Pharmaceuticals (Core Only) Flashcards
Atorvastatin
Class: Statin
I: high cholesterol/lipids and atherosclerosis
A: HMG CoA reductaste inhibitor
Major SE: inhibits CoQ10 formation = myalgias (depletes CoQ10)
CI: li/ki dz, alcohol, PREG X
Intx: increased effects with CYP3A4 inhibitors, decreased effects with CYP3A4 inducers, and increased toxicity with gemfibrozil and niacin, potentiates warfarin and digoxin
Gembibrozil
Class: Fibrates
I: high TGs, CAD risk
A: activate lipoprotein lipase A = decrease TGs
Major SE: gallstones, pancreatitis, myalgias
CI: li/ki dz, cholelithiasis and GB issues
Intx: avoid using with statin b/c rhabdomyolysis can occur, inhibits CYP2C8 enzyme, DEPLETES VITAMIN E
Nitroglycerin
Class: Nitrates
A: releases NO = SM relaxes
I: angina, heart spams, CHF
Major SE: syncope, hypOtension, reactive tachycardia — OD CAN BE LETHAL
CI: severe anemia, glaucome, head injury, increased intracranial pressure, hypertrophic cardiomyopathy
Intx: vasodilators and anti-HTN agents, heparin, alcohol
Digoxin
Class: Cardiac Glycoside
A: inhibits Na/K ATPase = increases contraction and decreases HR = more efficient beat
I: CHF, A.fib/flutter
Major SE: arrhythmias, yellow-green halos around objects —–OD CAN BE LETHAL (antidote: potassium and digoxin antibodies)
CI: low potassium and magnesium, high or low calcium, heart issues and kidney failure
Intx: MANY SERIOUS INTX - depleted magnesium
MP: serum digoxin levels, electrolytes, renal function, and EKG — must adjust dosage to reflect metabolism
Atropine
Class: anticholingeric
A: increases AV/SA node activity
I: bradycardia and heart blocks (mobitz type 1 - second and third degree)
Major SE: anticholingergic effects - urinary retention, confusion, hallucination, tachy, v.fib
CI: NA-glaucome, ischemic heart blocks
Intx: synergy with other anticholingerics and counteracts effects of beta-blockers
Amiodarone
Class: Class III Antiarrthymic: NOT FIRST LINE BECAUSE POTENTIAL FATAL TOXICITY
A: sodium channel blocker
I: serious ventricular arrhythmias and afib cardioversion
Major SE: hypotension, bradycardia, QT PROLONGATION, blue skin, tremor, muscle weakness
CI: serious heart dysfunction or 3rd degree heart block, cardiogenic shock, IODINE allergy
Intx: synergy with other anticholingergics and agents that cause QT prolongation
ACEi (lisinopril)
A: supresses AngII = vasoconstricts = interfers with aldosterone production
I: HTN, edema, CHF
Major SE: COUGH, angioedema, and high potassium
CI: previous angioedema, Renal artery stenosis, high potassium
Intx: capsaicin worsens cough, NSAIDs (decreases effects), increases digoxin and lithium
ARB (volsartan)
A: blocks angiotensin II from competing with angiotensin II receptors = vasodilates
I: HTN, HF - patients that cant tolerate ACEi cough
SE: high ass potassium
CI: renal artery stenosis, high ass potassium
Intx: decrease Vitamin D, decreases NSAID effects
Beta Blockers (atenolol, propranolol)
A: blocks beta adrenergic stimulation
I: HTN, angina, essential tremor, HA prevention
Major SE: bradycardia, hypotension, vivid dreams
CI: abrupt withdrawal, Raynauds, any severe heart/GI/lung issues basically
Intx: increased bradycardia and hypotenson with CCB, digoxin and amiodarone
- depleted CoQ10
Calcium Channel Blockers (amlodipine)
A: decreases calcium = vasodilation and can increase HR via reflux
I: HTN, angina
SE: edema, bradycardia, constipation
CI: serious heart issues and hypotension, acute MI
Intx: synergy with BB, grapefruit and many others
Clonidine
C: sedative and anti-hypertension
A: alpha adrenergic agonist (central) = peripheral vasodilation
I: HTN (2-3rd line), PHEOCHROMOCYTOMA (1st line), ADHD, smoking
SE: hypotension, syncope
CI: CHF and heart blocks, R/O prostate cancer if symptoms of BPH
Intx: other hypotensives and depleted COQ10
Furosemide
C: Loop Diuretic
A: inhibits Na and Cl reabsorption in proximal and distal tubules and loop of Henle = WASTES POTASSIUM, MAGNESIUM AND ZINC
I: HTN, edema
SE: low potassium, magnesium, hyperglycemia and uricema and lipidemia, OTOTOXIC
CI: anuria, severe electrolyte imbalance, sulfa intolerance
Intx: synergy with ototoxic drugs, synergy with thiazide diuretics
Hydrochlorothiazide (HCTZ)
C: Thiazide diuretic
A: acts in distal tubules and ascending loop = increase NaCl excretion
**WASTES POTASSIUM, SODIUM, MAGNESIUM, ZINC
I: HTN, edema, OP, DI
SE: low potassium/Mg/Na, high uric acid/Ca/glucose
CI: anuria, electrolyte imbalance, sulfa allergy
Intx: hypoglycemics, anticholinergics, digoxin, lithium
Spironolactone
C: Diuretic (“water pill”)
A: aldosterone receptor antagonist in distal renal tubule = increased NaCl and H20 excretion
***Potassium-sparing
I: HTN, low Potassium, edema
SE: high ass potassium, gynecomastia, mental confusion, GI bleed
CI: renal issues, anuria, high potassium
Intx: ACEI, ARB, sulf-tri, other potassium sparing diuretics, K+ supplements
Benzoyl Peroxide
C: TOPICAL antiseptic
A: keratolytic and antibacterial
I: acne vulgaria
SE: contact derm, xerodermia, hypersensitivity rxn
CI: hypersensitivity to drug
Intx: AVOID with topical hydroquinone and trentinoin
Isotretinoin
C: Vitamin A derivative
A: decreases sebum production from sebaceous glands
I: rosacea and severe nodular acne (no other tx worked)
SE: mucocutaneous dryness, high LFT
CI: MUST USE BIRTH CONTROL WHILE TAKING
Intx: alcohol
**DEPLETES ACETYL-L-CARNITINE AND L-CARNITINE
Clindamycin
C: Antibiotic
A: bacteriostatic protein synthesis inhibitor
Topical I: acne, rosacea, BV
Oral I: osteomyelitis, OM, PID, Sinusitis, strep
SE: diarrhea and PSEUDOMEMBRANEOUS COLITIS, C.DIFF INFECTIONS
CI: caution in previous colitis or UC
Intx: decreases OCPs, lactobacillus and bifidobacteria
Calcipotriol/Calcipotriene
C: Vitamin
A: binds Vitamin D receptors = cell differentiation = inhibits cell proliferation
I: plaque psoriasis
SE: high calcium
CI: high calcium and vitamin D
Intx: other forms of vitamin D
Selenium Sulfide
C: Antifungal
A: reduces epidermal and follicular corneocyte production = antifungal
I: Seborrheic dermatitis, tinea capitis/versicolor
SE: alopecia
CI: Hypersensitivity to drug
Triamcinolone
C: corticosteroid
A: long action to decrease inflammation and suppresses immune system activity
