Drugs Flashcards
(20 cards)
Motion sickness drugs
Want anticholinergic (muscarinic receptor
antagonist)
– Diphenhydramine (Benadryl®) – Dimenhydrinate (Dramamine®) – Meclizine (Bonine®) – Scopolamine (Transderm Scop®)
Drugs to treat drug induced nausea/vomiting:
Dopamine receptor blockers
– Promethazine (Phenergan®)
– Prochlorperazine (Compazine®)
– Trimethobenzamide (Tigan®)
Drugs to treat drug induced nausea/vomiting:
Serotonin receptor blockers
– Ondansetron (Zofran®)
– Dolasetron (Anzemet®)
Drug induced nausea/vomiting treatment:
Blocks both seratonin AND Dopamine
Metoclopramide (Reglan®)
Non sedating anti histamines
Cant use for PD, cant cross BBB
Terfenadine (Seldane), Astemizole (Hismanal), Fexofenadine (Allegra), Loratadine (Claritin), Cetirizine (Zyrtec)
CYP- 1A2 enzyme substrares, inhibitors, inducers
Substrates: Tacrine, Amitriptyline, Theophylline
Enz inhibitors:
Erythromycin, ciprofloxacin
Enz inducers: Carbamazepine, Rifampin, Tobacco
CYP-2C9 enzyme substrates, inhibitors, inducers
Substrates:
Warfarin
Tolbutamide
Phenytoin
Inhibitors:
Paroxitene, Fluoxetine
Metronidazole*
Fluconazole*
Inducers:
Phenobarbital
Rifampin
CYP-3A4 enzyme substrates, inhibitors, inducers
Substrates:
Lovastatin, Simvastatin Terfenadine (seldane), Astemizole (hismanal)
Estrogen, Progestins
Inhibitors:
Erythromycin* Clarithromycin*
Grape Fruit Juice
(Taking these will increase seldane and hismanal levels))
Inducers:
Carbamazepine
Rifampin
St John’s Wort (
H2 receptor blockers: uses, examples
Treatment of GI Ulcers
Cimetidine (Tagamet®) Ranitidine (Zantac®) **
Famotidine (Pepcid®)+
Note: ranitidine manufacturing had carcinogens? So now zanrac
Other non-H2 treatments for GERD
Can use anti-ACH drugs like Atropine, Pirenzepine, but the side effects are reeeally bad and last all day
Prostaglandin agonist: Misoprostol (Cytotec)
(DO NOT use for pregnant patients, stimulates uterine contractions
Protein pump inhibitors (PPI):
Omeprazole (Prilosec®) Antacids
Lansoprazole (Prevacid®)
“The purple pill” -Esomeprazole (Nexium®)
Note PPIs don’t prevent recurrence, so use Clarithromycin (Biaxin) and Amoxoxillin (trimox) to target H. pylori
Protein pump inhibitors (PPI):
Omeprazole (Prilosec®) Antacids
Lansoprazole (Prevacid®)
“The purple pill” -Esomeprazole (Nexium®)
Prostaglandin agonist:
Misoprostol (Cytotec ®)
Diclofenac/misoprostol (Arthrotec ®)
(DO NOT use for pregnant patients, stimulates uterine contractions
What do the adrenal glands release? What “axes” are these a part of?
Glucocorticoids (cortisol), part of a feedback loop with hypothalamus—> pituitary—>ACTH—>adrenal cortex—> cortisi
Mineralcorticoids (aldosterone), part of the Renin-Angiotensin acis
Do you use glucocorticoids for immediate treatment of anaphylaxis? Why or why not?
No bc cortisol is a steroid—> its MOA is on transcription—> takes time for effect to set in
How can you treat CHF by affecting the RAA system?
Aldosterone will increase water and sodium retention
ACE1 inhibitors lead vasodilation and less aldosterone, which leads to more water and sodium excreted. Good for CHF patients
General effects of glucocorticoids, and major examples
- main effect: control carb metabolism. More potent glucocorticoid= more glycogen deposition in liver, more anti-inflammatory
- can enhance catecholamines (epinephrine, albuterol at B2 receptor)
- more fat deposition around face, back (Cushing’s syndrome)
- lower vit D activity, lower calcium absorption, more bone catabopism (bad, could accelerate osteoperosis)
- Acute Adrenal Crisis
- anti inflammatoey means immunosuppression (less lymphcytes, dampened response, less cytokine released, lower COX release)
- more RBCs
- glucocorticoids + NSAIDS = stomach ulcer
- stimulate lung development in fetus, give to mom at premature birth
Examples: aldosterone, cortisone, hydroxcortisone, prednisone, triamcimopome
Most potent: dexamethasone, betamethasone
What is Acute Adrenal Crisis?
If you’re on Cortisol for 2 weeks or more, you stop producing endogenous cortisol—> can lead to rapid hypoglycemia, loss of consciousness
Mineralcorticoid examples
Natural: 11-deoxycorticosterone
Aldosterone
Many glucocorticoids also have mineral effects (cortisone, hydrocor, prenisolone)
Structures and functions of corticosteroids
- no hydoxyl 17, no glucocorticoid activity (present means yes)
- undaturated 2x bond btw C1 and 2, increase glucocorticoid/anti-inflammation
- Dexamethasone has 2x bond a C1=C2, halogenation at C9, methylation at C16–> the most potent glucocorticoid
Major diseases treated w glucocorticoids
GI diseases like UC, crohn’s, celiac
Organ transplants
Lupus, sarcoidosis
Contact detmatitis and lichen planus, tho mainly as an ointment
Arthritis: Rheymatoid (short term), osteoarthritis (direct koint injection
Decrease swelling after wisdom tooth (Medrol)
