Pharma Katzung Flashcards
Monoclonal ab that inhibits binding of plt glycoprotein IIb/IIIa to fibrinogen; prevent clotting after coronary angioplasty and in ACS
Abiciximab (also Eptifibatide and Tirofiban)
Antipyretic analgesic with no anti inflamm effect. With less GI distress than aspirin but dangerous in overdose (Hepatic necrosis)
Acetaminophen
Antidote for toxicity: acetylcysteine
Carbonic anhydrase inhibitor diuretic acting in the PCT. produces a NaHCO3 diuresis resulting in bicarb depletion and metabolic acidosis. Self limited diuretic but persistent bicarb depleting actions. Used in glaucoma and mountain sickness
Acetazolamide
Toxicity: paresthesia, hepatic enceph
Antiviral requiring activation by thymidine kinase. Inhibits dna synthesis in HSV and VZV. Toxicity: behavioral effects and nephrotoxicity (crystalluria), minimal myelosuppression
Acyclovir
Miscellaneous anti arrhythmic used parenterally. Hyperpolarizes AV node, blocks conduction for 10-15 s. Used for nodal re entry arrhythmias
Adenosine
Toxicity: hypotension, flushing, chest pain
Rapid acting beta 2 agonist, impt in acute asthma.
Toxicity: tachycardia, arrhythmia, tremor
Albuterol
Others with similar action: metaproterenol, terbutaline
Bisphosphonate; chronic tx with low doses increases bone mineral density and reduces fractures. Higher dose lowers serum calsium. Used in osteoporosis and hypercalcemia in pagets and malignancies
Alendronate
Toxicity: esophageal irritation at low doses; renal dysfunction and osteonecrosis of the jaw in high doses
Irreversible inhibitor of xanthine oxidase, reduce prodn of uric acid. Used in gout and as adjunct in chemotherapy.
Inhibits metabolism of purine analogs (mercaptopurine, azathiopurine)
Allopurinol
- febuxostat is similar
Human recombinant tissue plasminogen activator used to recanalize occluded bld vessels in acute M.I, severe pulmo embolism, and stroke.
Alteplase (t-PA)
- streptokinase is a bacterial protein with thrombolytic properties
Potassium sparing diuretic that blocks epithelial Na+ channels in cortical collecting tubule
Amiloride
Broad spectrum anti arrhythmic that blocks sodium, potassium, calcium channels, and beta receptors. High efficacy and very long half life. Toxicity: deposits in tissues, skin discoloration, thyroid dysfcn, pulmo fibrosis, optic neuritis
Amiodarone
Indirect acting sympathomimetic, displaces stored catecholamines jn nerve endings. Marked CNS stimulation, high abuse liability. Used in ADHD, short term wt loss and narcolepsy
Amphetamine
Tox: psychosis, htn, mi, seizures
Other indir acting: ephedrine, methylphenidate, tyramine
Commonly drug of choice for systemic mycoses. Binds to ergosterol to disrupt fungal cell memb permeability.
Toxicity: chills, fever, hypotension, nephrotoxicity (dose limiting)
Amphotericin B
Activity similar to Pen G plus E. Coli, H. Influenzae, P. Mirabilis, Shigella. Synergy eith aminoglycosides vs enterococcus and listeria. More adverse effects in GIT than other penicillins; maculopapular rash
Ampicillin
Aromatase inhibitor (enzyme converts testosterone to estradiol). Used in estrogen dep breast Ca
Anastrozole
Beta 1 selective blocker: low lipid solubility, less CNS effect. Used for HTN, angina.
Toxicity: asthma, bradycardia, av block, heart failure
Atenolol
*generic names of beta 1 sel A through M except Carteolol, Carvedilol, and Labetalol
Muscarinic cholinoceptor blocker prototype, lipid soluble, with CNS effects. Antidote for cholinesterase poisoning.
