtOH)
Bone stabilizer-pyrophosphate analog; reduces hydroxyapatite crystal formation, growth, and dissolution, which reduces bone turnover
I: Hypercalcemia of malignancy; Paget’s dz; osteoporosis; hyperparathyroidism
Allendronate [Fosamax]
Antigout-competitive inhibitor of xanthine oxidase
I: Chronic gout (due to renal obstruction or impairment or overproduction); rheumatic arthritis
SE: Rash; fever; GI problems; hepatotoxicity; inhibition in the metabolism of other drugs; enhance effect of axathioprine
Allopurinol [Zyloprim]
Impotency therapy; Prostaglandin E1
I: Impotence; maintain patent ductus arteriosus
SE: Penile pain; prolonged erection; flushing, bradicardia, tachycardia, hypotension, apnea
Alprostadil [Vasoprost]
Antiviral-anti-parkinsonian; inhibits fusion of lysosomes; inhibits uncoating; increases release of endogenous dopamine
I: Influenza A; Parkinson’s dz
SE: Anticholinergic; nervousness; insomnia; drowsiness; GI disturbances
Amantadine
Antibiotic- binds 30s ribosome subunits: bacteriostatic at low concentration; bactericidal at high concentration
I: Broad spectrum: gram positive and negative; good for bone infections
SE: Auditory, vestibular, renal toxicity; nausea; vomiting; vertico; allergic skin rash; super-infections
Aminoglycosides
Antiarrhythmic (class III)-K+ channel blocker
I: Ventricular/supraventricular arrhythmias
SE: Bradycardia; heart block/failure; pulmonary fibrosis; photodermatitis
Notes: Also functions as class IA, 2, and 4
Amiodarone
Antidepressant–TCA; blocks 5HT and NE reuptake
I: Sedative; anti-depressant; prophylaxis for migraines
Amitriptyline [elavil]
Antibiotic-inhibits B-lactamase; syndergistic w/ penicillins
Amoxicillin + Clavulanic acid [Augmentin]
Stimulant-releases NE, 5HT, dopamine
I: Narcolepsy; attention deficit d/o; weight reduction
SE: Psychosis; hallucination
Amphetamine
Antifungal-binds to cell membrane sterols (esp. ergosterol); forms pores in membrane; fungicidal
I:Candida, Histoplasma, Cryptococcus, Sporothrix
SE: Hypersensitivity; flushing; chills; fever; headache; pain; hypotension; convulsions; thrombophelebitis; anemai; vomiting; impairment of renal function
Amphotericin B [Fungizone]
Antihypertensive–B1 Blocker
I: Hypertension, angina
Atenolol
Lipid lowering agent–inhibits HMG-CoA reductase; lowers LDL
I: Hyperlipidemia (esp. type II)
SE: Liver toxicity; myopathy; mild GI disturbances
Notes: Contraindicated in pregnant or lactating women and children
Atorvastatin [Lipitor
Cholinergic blocker
I: Dries salivary secretions; Parkinson’s dz; peptic ulcer; diarrhea; GI spasm; bladder spasm; COPD; asthma; cholinomemetic poisoning; antidiarrheal; anti-emetic; high dose: vasodilation due to histamine release
SE: dry mouth; hyperthermia; mydriasis; tachycardia; hot and flushed skin; agitation; delerium
Notes: contraindicated in pts w/ glaucoma and men with BPH
Atropine
Immunosuppressant-purine antagonist; inhibits nucleic acid metabolism; blocks both CMI and humoral response
I: Transplant (esp. kidney); acute glomerulonephritis; renal component of lupus; rheumatoid arthitis
Notes: metabolized by xanthine oxidase
Azathioprine
Muscarinic agonist
I: Atony of bladder; paralytic ileum
Notes: c/i in pts as peptic ulcer, asthma, hyperthyroid, Parkinson’s
Bethanechol
Antineoplastic-DNA alkylation and cross-linking
I: Cancer
SE: Nausea; vomiting; bone marrow suppression; alopecia; teratogenicity; carcinogenicity
Bis-chloroethylamines (nitrogen mustards)
Anti-ulcer, antidiarrheal-cytoprotective
I: Bactericidal for H. pylori (with ranitidine and clarithromycin)
Bismuth
Presynaptic neuromuscular junction blocker-overstimulates ACh release
Black widow spider venom
Antineoplastic-binds, intercalats, and cuts DNA
I: Cancer
SE: Fever; blistering; stomatitis; pulmonary fibrosis
Bleomycin
Neuromuscular blocker-pre-synaptic neuromuscular jxn blocker; prevents ACh release
Botulinum [Botox]
Antiarrhythmic (Class III)-K+ channel blocker
SE: Arrhythmias; orthostatic, hypotension; nausea; vomiting
Bretylium
Anti-Parkinson’s-agonist at D2; partial antagonist at D1
I: Parkinson’s dz; acromegaly (paradoxical effect-releases growth hormone from normal pituitary)
SE: Inhibits prolactin release
Bromocriptine
Antidepressant-agonist at Da2, 5HT
I: Depression; smoking cessation
Buproprion
Opiod analog-mixed agonist/antagonist action
I: Similar to pentazocine
Butorphanol
Stimulant-phosphodiesterase inhibitor, resulting in increased cAMP; stimulates CNS and cardiac mm; relaxes smooth mm; produces diuresis; increases cerebrovascular resistance
