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Flashcards in Drug classes Deck (140)
1

albuterol

SABA

2

Pirbuterol

SABA

3

terbutaline

SABA

4

Levoalbuterol

SABA

5

Ipratropium

Anticholinergic

6

Tiatropium

Anti-Cholinergic

7

Atropine

Anti Cholinergic

8

Prednison

Systemic Coticosteroid

9

Methylprednison

Systemic corticosteroid

10

Hydrocortison

Systemic corticosteroid

11

Prednosilone

Systemic corticosteroid

12

Fluticasone

ICS

13

Budenoside

ICS

14

Beclamethasone

ICS

15

flunisolide

ICS

16

Triancinolone

ICS

17

Salmeterol

LABA

18

Formoterol

LABA

19

Theophylline

Methyxanthine

20

Aminophylline

Methylxanthine

21

Zafirlukast

Leukotriene modifier

22

Montelukast

Leukotriene modifier
some efficacy in Migraine

23

Omiluzimab

anti IgE Ab

24

APAP

Centrally acting NSAID

25

Ibprofen

peripheral NSAID

26

Ketoprofen

NSAID

27

Naproxen

NSAID- dysmenorrheal

28

Etodolac

cox 2 preferential NSAID

29

Ketorolac

parenteral NSAID for analgesia

30

Oxaprosin

NSAID- long half life, anti inflammatory

31

piroxicam

NSAID- long half life, anti inflammatory

32

Nambumetone

NSAID- anti inflammatory

33

Sulindac

NSAID- anti inflammatory

34

diclofenac

topical NSAID

35

voltaren gel/ flexor patch

diclofenac

36

Misoprostol

protect GI against NSAIDs- PGEI analogue
TERATOGEN

37

Triad of findings with GI toxicity from NSAID use

perforated ulcer
obstruction
bleeding

38

Omeprazole

PPI- DOC for blocking GI symptoms of NSAIDs

39

Indomethacin

NSAID
Gout

40

Rofecoxic

COX-2 inhibitor

41

Valdecoxib

COX-2 inhibitor

42

Celebrex

COX-2 inhibitor- only one still on market

43

Tramadol

Central analgesic
weak mu agonist
SNRI
DO NOT GIVE IF PT IS AT RICK OF SEIZURE
NSAID alternative if pt has- hx PUD, renal insufficiency, HF, severe HTN, and opiod alt if pt has substance abuse problems

44

Capsacin

Substance P depletor

45

transderm lidocaine

block neuronal transmission?

46

Morphine

opiod- prototype, mu agonist

47

Meperidine

strong agonist
not recommended for long term use due to toxic metaoblite buildup
Short acting, IV
pupil dilation

48

Methadone

strong agonist
longer life controls withdrawal

49

Fentanyl

Meperidine like strong agonist
Super strong
fast on set
short duration
Patch formulation- 8-12 hours to get to therapeutic dose
Anesthesia

50

Propoxyphene

more risk than benefit
methadone like moderate agonist

51

Codeine

Morphine precursor
used as antifussive w/o analgesia
Combined with APAP for analgesia
converted to morphine by CYP2D6 system

52

Naloxone

Tx for opiod OD
competitive mu agonist
can precipitate withdrawal in opioid addict

53

Oxymorphone

Morphine like agonist

54

Hydromorphone

Morphine like strong agonist
10x stronger than morphine
more respiratory depression but less nausea and constipation than morphine

55

Hydrocodone

Morphine like strong agonist, codeine derivative
similar efficacy to morphine

56

Oxycodone

Morphine like strong agonist, codeine derivative
similar efficacy to morphine

57

Pentazocine

mixed agonist- agonize pain but also antagonize at dif site
can precipitate withdrawal

58

Buprenorphine

mixed agonist- agonize pain but also antagonize at a dif site
long duration

59

metoclopramide

Tx nausea
Causes drug induced PD (bilateral and sudden)