Toxicity: red as a beet, dry as a bone, blind as a bat, mad as a hatter, urinary retention, mydriasis
Atropine
Antimuscarinics for ophthalmology that cause cycloplegia and mydriasis
Cyclopentolate, Tropicamide
Antimuscarinic eith decreased CNS effects
Glycopyrrolate
Macrolide similar to erythromycin but greater activity against H. Influenzae, chlamydia, and strep.
Tox: GI distress, no inhibition of drug metabolism
Azithromycin
- clarithromycin: similar with shorter half life and inh drug metab
GABA analog orally active. Actuvates GABA B receptors in spinal cord; spasmolytic
Baclofen
Centrally acting antimuscarinic prototype for parkinsonism
Benztropine
Prototype dopamine agonist in CNS, inhibits prolactin release. Used in hyperprolactinemia and rarely as alternative in parkinsonism
Tox: various cns disturbances, dyskinesia, hypotension
Bromocriptine
Long acting amide local anesthetic prototype. Greater cardiovascular toxicity than most local anesth
Bupivacaine
Long acting partial agonist of mu receptor, effective for detoxification and maintenance in opioid dependence
Buprenorphine
Antidepressant and used in smoking cessation. No direct action on CNS amines.
Tox: agitation, anxiety, aggravation of psychosis, and seizures at high doses
Bupropion
Decreases serum calcium and phosphate by decreasing bone resorption. Nasal spray and subcutaneous injection
SE: rhinitis
Calcitonin
ACE-I prototype; used in HTN, DM nephropathy, and heart failure
Captopril
Drug of choice for trigeminal neuralgia and a back up drug in bipolar. Also used for tonic clonic and partial seizures. Blocks sodium channels in neuron membranes.
Carbamazepine
Adrenoceptor blocker, non selective beta blocker and alpha 1 blocker. Used in HTN, and prolongs survival in HF
Carvedilol
Tox: CV depression, asthma
Inhibits beta 1-3 glucan synthesis. Used for disseminated Candida and Aspergillus inf
Tox: Gi, flushing, increases cyclosporine levels
Caspofungin
Broad spectrum, 50s inhibitor. Restricted to back up for bact meningitis, inf due to anaerobes, salmonella
Tox: reversible myelosuppression, aplastic anemia, gray baby syndrome
Chloramphenicol
Blood schizonticide used for tx and prophy in susceptible p falciparum. Binds to heme.
Tox: gi distress and rash at low doses, peripheral neuropathy, auditory and visual impairment, quinidine like cardiotoxicity at high doses
Chloroquine
Antihistamine first gen H1 blocker prototype. Less sedation and ANS blocking action than diphenhydramine
Chlorpheniramine
Phenothiazone antipsychotic prototype, blocks most dopamine receptors in CNS.
Tox: atropine like, EPS, hyperprolactinemia, postural hypotension, sedation, seizures, additive with other depressants
Chlorpromazine
Bile acid binding resin prototype that sequesters bile acids in gut and diverts more cholesterol from the liver to bile acids. Used in hypercholesterolemia
Tx: bloating, constipation, interferes with absorption of some drugs
Cholestyramine
H2 blocker prototype used in acid peotic disease.