I: Acute migrane attack
Caffeine
Hypocalcemic agent
anti-osteoporotic agent; lowers plasma Ca++ and phophate; inhibits bone and kidney reabsorption
I: Hypercalcemia; Paget’s dz; osteoporosis
Calcitonin
Dietary Ca++ supplement
Calcium lactate
Antihypertensive-heart failure agent; post-MI agent; vasodilator; ACE inhibitor
I: Congestive heart failure
SE: Postural hypotension; renal insufficiency; hyperkalemia; persistant dry cough
Notes: contraindicated in pregnancy
Captopril
Anti-epileptic-Na+ channel blocker; decreases glutamate (and other excitatory neurotransmitters)
I: Epilepsy (partial and tonic-clonic); trigeminal neuralgia
SE: Agranulocytosis
Notes: Induces cytochrome P450
Carbamazepine
Anti-Parkinsons-inhibits decarboxylase (L-DOPA to dopamine) in peiphery
I: Parkinson’s dz; used w/ levodopa
Carbidopa
Antibiotic-inhibits transpeptidase and cell wall synthesis
3rd generation cephalosporins are used for meningitis, Klebsiella, Lyme dz, and gram - bacteria
SE: Allergic rxns; pain at injection site; thrombophlebitis; bleeding d/o
Notes:
1st generation: cefazolin, cephalexin
2nd generation: cefaclor, cefoxitin, cefuroxime
3rd generation: ceftriaxone
4th generation: cefepime
Cephalosporins
Antibiotic-binds 50s ribosome subunits; bacteriostatic, but bactericidal versus H. flu and N. menigitidis
I: Broad-spectrum v. gram negatives; typhoid fever; salmonella; Rocky Mountain spotted fever in children
SE: Red cell anemia; bone marrow aplasia; gray baby syndrome
Notes: Interactions w/ phenytoin, warfarin, or coumarin; inhibits P450
Chloramphenicol
Anti-malarial-uncertain mechanism
I: Suppression of malerial and treatment of acute attack; amebiasis; clonorchis; rheumatic arthritis; SLE
SE: Headache; GI disturbances; visual disturbances; pruritis; rolonged therapy may lead to retinopathy
Chloraquin phosphate
Lipid lowering–inpedes fat absorption; lowers LDL; binds cholesterol metabolites
I: reduction of cholesterol
SE Steatorrhea; constipation; imparement of absorption of drugs/vitamins
Notes: Inhibits warfarin absorption
Cholestyramine
Cimetidine
I: Prophylaxis for falciparum; suppressionn of vivax
SE: Minor GI upset
Chlorquanide
Quinolone antibiotic-blocks DNA synthesis by inhibiting DNA gyrase
I: G - infections (esp UTI and bone): Pseudomonas, enterobacteriacae, Neisseria; G + infections; intracellular: Legionella
SE: GI disturbances; headache; dizziness; phototoxicity; cartilage damage
Notes: may elevat theophylline to toxic levels causing seizure
Ciprofloxacin
Antibiotic-binds 50s ribosome subunits; bacteriostatic, but bactericidal versus H. flu and N. menigitidis
I: Broad-spectrum v. gram negatives; typhoid fever; salmonella; Rocky Mountain spotted fever in children
SE: Red cell anemia; bone marrow aplasia; gray baby syndrome
Notes: Interactions w/ phenytoin, warfarin, or coumarin; inhibits P450
Chloramphenicol
Anti-malarial-uncertain mechanism
I: Suppression of malerial and treatment of acute attack; amebiasis; clonorchis; rheumatic arthritis; SLE
SE: Headache; GI disturbances; visual disturbances; pruritis; rolonged therapy may lead to retinopathy
Chloraquin phosphate
Lipid lowering–inpedes fat absorption; lowers LDL; binds cholesterol metabolites
I: reduction of cholesterol
SE Steatorrhea; constipation; imparement of absorption of drugs/vitamins
Notes: Inhibits warfarin absorption
Cholestyramine
Cimetidine
I: Prophylaxis for falciparum; suppressionn of vivax
SE: Minor GI upset
Chlorquanide
Anti-neoplastic-cross-links DNA
I: Cancer
SE: Bone marrow and renal toxicity; cystitis; peripheral neuropathy; ototoxicity; alopecia (severe)
Cisplatin
Antibiotic-binds to 50s subunits; bacteriostatic or bactericidal
I: G+ bone infections; anarobic infections
SE: Severe diarrhea; potentially fatal pseudomembranous colitis due to Clostridium difficile
Clindamycin
Ovarian stimulant-partial estrogen receptor agonist; decreases estrogen feedback inhibition of GnRH; leads to increase in gonadotropin secretion
I: stimulates ovulation in infertility
SE: Ovarian enlargement
Clomiphene
Antiepileptic-benzodiazepine
I: epilepsy (absence seizures)
Clonazepam
Antihypertensive - alpha 2-agonist
Hypertension; smoking withdrawal; heroine and cocaine withdrawal
Drowsiness; dry mouth; rebound hypertension after abrupt withdrawal
Clonidine
Antifungal-inhibit ergosterol synthesis, so cell membrane can’t form
I: topical use against dermatophytes, ringworm, fungi, mold, and oral candidiasis in AIDS
Clotrimazole
