Sheet-2 Flashcards
Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema
Morphine
Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI’s can lead to serotonin syndrome
Meperidine
Moderate opioid agonists
Codeine, hydrocodone, and oxycodone
Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures
Propoxyphene
Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal
Buprenorphine
Opioid antagonist that is given IV and had short DOA
Naloxone
Opioid antagonist that is given orally in alcohol dependency programs
Naltrexone
These agents are used as antitussive
Dextromethorphan, Codeine
These agents are used as antidiarrheal
Diphenoxylate, Loperamide
Inhalant anesthetics
NO, chloroform, and diethyl ether
Toxic to the liver, kidney, lungs, bone marrow, peripheral nerves, and cause brain damage in animals, sudden death has occurred following inhalation
Fluorocarbons and Industrial solvents
Cause dizziness, tachycardia, hypotension, and flushing
Organic nitrites
Causes acne, premature closure of epiphyses, masculinization in females, hepatic dysfunction, MI, and increases in libido and aggression
Steroids
Readily detected markers that may assist in diagnosis of the cause of a drug overdose include
Changes in heart rate, blood pressure, respiration, body temperature, sweating, bowel signs, and pupillary responses
Most commonly abused in health care professionals
Heroin, morphine, oxycodone, meperidine and fentanyl
This route is associated with rapid tolerance and psychologic dependence
IV administration
Leads to respiratory depression progressing to coma and death
Overdose of opioids
Lacrimation, rhinorrhea, yawning, sweating, weakness, gooseflesh, nausea, and vomiting, tremor, muscle jerks, and hyperpnea are signs of this syndrome
Abstinence syndrome
Treatment for opioid addiction
Methadone, followed by slow dose reduction
This agent may cause more severe, rapid and intense symptoms to a recovering addict
Naloxone
Sedative-Hypnotics action
Reduce inhibition, suppress anxiety, and produce relaxation
Additive effects when Sedative-Hypnotics used in combination with these agents
CNS depressants
Common mechanism by which overdose result in death
Depression of medullary and cardiovascular centers
Date rape drug
Flunitrazepam (rohypnol)
The most important sign of withdrawal syndrome
Excessive CNS stimulation (seizures)
Treatment of withdrawal syndrome involves
Long-acting sedative-hypnotic or a gradual reduction of dose, clonidine or propranolol
These agents are CNS depressants
Ethanol, Barbiturates, and Benzodiazepines
Withdrawal from this drug causes lethargy, irritability, and headache
Caffeine
W/D from this drug causes anxiety and mental discomfort
Nicotine
Treatments available for nicotine addiction
Patches, gum, nasal spray, psychotherapy, and bupropion
Chronic high dose abuse of nicotine leads to
Psychotic state, overdose causes agitation, restlessness, tachycardia, hyperthermia, hyperreflexia, and seizures
Tolerance is marked and abstinence syndrome occurs
Amphetamines
Amphetamine agents
Dextroamphetamines and methamphetamine
These agents are congeners of Amphetamine
DOM, STP, MDA, and MDMA “ecstasy”
Overdoses of this agent with powerful vasoconstrictive action may result in fatalities from arrhythmias, seizures, respiratory depression, or severe HTN (MI and stroke)
Cocaine “super-speed”
Most dangerous of the currently popular hallucinogenic drugs, OD leads to nystagmus, marked hypertension, and seizures, presence of both horizontal and vertical nystagmus is pathognomonic
PCP
Removal of PCP may be aided
Urinary acidification and activated charcoal or continual nasogastric suction
THC is active ingredient, SE’s include impairment of judgment, and reflexes, decreases in blood pressure and psychomotor performance occur
Marijuana
This agent has greater affinity for muscarinic receptors and used for postoperative and neurogenic ileus and urinary retention
Bethanechol
Only direct acting agent that is very lipid soluble and used in glaucoma
Pilocarpine
This agent used to treat dry mouth in Sjögren’s syndrome
Cevimeline
