Abbreviated Pharm Flashcards by Stephanie Raven

Decrease angiotensin II (potent vascoconstrictor) and have SE of angioedema (severe), acute RF, and persistent dry cough

Ace-Inhibitors

Lisinopril and Ramipril

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Lisinopril depletes

zinc

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Alpha-2-agonist that decreases vasoconstriction and CO

Clonidine

AntiHTN

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Alpha-1-antagonist: decease NE; used to tx HTN and BPH

Doxazosin

Terazosin

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Do not use these AntiHTN drugs with African Americans

ARBs

Losartan, Irbesartan, Valsartan

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Major ADR of ARBs

HYPERkalemia

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Selective (B1) Antagonists

Atenolol

Metoprolol

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Nonselective (B1 and B2) Antagonists

Carvedilol
Propanolol
Timolol

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_______ BB crosses the BBB and has more SE

Propanolol

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Which BB is commonly used in CHF?

Carvedilol

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Which antihypertensive drugs are NOT 1st line for CHF?

CCB

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CCB

Amlodipine
Diltiazem
Verapamil

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Amlodipine depletes

Potassium

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Verapamil depletes

Vitamin E

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Potassium wasting diuretic that inhibits Na+ and Cl- at the ascending loop

Furosemide

Loop diuretic

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Furosemide SE

hypokalemia, ototoxicity, and nutrient depletion

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Furosemide is CI in

allergy to sulfonamides

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Potassium wasting diuretic that inhibits NaCl transporter in distal tubule

Hydrochlorothiazide

Thiazide diuretic

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Hydrochlorothiazide SE

hypokalemia and hyperglycemia

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Hydrochlorothiazide is CI in

allergy to sulfonamides

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Potassium sparing diuretics

Spironolactone

Triamterene

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Spironolactone and Triamterene are weak diuretics with SE of ______

HYPERkalemia

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Aldosterone antagonist that works at the distal convoluted tubule

Spironolactone

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What does hydralazine do?

Antihypertensive

unknown MOA, peripheral vasodilation

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Major SE of NTG

NTG C/I

Sildenafil (w/in 24 hrs)

Prophylactic vasodilator w/ a slower action than NTG

Isosorbide mononitrate

sympathomimetic with vasoconstriction via alpha-1 and bronchodilation via beta-2

Epinephrine | increases HR and contractility

This antiarrhythmic has a narrow therapeutic window

Potassium chloride

Potassium chloride SE

Hyperkalemia

Sodium channel blockers

Class I anti-arrhythmics: Lidocaine and Flecainide

BBW for Class I anti-arrhythmics: Lidocaine and Flecainide

increased mortality *use as a last resort in hospital setting

Class II anti-arrhythmics

BB (-olol)

Potassium channel blockers

Class III anti-arrhythmics: Amiodarone

70% of pt on amiodarone have ADR, including:

pulmonary fibrosis, heart block, hypotension, hypo/hyperthyroidism, hepatotoxicity, coronary/skin deposits

Class IV anti-arrhythmics

CCB: Amlodipine, Diltiazem, Verapamil

anti-arrhythmics that inhibits N/K/ATPase

Digoxin (Class V)

Which anti-arrhythmics can be used for LHF (palliative) and A flutter, but must be monitored d/t narrow therapeutic window

Digoxin

Combining digoxin w/ diuretics increases the risk of

hypokalemia

fatigue, mm. weakness, agitation, anorexia, and yellow halos around vision are sx of _______ toxicity

Digoxin

Bile acid sequestrant used to tx T2DM, familial hypercholesterolemia and hyperlipidemia

Colesevelam

Colesevelam SE

wastes nutrients when bile is sequestered

Colesevelam C/I

bowel obstruction or TG > 500

Cholesterol absorption inhibitor

Ezetimibe

Ezetimibe C/I

active liver dz

fibrate drug used to tx triad of low HDL, high LDL, high TG (Type IV and V)

Gemfibrozil

Gemfibrozil interacts with

Warfarin and statins (inc SE of LV DZ)

Gemfibrozil SE

gallstones, elevated liver enzymes, enhances anticoagulants, myositis/rhabdomyolysis

HMG-CoA reductase inhibitors

Atorvastatin and Simvastatin

Statins interact with

fibrates and niacin

Statin SE

elevated LFT, myositis, rhabdomyolysis - d/c if pt has muscle pain

______ should always be given with statins

75-100 mg CoQ10

Best drug in anaphylaxis

Epinephrine

antitussive that suppresses cough reflex at source (i.e. anesthetizes respiratory passage)

Benzonatate | it's actually an ester local anesthetic

antitussive that works at cough center in medulla

Dextromethorphan

Which antitussive can cause serotonin syndrome?