Antibiotic-Beta lactam; penicilinase resistant
I: Staph infections
Cloxacillin
Antipsychotic-blocks D2 and 5-HT2 receptors; also blocks D4
I: Anti-psychotic
SE: Orthostatic hypotension; sedation; agranulocytosis
Clozapine
CNS stimulant-blocks NE, 5HT, & Dopa reuptake
I: local anesthetic
SE: Vasocx; HTN; nasal mucus ischemia
Cocaine
Opiod agonist
I: Good anti-tussive; moderate for pain
SE: Constipation
Codeine
Antigout-inhibits phagocytosis and secretion of inflammatory mediators; decreases LTB4
I: Acute gout
SE: N/V/D/ abd pain
Notes: C/I in elderly & pts w/ GI, CV, & renal DO
Colchicine
Glucocorticoid-induces new protein synthesis; increases gluconeogenesis and lipolysis; reduces peripheral glucose use; catabolic effect on mm, bone, skin, fat, lymph tissue; anti-inflammatory; immunosuppressant
I: Adrenal insufficiency; conginital adrenal hyperplasia; dx of pituitary-adrenal d/o; reduce inflammation (esp. chronic); leukemia; decrease hypercalceimia
SE: Iatrogenic cushing’s syndrome; redistribution of fat; acne; insomnia; weight gain; hypokalemia; decrease in skeletal mm; osteoporosis; hyperglycemia; ulcers; psychosis; cataracts; increased suscceptibity to infections; growth suppression in children
Cortisol
Anti-asthmatic-anti-allergic; inhibits histamine release from mast cells
I: Prophylaxis for asthma
SE: Laryngeal edema (rare)
Cromolyn
Immunosuppressant-alkylating agent; destroys proliferating lymphoid cells; alkylates resting cells
I: Transplant rejection; rheumatoid arthritis
SE: GI & bone marrow toxicity; hemorrhagic cystitis
Cyclophosphamide
Immunosuppressant-inhibits T-helper cell activity; inhibits IL-2, IL-3 & INF-gamma formation by T-helper cells
I: transplant rejection
SE: Nephrotoxic; hepatotoxic; HTN; incrased incidence of viral infection and lymphoma
Cyclosporine
Testosterone derivative-weak agonist for androgen, progesterone, and glucocorticoid receptors
I: Endometriosis and fibrocystic dz
SE: Masculinization in females; gynecomastia in males
Danazol
Non-centrally acting muscle relaxant-decrease Ca++ from sarcoplasmic reticulum
I: Malignant HTN
SE: Hepatotoxic
Dantrolene
Antineoplastic-oxidases free radicals; breaks DNA; intercalates into DNA; affects plasma membrane
I: Cancer
SE: Cardiac changes resulting in cumulative cardiotoxicity
Daunorubicin
Metal chelator
I: Acute toxicity of iron
SE: Hypotensive shock; neurotoxic if long-term use
Deferoxamine
Antidiuretic-recruits water channels to luminal membrane in collecting duct
I: Anti-diuresis
SE: Overhydration; allergic rxn; larger doses result in pallor, diarrhea, HTN, coronary constriction, chronic rhinopharyngitis
Notes: Synthetic analog to vasopressin; intranasal administration
Desmopressin (DDAVP)
Corticosteroid-reduces lymph node and spleen size; inhibits cell cycle activity of lymphoid cells; lyses T-cells; suppresses antibody; prostaglandin, and leukotriene synthesis; blocks monocyt produciton of IL-1
I: Anti-emeetic; autoimmune d/o; allergic reactions; asthma; organ transplant (esp. during rejection crisis)
SE: Insomnia; epigastric disturbances; cushingoid rxn; psychosis; glucose intolerance; infection; hypertension; cataracts
Dexamethasone
Anti-anxiety; bensodiazepine-enhances GABA; increase IPSP amplitude
I: Sedative; hypnotic; anti-anxiety; anti-epileptic (status epilepticus, grand mal)
SE: Sedation
Diazepam
Antiviral-reverse transcriptase inhibitor
I: AIDS
SE: Abd cramps; diarrhea; peripheral neuropathy; acute pancreatitis
Dideoxyinisine [ddI]
Didanosine [ddA]
Inotropic agent-cardiac glycoside; increases cardiac contractility
I: Severe left ventricular systolic dysfunction; antiarrhythmic
SE: Progressive dysrhythmia; anorexia; nausea; vomiting; headache; fatigue; confusion; blurred vision; altered color perception; haloes around dark objects
Notes: C/I in pts by right sided heart failure, diastolic failure; ECG changes: increases PR, decreases QT, depresses ST, inverts T
Digoxin
Antiarrhythmic (Class IV)-Ca++ blocker
I: Angina; AV node arrhythmia; decreases blood pressure
Diltiazem
Anti-parkinson’s antihistamine; anti-emetic; muscarinic blocker; H1 blocker
I: Parkinson’s dz; asthma; motion sickness; anti-emetic
SE: Sedation; CNS depression; atropine-like effects; allergic dermatitis; blood dyscrasias; teratogenicity; acute anti-histamine poisoning
Diphenhydramine
Anti-alcoholic agent-inhibits aldehyde dehydrogenase
I: Etoh injestion
SE: tachycardia; hyperventilation; nausea
Disulfiram
Inotropic agent-beta agonist; positive inotropic effects on the heart and vasodilation
