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quick drugs hankk Flashcards

1
Q

rapid acting insulin

A

Lispro, aspart, and glulisine.

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2
Q

long acting insulin

A

detemir and glargine

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3
Q

Biguanides (metformin)

A 
increases insulin sensitivity
lactic acidosis (contraindicated in renal insufficiency)
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4
Q

sulfonyl ureas

A

1st gen- chlorpropamide, tolbutamide
2nd gen- glimepiride glyburide and glipizide
glipizide associated with hepatotoxicity and glimepiride and glyburide with hypoglyceia because of long action
MOA: closes K+ channel in beta cell leading cell depolarization and insulin release.
first generation disulfuram like effects
weight gain and hypoglycemia

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5
Q

Glitazones/TZDs

A

pioglitzone rosiglitazone
increases insulin sensitivoty. binds to PPAR-gamma nuclear transcription regulator.
AE: weight gain, edema, hepatotoxicity, heart failure and increases risk of fracture.

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6
Q

meglitinides

A

nateglinide, repaglinide.
bind to K+ channel in beta cell increasing insulin release.
AE: hypoglycemia and weight gain.

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7
Q

GLP-1 analogs

A

exenatide liraglutide.

AE: pancreatitis, modest weight loss

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8
Q

DPP-4 inhibitors

A

linagliptin, saxagliptin, sitagliptin

AE: mild urinary or respiratory infections.

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9
Q

amylin analogs

A

pramlinitide.
MOA: decrease gastric emptying and decrease glucagon.
hypoglycemia and nausea.

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10
Q

SGLT-2 inhibitors

A

canagliflozin, dapagliflozin, and empagliflozin.
block reabsorption of glucose in PCT.
AE: glucosuria, UTIs, vaginal yeast infections, hyperkalemia, dehydration.

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11
Q

alpha glusidase inhibitors

A

acarbose, miglitol

inhibit intestinal brush border alpha glucosidases.

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12
Q

propylthiouracil (thionamides)

A

block thyoid peroxidase, inhibiting oxidation of iodide and organification of iodine. (methimazole also).
PTU also inhibits 5’-deiodinase decreasing peripheral conversion of T4 to T3.

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13
Q

demeocycline

A

ADH antogonist.

member of tetracycline family.

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14
Q

fludricortisone

A

synthetic analog of aldosterone

AE: worsens HF and leads to hyperpigmentation.

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15
Q

H2 blockers

A

cimentidine, ranitidine, famotidine, nizatidine.
reversible block of H2 receptor.
cimentidine is also a potent blocker of the CYP450 system. also has antoandrogenic effects(prolactin release), gynecomastia, impotence, decreased libido.

both ranitidine and cimentidine decrease renal excretion of creatinine.

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16
Q

PPIs

A

irreversibly inhibit H+/K+ ATPase.

AE: increase risk of C diff infection, pneumonia, decreases serum Mg2+ with long term use, osteoporotic hip fractures

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17
Q

aluminum hydroxide

A

constipation, hyperphosphatemia, prox muscle weakness, osteodystrophy, and seizures.

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18
Q

magnesium hydroxide.

A

diarrhea, hyporeflexia, hypotension, cardiac arrest.

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19
Q

ondansetron

A

5-HT3 antagonist.
post op patients and chemo patients.
AE: headache, constipation and QT interval prolongation

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20
Q

memantine

A

NMDA receptor antagonist (helps prevent exitotoxicity)

used in alzheimer disease

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21
Q

Sumitriptan.

A

5HT 1B/1D agonist. inhibit trigeminal nerve activation. prevent vasoactive peptide release; induce vasoconstriction
AE: coronary vasospasm (contraindicated in patients with CAD or prinzmetal angina); mild paresthesia.

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22
Q

antipsychotics

A

Haloperidol, trifluoperazine, thioridazine, chlorpromazine
block D2 receptors.
high potency: trifluoperazine, fluphenazine, and haloperidol
low potency: chlopromazine thioridazine.

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23
Q

atypical antipsychotics

A

aripripazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone
AE: all cause prolonged QT interval
pines-metabolic syndrome, clozapine agranulocytosis,
risperidone-hyperprolactinemia.

