Pharm Drugs USMLE Flashcards by Mani Yavi

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)

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Analgesic, antipyretic-unknown mechanism; not anti0inflammatory

I: Pain; fever

SE: Liver toxicity at high doses

Notes: Overdose treated with N-acetylcysteine

Acetaminophen [Tylenol]

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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]

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Muscarinic agonist

I: Eye sx (miotic)

contraindicated for patients with peptic ulcer, asthma, hyprthyroidism, or parkiinsonism

Acetylcholine

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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)

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Increases production of steroids by the adrenal gland (zona fasciculata)

ACTH (corticotropin)

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Antiviral–guanosine analog; inhibits DNA polymerase

I: Herpes, varicella, EBV, CMV (at high doses)

SE: GI disturbances; CNS; renal problems; headache; tremor; rash

Adenosine

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Bronchodilation – beta2agonist

I: Asthma

Albuterol

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Acts at GABA receptor

I: Sedative; hypnotic; depressive action on brain

Alcohol (EtOH)

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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]

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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]

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Impotency therapy; Prostaglandin E1

I: Impotence; maintain patent ductus arteriosus

SE: Penile pain; prolonged erection; flushing, bradicardia, tachycardia, hypotension, apnea

Alprostadil [Vasoprost]

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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

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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

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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

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Antidepressant–TCA; blocks 5HT and NE reuptake

I: Sedative; anti-depressant; prophylaxis for migraines

Amitriptyline [elavil]

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Antibiotic-inhibits B-lactamase; syndergistic w/ penicillins

Amoxicillin + Clavulanic acid [Augmentin]

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Stimulant-releases NE, 5HT, dopamine

I: Narcolepsy; attention deficit d/o; weight reduction

SE: Psychosis; hallucination

Amphetamine

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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]

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Antihypertensive–B1 Blocker

I: Hypertension, angina

Atenolol

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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

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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

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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

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Muscarinic agonist

I: Atony of bladder; paralytic ileum

Notes: c/i in pts as peptic ulcer, asthma, hyperthyroid, Parkinson’s

Bethanechol

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Antineoplastic-DNA alkylation and cross-linking

I: Cancer

SE: Nausea; vomiting; bone marrow suppression; alopecia; teratogenicity; carcinogenicity

Bis-chloroethylamines (nitrogen mustards)

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Anti-ulcer, antidiarrheal-cytoprotective

I: Bactericidal for H. pylori (with ranitidine and clarithromycin)

Bismuth

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Presynaptic neuromuscular junction blocker-overstimulates ACh release

Black widow spider venom

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Antineoplastic-binds, intercalats, and cuts DNA

I: Cancer

SE: Fever; blistering; stomatitis; pulmonary fibrosis

Bleomycin

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Neuromuscular blocker-pre-synaptic neuromuscular jxn blocker; prevents ACh release

Botulinum [Botox]

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Antiarrhythmic (Class III)-K+ channel blocker

SE: Arrhythmias; orthostatic, hypotension; nausea; vomiting

Bretylium

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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

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Antidepressant-agonist at Da2, 5HT

I: Depression; smoking cessation

Buproprion

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Opiod analog-mixed agonist/antagonist action

I: Similar to pentazocine

Butorphanol

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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

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Hypocalcemic agent
anti-osteoporotic agent; lowers plasma Ca++ and phophate; inhibits bone and kidney reabsorption

I: Hypercalcemia; Paget’s dz; osteoporosis

Calcitonin

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Dietary Ca++ supplement

Calcium lactate

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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

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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

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Anti-Parkinsons-inhibits decarboxylase (L-DOPA to dopamine) in peiphery

I: Parkinson’s dz; used w/ levodopa

Carbidopa

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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

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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

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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

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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

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Cimetidine

I: Prophylaxis for falciparum; suppressionn of vivax

SE: Minor GI upset

Chlorquanide

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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

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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

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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

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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

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Cimetidine

I: Prophylaxis for falciparum; suppressionn of vivax

SE: Minor GI upset

Chlorquanide

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Anti-neoplastic-cross-links DNA

I: Cancer

SE: Bone marrow and renal toxicity; cystitis; peripheral neuropathy; ototoxicity; alopecia (severe)

Cisplatin

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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

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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

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Antiepileptic-benzodiazepine

I: epilepsy (absence seizures)