I: Acute heart failure; incrases cardiac output
Dobutamine
non-depolarizing neuromuscular blocker
d-Tubocurarine
Cholinesterase inhibitor
I: Dx of myasthenia gravis; emergency anesthetic
Edrophonium
Antihypertensive-vasodilator; ACE inhibitor
I:CHF
SE: Postural hypotension; renal insufficiency; hyperkalemia; persistant dry cough
CI: Pregnancy
Enalapril
Bronchodilation-mixed adrenergic agonist
I: Stimulates NE release; anti-tussive; myasthenia gravis
SE: Increases BP
ephedrine
Prostacyclin-increases cardiac index, stroke volume; decreases pulmonary vascular resistance and mean systemic pressure
I: pulmonary HTN
Epoprostenol
Anti-migraine-vasocxn
I: Attack of migranes
SE: Gangrene due to vasocxn
C/I: pregnant pts or pts w/ CV dz
Ergotamine
Antibiotic-binds to the 23s of the 50s ribosome subunes
I: 1st choice for cell wall deficient bugs: Mycoplasma, Rickettsia, Clamydia, Legionella; Cornybacterium diphtheria
Erythromycin
Colony stimulating factor
I: Anemia; renal defects; AIDS
SE: HTN
Erythropoietin (EPO)
Prostacyclin-increases cardiac intex, stroke volume; decreases pulmonary vascular resistance and mean systemic pressure
I: pulmonary HTN
Epoprostenol
Antiarrhythmic (class II) - Beta blocker
I: Block effect of catecholamines on heart; decreases activity of nodal tissue; slows sinus rate; depress AV conduction
SE: Asthma; negative isotrope
Esmolol
Growth and development of female organs; linear bone growth; epiphyseal closure; endometrial growth; maintain responsiveness of breasts, uterus, and vagina; inhibits bone reabsorption; increases hepatic production of alpha-2-globulins, coagulation factors II,VII, IX, X and HDL; decreases antithrombin III and cholesterol
I: Osteoporosis; contraception; can be used in combo with progesterone
SE: May lead to sodium and water retention; nausea; breast tenderness; hyperpigmentation; increased risk of bleeding, gallbladder dz, migranes, hypertension
Estrogen
Anesthetic agent
I: General anesthetic
Ether
H2blocker
I: Inhibits gastric acid secretion (esp. ulcer)
SE: Gynecomastia; rare: headache, dizziness, fatigue, CNS, leukopenia, reduced sperm count
Notes: Inhibits metabolism and/or absorption of some drugs
Famotidine (pepsid)
Opiod agonist
I: Analgesic; general anesthetic
SE: Prolonged recovery; nausea
Fentanyl
Androgen hormone inhibitor-inhibits 5-alpha reductase
I: BPH
Finasteroide
Antifungal-inhibits ergosterrol synthesis, preventing cell membrane formation
I: Cryptococcal meningitis; oral candidiasis in AIDS
SE: abdominal pain; nausea
Fluconazole
Antidepressant-antianxiety; SSRI
I: depression; anxiety; OCD
SE: Agitation; tremors; mania; preocupation w/ suicide; nausea; headache; insomnia
Fluoxetine
Antineoplastic-competitive androgen receptor blocker
I: Metastatic prostate cancer
Flutamide
Loop diuretic-inhibits Na+/K+/Cl- reabsorption in the Loop of Henle
I: CHF; diuresis
SE: Ototxicity; hyperuricemia; acute hypovolemia; hypokalemia; metabolic alkalosis; hyprglycemia
Furosemide
Antiviral-guanosine analog; inhibits DNA polymerase
I: CMV (esp. CMV retinitis in AIDS)
SE: Bone marrow suppression; renal impairment, seizures
Ganciclovir
Antibiotic-aminoglycoside; binds 30s ribosome subunits; bacteriostatic at low concentration; bactericidal at high
I: G- meningitis
C/I in neonates; peak and trough levels must be measured
Gentamicin
Hypoglycemia agent-sulfonylurea; reduces K+ efflux, increases Ca++ influx, increases secretion of insulin
I: oral tx for NIDDM (type II dbts)
SE: hypoglycemia; GI disturbances; mm weakness; mental confusion
Glipizide
Hypoglycemic agent-sulfonyruea; reduces K+ efflux, increases Ca++ influx, increases secretion of insulin
I: oral tx for NIDDM (type II dbts)
SE: hypoglycemia; GI disturbances; mm weakness; mental confusion
Glybuteride
Expectorant-increases bronchial secretion
I: Promotes cough
Glyceryl guaiacolate
Antimuscarinic
I: Bladder/GI spasm; decreases acid in ulcer
Glycopyrrolate
Controlls release of FSH, LH
I: stimulates pituitary fx
GnRH
Analog of GnRH-controls release FSH, LH
I: Stimulates pituitary fx
Gonadorelin
Antifungal-inhibit cell mitosis by disrupting mitontic spindles; binds to tubulin
I: Dermatophytes (esp. Trichophyton rubrum)
SE: Headache; lethargy; mental confusion, fever, rash; nausea; vomiting diarrhea; hepatotoxic; photosensitivity
Grisofulvin
Causes liver to produce insulin-like growth factors (somatomedins)
I: Replacement tx in children and burn victims
Growth hormone (somatotropin)
Stimulates release of GH