60

Sinemet

CD/LD combo
DOC in PD
LD- precursor of DA crosses BBB and is decarboxylated
CD- inhibits peripheral DA decarboxylase
AE- nausea, orthostatic HypoTN, and hallucinations
CI- high protein diet
Wait to use in younger pts, may accelerate PD

61

Amantadine

Antiviral and Anti PD for dyskinesia
also used for tremor and drooling

62

DA agonists

cont stim @ DA receptors
AE toxic psychosis, sleep attacks (may or may not have prodrome), impulse control disorders
(overall worse CNS effects but better peripheral)
Use- early mild dz, young pts
CI- dementia

63

Bromocriptine

ergot derivative DA agonist

64

Pramipexole

DA agonist- non ergot derivative
mono tx or w/ LD

65

Rotigotine

non ergot derivative, available as transderm patch

66

Apomorphine

DA agonist- subq
used in advanced dz to break off spells but causes bad nausea. give with antinemics

67

Entacapone

COMT inhibitor used in PD as adjuct to LD tx to provide longer duration
causes diarrhea and urine discoloration

68

Selegilline

MAO-B inhibtor that loses selectivity at higher dose
CI in meperideine
adjunct to LD so can use lower dose
or Monotx in early dz

69

Rasagilline

MAO-D inhibitor that is not selective
CI in meperideine
adjunct to LD so can use lower dose
or Monotx in early dz

70

Trihexyphenidyl

Anticholinergic
AE are severe in elderly
used in younger pts to manage tremor

71

Benztropine

Anticholinergic
AE are severe in elderly
used in younger pts to manage tremor

72

Triptans- MOA

5HTB agonism- vasoconstriction
5HT1D presynaptic inhibition- inhibits inflammatory neuropeptide rls from trigeminal nerve
5HT1D- stimulations- prevents pain transmission from trigeminal nuclei

73

Chlorpromazine

Triptan- antiemetic and analgesic
CI in CAD
AE med overuse rebound HA, serotonin syndrome
DO not use w/ ergots

74

Prochlorperazine

Triptan- IV, oral PR formulas
CI CAD
AE med overuse rebound HA, serotonin syndrome
do not use with ergots

75

Promethazine

triptan- lower rade of extrapyramidal problems compared to prochlorperazine
best one
CI in CAD
AE medication overuse HA, serotonin syndrome
DO not use with ergots

76

Propranolol

beta blocker for prophylactic use in migraine HA
caution in pts w/ asthma, COPD, Hx of depression or PVD
DOC in prophylaxis and great for pts w/ co morbid conditions ie HTN, post MI, panic disorders
used less frequently than others b/c crosses BBB
gradually inc dose

77

Atenolol

betablocker used in prophypactic migraine tx
caution in pts w/ COPD, asthma, Hx of depression or PVD
DOC for prophylaxis and great in pts with HTN, post MI, or panic disorder
use if pts cant tolerate CNS effects of propranolol
gradually inc dose

78

Nadolol

betablocker used in migraine prophylaxis
caution in pts w/ asthma, COPD, hx of depression, or PVD
DOC for prophylaxis and great in pts w/ HTN, post MI, or panic disorder
gradually inc dose

79

nortryptilline

TCA
better tolerated b/c 2nd gen
can cause: sedation, weight gain, arhymia, dementia
reduces frequency and severity of migraine and tension HA
Ideal in migraine pts w/ comorbid- depression, insomnia, or neuropathic paiin

80

Desiprammine

TCA
AE- sedation, weight gain, prolonged QT, dementia
better tolerated b/c 2nd gen
dec frequency and severity of migraines and tension HA
ideal for pts in migraine with comorbid- depression, insomnia, or neuropathic pain

81

Amitriptyline

1st gen TCA clinically shown to work for migraine but high AE
AE: sedation, weight gain, prolonged qt interval, dementia
1st gen so not tolerated as well as 2nd
dec frequency and severity of migraines and tension HA
great for migraine pts w/ comorbid depression, insomnia, or neuropathic pain

