pharmacology Flashcards
drugs that cause Stevens-Johnson syndrome
ANTI-CONVULSANTS: ethosuximide lamotrigine carbamazepine phenytoin ANTIBIOTICS sulfonamides penicillin XANTHINE OXIDASE INHIBITORS: gout, kidney stones allopurinol
drugs that cause agranulocytosis
carbamazapine (anti-convulsant)
clozapine (anti-psychotic)
colchicine (gout)
PTU + methimazole (anti-thyroid meds)
drugs with low therapeutic index - must monitor closely
seizure drugs: phenobarbital
lithium
warfarin
digoxin
name for phase of drug metabolism that involves:
reduction
oxidation
hydrolysis
mediated by cytochrome P450 enzymes
result: slightly polar, water-soluble + active metabolite, may convert prodrug to drug or make drug more toxic (methanol →fermaldehyde)
phase 1 reaction
name for phase of drug metabolism that involves:
conjugation: glucaronidation, acetylation, sulfation, methylation
result: very polar, inactive metabolite, renal excretion (can’t cross membranes, trapped in urine)
phase 2 reaction
elderly lose this phase of metabolism first
phase 1 reactions: reduction, oxidation, hydrolysis
consequence of slow acetylators (Phase 2 reaction)
build up of drug → ↑drug levels → SE + toxicity
tx: less frequent doses
location of phase 1 and phase 2 reactions for drug metabolism
primarily occur in liver, some in kidney
roles of cytochrome P450s (cyp450s)
bile acid synthesis
steroid synthesis
drug metabolism (CYP3A4 metabolizes 50% of drugs, if more than one drug used by CYP, may prolong action of drug, ↑plasma level, drug-drug interactions)
activation of drugs
drugs that inhibit P450
CRACK AMIGOS Cimetidine Ritonavir (ALL protease inhibitors - MOA is to inhibit P450s) Amiodarone Ciprofloxacin Ketoconazole ACUTE alcohol use Macrolides Isoniazid Grapefruit juice Omeprazole Sulfonamides
drugs that can cause disulfiram-like reaction when taken with alcohol
metronidazole
cephalosporins - some (cefoperazone, cefotetan,cefamandole)
procarbazine - tx of hodgkin’s lymphoma
sulfonylureas - 1st generation (tolbutamide)
drugs that induce P450s
Coronas, Guiness, PBRs induce CHRONIC ALCOHOLISM Carbamazepine (seizure) Griseofulvin (antifungal) Phenytoin (seizure), Phenobarbital Barbiturates Rifampin St. John's Wart Chronic Alcoholism (CYP 2E1)
drugs eliminated by zero order elimination
PEA - round like “0”
Phenytoin
Ethanol
Aspirin (high or toxic concentration)
drugs that prolong the QT intervial and can lead to Torsades de Pointes
Some Risky Meds Can Prolong QT: Sotalol (class 3) Risperidone, haloperidol (anti-pyshcotics) Macrolides, Methadone Chloroquine (antimalarial) Protease inhibitors Quinidine (class 1A) Thiazides
drugs that cause aplastic anemia
Can't Make New Blood Cells Properly Chloramphenicol Methimazole (antithyroid) NSAIDs Benzene Carbamazepine Propylthiouracil (antithyroid)
drugs that cause flushing
VANC Vancomycin (red man syndrome) Adenosine (vasodilator) Niacin Calcium channel blocker (dihydropyridine, smooth muscle relaxation)
drugs that cause pulmonary fibrosis
Breathing Air Badly from Meds Bleomycin (anticancer) Amiodarone (afib) Busulfan (anticancer) Methotrexate
drugs that cause hepatic necrosis
liver HAVAc Halothane Acetaminophen Valproic acid Amanita phalloides (mushroom toxin)
drugs that cause gynecomastia
STACKED Spironolactone THC (marijuana) Alcohol (chronic use) Cimetidine (H2 blocker) Ketoconazole Estrogens Digoxin
drugs that cause gout
Painful Tophi + Feet Need Care Pyrazinamide Thiazide diuretic Furosemide (loop diuretic) Niacin (increase HDL) Cyclosporine
drugs that cause photosensitivity
SAT for photo
Sulfonamides
Amiodarone
Tetracycline
drug-induced lupus
SHIPP Sulfonamides Hydralazine Iisoniazid Procainamide Phenytoin
drugs that cause parkinson-like syndrome
ARM
Antipsychotics
Reserpine
Metoclopramide
common side effects of B blockers
bradycardia
AV block
CHF: due to ↓contractility
non-selective: bronchoconstriction, mask symptoms of hypoglycemia
drugs that cause sexual dysfunction
antihypertensives
neuroleptics
SSRIs: ↓libido
ethanol
serotonin syndrome
muscle rigidity
hyperthermia
CV collapse due to autonomic instability
TCA overdose
tri C's: convulsions = seizures coma cardiotoxicity hyperpyrexia (from seizure) respiratory depression
neuroleptic malignant syndrome
initially: delerium + mental status change autonomic instability: tachycardia muscle rigidity myoglobinuria hyperpyrexia
nephrotoxic + ototoxic
vancomycin
aminoglycosides
loop diuretics
cisplatin + carboplatin
testicular cancer
Eradicate Ball Cancer:
etoposide + bleomycin (or ifosfamide) + cisplatin
interfere with microtubules
Microtubules Get Constructed Very Poorly
Mebendazole, albendazole (anti-helminthic)
Griseofulvin (antifungal)
Colchicine (gout)
Vincristine, Vinblastine (anti-cancer): block polymerization)
Paclitaxel (anti-cancer): stabilize microtubules
cancer drugs that are cardiotoxic
trastuzumab
doxorubicin, daunorubicin