I: Dwarfism
SE: Pain at injection
Growth hormone releasing hormone (GH-RH)
Antihypertensive-interferes with NE release
I: Severe HTN
SE: postural hypotension; impotence
C/I: pts taking TCAs
Guanethidine
Antipsychotic-blocks D2 receptors
I: psychosis
SE: Parkinsonism; tarditive dyskinesia
Haloperidol
Antifungal-unknown MOA; fungistatic
I: Topical for tinea pedis
Haloprogin
Anesthetic agent
I: General anesthetic
SE: Hepatotoxic; malignant hyperthermia (w/succinylcholine); arrhythmia
C/I: adults
Halothane
Increases PTT by joining w/ antithrombin-III
I: DVT; pulmonary vein thrombosis
SE: Overdose reversed by IV protamine sulfate; osteoporosis
CI: Fast acting; does not cross placenta
Heparin
Metabolized to morphine
More lipid soluble than morphine
Heroin
Antihypertensive-vasodilator
I: CHF, HTF
SE: Lupus-like rxn
Hydralazine
Diuretic-decrease Na++ absorption in the distal tubule by inhibiting the Na+/Cl- transport; reduced peripheral resistance
I: HTN, CHF
SE: Hypokalemia; hyperuricemia; hypovolemia; hyperglycemia (esp. in dbts); hypercalcemia; hypersensitivity rxn
Hydrochlorothiazide
Antineoplastic-binds ribonucleotide reductase; inhibits formation of DNA
I: Melanoma; chronic myelogenous leukemia; sickle cell dz
SE: N/V bone marrow suppression
Hydroxyurea
NSAID
SE: fewer than aspirin
Ibuprofen
Antiviral-protease inhibits
I: AIDS
Indinavir
NSAID
I: Closes PDA; gout
Indomethacin
Antiviral-decrease protein synthesis
I: Genital warts; chronic hepatitis B and C; AIDS related Kaposi’s sarcoma; laryngeal papillomatosis; hairy cell leukemia
SE: Flu-like symptoms; tachycardia; fever; netropenia; headache; somulence; malise
Interferon, alpha 2A and alpha 2b
Vitamin A anolog
I: Severe acne; psoriasis
SE: Keratinization; teratogenic
Isotretinoin
Anesthetic agent
I: General anesthetic
SE: Dissociative anesthesia; catotonia; hallucinations
Ketamine
antifungal-inhibits ergosterol synthesis, preventing cell membrane formation; inhibits gonadal steroid synthesis
I: Chronic mucocutaneous candidiasis; blastomycosis; histoplasmosis; prostate carcinoma
SE: N/V/D rash, headache anorexia; thrombocytopenia; gynecomastia; hepatotoxic
notes: inhibits cytocrome P450
Ketoconazole
Antihypertensive- beta and alpha 1 blocker
I: HTN
Labetolol
GnRH agonist-suppression of FSH, LH when given continuously
I: Prostate cancer; polycystic ovary dz; uterine fibroids; endometriosis
Leuprolide
Anti-Parkinsonian agent- precursor of dopamine; administered with carbidopa (most often) or benserazide to inhibit carboxylase deactivation of levodopa in periphery
I: Parkinson’s dz
Notes: Inhibited by vit B6; do not give w/ MAOI or pyridoxine
Levodopa
Quinolone antibiotic-blocks DNA synthesis by inhibiting DNA gyrase
I: G- infection (esp. UTI and bone): Pseudomonas, enterobacteriaceae; Neisseria; G + infections; intracellular: Legionella
SE: GI disturbances; headache; dizziness; phototoxicity; cartilage damage
C/I: May elevate theophylline to toxic levels causing seizure
Levofloxacin
Synthetic analog of thyroid hormone T4
I: replaacement therapy for thyroid hormone
Levothyroxine (T4)
Antiarrhythmic (class IB), anesthetic agent-block Na+ channels intracellularly
I: Local anesthetic; ventricular tachycardia; post-MI ventricular tachycardia
SE: Sleepiness; light-headed; visual/audio disturbances; restlessness; nystagmus; shivering; tonic-clonic convulsion; death
C/I: Given w/ epi to maintain locality and increase duration of anesthetic properties via epinephrine mediated vasocxn
Lidocaine
Antihypertensive-vasodilator; ACE inhibitor
I: CHF
SE: Postural hypotension; renal insufficiency; hyperkalemia; persistant dry cough
C/I: Pregnancy
Lisinopril
Antimanic agent
I: Manic-depression; cluster headache
SE: dbts insipidus; ataxia; tremors; confusion; seizures
Lithium carbonate
Antidiarrheal-similar to opiod agonist
I: Oral antidiarrheal
Loperamide
Antihistamine
I: Seasonal allergies
SE: Gynecomastia; rare: headache, dizziness, fatigue, CNS, weak anti-androgenic effect, leukopenia, reduced sperm count
C/I: Inhibits metabolism and/ or absorption of some drugs
Loratadine [Claritin]
Antihypertensive-ATN II receptor antagonist
I: HTN
SE: dizziness; URI; headache
Losartan
Lipid lowering agent-inhibits HMG-CoA reductase; lowers LDL
I: Hyperlipidemia (esp. type II)
SE: Liver toxicity; myopathy; mild GI disturbances
C/I: pregnant/lactating women or children
Lovastatin
Opiod agonist
I: Analgesic; acute migrane attacks
SE: CNS exitation at high doses; histamine release