Tox: inhibits hepatic drug metab, anti androgen effects
Cimetidine
Tx for hyperparathyroidism. Activates calcium sensing receptor
Tox : nausea, hypocalcemia, adynamic bone
Cinacalcet
2nd gen fluoroquinolone. E. Coli, h. Influenzae, campylobacter, enterobacter, pseudomonas, shigella
Tox: CNS dysfunction, GI distress, superinfection, collagen dysfunction
Inhibits metab of caffeine, theophylline, warfarin
Ciprofloxacin
Platinum containing alkylating anti cancer drug used for solid tumors
Tox: neurotoxic, nephrotoxic
Cisplatin
Lincosamide. Bacteriostatic inh of 50s. Active against gr + cocci, Bacteroides fragilis
Tox: GI distress, pseudomembranous colitis
Clindamycin
Selective estrogen receptor modulator used in infertility to induce ovulation by blocking pituitary estrogen receptirs
Clomiphene
Alpha 2 agonist acting centrally to reduce SANS outflow. Used in HTN and in drug dependency
Tox: mild sedation in normal doses, rebound HTN
Clonidine
Prodrug, active metabolite irrev inhibits plt ADP receptors and plt aggregation. Used in TIA, prevent strokes and restenosis after coronary stent placement
Tox: bleeding, neutropenia
Clopidogrel
*ticlopidine: similar, but higher risk of neutropenia and TTP
Microtubule assembly inhibitor. Reduces macrophage mobility and phagocytosis. Used in chronic gout
Tox: GI (often severe), hepatic, renal damage
Colchicine
Immunosuppresant: immunophilin ligand; inhibits T cell synthesis of cytokines
Tox: neohrotoxicity, htn, peripheral neuropathy, seizures
Cyclosporine
Oral direct thrombin inhibitor. No monitoring but can be msred with aPTT. Fixed dosing
Dabigatran
Muscle relaxant, blocks calcium release from SR of skeletal ms. Used in ms spasm (cerebral palsy, multiple sclerosis, cord injury) and in emergency tx of malignant hyperthermia
Dantrolene
RANK ligand inhibitor used for osteoporosis. Prevents stimulation of osteoclast differentiation and function. Given SC every 6 mos.
SE: increased risk of infection
Denosumab
Vasopressin analog, more selective for V2. Used for pituitary diabetes inspidus and mild hemophilia A and von willebrand disease
Desmopressin
*Vasopressin- agonist for V1-2, D.I and bleeding esophageal varices
Binds to Bz in GABA A receptor chloride ch and increases frequency of opening
Uses: anxiety states, ethanol detox, muscle spasticity, status epilepticus
Diazepam
Cardiac glycoside prototype, inhibits sodium K ATpase. Positive inotropic drug for HF.
Tox: calcium overload arrhythmias, GI upset
Digoxin
NT and agonist at dopamine receptors. Low dose in shock to inc renal blood flow, moderate dose to inc cardiac output
Dopamine
Anthracycline, intercalates between base pairs, inhibits topoisomerases, and forms cytotoxic free radicals
Tox: cardiomyopathy, myelosuppression
Doxorubicin
- antidote for cardiomyopathy: Dexrazoxane
More effective than other tetracyclines against chlamydia amd in lyme disease, malaria prophylaxis. Elim mainly in feces
Doxycycline
Nonnucleoside reverse transcriptase inhibitor used in combination regimens of HIV
Tox: rash, CNS effects, avoid in pregnancy
Efavirenz
HIV fusion inhibitor used in combination regimens
Tox: injection site rxns, rare hypersensitivity
Enfuvirtide
LMW heparin parenteraaly for anticoag. Primary effect on factor Xa, less on thrombin. aPTT unreliable
Enoxaparin
COMT inhibitor enhances levodopa access to CNS neurons. Adjunct in parkinson’s disease
Entacapone
Prolonged vasoconstriction and uterine contraction. Used in migraine and obstetrics
Tox: vasospasm
Ergot alkaloids: ergonovine, ergotamine
Bacteriostatic inhibitor 50s. Gram pos cocci and bacilli, Mycoplasma pneumoniae, legionella, chlamydia
Tox: cholestatic jaundice (avoid estolate in preg), inhibits liver drug metab enzymes. Interacts with cisapride, theophylline, warfarin
Erythromycin
Inhibitor of arabinogalactan synthesis
Tox: dose dependent ocular dysfunction, dizziness, headache, hyperuricemia
Ethanbutol
Used in absence seizures. Block T type calcium channels in thalamic neurons
Tox: GI distress; safe in preg!
