Random drugs Flashcards
Fenoldopam
Dopamine D1 receptor agonist used for coronary, peripheral, renal, and splanchnic vasodilation in htn emergency
Drugs to treat spasticity
Baclofen (GABA-B agonist) and tizanidine (alpha2 agonist)
decrease excitability of SC reflexes
used eg in MS spasticity
Diuretics that increase survival in CHF
aldo receptor antagonists (spironolactone and eplerenone)
diuresis, K-sparing, and block aldo-induced ventricular remodeling
loop diuretcs are strongest diuretic and used to treat pulm congestion and fluid retention, but don’t provide survival benefit (just improve sx)
Triptans - mech of action?
serotonin agonists - inhibit release of vasoactive peptides (substance P, calcitonin gene-related peptide etc) to decrease neurogenic inflamm, vasoconstrict meningeal vessels, and block brainstem pain pathways
used to treat migraines (abortive)
Migraine prophylaxis
beta blockers, SNRIs (TCAs, venlafaxine), anti-seizure meds (eg topiramate)
vs SSRIs and DNRIs don’t work
bupropion
DNRI - used to treat depression and smoking cessation
Eplerenone
aldo antagonist
weak diuretic, K sparing
fewer side effects with eplerenone than with spiron (eg less gynecomastia)
First-line dz modifying agent to treat RA?
methotrexate
Meds with anticholinergic properties
antihistamines
TCAs
1st gen low-potency antipsychotics (chlorpromazine) - vs haloperidol (high-potency) has more neuro side effects from D2 antagonism
Clozapine (2nd gen)
anti-PD drugs (eg benztropine, trihexyphenidyl)
belladonna alkaloids (eg atropine)
Methotrexate mech
inhibits dihydrofolate reductase, which regenerates THF from DHF
THF is the methyl donor that helps thymidylate synthase catalyze the conversion of dUMP to dTMP
so without THF, can’t do DNA synthesis - used for chemo
Anthracycline mech
intercalate between bases during DNA replication –> defective base pairing and splitting of DNA strands
Drugs that can cause serotonin syndrome
Combinations of several serotonin-affecting drugs, eg MAOI (eg LINEZOLID, tranylcypromine, phenelzine, pargyline, clorgyline, selegiline) + SSRI, SNRI, TCA
Isoniazid adverse effects
B6 deficiency –> periph neuropathy
Direct hepatotox (mild in 10-20% of pts and usually goes away with time, even if continue drug, but in
Eculizumab
terminal complement inhibitor used to treat PNH
Chlorthalidone - fxn and AE?
fxn: thiazide diuretic
AE: hypokalemia and metabolic alk; can also decrease insulin secretion –> hyperglycemia
Alirocumab
PCSK9 inhibitor (decreases LDL receptor degradation)
Treatment for TCA overdose?
sodium bicarb
Treatment for neonatal abstinence syndrome due to withdrawal from opiates?
opiates - morphine or methadone with increasing dose until sx are controlled, and then weaning off of it over next few weeks
Filgrastim
granulocyte colony stimulating factor analog
used to stimulate proliferation and differentation of granulocytes in pts with neutropenia (eg after chemo)
Amiodarone side effects
heart: sinus bradycardia, heart block, proarrhythmic
lungs: chronic interstitial pneumonitis
endo: hypo/hyperthyroidism (b/c amiodarone is 40% iodine) - so can cause decreased or increased prodn ( esp in pts with preexisting thyroid condition) or destructive thyroiditis –> release of preformed hormone
GI: elevated AST/ALT, hepatitis
ocular: corneal microdeposits, optic neuropathy
derm: blue/gray skin discoloration
neuro: peripheral neuropathy
Bortezomib
proteasome inhibitor used to treat MM and Waldenstrom macroglobulinemia
Omalizumab
anti-IgE used to treat refractory, severe asthma set off by allergy
Pentamidine
used for prophylaxis and treatment of PJP
Bosentan
endothelin-receptor antagonist (vasodilates and decreases endothelial proliferation)
used to decrease pulmonary arterial pressure in idiopathic PAH
Etanercept
anti-TNF-alpha
anti-inflamm agent, used to treat RA, psoriasis, psoriatic arthritis
sx of ischemic vs hemorrhagic stroke
ischemic: fluctuating sx that may progress with periods of improvement