C/I: pts w/ MAO inhibitors (results in hyperpyrexia)
Meperedine
Opiod agonist-synthetic
I: Maitnenance therapy for heroin addiction
Methadone
Thyrotoxic agent-inhibits peroxidase enzyme in thyroid; decreases synthesis of thyroid hormone
I: Hyperthryoidism
SE: Agranulocytosis
Methimazole
Antineoplastic-dihydrofolate reductase inhibitor; immunosuppressant
I: rheumatic arthritis; bone marrow transplant; acute lymphocytic and myelogenous leukemia; choriocrcinoma; lung cancer
SE: oral and GI ulceration; bone marrow suppression; thrombocytopenia; leukopenia; hepatotoxic
notes: Leucovarin is given as an adjuvant after tx
Methotrexate
Antihypertensive-inhibits sympathetic outflow; centrally acting
I: HTN
SE: Hemolytic anemia
C/I: Positive Coombs’ test
Methyldopa
Anti-migrane-5HT antagonist and weak vasoconstrictor
I: Prophylaxis of migrane
SE: GI distress; inflammatory fibrosis of kidney, lung and cardiac valves
C/I: in pts by peripheral vascular dz, CAD, & pregnancy; pt placed on drug holiday to prevent SE
Methysergide
GI stimulant-stimulates Ach (D2 and 5HT3 antagonist); pro-kinetic
I: Anti-emetic; relief of nausea from migrane; increases stomach motility
SE: Sleepiness; fatigue; headache; insomnia; dizziness; nausea
Metoclopramide
Non-depolarizing neuromuscular blocker
Metocurine
Antibiotic-penetrates cell membrane and gives off nitro moiety; reacts w/ DNA; inhibits replication; bactericidal
I: B. Fragilis (esp. for endocarditis and CNS); amebiasis; giardiasis
SE: N/V disulfram-like rxn to etoh; metalic taste; paresthesia; stomatitis; carcinogenic and mutagenic
C/I: pregnancy
Metronidazole
Immunosuppressant-monoclonal antibody against CD3 on T-lymphocytes
I: Acute rejection of renal transplants
Muromonab (OKT3)
Muscarinic agonist
SE: Abdominal pain; diarrhea; brochoconstriction
C/I: peptic ulcer, asthma, hyperthyroid, Parkinson’s dz
Muscarine
Mucolytic-replenish glutathione
I: Overdose of acetaminophen; liquefy sputum to assist expulsion
n-Acetylcysteine
Antagonist of all opiods
I: Drug of choice for opioid antagonism
SE: Ineffective to use agonist barbituate overdose but safe
Naloxone
Inhibits cholinesterase
I: Paralytic ileus; neurogenic bladder; myasthenia gravis
Neostigmine
Nicotinic agonist
I: Stop smoking
Nicotine
Antianginal-Ca++ blocker
I: Angina
SE: Dizziness; nausea; headache; gingival problems
Nifedipine
Antianginal-stimulates synthesis of cGMP leading to mm relaxation via NO formation
I: angina
SE: Headache; orthostatic hypotension; syncope
Notes: Short acting
Nitroglycerine
Antifungal0binds to cell membrane sterols (esp. ergosterol); forms pores in membrane; fungicidal
I: Mucosal candida infections (skin, vaginal, GI)
SE: few
Nystatin
Analog of somatostatin-decreases release of GH, gastrin, secretin, VIP, CCK, glucagon, insulin, calcitonin, PH, renin, and TSH
I: Acromegaly; glucagonoma; insulinoma
SE: Nausea; cramps; gallstones
Octreotide
Anti-ulcer-proton pump inhibitor; blocks H+/K+ ATPase
I: Reduce acid secretion
Notes: Inhibits cytochrome P450; Given w/ clarithromycin and amoxicillin for H. pylori
Omeprazole
Anti-emetic-5HT3 blocker
I: Emesis (due to cancer tx)
SE: Headache; constipation; dizziness
Ondansetron
Stimulates uterine contraction; contraction of breast myoepithelial cells; milk letdown reflex
I: Induce labor
Oxytocin
Antibiotic-inhibits transpeptidase and cell wall synthesis
I: G+ bacteria-anerobic, some anaerobic, and spirochetes
SE: Allergic rxns; platelet aggregation problems; direct CNS toxicity; superinfections
Penicillin
Barbiturate-prolongs IPSP duration
I: anti-epileptic (partial and tonic clonic); cerebral edema; anesthetic
Phenobarbital
Anti-hypertensive-alpha blocker
I: Dx of pheochromocytoma; hypertension (esp. tyrosine induced)
Phentolamine
NSAID
I: Rheumatic arthrits; acute gout
SE: Agranulocytosis; aplastic anemia
Phenylbutazone
Anti-epileptic-decreases Na+ flux
I: Epilepsy (partial and tonic-clonic); digitalis-induced arrhythmia
SE: Decreases folic acid; gingival hyperplasia; hirsutism; nystagmus
Notes: Induced cytochrome P450
Phenytoin
Inhibits cholinesterases
I: Intestinal or bladder atony; glaucoma
Physostigmine
Anti-glaucoma-muscarinic agonist
I: Xerostomia; narrow and open angle glaucoma
SE: Focusing problems; nausea; abdominal pain; sweating; hight doese: bradycardia, hypotension
C/I: pts w/ peptic ulcer, asthma, hyperthyroid, Parkinson’s dz
Pilocarpine
Antibiotic-disrupts cell membranes; bactericidal
I: G- bacteria: Pseudomonas and coliform; topical only ; intrathecal for pseudomonas meningitis