82

Imipramine

TCA - 1st gen so not tolerated as well as 2nd
AE: sedation, weight gain, prolonged qt, and dementia
reduce severity and frequency of migraine and tension HA
great in pts with comorbid depression, panic disorders, or neuropathic pain

83

Valproate and Depakote

antiepileptic that reduces neuronal firing and enhances GABA
can cause significant weight gain
cat D in pregnancy
ideal for migraines in epileptics or bipolar disorder (RAPID CYCLERS/ MIXED MANIA0

84

Verapamil

CCB- used to dec frequency of migraines
only after BB, TCAs, and valproate have failed

85

Topiramate

Shows efficiency in 1st month
looks similar to DA
causes cognitive dysfunction and language
BUT also causes weight loss

86

Riboflavin

prevent migraines, safe during pregnancy but takes 2 weeks

87

Gabapentic

best tolerated antiepilectic drug

88

estrogen gel

start 2 days bfr menstral HA

89

Botox for migraines

can reduce migraines with injection

90

ACE/ ARB

show reduced migraine frequency

91

Fluoxetine

SSRI- long t1/s, DOC for MDDduring preg, most activating,
OCD

92

Citalopram

SSRI- least activating

93

Paroxetine

SSRI-
DONT USE IN PREG, short t1/2 beware of withdrawal
GAD
OCD
PTSD

94

Sertaline

SSRI
OCD
PTSD

95

Fluvoxamine

SSRI
OCD

96

Escitalopram

SSRI
GAD

97

SSRI

inhibit presmpatic 5HT Reuptake, down regulate receptors 5HT2 agonism
AE- transient jitters, insomnia, diarrhea, and anxiety.
sexual dysfunction
serotonin syndrome
SSRI- withdrawal- anxiety, electric shock feeling flu
Take time to work (takes a few weeks to down-regulate the postynaptic beta receptors)
DOC- in MDD, Panic disorder, OCD

98

TCA

SNRI, alpha adrenergic agonist, H1 receptor agonist, anticholinergic
AE-
CARDIAC TOXICITY- TORSADES DE POINTES
othrostatic HypoTN, weight gain, anticholinergic
sexual dysfunction
5HT syndrome w/ other antidepressants
lowers seizure threshold
low risk teratoginicity
OD can kill- tx with NaHCO3
CI- CAD, seizure disorders

99

TCA uses

antidepression
chronic pain
migraine HA
atypical depression

100

MAO-Is

inhibit breakdown of biogenic amines
AE
TERAOTOGENIC
wine and cheese rxn (tyrammine OD, HTN crisis --> hemorrhagic stroke)
orthostatic hypoTN, weight gain, anticholinergic
sexual dysfunciton
serotonin syndrome

101

MAO-Is drug interactions

serotonin syndrome- meperdine, tramadol, dextromethorphan
fever, HTN, delirium- meperidine, sympathomimetics, phenylephrine,

102

MAO- USES

atypical depression (weight gain, sleeping, inc sensitivity to rjxn)
WAIT 2 WEEKS WHEN SWITCHING TO AN MAOI FROM ANOTHER DRUG

103

Isocarboxacid

MAOI

104

Phenelzine

MAOI

105

Tranylcypromine

MAOI

106

Venlafaxime

SSRI @ low dose
SNRI @ high dose
avoid in uncontrollable HTN
used in depression, GAD

107

Duloxetine

SNRI at all doses
DIABETIC NEUROPATHY, GAD
watch for liver toxicity

108

Nefazodone

SNRI and blocks 5HT2A (ELIMINATES ANXIETY, INSOMNIA, AND SEXUAL DYSFUNCTION)
used for depression, anxiety, insomnia
AE- sedation, GI, dry mouth, constipation
drug interactios and deadly hepatic failure

109

Trazodone

SSRI and blocks 5HT2A (RI and antagonist) as well as H1 and alpha 1
AE- orthostatic hypotn, sedating, PRIAPRISM
use- use w/ SSRI to counter insomnia ("trazodoze")

