Pharm Mini Board Flashcards
1
Q
Tacrolimus
A
Calcineurin inhibition preventing IL-2 transcription; used for transplant rejection prophylaxis
ADRs: Nephrotoxicity
2
Q
Sirolimus
A
mTOR inhibitor that prevents T-cell response to IL-2; used for kidney transplant prophylaxis
ADRs: Aplastic anemia, insulin resistance, delayed wound healing
3
Q
Daclizuma, basiliximab
A
Abs that block the IL-2 receptor
4
Q
Azathioprine
A
Antimetabolite precursor of 6-MP; inhibits lymphocyte proliferation “Azathiopurine”
Uses: Transplant rejection prophylaxis, RA, Crohn’s
ADRs: Aplastic anemia, increased toxicity w/ allopurinol since 6-MP is degraded by xanthine oxidase
5
Q
Glucocorticoids (immunosuppressive action)
A
Inhibits NFkB; decreases transcription of cytokines
Uses: Transplant rejection prophylaxis. AI disorders, inflammation
6
Q
Cyclosporine
A
Binds to cyclophilin and inhibits IL-2 transcription; used to prevent transplant rejection as well as for psoriasis
ADRs: Nephrotoxicity, gingival hyperplasia, hirsutism, HTN
7
Q
Alemtuzumab
A
CD52 antibody
Used for CLL
“lem=lymphocytic”
8
Q
Bevacizumab
A
VEGF ab
-Used for colorectal and renal cell carcinomas
9
Q
Rituximab
A
CD20 ab
B-cell non-Hodgkin’s lymphoma, CLL, RA, ITP
10
Q
Etanercept
A
Decoy TNF-a receptor used for IBD, RA, ankylosing spondylitis
-Adalimumab and infliximab are TNF-a abs
11
Q
Eculizumab
A
C5 ab
Used for PNH
12
Q
Natalizumab
A
a4-integrin ab
Used for MS, Crohn’s
13
Q
Abciximab
A
Glycoprotein IIb/IIIa ab
- Used for prevention of ischemic complications in pts. undergoing coronary interventions;
- also for unstable angina ya dingus
14
Q
Denosumab
A
RANKL ab
-Used for osteoporosis; mimics osteoprotegrin by inhibiting osteoclast maturation
15
Q
Omalizumab
A
IgE ab
Used for severe allergic asthma
16
Q
Palivizumab
A
RSV F protein ab
-Used as prophylaxis for high risk infants
17
Q
Penicillinase Resistant Drugs
A
Methicillin, Oxacillin, Nafcillin (IV), Cloxacillin, Dicloxacillin (PO)
-Also, general ADRs for penicillins include rash, interstitial nephritis, and seizures
18
Q
DOC for Listeria
A
Ampicillin; aminopenicillins also have more gram neg activity and useful for enterics
19
Q
Antipseudomonal penicillins
A
Piperacillin, Ticarcillin (taken off market due to INCREASED SODIUM)
- Also covers anaerobes, Staph/**Enterococcus, Piddly, Fence, SPACE)
- Make sure to use B-lactamase inhibitor with these
20
Q
Cefazolin
A
1st gen Cephalosporin that covers Gram +, ^PEK
-Used as a prophylactic prior to surgery to prevent S. aureus infxns
21
Q
Cefuroxime, Cefoxitin, Cefotetan
A
Covers Gram +, ^PEK
TAN FOX =» Also covers ANAEROBES
22
Q
Ceftriaxone
A
3rd gen cephalosporins that cover serious Gram - inxns (^SACE)
DOC for N. meningitidis/gonorrheae and Lyme disease
23
Q
Ceftazidime
A
3rd gen cephalosporin that covers Pseud BUT loses gram +
24
Q
Cefepime
A
Same as ceftazidime but recovers Gram + orgs
-What does this mean it covers?