Indirect-Acting ACh Agonist, alcohol, short DOA and used in diagnosis of myasthenia gravis
Edrophonium
Carbamate with intermediate action, used for+A1170 postoperative and neurogenic ileus and urinary retention
Neostigmine
Treatment of atropine overdose and glaucoma (because lipid soluable). Enters the CNS rapidly and has a stimulant effect, which may lead to convulsions
Physostigmine
Treatment of myasthenia gravis
Pyridostigmine
Antiglaucoma organophosphate
Echothiophate
Associated with an increased incidence of cataracts in patients treated for glaucoma
Long acting cholinesterase inhibitors
Scabicide organophosphate
Malathion
Organophosphate anthelmintic agent with long DOA
Metrifonate
Toxicity of organophosphate:
DUMBELSS (diarrhea, urination, miosis, bronchoconstriction, excitation of skeletal muscle and CNS, lacrimation, salivation, and sweating)
The most frequent cause of acute deaths in cholinesterase inhibitor toxicity
Respiratory failure
The most toxic organophosphate
Parathion
Treatment of choice for organophosphate overdose
Atropine
This agent regenerates active cholinesterase and is a chemical antagonist used to treat organophosphate exposure
Pralidoxime
Prototypical drug is atropine
Nonselective Muscarinic Antagonists
Treat manifestations of Parkinson’s disease and EPS
Benztropine, trihexyphenidyl
Treatment of motion sickness
Scopolamine, meclizine
Produce mydriasis and cycloplegia
Atropine, homatropine,C1208 tropicamide
Bronchodilation in asthma and COPD
Ipratropium
Reduce transient hyper GI motility
Dicyclomine, methscopolamine
Cystitis, postoperative bladder spasms, or incontinence
Oxybutynin, dicyclomine
Toxicity of anticholinergics
block SLUD (salivation, lacrimation, urination, defecation
Another pneumonic for anticholinergic toxicity
dry as a bone, red as a beet, mad as a hatter, hot as a hare, blind as a bat
Atropine fever is the most dangerous effect and can be lethal in this population group
Infants
Contraindications to use of atropine
Infants, closed angle glaucoma, prostatic hypertrophy
Limiting adverse effect of ganglion blockade that patients usually are unable to tolerate
Severe hypertension
Reversal of blockade by neuromuscular blockers
Cholinesterase inhibitors
Tubocurarine is the prototype, pancuronium, atracurium, vecuronium are newer short acting agent, produce competitive block at end plate nicotinic receptor, causing flaccid paralysis
Nondepolarizing Neuromuscular Blockers
Only member of depolarizing neuromuscular blocker, causes fasciculation during induction and muscle pain after use; has short duration of action
Succinylcholine
Chemical antagonists that bind to the inhibitor of ACh Estrace and displace the enzyme (if aging has not occurred)
Cholinesterase regenerators, pralidoxime
Used to treat patients exposed to insecticides such as parathion
Pralidoxime, atropine
Pneumonic for beta receptors
You have 1 heart (Beta 1) and 2 lungs (Beta 2)
This is the drug of choice for anaphylactic shock
Epinephrine
Phenylisopropylamines that are used legitimately and abused for narcolepsy, attention deficit disorder, and weight reduction
Amphetamines
Alpha agonist used to produce mydriasis and reduce conjunctival itching and congestion caused by irritation or allergy, it does not cause cycloplegia
Phenylephrine
Newer alpha 2 agonist (apraclonidine and brimonidine) treat glaucoma by acting to
Reduce aqueous secretion
Short acting Beta 2 agonists that is drug of choice in treatment of acute asthma but not recommended for prophylaxis
Albuterol
Longer acting Beta 2 agonist is recommended for prophylaxis of asthma
Salmeterol
These agents increase cardiac output and may be beneficial in treatment of acute heart failure and some types of shock
Beta1 agonists
These agents decrease blood flow or increase blood pressure, are local decongestants, and used in therapy of spinal shock (temporary maintenance of blood pressure which may help maintain perfusion
Alpha1 agonists
Shock due to septicemia or myocardial infarction is made worse by
Increasing afterload and tissue perfusion declines
Epinephrine is often mixed with a local anesthetic to