I: inflammatory and allergic dx
SE: topical - telangiectasia and atrophy/skin thinning, HPA axis suppression
CI: fungal, viral, bacterial mouth/throat infx
Latanoprost
C: prostaglandin F2 analog
A: decreases IOP by increasing fluid outflow
I: primary open angel glaucoma
SE: conjunctival hyperemia, changes to iris pigmentation, thick darkened eyelashes
CI: uveitis, macular edema, HSV keratitis
Intx: other prostaglandin analogs
Triple antibiotic therapy
C: Antibiotic
A: bacitractin + neomycin + polymyxin B
I: ophthalmic infections in cornea and conjunctiva
SE: conjunctival/cutaneous sensitivity, ocular toxicity
CI: deep seated ocular infx
Pseudoephedrine (oral), Oxymetazoline (topical)
C: Decongestants
A: sympathomimetic - blood vessel constriction
I: allergic rhinitis and nasal congestion for any issue
SE: HTN, tachycardia, rebound congestion if use over 7 days, CNS over stimulation sx
CI: severe HTN, CAD, kids younger than 6
Intx: other sympathomimetics and agents that increase effects of sympathomimetics
Diphenhydramine (Benadryll)
C: Antihistamine
A: central H1 receptor antagonist - CROSSES BBB and anticholinergic
I: allergic rhinitis (not helpful for congestion), insomnia, motion sickness
SE: drowsiness, anticholingergic effects
CI: BPH, GI/GU obstruction, glaucoma *AVOID DRIVING
Intx: synergy with other anticholingergics, MAO and CNS depressants
Hydroxyzine
C: Antihistamine
A: central H1 antagonist that crosses BBB
I: allergic rhinitis (not helpful for congestion), insomnia, motion sickness
SE: drowsiness, anticholingergic effects
CI: BPH, GI/GU obstruction, glaucoma *AVOID DRIVING
Intx: synergy with other anticholingergics, MAO and CNS depressants
Loratidine (Claritin)
C: Antihistamine
A: central H1 antagonist that crosses BBB
I: allergic rhinitis/conjunctivitis (not helpful for congestion), allergic skin conditions, seasonal allergies
SE: headache
CI: other QT prolongation drugs, macrolides, synergy with anticholinergics and CNS depressants
Epinephrine (adrenalin)
C: sympathomimetics
A: sympathetic adrenergic agonist (alpha and beta)
I: anaphylaxis, asthma attack, cardiac arrest
SE: tachycardic arrythmias, v fib, HTN, angina
CI: arrthymias, atherosclerosis of coronary artery, DM, hyperthyroidism, epilepsy, glaucoma
Intx: tamsulosin, antihypertensives, MAOs, synergy with other sympathomimetics
KNOW that there is two different epi solutions
1 mg/mL = 1:1000 solution AND 0.1 mg/mL = 1:10,000 solution
Bromocriptine
C: Dopamine receptor agonist
A: inhibits glutamate GLT1 transporter
I: PD, DM2, restless leg syndrome. high prolactin levels
SE: Raynauds syndrome, cardiac valve and pulmonary fibrosis, impulse control disorders
*hallucinations, orthostatic hypOtension
USP Thyroid
C: hormone replacement
A: replaces thyroid gland secretions - T3, T4, DIT, MIT
I: hypOthyroidism and post-thyroidectomy
SE: palpitations, tremor
CI: acute MI, thyrotoxicosis without hypothyroidism
Intx: cholestyramine, Ca, Iron, estrogens and OCPs, anticoagulants, decreases insulin and hypoglycemics
Levothyroxine (T4)
C: Hormone
A: replaces T4 = increases T3
I: hypOthyroidism
SE: palpitations, tremor
CI: acute MI, thyrotoxicosis without hypothyroidism
Intx: cholestyramine, Ca, Iron, estrogens and OCPs, anticoagulants, decreases insulin and hypoglycemics
Liothyronine (T3)
C: Hormone
A: replaces T3
I: hypOthyroidism
CI: acute MI, thyrotoxicosis without hypothyroidism
Intx: cholestyramine, Ca, Iron, estrogens and OCPs, anticoagulants, decreases insulin and hypoglycemics
Propylthiouracil (PTU)
C: TPO inhibitor
A: blocks formation of T4 to T3 in thyroid and blocks 5’ deiodinase and conversion in periphery
I: hypERthyroidism and thyroid stom
SE: FDA WARNING = CAN CAUSE FATAL LIVER INJURY - USE METHIMAZOLE OR OTHER TX
Liraglutide
C: GLP1 analog (long acting)
A: increases glucose -dependent insulin secretion = decreases glucagon secretion = increases B cell growth = slows gastic emptying = decreases food intake
**Decreases HgA1c by 1%
I: DM2, weight management
SE: thyroid c-cell tumor, increase HR and SI
CI: fhx of medullary thyroid carcinoma and endocrine neoplasia syndrome
Intx: MANY, agents that compound nephrotoxicity
Canagliflozin
C: antidiabetic - third line
A: SGLT2 inhibition = increases urinary glucose excretion
I: DM2
SE: increased risk of foot and leg amputation, kidney impairment/failurem high potassium, hypOglycemia and hypOtension
CI: pregnancy, DM1, DM ketoacidosis, kidney issues
Intx: many
Glyburide
C: Antidiabetic
A: insuliin secretagogue = increases peripheral glucose utilization = decreases liver glucose production
I: DM2
SE; hypoglycemia - WORSE OF ALL hypoglycemics
CI: DM1 and hypoglycemia
Intx: disulfiram-like rxn, hypoglycemia with anticoagulants, etc.
Metformin
C: Biguanide - Antidiabetic
**First line
A: improves insulin sensitivity = decreased hepatic production
I: DM2
SE: GI upset - take with food, LACTIC ACIDOSIS - rare but 50% lethal
CI: metabolic acidosis, DM1, renal failure and liver dz
Intx: ethanol
*depletes CoQ10, folic acid, B12
Sitagliptin
C: Antidiabetic
A: inhibits DPP4 = decreases incretin metabolism = increases insulin synthesis/release = decreases glucagon levels
I: DM2
SE: pancreatitis and renal injury
CI: DM1
Intx: many including fluoroquinolones
Thiazolidinediones
C: antidiabetic
A: increases insulin sensisitivity and muscle uptake = decreases glucose production
I: DM2
SE: edema, weight gain, worsening CHF - REMOVED FROM US MARKET D/T DEATHS FROM LIVER FAILURE
Deferoxamine
C: Iron chelating agent
A: Chelates iron but NOT calcium
I: hemochromatosis, thalassemia, high iron levels
SE: neurotoxic long term
CI: pregnancy, kidney dz
*depletes zinc and vitamin C can cause heart issues
Dimercaptopropane sulfonate (DMPS)
C: chelation
A: chelates Hg, Au, arsenc
I: Mercury, Gold and arsenic poisoning
SE: Steven-johnson syndrome
CI: liver insufficiency
Intx: DEPLETES COPPER, SELENIUM, ZINC, MAGNESIUM
EDTA
C: Chelator
A: chelates lead out of bone - also calcium, zinc, Mn, and iron
I: lead poisoning, digoxin arrhythmias
SE: hypocalcemia, kidney damage
Intx: depleted calcium
Penicillamine
C: Immunosuppressant and heavy metal chelator
A: chelates copper, Hg, Zn and lead, decreases IgM RF levels