Ethosuximide
Inhibits Gi transporter of dietary cholesterol and cholesterol secreted in bile. For hypercholesterolemia in combi with statin
Tox: poss inc risk hepatic damage with statin
Ezetimibe
Steroid inhibitor of 5alpha reductase that inhibits synthesis of dihydrotestosterone. Used in BpH and male pattern baldness
Finasteride
Group 1C antiarrhythmic. Used in Vtach and rapid atrial arrhythmias with Wolff Parkinson White syndrome
Tox: arrhythmogenic, cns excitation
Flecainide
Imidazole, inhibits ergosterol synthesis. CNS entry and renal elim
Uses: esophageal and vaginal candidiasis, coccidiodomycosis, prophy and tx of fungal meningitis
Less severe side effects than ketoconazole
Fluconazole
High mineralocorticoid and moderate glucocorticoid activity, long duration of action. Used in Addison’s disease
Fludrocortisone
Used to reverse CNS depressant effects of benzodiazepines, zolpiden, eszopiclone, and zaleplon. Benzodiazepine receptor antagonist
Flumazenil
Cell cycle specific pyrimidine antimetabolite that irrev inhibits thymidylate synthase, dTMP deficiency. “thymine less death”. Mainly used for solid tumors
Tox: Gi distress, myelosupression, neurotox
Fluorouracil
SSRI prototype, less ANS adverse effects and cardiotoxic potential than tricyclics
Tox: CNS stim, sexual dysfunction, seizures in overdose, serotonin syndrome
Fluoxetine
Prototype androgen receptor antagonist used in prostatic cacinoma
Flutamide
Structural analog of GABA that facilitates its inhibitory actions. For partial seizures, neuropathic pain, bipolar disorder
Tox: sedation, movement disorder
Gabapentin
Antiviral against CMV and HSV. For CMV requires bioactivation via viral phosphotransferase
Tox: myelosup, nephrotox, neurotox
Ganciclovir
Fibrate prototype for hypertriglyceridemia. Lowers VlDL and TG and increases HDL by actuvating peroxisome prolif activated rceptor alpha nuclear receptors
Tox: inc myopathy combined with statins or niacin, Gi, cholelithiasis
Gemfibrozil
Second gen, potent sulfonylurea secretagogue. Blocks potassium channels in lancreatic beta cells
Tox: hypogly, weight gain
Glipizide
Prototype carbapenem active against many aerobic and anaerobic bacteria including penicillinase producing org. Used with cilastatin
Imipenem
HIV protease inhibitor component of combination regimens in AIDS.
Tox: anemia, nephrolithiasis, metabolic disorder, inhibits p450
Indinavir
Tx of Hepa B and C viral infections and some malignancies
Tox: flu like, myelosupression, neurotox
Interferon alpha
Sole agent in tx of latent Tb inf. Metabolic clearance via N acetyltransferase (genetic var).
Tox: age dependent hepatotoxicity, periph neuropathy (reversed by pyridoxine), hemolysis in g6pd def
Isoniazid
Beta 1 and 2 agonist, bronchodilator, cardiac stimulant. Always causes tachycardia because both direct and reflex inc Hr
Tox: tremor, arrhythmias, angina
Isoproterenol
DOC onchocerciasis and threadworm inf. Intensifies GABA mediated neurotransmission
Ivermectin
Azole prototype active systemically. Used for candida, dermatophytosis, and non life threatening systemic mycoses. Sometimes used to suppress adrenocorticoid or gonadal hormone synthesis
Tox: hepatic dysfunction, inhibits steroid synth, p450 dep drug metab
Ketoconazole
Only NSAID in parenteral, as systemic analgesic
Ketorolac
Least toxic nucleoside reverse transcriptase inhibitor. Use in chronic Hepa B in addition to HIV infection
Lamivudine
For absence and partial seizures, also used in bipolar affective
Tox: rash possibly life threatening esp pedia
Lamotrigine
PGF2 alpha analog used topically in glaucoma
Latanoprost
- also Bimatoprost and Travoprost
Recombinant antithrombotic that directly inhibits thrombin. Parenteral, rapid onset.
