Pharmacology Pearls Flashcards by John Michael Teotico

Bactericidal Antibiotics

Very Finely Proficient at Murder!

Vancomycin Fluroquinolones Penicillins Aminoglycosides Metronidazole

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Bacteriostatic Antibiotics

ECSTaTiC with bacteriostatics!

Erythromycin 
Clindamycin 
Sulfamethoxazole 
Trimethoprim 
Tetracycline 
Chloramphenicol

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Narrow Spectrum Penicillins.

SE: Hypersensitivity

Penicillin G

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Penicillinase-resistant penicillins

SE: Interstitial Nephritis

Methicillin *

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Extended-spectrum Penicillins

SE: Pseudomembranous Colitis

Ampicillin

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Antipseudomonal Penicillin

SE: Hypertension, hypervolemia, bleeding

Ticarcillin

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Oral Penicillin

Penicillin V

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IV Penicillin

Penicillin G

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Between Ampicillin and Amoxicillin which has greater oral bioavailability?

AMPed up penicillin (Ampicillin)

greater Oral bioavailability (amOxcicillin)

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Amoxicillin enterococci coverage

Amoxicillin HELPS kill Enterococci

Haemophilus influenzae
Escherichia Coli
Listeria monocytogenes
Proteus mirabilis
Salmonella spp
Enterococci

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Takes Care of Pseudomonas

TCP: Ticarcillin Carbenicillin Piperacillin

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1st generation Cephalosporin
high bone penetration
surgical prophylaxis
greatest Gram + coverage

SE: Hypersensitivity reaction

Cefazolin

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2nd generation Cephalosporin
added gram negative coverage

SE: Disulfiram reaction

Cefamandole

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3rd generation Cephalosporin
Pseudomonas coverage

SE: Disulfiram reaction

Cefoperazone

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Most efficacious Cephalosporin against Pseudomonas Aeroginosa

Ceftazidime

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4th generation Cephalosporin

broad spectrum activity G+/-

Cefepime

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Cephalosporin with the best penetration of the BBB

Ceftriaxone

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1st generation Cephalosporin Microbe Coverage

PEKpek

Proteus
E. Coli
Klebsiella

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1st generation Cephalosporins

FADer, help me FAZ my Pharmacology boards!

CeFADroxil ceFAZolin cePHalothin cePHapirin cePHradine cePHalexin

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2nd generation microbe coverage

PEKpek of HENS:

Proteus mirabilis
Escherichia coli
Klebsiella pneumoniae

Haemophillus influenzae
Enterobacter aerogenes
Neiserria spp
Serratia marcescens

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2nd generation cephalosporins

in a FAMily gathering you can see your FOXy cousin wearing a FUR coat and drinking TEA.

FAC! LORA the PROfessional AZhOLE is still on the FONe

ceFAMandole, ceFOXitin, ceFURoxime, cefoTEtan, ceFAClor, LORAcarbef, cefPROzil, cefmetAZOLE, ceFONicid

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Cephalosporins with Disulfiram Reaction

Cefamandole
Cefmetazole
Cefotetan
Cefoperazone

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3rd generation Cephalosporins

Fenge PO ng PERA to FIX my TTTTTV! ceFEtamet, cefPOdoxin, cefoPERAzone, ceFIXime, cefTriaxone, cefTazidime, cefoTaxime, cefTizoxime, cefTibuten

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Anti-pseudomonal Cephalosporins

Cefoperazone
Ceftazidime
Cefipime

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Protein synthesis inhibitors that binds to 50s subunit SE: aplastic anemia, gray baby syndrome

Chloramphenicol

Protein synthesis inhibitors that binds to 30s subunit SE: tooth enamel discoloration, photosensitivity

Tetracycline

Protein synthesis inhibitors that binds to 50s subunit DOC for penicillin-allergic patients SE: Diarrhea, cholestatic jaundice

Macrolide (Erythromycin)

Protein synthesis inhibitors that binds to 50s subunit Highest volume of distribution single dose administration

Azithromycin

Protein synthesis inhibitors that binds to 50s subunit anaerobic coverage SE: Pseudomembranous Colitis

Clindamycin

Protein synthesis inhibitors that binds to 50s subunit, next line after Vancomycin resistance

Linezolid

Protein synthesis inhibitors that affect the 30s subunit

Tetracycline & Aminoglycoside

Protein synthesis inhibitors that affect the 50s subunit

Streptogrammin, Erythromycin (Macrolide), Linezolid

Treatment for anaerobic infections ABOVE the diaphragm

Clindamycin

Treatment for anaerobic infections BELOW the diaphragm

Metronidazole

Prototype aminoglycoside, bactericidal, which binds to the 30s subunit SE: Nephrotoxicity, ototoxicity

Gentamycin

Bactericidal antibiotic which binds to the 30s subunit, for ocular infection treatment

Tobramycin

Bactericidal antibiotic which binds to the 30s subunit, an adjunct to Tuberculosis treatment

Streptomycin

Bactericidal antibiotic which binds to the 30s subunit, a treatment to drug-resistant gonorrhea

Aminoglycoside - Streptomycin

Bactericidal antibiotic which binds to the 30s subunit, widest spectrum of activity, pseudomonas coverage, narrow therapeutic window

Amikacin

Bactericidal antibiotic which binds to the 30s subunit, treatment for hepatic encephalopathy

Neomycin

Aminoglycoside of choice for anaerobic infections

None, they require O2 for transport thus won't work under anaerobic conditions

Side effects of Aminoglycosides

NOT! Nephrotoxicity, ototoxicity, teratogenic

This drug blocks dihydropteroate synthase

Sulfamethoxazole

Blocks dihydrofolate reductase

Trimethoprim & Methotrexate

Sequential blockade in folate synthesis, bactericidal together, for UTI SE: Hypersensitivity (SJS, TEN), kernicterus, hemolysis in patients with G6PD

TMP-SMX

Treatment for Burn infections

Sulfadiazine

2nd generation quinoline, treatment for UTI and GIT infections SE: Tendinitis

Ciprofloxacin

3rd generation quinolone which could be used as treatment for pulmonary infections

Levofloxacin

4th generation quinoline, broad spectrum of activity, anaerobic coverage, treatment for ocular infections

Moxifloxacin

4th generation quinolone SE: Diabetes mellitus

Gatifloxacin

Side effect of Fluroquinolones thus avoid giving to pediatric patients

FluroquinoLONES hurt attachments of your BONES (cartilage damage)

Anti-mycobacterial agent that inhibits mycolic acid synthesis SE: Neurotoxicity, hepatotoxicity, sideroblastic anemia, drug induced Lupus, Potent cyp450 inhibitor

Isoniazid

Anti-mycobacterial drug that inhibits DNA-dependent RNA polymerase, rapidly develops resistance SE: red orange urine, hepatotoxicity

