Pharm one liner I Flashcards
Agent that is a partial agonist for the 5-HT1A receptor
Buspirone
Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia
Phenylephrine
Atropine fever is the most dangerous effect and can be lethal in this population group
Infants
Prolonged exposure to this inhaled anesthetic may lead to megaloblastic anemia
Nitrous oxide
“Date rape drug”
Flunitrazepam (rohypnol)
1st generation antihistamine that is highly sedating
Diphendydramine
1st generation antihistamine that is least sedating
Chlorpheniramine
2nd generation antihistamines
Fexofenadine, loratadine, and cetirizine
3 zones of adrenal cortex and their products
Glomerulosa (mineralocorticoids), fasciculata (glucocorticoid=GC), and reticularis (adrenal androgens)
5 alpha-reductase inhibitor used for benign prostatic hyperplasia (BPH) and male pattern baldness
Finasteride (Proscar and Propecia respectively)
5HT-1D/1B agonist used for migraine headaches
Sumatriptan, naratriptan, and rizatriptan
5ht-3 antagonist that has been MOST associated with QRS and QTc prolongation and should not be used in patients with heart disease
Dolasetron
5HT-3 antagonist used in chemotherapeutic induced emesis
Ondansetron, granisetron, dolasetron and palonosetron
5HT2 antagonist mediate synaptic excitation in the CNS and smooth muscle contraction
Ketanserin, cyproheptadine, and ergot alkaloids (partial agonist of alpha and serotonin receptors)
A class of endogenous substances that include histamine, serotonin, prostaglandins, and vasoactive peptides that work in autocrine or paracrine manner
Autacoids
A1a-selective blocker used for BPH
Tamsulosin (Flomax)
Ability of a drug to produce maximal response after binding to the receptor
Full agonist
Ability of drug to produce the maximal biologic effect
Efficacy
Ability to bind irreversibly to the active site or bind to a site distinctly separate from the agonist binding site
Noncompetitive antagonist
Ability to bind reversibly to the same site as the drug and without activating the effector system
Competitive antagonist
Ability to produce less than maximal response after binding to the receptor
Partial agonist
ACE inhibitors are contraindicated in
pregnancy and with hyperkalemia
Acetaminophen only has what activity?
Antipyretic and analgesic activity
ACTH analog used for diagnosis of patients with corticosteroid abnormality
Cosyntropin
Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release and pain transmission
Presynaptic mu, delta, and kappa receptors
Activation of these receptors open K+ ion channels to cause membrane hyperpolarization
Postsynaptic Mu receptors
Additive effects when Sedative-Hypnotics used in combination with these agents
CNS depressants
Adenosine’s MOA
Activates acetylcholine sensitive K+ channels in SA and AV node
ADH agonist used for central diabetes insipidus
Desmopressin (DDAVP)
Agent can blocking muscarinic receptors
Pancuronium
Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects
Benztropine
Agent effective in physiologic and essential tremor
Propranolol
Agent for pernicious anemia
Cyanocobalamin (Vit B12)
Agent more frequently associated with extrapyramidal side effects that can be treated with benzodiazepine, diphenhydramine or muscarinic blocker
Haloperidol
Agent of choice for the treatment of hypothyroidism
Levothyroxine (T4)
Agent similar to cisplatin, less nephrotoxic, but greater myelosuppression
Carboplatin
Agent that competes for alcohol dehydrogenase in the case of methanol overdose
Ethanol
Agent that inhibits hepatic metabolism, is hepatotoxic and teratogen that can cause neural tube defects and gastrointestinal distress
Valproic acid
Agent that inhibits xanthine oxidases and used to treat chronic gout
Allopurinol, febuxostat
Agent that is metabolized to acetaldehyde by alcohol dehydrogenase and microsomal ethanol-oxidizing system (MEOS)
Ethanol
Agent that is teratogen and causes a fetal syndrome
Alcohol
Agent to treat hypochromic microcytic anemias
Ferrous sulfate
Agent to treat torsades de pointes
Magnesium sulfate
Agent undergoing Hofmann elimination (breaking down spontaneously)
Atracurium
Agent used for acute muscle spasm
Cyclobenzaprine
Agent used for anemias associated with renal failure
Erythropoietin
Agent used for closure of patent ductus arteriosus
Indomethacin
Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy
Folic acid
Agent used for neurological deficits in megaloblastic anemia
Vitamin B12
Agent used in acutely decompensated CHF resembling natriuretic peptide
Nesiritide (Natrecor)
Agent used in CHF that is a selective alpha and nonselective beta blocker
Carvedilol
Agent used in drug therapy of Parkinson’s instead of Dopamine which has low bioavailability and does not cross the BBB
L-dopa
Agent used in the treatment of alcoholism, if alcohol is consumed concurrently, acetaldehyde builds up and results in nausea, headache, flushing, and hypotension
Disulfiram