I: wilsons disease, copper toxicosis, mercury and lead poisoning
SE: aplastic anemia, leukopenia, proteinuria
CI: penicillin allergy, kidney dz
Intx: gold, antmalarials, other immunosuppressants
DEPLETES COPPER, IRON, MAGNESIUM PYRIDOXINE, FERRITIN
DMSA (succimer, Dimercaptosuccinic acid)
C: Chelator
A: chelates Pb, Hg, Cd, Ar and removes in urine
I: lead, mercury, arsenic, cadmium poisoning
SE: transient elevation in liver enzymes
Intx: DEPLETES ZINC, IRON, CALCIUM, MAGNESIUM
Odansetron (Zofran)
C: anti-emetic
SE: prolonged QT intervals
Intx: Many
Prochlorperazine
C: anti-emetic and antipsychotic
A: Dopamine antagonist
I: N/V, psychosis (schizo), anxiety
SE: anticholinergic effects and extrapyramidal symptoms
CI: PD, epilepsy
Intx: MAOis, CNS depressants, anticholinergics
Metoclopramide (Reglan)
C: Anti-emetic
A: DA antagonist, pro-PNS, and improves gastric motility
I: N/V, GERD
SE: extrapyramidal symptoms, diarrhea
CI: pheochromocytoma, PD, epilepsy
Intx: synergy with DA antagonists/sedatives/CNS depressants
Sodium Phosphate
C and A: OSMOTIC laxative
I: colonoscopy, barium enema, surgery prep, atonic constipation
SE: high phosphates
CI: elderly, kidney failure, IBD, hear issues
Intx: ACEi, ARB, diuretics, NSAIDs
***DEPLETES MAGNESIUM AND PHOSPHORUS
Bisacodyl
C: Laxative
A: increased colon motility
I: atonic constipation (short term)
SE: low potassium, long term = can induce atonic constipation and pseudomembraneous constipation
CI: 10+ days, obstruction, appendicitis, IBD, tartrazine allergy
Intx: many drugs and herbs by decreasing TT, potentiates hypokalemia inducing agents
Docusate
C: stool softener - NOT LAXATIVE
A: increases fat and water mixing to soften stool
I: atonic constipation, hemorrhoids, anal fissures
SE: minimal
CI: long-term, obstruction
Bismuth subsalicylate
C: anti-diarrheal
A: modulates inflam and anti-secretory, protects the mucosa
I: PUD with H.pylori, gastroenteritis
SE: black tongue and stool, high calcium, salicylate toxicity
CI: salicylate allergy, younger than 2 yo, viral infx
Intx: tetracycline, NSAIDs
Loperamide (Imodium)
C: Anti-diarrhea
A: Cholinergic muscarinic antagonist (anti-cholinergic)
I: acute diarrhea, IBS-diarrhea
SE: anticholinergic effects (dry mouth, cramping)
CI: acute UC, pseudomembraneous coli
Intx: gemfibrozil, SJW and Valerian (increased toxicity)
Esomeprazole
C: PPI
A: blocks Hcl formation in stomach
I: erositive esophagitis, PUD, GERD
SE: decreases B12 absorption, C. diff and gastric infx - more serious SE with long-term
CI: severe liver dz, stomach cancer
Intx: depleted calcium, magnesium, folic acid, iron, B12
Misoprostol
C: Prostaglandins
A: inhibits gastric acid secretions = increased bicarb and mucus = increased TT and stool
I: gastric ulcers, pregnancy termination, PP hemorrhagic
SE: uterine contractions
CI: PREGNANCY X
Sucralfate
C: Protectants
A: creates a gel barrier = protecting mucosa from injury
I: GERD, PUD, ulcers
SE: constipation, hyperglycemia
CI: renal failure, AD
Intx: interferes with drug absorption
Sulfasalazine
C: Anti-inflam
A: converted into 5-ASA = inhibits COX = antiinflam
I: UC, mild Crohns
SE: GI irritation, HA - high dose = BM suppression, liver/kidney toxicity, pancreatitis
CI: sulfa/salicylate allergy, obstruction, kids under 2 yo , G6PD def
Intx: iron, digoxin
*depletes folic acid
Phentermine
C: anoretic
A: suppresses appetite
I: obesity
SE: palpitations, HTN, heart valve issues, addiction, hyperglycemia
CI: atherosclerosis, CVD, CAD, stroke, CHF, hyperthyroidism
Intx: MAOIs (hypertensive crisis), SSRI, other stimulants
Dicyclomine
C: Anticholinergic
A: GI smooth muscle relaxant
I: IBS with spasms
SE: anticholinergic - esp constipation, blurred vision, dizziness
CI: GI/renal obstruction, GERD, MG
Intx: alcohol and other anticholinergics
Interferon
C: Biologic response modifier
A: anticancer and anti-hepatitis
I: cancer, chronic hep B and C, multiple sclerosis
SE: neutropenia, thrombocytopenia, fever/flu-like sx, SI
CI: renal insufficiency, major depression, alcohol, AI dz
Intx: NSAIDs help reduce flu-like SE, synergistic BM suppression with zidovudine
Mebendazole
C: Anti-helmintics
A: destroys worms
SE: very safe because not systemically absorbed
Intx: metronidazole = necrolysis
Rivastigmine
C: parasympathomimetic
A: increases Acetylcholine in PNS
I: AD, PD
SE: diarrhea, N/V, cholinergic SE, SEIZURES
CI: active GI ulcer/bleed
Intx: other anticholinergics, cholinergics, beta blockers
Donepezil
C: parasympathomimetic
A: increases Acetylcholine in PNS
I: AD
SE: diarrhea, N/V, cholinergic SE, SEIZURES
CI: active GI ulcer/bleed
Intx: CYP3A4 inhibitors and inducers, cholinergics, anticholinergics, beta blockers
Trastuzumab
C: chemotherapy
A: monoclonal antibody
I: Her2 GI and breast cancer
SE: v. dysfunction, cardiomyopathy, CHF
CI: none but cautiously use
Intx: other cardiotoxic and myelosupressive drugs
Anastrozole
C: Aromataste inhibitor
A: presents estrogen production
I: E2+ breast cancer, BPH, prostate cancer (excess testosterone)
SE: hot flashes, vasodilation, HTN, mood changes, OP
CI: caution CVD< angina, MI, OP
Intx: estrogen and testosterone drugs
Norelgestromin/ethinyl estradiol and norgestimate/ethinyl estradiol
C: birth control
A: supresses GSH, LD = inhibits ovulation and makes cervical mucus impenetrable = replaces Progesterone made endogenously
I: BC and acne
SE: stroke, MI, DVT, HTN, emdometriol or liver cancer, cholelithiasis
CI: smoker, pregnancy, CVD, HTN, clotting issues, estrogen-sensitive cancers, major surgery/prolonged immobilization
Intx: warfarin, TCA, CYp3A4 inhibitors/inducers
Conjugated estrogens
C: Homones
A: blocks bone breakdown and replace estrogen to decrease menopausal sx
I: OP, menopause, AUB
SE: stroke, MI, DVT, HTN, emdometriol or liver cancer, cholelithiasis
CI: smoker, pregnancy, CVD, HTN, clotting issues, estrogen-sensitive cancers, major surgery/prolonged immobilization
Intx: warfarin, TCA, CYp3A4 inhibitors/inducers
Natural estrogens
C: Hormones (strongest: E2, weakest: estriol (E3), estrone is 1/3 as strong as estradiol)
A: blocks bone breakdown and replace estrogen to decrease menopausal sx
I: OP, menopause, AUB, vulva atrophy, etc.