Used in heparin induced thrombocytopenia
Tox: bleeding, monitor with aPTT
Lepirudin
*Dabigatran oral thrombin inhibitor
Bivalirudin used in PCI
GnRH analog, continuous to suppress gonadotropin and gonadal hormone synthesis, with gonadotropins for induction of ovulation and advanced prostate ca.
Tox: decreased bone density with prolonged use, hot flushes, gynecomastia
Leuprolide
Dopamine precurcor used in parkinsonism usually in combination with carbidopa (periph inhibitor of dopamine metabolism)
Tox: dyskinesias, hypotension, on-off phenomenon, behav changes
Levodopa
Plan B emergency contraceptive
Levonorgestrel
Highly selective use-dependent group 1B anti arrhythmic. Used for nerve block and acute post MI ischemic ventricular arrhythmias. Parenteral only
Tox: CNS excitation
Lidocaine
Primary drug in mania and bipolar affective disorders. Blocks recycling of phosphatidylinositol second messenger system
Tox: tremor, diabetes insipidus, goiter, seizures
Lithium
HMG CoA reductase ihibitor prototype used for hypercholesterolemia. In liver, reduces synthesis of cholesterol and indirectly increases LDL receptor synthesis
Tox: hepatotoxicity, muscle damage, teratogen
Lovastatin
Important drug for common nematode infections. Inhibits microtubule synthesis and glucose uptake in nematodes
Tox: Gi distress, caution in pregnancy
Mebendazole
Used in combination with estrogen for tx of menopausal symptoms and used as long acting injection (Depo-Provera) for contraception
Medroxyprogesterone
Prophy and tx of chloroquine resistant malaria. Unknown MOA.
Tox: GI distress, dizziness, seizures in overdose, arrhythmias
Mefloquine
Synthetic, equivalent to morphine in efficacy but orally bioavailable. Strong agonist at mu receptors, blocks muscarinic receptors, serotonergic activity
Meperidine
Prototype biguanide, inhibits hepatic and renal gluconeogenesis, minimal hypoglycemia or weight gain
Tox: GI distress, lactic acidosis
Metformin
Equivalent to morphine but orally bioavailable with longer half life. Used as analgesic, suppression of withdrawal symptoms, and in maintenance programs
Methadone
Antineoplastic, DMARD, and immunosuppressant. Cell cycle specific, inhibits dihydrofolate reductase. Major dose reduction in renal impairment
Tox: gi distress, myelosuppression, crystalluria
– leucovorin for toxicity
Methotrexate
D2 receptor antagonist used to stimulate upper GI motility in pxs with gastroparesis and as anti emetic
Tox: restlessness, insomnia, agitation, EP effects, elevated prolactin
Metoclopramide
DOC extraluminal amoebiasis and trichomoniasis, also effective against anaerobes inc B. Fragilis and antibiotic induced colitis from C. Difficile
Tox: peripheral neuropathy, GI distress, ethanol intolerance, mutagenic potential
Metronidazole
PGE1 derivative, to prevent GI ulcers caused by NSAIDs. Used with Mifepristone (progestin and glucocorticoid receptor anatagonist) as abortifacient
Misoprostol
Leukotriene receptor blocker esp LTD4 used for prophylaxis in asthma. Once daily dosing. Minimal toxicity
Monteleukast
Penicillinase resistant penicillin used for suspected or known staph infections. Not effective against MRSA
Nafcillin
Mu receptor antagonist. Used to reverse CNS depressant effects of opioid analgesics
Naloxone
*Naltrexone - related; used in ethanol dependency
Vitamin that inhibits VLDL synthesis and release of fatty acids from adipose. Lowers LDL snd triglycerides and raises HDl
Tox: flushing, pruritus, liver dysfunction, knc risk myopathy when combined with statins
Niacin
Used as pulmonary dilator in neonatal hypoxia, pulmonary HTN
Nitric oxide
Standard of therapy in angina (atherosclerotic and variant). Releases No in veins, less in arteries
Tox: tachycardia, orthostatic hypotension, headache
Nitroglycerin
High affinity antagonist at 5-HT2A receptor with minimal extrapyramidal side effects. Improves both positive and negative symptoms in schizophrenia
Tox: weight gain, T2DM, hyperlipidemia, inc prolactin
Olanzapine
*Sertindole - QT prolongation; Clozapine- agranulo
5-HT3 receptor blocker prototype. Impt anti emetic for cancer chemo, also post op.