Agent used neutropenia especially after chemotherapy
G-CSF (filgrastim) and GM-CSF (sargramostim)
Agent used to treat chronic gout by increasing uric acid excretion through inhibition of URAT1 anion transporter
Probenecid
Agent used to treat MI and to reduce incidence of subsequent MI
Aspirin
Agent with zero-order kinetics
Ethanol, theophylline, tolbutamide, warfarin, aspirin, phenytoin
Agent with greater affinity to 5HT2A receptor; reserved for refractory schizophrenia, and can cause weight gain and agranulocytosis
Clozapine
Agent with long duration of action and is sost likely to cause histamine release
Tubocurarine
Agents acting in the CNS or in the skeletal muscle, used to reduce abnormally elevated tone caused by neurologic or muscle end plate disease
Spasmolytic drugs
Agents for reduction of postpartum bleeding
Oxytocin and ergonovine
Agents having active metabolites, long half lives, and a high incidence of adverse effects
Diazepam, Flurazepam, chlordiazepoxide, and clorazepate
Agents having higher sedation and antimuscarinic effects than other TCA’s
Tertiary amines
Agents may exacerbate tardive dyskinesias (may be irreversible and there is no treatment)
Muscarinic blockers
Agents that inhibit aldehyde dehydrogenase
Disulfiram, metronidazole, certain sulfonylureas and cephalosporins
Agents used for SIADH
Tolvaptan and conivaptan
Agents used in Huntington’s Disease
Tetrabenazine (amine depleting drug), Haloperidol (antipsychotic)
Agents used in Tourette’s dx
Haloperidol or pimozide
Agents used in treatment of carcinoid tumor
Cyproheptadine
Alkylating agent that produces disulfiram-like reaction with ethanol
Procarbazine
Alkylating agent, vesicant that causes tissue damage with extravasation
Mechlorethamine
All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion
Side-effect profile and prior pt response
All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction
Meperidine
Almost all local anesthetics have this property and sometimes require the administration of vasoconstrictors (ex. Epinephrine) to prolong activity
Vasodilation
Alpha 1 agonist toxicity
Hypertension
Alpha 1selective blockers
Prazosin, terazosin and doxazosin (-AZOSIN ending)
Alpha cells in the pancreas
Produce glucagon
Alpha-glucosidase inhibitor associated with elevation of LFT’s
Acarbose
Alternative anticoagulant used if HIT develops
Lepirudin
Amino acid derivative for treatment of Type II diabetes
Nateglinide
Aminoglycoside that is least ototoxic
Streptomycin
Aminoglycosides used with loop diuretics potentiate this adverse effect
Ototoxicity
Amount of drug necessary to elicit a biologic effect compared with another drug
Potency
Amphetamine agents
Dextroamphetamines and methamphetamine
An early generation tetracyclin that may be used for chronic persistant SIADH
demeclocycline
An electrolyte that is lost in the urine by acute treatment with loop diuretics but can be retained by thiazides
Calcium
An isomer of T3 which may be used in myxedema coma
Liothyronine (T3)
Anabolic steroid that has potential for abuse
Nandrolone and stanozolol
Analog of hypoxanthine, needs HGPRTase for activation
6-mercaptopurine (6-MP)
Anemia caused by trimethoprim
Megaloblastic anemia
Another pneumonic for anticholinergic toxicity
“dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat”
Anti-androgen used for hirsutism in females
Cyproterone acetate
Anti-androgen used for prostate cancer
Flutamide (Eulexin)
Anti-arrhythmic with <10 second duration of action
Adenosine
Anti-arrhythmics that decrease mortality
B-blockers
Anti-bacterials that cause hemolysis in G6PD-deficient patients
Sulfonamides
Anti-emetics used in association with anti-cancer drugs that are 5-HT3 (serotonin receptor subtype ) antagonist
Odansetron, granisetron, dolasetron, palonosetron
Anti-estrogen used for estrogen receptor + breast cancer
Tamoxifen
Anti-malarial drug used in rheumatoid arthritis (RA)
Hydroxychloroquine
Anti-Parkinson’s drug which increases intraocular pressure and is contraindicated in closed angle glaucoma
Levodopa
Anti-progesterone used as abortifacient
Mifepristone (RU-486)
Anti-psychotics available in depot preparation
Fluphenazine and haloperidol
Anti-psychotics shown not to cause tardive dyskinesia
Clozapine and quetiapine
Anti-rheumatic agent also used for ulcerative colitis
Sulfasalazine
Anti-seizure agent that exhibits non-linear metabolism, highly protein bound, causes fetal hydantoin syndrome, and stimulates hepatic metabolism
Phenytoin
Anti-seizure agent that induces formation of liver drug-metabolism enzymes, is teratogen and can cause craniofacial anomalies and spina bifida
Carbamazepine
Anti-seizure drugs used also for bipolar affective disorder (BAD)
Valproic acid, carbamazepine, phenytoin and gabapentin
Anti-seizure drugs used also for pain of neuropathic orgin
Gabapentin
Anti-seizure drugs used also for Trigeminal neuralgia
Carbamazepine
Anti-seizure drugs used as alternative drugs for mood stabilization