SE: stroke, MI, DVT, HTN, emdometriol or liver cancer, cholelithiasis
CI: smoker, pregnancy, CVD, HTN, clotting issues, estrogen sensitive cancers, major surgery/prolonged immobilization
Intx: warfarin, TCA, CYp3A4 inhibitors/inducers
Progesterone
C: Hormone
A: suppresses FSH and LH and replaces progesterone, thickens cervical mucus plug
I: post meno endometrial hyperplasia prevention (given with estrogen), secondary amenorrhea
SE: depression, weight gain
CI: liver dz, breast or uterine cancer, missed abortion, undx vaginal bleeding
Intx: warfarin, TCA, CYp3A4 inhibitors/inducers
NO PREGNANCY CATEGORY - SOMETIMES USED TO PREVENT MISCARRIAGE
Progestins
C: Synthetic hormones
A: suppresses FSH and LH and replaces progesterone, thickens cervical mucus plug
I: (oral) - contraception, emergency contraception, PMS, dysfunctional uterine bleeding, secondary amenorrhea, endometriosis, etc
I: (IUD) - contraception, dysmenorrhea
SE: TOXIC - always try natural progesterone first but fluid retention, breast cancer, spotting for 3 months post IUD implant, ectopic pregnancy, PID, uterine/cervical perforation
CI: liver dz, breast or uterine cancer, missed abortion, undx vaginal bleeding, clotting issues, hx ectopic pregnancy (IUD)
Intx: CYp3A4 inhibitors/inducers
Doxorubicin (Adriamycin)
C: Antibiotic
A: anthracycline antibiotic
I: one of most useful cancer drug
SE: CHF, necrosis of colon, esophagitis
CI: CHF, heart arrhythmias, previous tx with rx, BM supression
Intx: allopurinal, cyclosporine, progesterone
5 - FU
C: pyrimidine antimetabolite
A: interferes with DNA synthesis
I: carcinomas, actinic keratosis, solar keratosis, BCC
SE: stomatitis, leukopenia, GI ulcerations, myelosuppression
CI: poor nutritional status, thrombocytopenia, major surgery
Intx: MT, avoid alcohol
Vinblastine
C: anti-neoplastic
A: inhibits mitosis
I: hodgkins and non-hodgkins lymphoma
SE: raynauds disease
CI: severe BM supression, bacterial infx
Intx: SJW
Paclitaxel
C: antimicrotubule
A: inhibits microtubule formation
I: cancer - lung, ovary, breast, head/neck
SE: anaphylaxis - REQUIRED TO PRETX WITH STEROID/ANTIHISTAMINE
CI: severe neutropenia
Intx: cyp3a4 inducer/inhibitors
Clopidogrel
C: antiplatelet
A: prevents fibrinogen = decreased platelet adhesion and aggregation
I: stroky things and atherosclerosis
SE: diarrhea, rash, hemorrhage, bleeding
CI: allergy, coag dz
Intx: cyclosporine, diltiazem, NSAIS, anticoagulants
Warfarin
C; Vitamin K analog
A: anticoagulation - inhibits formation and activity of vitamin K - dependent clotting factors - prothrombin, 7, 9, 10
I: DVT, hypercoagulation, a.fib, artificial heart valves
SE: hemorrhage, necrosis, OD can be lethal (OD: vitamin K, prothrombin)
CI: hemorrhage, Menorrhagic, leukemia, cancer, GI bleed, severe HTN, etc.
Intx: manyyyy - highly protein bound
*MONITOR PT OR INR REGULARLY
Zidovudine
C: nucleoside analog (HIV)
A: inhibits HIV transcriptase
I: HIV/AIDs, post-exposure prevention
SE: BM suppression - anemia and neutropenia, muscle wasting, myalgia
CI: caution in BM suppression
Intx: accetaminophen, vinblastin, acyclovir
Acyclovir, Valacyclovir
C: nucleoside analog
A: inhibits viral replication
I: HSV
SE: increased liver enzymes
CI: caution in kidney impairment
Intx: synergy with Zidovudine
Cyclosporine
C: Immunosuppresant
A: suppresses immune system
I: prevention of organ rejection in transplants
SE: nephrotoxicity, HTN
CI: RA, psoriasis, malignancy
Intx: MANY
Amoxicillin and Penicillin
C: B-lactams
A: cell wall synthesis inhibition
I: URTI. AOM, sinusitis, CT, OM
SE: GI upset
CI: allergy is common
Intx: tetracyclies, aminoglycosides
Azithromycin, Clarithromycin
C: Macrolide antibiotics
A: inhibits bacterial protein synthesis
I: traveler’s diarrhea, GC/CT, non-gonococcal urethritis/cervicitis
SE: Gi irritation
Intx: serious toxicity with bromocriptine, carbamazepine, cyclosporine, digoxin, theophylline
Cephalexin
C: Cephalosporin
*similar drugs - cephalexin (1st generation), cefdinir (3rd generation)
A: inhibits cell wall synthesis
I: 1st gen - impetigo, carbuncles, cellutitis, OM
I: 3rd gen - URTI, GC
SE: allergic rxn, pseudomembraneous colitis, leukopenia
CI: penicillin allergy
Intx: alcohol
Ciprofloxacin
C: Fluoroquinolones
A: inhibits DNA gyrase
I: UTI, traveler’s diarrhea, OM, GC, flu
SE: c-diff infections, tendon rupture, QT prolongation
CI: kids
Intx: antacids, sucralfate, chemo drugs, other QT prolongation agents
Doxycycline
C: Tetracycline antibiotic
A: inhibits protein synthesis
I: rickettsiae, acne, rosacea, PID, syphillis
SE: photosensitivity, yellow teeth in kids
CI: kids under 8 yo, activates SLE
Intx: penicillin
Metronidazole
C: ANTIBIOTIC
A: reduces organism = DNA damage
I: Trichomonas, Crohns, Hpylori, C. diff
SE: Disulfiram reaction, neurotoxic with long-term usage
CI: liver failure, 1st trimester of pregnancy, lactation
Sulfamethoxazole/trimethoprim
C: Sulfonamides
A: blocks bacterial enzymes and folate synthesis
I: travelers diarrhea, malaria, MRSA, UTI
SE: SJS
CI: sulfa allergy, porphyria, severe liver/renal dz, G6PD deficiency
Intx: cyclosporine, MTX, phenytoin, etc.
Isoniazid
C: anti-TB agent
A: pyridoxine (B6) analog
I: TB
SE: peripheral neuropathy from pyridoxine deficiency
CI: hypersensitivity
Intx: alcohol, other drugs that are chemically similar
Mupirocin
C: carboxylic acid
A: inhibits bacterial protein and RNA synthesis
I: IN for MRSA, topical for impetigo d/t infx
SE: normal shit if apply topically or IN
CI: open wounds and burns
Fluconazole
C: antifungal
A: inhibits fungal cell wall synthesis
I: Candida, menigitis, other fungal infx
SE: SJS and QT prolongation
Intx; MANYYYY intx because strong multi-CYP inhibitor
Nystatin
C: antifungal
A: fungicidal
I: vaginal candida, thrush
SE: not systemically absorbed so mild SE
CI: Preg B - swish and spit, Preg C - oral
Terbinafine
C: Antifungal
A: inhibits squalene epoxidase
I: tinea of all kinds
SE: pancytopenia, neutropenia, SJS, hepatotoxic
CI: SLE
Intx: CYP2D6 inhibitors
Permethrin
C: scabicides and pediculicides
A: sodium channel inhibitor in arthropods
I: scabies and lice
SE: seizures
CI: keep out of mouth of breast feeding infants, ragweed or chrysanthemium spp allergies.