SE: Neurotoxic; nephrotoxic
Polymyxins
Anticholine esterase reactivator
I: Overdose of malthion/parathion organophosphates; must be used before aging occurs
Pralidoxime
Antihypertensive-alpha1blocker
I: pheochromocytoma; HTN
SE: Postural hypotension
Prazosin
Glucocorticoid-inhibits protein synthesis; reduce LN and spleen size; inhibits cell cycle activity of lymphoid cells; lyse T-cells; suppress antibody, prostaglandin, and leukotriene synthesis; block monocyte production of IL-1
I: rheumatic arthritis; autoimmune d/o; allergic reaction; asthma; organ transpland (esp. during rejection crisis)
SE: Osteoporosis; cushingoid rxn; psychosis; glucose intolerance; infection; hypertension; cataracts
Prednisone
Antimalarial-unknown mechanis
I: Cures vivax malaria; prophylaxis for falciparum maleria
SE: GI disturbances; mild anemia; mark hemolysis in G-6PD deficient individuals; prolongs QT interval
Primaquine phosphate
Antigout-small dose inhibits tubule excretion; large dose inhibits tubule reabsorption (e.g., promotes excretion) of uric acid
I: Chronic gout
SE: Rash; GI disturbances; drowsy
C/I: Acute gout
Probenecid
Antiarrhythmic (Class IA)-Na+channel blocker
I: Ventricular arrhythmia
SE: Lupus-like syndrome
Procainamide
Hormone-secretory changes in endometrium and breast; necessary to maintain pregnancy
I: Tx primary hypogonadism; relief of menopause; decrease osteoporosis; suppress dysmenorrhea and excess androgen secretion by ovary; used in combo w/ estrogen for oral contraception
SE: Long-lasting suppression of menses; endometriosis; hirsutism; bleeding d/o; nausea; breast tenderness; hyperpigmentation; gallbladder dz; migranes; hypertension
Progesterone
Stimulates lactation of breast
Prolactin
Antihypertensive; anti-anginal; antiarrhythmic (Class II)-anti-migrane; B-blocker
I: HTN; angina; MI; arrhythmias; prophylaxis of migrane
SE: Reduces renin secretion
Propranolol
Inhibits peroxidase enzyme in thyroid; decreases synthesis of thyroid hormone
I: HYperthyroidism
SE: Agranulocytosis
Propylthiouracil {PTU)
Inhibits cholinesterase
I: Myasthenia gravis
Pyridostigmine
Antiarrhythmic (class IA)-Na+ channel blocker
I: Arrhythmias; acute malarial infection
SE: May precipitate arrhythmias at high doses; N/V/D; cinchonism: tinnitus, headache, disturbed vision, renal damage; hemolytic anemia; purpura; agranulocytosis
C/I: Torsades des Pontes
Quinidine
Antimalarial-unknown mechanism
I: Supression and tx of acute attach of chloroquine-resistant organism
SE: Cinchonism: tinnitis, headache, nausea, disturbed vision; renal damage; hemolytic anemia; purpura;agranulocytosis
Quinine
Destroys thyroid gland
I: Hyperthyroidism
SE: Hypothyroidism
Radioiodide (I-131)
H2 blocker
I: Inhibits gastric acid secretion (esp. ulcer)
SE: Gynecomastia;
rare: headache, dizziness, fatigue, CNS, leukopenia, reduced sperm count
C/I: inhibits metabolism and/or absorption of some drugs
Ranitidine
Rh immunoglobin
I: Prevents hemolytic dz of the newborn
RhoGam
Antiviral-guanosine analog; inhibits DNA polymerase
I: Broad spectrum against DNA (herpes) and RNA (influenza A and B); RSV in children
SE: Headache; rash; fatigue; dyspnea
Ribavirin
Antibiotic-inhibits DNA dependant RNA polymerase
I: Mycobacterium
SE: Orange body fluids
C/I: Interferes w/ birth control pills by increasing estrogen metabolism; induces cytochrome P450
Rifampin
Phosphodiesterase type 5 inhibitor (cGMP specific)
I: Erectile dysfunction
SE: Abnormal vision; UTI’s; CV events; priapism; dyspepsia
Sildenafil
Hormone-decreases release of GH, gastrin, secretin, VIP, CCK, glucagon, insulin, calcitonin, PTH, renin, and TSH
I: Acromegaly; glucagonoma; insulinoma
SE: Nausea; cramps; gallstones
Somatostatin
K+ sparing diuretic; aldosterone antagonist acts at DCT
I: Diuresis
SE: Hyperkalemia; gynecomastia; impotence; GI disturbances
Spironolactone
Thrombolytic-plasminogen activator
I: Lysis of clots
SE: Hemorrhage
Streptokinase
Antibiotic-aminoglycoside; binds 30s ribosome subunits; bacteriostatic at low concentration; bactericidal at high
I: TB and other mycobacteria
Streptomycin
Depolarizing neuromuscular blocker
SE: Increases intra-ocular pressure; scoline apnea in genetically defective pseudocholinesterase; malignant hyperthermia if given w/ halothane
C/I: in pts w/ glaucoma, antibiotics
Succinylcholine
Antibiotic-competitive inhibitor of dihydropteroate synthetase (blocks folic acid synthesis)
I: Broad spectrum; G+ UTI; Chlamydia infection of genital tract and eye; tx of nocardiosis