Carbamazepine, gabapentin, lamotrigine, and valproic acid
Anti-seizure medication also used in the prevention of migraines
Valproic acid
Anti-thyroid drugs
Thioamides (methimazole, propylthiouracil), potassium iodide, radioactive iodine (131I)
Anti-viral agents associated with Stephen Johnson syndrome
Nevirapine, amprenavir
Anti-viral with a dose limiting toxicity of pancreatitis
Didanosine
Antiarrhythmic effective in most types of arrhythmia
Amiodarone
Antiarrhythmic that exhibits Class II and III properties
Sotalol
Antibacterials for optimal treatment of acute pyelonephritis
Fluoroquinolones (ciprofloxacin, levofloxacin), trimethoprim-sulfamethoxazole
Antibacterials for optimal treatment of acute uncomplicated cystitis
Nitrofurantoin, trimethoprim-sulfamethoxazole, fosfomycin
Antibiotic causing red-man syndrome, and prevention
Vancomycin, can be prevented by infusion at a slow rate and antihistamines
Anticancer drug also used in RA, produces acrolein in urine that leads to hemorrhagic cystitis
Cyclophosphamide
Anticoagulant of choice in pregnancy
Heparin
Antidepressant also used for sleep that causes priapism
Trazodone
Antidepressant associated with neuroleptic malignant syndrome
Amoxapine
Antidepressant associated with seizures and cardiotoxicity
Maprotiline
Antidepressant having stimulant effects similar to SSRI’s and can increase blood pressure
Venlafaxine
Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake
Venlafaxine
Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure
Nefazodone
Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating
Mirtazapine
Antidote for acetaminophen toxicity
N-acetylcysteine
Antidote for arsenic, mercury, and gold poisoning
Dimercaprol
Antidote for beta-blocker overdose and hypoglycemia
Glucagon
Antidote for digoxin toxicity
Digibind
Antidote for hyperkalemia
sodium polystyrene sulfonate (Kayexalate)
Antidote for methotrexate toxicity
Leucovorin
Antidote for severe CV toxicity of theophylline
Beta blockers
Antidote for severe lead poisoning (with encephalopathy)
Dimercaprol AND CaEDTA (edetate calcium disodium)
Antidote for thrombolytics
Aminocaproic acid
Antidote for tissue plasminogen activator (t-PA), streptokinase
Aminocaproic acid
Antidote to benzodiazepine overdose (antagonist that reverses the CNS effects)
Flumazenil
Antidote to reverse actions of heparin
Protamine sulfate
Antidote to reverse actions of warfarin
Vitamin K or fresh frozen plasma
Antidote used for acetaminophen (APAP) toxicity
N-acetylcysteine
Antidote used for anticholinergic poisoning
Physostigmine
Antidote used for benzodiazepine toxicity
Flumazenil
Antidote used for beta agonist toxicity (eg. Metaproterenol)
Esmolol
Antidote used for carbon monoxide poisoning
100% O2 and hyperbaric O2
Antidote used for cyanide poisoning
Nitrites, sodium thiosulfate, hydroxocobalamin (cyanokit)
Antidote used for digitalis toxicity
Digibind (also need to d/c digoxin, normalize K+, and lidocaine if pt. Is arrhythmic)
Antidote used for heparin toxicity
Protamine Sulfate
Antidote used for iron salt toxicity
Deferoxamine
Antidote used for lead poisoning (without encephalopathy)
Dimercaprol, Edetate calcium disodium, or succimer
Antidote used for methanol and ethylene glycol toxicity
Ethanol
Antidote used for opioid toxicity
Naloxone (IV), naltrexone (PO)
Antidote used for organophosphate/anticholinesterase poisoning
Atropine, pralidoxime (2-PAM)
Antidote used for tricyclic antidepressants (TCA)
Sodium bicarbonate
Antidote used for warfarin toxicity
Vitamin K and Fresh frozen plasma (FFP)
Antidote used in Wilson’s disease (copper poisoning)
Penicillamine
Antidote useful for some drug induced Torsade de pointes
Magnesium sulfate
Antiestrogen drugs used for fertility and breast cancer respectively
Clomiphene and tamoxifen
Antifungal agent used for inhibition of all gonadal and adrenal steroids
Ketoconazole
Antiglaucoma organophosphate, indicated but not used much clinically anymore due to long duration of action
Echothiophate
Antihistamine that is indicated for allergies, motion sickness, and insomnia
Diphenhydramine
Antiplatelet drug reserved for patients allergic to aspirin
Ticlopidine
Antiprogestin used as potent antagonist of GC receptor
Mifepristone
Antipsychotic having the weakest autonomic effects
Haloperidol
Antipsychotics having the strongest autonomic effects
Chlorpromazine or Thioridazine
Antipsychotics that reduce positive symptoms only
Older antipsychotics
Antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog) and is irreversible
Drug induced Parkinsonism
Antivirals associated with neutropenia
Ganciclovir, zidovudine, saquinavir, and interferon
Antivirals that are teratogens
Delavirdine, efavirenz, and ribavirin
Approved for use in severe pulmonary HTN
PGI2 (epoprostenol)
Arterial vasodilator that works by opening K+ channels
Minoxidil
Aspirin reduces mortality in unstable angina by