Rifampicin

Anti-mycobacterial that inhibits arabinogalactan synthesis SE: Visual dysfunction (Retrobulbar neuritis, color blindness)

Ethambutol

Anti-mycobacterial drug that is generally bacteriostatic but is bactericidal on actively dividing MTB SE: Hyperuricemia, greatest effect on hepatotoxicity

Pyrazinamide

Anti-mycobacterial drug which binds to the 30s subunit of the ribosome SE: Nephrotoxicity, ototoxicity

Streptomycin

Hepatotoxic TB Drugs

Isoniazid < Rifampin < Pyrazinamide

Most active drug against M. Leprae, Inhibits Folate synthesis SE: Methemoglobinemia, G6PD

Dapsone

Drug for M. Leprae that Inhibits DNA-dependent RNA polymerase SE: Red-orange urine, delays onset of Dapsone resistance

Rifampicin

Drug for M. Leprae that is a Phenazine dye which binds to guanine bases SE: Skin discoloration

Clofazimine

Anti-microbial agents that is the silver bullet against gram negative bacteria, no gram positive coverage, with PSEUDO COVERAGE

Aztreonam

Beta-Lactamase Inhibitors

Clavulanic Acid

Treatment for MRSA SE: Red man syndrome

Vancomycin

Anti-microbial drug of last resort, broad spectrum of activity SE: CNS Toxicity

Meropenem

Anti-microbial with anaerobic, and antiprotozoal coverage, treatment for pseudomembranous colitis SE: Disulfiram reaction, metallic taste, neurotoxicity

Metronidazole

Anti-microbial treatment for UTI SE: Pulmonary Fibrosis

Nitrofurantoin

Anti-microbial drugs of Last Resort

I AM your Last Shot at Victory: Imipenem, Amikacin, Meropenem, Linezolid, Streptogramins, Vancomycin

Most efficacious anti-fungal drug, forms artificial pores SE: Nephrotoxicity (RTA, ATN)

Amphotericin B

Topical Treatment of dermatophytosis and candidiasis SE: Gynecomastia and a CYP450 inhibitor

Ketoconazole

Prophylaxis and treatment of candidiasis and cryptococcus

Fluconazole

Interferes with fungal microtubules SE: Potent CYP450 inducer

Griseofulvin

Treatment fo candidiasis (oropharyngeal, esophageal, vaginal), swish and swallow of suppository preparations

Nystatin

Treatment of HSV and VZV, requires activation by viral thymidine kinase SE: Crystalluria

Acyclovir

Treatment of CMV, requires activation by viral thymidine kinase

Gangciclovir

Treatment of HSV, VZV, CMV. Does NOT require thymidine kinase activation

Foscarnet

Prevents viral uncoating, influenza A coverage SE: cerebellar dysfunction, livedo reticularis

Amantadine

Neuraminidase inhibitor | DOC for Influenza

Oseltamivir

Hepatitis B infection treatment

Lamivudine

Hepatitis C infection and RSV infection

Ribavirin

Amantadine blocks ___ and ___ causes problems with the ___.

Influenza A, rubellA, cerebellA

Nucleoside reverse transcriptase inhibitor (NRTI) requires phosphorylation primary drug for HIV prevents vertical transmission of HIV SE: Lactic Acidosis

Zidovudine (AZT)

Non-nucleoside reverse transcriptase inhibitor (NNRTI), No phosphorylation required

Delavirdine

Indinavir

Protease inhibitor SE: Fat redistribution syndrome, hyperlipidemia, insulin resistance

Fusion inhibitor which binds to the gp41 subunit

Enfuvirtide *

Binding inhibitor, CCR5 antagonist

Maravirol

Nonnucleoside reverse Transcriptase Inhibitors (NNRTIs)

Never Ever Deliver Nucleosides: Nevirapine, Efavirenz, Delavirdine

Protease Inhibitors

All protease inhibitors end with -navir. NAVIR every TEASE a PROTEASE

Primary drug for malaria. Prevents heme polymerization into hemozoin SE: Retinal Damage, hearing loss

Chloroquine

Chloroquine-resistance severe malaria DOC for pregnant patients with malaria SE: Hypoglycemia, Blackwater fever, Cinchonism

Quinine

Drug to eradicate hyponozoites of P. Vivax and Ovale

Primaquine

Chemoprophylaxis (Chloroquine-resistant areas)

Mefloquine, Malarone

Chemoprophylaxis (Multi-drug resistant Malaria drug areas)

Doxycycline

DOC for Malaria in the the Philippines (P. Falciparum)

Co-artem

Treatment for Asymptomatic cyst carries of E. Histolytica

Diloxanide Furoate

Treatment for amebic dysentery, trichomoniasis, bacterial vaginosis

Metronidazole

Treatment for Cryptosporidium parvum infection

Nitaxoxanide

Treatment for Toxoplasmosis

Pyrimethamine Sulfadiazine

Treatment for African sleeping sickness

Suramin & Melosoprol

Treatment for Chagas diase

Nifurtomix

Treatment for Leishmaniasis

Stibogluconate

Inhibits helmithic microtubules, ovicidal

Mebendazole

Inhibits helmithic microtubules, ovicidal, larvicidal, DOC for hydatid disease (echinococcus)

Albendazole

DOC for Filaria and Loa Loa SE: Filarial Fever

DEC

DOC for Strongyloides and Onchocerca SE: Mazotti reaction

Ivermectin

DOC for enterobius Vermicularis

Pyrantel Palmoate (Combantrin)

DOC for Trichinosis

Thiabendazole

DOC for Trematodes and Cestodes EXCEPT Echinococcus

Praziquantel

Back up drug for Praziquantel

Niclosamide

Sedative hypnotic drug, acute anxiety attacks, anesthesia induction, preoperative sedation

Midazolam

Seizure disorders (Status epilepticus), alcohol withdrawal, Tranquilizer

Diazepine

Date rape drug

Flunitrazepam

Antidote to benzodiazepine overdose

Flumanezil

Anesthesia induction, Lethal unjection, truth serum

Thiopental

Seizure disorders in children, SE: Precipitates porphyria, potent inducer of CYP450

Phenobarbital

Gaba receptor effects which increases frequency of GABA channel opening? Duration?

FREnzodiazepines (Frequency), BarbiDURATes (Duration)

Abnormal sleep pattern resulting from benzodiazepine use

Decreased REM Sleep

Which benzodiazepine has the longest half-life?