Reduce the loss from area of injection
Chronic orthostatic hypotension can be treated with
Midodrine
Beta 2 agonist used to suppress premature labor, but cardiac stimulatory effects may be hazardous to mother and fetus
Terbutaline
Sympathetic agent which stimulates heart rate and can dilate vessels in skeletal muscle at low doses
Epinephrine
Mast cells to reduce release of hisamine and inflammatory mediators
Epinephrine
Agent used in shock because it dilates coronary arteries and increases renal blood flow
Dopamine
Agent which stimulates cardiac contractile force more than rate with little effect on total peripheral resistance
Dobutamine
Long acting sympathomimetic, sometimes used to improve urinary continence in children and elderly with enuresis
Ephedrine
Alpha 1 agonist toxicity
Hypertension
Beta 1 agonist toxicity
Sinus tachycardia and serious arrhythmias
Beta 2 agonist toxicity
Skeletal muscle tremor, tachycardia
The selective agents loose their selectivity at
high doses
Nonselective alpha-blocking drug, long acting and irreversible, and used to treat pheochromocytoma. Blocks 5-HT, so occasionaly used for carcinoid tumor. Blocks H1 and used in mastocytosis
Phenoxybenzamine
Nonselective alpha-blocking drug, short acting and reversible, used for rebound HTN from rapid clonidine withdrawal, and Raynaud’s phenomena
Phentolamine
Selective Alpha 1 blocker used for hypertension, BPH, may cause first dose orthostatic hypotension
Prazosin, terazosin, doxazosin
Selective Alpha-1A blocker, used for BPH, but with little effect on HTN
Tamsulosin
Selective Alpha 2 blocker used for impotence (controversial effectiveness)
Yohimbine
SelectiveB1 Receptor blockers that may be useful in treating patients even though they have asthma
Acebutolol, atenolol, esmolol, metoprolol
Combined alpha and beta blocking agents that may have application in treatment of CHF
Labetalol and carvedilol
Beta blockers partial agonist activity (intrinsic sympathomimetic activity) cause some bronchodilation and may have an advantage in treating patients with asthma
Pindolol and acebutolol
This beta blocker lacks local anesthetic activity (a property which decreases protective reflexes and increases the risk of corneal ulceration) and used in treating glaucoma
Timolol
This parenteral beta blocker is a short acting (minutes)
Esmolol
This beta blocker is the longest acting
Nadolol
These beta blockers are less lipid soluble
Acebutolol and atenolol
This beta blocker is highly lipid soluble and may account for side effects such as nightmares
Propranolol
Clinical uses of these agents include treatment of HTN, angina, arrhythmias, chronic CHF, and selected post MI patients
Beta blockers
Toxicity of these agents include bradycardia, AV blockade, exacerbation of acute CHF; signs of hypoglycemia may be masked (tachycardia, tremor, and anxiety)
Beta blockers
Cholinomimetics that increase outflow, open trabecular meshwork, and cause ciliary muscle contraction
Pilocarpine, carbachol, physostigmine
Nonselective alpha agonists that increases outflow, probably via the uveoscleral veins
Epinephrine, dipivefrin
Selective alpha agonists that decreases aqueous secretion
Apraclonidine, brimonidine
These Beta blockers decrease aqueous secretion
Timolol (nonselective), betaxolol (selective)
This diuretic decreases aqueous secretion due to lack of HCO3- ion. Causes drowsiness and paresthesias, alkalinization of the urine may precipitate calcium salts, hypokalemia, acidosis
Acetazolamide
This agent cause increased aqueous outflow
Prostaglandin PGF2a
Inhibit angiotensin-converting enzyme (ACE)
ACE inhibitors
Captopril and enalapril (-OPRIL ending) are
ACE inhibitors
SE of ACE inhibitors
Dry cough, hyperkalemia
ACE inhibitors are contraindicated in
pregnancy and with K+
Losartan and valsartan block
Angiotensin receptor
Angiotensin receptor blockers do NOT cause
Dry cough
Agents that block L-type calcium channel
Calcium channel blockers
CCB contraindicated in CHF
Verapamil
CCB with predominate effect on arteriole dilation
Nifedipine
SE of CCB
Constipation, edema, and headache