Dextromethorphan | it is C/I to use MAO-I w/in 14 days of dextromethorphan

Opioid antitussive(s)

Codeine | Hydrocodone

Mucolytic, expectorant

Guaifenesin

1st generation anti-histamines that cross BBB and cause sedation

Diphenhydramine Hydroxyzine Promethazine

2nd generation anti-histamines that do not cross BBB (thus do not cz sedation)

Cetirizine Fexofenadine Loratadine

Dose of diphenhydramine during anaphylaxis

50 mg IM

The anti-histamine _____ is used as an anxiolytic

Hydroxyzine

The anti-histamine _______ is used as an antipsychotic

Promethazine

Antihistamines that are used for allergies/asthma are ____ antagonists

Loratadine SE

QT prolongation

sympathomimetic nasal spray (mostly alpha-adrenergic)

Phenylephrine | decongestant

sympathomimetic decongestant (alpha and beta)

Pseudoephedrine

Pseudoephedrine C/I

MAO-I: phenelzine (HTN crisis)

Decongestants

Phenylephrine (nasal spray), Pseudoephedrine, Epinephrine

mast cell stabilizer that inhibits histamine release

Cromolyn sodium

Albuterol onset is ___ and lasts ____

onset: 15 min lasts: 3-4 hrs

Albuterol C/I

MAO-I (phenelzine), TCA, sympathomimetic

Long-acting B2 agonist that lasts 12-24 hr

Salmeterol | usu. used in combo w/ glucocorticoids

Salmeterol C/I ______ and ADR _____

C/I: acute asthma | ADR: prolonged QT

Salmeterol BBW

may increase asthma-related death

Inhaled steroids

Fluticasone, Mometasone, Beclomethasone, Budesonide

leukotriene antagonist used for prophylaxis and maintenance of persistent asthma, aspirin-induced asthma, and exercise-induced asthma

Montelukast

Montelukast SE

Churg-strauss syndrome, hypereosinophilia

antimuscarinic bronchodilator that inhibits ACh in smooth muscle of respiratory tract and is used for maintenance therapy in COPD

Tiotropium bromide

antimuscarinic bronchodilator that is shorter acting

Ipratropium bromide

Procoagulant that stimulates factors II, VII, IX, X

Vitamin K1

drug that inhibits ADP-induced platelet aggregation and is often used in pt that are aspirin intolerant

Clopidogrel

drugs that inhibits COX and inhibits platelet aggregation

Aspirin

Aspirin increases which drug?

Phenytoin (seizure drug)

Aspirin C/I

kids < 12 y/o (Reye's syndrome) and G6PD deficiency

inhibits synthesis of vitamin K-dependent factors but has no effect on established thrombus

Warfarin

has a narrow therapeutic window and requires monitoring of PT/INR

Warfarin

Drugs that can increase effects of Warfarin

Acetaminophen, Androgens, BB, Corticosteroids, Omeprazole, Phenytoin

xanthine derivative that reduces blood viscosity and is used in intermittent claudication and peripheral vascular dz

Pentoxifylline

Factor X inactivator that binds anti-thrombin III to prevent conversion of fibrinogen to fibrin (intrinsic pathway)

Heparin

Low molecular weight heparin (factor X inactivator)

Enoxaparin

Factor Xa inactivator that inhibits platelet activation and fibrin clot formation

Rivaroxaban

direct thrombin inhibitor that inhibits free and fibrin-bound thrombin

Dabigatran

Iron chelator used to tx chronic iron overload, hemochromatosis, routine transfusions

Deferoxamine

chelator of mercury, gold, arsenic

DMPS

chelator of mercury, lead, antimony, and arsenic

DMSA | oral version of DMPS so it has less severe ADR

chelator of lead, mercury, iron; also acts as anti-coagulant in blood tubes

Edetate calcium disodium (EDTA)

chelator of copper and other heavy metals; used to tx Wilson's dz

Penicillamine

drug used in anemia of chronic dz because it stimulates erythropoiesis

Epoetin alfa

Antibacterial classes that inhibit cell wall synthesis

Penicillins, Glycopeptides, Cephalosporins

Antibacterial classes that inhibit protein synthesis

Tetracyclines, Macrolides, Lincosamides, Aminoglycosides

Antibacterial classes that inhibit DNA synthesis

Fluoroquinolones

Antibacterial classes that inhibit RNA synthesis

Synthetase inhibitors (Mupirocin), Monoxycarbolic acid agents (Rifaximin, Nitrofurantoin)

Antibacterial classes that act as PABA analogue/dihydrofolate reductase inhibitors

Sulfamethoxazole-trimethorpim C/I in KIDDOS

B-lactam drug used to tx dental abscesses, recurrent rheumatic fever, recurrent strep cellulitis in lymphedema but has SE of anaphylaxis and black hairy tongue

Penicillin G/VK | i.e. natural penicillin

synthetic B-lactam drugs that are 1st choice for uncomplicated ENT infx

Ampicillin, Amoxicillin, Amoxicillin + clavulanate

What is clavulanate?

B-lactamase inhibitor (added to B-lactam drug Ampicillin)

Are the synthetic penicillin drugs (ampicillin, amoxicillin, and amox + clavulanate) safe in Pg?

Yes

glycopeptide drugs that is IV only and used to tx MRSA

Vancomycin

Cephalosporins

Cefdinir Cefuroxime Ceftriaxone Cephalexin

10-15% of pt that are hypersensitive to penicillins will also reach to ________

Cephalosporins | cefdinir, cefuroxime, ceftriaxone, cephalexin

Cephalosporins (cefdinir, cefuroxime, ceftriaxone, cephalexin) tx

cellulitis

broad-spectrum antibiotics that can have ADR of photosensitivity and tooth discoloration/bone effects in kids < 8

Tetracyclines (minocycline, doxycycline)

_________ antibiotics should be taken on an empty stomach, where as ______ antibiotics should be taken with food

Empty = tetracyclines Food = macrolides

Are macrolides safe in pregnancy?