Platelet aggregation inhibition
Atypical antipsychotic causing high prolactin levels
Risperidone
Available bisphosphonates
Alendronate, etidronate, risedronate, pamidronate, tiludronate, and zoledronic acid
Barbiturate used for the induction of anesthesia
Thiopental
Barbiturates decrease the effectiveness of many other drugs via this pharmacokinetics property
Liver enzyme INDUCTION
Barbiturates may precipitate this hematologic condition
Acute intermittent porphyria
Barbiturates MOA
Increase the DURATION of GABA-mediated chloride ion channels
Barbiturates, phenytoin, carbamazepine, and rifampin all do this
Induce CYP450
Benzodiazepine receptor antagonist, it accelerates recovery from benzodiazepine overdose
Flumazenil
Benzodiazepine that has efficacy against absence seizures and in anxiety states, such as agoraphobia
Clonazepam
Benzodiazepine that is used for anesthesia
Midazolam
Benzodiazepine that undergo extrahepatic conjugation (which are useful in older or hepatically impaired)
Lorazepam, oxazepam, and temazepam
Benzodiazepine used adjunctively in anesthesia
Midazolam
Benzodiazepine with useful relaxant effects in skeletal muscle spasticity of central origin
Diazepam
Benzodiazepines that are the most effective in the treatment of panic disorder
Alprazolam and Clonazepam
Beta 1 agonist toxicity
Sinus tachycardia and serious arrhythmias
Beta 1 agonists used in acute CHF
Dobutamine and dopamine
Beta 2 agonist toxicity
Skeletal muscle tremor
Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus
Terbutaline
Beta blockers are used for which type of anginal attack
Classic
Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma
Pindolol and acebutolol
Beta blockers work in CHF by
Reducing progression of heart failure (never use in acute heart failure)
Beta cells are found
Islets of Langerhans
Beta cells in the pancreas
Produce insulin
Beta-blockers should be used cautiously in
Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease
Biguanide
Metformin
Binds tubulin and prevents the disassembly of microtubules during the M phase of the cell cycle inducing mitotic arrest
Paclitaxel (taxol)
Bisphosphonates that cannot be used on continuous basis because it caused osteomalacia
Etidronate
Block glycoprotein IIb/IIIa involved in platelet cross-linking
Abciximab, tirofiban and eptifibatide
Block L-type calcium channel
Calcium channel blockers
Blows DNA (breaks DNA strands), limiting SE is pulmonary fibrosis
Bleomycin
Bronchodilation in asthma and COPD
Ipratropium, tiotropium
Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism
Iodide salts (potassium iodide)
Captopril and enalapril (-OPRIL ending) are
ACE inhibitors
Carbamate with intermediate action and used as off-label for postoperative paralytic ileus and urinary retention
Neostigmine
Carbamazepine may cause
Agranulocytosis
Carbonic anhydrase inhibitor
Acetazolamide
Cardioselective Beta 1-blockers
Atenolol, acebutolol, and metoprolol
Cause dizziness, tachycardia, hypotension, and flushing
Organic nitrites
Causes acne, premature closure of epiphyses, masculinization in females, hepatic dysfunction, MI, and increases in libido and aggression
Steroids
Causes bone marrow suppression
Methotrexate
CCB are DOC for
Prinzmetal’s angina
CCB with predominate effect on arteriole dilation
Nifedipine
Cephalosporin causes kernicterus in neonates
Ceftriaxone or cefuroxime
Cephalosporins able to cross the BBB
Cefixime (2nd) and 3rd generation
Cheap wide spectrum antibiotic DOC of otitis media
Amoxicillin
Chelating agent used in acute iron toxicity
Deferoxamine
Chelating agent used in Wilson’s disease
Penicillamine
Cholestyramine and colestipol are
Bile acid-binding resins
Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction
Pilocarpine, carbachol, physostigmine
Chronic high dose abuse of nicotine leads to
Psychotic state, overdose causes agitation, restlessness, tachycardia, hyperthermia, hyperreflexia, and seizures
Chronic orthostatic hypotension can be treated with
Midodrine
Cimetidine, ketoconazole, isoniazid, and grapefruit all do this
Inhibit CYP450
Class II antiarrhythmics are
B-blockers
Class III antiarrhythmic that exhibits properties of all 4 classes
Amiodarone
Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents
Class IC (flecainide, propafenone, moricizine)
Class of antibiotics that have 10% cross sensitivity with penicillins
Cephalosporins
Class of drugs that may cause cross-sensitivity with thiazide diuretics
Sulfonamides
Class of drugs that reversibly inhibit COX
NSAIDS
Class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins
Ezetimibe (Zetia)
Clinical response that may fluctuate in tx of Parkinson’s dx
“On-off-phenomenon”
Clinical use for H2 blockers
Acid reflux disease, duodenal ulcer and peptic ulcer disease
Clinical uses of these agents include treatment of HTN, angina, arrhythmias, and chronic CHF
Beta blockers
Combined alpha and beta blocking agents that may have application in treatment of CHF