hemorrhagic: abrupt onset of sx with loss of consciousness, irreg breathing etc (most common adverse effect of MI thrombolysis)
Donepezil
AChE inhibitor used in AD
Phenelzine
MAOI
used in atypical subtype of major depression (mood reactivity, leaden paralysis, rejection sensitivity, and reversed vegetative signs) + treatment-resistant depression
Antidepressants that don’t cause sexual side effects
bupropion and mirtazapine (NSRI)
Escitalopram
SSRI
First-line agent for trigeminal neuralgia
carbamazepine
baclofen
skeletal muscle relaxant
activates GABA-B receptors in SC
Moxifloxacin
used to treat respiratory infxns (eg copd exacerbation, sinusitis, CAP)
Nystatin vs amphotericin B
nystatin isn’t absorbed from GI, so given oral for oropharyngeal candidiasis
vs. amph B = IV and has many toxic AEs, so given for more complex fungal infxns
both work by binding ergosterol in fungal cell membrane and causing pores to form
Danazol
synthetic estrogen used to treat endometriosis and hereditary angioedema
mech: suppresses GnRH via negative feedback –> decreased LH/FSH –> decreased estrogen –> decreased endometrial growth
Ibutilide
class 3 anti-arrhythmic
used for afib, atrial flutter
AE: torsades
Riluzole
ALS drug
blocks Na channels, inhibiting kainate and NMDA receptors - antiglutamatergic, so decrease excitotox
Nesiritide
recombinant BNP
used to treat decompensated LV dysfxn –> CHF
Sevelamer
non-absorbable phosphate-binding polymer that decreases absorption of phosphate in GI tract
used to treat hyperphosphatemia in dialysis pts
Butorphanol
kappa opioid receptor agonist and mu partial agonist; used to treat severe pain
AE: can get opioid withdrawal sx if give with full mu agonist; overdose not easily reversed
Tramadol
weak opioid agonist; also inhibits serotonin and NE reuptake so can cause serotonin syndrome, seizures, dependence etc
used for chronic pain
meperidine
mu opioid agonist
pentazocine
opioid analgesic
fentanyl
opioid analgesic
Cyclobenzaprine
centrally acting skel muscle relaxant
structurally similar to TCAs, has similar anticholinergic side effects
AChE inhibitors used to treat AD
donepezil, galantamine, rivastigmine, tacrine
HD drugs
Tetrabenazine and reserpine - inhibit VMAT to decrease DA packaging and release
haloperidol - D2 receptor antag
based on idea that DA is increased in HD
DDAVP
synthetic vasopressin - has antidiuretic effects (to treat central DI and nocturnal enuresis) and –> release of VWF and factor 8 from endothelial cells
minimal effect on V1 vasopressin receptor, so doesn’t really contract smooth muscle in vv, no increased BP
causes of ED
psychogenic stressors, performance anxiety, depression (esp if ED came on suddenly and still get spontaneous erections at night)
drugs (SSRIs, sympathetic blockers like beta blockers)
vascular or neuro impairment
GU trauma (eg prostate surgery, pelvic trauma, priapism)
Contact precautions vs standard precautions vs airborne precautions vs droplet
contact (eg c diff) - handwashing with soap and water, gown, nonsterile gloves
standard - handwashing, proper disposal of cleaning instruments and linens, occasional use of gown and gloves for contact with body fluids
airborne (5microns, eg Neisseria meng, flu, Bordetella pertussis, mycoplasma pna, RSV) - simple facemask
Griseofulvin mech and use
mech: enters fungal cells and binds MTs, inhibiting mitosis
use: dermatophyte fungal infxns (accumulates in keratin-containing tissues)
Ipratropium - use and mech
asthma and COPD in conjunction with beta-2 agonists (b/c they’re not as effective at bronchodil alone)
block bronchocon effects of PS system and also the mucus production of PS system
Flunisolide
inhaled glucocorticoid used for prophylactic treatment of bronchial asthma
Methylxanthinges
theophylline, aminophylline
bronchial dilation by blocking PDE
Oxybutynin
antimuscarininc used to treat urge incontinence
Puromycin
aminonucleoside antibiotic that has structure like aminoacyl-tRNA, so it binds the ribosome and causes premature release of unfinished polypeptide in the bacterium
Pentagastrin use?