Intx: none cause topical application
Tdap and DTaP vaccine
C: Vaccine
A: immune stimulation
I: diphtheria, pertussis, Tetanus preventon
SE: seizures (uncommon) - normal SE of vaccines
CI: previous reaction to DTaP, fever over 105
Intx: None
Hepatitis A
C: vaccine
A: immune stimulation
I: HAV
SE: normal shit
CI: moderate/severe illness
Intx: None known
2 doses 1 month apart in kids
Hepatitis B
C: vaccine
A: immune stimulation
I: HBV
SE: normal shit + hypotension
CI: moderate/severe illness and hypersensitivity to yeast
Intx: None known
Haemophilus influenzae type B conjugate vaccine
C: vaccine
A: immune stimulation
I: H. influenzae B meningitis and pneumonia prevention
SE: normal shit
CI: moderate/severe illness, immunosuppression
Intx: None known
2 doses 1 month apart in kids
HPV Quadrivalent Vaccine
C: Vaccine
A: induce immunity against 6, 11, 16, 18
I: HPV infection prevention
SE: AI dz (very rare) otherwise normal SE
CI: administration before 9 yo, moderate/severe illness, pregnancy, low platelets
Intx: None
Influenza Vaccine
C: vaccine
A: immune stimulation
I: Influenza
SE: normal shit
CI: moderate/severe illness, immunocompromised (if live vaccine)
Intx: None known but if live vaccine, administer 4 weeks between other vaccines
Meningococcal Vaccine
C: vaccine
A: immune stimulation
I: prevention of neisseria meningitidis
SE: normal shit
CI: moderate/severe illness
Intx: None known
MMR Vaccine
C: vaccine
A: immune stimulation (live)
I: MMR prevention
SE: rare - febrile seizures, loss of hearing, brain damage, coma, prolonged seizures
CI: moderate/severe illness, pregnancy, blood dyscraasia, leukemia
Intx: None known but decreased efficacy if taken within 4 weeks of another live vaccine
Pneumococcal vaccine
C: vaccine
A: immune stimulation
I: prevent strep pneumonia, meningitis, sepsis, etc in vulnerable populations
SE: normal shit
CI: moderate/severe illness
Intx: None known
Polio vaccine
C: vaccine
A: immune stimulation
I: polio prevention
SE: normal shit
CI: moderate/severe illness and anaphylaxis to neomycin, strep and polymyxin
Intx: None known
Rotavirus (RGE) Vaccine
C: vaccine
A: immune stimulation (live)
I: prevention of RGE gastroenteritis
SE: normal shit + intussception
CI: moderate/severe illness
Intx: None known
Varicella Vaccine
C: vaccine
A: immune stimulation (live)
I: varicella prevention
SE: normal shit but also rare/serious are rash/seizure
CI: moderate/severe illness, pregnancy, immunodeficiency
Intx: None known
Zoster Vaccine
C: vaccine
A: immune stimulation
I: Shingles prevention over 50 yo
SE: normal shit but also rare/serious are rash/seizure
CI: moderate/severe illness
Intx: None known
Testosterone
C: Hormone
A: anabolic on mm but also increased bone density, EPO production, and may be protective against AI disorders
I: AIDS wasting, anorchia, hypogonadism, OP
SE: virilization, gynecomastia, high calcium and cholesterol, liver cancer, edema, jaundice
CI: severe CVD, breast or prostate cancer, BPH (can worsen)
Intx: warfarin and cyclosporin
Dehydroepiandrosterone (DHEA)
C: Hormone
A: decreases blood lipids, anticancer, anti-glucocorticoid, stimulates immune system, increases hormone production
I: aging, depression, SLE, ED, OP
SE: androgenic effects - acne, hirsutism
CI: G6PD deficiency, cancer of breast, prostate, uterus, ovaries
Intx: estrogen possibly
Pregnenolone
C: Hormone
A: precursor to steroid hormones - can be converted into many different hormones
I: memory enhancement, AD, etc.
SE: unknown
CI: G6PD deficiency, cancer of breast, prostate, uterus, ovaries
Tamsulosin
C and A: alpha-adrenergic blocking agent
I: BPH sx reflief
SE: retrograde ejaculation, orthostatic hypotension
CI: caution in CAD< liver dz, sulfa allergy
Intx: other meds in same category or anti HTN agents
Finasteride
C and A: 5 alpha reductase inhibitors to reduce prostatic volume
I: BPH
SE: ED, low libido
CI: liver dz
Intx: none
Sildenafil
C: PDE5 inhibitor
A: releases NO in corpus cavernosum = increases cGMP = SM relaxation = inflow of blood
I: ED
SE: HA, flushing, nasal congestion - rare: MI, vision loss
CI: using with nitroglycerin and CHF/MI
Intx: CYP3A4 inducers/inhibitors and increased bleeding in patients with heparin
Cocaine
C: local anesthetic
A: blocking MAO and NE, HT, DA = anesthesia
I: URT local anesthetic - nasal/lacrimal duct surgery
SE: vasoconstriction locally,, seizures, arrhythmias, perforated nasal septum, etc.
not commonly used d/t hypertensive effects and vasoconstriction
CI: pregnancy
Intx: unknown
Sumatriptan
C: selective serotonin receptor agonist
A: works in cranial nerves = vasoconstriction and anti-inflammatory
I: tx of migraine with or w/o aura
SE: burning at injection site. dizziness, paresthesias, pain/chest tightness, worm/cold temp sensations
CI: CVD, HTN, peripheral vascular dz - BASILAR AND HEMIPLEGIC MIGRAINES
Intx: bromocriptin, MAOis, SSRIs, TCA
Caffeine
C: Stimulant
A: adenosine antagonist, diuretic
I: HA, migraine, mental stimulation
SE: tachyarrhythmias, dependence
CI: None?
Intx: fluvoxamine and levofloxacin
Modafinil
C: controlled substance class 4 drug
A: CNS depressant = increases glutamate (excitatory)
I: narcolepsy, shift workers
SE: rhinitis, anorexia, nausea, restlessness, HTN, SJS
CI: CVD
Intx: alcohol, synnergy with other stimulants - pausin. yohimbe and ephedra sinica, OCPs
Ketamine
C: anesthetic
A: blocks NMDA receptors = analgesia and sedation
I: anesthesia, nerve pain topically
SE: nystagmus, hallucinations, dissociations, vivid dreams, HTN, tachy, etc.
CI: HTN, eye injury, psychiatric disorders
Intx: opioids, narcotics, barbiturates
Levodopa-carbidopa
C: Decarboxylase inhibitors
A: decreasing peripheral catabolism of levodopa = levodopa enters CNS = levodopa is converted into dopamine
I: PD, RLS
SE: dyskinesia, dystonia, loss of effect after 5 years, ortho hypOtension
CI: abrupt withdrawal, MAOIs, glaucoma
Intx: iron, isoniazid, meochlopramide, prochlorperazine
Pramipexole
C and A: Dopamine receptor agonist
I: PD and RLS
SE: ortho hypo, somnolence, compulsive behavior, confusion, edema, etc.
CI: abrupt withdrawal
Intx; SAFE WITH L-DOPA, other agents that can cause ortho hypo
Carbamazepine
C: Anticonvulsant
A: decreases neurotransmission and excitability in CNS
I: Seizures, trigeminal neuralgia, BPD, schizo, RLS
SE: dizziness, drowsiness, leukopenia, SJS, increased LFT
CI: MAOIs, liver dz, abrupt withdrawal
Intx: MANY
Gabapentin
C: Anticonvulsant
A: unknown - structurally similar to GABA but doesnt react with GABA receptors
I: adjunct tx for patient seizures, neuro pain, RLS
SE: dizziness, drowsiness, leukopenia, SJS, increased LFT
CI: abrupt withdrawal
Intx: antacids, ethanol, sedatives
Phenytoin
C: anticonvulsant
A: slows sodium channels = decreasing neuronal firing/excitability
I: adjunct seizures and status epilepticus and trigeminal neuralgia
SE: gingival hyperplasia, hirsutism, rash
CI: arrhythmias and heart blocks, abrupt withdrawal
Intx: MANY
Melatonin (N-acetyl-5-methoxytryptamine)
C: endogenous hormone
A: antioxidant, immunomodulating, antineoplastic
I: jet lag, shift work, insomnia, SAD, not directly sedative
SE: hyperprolactinemia (rare)
CI: daytime usage
Intx: unsure?