Labetalol and carvedilol
Common mechanism by which overdose result in death
Depression of medullary and cardiovascular centers
Common SE of spironolactone
Gynecomastia and hyperkalemia
Common SE of sulfonylureas, repaglinide, and nateglinide
Hypoglycemia
Common SE of tamoxifen and raloxifene
Hot flashes
Common side effect of hypnotic agents
Sedation
Common side effect of Rifampin
Orange urine discoloration
Common toxicities of cisplatin
Nephro and ototoxicity
Commonly abused LA which has cardiovascular toxicity including severe hypertension with cerebral hemorrhage, cardiac arrhythmias, and myocardial infarction
Cocaine
Concentration in the plasma times (clearance divided by bioavailability)
Maintenance dose (Cp*(CL/F))
Concurrent use of fibrates and statins increases risk of
Rhabdomyolysis
Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)
Hypertensive crisis
Constant amount of drug metabolized per unit time
Zero order kinetics
Constant low dose of estrogen and increasing dose of progestin for 21 days (last 5 days are sugar pills or iron prep)
Combination oral contraceptives (OC)
Constant percentage of drug metabolized per unit time
First order kinetics
Constant proportion of cell population killed rather than a constant number
Log-kill hypothesis
Contraindications to use of atropine
Infants, closed angle glaucoma, prostatic hypertrophy
Converted to more active form DHT by 5 alpha-reductase
Testosterone
Converts asparagine to aspartate and ammonia, denies cancer cells of essential AA (asparagine)
L-asparaginase
COX 2 inhibitors may have reduced risk of
Gastric ulcers and GI Bleeding
COX 2 inhibitors should be used cautiously in pts with
Pre-existing cardiac or renal disease
Cutaneous flush due to niacin can be reduced by pretreatment with
Aspirin
Cystitis, postoperative bladder spasms, or incontinence
Oxybutynin, dicyclomine
Decrease intestinal absorption of cholesterol
Bile acid-binding resins
Decreases liver triglycerol synthesis
Niacin
Delta cells in the pancreas
Produce Somatostatin
Difference between aspirin and other NSAIDS
Aspirin irreversibly inhibits cyclooxygenase
Difference between COX1 and COX2
COX 1 is constitutive while COX 2 may be induced during inflammation, although COX 2 is constitutive in some tissues
Different steps of Phase I
Oxidation, reduction, hydrolysis
Digoxin is used in
Atrial fibrillation and CHF
Digoxin toxicity can be precipitated by
Hypokalemia
Direct vasodilator of arteriolar smooth muscle
Hydralazine
Disease caused by excess ergot alkaloids
St. Anthony’s Fire
Distribution of histamine receptors H1, H2, and H3
Smooth muscle and mast cells; stomach, heart, and mast cells; nerve endings, CNS respectively
Diuretic used as first line for treatment of hypertension
Thiazides
Diuretic used as prophylactic for mountain sickness and glaucoma
Acetazolamide
Diuretic used in hypertensive patients with renal failure
Loop diuretics (furosemide, ethacrynic acid, butmetanide)
Diuretic used to antagonize aldosterone receptors
Spironolactone
Diuretic used to reduce intracranial pressure
Mannitol
Diuretic used to treat primary aldosteronism
Spironolactone, eplerenone
Diuretics work in CHF by
Reducing preload
DMARDs are slow acting drugs for
Rheumatic disease
DOC for bipolar affective disorder
Lithium
DOC for CMV retinitis
Ganciclovir
DOC for digoxin induced arrhythmias
Phenytoin
DOC for febrile seizures
Phenobarbital
DOC for giardia, bacterial vaginosis, pseudomembranous colitis, and trichomonas
Metronidazole
DOC for herpes and its MOA
Acyclovir; activates thymidine kinase
DOC for influenza A and B
Oseltamivir or Zanamivir
DOC for malignant hyperthermia by acting on the sarcoplasmic reticulum or skeletal muscle
Dantrolene
DOC for malignant hyperthermia that may be caused by use of halogenated anesthetics
Dantrolene
DOC for management of acute Ventricular arrhythmias
Lidocaine
DOC for N. gonorrhea
Ceftriaxone
DOC for paroxysmal supraventricular tachycardia (PSVT)
Adenosine
DOC for RSV
Ribavirin
DOC for status epilepticus
Diazepam
Dopamine agonist used in hyperprolactinemia
Bromocriptine
Dose which is lethal to 50% of the population
LD50
Dose which is toxic in 50% of the population
TD50
Dose which produces therapeutic response in 50% of the poopulation
ED50
Drug causes teeth discoloration
Tetracycline
Drug causing depletion of substance P (vasodilator)
Capsaicin
Drug increases the renal clearance hence decreases levels of lithium
Theophylline
Drug notorious for causing pseudomembranous colitis
Clindamycin
Drug of choice for generalized anxiety disorder, NOT effective in acute anxiety
Buspirone
Drug of choice for Legionnaires’ disease
Azithromycin (or macrolides)
Drug of choice for leprosy
Dapsone
Drug of choice for myoclonic seizures
Valproic acid
Drug of choice for tx of pseudomembranous colitis
Metronidazole
Drug that causes contraction of the uterus
Oxytocin
Drug that causes gray baby syndrome and aplastic anemia
