Pharmacopoeia Flashcards
Heparin (unfractionated)
- Anticoagulant
- promotes antithrombin III (ATIII) activity, inactivating factor Xa and thrombin.
- Only given parenterally (IV, SC)
- Requires ongoing aPTT monitoring
- Used acutely (PE, DVT, DIC) and prophylactically in surgery or in patients at high risk for clotting disorders
- Antidote is Protamine if excessive bleeding is present
Cocaine
- Ester-type local anaesthetic
- Sodium channel blocker
- causes local vasoconstriction, prolonging duration of action
- relatively weak anaesthetic effect and high risk of abuse, so rarely used
Esbriet (Perfenidone)
- Anti-fibrotic, anti-inflammatory
- Used in management of IPF
- thought to interfere with production of inflammatory proteins like TGF-Beta and TNF
Claritin (Loratadine)
- Second-generation antihistamine, H1 receptor antagonist
- Blocks peripheral H1 receptors, does not closs blood-brain barrier
- Alleviates allergy symptoms without causing significant sedation/hypnosis
Decadron (Dexamethasone)
- Long-acting, high-potency corticosteroid
- Causes broad anti-inflammatory effects
- Decreases eicosanoid production
- Decreases inflammatory cytokine production
- Decreases inflammatory cell produciton and recruitment
- Reduces histamine production and release
- Used in dexamethasone suppression test and in long-term anti-inflammation, anti-immune treatment
- Prolonged use may disrupt HPA axis and lead to addisonian crisis when withdrawn
Apo-Hydro (Hydrochlorothiazide)
- thiazide diuretic
- Acts on NaCl symporter in DCT, causing natriuresis, kaliuresis, and Calcium retention
- First line diuretic for treatment of hypertension and edematous states.
- Also used in treatment of nephrolithiasis, diabetes insipidus, and renal disorders
- Common side effects: hypokalemia, hyperglycemia, hyperlipidemia, hyperuricemia
Levophed (Norepinephrine)
- Direct-acting adrenergic agonist, endogenous catecholamine
- Has high α1 specificity, so minimal cardiac effects with signigicant peripheral vasoconstriction
- incr. BP due to incr. SVR. high potential for reflex bradycardia (no beta effect)
- used in treatment of shock and hypotension
Diprivan (Propofol)
- Parenteral, non-opioid anaesthetic
- Cause GABA potentiation (similar to BZs) to produce sedation and anaesthesia
- generally used to induce anaesthesia which is maintained by an inhalational anaesthetic, except in short, minor procedures. (20s onset, 5-10 min duration)
- Reduces ICP and BP, so near ideal for head injury management
- prolonged use potentiates cardiovascular depression
Spiriva (Tiotropium bromide)
- Muscarinic-selective receptor antagonist (synthetic atropine analog)
- used for bronchodilation and reduced mucus secretion in asthma/COPD
Atrovent (Ipratropium bromide)
- Muscarinic-selective receptor antagonist (synthetic atropine analog)
- used for bronchodilation and reduced mucus secretion in asthma/COPD
QVAR (Beclomethasone dipropionate)
- Inhaled Corticosteroid (ICS)
- Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
- MDI only given BID
Pulmicort (Budesonide)
- Inhaled Corticosteroid (ICS)
- Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
- Turbuhaler DPI only, given BID
Viagra (sildenafil)
- Type 5 phosphodiesterase inhibitor (PDE5 inhibitor)
- PNS innervation of vascular smooth muscle causes vasodilation and cGMP release (causing further smooth muscle relaxation). PDE5 inhibitors slow the breakdown of cGMP leading to increased/prolonged vasodilation.
- As Viagra, sildenafil is used to treat erectile dysfunction
Ativan (Lorazepam)
- Benzodiazepine, sedative-hypnotic
- Lipid-soluble GABA agonist, causes CNS depression due to potentiation of GABA receptors and post-synaptic hyperpolarization
- Fast onset with medium duration of action and no active metabolites
- Dose dependent effects with ceiling effect: at low doses sedation only, at higher doses hypnosis and anterograde amnesia
Atropine (atropine)
- muscarinic receptor antagonist (belladonna alkaloid, tertiary amine)
- toxixicity is dose dependent, remember; dry as a bone, red as beet, mad as a hatter, blind as a bat
- causes dilatation, positive chronotropy, decreased secretions, decreased GI motility, bronchodilation, etc.
- used to reverse cholinesterase overdose and as a positive chronotrope
Tagamet (Cimetidine)
- H2-receptor antagonist
- reduces gastric acid secretion to reduce dyspepsia/gastroenteritis in GERD
Allegra (Fexofenadine)
- Second-generation antihistamine, H1 receptor antagonist
- Blocks peripheral H1 receptors, does not closs blood-brain barrier
- Alleviates allergy symptoms without causing significant sedation/hypnosis
TNKase (Tenecteplase)
- fibrinolytic, thrombolytic, recombinant tPA
- causes plasmin activation from plasminogen, with high specificity for fibrin-bound plasminogen
- longer duration of action than alteplase
- used in resolution of STEMI
Alvesco (Ciclesonide)
- Inhaled Corticosteroid (ICS)
- Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
- MDI only, given QD
Haldol (Haloperidol)
- first generation, typical antipsychotic
- blocks D2 receptors in the mesocortical, mesolimbic and other pathways
- high potency, very high risks of extrapyramidal side effects
- generally only useful in treatment of positive symptoms of schizophrenia.