Zolpidem
C: Nonbenzo Sedative
A: structurally similar to benzos and works on its receptors
I: short-term insomnia tx
SE: impaired memory, complex sleep issues, SI
CI: abrupt withdrawal
Intx: alcohol, CNS depressants, CYP3A4 inducers/inhibitors
Pitocin
C: synthetic oxytocin
A: stimulates uterine contraction and lactation (nasal)
I: induction of labor, incomplete abortion, postpartum hemorrhage
SE: uterine rupture, water intoxication, fetal death, hemorrhage, arrhythmias
CI: fetal distress, abnormal baby position at birth
Intx: vasoconstrictive agents that increase BP
Carisoprodol
C: muscle relaxant
A: unknown
I: muscle spasms, myalgia
SE: aggitation, dizziness, vertigo
CI: porphyrias
Intx: CYP2C19 inhibitos, SJW, alcohol, CNS depressants
Cyclobenzaprine
C: muscle relaxant
A: antispasmodics
I: skeletal muscle spasms
SE: drowsiness, seizures, arrhythmias, normal SNS sx
CI: arrhythmias, acute MI, CHF, heart block
Intx: MAOIs, anticholinergics
Methylphenidate
C: Sympathomimetic
A: unknown
I: narcolepsy, ADHD, weight loss
SE: hallucainations, zombie-like effects, glassy eye appearance, sudden cardiac death - stop usage if serious side effects
CI: CVD, atherosclerosis, caution with mental health disorders
Intx: MAOIs, other sympathomimetics
Dextroamphetamine
C: Stimulant - controlled substance
A: sympathomimetic - increases DA and NE/Epi release and blocks reuptake
I: fatigue, ADD, narcolepsy, excess appetite
SE: hallucainations, zombie-like effects, glassy eye appearance, sudden cardiac death - stop usage if serious side effects
CI: CVD, atherosclerosis, caution with mental health disorders
Intx: MAOIs, other sympathomimetics
Haloperidol
C: antipsychotic
A: works on DA and serotonin
I: psychosis, tourette
SE: extrapyramidal sx, qt prolongation
CI: CNS depression, coma, PD
Intx: drugs that increase QT prolongation, cardiac arrhythmias, and extrapyramidal sx
Aripiprazole
C: Antipsychotic
A: Antagonizes dopamine in brain
I: schizo, BPD1, MDD as adjunctive tx
SE: anticholinergic sx and QT prolongation
CI: hypersens rxn
Intx: lowers seizure threshold, drugs that increase CNS depression and extrapyramidal s/e
Risperidone
C: 2nd generation antipsychotic
A: DA and 5HT antagonist
I: psychosis and schizo
SE: increased risk of torsade de pointe and QT prolongation, anticholinergic side effects, tardice dyskinesia, extrapyramidal s/e, ortho hypo
CI: caution in CVD, seizure, PD, low BP
Intx: CNS depressants, anti-HTN, DA agonist (levodopa), CYP3a4 inhibitors/inducers, drugs that cause QT prolongation
Phenelzine
C: MAOIs
A: inhibits MAO from breaking down Epi, NE, DA, sero = antidepressant
I: Depression and severe anxiety
SE: HTN, ortho hypo, sexual dysfxn
CI: pheochromocytoma, CHF, HTN
Intx: MANY
Amitriptyline
C: Tricyclic Antidepressants
A: inhibits catecholamine reuptake = sedative, anticholinergic, antihistamine, antidepresant
I: depression, enuresis, chronic pain, OCD
SE: anticholinergic effects, qt prolongation
CI: recent MI, seizure hx
Intx: MANY
Fluoxetine
C: SSRI
A: inhibits serotinin reuptake
I: depression, panic, bulimia, OCD
SE: insomnia, tremor, SI, HI, serotonin syndrome
CI: liver failure, mania, seizure
Intx; MANY
Escitalopram
C: SSRI
A: inhibits serotonin reuptake
I: MDD, GAD
SE: insomnia
CI: MAOi
Intx: phenelzine
Bupropion
C: Antidepressant
A: inhibits reuptake of NE, 5HT, and DA
I: Depression, stop smoking, SAD
SE: agitation, insomnia, mania, seizure risk because lowers threshold
CI: seizure and eating disorders, head trauma hx
Intx: buspirone, dextromethorphan, SJS, TCA, trazodone
Trazodone
C: SARI antidepressant
A: 5HT receptor antagonist
I: depression, aggression, panic, anxiety
SE: sedation, ortho hypo, anticholinergic sx, increased SI
CI: recent MI
Intx: MANY
Venlafaxine
C: SNRI
A: serotonin, NE, Da reuptake inhibition
I: depression, anxiety, panic
SE: insomnia
CI: MAOI usage
Intx: phenelzine
Lithium
C: Antimanic agent
A: increases presynaptic degradation and decreases neuronal synapses release of 5hT, DA and NE
I: Manic-depression, BPD
SE: third, polyuria, hypothyroid - VERY NARROW THERAPEUTIC WINDOW - sluggish, tremor, confusion
CI: renal dysfunction, CHD
Intx: DO not combine with first generation antipsychotics, caffeine
Alprazolam (short acting) and Diazepam (long acting)
C: benzo
A: increases GABA
I: anxiety, panic
SE: impaired sleep quuality, poor concentration, addictive potential and withdrawal sx possible
CI: acute glaucoma
Intx: CNS depressants - antihistamines, barbiturates, alcohol, MAOIs, opioids, CYP3A4 inducers/inhibitors
Buspirone
C: Anxiolytic
A: serotonin, Da, NE receptor agonist without muscle relaxation as seen in other benzos
I: anxiety
SE: nervousness, restlessness
CI: liver/kidney issues
Intx: CYP3A4 inducers/inhibitors, SJW, Trazodone, TCAs
Nicotine - transdermal patch
C: stimulant
A: binds to acetylcholine receptors
I: smoking cessation
SE: burning/sensitivity where patch is located
CI: serious arrthymias, angina, recent MI
Intx: nicotine influences drug clearance
Varenicline
C and A: smoking cessation aid by blocking acetylcholine receptors
I: stop smoking
SE: abnormal dreams, insomnia
CI: None
Intx: h2 receptor antagonist and quinolones
Amantadine
C: Dopamine agonist and antiviral
A: inhibits viral RNA transcription, and changes dopamine activitiy
I: prevent and tx influenza A, early PD
SE: anticholinergic SE, CNS issues, livedo reticularis, ankle edema
CI: abrupt withdrawal
Intx: synergy with other anticholinergic agents and CNS stimulants
Oseltamivir
C: Antiviral
A: inhibits neuraminidase = virus cant penetrate cellls
I: Influenza A or B
SE: N/V, seizure, arrhythmias
CI: CVD
Intx: clopidogrel
Guaifenesin (Mucinex)
C: expectorant
A: expels mucus
I: clearing plegm and ADHD
SE: bradycardia, hypOtension
CI: None
Intx: TCA, CYP3A4 inducers/inhibitors
Dextromethorphan (Robitussin)
C: Cough suppressant
A: opioid agonist = antitussive properties and analgesia
I: spasmodic, acute, and chronic cough
SE: confusion, hallucination, HTN, sedation
CI: cough related to other cardiopulm issues
Intx: MAOIs and SSRIS, increase effects with grapefruit juice, CNS depressants
Fluticasone
C: Corticosteroid
A: vasoconstrictive and anti-inflammatory
I: asthma prevention, COPD, Allergic rhinitis (IN)
SE: URTI, oral candida, sinus infection
CI: hypersensitivity to milk protein, status asthmaticus, acute bronchospasms
Intx: demopressin
Salmeterol (serevent)
C: Bronchodilator
A: LONG acting beta 2 agonist = bronchodilation
I: prophylactic tx of asthma ( ONLY USE WITH INHALED GC)
SE: asthma - related death when taken alone
CI: acute asthma attack
Intx: hypertensive crisis with MAOIs and TCAs
Albuterol (Salbutamol)
C: Rescue inhaler - B2 agonist
A: SHORT acting b2 agonist
I: acute bronchospasms, preventing exercise-induced asthma, COPD
SE: paradoxical bronchospasm (life-threatening) and other SNS sx, hypokalemia
