Drugs Flashcards
(46 cards)
1
Q
Dexamethasone
A
•Decadron
•glucocorticoid
Also used for lupus, organ transplant, asthma
•MOA: increase levels of lipocortin that inhibits phospholipase A2, decreasing inflammatory mediators
•oral
•Side Effects: immunosuppressive and cushingoid (central obesity, moon face, hyperglycaemia, osteoporosis etc…), mood swings
2
Q
Triamcinolone
A
- Aristocort, Nasacort
- glucocorticoid
- MOA: increase levels of lipocortin that inhibits phospholipase A2, decreasing inflammatory mediators
- oral, topical, injectable
- Side Effects: immunosuppressive and cushingoid (central obesity, moon face, hyperglycaemia, osteoporosis etc…), mood swings
3
Q
Budesonide
A
- Entocort, Symbocort+formoterol
- MOA: increase levels of lipocortin that inhibits phospholipase A2, decreasing inflammatory mediators
- inhaled
- Side Effects: immunosuppressive and cushingoid (central obesity, moon face, hyperglycaemia, osteoporosis etc…), mood swings
4
Q
Hydrocortisone
A
- Cortisol
- glucocorticoid
- MOA: increase levels of lipocortin that inhibits phospholipase A2, decreasing inflammatory mediators
- topical
- Side Effects: increased risk of infection, severe allergic reactions and skin irritation, psychosis, increased hair growth
5
Q
Teraparatide
A
- Forteo
- osteoporosis medication
- anabolic agents (increase bone density)
- MOA: recombinant truncated form of parathyroid hormone, binds to PTH receptors on osteoblasts to stimulate RANK ligand release
- Side Effects: JOINT ACHES, nausea, leg cramps, allergic reaction, slight chance of developing osteosarcoma in rats
6
Q
Denosumab
A
- XGEVA, Prolia
- osteoporosis medication
- antiresorptive
- MOA: human monoclonal antibody designed to inhibit RANKL therefore inhibiting the maturation of osteoclasts, hence a decrease in osteoclasts
- Side Effects: infections of the respiratory and urinary tracts, cataracts, constipation, rashes and joint pain, contraindicated in patients with hypocalcemia
7
Q
Raloxifene
A
- Evista
- osteoporosis medication
- selective estrogen receptor modulators (SERMs)
- MOA: mixed agonist/antagonist for estrogen receptors, agonist for estrogen receptors in bone - enhancing osteoblasts activity
- Side Effects: increased risk for endometrial cancer, hot flashes, flushing, fatty liver, risk of blood clots
8
Q
Alendronate
A
- Fosamax
- osteoporosis medication
- bisphosphonate/ antiresorptive
- MOA: a pyrophosphate that lines the bone, is absorbed by the osteoclast and kills the osteoclast by blocking an enzyme for cholesterol synthesis
- Side Effects: ulceration of the eso-Hague’s, eso-Hague’s cancer, necrosis of the jaw, skin rash, uveitis
9
Q
Zolendronic
A
- Zometa
- osteoporosis medication
- bisphosphonate/ antiresorptive
- MOA: a pyrophosphate that lines the bone, is absorbed by the osteoclast and kills the osteoclast by blocking an enzyme for cholesterol synthesis
- Side Effects:fatigue, anemia,muscle aches, necrosis of the jaw
10
Q
Ustekinumab
A
- Stelara
- arthritis medication, also used to treat plaque psoriasis
- biologic DMARD, IL-12 inhibitor
- MOA: monoclonal antibody that inhibits IL-12 and IL-23, decreasing T-Cell activation
- Side Effects: SERIOUS INFECTIONS including TB, upper respiratory tract infection, fatigue
11
Q
Guselkumab
A
- Tremfya
- arthritis medication, also used to treat plaque psoriasis
- biologic DMARD, IL-23 inhibitor
- MOA: monoclonal antibody that inhibits IL-23
- Side Effects: SERIOUS INFECTION including TB, upper respiratory tract infection, fatigue
12
Q
Ciprofloxacin
A
- Cipro
- antibacterial, broad spectrum Gram - and Gram + bacteria
- fluorquinilone
- MOA: inhibits DNA gyrase (a type of II and IV topoisomerase)
- Side Effects: TENDON DAMAGE/RUPTURE, muscle weakness, GI disturbances, headache, dizziness
13
Q
Azithromycin
A
- Zithromax
- macrolide
- antibacterial, broad spectrum against aerobic and anaerobic, Gram - and Gram + bacteria