110

Buproprion

NE and DA reuptake inhibitor- same MOA as cocaine
AE- anorexia, psychosis, HA, insomnia, psychomotor activation
AE- inc seizures and inc sexual function
can also cause weight loss
DO NOT GIVE TO PTS WITH SEIZURE HX, ANXIETY, OR BULIMIA
used for depression, quit smoking

111

Mirtazapine

Sleep, sex, food antidepressant
antagonizes presynaptic alpha 2 to inc NE release also blocks 5HT2, 3 and H1
used for- comorbid anxiety, reduced sexual dysfunciton, and has a low potential for OD
AE- agranulocytosis, weight gain, sedation

112

BZD

inc frequency of GABA channel opening
has ceiling effect
AE- ataxia, sedation, anterograde amnesia, resp depression, paradoxical excitement, aggression NO NYSTAGMUS

113

BZD use

short term while waiting for SSRI to kick in
long term in pts with anxiety disorder and somatic symptoms
insomnia, acute mania, akasthesia, RLS, seizures, EtoH detox
taper b/c withdrawal can be deadly
CI in EtoH and Narcotic ingestion

114

BZD tolerance

to euphoria but not anxiolytic effects

115

Lorazepam

BZD- short acting- met is glucronidation better in elderly and liver

116

Oxazepam

BZD- short acting- met is glucoronidation, better in elderly and liver dz

117

Diazepam

BZD- long acting and most lipophillic

118

Temazepam

BZD- least lipophillic

119

Clorazepate

BZD- long acting

120

Chlodiazepozide

BZD- long acting

121

Flumazenil

ccompetitive to BZD @ GABA A
AE- can precipitate withdrawal in BZD dependent individuals

122

Buspirone

partial agonist @ presynaptic 5HT1A
scheduled med GAD, sleep apena, substance abuse, h/o of BZD tx
AE- HA, N, dizziness, nervousness, SLOW ACTING
AE are mild
used in GAD esp if pt has hx of substance abuse, sleep apnea, or hx of falls

123

Clonazepam

BZD- scheduled basis for panic disorder

124

alprazolam

BZD- assoc w/ withdrawal and seizures

125

Clomipramine-

TCA with strong seratonergic component good for OCD

126

OCD tx

if using SSRI- use higher dose than depression
clomipramine
also need CBT

127

PTSD tx

SSRI (paroxetine, sertaline), MAOI, TCA
BZD or alcohol after event make it worse
antipsychotic or anticonvulsant can help
betablockers can help

128

SAD tx

SSRI, MAOI

129

specific phobia tx

CBT

130

performance anxiety

beta blocker

131

LI

DOC in Bipolar disorder- prevents relapse of mania and depression (mania more than depression) and dec suicide rates.
1-2 weeks to see effect- use adjuncts until then (antipsychotics or benzos)
AE- tremor, psoriasis, weight gain, acne, hypothyroidism, nephrogenic diabetes, bad for kidneys.

132

LI- actue intoxication

seizures, arrhythmias permanan neurologic impairment, kidney damage, maintain adequate Na ad fluid levels.

133

LI- drug interactions

anything that dec GFR--> inc of serum levelsNSAIDs, ACE, ARB, HCTZ

134

LI-CI

prenancy

135

Li- baseline lab tests

CBC
SCr
Thyroid
urinalysis
electrolytes

136

Li- monitor lab tests

Li levels
CBC
SCr/ BUN
TSH

137

carbamazapine/ oxcarbazepine

antiepileptics for when Li/ Valproate fail

138

Lamotrigine

blocks voltage gated Na channels to block glutamate and aspartate
2 mnth sto get therapeutic dose
AE- rash
Used to prevent depression but use with Li

139

SSRI in bipolar disorder

careful about using dont want to throw them into mania, make sure they are on a mod stabilizer first

140

bipolar disorder and preg

use atypical antipsychotics- they are fast acting