Chlordiazepoxide (36-200 hour halflife)

Drugs considered as date-rape drugs

Alcohol, Flunitrazepam, Gamma hydroxybutyrate

Shortest acting sedative hypnotic

Thiopental (TAYO agad)

Sleep disorder drugs

Zolpidem, Zalepion

Drug for always anxious people

BUSpirone for BUSy people

Sedative hypnotic poisoning symptoms

Hot Hot Hot DeCisioN: Hypothermia, hypotension, hypoactive bowel sounds, disinhibition, coma, nystagmus

Most frequently abused drug, Wernicke-Korsakoff syndrome in overdose, delirium tremens in withdrawal

Ethanol

Prevention of Wernicke-Korsakoff syndrome

Thiamine (Vitamin B1)

Treatment for Alcohol Withdrawal

Diazepam

Wood Alcohol SE: Visual dysfunction due to formaldehyde accumulation

Methanol

Antifreeze SE: Nephrotoxicity, dye to oxalic acid accumulation

Ethylene Glycol

Alcohol dehydrogenase inhibitor

Fomepizole

Aldehyde dehydrogenase inhibitor

Disulfiram

Disulfiram reaction drugs

Clara took the Pre-Medical Test in the PM: Chlorpropamide, Cefo (Perazone, Mandole, Tetan, Procarbazine,), Metronidazole

Anti-serizure drug that is a potent CYP450 inducer SE: gingival hyperplasia, hirsutism, fetal hydantoin syndrome

Phenytoin

Potent CYP450 inducer, DOC for partial seizures and trigeminal neuralgia SE: Blood dyscracias

Carbamazepine

Potent CYP450 inhibitor, DOC for seizures in children and pregnant women SE: Teratogen (Porphyria)

Phenobarbitals

Potent CYP450 inhibitor, DOC for GTC, and myoclonic seizures SE: Teratogen (Spina Bifida)

Valproic Acid

DOC for absence seizures

Ethoxsuximide

DOC for status epilepticus

Diazepam

Treatment for neuropathic pain

Gabapentin

Anti-seizure drug which cayses SJS as its side effect

Lamutrigine

Summary Anti-seizure drugs DOC for GTC

Valproic acid, Phenytoin, carbamazepine

Summary Anti-seizure drugs DOC for Partial Seizure

Carbamazepine, Lamotrigine, Phenytoin

Summary Anti-seizure drugs DOC for Absence Seizures

Ethosuximide, Valproic Acid

Summary Anti-seizure drugs DOC for Myoclonic and Atypical Absence Syndromes

Valproic Acid

Summary Anti-seizure drugs DOC for Status Epilepticus

Lorazepam, Diazepam, Phenytoin, Phenobarbital

Highest MAC (lowest potency) SE: Euphoria

Nitrous oxide

Not clearly described MOA SE: Pulmonary irritant

Desflurane

Not clearly defined MOA, postoperative hepatitis, malignant hyperthermia

Halothane

Lowest MAC (highest potency) slowest induction and recovery

Methoxyflurane

Dissociative anesthesia, NMDA receptor blocker SE: Emergence Delirium

Ketamin

Anesthesia for patients with limited cardiopulmonary reserve SE: Adrenal suppression

Ethomidate

Prolonged sedation, Milk of magnesia SE: Hypotension

Propofol

How to distinguish local anesthetics if they are esters or amides?

esters one I (tetracaine, procaine, benzocaine); amides to ii (Bupivacaine, Ropivacaine, Lidocaine)

Which local anesthetics have the shortest and longest half-lives?

A PRO finishes the race fastest (Procaine 1-2 mins), at the end of the long ROPe (Ropivacaine 4.2 hours)

Why should we not inject Licodaine in to absecesses

won't work due to acidic environment

What is the toxic dose of Lidocaine

5mg/kg, 1% = 10mg/ml

Skeletal muscle relaxant that is a prototype non-depolarizine neuromuscular blocker se: orthostatic hypotension

Tetradotoxin

Skeletal muscle relaxant that undergoes Hoffman elimination SE: Bronchospasm, most frequently used nondepolarizing neuromuscular blocker

Atracurium

Skeletal muscle relaxant that is used for lethal injection, strychnine poisoning

Pancuronium

Reversal agent for non-depolarizing neuromuscular blockage

neostigmine

Skeletal muscle relaxant that is the only depolarizing neuromuscular blocker SE: Malignant Hyperthermia, affected by pseducholinesterase activity

Succinylcholine

Treatment for Malignant Hyperthermia

Dandrolene

Drug of choice for Parkinson's disease

Levodopa + Carbidopa

Bromocriptine

Treatment of hyperprolactenemia SE: Erythromelalgia, pulmonary fibrosis

Entacapone

Adjnctive drug for wearing off phenomenon

Antiparkinsonism drug with antiviral properties, SE: Livedo reticularis, cerebellar ataxia

Amantadine

Improves tremor and rigidity but has no effect of bradykinesia, atropine like effects

Benztropine

Parkinson's disease symptoms

It's a TRAP: Tremor, Rigidity, Akinesia, Postural instability

Livedo reticularis causing drugs

A man reads FHM and GQ! Amantadine, Hydroxyurea, Minocycline, Gemcitabine, Quinidine

Prototype atypical antipsychotic drug SE: Corneal and lens deposits, failure of ejaculation

Chlorpromazine

Treatment of Floridly psychotic patients SE: Major EPS (Neuroleptic Malignant syndrome)

Haloperidol

DOC for suicidal and refractory schizophrenics SE: Agranulocytosis

Clozapine

2nd generation antipsychotic SE: Marked with gain, hyperglycemia

Olanzapine

2nd generation antipsychotic SE: Priaprism, hypnagogic hallucinations

Quetiapine

Anti-psychotic for schizophrenia in the youth SE: Marked prolactinemia

Risperidone

Drug for Mania SE: Nephrogenic DI, Teratogen (Ebstein's Anomaly)

Lithium

Features of Neuroleptic Malignant syndrome

FEVER! Fever, Encephalopathy, Vitals unstable, Elevated CPK, Rigidity

Tricyclic Antidepressant, Treatment of enuresis SE: Atropine-like effects, Cardiotoxicity

Imipramines

SSRI, First line for MDD SE: Erectile dysfunction, serotonin syndrome

Fluoxetine,

SNRI SE: Hypertension

Venlafaxine

Serotonin Antagonist SE: Priparism

Trazodone

Tetracyclic antidepressant, smoking cessation SE: Weight loss, priaprism, seizures

Bupropion

MAOi SE: Hypertensive crisis when taken with tyramine (cheese), serotonin syndrome

Phenelzine

Features of TCA overdose

CCC: Coma, convulsion, cardiotoxicity

Erectile dysfunction drugs

A SORE Penis can't Fuck Hard! SSRIs, Opiates, Risperidones, Ethanol, Propanolol, Estrogens, Spironolactone, Finasteride, Hydrochlorothiazide