Chloramphenicol
Drug that inhibits alcohol dehydrogenase and is used in ethylene glycol exposure
Fomepizole
Drug that selectively inhibits COX 2
Celecoxib
Drug used concurrently with toxic anticancer agents to reduce renal precipitation of urates
Allopurinol
Drug used for African sleeping sickness
Suramin
Drug used for MRSA
Vancomycin
Drug used in cancer therapy causes Cushing-like symptoms
Prednisone
Drug used in Chagas disease
Nifurtimox
Drug used in ergot alkaloids overdose, ischemia and gangrene
Nitroprusside
Drug used in exoerythrocytic cycle of malaria
Primaquine
Drug used in neuroleptic malignant syndrome
Dantrolene
Drug used supraventricular arrhythmias
Digoxin
Drugs available in combination with metformin
Acroplus Met progutazone and metformin, Janumet and Janumet XR Sitagliptin and Metformin, Glyburide, glipizide, and rosiglitazone
Drugs of choice for absence seizures
Ethosuximide and valproic acid
Drugs of choice for generalized tonic-clonic and partial seizures
Valproic acid, Phenytoin and Carbamazepine
Drugs of choice for status epilepticus
IV diazepam (or lorazapam) followed by phenytoin
Drugs that can be used for infantile spasms
Corticosteroids
Drugs that have a high margin of safety is indicated by
High therapeutic index
Drugs that have a narrow margin of safety is indicated by
Low therapeutic index
Drugs used in the management of angina
Aspirin, Nitrates, CCB, and Beta blockers
During Phase I these agents worsen the paralysis by succinylcholine, but during phase II they reverse the blockade produced by succinylcholine
Cholinesterase inhibitors
Effective in preventing TIA’s
Clopidogrel and ticlopidine
Endogenous insulin
Normal C-peptide
Enhances dopaminergic neurotransmission SE’s include CNS excitation, acute toxic psychosis and livedo reticularis
Amantadine
Enzyme that metabolizes acetaldehyde to acetate
Aldehyde dehydrogenase
Enzyme which theophylline inhibits
Phosphodiesterase
Epinephrine and dipivefrin are used for
Glaucoma
Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia
Bromocriptine
Ergot alkaloid used as an illicit drug
LSD
Estrogen mostly used in oral contraceptives (OC)
Ethinyl estradiol and mestranol
Example of three antidepressants that are indicated for obsessive compulsive disorder
Clomipramine, fluoxetine and fluvoxamine
Examples of alpha-glucosidase inhibitors (AGI)
Acarbose, miglitol
Except for these agents all SSRI have significant inhibition of CytP450 enzymes
Citalopram and its metabolite escitalopram
Extrapyramidal dysfunction is more common with these agents, which block this subtype of dopamine receptor
Older antipsychotic agents, D2 receptors
Facilitates GABA presynaptic inhibition
Diazepam
Fibrates (gemfibrozil) increase activity of
Lipoprotein lipase
Fibrates are contraindicated in
Pregnancy
First generation sulfonylurea
Chlorpropamide, tolbutamide, tolazamide, etc.
Fluoride released by metabolism of this inhaled anesthetic may cause renal insufficiency
Methoxyflurane
For rebound HTN from rapid clonidine withdrawal
Phentolamine
Four main actions of NSAIDS
Anti-inflammatory, analgesia, antipyretic and antiplatelet activity
GABA agonist in the spinal cord
Baclofen
Ganglion blockers that were indicated (but not anymore) for severe hypertension
Hexamethonium, trimethaphan
Generation of antihistamine that has the most CNS effects
First generation due to being more lipid-soluble
GHRH analog used as diagnostic agent
Sermorelin
GnRH agonist used for infertility or different types of CA depending on pulsatile or steady usage respectively
Leuprolide
GnRH antagonist with more immediate effects, used for infertility
Ganirelix
Good hypnotic activity with less CNS SE than most benzodiazepines
Zolpidem, zaleplon
H1 antagonist used in motion sickness
Dimenhydrinate and other 1st generation
H1 blocker that is also a serotonin antagonist
Cyproheptadine
H2 blocker that causes the most interactions with other drugs
Cimetidine
Heparin (PTT) increases activity of
Antithrombin 3
HIV antiviral class known to have severe drug interactions by causing inhibition of metabolism
Protease inhibitors
HIV med used to reduce transmission during birth
AZT (zidovudine)
HMG CoA reductase inhibitors are contraindicated in
Pregnancy
Hormone inhibiting prolactin release
Dopamine
How drug or foods (grapefruit juice) increase statin effect
Inhibit Cytochrome P450 3A4
Hyperglycemic agent that increases cAMP and results in glycogenolysis, gluconeogenesis, reverses hypoglycemia, also used to reverse severe beta-blocker overdose and smooth muscle relaxation
Glucagon
Important drug interaction with chloral hydrate
May displace coumadin from plasma proteins
Important in muscle and adipose tissue for glucose transport across muscles and TG storage by lipoprotein lipase activation
GLUT 4
Important in synthesis of glucose to glycogen in the liver
GLUT 2
Increase bone density, also being tested for breast CA tx.