25
Ceftaroline
5th gen cephalosporin that covers Gram pos, neg, and MRSA
-Lose pseud tho
26
Cephalosporin ADRs
- Cross reactivity w/ penicillin allergy
- Bleeding due to inhibition of Vitamin-K coag factors
- Disulfarim like reaction
- Pseudoemembranous colitis
- Don't use w/ AGCs (increases nephrotoxicity)
27
Imipenem
DOC for ESBL species; also used for Staph, Strep, Entero, SPACE, anaerobes
- Is metabolized in the kidneys to a nephrotoxic product; administer w/ cilastatin (to make the kill lastin')
- Severe ADRs include: Seizures, anemia/leukopenia/thrombocytopenia
28
Ertapenem
Similar to meropenem and doripenem BUT adds some pseud. coverage and takes away entero
29
Aztreonam
DOC for penicillin allergy pts. but only covers Gram negs
30
Ciprofloxacin, moxifloxacin, levofloxacin
MOA: DNA gyrase inhibitor (topoisomerase II); exhibits a PAE
***CANNOT TAKE W/ ANTACIDS
ADRs: Damage cartilage (young people usually) => tendonitis and tendon rupture (old people usually)
QT prolongation
Photosensitivity, rashes
CI= pregnant women
31
Ciprofloxacin facts
Least tendency to prolong QT interval of FQNs
Highest tendency for photosensitivity
Good pseud. coverage
32
Levofloxacin
Good for enteric GNR inxns, atypical pneumonias
33
Moxifloxacin
Hs anaerobic coverage
34
Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin,
Mean GNATS caNNOT kill anaerobes
AGCs tht bind to the 30s subunit and inhibit the initiation complex
*Bactericidal, concentration dependent killing
DOC for gram negative AEROBES (requires O2 for uptake)
ADRs: Nephrotoxicity, Ototoxicity, Teratogen
35
Mechanism of tetracycline resistance
Efflux of active drug, (classic question)
-Decreased absorption w/ milk and antacids
36
Doxycycline
Only tetracycline not cleared by the kidney or liver (can be used in renal failure); accumulates intracellular (good for rickettsia and chlamydia)
37
Macrolide general characteristics
Bind to 23S rRNA of the 50s subunit (bacteriostatic)
-Good for covering atypical pneumonias (mycoplasma, chlamydia, legionella) and pertussis
```
ADRs:
Motility issues (GI)
Arrhythmia (QT prolongation)
Cholestatic hepatitis (estolate form; DONT USE IN PREGNANCY)
Rash
eOsinophilia
```
**CYP450 inhibitors***
*MoR: Methlyation of 23s rRNA-binding site
38
DOC for legionella
Azithromycin (also covers other respiratory pathogens like h. flu, m. cat, s. pneumo, mycoplasma)
39
Telithromycin
Macrolide used against resistant S. pneumo
-Reaches high tissue conc.
40
Bactrim
Sulfonamide: PABA analog that inhibits dihydropteroate synthase
ADRs: Displaces warfarin from albumin
Morbilliform rash, Steven-Johnson
Tubulointerstitial nephritis (administer w/ fluids)
Kernicterus in newborns (given during late pregnancy)
Trimethoprim: Inhibits DHFR
ADRs: Megaloblastic anemia, leukopenia
Uses: Staph (+MRSA), Gram negs (UTIs), salmonella, shigella, chlamydia
*Prophylaxis for Toxoplasma gondii and PCP
41
Vanc ADRs
Nephrotoxicity
Ototoxicity
Thrombophlebitis (Red-Man Syndrome; slow infusion rate)
42
Daptomycin
Disrupts cell membrane of Gram + cocci
**Inactivated by pulmonary surfactant, so don't use for pneumonia
***ADRs: Rhabdomyolysis (monitor CK)
43
Linezolid
Similar to Macrolides; useful for MRSA and VRE
ADRs: Aplastic anemia
***Serotonin syndrome w/ serotonergics
Peripheral neuropathy
44
Clindamycin
Used for anaerobic infxns above the diaphragm (Bacteroides, C. perfringens); typically in aspiration pneumonia or oral infxns
-But causes what classic GI infxn
45
Metronidazole
Generates free radicals that damage bacterial RNA
DOC for anaerobes and C.diff BELOW the diaphragm
-Also used for Giardia, entamoeba, trichomonas, gardnerella
ADRs: Dilsulfarin w/ alcohol (hypotension, flushing, tachycardia)
46
Chloramphenicol
***Causes aplastic anemia and gray baby syndrome (due to accumulation)
But works great against anaerobes and meningitis and stuff (just FYI)
47
t^1/2 equation
.693/ke
or
Vd x .693/ CL
so what does Ke equal?
48
Zero-order eliminated drugs
Phenytoin
Ethanol
Aspirin
-Same amnt is eliminated no matter what
49
Works on Gq/ PLC (autonomics)
HAVe 1 M&M
H1, a1, V1, M1, M3
50
Works on Gi (autonomics)
MAD 2s
M2, a2, D2
51
Where are M1 receptors found?
Brain
52
Where are M2 receptors found?