Priaprism causing drugs

Tigas Penis Qu AyaW Bumaba! Trazodone, Papaverine, Sildenafil, Quetiapine, Alprostadil, Warfarin, Bupropion

Symptoms of Serotonin Syndrome

FAT CHD! Fever Agitation Tremor Clonus Hyperreflexia Diaphoresis

Prototype Opiod (Full agonist) SE: Miosis, respiratory depression, constipation

Morphine

Drug for Severe Pina, Breakthrough Cancer pain, available in lollipop form or transdermal patch

Fentanyl

Opiod of choice for acute pancreatitis, does NOT cause miosis SE: Seizures

Meperidine

Replacement therapy for opiod dependence

Methadone

Cough suppression drug

dextrometorphan

Balanced anesthesia, frequently abused by healthcare professionals

Nalbuphine

Antidote for opiod overdose

Naloxone

Treatment for opiod depence

Naltrexone

Opiods with the longest and shortest half-lives

REMIFENTANIL: Shortest (3-4 mins), Buprenorphine: Longest (4-8 hours)

Opiod overdose triad

Miosis, coma, respiratory depression

Opiod receptor functions

Mu (Mubagal huminga, delTa (Tolerance), Kappa (Konstipation)

Drug of abuse which causes euphoria, sleeplessness, self-confidence

Amphetamine

Drug of abuse which causes sexual enhancement, hyponatremia

MDMA

Drug of abuse which causes mydriasis, crack lung, teratogen (cystic cortical lesions)

Cocaine

Most dangerous hallucinogen, psychotomimetic effects, nystagmus

Phenylcycline

Psychedelic effect drug of abuse which causes out of body experiences, mind raveling effects, bad trips

LSD

Drug of abuse which causes a dream like state, red conjunctiva, tachycardia, dry mouth

Marijuana

HMG-CoA reductase inhibitor, lowers LDL SE: Hepatotoxicity, rhabdomyolysis, myopathy

Statin

Bile acid binding resin, lowers LDL SE: Constipation & Steatorrhea

Cholestyramine ***

Cholesterol absorption blocker, lowers LDL

Ezetimide

Reduces all building blocks of hyperlipidemia, increases HDL, lowers LDL and TG SE: Flushing, hyperglycemia, hyperuricemia

Niacin

PPAR-a activator, upregulates lipoprotein lipase, lowers TF SE: Gallstones, additive myopathy

Gemfibrozil

Why are statins used in the management of coronary artery disease?

Stabilizes atherosclerotic plaque

Drugs that cause flushing

Vancomycin, adenosin, niacin, CCB

Treatment of genetic short stature, failure to thrive

Somatropin

Treatment of acromegaly, variceal bleeding

Octreotide

Treatment of hyperprolactenemia, prolactinoma

Bromocriptine

Labor induction and augmentation, control of PPF SE: Fluid retendion

Oxytocin

Treatment for Central DI

Desmopressin

Treatment of hypothyroidism, myxedema coma

Levothyroxine

Inhibits thyroid peroxidase, blocks peripheral conversion of T4 to T3 SE: Aganulocytosis, DOC in pregnant hyperthyroid patients

PTU

Inhibits Thyroid Perocidase SE: Agranulocytosis, Teratogen (Aplasia Cutis)

Methimazole

Preferred treatment for hyperthyroidism SE: Permanent hypothyroidism

Radioactive Iodine

Reduces size and vascularity of thyroid gland

Lugol's Solution or SSKI

Symptomatic treatment of hyperthyroidism, decreases peripheral conversion of T4 to T3

Propanolol

Difference between Wolf-Chaikoff effect from Jod-Basedow phenomenon?

WC: Iodine Ingestion leads to hypothyroidism JB: leads to hyperthyroidism

Anti-thyroid drugs that inhibit peripheral conversion of T4 to T3

Propanolol, PTU, Hydrocortisone

Drugs that cause drug-induced hyperthyroidism

Clofibrate, Amiodarone, Methadone?*

Acute Adrenal Insufficiency, Status Asthmaticus, Thyroid Storm

Hydrocortisone

Prototype oral glucocorticoid SE: Adrenal suppresion, cushing syndrome

Prednisone

Hastens fetal lung maturation

Betamethasone

Mineralocorticoid replacement for chronic adrenal insufficiency (Addison disease)

Fludrocortisone

Two steroids you have to give for hypoadrenalism

Prednisone and Fludrocortisone

Most frequently used synthetic estrogen in OCPs SE: Hypertension, DVT/PE, endometrial CA, CI in women AGE >35, who are heavy smokers

Ethynyl estradiol

Female gonadal hormone drug which has this SE: Clear cell vafinal adenoCA in daughter

Diethylsilbestrol

Prevents estrogen-induced endometrial CA

Norgestrel

OCP of choice in lactating women

DMPA

Emergency contraception, Yuzpe Regimen

Levonorgestrel

Hormone-reponsive breast CA SE: Endometrial CA

Tamoxifen

Ovulation induction SE: Multiple pregnancies

Clomiphen

Treatment for endometriosis

Danazol

Medical Abortion

Mifepristone

Treatment of male hypogonadism SE: Virilization, paradoxical feminization

Testosterone

Anabolic steroids, illegal performance enhancers

Oxanprolone

treatment of prostate cancer, coadministered to prevent acute flareups of tumor

Flutamide + Leuprolide, FLUtangina it’s a FAKE androgen

5-a-reductase inhibitor, treatment for BPH and male pattern baldness

Finasteride

Most efficatious antidiabetic drug which activates tyrosine Kinase SE: Hypoglycemia, lipodystrophy

Insulin

1st generation SU SE: Hypoglycemia, weight gain, Disulfiram reaction

Chlorpromaide

2nd generation SU SE: Hypoglycemia, weight gain, disulfiram reaction

Glipizide

Newer insulin secretagogue, no hypoglycemia

Repaglinide

First line antidiabetic drug, decreases gluconeogenesis SE: Lactic acidosis, weight loss, GI upset

Metformin

TZC, Acts on PPAR-gamme, insulin sensitizer SE: CHF

Pioglitazone

a-glucosidase inhibitor SE: Flatulence

Acarbose

Insulin noteable drugs

LISpro (mabiLIS), gLARGine (Go Large), LANTus (LANTa na sa sobrang tagal!)

Which patients are more prone to developing hypoglycemia with insulin use?