Yes (Cat. B)

Macrolides

"-romycin" Azithromycin Clarithromycin Erythromycin

alternative antibiotic for people w/ penicillin allergy

Clindamycin

antibiotic that is used topically for acne

Clindamycin

Clindamycin ADR

C. diff super infx (pseudomembranous colitis)

topical aminoglycoside antibiotic used for ocular infx

Gentamicin

1st line drug for UTIs

Ciprofloxacin and Levofloxacin | Fluoroquinolones

Ciprofloxacin and Levofloxacin BBW

tendon rupture

Ciprofloxacin and Levofloxacin C/I

< 18 y/o (can arrest growth plate)

topical antibiotic for MRSA and impetigo

Mupirocin

Monoxycarbolic acid agent used to tx SIBO, traveler's diarrhea, IBS, hepatic encephalopathy

Rifaximin

"everything inhibitor" used to tx acute uncomplicated UTIs

Nitrofurantoin

Nitrofurantoin C/I

G6PD deficiency, lactation, and 3rd trimester of Pg (can cz hemolysis of newborn)

Give _____ with Sulfamethoxazole-trimethorpim

Folate

Sulfamethoxazole-trimethorpim SE

photosensitivity and megaloblastic anemia

Sulfamethoxazole-trimethorpim interactions

OCPs

Triple Antibiotic Ointment

Bacitracin + Neomycin + Polymyxin B B: inhibits cell wall synth N: aminoglycoside PB: cell wall permeability

Triple Antibiotic Ointment SE

allergic contact derm and SNHL (neomycin)

Neomycin SE

permanent SNHL | aminoglycoside drug

Anti-tuberculosis drugs

Isoniazid and Rifampin Note: use both drugs together for active infx

can be used to tx latent and active TB but is also hepatotoxic

Isoniazid

Rifampin SE

red tears/saliva/urine, hepatotoxic

anti-fungals that penetrate into all body fluids

Fluconazole and Ketoconazole | Triazoles

Fluconazole and Ketoconazole interactions

Warfarin, phenytoin, others

Anti-fungal used for onychomycosis

Terbinafine

Terbinafine SE

hepatotoxic, SJS, neutropenia

anti-fungal that disrupts cell wall formation and only works topically (even in GI it works as topical agent)

Nystatin

Malaria prophylaxis

Hydroxychloroquine

anti-helminthic drugs that destroy microtubules and block glucose uptake

Albendazole and Mebendazole

topical application for lice, ticks, mites; 1st line tx scabies

Permethrins

anti-parasitic for roundworms, lice, scabies

Ivermectin

anti-protozoel for anaerobic infx, C. diff, H. pylori ulcers, BV, trichomonas, and giardia

Metronidazole

Metronidazole C/I

EtOH (disulfiram rxn)

guanosine analogue that inhibits viral DNA polymerase and tx actively replicating HSV

Acyclovir and Valacyclovir

reverse transcriptase inhibitor; drug accumulates in all dividing cells

Zidovudine

Parkinson's drugs that can also tx Influenza A

Amantadine | no longer recommended for influenza A

tx influenza A and B; prevents release of virus

Oseltamivir

tx chronic HBV and HCV

interferon-a-2

alkylating agent used to tx metastatic testicular and ovarian tumors and adv bladder CA

Cisplatin

Cisplatin BBW

renal toxicity, myelosuppression, ototoxicity

alkylating agent used to tx leukemia, lymphoma, and many other CA

Cyclophosphamide

anthracycline drug used to tx Kaposi's sarcoma, ovarian CA, multiple myeloma

Doxorubicin

Doxorubicin SE

life-threatening heart damage

Doxorubicin C/I

cardiac dz

drug used to tx Her-2+ breast CA

Trastuzumab

Trastuzumab BBW

fatal heart/lung problems and fetal harm

folic acid antagonist used to tx many CA and to induce abortion

Methotrexate

anti-microtuble drug used to tx Hodgkin's, testicular CA, and Kaposi's sarcoma

Vinblastine (IV only)

Vinblastine is derived from

Vinca rosea (periwinkle)

aromatase inhibitor used reduce serum estradiol in breast CA pt post-surgery and for METS

Anastrozole

GnRH analogue; testosterone antagonist used to tx metastatic prostate CA

Bicalutamide

Bicalutamide C/I

women, pregnancy (X)

GnRH analogue; suppression of ovarian/testicular steroidogenesis for prostate CA, endometriosis, uterine fibroids

Leuprolide

mitotic inhibitor that binds tubulin and affects rapidly dividing cells

Paclitaxel

drug used to tx advanced ovarian CA, non-small cell lung CA, ovarian/breast CA METS unresponsive to 1st line drugs

Paclitaxel

pyrimidine analogue use to tx many CA

5-Fluorouracil

5-Fluorouracil is used topically to tx

BCC

SERM used prophylactically for postmenopausal osteoporosis

Raloxifine

SERM that competes with E2 for E-receptor proteins and is used to tx E+ CA

Tamoxifen

Tamoxifen BBW

uterine malignancies, stroke, PE

cytokine inhibitor (TNF-alpha); circulating receptor fusion protein used to tx RA, jRA, PsA, AS, plaque psoriasis

Etanercept

Etanercept BBW

incr risk of serious infx and CA

TNF-a inhibitor used to tx inflammatory dz (RA, PsA, IBD)

Adalimumab

Adalimumab BBW

incr risk of serious infx and CA

Infliximab BBW

incr risk of serious infx and CA *can also cz HF, pancytopenia, and demyelinating dz