Heart
53
Cholinesterase inhibitor poisoning
```
Diarrhea
Urination
Miosis
Bradycardia
Bronchospasm
Excitation of skeletal muscles and CNS
Lacrimation
Sweating
Salivation
```
54
Muscarininic antagonist ADRs
Hot as a hare (decreased sweating)
Dry as a bone (dry mouth/skin)
Red as a beet (flushed skin)
Blind as a bat (cycloplegia)
Mad as a hatter (disorientation)
55
Raltegravir
HIV integrase inhibitor
-disrupts the ability of HIV dsDNA to integrate into the host cell's chromosomes thereby preventing transcription of viral mRNA
56
Beer's Criteria
Anticholinergics: 1st gen antihistamines like diphenhydramine and GI antispasmodics
CV: a-blockers, antiarrhythmics
CNS: TCAs, antipsychotics, barbiturates, benzos
Endocrine: Sulfonylureas
Pain: Indomethacin, Meperidine
57
Calcipotriol
Calcitriol analog that binds to the Vitamin D receptor, a nuclear transcription factor, and inhibits keratinocyte proliferation
-Can also inhibit T-cell proliferation
58
Dobutamine
B-agonist that primarily works on B1 receptors
=>>increased inotropy, mild vasodilation, increased HR
-increased myocardial O2 demand is outweighed by heavy increased in CO
-Also has some action on B2 and a1
59
Ipratropium
Competitive muscarinic receptor blocker
=>>Prevention of bronchoconstriction
- enhances effect of B2 agonists (albuterol) but not as good alone
- Also blocks submucosal gland secretion in the lungs
60
Ribavirin
Inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase
=>>depletes intracellular GTP and overall inhibition of the duplication of viral genetic material
-Used in HCV and RSV
ADRs: Hemolytic anemia; teratogen
61
Drug used to decreased likelihood of calicum renal stones
HCTZ
-By reabsorbing Ca2+, there will be less in the lumen; also there will be a higher h2o content in the lumen
62
Sotalol
BB and a type III anti arrhythmic
***Excessive B-blockade can cause TORSADES DE POINTES
63
Lidocaine, Mexilitine
Class IB antiarrhythmic that Decreases the AP duration
***Preferentially affects ischemic or depolarized tissue
*DOC for post-MI arrhythmias and digitoxin-induced arrhythmias
64
Nimodipine
CCB useful in prevention of cerebral vasospasms following an SAH
65
Nitroprusside
Directly stimulates NO increasing cGMP
*Used in HTN emergencies
**OD can cause CN- toxicity =>> Give thiosulfate
66
Dopamine doses
Low =>> vasodilation of renal BF
Medium =>> increased cardiac contractility
High =>> Generalized vasoconstriction
67
Metoclopramide
D2 receptor antagonist that is used to increase LES tone, motility, and contractility of the GI tract
ADRs: Parkinsonian effects! Tardive dyskinesia
68
Cilostazol
PDE III inhibitor; increases the cAMP in platelets resulting in decreased aggregation
Tx: Intermittent claudication, coronary vasodilation, prevention of stroke/TIAs
ADRs: Flushing, nausea, headache e
69
5-FU
Pyrimidine analog activated to 5F-dUMP which complexes w/ folic acid
=>>inhibition of thimidylate synthase
Uses: Solid tumors (colon cancer, pancreatic cancer, basal cell carcinoma)
ADRs: Myelosuppression (can't be rescued)
70
Methotrexate
Folic acid analog that inhibits DHF
Uses: Leukemia, Lymphoma, choriocarcinoma, sarcomas, abortion, RA, psoriasis, IBD
ADRs: Myelosuppression (rescued), hepatotoxicity, pulmonary fibrosis
71
Azathioprine, 6-MP
Purine analog that must be activated by HGPRT; azathioprine is metabolized to 6-MP
Uses: Rejection prophylaxis, IBD, RA, SLE
ADRs: Myelosuppression; ***Increased toxicity w/ allopurinol