CI: caution in CVD, etc
Intx: hypertensive crisis with MAOIs and TCAs, other sympathomimetics, beta-blockers (inhibit bronchodilation), hypokalemia with HCTZ and loops
Ipratroprium bromide (atrovent)
C: Bronchodilation
A: anticholinergic
I: COPD maintainance tx
SE: COPD exacerbation
CI: hypersensitivity to soy and peanuts (derivative of atropine)
Intx: other anticholinergics
Tiotropium bromide
C: Bronchodilator
A: LONG acting anticholinergic = bronchodilation with antisecretory effects
I: asthma, COPD
SE: anticholinergic sx, metallic taste, paradoxical bronchospasms
CI: caution in glaucoma and urinary outflow obstruction
Intx: other anticholinergic agents and agents that increase QT prolongation
Montelukast (Singular)
C: leukotrient receptor antagonist
A: reduces inflam and bronchoconstriction - LONG acting and PREVENTION
I: prevention and chronic tx of asthma
SE: HA and flu-like sx, increased LFT, Churg-strauss syndrome, altered behavior
CI: acute bronchospasm
Intx: CYP3A4 inducers and inhibitors
Capsaicin
C: TRPV1 receptor agonist
A: depletes substance P = decreased pain levels
I: OA, RA, myalgias, etc
SE: normal shit if apply topically
CI: dont apply to wounds or burns
Intx: increases cough induced by ACEI
Codeine
C: Opiate analgesics
A: binds to opiate receptors to inhibit pain pathways
I: prodrug converted into morphine and used for mild-mod pain or as antitussive
SE: sedation and constipation are big ones but other normal opiate s/e
CI: respiratory weakness, urinary bladder obstruction, kids under 12 yo
Intx: drugs that cause QT prolongation
Heroin
C: Opiate analgesics
A: binds to opiate receptors to inhibit pain pathways
I: severe pain
SE: sedation and constipation are big ones but other normal opiate s/e
CI: respiratory weakness, urinary bladder obstruction, kids under 12 yo
Intx: alcohol and CNS depressants
Hydrocodone
C: Opiate analgesics
A: binds to opiate receptors to inhibit pain pathways
I: semi-synthetic prodrug converted into hydromorphone and used for mild-mod pain or as antitussive
SE: sedation and constipation are big ones but other normal opiate s/e
CI: respiratory weakness, urinary bladder obstruction, kids under 12 yo
Intx: more interactions than morphine drugs that cause QT prolongation
Methadone
C: Opiate analgesics
A: binds to opiate receptors to inhibit pain pathways
I: severe pain and detox
SE: sedation and constipation are big ones but other normal opiate s/e
CI: respiratory weakness, urinary bladder obstruction, arrhythmias
Intx: MANY d/t usage of CYP450 enzymes
Morphine
C: Opiate analgesics
A: binds to opiate receptors to inhibit pain pathways
I: severe pain
SE: sedation and constipation are big ones but other normal opiate s/e
antidote: naloxone
CI: respiratory weakness, urinary bladder obstruction, arrhythmias
Intx: less than methadone and oxycodone - avoid with MAOIS and ethanol and CNS depressants
*schedule 2 controlled substance
Oxycodone
C: Opiate analgesics
A: binds to opiate receptors to inhibit pain pathways
I: semi-synthetic opioid used for pain
SE: sedation and constipation are big ones but other normal opiate s/e
CI: respiratory weakness, urinary bladder obstruction, arrhythmias
Intx: more interactions than morphine drugs and drugs that cause QT prolongation and CNS depression
Naloxone (Narcan)
C: Opioid antagonist
A: opioid receptor antagonist
I: opioid addiction and OD
SE: seizures, v. fib, tachy, HTN
CI: caution in CVD and seizure hx
Intx: reversal of opioid analgesic effects
Naltrexone
C: Opioid antagonist
A: opioid receptor antagonist
I: opioid addiction and OD and alcoholism
SE: N/V, headache, hepatitis
CI: patient who requires opiates for pain control
Intx: reversal of opioid analgesic effects
Acetaminophen/Paracetamol (Tylenol)
C: Analgesic and antipyretic
A: inhibits CNS PG synthesis - DOES NOT affect platelet aggregation or inflam
I: mild pain, MSK pain, RA, OA
SE: nephro/hepatotoxicity, antidote: charcoal, NAC
CI: liver dz/failure, alcoholism
Aspirin (acetylsalicyclic acid)
C: NSAID
A: inhibits COX1 and COX2 = decreases PG synthesis + analgesia + AI + antipyretic + IRREVERSIBLE platelet aggregation
I: minor pain, fever, OA, RA, thromboembolism (prevent and tx MI and ischemic strokes)
SE: nephrotoxic, salicylism - tinnitus, OD may be lethal
CI: children with viral infx, PUD, bleeding disorders, HF, allergy
Intx: alcohol, SSRI, anticoagulants, hypoglycemics, insulin
Ibuprofen and Naproxen
C: NSAIDs
A: inhibits COX1 and COX2 = decreases PG synthesis + analgesia + AI + antipyretic + IRREVERSIBLE platelet aggregation
I: minor pain, fever, OA, RA
SE: nephrotoxic, allergy is common, OD may be lethal
CI: PUD, bleeding disorders, HF
Intx: cyclosporine, alcohol, SSRI, anticoagulants
Celecoxib (Celebrex)
C: NSAIDs
A: selective COX2 inhibitor - less GI irritation so safer choice in patients with pain and PUD because not working on both COX enzymes
I: minor pain, fever, OA, RA, MSK pains
SE: SERIOUS CVD events, nephrotoxic, allergic rxn is common
CI: CVD, bleeding disorders, HF
Intx: alcohol, SSRI, anticoagulants, other NSAIDs, salicylates, anti-HTN drugs
Cannabis
C and A: anti-emetic, anticonvulsive, psychoactive effects
I: glaucoma, appetite loss, chemo induced nausea and vomiting, tremors and spasticity with MS
SE: Many
CI: CV or respiratory dz, immunocompromised, epilepsy
Intx: theophylline, barbiturates, warfarin, CNS depressants
Prednisone
C: Glucocorticoid
A: AI, immunosuppressive, catabolic effect on skin, bone, and muscle. Alters fat deposition
I: inflam and allergic conditions, IBD, AI dz
SE: adrenal suppression, cushings, HTN, avascular necrosis of femur, changes in behavior
CI: systemic fungal or other severe infx, live vaccine, abrupt wthdrawal
Intx: estrogens and many more
Fluticasone and Mometasone
C: Inhaled corticosteroids
A: AI, immunosupressive, vasoconstrictive (IN)
I: prevent asthma
SE: oral thrush is big one, adrenal suppression and cushings
CI: systemic fungal or other severe infx, live vaccine, abrupt wthdrawal
Intx: estrogens and many more
Dexamethasone
C: Corticosteroids
A: AI, immunosupressive
I: inflam and allergic conditions, AI dz
SE: acne, weight gain, high glucose, low potassium, OP, avascular necrosis of femur
CI: systemic fungal or other severe infx, with a vaccine, abrupt wthdrawal
Intx: estrogens and many more
Methylprednisolone
C: Corticosteroid
A: synthetic glucorticoid = decreases inflam and immune response = SM relaxation
I: acute or severe persistent asthma, arthritis
SE: weight gain, high glucose, low potassium, OP, etc.
CI: system fungal or other severe infx, abrupt withdrawal, premature infants
Intx: live vrus vaccines, desmopressin
Hydrocortisone (cortisol)
C: Corticosteroid
A: AI, immunosuppressant
I: acute or severe persistent asthma, arthritis
SE: weight gain, high glucose, low potassium, Cushings, adrenal suppression, OP, etc.