Raloxifene (SERM-selective estrogen receptor modulator)
Increased risk of developing cataracts
Quetiapine
Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis
Edrophonium
Inhalant anesthetics
NO, chloroform, and diethyl ether
Inhaled anesthetic causes peripheral vasodilation
Isoflurane
Inhaled anesthetic that may sensitize the myocardium to arrhythmogenic effects of catecholamines and has produced hepatitis
Halothane
Inhaled anesthetic with a low blood/gas partition coefficient
Nitrous oxide
Inhaled anesthetics are myocardial depressants
Enflurane and halothane
Inhaled anesthetics metabolized by liver enzymes which has a major role in the toxicity of these agents
Halothane and methoxyflurane
Inhaled anesthetics, less likely to lower blood pressure than other agents, and has the smallest effect on respiration
Nitrous oxide
Inhibit angiotensin-converting enzyme (ACE)
ACE inhibitors
Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons
Ascending pathways
Inhibitor of leukotrienes (LTD4) receptors and used in asthma
Zafirlukast and montelukast
Inhibitor of lipoxygenase
Zileuton
Inhibitor of MAO type B which metabolizes dopamine, used adjunct to levodopa or as sole agent in newly diagnosed pt’s
Selegiline
Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson’s dx and cause acute hepatic failure (monitor LFT’s)
Entacapone and Tolcapone
Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis
Aminoglutethimide
Insecticide organophosphate
Malathion, parathion
Interaction with this drug requires dose reduction of 6-MP
Allopurinol
Interferes with activity of T-lymphocytes
Hydroxychloroquine
Intermediate acting GC’s
Prednisone, methylprednisolone, prednisolone, oaramethasone, fluprednisone and triamcinolone
Inversely related to potency of anesthetics
Minimum alveolar anesthetic concentration (MAC)
Irreversible, nonselective COX inhibitor
Aspirin (or other salicylates)
IV barbiturate used as a pre-op anesthetic
Thiopental
IV Drug used Hypertensive Crisis
Nitroprusside
LA causing methemoglobinemia
Prilocaine
Laboratory value required to be monitored for patients on valproic acid
Serum ammonia and LFT’s
Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome
Abstinence syndrome
Lactam that can be used in PCN allergic patients
Aztreonam
Life threatening cardiac event that prolong QT leads to
Torsades de pointes
Limiting side effect of Quinidine
Prolongs QT interval
Lithium is associated with this congenital defect
Cardiac anomalies and is contraindicated in pregnancy or lactation
Local anesthetic with vasoconstrictive property, favored for head, neck, and pharyngeal surgery
Cocaine
Long acting beta 2 agonist used in asthma
Salmeterol
Long acting GC’s
Betamethasone, dexamethasone, and paramethasone
Long acting insulin
Ultralente (humulin U)
Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis
Ephedrine
Longer acting benzodiazepines used in the management of withdrawal states of alcohol and other drugs
Chlordiazepoxide and Diazepam
Longer acting Beta 2 agonists is recommended for prophylaxis of asthma
Salmeterol
Longer acting local anesthetics which are less dependent on vasoconstrictors
Tetracaine and bupivacaine
Losartan and valsartan block
AT1 receptors
Main route of metabolism for benzodiazepines
Hepatic
Major drug interaction with Quinidine
Increases concentration of Digoxin
Major effect of benzodiazepines on sleep at high doses
REM is decreased
Major indication for H1 receptor antagonist
Use in IgE mediated allergic reaction (allergic rhinitis, urticaria)
Major nutritional side effect of bile acid-binding resins
Impair absorption of fat soluble vitamin absorption (A,D,E,K)
Major route of elimination for Lithium
Kidneys
Major SE of bisphosphonates
Chemical esophagitis
Major SE of zileuton
Liver toxicity
Major side effect of insulin
Hypoglycemia
MAOI should not be administered with SSRI’s or potent TCA’s due to development of this condition
Serotonin syndrome
May protect against doxorubicin cardio-toxicity by chelating iron
Dexrazoxane
Mechanism of action (MOA) utilizes intracellular receptors
Steroid and hormones
Mechanism of action (MOA) utilizes ligand gated ion channels
Acetylcholine, nicotine
Mechanism of action (MOA) utilizes transmembrane receptors that have intrinsic enzymatic activity
Insulin, EGF, TGFbeta, PDGF, ANP
Mechanism of action of amiloride
Inhibit epithelial sodium channels in the distal convoluted tubules and collecting duct
Mechanism of action of loop diuretics
inhibits Na+/K+/2Cl- cotransporter
Mechanism of action of macrolides (erythromycin, clarithromycin)
Inhibit protein synthesis by binding to domain V of 23S rRNA of 50S ribosome subunit
Mechanism of action of spironolactone
Inhibit mineralocorticoid receptor and inhibit Na/K-ATPase and ENaC synthesis
Mechanism of action of tetracycline
Decreases protein synthesis by binding to 30S ribosome and prevent binding of tRNA to A site
Mechanism of action of thiazide diuretics
Inhibit Na+/Cl- cotransport
Mechanisms of action for Phenytoin, Carbamazepine, Lamotrigine
Sodium blockade
Mediator of tissue pain, edema, inactivated by ACE, and may be a contributing factor to the development of angioedema
Bradykinin
Meglitinide
Repaglinide
Meningitis prophylaxis in exposed patients
Rifampin
Method to reduce salicylate intoxication
Alkalinize urine, dialysis
Methyldopa is contraindicated in
Geriatrics due to its CNS (depression) effects
Methylxanthine derivative used as a remedy for intermittent claudication