Cytokine/TNF inhibitors

Etanercept, Adalimumab, Infliximab

DMARD used to tx SLE and RA

Hydroxychloroquine

DMARD used to tx CA, RA, severe psoriasis, ectopic pg (abortifacient)

Methotrexate

DMARD used RA (also a copper chelating agent)

Penicillamine

DMARD used to tx IBD and RA that is C/I in people with sulfonamide/salicylate allergy

Sulfasalazine

JAK inhibitor used to tx RA when it's refractive to methotrexate

Tofacitinib *new on NPLEX

Tofacitinib BBW

incr risk of serious infx and CA

used for prophylaxis during organ transplant and for dry eyes

Cyclosporine

transplant drug that has BBW of incr risk of serious infx and CA

Tacrolimus

drug used to tx leprosy and multiple myeloma

Thalidomide

Thalidomide C/I

pregnancy (X)

4x stronger than cortisol and longer acting than hydrocortisone

Prednisone

non-selective COX inhibitor used to tx fever, pain, inflamm, and platelet agg

Aspirin

Salicylism

dose-dependen reversible vertigo, vomiting, tinnitus, hearing loss (aspirin toxicity - max dose = 4g)

Diclofenac gel

non-selective COX inhibitor for inflammation; NSAID

non-selective COX inhibitor that decreases cartilage synthesis

Ibuprofen

Ibuprofen interacts with

Aspirin do not combine

Indomethacin

non-selective COX inhibitor for inflammation

non-selective COX inhibitor use for moderate-severe pain only; IV or IM

Ketorolac

Ketorolac C/I

use > 5 days and in peds

Naproxen

non-selective COX inhibitor for inflammation

Naproxen sodium

greater absorption and faster onset than Naproxen (NSAID)

non-selective COX inhibitor used for post-cataract surgery

Nepafenac

Selective Cox-2 inhibitor

Celecoxib

Celecoxib has less ______ than aspirin, but increased risk of _______

less: GI distress incr: risk of serious thrombosis

Celecoxib C/I

perioperative pain from CABG

Muscle relaxants for acute use (1-2 wks)

Carisoprodol Cyclobenzaprine Diazepam (benzo) Methocarbamol

muscle relaxants C/I

CNS depressants

Methocarbamol SE

black/blue/green urine

you need to taper this drug that is used to tx mm. spasticity, spinal cord injury, and rheumatic d/o

Baclofen

alpha-2 agonist used for mm. spasticity

Tizanidine

inhibits ACh release and causes flaccid paralysis

Botulinum toxin

bisphosphonate drug that inhibits osteoclasts

Alendronte

_______ must be taken on an empty stomach with 6-9 oz water and remain upright for 30 min

Alendronte

Alendronte SE

esophageal erosion, osteonecrosis of jaw

Alendronte C/I

hypocalcemia

hormone used to inhibit osteoclasts and tx osteoporosis (not prevention)

Calcitonin

monoclonal antibody use to tx osteoporosis

Denosumab SQ q 6 mo

SERM used for postmenopausal osteoporosis prophylaxis

Raloxifene

Raloxifene C/I

past VTE, pregnancy (X)

centrally acting analgesic that inhibits prostaglandin synthesis for pain and fever; not anti-inflammatory

Acetaminophen

Acetaminophen interactions

EtOH 3 drinks/day + 3 g can shut down the liver

Acetaminophen max dose

4 g in 24 hours #1 drug to OD on

xanthine oxidase inhibitor used in prevention of further gouty attacks (decreases uric acid production)

Allopurinol

drug used in acute gouty attacks; microtubule inhibitor that prevents neutrophils causing gout sx

Colchicine

______ is used to tx acute gout, whereas ______ is used to prevent further gout attacks

Acute = colchicine Prevention = allopurinol

rubefacient used as a counter-irritant for pain, vasodilation, and blocks substance P

