Pharm SEs Flashcards
Cimetidine
- Gynecomastia
- CYP450 inhibition
(inc’d levels of Warfarin, Phenytoin, Propranolol, Metoprolol, Quinidine, & Theophylline)
Metformin
Lactic acidosis
thus contraindicated in renal failure
Atorvastatin
Hepatitis & Myositis
Tricyclic Antidepressants
- Tremor, insomnia (inhibition of presynaptic NE & 5HT reuptake)
- Conduction defects, arrhythmias, hypotension (blockade of cardiac fast sodium channels)
- Hyperthermia, flushing, dilated pupils, intestinal ileus, urinary retention, sinus tachycardia (antagonism of central & peripheral muscarinic ACh receptors)
- Peripheral vasodilation – orthostatic hypotension (antagonism of peripheral α-1 adrenergic receptors)
- Sedation (antagonism of H1-receptors)
Name 4 TCA drugs
Imipramine, Clomipramine, Doxepin, Amitriptyline
Vancomycin
- Red man syndrome
- Nephrotoxicity
Daptomycin
- Myopathy & CPK elevation
- inactivated by pulmonary surfactant
(used for gram-positives, including MRSA)
Linezolid
- Thrombocytopenia
- Optic neuritis
- High risk for serotonin syndrome
Propylthiouracil (PTU)
- Skin rash
- Agranulocytosis
- Aplastic Anemia
- Hepatotoxicity
(thionamide drug)
Methimazole
- Skin rash
- Agranulocytosis
- Aplastic Anemia
- Teratogenic
(thionamide drug)
Sulfonylureas
1st generation = Disulfiram-like reaction
(Tolbutamide, Chlorpropamide)
2nd generation = Hypoglycemia
(Glyburide, Glimepiride, Glipizide)
Glitazones / thiazolidinediones
- Weight gain
- Edema
- Hepatotoxicity
- Heart failure
(Pioglitazone, Rosiglitazone)
α-glucosidase inhibitors
GI disturbances
Acarbose, Miglitol
Pramlitinide
Hypoglycemia, Nausea, Diarrhea
Amylin analog → ↓glucagon
(T1 & T2 diabetes)
GLP-1 analogs
Nausea, Vomiting, Pancreatitis
Exenatide, Liraglutide
(MOA = ↑insulin, ↓glucagon release)
(T2 diabetes)
DPP-4 inhibitors
Mild urinary or respiratory infections
Linagliptin, Saxagliptin, Sitagliptin
(MOA = ↑insulin, ↓glucagon release)
(T2 diabetes)
Demeclocycline
- Nephrogenic DI
- Photosensitivity
- Abnormalities of bone & teeth
Proton-Pump Inhibitors
- Increased risk of C. dificile infection
- Pneumonia
- Hip fractures
- ↓serum Mg(2+) w/ long-term use
Misoprostol
- Diarrhea
- Contraindicated in women of childbearing potential (abortifacient)
(MOA = PGE1-analog, ↑production & secretion of mucous barrier, ↓acid production)
Octreotide
Nausea, cramps, steatorrhea
Antacids
Hypokalemia (all)
Aluminum Hydroxide
- Constipation
- Hypophosphatemia
- Proximal muscle weakness
- Osteodystrophy
- Seizures
(antacid, thus hypokalemia also)
Magnesium Hydroxide
- Diarrhea
- Hyporeflexia
- Hypotension
- Cardiac arrest
(antacid, thus hypokalemia also)
Calcium carbonate
Hypercalcemia & rebound acid ↑
Infliximab
- Infection (reactivation of TB)
- Fever
- Hypotension
Sulfasalazine
- Malaise
- Nausea
- Sulfonamide toxicity
- Reversible oligospermia
Ondansetron
Headache & Constipation
Metoclopramide
↑ Parkinsonian effects
Succinylcholine
- Hypercalcemia
- Hyperkalemia
- Malignant hyperthermia
Dantrolene: MOA & use?
MOA: Prevents release of Ca(2+) from sarcoplasmic reticulum of skeletal muscle
Use:
- Malignant hyperthermia, a rare but life-threatening side effect of inhalation anesthetics (except N2O) & Succinylcholine
- Neuroleptic malignant syndrome (toxicity of antipsychotic drugs)
Sumatriptan: MOA & use?
MOAs: 5-HT(1B/1D) agonist, inhibits trigeminal nerve activation, prevents vasoactive peptide release, induces vasoconstriction
Use: Acute migraine & Cluster headaches
Toxicity = Coronary vasospasm (contraindicated in Prinzmetal’s angina)
Topiramate
Sedation, weight loss, & kidney stones
“toe-primate” picmonic
(↑GABA, blocks voltage-gated Na-channels)
Gabapentin
Sedation, Ataxia
Lamotrigine
Stevens-Johnson Syndrome
Valproic Acid
- GI distress
- Hepatotoxicity (rare but fatal; measure LFTs)
- Neural tube defects in fetus (spina bifida –c/i in pregnancy)
- Tremor
- Weight gain
(“vault pro lemon” picmonic)
Tramadol
- Similar to other opioids (it is a weak opioid agonist & NE/5HT-reuptake inhibitor)
- decreases seizure threshold
(“trauma doll” picmonic, treats chronic pain)
Indications for Zanamivir?
Influenza A & B
NA & viral release inhibitor
Indications for Oseltamivir?
Influenza A & B
NA & viral release inhibitor
Indications for Ribavirin?
RSV (viral bronchiolitis) & Hepatitis C
nucleoside analog – inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase
Indications for Interferon-α?
Hepatits B & C & Kaposi’s Sarcoma
Indications for Amantadine?
Influenza A
impairs uncoating of virion after host cell endocytosis
Indications for Famciclovir?
Herpez Zoster
Indications for Acyclovir?
HSV & VZV (weak activity against EBV, NO activity against CMV)
(Guanosine analog, preferentially inhibits viral DNA polymerase by chain termination. Monophosphorylated by HSV/VZV thymidine kinase)
Indications for Ganciclovir?
CMV, especially in immunocompromised pts
- Guanosine analog
- 5’-monophosphate formed by CMV viral kinase
- Triphosphate formed by cellular kinases
- Preferentially inhibits viral DNA polymerase
Indications for Foscarnet?
- CMV retinitis in immunocompromised patients that fail Ganciclovir therapy
- Acyclovir-resistant HSV
(viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme. Does NOT REQUIRE activation by viral kinase)
**essentially it’s a “pyroFOSphate” analog
MOA of drugs, “____navir”
Protease inhibitors
HIV-1 protease = pol gene
“navir tease a protease”
MOA of drugs, “____clovir”
Nucleosides (require both viral and host-cell kinase for activation)
MOA of drugs, “____fovir”
Nucleotides (only require host-cell kinase for activation)