Agents that reduce heart rate, contractility, and O2 demand
Beta-blockers
B-blockers that are more cardioselective
Beta-1 selective blockers
Cardioselective Beta 1-blockers
Atenolol, acebutolol, and metoprolol
Beta-blockers should be used cautiously in
Asthma (bronchospastic effects), diabetes (block signs of hypoglycemia) and peripheral vascular disease
Non-selective Beta-blocker also used for migraine prophylaxis
Propranolol
SE of beta blockers
Bradycardia, SEXUAL DYSFUNCTION, decrease in HDL, and increase in Triglycerols (TG)
Alpha 1selective blockers
Prazosin, terazosin and doxazosin (-AZOSIN ending)
Non-selective Alpha1blockers use to treat pheochromocytoma
Phenoxybenzamine
For rebound HTN from rapid clonidine withdrawal
Phentolamine
A1a-selective blocker with no effects on HTN used for BPH
Tamsulosin (Flomax)
SE of alpha blockers
Orthostatic hypotension (especially with first dose) and reflex tachycardia
Presynaptic Alpha 2 agonist used in HTN, and acts centrally
Clonidine, and methyldopa
SE of methyldopa
Positive Comb’s test, depression
Methyldopa is contraindicated in
Geriatrics due to its CNS (depression) effects
SE of clonidine
Rebound HTN, sedation, dry mouth
Direct vasodilator of arteriolar smooth muscle
Hydralazine
SE of hydralazine
Lupus-like syndrome
Arterial vasodilator that works by opening K+ channels
Minoxidil
SE of minoxidil
Hypertrichosis
IV Drug used Hypertensive Crisis
Nitroprusside
Nitroprusside vasodilates
Arteries and veins
Toxicity caused by nitroprusside and treatment
Cyanide toxicity treated with sodium thiosulfate
Carbonic anhydrase inhibitor
Acetazolamide
Diuretic used for mountain sickness and glaucoma
Acetazolamide
SE of acetazolamide
Paresthesias, alkalization of the urine (which may ppt. Ca salts), hypokalemia, acidosis, and encephalopathy in patients with hepatic impairment
MOA of loop diuretics
inhibits Na+/K+/2Cl- cotransport
Site of action of loop diuretics
Thick ascending limb
SE of loop (furosemide) diuretics
Hyperuricemia, hypokalemia and ototoxicity
Aminoglycosides used with loop diuretics potentiate adverse effect
Ototoxicity
Loops lose and thiazide diuretics retain
Calcium
MOA of thiazide diuretics
Inhibit Na+/Cl- cotransport
Site of action of thiazide diuretics
Work at early distal convoluted tubule
Class of drugs that may cause cross-sensitivity with thiazide diuretics
Sulfonamides
SE of thiazide (HCTZ) diuretics
Hyperuricemia, hypokalemia and hyperglycemia
Potassium sparing diuretics inhibit
Na+/K+ exchange
Diuretic used to treat primary aldosteronism
Spironolactone
SE of spironolactone
Gynecomastia hyperkalemia, and impotence
Osmotic diuretic used to treat increased intracranial pressure
Mannitol
ADH agonist used for pituitary diabetes insipidus
Desmopressin (DDAVP)
Used for SIADH
Demeclocycline
SE of demeclocycline
Bone marrow and teeth discoloration for children under 8 years of age
MOA of class I A (eg. Procainamide), class IB (eg. Lidocaine), and class IC (eg. Flecainide) antiarrhythmics
Sodium channel blockers
SE of procainamide
Lupus-like syndrome
Limiting side effect of Quinidine
Prolongs QT interval
Other side effects of Quinidine
Thrombocytopenic purpura, and CINCHONISM
Major drug interaction with Quinidine
Increases concentration of Digoxin
DOC for management of acute ventricular arrhythmias
Amiodarone
DOC for digoxin induced arrhythmias
Phenytoin
SE of phenytoin
Gingival hyperplasia
Class of anti-arrhythmics that has a pro-arrhythmic effect (CAST trial), therefore are used as last line agents
Class IC (flecainide, propafenone, moricizine)
Class II antiarrhythmics are
B-blockers
Antiarrhythmic that exhibits Class II and III properties
Sotalol
Side effect of sotalol
prolongs QT and PR interval
Used intravenously for acute arrhythmias during surgery
Esmolol
Anti-arrhythmics that decrease mortality
B-blockers
MOA of class III antiarrhythmics
Potassium channel blockers
Class III antiarrhythmic that exhibits properties of all 4 classes
Amiodarone
Specific pharmacokinetic characteristic of amiodarone
Prolonged half-life, up to six weeks
Antiarrhythmic effective in most types of arrhythmia
Amiodarone
SE of Amiodarone