capsaicin

kappa and mu receptor activities

``` Codeine Fentanyl Hydrocodone Morphine Oxycodone Tramadol ``` *all are class II except hydrocodone, which is class III

strongest non-synthetic opiate

morphine

Tramadol SE

seizure risk

synthetic opioid agonist for addiction and detox

Methadone

partial opioid agonist/antagonist for addiction

Buprenorphine

competitive opioid antagonist for addiction that is C/I in pt taking opiates

Naltrexone

competitive opioid antagonist for acute OD

Naloxone

immunosuppressant and ocular emulsant; used to tx keratoconjunctivitis sicca (Sjogrens, scleroderma)

Cyclosporine

aminoglycoside, bacteriocidal eye drops

Gentamicin

bacteriostatic drug used for conjunctivitis, superficial ocular infx

Sulfacetamide

macrolide used for superficial ocular infx that has a SE of eye irritation

Erythromycin

BB for ocular HTN and open-angle glaucoma

Timolol

prostaglandin analog that reduces IOP by increasing outflow of aqueous humor

Latanoprost

Latanoprost SE

iris darkening

cholinergic agonist causing miosis (constriction) and decreased pressure in open-angle glaucoma or ocular HTN; also used in acute-open angle glaucoma

Pilocarpine

anticholinergic drug used to dilate eyes for exam (mydriatic agent)

Atropine

NSAID for cataract surgery to decrease pain and inflammation

Nepafenac

Nepafenac SE

increased bleeding time, delayed healing, corneal ulcers

ophthalmic antihistamine used in tx allergies

Olopatadine

sympathomimetic decongestants that cause rebound congestion (aka rhinitis medicamentosa)

Oxymetazoline | Phenylephrine

Oxymetazoline and Phenylephrine C/I

use > 3 days, glaucoma, MAO-I

topical antibacterial and steroid for swimmer's ear, superficial bacterial infx of external auditory canal

Neomycin/Polymyxin B/Hydrocortisone

cholinesterase inhibitors used to tx dementia

Donepezil | Rivastigmine

drug that blocks NMDA-R and decreases excitotoxicity for moderate to severe Alzheimers

Memantine

GABA analogue used as adjunct in epilepsy tx

Gabapentin | Pregabalin

sodium channel blocker used to tx partial seizures, bipolar mania, and trigeminal neuralgia

Carbamazepine

Carbamazepine SE

ataxia

sodium channel blocker seizure drug that has SE of gingival hyperplasia and suicidal ideation

Phenytoin

Phenytoin SE

- P: peripheral neuropathy - H: hyperplasia of gingiva, hirsutism, hypersensitivity - E: enlarged LN - N: nystagmus - y - T: teratogenicity - O: osteomalacia - I: inhibition of insulin - N: nausea

benzodiazepine use in seizure tx

Diazepam

Diazepam C/I

CNS depressants

seizure drugs with SE of sudden unexplained death and suicidal ideation

Lamotrigene Topiramate Valproate

PD drugs that is a dopamine precursor

Levodopa/carbidopa

inhibits peripheral degradation of levodopa but has no effect if used alone

carbidopa

Levodopa/carbidopa SE

tolerance over time

Levodopa/carbidopa interaction

B5 (increases peripheral DA catabolism)

dopamine agonist used to tx PD, acromegaly, and hyperprolactinemia

Bromocriptine

Bromocriptine SE

pulmonary fibrosis

dopamine agonist for tx PD that is s/t used to delay starting Levodopa

Pramipexole

anticholinergics for dyskinesia (in PD)

Benztropine Scopolamine Diphenhydramine

drug used to levodopa-induced dyskinesia

Amantadine

sphingosine-1-phosphate-R modulator used to tx MS; it decreases inflammation

Fingolimod

immune modulator used to tx MS, that activates suppressor T-cells to decrease inflammation

Glatiramer acetate

interferon used to reduce MS exacerbations

Interferon-beta-1

drugs used to spasticity related to MS

Tizanidine (mm. relaxant) Baclofen (unknown MOA) Botulinum toxin

drug used for postherpetic neuralgia, epilepsy, and bipolar mania

Gabapentin

drug used for neuropathic pain, fibromyalgia, and postherpetic neuralgia

Pregabalin

5HT-1 agonist, potent vasoconstriction of cranial aa., take at onset of migraine or cluster HA

Sumatriptan

Sumatriptan CI

ischemic heart dz, history of MI or stroke

tx for chronic migraines that blocks ACh release

Botulinum toxin

Topiramate and Valproate can both be used to tx

migraines and seizures

Amides are metabolized

by the liver

Esters are metabolized

in peripheral plasma to PABA

Lidocaine is an

amide (liver)

Bupivacaine is an

amide (liver)

Procaine is an

ester (peripheral plasma)

Lidocaine onset and duration

onset: 1-10 min duration: 30-60 min

Bupivacaine

onset: 8-12 min duration: 3-4 hr

Which type of nerve block agent is more likely to cause allergic rxn?

Esters | i.e. procaine

the nerve block agent _______ acts topically, and ______ does not act topically

Lidocaine Procaine

Procaines has a _____ onset, and ______ duration as Lidocaine

``` slower onset same duration (30-60 min) ```

NMDA receptor antagonist used in pain/procedures

Ketamine

Ketamine C/I

psychosis

1st generation antihistamines that are somnorific

Diphenhydramine Hydroxyzine Promethazine

non-benzo GABA potentiator - strong sedative, minor anxiolytic, rapid onset but short duration of hypnotic action

Zolpidem

Zolpidem SE

rebound insomnia (must taper)