- prolonged use may lead to tardive dyskinesia or neuroleptic malignant syndrome
Accolate (Zafirlukast)
- Leukotriene Receptor Antagonist (LTRA)
- second-line asthma controller
- given as adjunct with ICS or as second-line monotherapy where ICS not tolerated
- not useful in severe exacerbations of asthma
Sublimaze (Fentanyl)
- Strong, synthetic opioid, full opioid agonist
- 100x potency relative to morphine with fewer CV effects, faster onset, and less hangover than morphine
- powerful analgesic for acute and chronic pain
- adverse effects include sedation, respiratory depression, constipation, miosis, N/V
Lovenox (Enoxaparin)
- Anticoagulant, fractionated heparin / LMWH
- promotes antithrombin III (ATIII) activity, inactivating factor Xa
- Only given parenterally (IV, SC)
- Does not require ongoing aPTT monitoring
- Used acutely (PE, DVT, DIC) and mainly prophylactically in surgery or in patients at high risk for clotting disorders
- Antidote is Protamine if excessive bleeding is present
Bricanyl (Terbutaline)
- Non-catecholamine direct-acting adrenergic
- selective, short-acting β2 agonis (SABA). May activate β1 reeptors at higher doses.
- used to promote bronchodilation in COPD and asthma as a rescue medication
- adverse effects include tachycardia, tremor, and nervousness
Deltasone (Prednisone)
- Intermediate acting corticosteroid
- Causes broad anti-inflammatory effects
- Decreases eicosanoid production
- Decreases inflammatory cytokine production
- Decreases inflammatory cell produciton and recruitment
- Reduces histamine production and release
- Used to treat cancer, inflammation, allergy, and autoimmune disorders
- Prolonged use may disrupt HPA axis and lead to addisonian crisis when withdrawn
Sotacor (Zaleplon)
- non-BZ sedative-hypnotic
- used in management of sleep disorders
- increases GABA activity in CNS
- less tolerance and dependence forming than the BZ drugs
- preserves sleep architecture
Pravachol (Pravastatin)
- Statin, antihyperlipidemic
- HMG-CoA inhibitor, reduces LDL by 20-50%
- Shown to reduce mortality due to atherosclerosis
- adverse effects include muscle damage, GI issues, memory impairment, and NIDDM
- Pravachol has the lowest rate of adverse effects and drug interactions of any statin
Lopressor (Metoprolol)
- Selective β1-antagonist (beta-blocker)
- oral or parenteral
- good antihypertensive, antianginal, antiarrhythmic
- relatively short half-life (3-4hr)
Aldactone (Spironolactone)
- Potassium-sparing diuretic, aldosterone receptor antagonist
- inhibits binding of aldosterone in the late DCT and collecting duct, which prevents expression of sodium channels.
- Used in combination with other diuretics to prevent hyperkalemia, in treatment of primary hyperaldosteronism, and in PCOS as an anti-androgenic
- Adverse effects; gynecomastia and infertility in men, hyperkalemia.
Anexate (Flumazenil)
- Benzodiazepine antagonist, reversal agent
- Competitive BZ receptor antagonist
- used to reverse BZ overdose and BZ sedation
- short half-life (7-15 minutes) with unpredictable effects that may potentiate seizures. Rarely indicated due to low mortality with benzo overdose
Singulair (Montelukast)
- Leukotriene Receptor Antagonist (LTRA)
- second-line asthma controller
- given as adjunct with ICS or as second-line monotherapy where ICS not tolerated
- not useful in severe exacerbations of asthma
Persantine (Dipyridamole)
- antiplatelet
- relatively weak antiplatelet effect, but also acts as a coronary vasodilator by causing adenosine release
- Often combined with aspirin for post-CVA therapy
Protamine (Protamine sulphate)
- heparin antidote
- used to treat uncontrollable bleeding in the context of heparin administration
BLES (Bovine Lipid Extracted Surfactant)
- Natural surfactant extracted from bovine lungs
- First choice treatment for managment of RDS
- Reduces pulmonary gas-liquid interface surface tension and work of breathing
- Instilled through endotracheal tube
Celebrex (Celecoxib)
- NSAID, selectie COX-2 inhibitor
- Reduces PG production associated with inflammation without causing gastric irritation
- used in management of pain and inflammation
- increased risk of cardiovascular events (MI, CVA)
Oxeze (Formoterol)
- Long-acting Beta Agonist (LABA), Fast-acting Beta Agonist (FABA)
- 12hr duration of action with relatively fast onset
- Used always as combination therapy with an ICS for asthma control
- causes bronchodilation and potentiates anti-inflammatory effects of ICS
- may be used for asthma control or relief
Flovent (Fluticasone propionate)
- Inhaled Corticosteroid (ICS)
- Used as an anti-inflammatory and to potentiate beta-agonists effects in asthma control
- MDI or Diskus DPI given BID
Xylocaine (Lidocaine)
- Class 1B antiarrhythmic
- Preferentially binds to sodium channels in the inactivated state
- Has fast, rate-dependant kinetics. Slows conduction in rapidly depolarizing tissue and limits reentry
- Used in the management of refractory Ventricular arrhythmias, esp. VTach and VFib
- Second-line choice if amiodarone is unsuccessful
Xylocaine (Lidocaine)
- Amide-type local anaesthetic
- sodium channel blocker that produces use-dpendent and size-dependent blockade
- may be given with epi to induce vasoconstriction and prolong duration of action
- relatively strong local anaesthetic effect
Prozac (fluoxetine)
- SSRI antidepressent
- selectively blocks reuptake of serotonin, increasing serotonin concentration in the synaptic cleft
- highly effective with a low rate of adverse effects (e.g. sedation, anticholinergic effects, ortho hypo, dysrhythmia)
- most common and first line drug in treatment of depression