72
Bleomycin
Induces free radical formation =>> breaks in dsDNA
Uses: Testicular cancer, Hodgkin's
ADRs: ***Pulmonary fibrosis, skin hyperpigmentation
73
Doxorubicin
Generates free radicals that intercalate into DNA and produce breaks
Uses: Solid tumors, leukemias, lymphomas
ADRs: Dilated cardiomyopathy, alopecia
****Dexrazoxane will prevent cardiomyopathy
74
Cyclophosphamide
Cross link DNA; requires hepatic activation
Uses: Solid tumors
ADRs: Hemorrhagic cystitis; prevent w mesna
75
Carmustine, Lomustine, Streptozocin
Alkylating agent that can cross the BBB
Uses: ***Glioblastoma multiforme and other brain tumors
ADRs: Convulsions, dizziness, ataxia
76
Paclitaxel
Stabilize polymerized microtubules in the M phase
=>>mitotic spindle cannot break down
Uses: Women cancers
ADRs: alopecia, myelosuppression
77
Vincristine, Vinblastine
Bind to B-tubulin and inhibit microtubule polymerization
=>>prevents microtubule formation
Uses: Solid tumors
ADRs: Neurotoxicity
78
Kinase inhibitor suffix
-nib
79
Aldrenoate
Pyrophosphate analogs that bind hydroxyapetite in bones and inhibit osteoclast activity
ADRs: Corrosive esophagitis =>> pts. should remain upright for 30 mins
Osteonecrosis of jaw
80
Pilocarpine
Cholinomimmetic that increases the outflow of aqueous humor via contraction of the ciliary muscle (produces miosis)
-Physostigmine will indirectly do this as well
81
DOC for acute angle closure glaucoma
Pilocarpine
82
Latanoprost
PGF2a that increases outflow of aqueous humor
-Darkens the Iris (browning)
83
Timolol, betaxolol
BBs used to decrease aqueous humor synthesis
84
Drugs to not use in closed-angle glaucoma
Epinephrine (produces mydriasis)
85
Second line tx for absence seizures
VA
86
Olanzapine
Atypical antipsychotic that is assoc. w weight gain
87
Clozapine
Atypical antipsychotic that is assoc. w/ agranulocytosis
88
Risperidone
Atypical antipsychotic that is assoc. w/ increased prolactin
=>>gynecomastia and lactation
89
Neuroleptic malignant syndrome
Caused by the typical antipsychotics (haloperidol + -azines)
```
Fever
Encephalopathy
Vitals (unstable)
Enzymes (increased)
Rigidity of muscles (myoglobinuria too)
```
Tx: Dantrolene
90
Tardive dyskinesia
Odd, stereotypical facial movements after LONG-TERM typical antipsychotic (chlorpromazine, thioridazine, haloperidol) use
91
Amitryptiline, imipramine, amoxapine
TCAs that block reuptake of NER and 5-HT3
Uses: Major depression, OCD, peripheral neuropathy, migraines
ADRs: Sedation, a1 blocking effects (postural hypotension), anticholinergic effects (dry mouth, tachycardia)
*Amitryptiline can also prolong QT interval (just cause its stronger)
92
3 Cs of TCAs
Convulsions
Coma
Cardiotoxicity
-Also see respiratory depression
Tx: NaHCO3
93
Phenelzine
MAOI used for atypical depression or anxiety
ADRs: HTN crises w/ ingestion of tyramine foods
-Do not use w/ SSRIs, TCAs, detromethorphan
**Irreversibly inhibits the enzyme SO
94
Bupropion
Dopamine and NER reuptake inhibitor that has decreased sexual side effects
95
Ethacrynic acid
Loop diuretic used in pts w/ a sulfa allergy
96
Amphetamine OD tx
NH4Cl =>> acidifies urine
97
Digitalis OD tx
Anti-dig Fab fragments
98
Mercury OD tx
Dimercaprol
MERC
99
tPA, streptokinase reversal tx
Aminocaproic acid
100
Rapid glucocorticoid withdrawal
Will get a adrenocortical insufficiency due to chronic HPA suppression
101
-azole
Ergosterol synthesis inhibitor
-Ketoconazole
102
-ivir
Neuraminidase inhibitor