Tox: extrapyramidal effects
Ondansetron
Neuraminidase inhibitor blocking release of mature virions of influenza A and B, decreases infectivity. Prophylactic and shortens duration of flu symptoms
Oseltamivir
Muscarinic cholinoceptor blocker used to relieve bladder spasm and incontinence
Oxybutynin
Plant alkaloid M-phase specific which inhibits mitotic spindle DISASSEMBLY
Tox: hematotoxicity, periph neuro, hypersensitivity
Paclitaxel
Chelator and immunomodulator. Treatment of copper poisoning and Wilson’s disease, formerly used in RA
Penicillamine
Irreversible non selective MAO inhibitor, used as back up drug for atypical depression.
Tox: malignant htn with indirect acting sympathomimetics and tyramine, serotonin syndrome
Phenelzine
Irreversible alpha blocker used in pheochromocytoma
Tox: excess hypotension, GI distress
Phenoxybenzamine
Long acting barbiturate used as sedative and for tonic clonic seizures. Partial renal clearance increased by urine alkalization. Chronic use leads to induction of liver drug metabolizing enzymes and ALA synthase.
Tox: psychological and physiological dependence
Phenobarbital
Blocks sodium channels in neuronal membranes. Used for tonic clonic and partial seizures
Tox: sedation, diplopia, hirsutism, gingival hyperplasia, fetal hydantoin syndrome
Phenytoin
Muscarinic receptor partial agonist that may cause paradoxic HTN. Used in Sjogrens syndrome, xerostomia, glaucoma
Pilocarpine
Acetylcholinesterase regenerator, with atropine antidote for organophosphate poisoning. Chemical antagonist with very high affinity for phosphorus
Tox: neuromuscular weakness
Pralidoxime
Dopamine D3 receptor agonist in CNS, often first line in parkinsonism
Tox: postural hypotension, dyskinesia (less than Bromocriptine)
Pramipexole
Important drug for trematodes and cestode infections. Inc membrane permeability to calcium
Tox: potential abortifacient, headache, dizziness, GI distress, fever
Praziquantel
Alpha 1 selective blocker prototype used in HTN and BPH
Tox: first dose hypotension but less reflex tachycardia than nonselective
Prazosin
Uricosuric, inhibitor of renal weak acid secretion and reabsorption in PCT. accelerates clearance of uric acid qnd prolongs half life of some antimicrobials
Used in gout due to underexcretion
Probenecid
Group 1A anti arrhythmic prototype, metabolized by N-acetyltransferase.
Tox: lupus like syndrome and torsades de pointes, similar to quinidine but more cardiodepressant
Procainamide
Non selective beta blocker. Local anesthetic action, no partial aginist effect. Used in HTN, angina, arrhythmias, migraine, hyperthyroidism, tremor
Tox: asthma, AV block, HF
Propranolol
PGI2, vasodilator and inhibitor of plt aggregation.