anti-convulsant drugs used to tx mania in bipolar d/o

Lamotrigine Valproate Carbamazepine

Carbamazepine blocks ____ channels

sodium

drugs that block 5HT and DA

``` Atypical anti-psychotics: Risperidone Aripiprazole Quetiapine Clozapine ```

The atypical anti-psychotic ______ is used to tx irritability in autism

Risperidone

Aripiprazole SE

dysglycemia (caution with DM)

drug used to tx mania that has a narrow therapeutic window and must be monitored

Lithium

Lithium SE

hypothyroidism, hyponatremia

_____ are first line anxiolytic for MDD, OCD, GAD, and eating d/o

SSRIs: Escitalopram Fluoxetine Paroxitine

SSRIs (Escitalopram, Fluoxetine, Paroxitine) C/I

MAO-I (serotonin syndrome)

Benzodiazepines

Alprazolam | Diazepam

Benzodiazepine (Alprazolam, Diazepam) SE

anterograde amnesia, must taper

Benzodiazepine (Alprazolam, Diazepam) C/I

CNS depressants

long-acting benzo used to tx epilepsy, EtOH w/drawal, and mania

Diazepam

antipsychotic that blocks D2, some H1, some cholinergic, some alpha-adrenergic and has LOTS of SE

Haloperidol

Haloperidol C/I

severe CNS depression, dementia-related psychosis

anti-psychotic used to tx psychosis and vomiting

Phenothiazines: Prochlorperazine Promethazine

Phenothiazines (Prochlorperazine, Promethazine) SE

tardive dyskinesia

Phenothiazines (Prochlorperazine, Promethazine) C/I

CNS or bone marrow depression

atypical antipsychotic used in treatment-resistant schizophrenia and suicide risk reduction

Clozapine

Clozapine BBW

severe neutropenia

Quetiapine

atypical antipsychotic used to tx mania

amphetamine agents used to tx narcolepsy

Dextroamphetamine | Methylphenidate

non-amphetamine CNS stimulation used to tx narcolepsy

Modafinil

Modafinil SE

SJS

Anorexiants (used to suppress appetite)

Phentermine | Dextroamphetamine

Is Phentermine safe in pregnancy?

No (Cat. X)

ADD/ADHD meds

Dextroamphetamine Methylphenidate Clonidine

Clonidine MOA

alpha-2 agonist

methylxanthine, phosphodiesterase inhibitor

caffeine

CNS stimulant and local anesthetic that works by reducing Na+ permeability

cocaine

Nicotinic ACh-R partial agonist

Varenicline

Varenicline BBW

suicidal ideation

Nicotine interactions

Bupropion is used to tx

smoking cessation

Bupropion C/I

seizure d/o, eating d/o

hallucinogen that affects 5HT release, increases catecholamines, inhibits parasympathetics

Cannabis

hallucinogen that is an NMDA receptor antagonist

Ketamine

anticholinergic used to tx bradycardia, organophosphate poisoning, and PD

Atropine

Atropine C/I

acute glaucoma

MOA inhibitor that increases NE, DA, 5HT - used in depression

Phenelzine

Phenelzine C/I

all antidepressants and any meds that affect catecholamines

tricyclic that increases NE and 5HT - used in depression

Amitriptyline

Amitriptyline C/I

MAO-I or SSRI

tetracycline drug used for MDD

Mirtazapine

the smoking cessation drug ______ can also be used to tx depression

Buproprion | although takes several wk for antidepressant effects

which anti-depressant has the fewest sexual SE

Buproprion

5HT antagonist and reuptake inhibitor (SARI) used off label to tx insomnia

Trazodone

SSRI used to tx MDD, OCD, GAD, eating d/o, panic attack

SSRI: Escitalopram, Fluoxetine, Paroxetine

1st line tx for depression and panic d/o

Fluoxetine (SSRI)

drug used to social anxiety, MDD, OCD, panic d/o, GAD

Paroxetine

SNRI used to tx depression, GAD and diabetic neuropathy

Duloxetine

SNRI used to tx MDD

Venlafaxine

ADHD med, NE reuptake inhibitor

Atomoxetine

antibacterial used topically for acne that has SE of photosensitivity

Benzoyl peroxide

synthetic retinoid that reduces sebaceous gland size and sebum production

Isoretinoin

Isoretinoin SE and C/I

SE: chelitis, increased LFTs | C/I: pregnancy (X)

synthetic retinoid cream used for acne - reduces sebaceous gland size and sebum production

Tretinoin

blocks ACh release and can tx hyperhydrosis

Botulinum toxin

Topical steroids for eczema

``` Clobetasol propionate Fluocinonide Mometasone Fluticasone Triamcinolone Hydrocortisone ```

RNA synthesis blocker that tx staph infx

Mupirocin

synthetic calcitriol (Vit D) to aid in proliferation and differentiation of various cell types; used to tx psoriasis

Calcipotriol

Calcipotriol SE

hypercalcemia

tx tinea versicolor, seborrheic derm, and dandruff

selenium disulfide

used to tx actinic keratosis and external genital warts

Imiquimod

Imiquimod C/I

immunocompromised and kids with molluscum (ineffective)

tx diarrhea and ulcers; coats stomach; cytoprotective against H. pylori

Bismuth subsalicylate

Bismuth subsalicylate SE

black tongue, tarry stool

mast cell stabilizer that inhibits histamine release and can tx diarrhea

Cromolyn sodium

anti-diarrheal effect on circular smooth muscle of bowel; may prolong transit time

Diphenoxylate/atropine

Diphenoxylate/atropine C/I

pseudomembranous colitis, enterotoxin-producing bacteria

opioid analogue that inhibits peristalsis and prolongs transit time; tx diarrhea

Loperamide

Loperamide C/I

bloody diarrhea, high fever, infectious diarrhea, pseudomembranous colitis

somatostatin analog (inhibits GH, glucagon, insulin, LH, and VIP); tx vasoactive intestinal peptide tumors, acromegaly, and watery diarrhea

Octreotide

detergent agent that pulls more water into fecal matter

Docusate

Docusate interactions

mineral oil

Docusate C/I

obstruction

increase water into lumen and increase peristalsis; between softener and laxative

Oral osmotic agents: Lactulose Milk of magnesium PEG 3350

stimulant laxative that evacuates bowels 8 hr after taking

Bisacodyl

phosphoric acid salt that exerts osmotic effect and acts as a laxative/bowel evacuant

Sodium phosphate enema

binds prostaglandin R or parietal cells increasing HCO3-, decreasing pepsin, protecting tight jn, and thickening mucous layer; used for prevention of NSAID-induced ulcers

Misoprostal

Misoprostal C/I

pregnancy (X; abortifacient)

enhances mucosal barrier, adheres to "roughed up" gastric mucosa, little systemic absorption/no toxicity; powerful demulcent

Sucralfate

H2 blockers that inhibit gastric acid secretion by binding reversibly to H2-R in parietal cells, for short-term use

Cimetidine | Ranitidine

suppress gastric acid secretion by irreversible blocking H/K/ATPase at parietal cells

PPI: Esomeprazole Lansoprazole Omeprazole

Are H2 blockers safe in Pg?