Oseltamivir
103
-navir
Protease inhibitor
-Ritonavir
104
-ovir
DNA polymerase inhibitor
-Acyclovir
105
-azine
Typical antipsychotic
-Thioridazine, dont forget about haloperidol tho
106
-ipramine
TCA
-imipramine
107
-triptyline
TCA
-Amitriptyline
108
-zolam
Benzo
-Alprazolam
109
-chol
Cholinergic agonist
-Bethanechol, carbachol
110
-curium
Nondepolarizing paralytic
-Atracurium
111
-curonium
Nondepolarizing paralytic
-Vecuronium
112
-terol
B2-agonist
-Albuterol
113
-zosin
a1-antagonist
-Prazosin
114
-dipine
Dihydropyridine CCB
-Amlodipine
115
-glitazone
PPAR-y acivator
-Rosiglitazone
116
-prost
Prostaglandin analog
-Latanoprost
117
Bethanechol
Cholinomimetic that is used to activate the bowel and bladder after a postoperative ileus can occur
*wouldn't let you leave after your hernia but these fuckers coulda given you this
118
Carbachol
Cholinomimetic that constricts the pupil; can relieve the intraocular pressure in glaucoma
119
Methacholine
Cholinomimmetic most commonly used to diagnose asthma; excess reaction to it will cause bronchospasm
120
Neostigmine
Anticholinesterase often used to tx MG or reverse neuromuscular blockades
121
Physostigmine
AchE-inhibitor that crosses the BBB; used during atropine OD
122
Tropicamide
Muscarinic antagonist used for opthalmic examination of the retina; produces short-term mydriasis and cycloplegia
123
Benztropine
the muscarinic antagonist used to tx Parkinsons
124
Atropine
Muscarinic antagonist used to tx bradycardia
-Has systemic efffects: Dilates pupil and produces cycloplegia
Decreases secretions
Decreases gut motility
Decreases urinary urgency
OD: Hot as hare, dry as a bone, red as a beet, blind as a bat, and mad as a hatter
125
Pufferfish poison
Toxin that binds to Na+-gated channels in the cardiac and nerve tissue; prevents depolarization
=>>Diarrhea, parasthesias, weakness, dizziness
Tx: Supportive
126
Snapper/Eel toxin
Opens Na+ channels causing excess depolarization
⭐️Classically assoc. With temperature dysethesia
DUMBBELSS
Tx: Supportive
127
Mahi-mahi/tuna poisoning
Scombroid; endogenous histidine is converted to histamine
Anaphylaxis-like presentation (urticaria, pruritus, flushing, headache)
**BURNING SENSATION OFF MOUTH
Tx: Antihistamines
128
Vinyl chloride (chronic)
Angiosarcomas (most likely liver)
129
Ionizing radiation chronic
Papillary thyroid carcinoma
130
Radon exposure
Lung cancer
Found in the soil
131
CCl4 exposure
Centrilobular hepatic necrosis
132
Verapamil
Nondihydropyridine CCB that works primarily on the Ventricles; also considered a class IV anti arrhythmic
ADRs: AV block, hyperprolactinemia,
(shared by dihydropyridines)- gingival hyperplasia, edema, flushing, dizziness (due to vascular relaxation dawg)
133
Hydralazine
Increases cGMP (arterioles)
-used during HTN emergencies during pregnancy; coadminister w/ BB to prevent reflex tachycardia
ADR: Lupus-like rxn, reflex tachycardia
134
Fenoldopam
D1 agonist that causes coronary, renal, and peripheral vasodilation (general)
-Increases natiuresis; is short-acting
135
Monday Disease
Development of tolerance for nitrates during work week and loss of tolerance over weekend
-Dizziness and headache on rexposure
136
Class III antiarrhythmics
Amiodarone (torsades, hepatotoxic, corneal deposits, p. fibrosis)
Ibutilide
Dofetilide
Sotalol (BB as well)
137
Adenosine
Antiarrhythmic that increases K+ efflux out of cells; DOC in abolishing supraventricular tachycardia?