SE: Form crystals in kidney and bladder causign damage, nausea, vomiting, headace
Sulfonamides
Antimigrane-agonist at 5-HT receptors
I: Acute attack of migrane
Sumatriptan [Imitrex]
Alzheimer’s agent-noncompetitive cholinesterase inhibitor; muscarinic agonist
I: Alzheimer’s dz
Tacrine
Antineoplastic-competitive estrogen receptor blocker
I: Treats estrogen dependant breast cancer in post-menopausal women; reduce contralateral breast cancer
SE: May increse risk of other cancer; hot flashes; flushing
Tamoxifen
Bronchodilator-B2 agonist
I: Bronchodilates to treat asthma; inhibit pre-term labor; relax uterus
Terbutaline
Antibiotic-binds 30s ribosome subunits; bacteriostatic
I: Broad spectum including Chlamydia, Rickettsia, and Mycoplasma
SE: Liver toxicity; depressionof bone/teeth development; phototoxic reactions; superinfections due to broad spectrum; Fanconi’s syndrome
C/I: pregnancy and children
Tetracycline
Bronchodilator-unknown mechanism; stimulates CNS, cardiac muscle; relaxes smooth muscle; produces diuresis; increases cerebral vascular resistance
I: Asthma
Notes: Tolerance develops
Theophylline
Antihelminthic
I: Strongyloides; Ancylostoma (hookworm); Enterobius (pinworm); Trichuris (whipworm)
SE: Vomiting; diarrhea; dizziness; bradycardia; hypotension; paresthesias; yellow vision; angioneurotic edema; perianal rashes
Thiabendazole
Inhibits ADP-induced platelet aggregation; acts on ADP receptor
I: Transient ischemic attack (TIA); stroke
ticlopidine
Thrombolytic-plasminogen activator
I: Lysis of clots
SE: Hemorrhage
t-PA
Antibiotic-competitive inhibition of dihydrofolate reductase (blocks folic acid synthesis)
I: G- UTI; combined w/ sulfonamides to tx UTI, otitis media, chronic bronchitis, shigellosis, and PCP
Trimethoprim
Increase output of thyroid hormone
I: Assess thyroid fx; increase uptake of I-131 in thyroid carcinoma
TSH (thyrotropin)
Thrombolytic agent-plasminogen activator
I: Lysis of clots
SE: Hemorrhage
Urokinase
Antiviral-guanosine analog; inhibits DNA polymerase
I: Herpes; Varicella; EBV and CMV at hight doses
SE: GI disturbances; CNS and renal problems; headache; tremor; rash
Notes: longer lasting than acyclovir
Valacyclovir
Anti-epileptic-blocks Na+ channels and increases GABA
I: Epilepsy: partial, absence, and tonic-clonic
SE: Liver toxicity; pancreatitis; potentially fatal
Valproic acid
Antibiotic-disrupts cell well and cell membrane; bacteriocidal
I: Serious infections by G+ bacteria: strep, staph, pneumococcus and some anaerobes (esp. C. diff)
SE: Ototoxicity; nephrotoxicity; “red man syndrome” due to histamine release
Vancomycin
Anti-diuretic-recruits water channels to luminal membrane in collecting duct
I: anti-diuresis; treats pituitary diabetes insipidus
SE: Overhydration; allergic rxn;
larger doses: pallor, diarrhea, hypertension; coronary constriction; chronic rhinopharyngitis
Notes: Also known as ADH, AVP
Vasopressin
Antiarrhythmic (Class IV)-Ca++ blocker
I: Atrial tachyarrhythmia; decreases reperfusion injury
SE: AV block; constipation; hypotension; GI distress
Verapamil
Antineoplastic-depolymerizes microtubules
I: Hodgkin’s
SE: PEripheral neuritis
Vinblastine
Antineoplastic-depolymerizes microtubules
I: Acute leukemia
SE: Peripheral neuritis
Vincristine
Vitamin
I: Alcoholics (prophylaxis for Wernicke-Korsakoff)
C/I: Decrease results in beriberi
Vit B1 (thiamine)
Vitamin
I: Megablastic anemia
Vit B12 (Cobalamin)
Vitamen
Binds to receptors in cytoplasm; alters gene expression and protein synthesis; increases bone reabsorption of Ca++; increases renal and intestinal absorption of Ca++ and phosphate
I: Rickets; osteomalacia; hypocalcemia; hypoparathyroidism; osteoporosis
Vit D
Vitamen-Antioxidant
I: Prophylaxis for heart dz
Vit #
Vitamen-enhances clotting factors
I: Bleeding d/o
Notes: decreased in children of mothers taking phenytoin or phenobarbitol
Vit K
Vitamin-one carbon carrier
I: Nucleic acid synthesis; given tio pregnant mothers
Notes: Low levels result in neural tube defects
Folic Acid (vit M)
Anticoagulant-inhibits potassium epoxide regeneration
I: Thrombosis
SE: Bleeding
C/I: pts w/ liver, CNS, hemostatic dz, 99% exists protein bound
Warfarin
Anti-asthma agent-blocks leukotriene receptors (LTD4)
I: Reduces bronchoconstriction and inflammatory cell infiltrate in asthma
Zafirlukast
Antiviral-thymidine analog; reverse transcriptase inhibitor
I: AIDS
SE: Nausea; headache; bone marrow suppression; myalgias
Zidovudine
Anti-asthma agent- 5-Lipoxygenase inhibitor
I: Improves asthma
Zileuton