Advanced renal disease, elderly, children younger than 7 years

Inactive Vitamin D, treatment for Rickets and osteomalacia

Ergocalciferol

Active Vitamin D, Tx of 2 Hyperparathyroidism

Calcitriol

Treatment of Paget's disease of bone, hypercalcemia, Tumor marker for medullary thyroid Carcinoma

Calcitonin

Supresses osteoclast activity, treatment for Paget's disease of the bone and osteoporosis SE: Esophagitis

Alendrolate

Phosphate-binding resin

Sevelamer

PTH Function

Phosphate trashing hormone

Symptoms of Excess PTH

Painful bones, renal stones, abdominal groans, psychic overtones

Function of calcitonin

Tones down calcium in the body

Neutralizes stomach acids SE: Diarrhea-constipation (Cancels each other)

Maalox

Greatly suppresses nocturnal acid secretion, H2 blocker SE: Gynecomastia

Cimetidine

Irreversible blockade of H+/K+ ATPase, DOC for PUD and Zollinger-Ellison syndrome

Omeprazole

Prokinetic agent, antiemetic DOC for diabetic gastroparesis

Metoclopromide

Osmotive Laxatice, treatment of hepatic encephalopathy

Lactulose

Stimulant Laxative SE: Melanosis Coli

Senna

Opiod antispasmodic, DOC for noninfectious diarrhea SE: Paralytic ileus (in children)

Loperamide

Magnesium hydroxide vs Aluminum Hydroxide differences

MAGtatae ka! (Diarrhea) vs Ayaw LUMabas (Constipation)

Taxanes

M-phase: Albumin bound paclitaxel, Docetaxel, Paclitaxel

Vinca alkaloids

M-phase: Vinblastine, Vincristine, Vinorelbine

Antimicrotubules inhibitor

M-phase: Ixabepilone

Antitumor antibiotics (G2-M Phase)

Bleomycin

Anthracyclines

Daunorubicin, doxorubicin, epirubicin, idarubicin, mitoxantrone

Antitumor abtibiotics

dactinomycin, mitomycin

Camptothecins (Topoisomerase I inhibitors)

Irinotecan, Topotecan

Platinum Analogs

Carboplatin, Cisplatin, Oxaliplatin

Antimetabolites (S-phase)

5-flurouracel, 6-merceptopurine

Alkylating Agents

Busullfan Carmustine Cyclophosphamide Dacarbazine

Treatment of Lymphomas is using the alkylating agent SE: Hemorrhagic systitis. What is its Rescue agent?

Cyclophosphamide (Rescue: Mesna)

Alkylating agent side effect of this drug is marked vesicant actions (Skin blistering)

Mechlorethiamine

Alkylating agent used for the treatement of Colon Cancer SE: Ototoxicity, Nephrotoxicity. What is its rescue agent?

Cisplatin (Rescue: Amifox)

This alkylating agent's SE are Disulfiram reaction and Leukemogenesis

Procarbazine

Side effect of this alkylating agent is Pulmonary Fibrosis, bone marrow sparing

Bulsulfan

Alkylating agent used in the treatment of brain tumors SE: CNS Toxicity

Carbustine

Which drugs cause pulmonary fibrosis

BBBAN ME! Bleomycin, Busulfan, Bromocriptine, Amiodarone, Nitrofurantoin, Methotrexate

Antimetabolite used for the treatment of lymphomas and GTN SE: Myelosuppression, pulmonary fibrosis. What is its rescue agent?

Methotrexate (Leucovorin or Folinic acid)

Antimetabolite. Treatment of acute leukemia. SE: Myelosuppression, hepatotoxicity, metabolism inhibited by allopurinol

6-mercaptopurine

Treatment of colorectal and skin cancer, causes thymine-less death of cells. SE: Myelosuppression

5-Flurouracil

Treatment of CML in blast crisis, most specific for the S phase of the cell cycle. Antimetabolite.

Cytarabine

Inhibits ribonucleotide reductase, treatment of pancreatic cancer

Gemcitabine

Vinca alkaloid. Prevents microtubule assembly. SE: Peripheral neuropathy

Vincristine

Podophyllotoxin, inhibits DNA topoisomerase II, Treatment of lung cancer, Non-hodgkin's lymphoma and GTN

Etoposide

Camptothecin, inhibits DNA topoisomerase I, treatment of small cell lung cancer

Topotecan

Taxane, prevents mictrotubule disassembly, advanced breast and ovarian cancers

Paclitaxel

Intercalating agent SE: dilated cardiomyopathy. What is its rescue agent?

Doxorubicin (Rescue agent: Dexrazoxane)

Treatment of testicular cancer SE: Pulmonary fibrosis, most specific for the G2 phase of the cell cycle

Bleomycin

Treatment of melanoma, Wilms tumor and GTN

Actinomycin D

Tyrosine Kinase inhibitor, Treatment of CML SE: Fluid retention, multiple drug interaction

Imatinib

Treatment of metastatic breast cancer, active against cells expressing HER-2/neu

Transtuzumab

Inhibits VEGF, Treatment of metastatic cancers

Bevacizumab

Differentiation therapy, treatment of acute promyelocytic leukemia, only vitamin that can cure cancer

All-trans retinoic acid (ATRA)

Acute arsenic poisoning, acute mercury poisoning, chronic severe lead poisoning SE: Hypertension

Dimercaprol

Pica, ingestion of flakes of paint, abdominal colic, acute encephalopathy, wrist drop, mental retardation

Lead

Chronic Lead poisoning (oral treatment)

Succimer

Chronic severe lead poisoning SE: Hypocalcemia

EDTA

Rice-water stools, garlicky breath, Mee's lines, raindrop pigmentation, milk and roses complexion

Arsenic

Hemorrhagic gastroenteritis, renal failure, loosening of gums and teeth, erethism

Inorganic Mercury

Minamata disease (Cerebral palsy, deafness, blindness, mental retardation)

Organic Mercury

Severe GI Necrosis, hemosiderosis, restrictive cardiomyopathy

Iron

Acute iron poisoning, hemochromatosis

Deferoxamine

Hepatotoxicity, Kayser-Fleisher rings, sunflower cataracts

Copper

Copper poisoning, Wilson's disease SE: Drug induced lupus

Penicillamine

Anti-neoplastic drug known for its nephrotoxicity and acoustic nerve damage

Cisplatin and carboplatin

Anti-neoplastic drug known for its Peripheral Neuropathy

Vincristine

Anti-neoplastic drug known for Pulmonary Fibrosis

Bleomycin

Anti-neoplastic drug known for Hemorrhagic Cystitis

Cyclophosphamide (Rescue: Mesna)

Anti-neoplastic drug known for its Severe Myelosuppressive effects

Methotrexate, 5-flurouracil, 6-mercaptopurine

Refers to the amount of a drug that reaches the systemic circulation

bioavailability

used to determine the safety and efficacy of generic drugs vs the innovator drug

bioequivalence

Measures the dose oir concentration required to bring about 50% of the drug's maximal effect

potency

dose at which 50% of the individuals exhibit the specified quantal effect

Median effective dose

dose at which 50% of the animals manifest a particular toxic effect

Median Toxic dose

Transfer of drug from site of administration to blood stream

Absorption

Refers the apparent volume into which the drug is able to distribute

Volume of distribution

Eliminination of a drug at a constant rate

Zero order kinetics

Elimination at a rate that is proportional to the serum concerntraion of the drug

First order kinectic

Addition of a polar moiety (sulfate, acetate, or glucoronate)

Phase II Metabolism

Use of CYP450 system (oxidation, reduction, hydrolysis, or deamination)

Phase I Metabolism

Describes the rate at which a specific drug is cleared from the system

Clearance

Refers to the amount of time required for the amount of the drug in the body to decrease to half of its value after the administration of the drug has been stopped.