ADRs: Flushing, hypotension (vasodilation)
Chest pain, bronchospasm
138
Sumatriptan
5-HT agonist; inhibits CN V activation and inhibits vasoactive peptide release
*Used for migraines and cluster headaches
ADRs: *Coronary vasospasm (do not give to pts. w/ prinzmetal angina)
139
Diphenoxylate
Mu-opioid agonist; mostly used to tx. diarrhea
- Sometimes combined w/ atropine to produce adverse symptoms at high levels (dry mouth, blurry vision) to avoid people taking too much and developing dependence
- Loperamide is a similar drug
140
Akathisia
Antipsychotic ADR that is marked by restlessness and inability to sit still
-These drugs can also induce Parkinsonian like sx., dystonia (painful muscle contractions), tardive dyskinesia, and NMS
141
Metformin
Increases glycogen synthesis, increases insulin sensitivity, decreases gluconeogenesis
ADRs: Diarrhea, lactic acidosis
=>>CI'D IN RENAL FAILURE PTS. YOU MORON
142
Pioglitazone, Rosiglitazone
PPAR nuclear transcription regulator activators; increases the sensitivity of peripheral tissues to insulin
ADRs: Weight gain, edema, HF, hepatotoxicity, increased risk of fractures
143
Canagliflozin
Inhibits glucose reabsorption in the PCT; causes glucosuria, UTIs, vaginal yeast infxns
144
Acarbose, Miglitol
Inhibits brush border a-glucosidases; decreases absorption of glucose
-Sometimes used as monotherapy in type II; can cause diarrhea
145
Demclocycline
ADH antagonist used to tx SIADH
146
Cinacalcet
Sensitizes the Ca2+-receptor on the parathyroid
| =>>decreased PTH secretion
147
Misoprostol
PGE1 analog
-Increases production and secretion of gastric mucosal barrier; also used off-label to induce labor
ADRs: Diarrhea
148
Sulfasalazine
Drug that is activated by colonic bacteria and used to tx. the two IBDs
Guess what allergy it can flare up
149
Orlistat
Inhibits pancreatic lipase
-used for weight loss but you get bad poops
150
Cisplatin
Cross-links DNA on the same strand; used for testicular, bladder, ovary, and lung cancer
ADRs: NEPHROTOXICITY, ototoxicity
-Can prevent w/ amifostine co-administration
151
Etoposide
Inhibit toposiomerase II; used for solid tumors, leukemia, lymphoma
ADRs: Myelosuppression, alopecia
152
Raloxifene
Works like tamoxifen BUT it is also an estrogen antagonist in the endometrial tissue and not just the breast tissue
-Good for preventing osteoporosis as well
153
Trastuzumab
Ab against HER-2; used against breast cancer and gastric cancer if possible
ADRs: Cardiotoxicity (chemo-tox man)
154
Teriparatide
Recombinant PTH given to increase osteoblastic activity
Can cause transient hypercalcemia
155
Febuxostat
Xanthine oxidase inhibitor; works the same as allopurinol
-These fellas can also be used in lymphoma and leukemia to prevent tumor lysis syndrome
156
Hexamethonium, Mecamylamine
Nicotinic blocking agents; will only appear on questions and have no clinical use
-Will prevent reflex tachycardia in response to hypotension
157
Argatroban, Dabigatran
Direct thrombin inhibitors; alternative for pts. w/ HIT
158
Enoxaparin, Fondaparinux
LMWH that acts more on factor Xa and has a longer half-life
-Possible HIT (antibodies to heparin-bound platelet factor 4 producing thrombosis w/ thrombocytopenia)
159
Apixaban, rivaroxaban
Factor Xa inhibitors
Prophylaxis for DVT and PE, especially in A-fib pts.
160
Brimonidine
a2 agonist that decreases aqueous humor synthesis
161
Drug used during acute angle closure glaucoma (emergency)
Pilocarpine
162
Butorphanol
k-opioid agonist and partial u-opioid agonist; cause less respiratory depression than full agonists like morphine, fentanyl, meperidine
-Can cause withdrawal sx tho
163
Ethosuximide
Treats absence seizures by binding to thalamic T-type Ca2+ channels
ADRs: GI distress, Headaches, Itching, Stevens-Johnson
164
1st line prophylactic for status epilepticus seizures
Phenytoin; works by inactivating Na+ channels and is really the go-to for all seizures except absence
-Classically causes gingival hyperplasia, peripheral neuropathy, teratogenesis, SJ syndrome, ataxia
165
Gabapentin
Inhibits voltage-gated Ca2+ channels and is a neuroleptic drug also used for postherpetic neuralgia and peripheral neuropathy
166
Valproic Acid
Increases Na+ channel inactivation and increases GABA conc.