CI: system fungal or other severe infx, abrupt withdrawal, premature infants
Intx: live vrus vaccines, desmopressin
Adalimumab
C: TNF alpha inhibitor
A: AI and immunosuppressive effects
I: RA, PA, AS
SE: infection site reaction and infx, cancers, lymphomas
CI: SLE, HF, MS, active infx
Intx: increased risk of infx with live vaccinations
Hydroxychloroquine
C: Anti-malarials
A: inhibits movement of neutrophils and eosinophils = impairs complement dependent antigen-antibody reactons
I: RA, SLE, malaria prevention
SE: ocular toxicity, visual changes, skin pigmentations
CI: G6PD deficiency, eye dz
Intx: digoxin
Methotrexate
C: Folic acid analog
A: inhibits dihydrofolate reductaste = DNA synthesis cant happen = cytotoxic and immunosuppresant
I: RA, psoriasis, cancer
SE: asx elevation of liver enzymes, hepatotoxicity, diarrhea, ulcerative tomatitis, BM suppression, nephrotoxicity
CI: BM suppression, blood dyscrasia, anemia, alcoholism
Intx: cyclosporin, NSAIDS, Sulf-Tri and penicillin
Tofacitinib
C: JAK inhibitor
A: decreases hematopoiesis and immune system function
I: PA, RA, UC
SE: infx, viral reactivation, cytopenias
CI: active infx, cytopenia
Intx: live vaccines, other immunosuppressive agents
Alendronate
C: Bisphosphate Derivatives
A: inhibits bone resorption
I: OP and pagets dz of bone
SE: jaw osteonecrosis and esophageal ulcers, GI irritation
CI: low calcium, cant sit or stand upright for at least 30 minutes
Intx: raloxifene and estrogens, NSAIDs
Raloxifene
C: SERM
A: acts like estrogen to prevent bone loss without causing a lot of s/e as estrogen
I: OP in post-men females
SE: thromboembolism, DVT, leg cramps - decreasssse estrogen-sensitive breast cancer risk
CI: thromboembolic disorder, child-bearing females
Intx: cholestyramine, warfarin
Allopurinol
C: Xanthine oxidase inhibitor
A: prevents formation of uric acid
I: hyperuricemia, gout, calcium kidney stones
SE: gout, increase ALK PHOS and LFT
CI: normal shit
Intx: ACEi and antacids
Colchicine
C: Anti-gout agent
A: inhibits leukocyte microtubule assembly = reduce migration and phagocytosis = decreases cell metabolic activity
I: acute gout
SE: diarrhea, aplastic anemia (long term)
CI: normal shit
Intx: statins, Cyp3A4 inhibitors
Phenazopyridine (AZO)
C: analgesic
A: locally
I: pain of UTI until other tx works
SE: red/orange urine, jaundice
Intx: None
CI: long-term
Nitrofurantoin
C: Antibiotic
A: damages bacterial DNA
I: infectious cystitis, chronic bacterial prostatitis
SE: pulmonary and hepatic toxicity with long term usage
CI: pyelonephritis, G6PD def, porphyria
Intx: antacids
Tolterodine
C: Bladder selective muscarinic antagonist
A: antagonism of cholinergic receptors = increased residual urine volume and decreases detrusor muscle pressure
I: overactive bladder, urinary frequency/urgency/incontinence
SE: all anticholinergic sx
CI: urinary or gastric retention
Intx: other anticholinergics
Apixaban (Eliquis)
C: Factor Xa inhibitor
A: blocks factor Xa to inhibit blood clotting
I: anticoagulation for strokes/clots/DVT prevention
SE: severe bleeding, thrombocytopenia, anemia
CI: active bleeds, strokes, clots
Intx: many
Tamoxifen
C: Antiestrogen
A: binds to estrogen receptors
I: hormone receptor positive breast cancer, metastatic dz, DCIS, BrCa prevention
SE: BLACK BOX - uterine malignancy, stroke, PE, endometrial metaplasia, also can drop all WBC and platelets then normal other SE that comes with hormones and cancer shit
CI: prego, breast fx, hx thromboembolism, anticoagulant tx
Rifampin
C: Antibiotics
A: inhibits DNA dependent RNA polymerase
I: active and latent TB, bioterrorism
SE: hepatitis, hepatotoxic, decreases WBC and platelets, hemolytic anemia
*dont take with other hepatotox meds or alcohol
Pregabalin
C: Anticonvulsants
A: antinociceptive and anti-seizure effects
I: neuropathic pain, DM, herpes, seizures, fibro
- caution with alcohol and abrupt withdrawal
Phenylephrine
Brand: Preparation H
C: nasal decongestants
A: vasoconstriction
I: nasal congestion
SE: arrhythmia, HTN
CI: MAO, 1st trimester of pregnancy and urinary retention
Pentoxifylline
C: hemorrheologic agent - claudication
A: helps blood flow more easily through narrowed arteries
I: claudication, alcoholic hepatitis
SE: arrhythmias
CI: recent cerebral/retinal hemorrhage
Pembrolizumab (Keytruda)
A: binds to receptors on T cells to block PD1 pathway = decrease antitumor immune response = decrease tumor growth
I: melanoma, non-small cell lung cancer, SCC
Lugol Solution
iodine for disinfecting shit
Ipilimumab
A: binds cytotoxic T cells = changes T cell activation and proliferation
I: melanoma, renal cell cancer, HCC
Insulin - Regular (Norvolin)
A: stimulates peripheral glucose uptake = inhibits liver glucose production = regulates glucose metabolism
I: DM, Diabetic ketoacidosis
SE: low glucose/potassium, anaphylaxis, edema
*SHORT acting
Insulin - Lispro
A: stimulates peripheral glucose uptake = inhibits liver glucose production = regulates glucose metabolism
I: DM
SE: low glucose/potassium, anaphylaxis, edema
*RAPID acting
Insulin - Glargine
A: stimulates peripheral glucose uptake = inhibits liver glucose production = regulates glucose metabolism
I: DM1 and DM2
SE: low glucose/potassium, anaphylaxis, edema
*LONG acting
Heparin
C and A: Anticoagulant
I: thromboembolism, STEMI, NSTEMI
SE: bleeding, low platelets, prolonged clotting time, increase LFT
Exenatide
A: activates GLP1 receptors = increases insulin secretion = decreases glucagon secretion and delayed gastric emptying
I: DM2
SE: BLACK BOX - thyroid c- cell tumor risk
CI: thrombocytopenia, DM1
Dulaglutide (trulicity)
I: DM2 and decrease CVD risk
SE: BLACK BOX - thyroid c cell tumor risk
Cefuroxamine
A: peptidoglycin - inhibits cell wall synthesis
I: bacterial infx and pneumonia
SE: decrease immune system, c. diff, SJS
CI: sensitivity to penicillin
Ceftriaxone
C: antibiotic
A: B - lactam: inhibits cell wall synthesis
I: infx - GC, meningitis
SE: increase LFT, leukopenia, eosinophilia
CI: antibiotic associated colitis recent hx
Cefepime
C: Antibiotic
A: B-lactam
I: infx, pneumonia, UTIs
SE: increase LFT, leukopenia, eosinophilia
CI: antibiotic associated colitis recent hx
Carvedilol
C: beta blocker
I: HTN, HF with decreased EF, left ventricular dysfunction
SE: CHF, asthma, decreased HR and heart issues
CI: HF, bradycardia, cardiogenic shock, sinus sick syndrome, AV blocks
Atezolizumab
A: binds PDL1 on cancer-immune cells to decrease tumor growth
I: urothelial carcinoma, non small cell lung carcinoma, melanoma, breast cancer