Clonazepam

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Antihypertensive - alpha 2-agonist

Hypertension; smoking withdrawal; heroine and cocaine withdrawal

Drowsiness; dry mouth; rebound hypertension after abrupt withdrawal

Clonidine

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Antifungal-inhibit ergosterol synthesis, so cell membrane can’t form

I: topical use against dermatophytes, ringworm, fungi, mold, and oral candidiasis in AIDS

Clotrimazole

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Antibiotic-Beta lactam; penicilinase resistant

I: Staph infections

Cloxacillin

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Antipsychotic-blocks D2 and 5-HT2 receptors; also blocks D4

I: Anti-psychotic

SE: Orthostatic hypotension; sedation; agranulocytosis

Clozapine

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CNS stimulant-blocks NE, 5HT, & Dopa reuptake

I: local anesthetic

SE: Vasocx; HTN; nasal mucus ischemia

Cocaine

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Opiod agonist

I: Good anti-tussive; moderate for pain

SE: Constipation

Codeine

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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

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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

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Anti-asthmatic-anti-allergic; inhibits histamine release from mast cells

I: Prophylaxis for asthma

SE: Laryngeal edema (rare)

Cromolyn

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Immunosuppressant-alkylating agent; destroys proliferating lymphoid cells; alkylates resting cells

I: Transplant rejection; rheumatoid arthritis

SE: GI & bone marrow toxicity; hemorrhagic cystitis

Cyclophosphamide

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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

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Testosterone derivative-weak agonist for androgen, progesterone, and glucocorticoid receptors

I: Endometriosis and fibrocystic dz

SE: Masculinization in females; gynecomastia in males

Danazol

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Non-centrally acting muscle relaxant-decrease Ca++ from sarcoplasmic reticulum

I: Malignant HTN

SE: Hepatotoxic

Dantrolene

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Antineoplastic-oxidases free radicals; breaks DNA; intercalates into DNA; affects plasma membrane

I: Cancer

SE: Cardiac changes resulting in cumulative cardiotoxicity

Daunorubicin

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Metal chelator

I: Acute toxicity of iron

SE: Hypotensive shock; neurotoxic if long-term use

Deferoxamine

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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)

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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

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Anti-anxiety; bensodiazepine-enhances GABA; increase IPSP amplitude

I: Sedative; hypnotic; anti-anxiety; anti-epileptic (status epilepticus, grand mal)

SE: Sedation

Diazepam

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Antiviral-reverse transcriptase inhibitor

I: AIDS

SE: Abd cramps; diarrhea; peripheral neuropathy; acute pancreatitis

Dideoxyinisine [ddI]

Didanosine [ddA]

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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

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Antiarrhythmic (Class IV)-Ca++ blocker

I: Angina; AV node arrhythmia; decreases blood pressure

Diltiazem

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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

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Anti-alcoholic agent-inhibits aldehyde dehydrogenase

I: Etoh injestion

SE: tachycardia; hyperventilation; nausea

Disulfiram

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Inotropic agent-beta agonist; positive inotropic effects on the heart and vasodilation

I: Acute heart failure; incrases cardiac output

Dobutamine

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non-depolarizing neuromuscular blocker

d-Tubocurarine

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Cholinesterase inhibitor

I: Dx of myasthenia gravis; emergency anesthetic

Edrophonium

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Antihypertensive-vasodilator; ACE inhibitor

I:CHF

SE: Postural hypotension; renal insufficiency; hyperkalemia; persistant dry cough

CI: Pregnancy

Enalapril

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Bronchodilation-mixed adrenergic agonist

I: Stimulates NE release; anti-tussive; myasthenia gravis

SE: Increases BP

ephedrine

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Prostacyclin-increases cardiac index, stroke volume; decreases pulmonary vascular resistance and mean systemic pressure

I: pulmonary HTN

Epoprostenol

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Anti-migraine-vasocxn

I: Attack of migranes

SE: Gangrene due to vasocxn

C/I: pregnant pts or pts w/ CV dz

Ergotamine

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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

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Colony stimulating factor

I: Anemia; renal defects; AIDS

SE: HTN

Erythropoietin (EPO)

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Prostacyclin-increases cardiac intex, stroke volume; decreases pulmonary vascular resistance and mean systemic pressure

I: pulmonary HTN

Epoprostenol

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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

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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

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