Half-life

Defined ast the single amount of drug that is needed to achieve a desired plasma concentration quickly

Loading dose

Amount of drug that must be given over time in order to maintain a desired plasma concentration

Maintenance dose

Used as a measure of drugs safety

Therapeutic dose

Formula for therapeutic index

TD50 / ED50

Refers to the dosage range between the minimum effective therapeutic concenration of dose and minimum toxic concentration or dose

Therapeutic window

Substance that shifts the graded dose-response curve to the right

Competitive antagonists

Substance that does not produce the same maximum effect and is exhibited by a decrease in the Emax

Partial agonist

Substance that depress the graded-dose response curve

Irreversible antagonist

An agonist that interacts directly with the agonist and not at all or only incidentally with the receptor

Chemical antagonist

The action of the drug on the body

Pharmacodynamics

The action of the body on the drug

Pharmacokinetics

Permeation that is governed by Fick's Law

Aqueous diffusion, Lipid Diffusion

Permeation that is saturable and inhibitable

Carrier Transport

Adverse effect that is infrequently observed in most patients.

Idiosyncratic

Responsiveness decreases as a consequence of continued drug administration

Tolerance

Responsiveness diminishes rapidly after drug administration

Tachyphylaxis

Induction of developmental defects in the fetus

Teratogenesis

Induction of malignant characteristics in cells

Carcinogenesis

Induction of changes in the genetic material of animals of any age

Mutagens

Cytochrome P450 Inducers

Ethyl Booba takes Phen-Phen and Refuses Greasy Carb Shakes: Ethanol Barbituates Phenytoin, Rifampicin, Griseofulvin, Carbamazepine, St. John's Wort / Smoking

Cytochrome P450 Inhibitors

Queen Victoria's SICK GEAR: Quinidine, Valproic Acid, Sulfonamide, Isoniazid, Carbamazepine, Ketoconazole, Grapefruit Juice, Erythromycin, Amiodarone, Rifampicin

Route of drug administration with 100% bioavailability

Route of drug administration with First pass effect

Oral

Route of drug administration with partial avoidance of first pass effect

Rectal

Route of drug administration with application to skin for local effect

Topical

Route of drug administration with appllication to skin for systemic effect (80% bioavailability; prolonged absorption)

Transdermal

Phase of drug study with a small number of volunteers

Phase of drug study which answers the question "does it work in patients?"

Phase of drug study when a randomized, double blind, controlled trial is done

IIII

Phase of drug study with post-marketing surveillance

A drug for rare diseases

Orphan drug

How do you hasten extretion of an overdose with a weak base like Diphenhydramine

Acidyfying agent: Ammonium Chloride

How do you hasten extretion of an overdose with a weak acid like Aspirin

Alkalynyzing agent: Sodium Bicarbonate

Located in the Smooth muscles binding to these receptors promote vasoconstriction (Epi>NE>>Isoprotenol)

Alpha 1

Located in the presynaptic NT binding to these receptors inhibits relase of Neurotransmitters (EPI>NE)

Alpha 2

Located in the heart binding to these receptors increase rate and contractility (Isoprotenon>Epi>NE)

Beta 1

Located in the respiratory Smooth Muscles binding to these receptors promote bonchoconstriction / vasodilation (Isoprotenol>epi>NE)

Beta 2

Located in the splanchnic and renal vessels binding to these receptors promote vasodilation of renal blood vessels

Dopamine 1

Located in the nerve terminals of the CNS binding to these receptors regulate neurotransmitters

Dopamine 2

Bowel and bladder atony

Betanechol (Direct acting muscarinc action M2-M3)

Treatment for Sjoren Syndrome

Pilocarpine (Direct acting muscarinic M1,M2,M3)

Diagnosis of myesthenia gravis, differentiation of myasthenic and cholinergic crisis

Edrophonium (Indirect acting cholinomimetic, hydrolysis of cholinesterase)

Treatment of myasthenia gravis

Neostigmine (Cholinimimetic, indirect acting)

Reversal of non-depolarizing neuromuscular block

Neostigmine

Treatment of glaucoma

Physostigmine

Diagnosis of bronchial hyperreactivity

Methacoline (direct acting)

Treatment of Alzheimer's disease (Cholinergic Drug)

Donepezil (acetylcholinesterase inhibitor)

Components of Sjogren Syndrome

Autoimmune triad of: Xerostomia, Xerophthalmia & Rheumatoid Arthritis

Components of Myasthenia Gravis

Autoimmune destruction of nicotinic Ach receptors characterized by fluctuating muscle weakness (ocular symptoms, bulbar symptoms, proximal muscle weakness)

Differentiate myasthenic crisis from cholinergic crisis

Myasthenic crisis (acute worsening of symptoms due to infection, stress, or UNDER medication) Cholinergic crisis (excessive activation of cholinoreceptors due to OVER medication)

How does Edrophonium differentiate myasthenic crisis from cholinergic crisis?

Edrophonium IMPROVES muscle strength in myasthenic crisis and WEAKENS muscle strength in cholinergic crisis

Small cell cancer may present with a myasthenia like paraneoplastic syndrome. What is this condition called?

Lambert-Eaton syndrome: Destruction of presynaptic voltage gate Ca Channels by antibodies

What are the signs and symptoms of organophosphate poisoning?

DUMBBELSS: Diarrhea, urination, miosis, bronchospasm, bradycardia, excitation (skeletal muscle and CNS), sweating, salivation

Cholinergic antagonist that leads to induction of mydriasis and cycloplegia

Tropicamide

Treatment for Sinus bradycardia

Atropine

Cholinergic antagonist for Parkinson's disease

Benztropine

Cholinergic antagonist for COPS

Ipratropium (M3 antagonist)

Cholinergic antagonist for motion sickness, sea sickness

Scopolamine

Gastrointestinal Spasms

Hyoscyamine

Treatment for organophosphate poisoning/ nerve gas poisoning

Atropine & Pralidoxime

Muscarinic antagonists for Parkinsons disease

TRI to park your BENZ and make BIP BIP: TRIhexyphenidyl, BENZtropine, BIPeriden

Why is ipratropium the preferred bronchodilator in patients with comorbid COPD and heart disease?