synthetic gastrin - used to screen for carcinoid syndrome and MTC
Amifostine
cytoprotective free-radical scavenger used to decrease nephrotox associated with platinum-containing and alkylating chemo agents
also decreases xerostomia caused by chemo
Synthetic prostacyclin - uses?
use it for vasodil and anti-thrombotic properties to treat pulmonary HTN, peripheral vascular disease, and raynaud
Ranolazine
antianginal drug
inhibits late phase inward Na channels –> decreased [Na]i –> decreased calcium influx –> decreased contractility and myocardial oxygen demand
Fenoldopam
short-acting D1 agonist, no effect on alpha or beta receptors –> AC –> increased cAMP –> vasodilation of arterial beds and decreased BP
**renal vasodilation –> INCREASED RENAL PERFUSION, so good for pts with htn emergency and AKI
Short-acting insulin
Lispro, Aspart, Glulisine (peak in 45-75 min so used postprandially)
vs regular (peaks 2-4 hrs, but best IV, so used for DKA)
Long-acting insulin
Glargine, detemir (once-daily)
vs. NPH (twice daily) = intermediate-acting
Fluphenazine
DA antagonist
used to treat Tourette (antipsychotics are used for Tourette)
Milrinone
selective PDE3 inhibitor
used as inotropic agent in refractory HF to increase cAMP and thus increase [Ca]i in myocytes (positive inotrope)
but also –> vascular smooth m relaxation due to increased cAMP –> decreased BP
Ivabradine
selective inhibitor of funny sodium channels
prolonged phase 4 (depolarization) in nodes –> slowed HR with no effect on contractility (inotropy) or relaxation (lusitropy)
definition of “permissiveness” in pharm vs. “synergism”
one hormone allows another to exert its max effect
eg cortisol upregulates alpha1 receptors on vasc smooth muscle –> increased vascular responsiveness to NE (though cortisol alone has no effect on vessels, so not synergistic)
synergism: both drugs have some effect, and when combined, the effect is greater than the sum of their individual effects
Example of hormone with permissive effect on other hormones?
Cortisol
increases vasc and bronchial smooth muscle response to NE and epi
increases glucose release by liver in response to glucagon
Ranolazine
anti-anginal agent
blocks Na channels and K channels (dose-dep increase in QT, but no TdP)
“-prep” (aprepitant, fosaprepitant)
neurokinin 1 receptor antagonists
used to treat central (chemo-induced) nausea
Cytarabine, Gemcitabine
pyrimidine analog antimetabolites that are incorporated into DNA –> strand termination
gemcitabine isn’t S-phase specific, while cytarabine is
both are chemo drugs
fludarabine
purine nucleotide analog, chemo drug (used for CLL)
inhibits DNA pol, DNA primase, DNA ligase, ribonucleotide reductase
significance of monoclonality in T cell receptor genes?
indicates malignancy in lymph node (if responding to antigen, multiple genetically-distinct cells undergo limited monoclonal expansion –> overall polyclonal response, but malig = monoclonal)
Diphenoxylate
opioid anti-diarrheal agent (similar to meperidine)
binds mu opiate receptors in GI tract and slows motility
combined with atropine to cause adverse effects if taken in high doses (and thus to discourage abuse, since it produces euphoria and –> dependence at high doses)
clonidine - mech and use?
alpha 2 agonist
treats ADHD
Cladribine
cytotoxic purine analog used to treat HCL
resistant to degradation by ADA
Acitretin
systemic retinoid used to treat psoriasis, acne, photoaging, skin neoplasms
other systemic = isotretinoin
topical = tretinoin
its elimination t1/2 is 2 days, but in combo with alcohol, it’s esterified and has t1/2 of 120 days
Imiquimod
nucleoside analog that’s agonist of TLL7 and 8 –> activation of NF-kappaB
tx of genital or perianal warts/condyloma acuminata + actinic keratosis