24
Q

SSRIs

A

fluoxetine, paroxetine, setraline, citalopram.

25
SNRIs
venlafaxine, desvenlafaxine, duloxetine, levomilnacipran, milnacipran. AE: increase BP.
26
treatment of serotonin syndrome.
cyproheptadine.
27
Tricyclic antidepressants.
amitryptiline, nortriptiline, imipramine, desipramine, clomipramine, doxepin, amoxapine. Tri C's- coma convulsions and cardiotoxicity (arrhythmia due to Na+ channel inhibition. NaHCO3 can prevent arrhythmia in overdose.
28
monoamine oxidase inhibitors
tranylcypromine, phenylzine, isocarboxazid, selegiline.
29
bethanechol
activates bowel and bladder smooth muscle. resistant to ACHE | postop ileus, neurogenic ileus and urinary retention
30
carbachol
constricts pupil and relieves intraocular pressure in open angle glaucoma.
31
pilocarpine
potent stimulator of sweat, tears and saliva | used in open and closed angle glaucoma and xerostomia (sjogren syndrome)
32
neostigmine
increases Ach | postop and neurogenic ileus, urinary retention, myasthenia gravis and reversal of neuromuscular junction blockade
33
physostigmine
increases Ach phyxes atropine overdose used in anticholinergic toxicity, crosses BBB
34
pyridostigmine
increases Ach | myasthenia gravis; does not penetrate CNS.
35
glycopyrolate
muscarinic antagonist GI and respiratory parenteral: preoperative to reduce airway secretions oral: drooling, peptic ulcer.
36
hyoscyamine, dicyclomine
GI | antispasmotics for IBS
37
reduce bladder spasms and urge urinary incontinence
oxybutynin, solifenacin and tolterodine.
38
fenoldopam
D1 | post op HTN, hyper tensive crisis. promotes natriuresis. can cause hypotension and tachycardia.
39
midodrine
autonomic insufficiency and postural hypotension. may exacerbate supine HTN.
40
cephalosporins
1st gen. cefazolin, cephalexin 2nd gen. cefaclor, cefoxitin, cefuroxime 3rd gen. ceftriaxone, cefotaxime, cefpodoxime, ceftazidime ( for psuedomonas) 4th gen cefepime 5th gen ceftaroline (does not cover psuedomonas but does cover MRSA) MECHANISM OF RESISTANCE Structural change in penicillin-binding proteins (transpeptidases).
41
carbapenams
Imipenem, meropenem, ertapenem, doripenem. Imipenem is a broad-spectrum, β-lactamase– resistant carbapenem. Always administered with cilastatin (inhibitor of renal dehydropeptidase I) to decrease inactivation of drug in renal tubules. imipenam is associated with seizures
42
Monobactams (Aztreonam)
Less susceptible to β-lactamases. Prevents peptidoglycan cross-linking by binding to penicillinbinding protein 3. Synergistic with aminoglycosides. No cross-allergenicity with penicillins. only works against gram - rods. not effective against anaerobes
43
aminoglycosides
Bactericidal; irreversible inhibition of initiation complex through binding of the 30S subunit. Can cause misreading of mRNA. Also block translocation. Require O2 for uptake; therefore ineffective against anaerobes. AE: Nephrotoxicity, Neuromuscular blockade, Ototoxicity (especially when used with loop diuretics). Teratogen. MECHANISM OF RESISTANCE Bacterial transferase enzymes inactivate the drug by acetylation, phosphorylation, or adenylation
44
tetracycline
Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA; limited CNS penetration. Doxycycline is fecally eliminated and can be used in patients with renal failure. Do not take tetracyclines with milk (Ca2+), antacids (Ca2+ or Mg2+), or iron-containing preparations because divalent cations inhibit drugs’ absorption in the gut. AE:Bacteriostatic; bind to 30S and prevent attachment of aminoacyl-tRNA; limited CNS penetration. Doxycycline is fecally eliminated and can be used in patients with renal failure. Do not take tetracyclines with milk (Ca2+), antacids (Ca2+ or Mg2+), or iron-containing preparations because divalent cations inhibit drugs’ absorption in the gut. decreased uptake or increased efflux out of bacterial cells by plasmid-encoded transport pumps.