Ipratropium is less likely to cause tachycardia and cardiac arryhthmias

Signs of atropine toxicity?

HOT as a hare, DRY as a bone, RED as a beet, BLIND as a bat, MAD as a hatter

DOC for anaphylactic shock, adjunct to local anesthesia, cardiac arrest, croup

Epinephrine

Acute CHF, cardiac stress testing

Dobutamine

Acute CHF, Shock (Cardiogenic, septic)

Dopamine

Drug of last resort for shock

Norepinephrine

Nasal congestion, mydriasis WITHOUT cycloplegia

phenylephrine

SE: Rebound hypertension of this antihypertensive on discontinuation

Clonidine

Drug for preeclampsia SE: Hemolytic anemia (positive coombs test)

Methyldopa

Bronchial asthma, COPS

Salbutamol (B2-agonist)

Tocolysis for preterm labor

Terbutaline (B2-agonist)

Preoperative treatment for pheochromocytoma

Phenoxybenzamine

Treatment for rebound hypertension

Phentolamine

BPH SE: First dose orthostatic hypotension

Prazosin (Give before bed time)

Angina prophylaxis, hyperthyroidism, masks hypoglycemia in diabetics

Propanolol

Intrinsic sympathomimetic activity

Pindolol

Beta-1 selectivity

Atenolol

Treatment for glaucoma adrenergic antagonist which decreases production of aquaeous humor

Timolol

Combined alpha and beta blockade

Labetalol

What are drugs used to control blood pressure in pheochromocytoma?

Phenoxybenzamine, Phentolamine, Labetalol

What is the pharmacologic advantage of a1 selectivity?

Reflex tachycardia is less common and less severe

Isisoproterenol a beta blocker?

Is a ISOproterenol is NOT a beta blocker it is a nonselective beta agonist

What drugs have intrinsic sympathomimetic activity?

Pindolol, Acebutolol

Adrenergic antagonist with the longest half life

Nadolol (NAsaDOLO)

Adrenergic antagonist with the shortest half life

Esmolol (Esmol)

What is the formula for blood pressure?

BP = COxSVR

What is the expanded formula for your blood pressure?

BP=HRxSVxSVR

First line drug for essential hypertension

Hydrochlorothiazide

Hypertension with comorbid CHF/ DM SE: cough, angioedema, CI in bilateral RAS

Captopril (Ace-i)

Coughing with ACE inhibitors alternative

Losartan (ARBs)

Hypertension with comobid BPH

Prazosin (a1-blocker)

Pre-eclampsia (maintenance medication) SE: Hemolytic anemia (positive coombs test)

Methyldopa

Pre-eclampsia (acute BP lowering) SE: Reflex tachycardia, drug induced lupus

Hydralazine

Hypertensive emergency SE: Hypertrichosis

Minoxidil

Hypertensive emergency SE: Cyanide poisoning

Nitroprusside

Treatment of cyanide poisoning

Inhaled Amyl Nitrite + IV sodium nitrite + IV sodium thiosulfate

Which portion of the electron transport chain is affected by cyanide?

Complex IV (Cytochrome Oxidase)

Relief of acute anginal attacks SE: headache

NTG, ISDN (short onset)

Angina maintenance (Vascular > Cardiac effect) SE: Flushing edema, gingival hyperplasia

Nifedipine (dihydropterydine)

Angina maintenance (Vascular < Cardiac effect) vasospastic angina, Raynaud's phenomenon, doest NOT cause gingival hyperplasia

Diltiazem (non-dihydropteryine)

Supraventricular tachycardia (Cardiac > Vascular) SE: Gingival hyperplasia

Verapamil (non-DHP)

Why do patients taking nitrates usually experience throbbing headaches?

Dilation of meningeal

Why is calcium-dependent neurotransmission or hormone realease not affected by CCBs?

CCBs block L-type calcium channels other functions use N,P, and R types

Drugs that cause gingival hyperplasia

NapaCa Pangit ng gingiVa mo! Nifedipine, Cyclosporine, Phenytoin, Verapamil

Positive inotrope for heart failure SE arrythmias (PVC AVB) RG color blindness, yellow visual haloes

Digoxin

Treatment for pulmonary edema in CHF

Furosemide

First line drug for chronic CHF, cardioprotective, prevents cardiac remodelling

Ace-I, ARB

Improves survival (decreases mortality) in CHF

Ace-I, ARB, BB, Spironolactone

Decreases hospitalizations in CHF

Digoxin

Improves survival in CHF patients of African-American descent

Hydralazine + ISDN

What drugs have been shown to improve survival in cases of heart failure?

ABA! Buhay ka pa! ACEi, Beta Blockers, Aldosterone antagonists

Treatment of all types of arrythmias, WPW syndrome SE: Drug induced lupus

Procainamide

SE: Cinchonism (headache, tinnitus, vertigo)

Quinidine

Post-MI arrythmias, digitalis arrhytmias, SE Seizures

Lidocaine

CI post-MI, refractory arrythmia

Fleicanide

Perioperative and thyrotoxic arrhythmias, SVT

Esmolol

SE: dose-dependent torsades de pointes

Sotalol

Most efficacious antiarrythmic, SE: Skin deposits, pulmonary fibrosis, hyper/ hypothyroidism

Amiodarone

Outpatient management of SVT SE: Gingival hyperplasia

Verapamil

What are the effects of class I antiarrythmics on action potential duration?

1A: prolongs AP 1B: shortens 1C: no change

Class IA Anti-arrhythmics

I Am the Queen who Proclaimed Diso's pyramid: Quinidine, Procainamide, Dysopyramide

Class IB Anti-arrhytmics

I Buy Mexican Taco's from Lili: Mexiletine, Tocainide, Lidocaine (Best post MI)

Class IC Anti-arrhytmics

Chicken ay Pagkain for Enrico: IC: Propafenone, Flecainide, Encainide (IC: CI post MI)

Drugs that causes agranulocytosis

CCCAPPIT! Clozapine, Co-trimoxazole, colchicine, aminopyrine, phenybutazone, PTU, ondimethacin, Tocainide

Amiodarone Toxicity

Pulmonary fibrosis, paresthesias, tremors, thyroid dysfunction, corneal deposits, skin deposits

Why are dihydropyridine CCBs not useful as antiarrhytmics

They evoke compensatory sympathetic discharge which facilitates arrhytmias rather than terminating them

Antiarrythmics that prolong AP duration, PR interval, QRS duration, QT interval

1A Procainamide

Anti-arrythmics that shorten AP duration and has NO effect on normal cells on the ECG

1B Lidocaine

Anti-arrythmics that has no effect on AP duration, but prolongs QRS duration on ECG