Yes

Are PPI safe in Pg?

Yes | -"prazole"

PPI ("-prazole") SE

rebound hypersecretion (must taper)

spasmolytic drugs (dicyclomine, hyoscyamine, and scopolamine) C/I

glaucoma

spasmolytic, anticholinergic, tx diarrhea, IBS, spasms, PUD

Hyoscyamine | Dicyclomine

anticholinergic, parasympatholytic drug used for motion sickness prevention

Scopolamine

DMARD used to tx IBD and RA

Sulfasalazine

Sulfasalazine C/I

sulfa allergy

active metabolite of sulfasalazine (tx IBD)

Mesalazine

1st generation antihistamines used to prevent vestibular stimulation of vomiting center, prophylaxis for motion sickness

Diphenhydramine | Meclizine

blocks 5HT3-R, inhibits activation of vomiting reflex pathway; used for N/V with chemotherapy or surgery

Ondansetron

antipsychotics with anti-DA and anti-emetic effects

Prochlorperazine | Promethazine

Prochlorperazine and Promethazine SE and C/I

SE: extrapyramidal | C/I: kids <2 (fatal respiratory depression)

solubilizing agent for primary biliary cirrhosis; tx gallstonres

Ursodeoxycholic acid

Ursodeoxycholic acid C/I

biliary obstruction

progestin for anorexia/cachexia of AIDS

Megestrol acetate

Megestrol acetate C/I

pregnancy (X)

cholinergic, increased SLUDGE for dry mouth of Sjogren's or chemotherapy

Pilocarpine

Pilocarpine C/I

glaucoma

dopamine R antagonist that tx N/V associated with chemo or radiation, GERD (2nd line), diabetic gastroparesis

Metoclopramide

Metoclopramide SE and C/I

SE: extrapyramidal | C/I: used > 12 wk

5-alpha reductase inhibitor, decreases serum DHT for BPH and male pattern baldness

Finasteride

Finasteride C/I

Pregnancy (X)

BPH drugs that block alpha-1 R around bladder neck

Doxazosin Terazosin Tamsulosin (alpha-1-antagonists)

androgen that tx ED

Testosterone

Testosterone C/I

Pregnancy (X)

cGMP-PDE V Inhibitor, smooth muscle relaxation and inflow of blood to tx ED

Sildenafil

Sildenafil SE

HA (MC), sudden cardiac death

Sildenafil C/I

Nitrate use

prostaglandin analogue (PGE-1) that leads to vasodilation and platelet inhibition and tx ED; IM into corpus cavernosum or used as urethral suppository

Alprostadil

Alprostadil SE

curving of penis, priapism, testicular swelling/pain

Alprostadil C/I

pregnancy (X)

antimuscarinic drugs used to tx urinary incontinence

Oxybutynin Solifenacin Tolteridine

Antimuscarinic (Oxybutynin, Solifenacin, Tolteridine) C/I

glaucoma, gastric/urinary retention

block ACh release and tx urinary incontinence

Botulinum toxin

muscarinic agonist (structurally related to ACh) that acts as a parasympathomimetic and is used for acute post-op and postpartum urinary retention

Bethanechol

1st line tx for interstitial cystitis; also used to tx pain of UTI but does not tx infx

Phenazopyridine

Phenazopyridine SE

body fluids turn deep orange (will interfere with urinalysis results)

antibiotic that has high concentration in urine, for cystitis, uncomplicated UTIs, 1st line tx for E. coli UTI

Nitrofurantoin

Nitrofurantoin C/I

3rd trimester of pregnancy (can cz hemolysis of newborn)

HBV tx that inhibits reverse transcriptase and incorporates into viral DNA

Entecavir

Entecavir BBW

hepatitis B exacerbation if tx is d/c, HIV resistance (don't use in pt w/ coinfx)

NSAID used to tx OA and RA

Meloxicam

precursor of progestogens, mineralcorticoids, glucocorticoids, androgens, and estrogens

Pregnenolone

used in Addison's to replace mineralcorticoids

Fludrocortisone

Oral glucocorticoids

``` Hydrocortisone Prednisone Prednisolone Methyprednisolone Dexamethasone ```

Prednisone is ___ X stronger than hydrocortisone

Dexamethasone is ___ X stronger than hydrocortisone

Inhaled glucocorticoids

Fluticasone Momentasone Budesonide Beclomethasone

Glucocorticoid topical creams/gels

``` Fluocinonide Triamcinolone Hydrocortisone Clobetasol propionate Dexamethasone ```

Glucocorticoid nasal sprays

Beclomethasone Budesonide Fluticasone Mometasone

estrogen that is used for HT, prophylaxis of osteoporosis, naturally highest in postmenopausal F, and

Estrone

Estrone SE and C/I

SE: carcinogenic | C/I: pregnancy (X)

estrogen that is used for atrophic vaginitis, BrCA, osteoporosis, DUB/AUB

Estradiol

Estradiol SE and C/I

SE: clot formation | C/I: E+ tumor, pregnancy(X)

estrogen that is used for HT, atrophic vaginitis, and is highest during pregnancy