45
Chloramphenicol
Blocks peptidyltransferase at 50S ribosomal subunit. Bacteriostatic. AE: Anemia (dose dependent), aplastic anemia (dose independent), gray baby syndrome (in premature infants because they lack liver UDP-glucuronyltransferase). MECHANISM OF RESISTANCE Plasmid-encoded acetyltransferase inactivates the drug.
46
Oxazolidinones (Linezolid)
Inhibit protein synthesis by binding to 50S subunit and preventing formation of the initiation complex. AE: Bone marrow suppression (especially thrombocytopenia), peripheral neuropathy, serotonin syndrome. MECHANISM OF RESISTANCE Point mutation of ribosomal RNA.
47
Macrolides
Azithromycin, clarithromycin, erythromycin. Inhibit protein synthesis by blocking translocation (“macroslides”); bind to the 23S rRNA of the 50S ribosomal subunit. Bacteriostatic. AE: MACRO: Gastrointestinal Motility issues, Arrhythmia caused by prolonged QT interval, acute Cholestatic hepatitis, Rash, eOsinophilia. Increases serum concentration of theophylline, oral anticoagulants. Clarithromycin and erythromycin inhibit cytochrome P-450. MECHANISM OF RESISTANCE Methylation of 23S rRNA-binding site prevents binding of drug.
48
Sulfamethoxazole (SMX), sulfisoxazole, | sulfadiazine.
Inhibit dihydropteroate synthase, thus inhibiting folate synthesis. Bacteriostatic (bactericidal when combined with trimethoprim). AE: Hypersensitivity reactions, hemolysis if G6PD deficient, nephrotoxicity (tubulointerstitial nephritis), photosensitivity, Stevens-Johnson syndrome, kernicterus in infants, displace other drugs from albumin (eg, warfarin resistance: Altered enzyme (bacterial dihydropteroate synthase), 􀁲 uptake, or 􀁱 PABA synthesis.
49
Fluoroquinolones
Inhibit prokaryotic enzymes topoisomerase II (DNA gyrase) and topoisomerase IV. Bactericidal. Must not be taken with antacids. AE: GI upset, superinfections, skin rashes, headache, dizziness. Less commonly, can cause leg cramps and myalgias. Contraindicated in pregnant women, nursing mothers, and children < 18 years old due to possible damage to cartilage. Some may prolong QT interval. May cause tendonitis or tendon rupture in people > 60 years old and in patients taking prednisone. Ciprofloxacin inhibits cytochrome P-450. MECHANISM OF RESISTANCE Chromosome-encoded mutation in DNA gyrase, plasmid-mediated resistance, efflux pumps.
50
Daptomycin
Lipopeptide that disrupts cell membranes of gram ⊕ cocci by creating transmembrane channels. ADVERSE EFFECTS Myopathy, rhabdomyolysis.
51
selective arterial dilators
minoxidil and hydralazine result in sodium and fluid retention because of the reflex tachycardia which is provided by the sympathetic nervous which also causes renin release
52
side affects of mannitol
Pulmonary edema, dehydration. Contraindicated in anuria, HF.
53
Ethacrynic acid
Nonsulfonamide inhibitor of cotransport system (Na+/K+/2Cl−) of thick ascending limb of loop of Henle. more ototoxic than furosemide
54
thiazide dirutics adverse effects
Hypokalemic metabolic alkalosis, hyponatremia, hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia. Sulfa allergy. Hydrochlorothiazide, chlorthalidone, metolazone.
55
Potassium-sparing diuretics
Spironolactone and eplerenone; Triamterene, and Amiloride Spironolactone and eplerenone are competitive aldosterone receptor antagonists in cortical collecting tubule. Triamterene and amiloride act at the same part of the tubule by blocking Na+ channels in the cortical collecting tubule.
56
Aliskiren
Direct renin inhibitor, blocks conversion of angiotensinogen to angiotensin I.

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