- Can cause neural tube defects, hepatotoxicity, weight gain
- Also used for bipolar disorder, myoclonic seizure, and second line for absence
167
Phenobarbital
1st line tx of seizure in neonates; works by increases GABA-A action
-Produces respiratory depression, sedation, tolerance, and induces cytochromes
168
Proconvulsant inhaled anesthetic
Enflurane
169
Thiopental
IV anesthetic potent (which means what about this anesthetic?) and enters brain rapidly
-Effect is diminished via rapid redistribution to tissue and fat
170
Propofol
Used for rapid, short-term sedation in the ICU and causes less postoperative nausea than thiopental
171
Tubocurarine, other -curiumss
Competitive nicotinic receptor antagonists
-Reverse blockades w/ neostigmine + atropine (to prevent muscarinic effects)
172
Baclofen
GABA-B inhibitors at the spinal cord =>> muscle relaxation
-Used to tx. lower back pain/spasms
173
Memantine
Alzheimer's drug that acts as a NMDA receptor antagonist
174
Donepezil
AchE inhibitor used in Parkinson's (can also use others like rivastigmine)
175
Delirium tremens
Life-threatening alcohol withdrawal syndrome assoc. w/ autonomic hyperactivity (tachycardia, tremors, anxiety) up to 4 days after last drink
Classically occurs in hospital settings***
Tx: Benzos
-Hallucinosis is distinct and occurs within 2 days of last drink
176
Fluphenazine
Typical antipsychotic commonly used during the treatment of Tourette's
```
Evolution of extrapyramidal side effects:
4 hours- dystonia
4 days- akathisia
4 weeks- Parkinsonian sx
4 months- tardive dyskinesia
```
177
Duloxetine
SNRI that nonselectively inhibits the reuptake of 5-HT and NER; commonly used to tx. diabetic peripheral neuropathy (treats pain assoc. w/ depression)
Venlafaxine is also in this class
178
Bupropion
Atypical antidepressent that is Used for smoking cessation
-Has stimulant effects and seizures in anorexics
179
Mirtazapine
a2-antagonist and 5-HT2 and 3 antagonist
-Used for sedation, weight gain in elderly
180
Trazadone
a1 and 5-HT antagonist; used for insomnia
-Boners tho
181
Hydralazine
Increases cGMP causing arteriodilation >>>>> venodilation
-Used for severe HTN or HF during pregnancy
***Administer w/ BB to prevent reflex tachycardia
ADRs: FLUID AND SODIUM RETENTION
Lupus-like syndrome
Headache
Tachycardia if no BB
-Excluding LLS, ADRs are due to sympathetic reflex limiting this drug's chronic utility
182
Pediatric Febrile Seizure
Tx w/ acetaminophen/ibuprofen
-Caused by increased circulating cytokines due to current infxn; hypothalamus sets a high temperature point that is reduced by decreased PGE2
183
Pediatric Febrile Seizure
Tx w/ acetaminophen/ibuprofen
-Caused by increased circulating cytokines due to current infxn; hypothalamus sets a high temperature point that is reduced by decreased PGE2
184
Nevirapine
Works the same as efavirenz....
NNRTI !!!!
Binds to and inhibits RT; does NOT need to be phosphorylated intracellularly to become activated like NRTIs (lamivudine, tenofovir, emtricitabine)
ADRs: Rash, hepatotoxicity, ***VIVID DREAMS W/ EFAVIRENZ
185
Pramipexole
Dopamine agonist used in parkinsons
| replaces B in BALSAC
186
Drug-induced Lupus
Caused by procainamid, isoniazid, hydralazine
*These pts. are slow histone acetylators and it is why they have this rxn
187
Acyclovir, famciclovir
Guanosine analog phosphorylated by HSV thimydine kinase and terminate DNA chain polymers
TOXICITY: CRYSTALLINE NEPHROPATHY
=>>HYDRATE PTS. TO AVOID
188
Fluconazole
Inhibits fungal ergosterol synthesis by blocking lanosterol conversion
Itra for area-assoc. infxns (coccidiodes and such)
189
Amphotericin B
Binds to ergosterol forming membrane pores
ADR: ***Renal toxicity due to renal vasoconstriction =>>hypokalemia and hypomagnesemia
-Also fever, anemia, hypotension, arrhythmia
190
ADRs of corticosteroids
Skin: Central obesity, muscle weakness, buffalo hump, striae
GI: Bleed, PUD
Endocrine: Hyperglycemia, hypogonadism, osteoporosis
Immune: NEUTROPHILIA (demargination), suppression
Nervos: Psychosis
191
Aliskrein
Direct renin inhibitor (decreased angiotensinogen activation)
ADRs: Hyperkalemia, decreased renal fnxn
192
Demeclocycline
ADH antagonist used to tx. SIADH
193
Clomiphene
Estrogen receptor antagonist at the hypothalamus
=>> decreased negative feedback at the hypothalamus and overall increase in FSH and LH release
=>>ovulation
-Tx for pregnancy due to PCOS
194
Progestins
Increase the vascularization and decrease the growth of the endometrium
-Used in OCPs and tx of endometrial carcinoma
195
Mifepristone
Competitive inhibitor off progestins at progesterone receptors
-Used to terminate pregnancies alongside PGE1
196
CIs to OCPs
Smokers
Pts. w/ history of stroke/ coagulation disorders
Hx of estrogen-dependent tumors
197
Terbutaline
B2-agonist that relaxes the uterus and decreases contraction frequency in women during labor
198
Danazol
Androgen agonist; used for endometriosis and hereditary angioedema
ADRs: Weight gain, acne, hirsutism, virilization
199
Flutamide
Competitive androgen receptor inhibitor sometimes used in prostate carcinoma
200
Minoxidil
Was supposed to be a vasodilator but now used as ROGAINE
201
Diphenhydramine
H1 inhibitors used for allergies, motion sickness, and as sleep aids
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ADRs: Sedation, antimuscarine (5 classes), and anti-a1 adrenergic
-Can you think of another class of drug that causes these?