Estriol

Estriol C/I

pregnancy, thrombosis

estrogen used to tx atrophic vaginitis, F hypogonadism, osteoporosis, AUB

Conjugated Estrogen | from pregnant mare

Conjugated Estrogen C/I

pregnancy (X)

strong E, only E used in OCP

Ethinyl Estradiol (EE)

prevents endometrial hyperplasia in females with uterus with postmenopausal estrogen therapy

Progesterone

hormones used to tx amenorrhea, DUB, PMS, fibroids, insomnia (dose at night), and is used in OCP

Progesterone

IUD

Levonorgestrel

Levonorgestrel C/I

pregnancy (X)

contraception, endometriosis, IM q 3 months

Medroxyprogesterone acetate

Medroxyprogesterone acetate C/I

pregnancy (X)

progestin used in OCP - alone or in combo with ethinyl estradiol (EE); also used in menopause

Norethindrone

only OC that are safe in nursing moms

Progestin OC (Norethindrone) | they also have highest rate of unintended Pg

Norethindrone C/I

pregnancy (X)

Combo OCP

Drospirenone/Ethinyl Estradiol Norelgestromin/Ethinyl Estradiol Norgestimate/Ethinyl Estradiol

ovulatory stimulant used in ovulatory dysfn in F trying to become pregnant, PCOS, post-OCP amenorrhea, some 2' amenorrhea

Clomiphene

Clomiphene SE

ovarian hyperstimulation syndrome, hepatic dysfn

Clomiphene C/I

pregnancy (X)

increases production of E and T, decreases cortisol

DHEA

DHEA C/I

breast/uterine CA, endometriosis, fibroids

hormone for tx male hypogonadism

Testosterone | only give if AM plasma T is < 3 ng/mL

Testosterone SE (males)

gynecomastia, transfer to partner, liver CA, BPH, prostate CA

Testosterone SE (female)

clitoral hypertrophy, hirsuitism, acne, amenorrhea

Testosterone C/I

pregnancy (X)

competitive antagonist at androgen R, decreases T and tx hirsuitism d/t PCOS

Spironolactone

Insulin interactions

BB | can mask sx of hypoglycemia and prolong recovery

very rapid onset insulin (1 hr), very short-acting (3-4 hr), bolus dosing with meals

Lispro

rapid onset insulin (2-3 hr), short-acting (5-7 hr)

Regular

slow onset insulin (12 hr), long-acting (24 hr)

Glargine

rescue of hypoglycemia; given IV, IM, SQ

Glucagon

Glucagon C/I

pheochromocytoma

synthetic ADH, tx diabetes insipidus, limits H2O eliminated in urine

Desmopressin

Desmopressin SE

seizures, hyponatremia

labor/let down/love

Oxytocin

IV or nasal spray, postpartum hemorrhage, labor induction, incomplete abortion

Oxytocin

Oxytocin C/I

pregnancy (X)

prolactin blocker, dopamine agonist; tx hyperprolactinemia or prolactin-secreting adenoma

Bromocriptine

GH agonist used to tx dwarfism, growth failure (peds), HIV cachexia

Somatropin

stimulates chondrocytes, protein synthesis, EPO

Somatropin

given with Octreotide for acromegaly

Bromocriptine

somatostatin analogue that tx acromegaly, VIP tumor, carcinoid tumor

Octreotide

Octreotide SE

hyper/hypoglycemia, cardiac conduction d/o

iodine replenisher, radiation protection, inhibits release of thyroid hormone (ST); can be used in tx of both hyper and hypothyroidism

Lugol's sol'n

inhibits thyroid hormone synthesis, blocks TPO, safer than PTU

Methimazole

inhibits TPO, inhibits conversion of T4 to T3, preferred agent in thyroid storm

Propylthiouracil (PTU)

Propylthiouracil (PTU) SE

agranulocytosis, life-threatening hepatotoxicity

Levothyroxine

Levothyroxine C/I

uncorrected adrenal deficiency

Liothyronine

T4/T3 blend from desiccated pig thyroid

Thyroid USP

from C-cells, opposes PTH, decreases serum Ca++; tx Paget's disease of bone, hypercalcemia, postmenopausal osteoporosis

Calcitonin

induces ovulation and tx infertility in F; increases sperm count in M and helps testes descend

hCG

hCG SE

ovarian hyperstimulation syndrome

hCG C/I

pregnancy (X)

powerful antioxidant that tx disturbed biorhythms and sleep d/o

Melatonin

increases # and affinity of insulin R in periphery, decreases hepatic glucose output

Metformin | Biguanide

Metformin SE

lactic acidosis, diarrhea, B12 deficiency

Metformin C/I

metabolic acidosis, T1DM

sulfonyluria that stimulates insulin release

Glyburide

Glyburide SE

hypoglycemia

Glyburide C/I

DKA, sulfa allergy

insulin sensitizer in periphery

Pioglitazone

Pioglitazone BBW

cause/worsen heart failure

Pioglitazone C/I

CHF and liver disease

GLP1 agonist; incretin mimetic to increase insulin secreted in elevated blood glucose, slows gastric emptying

Liraglutide

SGLT2 antagonist that lowers renal glucose threshold, leading to increase urinary glucose excretion

Canaglifozin

Canaglifozin SE

increased urination, vag/penis stuff

DPP-4 inhibitor that increases/prolongs incretin increasing insulin release and decreasing serum glucose

Sitagliptin

Abbreviated Pharm Flashcards

(499 cards)