Pharmacology Flashcards
Bisphosphonates
- 4 drugs?
- MOA?
- Clinical Use?
- Adverse Effects?
- Alendronate, Ibandronate, Risedronate, Zoledronate
- Binds hydroxyapetite in bone, inhibiting osteoclast activity
- Osteoporosis, hypercalcemia, Paget Disease of bone, metastatic bone disease, osteogenesis imperfecta
- Esophagitis, osteonecrosis of jaw, atypical femoral stress fractures
Medications that can cause esophagitis?
- Antibiotic: Tetracyclines
- Anti-inflammatory Agents: Aspirin & many NSAIDs
- Bisphosphanates: Alendronate, Risedronate
- Others: Potassium Chloride, Iron
4 Drugs that can cause Franconi Syndrome (Disorder of kidney tubule function that results in excess amounts of glucose, bicarbonate, phosphates, uric acid, potassium and certain amino acids being excreted in the urine)
- Cisplatin (Cross-links DNA)
- Ifosfamide (Cross-link DNA at guanine, requires bioactivation by liver)
- Expired Tetracyclines
- Tenofovir (NRTI for HIV; competitively inhibits nucleotide binding to reverse transcriptase and terminates the DNA chain; it is the only NRTI that is a Nucleotide)
2 Drugs that can cause Hemorrhagic cystitis (Bladder condition that causes pain and hematuria)?
*Co-administration of what drug can prevent it?
- Cyclophosphamide
- Ifosfamide
(Both of these drugs are alkylation agents that cross-link DNA at guanine and require bioactivation by the liver)
*Co-administration of Mesna
7 Drugs that can cause Interstitial Nephritis?
Remember the 5 P’s
- Diuretics (Pee)
- NSAIDs (Pain-free)
- Penicillins & cephalosporins
- PPIs (Irreversibly inhibit H/K ATPase in stomach parietal cells)
- RifamPin
- Sulfa drugs
3 drugs commonly involved in chelation interactions with chelation cations (Iron, Calcium, Magnesium, Aluminum)? This results in decreased absorption of the drug and less effectiveness…
- Tetracyclines
- Fluoroquinolones
- Levothyroxine
Route of administration for Enzyme replacement therapy?
Intravenous because these enzymes are large proteins that cannot be orally absorbed.
MOA of statins?
Inhibit HMG-CoA reductase
Primary side effects of statins?
Myopathy and Hepatitis
Combining what drug with statins increases the risk for myopathy and hepatitis because of decreased clearance of statins?
Fibrates (eg, Gemfibrozil)
Important feature of aminoglycoside antibiotics?
They have a low Vd because they do not distribute into tissues well for the following reasons:
- Hydrophillic
- High Charge
- High plasma protein binding
- High molecular weight
8 Cytochrome P450 Inducers?
- Carbamazepine
- Phenytoin
- Rifampin
- Barbiturates
- Griseofulvin
- St. John’s Wort
- Modafinil
- Cyclophosphamide
8 Cytochrome P450 Inhibitors?
- Amiodarone
- Cimetidine
- Fluoroquinolones
- Clarithromycin
- Anole Antifungals
- Grapefruit juice
- Isoniazid
- Ritonavir (protease inhibitor)
Warfarin
- MOA?
- Clinical use?
- Adverse Effects?
- Inhibits epoxied reductase, which interferes with gamma-carboxylation of vitamin K-dependent clotting factors (II, VII, IX, X, and proteins C and S)
- Chronic anti-coagulation for prophylaxis of venous thromboembolism and prevention of stroke in atrial fibrillation. (Contraindicated in pregnant women because it crosses placenta, unlike heparin)
- Bleeding, Teratogenic, Skin/tissue necrosis, Drug-drug interactions,
(initial risk of hypercoagulation because Protein C has a shorter half-life than factors II and X)
Features of serotonin syndrome?
- Autonomic Instability: hyperthermia, hypertension, tachycardia, diaphoresis, diarrhea
- Altered Mental Status: agitation, confusion
- Neuromuscular Hyperactivity: tremor, hyperreflexia, myoclonus