Cardiac dysfunction, photosensitivity, skin (blue smurf syndrome), Pulmonary fibrosis, thyroid and corneal deposits
MOA of class IV antiarrhythmics
Calcium channel blockers
Life threatening cardiac event that prolong QT leads to
Torsades de pointes
Agent to treat torsades de pointes
Magnesium sulfate
Drug used supraventricular arrhythmias
Digoxin
DOC for paroxysmal supraventricular tachycardia (PSVT)
Adenosine
Adenosine’s MOA
Activattion on an inward K+ current and inhibition of Ca++ current resulting in marked hyperpolarization
Anti-arrhythmic with 15 second duration of action
Adenosine
MOA of sildenafil (Viagra)
Inhibits phosphodiesterase-5, enhancing effects of nitric oxide-activated increases in cGMP
Drugs used in the management of angina
Aspirin, Nitrates, CCB, and Beta blockers
Aspirin reduces mortality in unstable angina by
Platelet aggregation inhibition
MOA of nitrates
Relax vascular smooth muscle, at low doses dilate veins and at high doses dilate arterioles
Nitrate used for acute anginal attacks
Nitroglycerin sublingual tablets
Nitrate used to prevent further attacks
Oral and transdermal forms of nitroglycerin
Nitrate free intervals are needed due to
Tolerance
SE of nitrates
Postural hypotension, reflex tachycardia, hot flashes, and throbbing headache due to meningeal artery dilation
CCB are DOC for
Prinzmetal’s angina
Beta blockers are used for which type of anginal attack
Classic
MOA of Cardiac glycosides (eg. digoxin)
Indirectly increase intracellular calcium and cardiac contractility by inhibiting Na+/K+ ATPase
Digoxin is used in
Atrial fibrillation and CHF
Digoxin toxicity can be precipitated by
Hypokalemia
Antidote for digoxin toxicity
Digibind
Phosphodiesterase inhibitors that increase mortality and have been found to have NO beneficial effects
Amrinone and milrinone
SE of amrinone
Thrombocytopenia
Beta 1 agonists used in acute CHF
Dobutamine and dopamine
Diuretics work in CHF by
Reducing preload
Beta blockers work in CHF by
Reducing progression of heart failure (never use in acute heart failure)
Peptide drug used to treat CHF
Nesiritide (BNP)
MOA of nesiritide
Increasing sodium excretion and decreases arterial and venous tone
SE of nesiritide
Excessive hypotension and kidney failure
Agent used in CHF that is a selective alpha and nonselective beta blocker
Carvedilol
Agent used in acutely decompensated CHF resembling natriuretic peptide
Nesiritide (Natrecor)
Vitamin K dependent anticoagulant
Warfarin (PT)
Warfarin is contraindicated in
Pregnancy
Anticoagulant of choice in pregnancy
Heparin
Heparin (PTT) increases activity of
Antithrombin 3
Route of administration of warfarin
Oral
Routes of administration of heparin
IV and IM (only LMW)
SE of both warfarin and heparin
Bleeding
SE of heparin
Heparin induced thrombocytopenia (HIT)
Alternative anticoagulant used if HIT develops
Lepirudin
Antidote to reverse actions of warfarin
Vitamin K or fresh frozen plasma
Antidote to reverse actions of heparin
Protamine sulfate
MOA of aspirin
Irreversibly blocking cyclooxygenase
Agent used to treat MI and to reduce incidence of subsequent MI
Aspirin, metoprolol
SE of Aspirin
GI bleeding
Antiplatelet drug reserved for patients allergic to aspirin
Ticlopidine
SE for ticlopidine
Neutropenia and agranulocytosis
Effective in preventing TIA’s
Clopidogrel and ticlopidine
Prevents thrombosis in patients with artificial heart valve
Dipyridamole
Block glycoprotein IIb/IIIa involved in platelet cross-linking
Abciximab, tirofiban and eptifibatide
MOA of thrombolytics
Degradation of fibrin clots and are administered IV
Thrombolytics are used for
Pulmonary embolism and DVT
Thrombolytic that can cause allergic reaction
Streptokinase
Thrombolytic used for acute MI and ischemic (non hemorrhagic) CVA
Tissue plasmin activator
SE of tPA
Cerebral hemorrhage
Antidote for thrombolytics
Aminocaproic acid
Agent to treat hypochromic microcytic anemias
Ferrous sulfate
Chelating agent used in acute iron toxicity
Deferoxamine
Agent for pernicious anemia
Cyanocobalamin (Vit B12)
Agent used for neurological deficits in megaloblastic anemia
Vitamin B12