Prostacyclin
*Epoprostenol - analog, used in primary pulmonary HTN
Anti folate antiprotozoal and is synergistic with sulfadiazine against Toxoplasma gondii. Folinic acid is needed to offset hema toxicity
Pyrimethamine
Blood schizonticide, interferes with nucleic acid metabolism in plasmodium
Tox: cinchonism, GI upset
Quinine
Agonist at brain melatonin receptors
Tox: fatigue, inc prolactin, dec testosteron
Ramelteon
Inhibitor of DNA dependent RNA polymerase used in drug regimens for Tb and meningococcal carrier state
Tox: hepatic dysfunction, flu like syndrome with intermittent dosing
Rifampin
HIV protease inhibitor used at low dose as part of combination regimen in AIDS to inhibit metabolism of other drugs
Ritonavir
Stimulator of PPAR gamma and enhances target tissue sensitivity to insulin. Less hypoglycemia and weight gain than secretagogues
Tox: fluid retention, heart failure, fractures in women
Rosiglitazone
Oral factor X inhibitor for prevention of DVT, pulmonary embolism, post surgery, and stroke in A fib. Fixed dose, no routine monitoring
Rivaroxaban
MAO B inhibitor used in parkinson’s disease
Tox: gi distress, cns stimulation, dyskinesia, serotonin syndrome
Selegiline
Phosphodiesterase 5 inhibitor, preventing breakdown of cGMP, promoting vasodilation and smooth ms relaxation. Used for erectile dysfunction and pulmonary HTN
Tox: severe hypotension (with nitrates), impaired blue-green color vision
Sildenafil
Group 3 antiarrhythmic prototype, blocks Ik channels and beta receptors. Used for atrial and ventricular arrhythmias
Tox: torsades de pointes
Sotalol
Aldosterone receptor antagonist more selective, used kn HtN and heart failure
Eplerenone
- Spironilactone has androgen receptor blocking actions
Quinupristin+Dalfopristin, IV use for drug resistant gr pos cocci inc MRSA and VRE
Tox: infusion related pain, arthralgia, myalgia
Streptogramins
*linezolid- also inhibits protein synthesis for drug res gr positive including PRSP
Depolarizing neuromuscular relaxant implicated in malignant hyperthermia
Succinylcholine
- no antidote
5-ASA anti-inflamm drug used for IBDand RA
tox: gi disturbance, leukopenia
Sulfasalazine
Blocks estrogen receptors in breast tissue, activates endometrial receptors. Used in ER positive cancers, possibly prophylactic in high risk patients
Tamoxifen
Fungicidal inhibitor of squalene epoxidase. Most effective agent in onychomycosis
Terbinafine
Reclmbinant PTH for parenteral tx of osteoporosis. Increases bone formation and bone resorption. 1st 6 months with net gain in bone. Only approved for 2 yrs of use due to osteosarcoma risk
SE: hypercalcemia, hypercalciuria
Teriparatide
Non depolarizing neuromuscular blocking agent. Competitive nicotinic blocker.
Tox: respiratory paralysis, hypotension (histamine release) –> rarely used
Antidote: Cholinesterase inhibitor ex. Neostigmine
Tubocurarine
Indirect acting sympathomimetic prototype. Releases or displaces NE from stores in nerve endings. Presence in food can cause potentially lethal hypertensive responses in px taking MAO-inhibitors
Tyramine
Primary drug in absence, clonic tonic, and myoclonic seizure states. Also commonly used for bipolar disorder
Tox: GI distress, hepatic necrosis rarely, spina bifida, inhibits drug metab
Valproic acid
DOC for MRSA and effective in antibiotic induced colitis. Dose reduction required in renal impairment (or hemodialysis)
Tox: ototoxicity, hypersensitivity, renal dysfunction rarely
Vancomycin
M phase specific plant alkaloid. Inhibits mitotic spindle formation
Tox: peripheral neuropathy
Vincristine
*Vinblastine- causes myelosuppression
Oral anticoag prototype. Causes synthesis of nonfunctional versions of vit k dependent clotting factors. Measure with PT expressed as INR
Tox: bleeding, teratogenic
Antidote: vit k, FFP
Warfarin
Prototype NRTI used in combination for HIv infections and in prophylaxis for needlestick and vertical transmission
Tox: severe myelosuppression
Zidovudine
Others: Abacavir, Didanosine, Lamivudine, Stavudine, Zalcitabine
Non benzodiazepine hypnotic that acts via BZ1 receptor subtype. Reversed by Flumazenil. Has less amnesia and muscle relaxation and lower dependence liability
Zolpidem