1C Flecainide

Anti-arrythmics that has no effect on AP duration, but prolongs PR interval on ECG

2 Propanolol

Anti-arrythmics that prolongs AP duration, and prolongs QT interval on ECG

3 Dofetilide

Anti-arrythmics that has no effect on AP duration, but prolongs PR interval on ECG

4 Verapamil

This acts on the PCT, treatment of glaucoma and mountain sickness SE: NAGMA, hepatic encephalopathy

Acetazolamide

Acts on TAL, treatment of pulmonary edema, most efficacious diuretic SE: ototoxicity, hypokalemia, hypocalcemia

Furosemide

Acts on DCT SE: Hyper GLUC

Hydrochlorothiazide

Acts on PCT, DCT, CCD, Treatment of rhabdomyolysis and increased ICP, CI in heart failure

Mannitol

HAGMA drugs

MUDPILES

NAGMA drugs

HARDUP

Adverse effects associates with loop diuretics

OH DANG! Ototoxicity, Hypokelemia, Dehydration, Allergy to sulfa, Nephritis, Gout

Adverse effects of Thiazide diuretics

HYPER GLUC

What drugs can cause gynecomastia

Some Drugs Create Awesome Knockers: Spironolactone, Digoxin, Cimetidine, Alcohol, Ketoconazole

Treatment of iron deficiency anemia

Ferrous sulfate

treatment of megaloblastic anemia, Vitamin B12 deficiency

Cyanocobalamin

Treatment of megaloblastic anemia, prevention of Neural tube defects (Spina Bifida)

Folic acid

Anemia in chronic kidney disease

Erythropoetin

Treatment of neutropenia and agranulocytosis

Figrastim (GMCSF)

Treatment of chemotherapy induced thrombocytopenia

Opelverin (Thrombopoeitin)

Acute treatment of DVT, PE and AMI SE: Bleeding thrombocytopenia, monitor with PTT

Heparin

LMWH less risk of thrombocytopenia, no need for monitoring

Enoxaparin

Treatment of heparin-induced thrombocytopenia

Lepirudin

Antidote to heparin-induced bleeding

Protamine-Sulfate

Chronic anti-coagulation SE: Bleeding skin necrosis, and many drug interactions

Warfarin

Antidote to warfarin (Immediate and over time)

FFP, Vitamin K

What laboratory tests will you request to assess intrinsic and extrinsic coagulation pathways

PTT (intrinsic) PT (extrinsic

In patients requiring anticoagulation, why is an overlap between heparin and warfarin usually done?

1. Warfarin's effect requires elimination of preformed clotting factors (8-60h) 2. to bypass initial prothrombic effect of warfarin (skin necrosis)

Thrombolysis in AMI, ischemic CVD and PE SE Bleeding

Alteplase, R-TPA

Bacteria-derived thrombolytic, decreased effect on subsequent uses due to antibody formation

Streptokinase

Antidote to thrombolytic overdose

Aminocaproic Acid (Tranexamic acid)

Irreversible COS inhibitor, instant prevention of arterial thrombosis SE: Tinnitus, hypersensitivity, Reye Syndrome

Aspirin

ADP inhibitor, additive effects with Aspirin

Clopidogrel

Glycoprotein IIb-IIIa inhibitor

Abciximab

Phosphodiesterase inhibitor

Dipyridamole

How many 500 mg aspirin tablets must be ingested to produce toxicity? death?

toxic dose 150mg/kg x70kg = 21 tablets, lethal dose 500mg/kg = 70 tabs

Triad for aspirin hypersensitivity

Sampter's triad: aspirin hypersensitivity, asthma, nasal polyp

What are the signs of ASA poisoning?

Aspirin poisoning C-H-A-F-S (Coma, hyperventilation, Acidosis (HAGMA), Fever, Seizure

What is the expected acid-base abnormality in salicylate poisoning?

Respiratory alkalosis with HAGMA

What is the difference between an inhibitor and an uncoupler of oxidative phosphorylation ?

Inhibitors completely halt ETC, uncouplers: dissipate proton gradient without interrupting ETC

HMG-CoA reductase inhibitor, lowers LDL SE: Hepatotoxicity, rhabdomyolysis, myopathy

Simvastatin

Bile acid binding resin, lowers LDL SE constipation steatorrhea

Cholestyramine

Cholesterol absorption blocker, lowers LDL

Ezetmibe

Reduces all building blocks for hyperlipidemia, increases HDL, lowers LDL and TG se: flushing hyperglycemia, hyperuricemia

Niacin (Vitamin B3)

PPAR-a activator, upregulated lipoprotein lipase, lowers TG SE: Gallstones, additive myopathy

Gemfibrozil

Why statins are used in the management of coronary artery disease?

For atherosclerotic plaque stabilization

What are the drugs that cause flushing?

VANC: Vancomycin, Adenosine, Niacin, CCB

Irreversibly inhibits COX 1 & 2

Aspirin

Reversible inhibitor COX 1 & 2

NSAIDS (Ibuprofen)

Irreversibly inhibits COX 2

Celecoxib

Reversibly inhibits COX 1 and 2, antipyretic of choice in pediatric population

Paracetamol

Treatment of hypersensitivity SE: Sedation

Diphenhydramine

Adjunct for motion sickness, vertigo

Meclizine

Treatment of hypersensitivity, non-sedating

Cetirizine

Treatment of peptic ulcers SE Gynecomastia

Cimetidine

Drug of choice for migraine and cluster headache

Sumatriptan

Treatment for postop and postchemo vomiting

Ondansetron

adjunct for migraine and cluster headache

Ergotamine

Treatment of postpartum bleeding

Ergonovine

SE: retroperitoneal fibrosis

Methylsergide

PGE-1 analog used for erectile dysfunction and also maintains PDA patency

Alprostadil

PGE-1 analog which is used for NSAID induced gastritis

Misoprostol

PGEF2A analog which is used for chronic glaucoma

Latanoprost

PGE2 analog which could be used as an abortifacient or cervical ripening

Dinoprost

PGF2A analog which could be used as an abortifacient

Carboprost

PGI2 analog which could be used for pulmnonary hypertension

Epoprostenol

Drug of choice for acute asthma attacks

Salbutamol (B2-agonist)

adjunct for asthma maintenance

Salmeterol

Prophylaxis for nocturnal asthma SE Seizures, antidote: Propanolol

Theophylline (Methylxanthines)

Bronchodilator of choice in COPD

Ipratropium

Stabilizes mast cells, No bronchodilator effect

Cromolyn

Drug of choice for asthma maintenance SE: oral candidiasis, growth stunting

Fluticasone

Lipoxygenase inhibitor, SE: Increase AST/ALT

Zileuton

Blocks slow-reacting substances of anaphylaxis (Leukotrienes C4, D4, E4)

Montelukast