Pentoxifylline
Metronidazole SE if given with alcohol
Disulfiram-like reaction
Microtubule inhibitor that causes peripheral neuropathy, foot drop (eg. ataxia), and “pins and needles” sensation
Vincristine
Mineralocorticoids
Fludrocortisone and deoxycorticosterone
MOA action of cromolyn
Blocks opening of Cl channels to prevent mast cell degranulation
MOA and effect of nitric oxide
Stimulates cGMP which leads to vascular smooth muscle relaxation
MOA for benzodiazepines and barbiturates
GABA-related targets
MOA for Diazepines
increase the FREQUENCY of GABA-mediated chloride ion channel opening
MOA for Ethosuximide
Calcium channels
MOA for Valproic acid at high doses
Affect calcium, potassium, and sodium channels
MOA of AGI’s
Act on intestine, delay absorption of glucose
MOA of aspirin
Irreversibly blocks COX1 and COX2
MOA of Bisphosphonates
Inhibits osteoclast bone resorption
MOA of both generations
Insulin release from pancreas by modifying K+ channels
MOA of Cardiac glycosides (eg. digoxin)
Indirectly increase intracellular calcium and cardiac contractility by inhibit Na+/K+ ATPase
MOA of cisplatin
Alkylating agent
MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics
Sodium channel blockers
MOA of class III antiarrhythmics
Potassium channel blockers
MOA of class IV antiarrhythmics
Calcium channel blockers
MOA of Colchicine (used in acute gout)
Selective inhibitor of microtubule assembly
MOA of corticosteroids
Induce lipocortins to 1. inhibit phospholipase A2, 2. repress COX-2 gene and enzyme expression, 3. repress cytokines that activate COX-2
MOA of fluoroquinolones
Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV
MOA of general anesthetics
Unclear, thought to increase the threshold for firing of CNS neurons
MOA of gold salts
Alter activity of macrophages and suppress phagocytic activity of PMNs
MOA of Leflunomide (newer agent)
Inhibiting Dihydroorotate Dehydrogenase which leads to decreased pyrimidine synthesis
MOA of local anesthetics (LA’s)
Block voltage-dependent sodium channels
MOA of lovastatin (STATIN)
inhibits HMG COA reductase
MOA of metformin
Decreases hepatic glucose production and intestinal glucose absorption; increase insulin sensitivity
MOA of nateglinide
Stimulates rapid and transient release of of insulin through closure of the ATP-sensitive K+ channel
MOA of nitrates
Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles
MOA of NSAIDS
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
MOA of nystatin
Bind ergosterol in fungal cell membrane
MOA of penicillin
Block cell wall synthesis by inhibiting transpeptidase and block peptidoglycan cross-linkage
MOA of repaglinide
Insulin release from pancreas; faster and shorter acting than sulfonylurea
MOA of sildenafil (Viagra)
Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP
MOA of sulfonamides
Inhibit dihydropteroate synthase
MOA of thiazolindinediones
Stimulate PPAR-gamma receptor to regulate CHO and lipid metabolism
MOA of thrombolytics
Lyse thrombi by catalyzing the formation of plasmin which binds fibrin
Moderate opioid agonists
Codeine, hydrocodone, and oxycodone
Monitoring parameter to obtain before initiation of STATINS
LFT’s
MOPP regimen used in Hodgkin’s disease (HD)
Mechlorethamine+ oncovorin (vincristine)+ procarbazine, and prednisone
Most common SE of fibrates
Nausea
Most common side effect of 1st generation antihistamines
Sedation, anticholinergic
Most commonly abused in health care professionals
Heroin, morphine, oxycodone, meperidine and fentanyl
Most dangerous of the currently popular hallucinogenic drugs, OD leads to nystagmus, marked hypertension, and seizures, presence of both horizontal and vertical nystagmus is pathognomonic
PCP
Most frequent route of metabolism
Hepatic enzymes
Most important potential SE of metformin
Lactic acidosis
Most important toxic effects of most local anesthetics
CNS toxicity
Most inhaled anesthetics SE
Decrease arterial blood pressure
Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression
Monamine oxidase inhibitors
Muscarinic antagonist used in COPD
Ipratropium, tiotropium
Muscarinic that is very lipid soluble and used in glaucoma
Pilocarpine
Muscarinic used to treat dry mouth in Sjogren’s syndrome
Pilocarpine or Cevimeline
Name 3 Phase II conjugation reactions
Glucuronidation, acetylation, glutathione conjugation, glycine conjugation, sulfation, methylation, water conjugation
Neurologic SE of benzodiazepines
Anterograde amnesia
Neurotoxicity with isoniazid (INH) prevented by
Administration of Vit. B6 (pyridoxine)
Neurotransmitters affected by the action of antidepressants
Norepinephrine and serotonin
Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma
Reduce aqueous synthesis
Newer atypical antipsychotic used for bipolar disorder, known to cause weight gain, and adversely affect diabetes
Olanzapine
Newer atypical antipsychotics that also improve some of the negative symptoms and help acute agitation
Olanzapine and aripiprazole
Newer NSAIDs that selectively inhibit COX-2
Celecoxib
Nitrate free intervals are needed due to
Tolerance
Nitrate used for acute anginal attacks
Nitroglycerin sublingual tablets
Nitrate used to prevent further attacks
Oral and transdermal forms of nitroglycerin
Nitroprusside vasodilates
Arteries and veins
Nitrosoureas with high lipophilicity, used for brain tumors
Carmustine (BCNU) and lomustine (CCNU)
Non ergot agents used as first-line therapy in the initial management of Parkinson’s
Pramipexole and ropinirole