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CI'd in geriatric pts.; use a second generation
202
Bosentan
Competitively antagonizes the endothelin-1 receptor
=>>Decreased pulmonary vascular resistance
203
Salmeterol, formoterol
Long acting B2 agonists used for prophylaxis
ADRs: Tremor, arrhythmia
204
Theophylline
PDE inhibitor =>> increased cAMP =>> bronchodilation
*Narrow TI (cardiotoxic, neurotoxic)
CYP-metabolized
205
Glucose transporters
GLUT 1- RBCs, Brain
GLUT 2- Liver, kidney, SI, B-cells (pancreas)
GLUT 3- Brain
***GLUT 4- Adipose, striated muscle
GLUT 5- FRUCTOSE (sperm, SI)
206
Ephedrine
Increases release of stored catecholamines; used for nasal decongestion
207
Clonidine
a2-agonist used in a hypertensive urgency (sometimes)
208
a-methyldopa
a2 agonist used in HTN in pregnancy; can cause DAT (+) hemolysis and SLE-like syndrome
209
Mirtazapine
a2-antagonist used to tx depression
-Cases sedation and increased appetite
210
Glycopyrrolate
Muscarinic antagonist used to reduce airway secretions preoperatively
211
Oxybutynin, Tolterodine
Muscarinic antagonist that targets genitourinary receptors and reduces urinary incontinence
"Toilet-odine"
"Oxy-BUTT-IN"
212
Nonselective a and b agonists
Carvedilol, labetalol
213
Nebivolol
B1-blockade WITH B2 activation
214
Lamotrigine
Anticonvulsant that blocks voltage-gated Na+ channels
*Watch out for SJS***
215
PCSK9 inhibitors
Injections for diabetics that act as monoclonal abs that reduce LDL receptor degradation in the liver
-Cause great decrease in cholesterol levels
216
Fibrates
PPAR-y activators that decrease hepatic VLDL prod. and increase LPL activity
-Greatest reduction in TGLS
ADRs: Myopathy; cholesterol gallstones (esp. w/ fenofibrate
217
Blood/gas partition coefficient
Basically means solubility
A drug with a high blood/gas partition coefficients has...
LARGE amount needed to saturate the blood
SLOW rise in partial pressure in the blood
SLOW equilibration within the brain
SLOW onset of action
218
First line tx for acute status epilepticus
IV BENZOs; also for eclampsia seizures if there is no MgSO4
219
Colcichine
Binds and stabilizes tubulin to inhibit microtubule polymerization
**Disrupts PMN chemotaxis and degranulation
220
Anastrazole
Aromatase inhibitor!
- Used in ER (+) breast cancer
- Exemestane also does this
221
Chlorthalidone
Thiazide diuretic lol
ADRs: Hyperglcyemia, hyperlipidemia, hyperuricemia, hypercalcemia
222
Niacin
Inhibits lipolysis (LPL) in adipose; reduces hepatic VLDL synthesis
ADRs: Flushing, hyperglycemia, hyperuricemia
223
Class I antiarrhythmics
IA: Only ones that prolong the QT interval
IB: Preferred after MIs, lidocaine can possibly cause seizures;
IC: Highest potential to create dependence; bind strongest to the Na+ channel, CI'd in IHD
224
Possible Tx for torsades du pointes
Mg2+
-Also used for digoxin toxicity
225
Alprostadil
PGE1 analog used to tx sexual dysnfnxn and maintain the PDA
226
Carboprost
PGF2 analog used to increase uterine tone and shoot out stubborn babies
227
Methemeglobin Tx
Methylene blue
228
Risk of expired tetracyclines
Fanconi syndrome: generalized REABSORPTION defect in the PCT
-Can lead to a metabolic acidosis
229
Amifostine
Given alongside Cisplatin to prevent Ototoxicity
230
Miravoc
CCR5 inhibitor blocking the binding of HIV molecules to T-cells