Agent used for megaloblastic anemia (but does NOT reverse neurologic symptoms) and decrease neural tube defects during pregnancy
Folic acid
Agent used for anemias associated with renal failure
Erythropoietin
Agent used neutropenia especially after chemotherapy
G-CSF (filgrastim) and GM-CSF (sargramostim)
Treatment of patients with prior episodes of thrombocytopenia after a cycle of cancer chemotherapy
Interleukin 11 (oprelvekin)
Drugs decrease intestinal absorption of cholesterol
Bile acid-binding resins
Cholestyramine and colestipol are
Bile acid-binding resins
Major nutritional side effect of bile acid-binding resins
Impair absorption of fat soluble vitamin absorption (A,D,E,K)
MOA of lovastatin (STATIN)
inhibits HMG COA reductase
HMG CoA reductase inhibitors are contraindicated in
Pregnancy
MOA of drug or foods (grapefruit juice) that increase statin effect
Inhibit Cytochrome P450 3A4
SE of HMG COA reductase inhibitors
Rhabdomyolysis and Hepatotoxicity
Monitoring parameter to obtain before initiation of STATINS
LFT’s
Decreases liver triglycerol synthesis
Niacin
SE of niacin
Cutaneous flush
Cutaneous flush and be reduced by pretreatment with
Aspirin
Fibrates (gemfibrozil) increase activity of
Lipoprotein lipase
Most common SE of fibrates
Nausea
Fibrates are contraindicated in
Pregnancy
Concurrent use of fibrates and statins increases risk of
Rhabdomyolysis
New class of drugs that works by inhibiting absorption of intestinal cholesterol and can be given concurrently with the Statins
Ezetimibe (Zetia)
MOA of NSAIDS
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
Difference between aspirin and other NSAIDS
Aspirin irreversibly inhibits cyclooxygenase
Four main actions of NSAIDS
Anti-inflammatory, analgesia, antipyretic and antiplatelet activity
Agent used for closure of patent ductus arteriosus
Indomethacin
Aspirin is contraindicated in children with viral infection
Potential for development of Reye’s syndrome
SE of salicylates
Tinnitus, GI bleeding
NSAID also available as an ophthalmic preparation
Diclofenac, ketoralac
NSAID available orally, IM and ophthalmically
Ketoralac
NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
Ketoralac
Newer NSAID that selectively inhibits COX-2
Celecoxib
COX 2 inhibitors may have reduced risk of
Gastric ulcers and GI Bleeding
COX 2 inhibitors should be used cautiously in pts with
Pre-existing cardiac or renal disease
Acetaminophen only has
Antipyretic and analgesic activity
SE of acetaminophen
Hepatotoxicity
Antidote for acetaminophen toxicity
N-acetylcysteine
DMARDs are slow acting drugs for
Rheumatic disease
Initial DMARD of choice for patients with RA
Methotrexate
Drug ofter used in combination with TNF - alpha inhitors for RA
Methotrexate
Causes bone marrow suppression
Methotrexate
SE of penicillamine
Aplastic anemia and renal toxicity
Interferes with activity of T-lymphocytes
Hydroxychloroquine
Anti-malarial drug used in rheumatoid arthritis (RA)
Hydroxychloroquine
SE of hydroxychloroquine
Retinal destruction and dermatitis
MOA of Leflunomide (newer agent)
Inhibiting dihydroorotate dehydrogenase which leads to decreased pyrimidine synthesis, decreased T cell proliferation and decreased antibody production by B cells
Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)
Adalimumab, infliximab and etanercept
Anti-rheumatic agent also used for ulcerative colitis
Sulfasalazine
Anti-rheumatic agent also used for Chron’s disease
Infliximab
NSAID used in gout
Indomethacin
NSAID contraindicated in gout
Aspirin
MOA of colchicine (used in acute gout)
Selective inhibitor of microtubule assembly
SE of colchicine
Kidney and liver toxicity, diarrhea
Agent used to treat chronic gout by increasing uric acid secretion and excretion
Probenecid and sulfinpyrazone
Allopurinol treats chronic gout by decreasing uric acid production by inhibiting
Xanthine oxidase
Rapid acting insulins that do not self-aggregate
lispro insulin, aspart insulin, glulisine insulin
Peakless ling acting insulin
Insulin glargine
DOC for paroxysmal supraventricular tachycardia; has high efficacy and short duration of action
Adenosine