- MOA: inhibits protein synthesis by binding to the 50S subunit of the bacterial ribosome
- Side Effects: GI disturbances, rash
14
Q
Tetracycline
A
- Sumycin, Tetracyn, Panmycin
- polyketide
- antibacterial, Ricketsia, B. burgdorferi, chylamidia, H. pylori, broad spectrum Gram - and Gram + bacteria
- MOA: bacteriostatic, inhibits protein synthesis, binds the 30S ribosomal unit (inhibits RNA translation to protein)
- Side Effects: stain developing teeth, liver toxicity, GI disturbances, photosensitivity, decrease in bone growth in foetus
- Doxycycline
15
Q
Nafcillan
A
- Cubicin
- antibacterial, Gram + bacteria, used for Staph, but NOT MRSA
- MOA: beta lactam containing ring that inhibits the synthesis of the Gram + bacterial cell wall
- Side Effects: allergic reactions, GI disturbances, hypokalemia, abdominal pain, yeast infections
- Dicloxacillan
- Methicillan
16
Q
Clindamycin
A
- Cleocin, Clindacin, Clindagel, ClindaMax, Clindesse, Evoclin
- lincosamide
- antibacterial, anaerobic, streptococcal, staphylococcal bacteria
- MOA: bacteriostatic, binds 50S subunit and interferes with transpeptidation reaction, disrupting protein synthesis
- Side Effects: GI disturbance, including increased risk of Clostridium difficile colitis, allergic reaction, Stevens Johnson Syndrome
17
Q
Sulfamethoxazole
A
- Bactria, Septrin, Septra
- sulfonamides
- antibacterial, Gram + bacteria
- MOA: bacteriostatic, competitive inhibitor of dihydropteroate synthase - blocking folic acid production- hence blocking DNA synthesis
- Side Effects: GI disturbances, allergic reactions, Stevens Johnson Syndrome, can cause crystal formation in kidney and bladder, photosensitivity
18
Q
Ketoconazole
A
- Nizoral, Xolegel
- antifungal
- azole
- used for topical fungal infections and found in shampoos to treat dandruff
- MOA: inhibit fungal sterol (ergosterol) synthesis
- Side Effects: inhibition of testosterone synthesis (gynecomastia), LIVER DYSFUNCTION by inhibiting cyp450
19
Q
Clotrimazole
A
- Desenex
- antifungal
- azole
- topical for tinea (ringworm)
- MOA:inhibit fungal sterol (ergosterol) synthesis
- Side Effects: inhibition of testosterone synthesis (gynecomastia), liver dysfunction by inhibiting cyp450
20
Q
Fluconazole
A
- Diflucan
- antifungal
- azole
- oral or IV, often used for candida infections
- MOA: inhibit fungal sterol (ergosterol) synthesis
- Side Effects: rash, GI issues, LIVER DYSFUNCTION by inhibiting CYP2C19, CYP3A4
21
Q
Amphotericin B
A
- Ambisome, Abelcet
- antifungal
- polyene
- oral treatment of candidiasis resistant to azole, histoplasmosis, coccidiomycosis, aspergillosis, cryptococcosis
- MOA: binds ergosterol, forms membrane pores
- Side Effects: chills, fever, vomiting, NEPHROTOXICITY, bone marrow suppression
22
Q
Nystatin
A
- Nyamyc, Nystop
- antifungal
- polyene
- topical treatment of oral, vaginal and cutaneous candidiasis, diaper rash, thrush
- MOA: binds ergosterol, forms membrane
- Side Effects: hypersensitivity, rash, SJS
23
Q
Terbinafine
A
- Lamisil
- antifungal
- polyene
- oral use for onychomycosis or widespread tinea, fungal nail
- MOA: inhibits fungal enzyme squalene epoxidase inhibiting infections, athlete’s foot, “jock itch”
- Side Effects: GI disturbance, HEPATOTOXICITY, headaches, vertigo
24
Q
Griseofulvin
A
- Gris-PEG
- antifungal
- polyene
- oral treatment of superficial fungal infections unresponsive to topical agents or involving scalp or nails
- MOA: interferes with microtubule function, disrupts mitosis, deposits in keratin containing tissues
- Side Effects: TERATOGENIC, CARCINOGENIC, confusion, headaches, increased CYTP450 and Warfarin metabolism
25
Acyclovir
* antiviral
* nucleic acid synthesis inhibitor
* MOA: guanosine analog, preferentially inhibits viral DNA polymerase by chain termination
* Side Effects: NEPHROPATHY if not adequately hydrated
26
Famciclovir
* antiviral
* nucleic acid synthesis inhibitor
* MOA: is converted to penciclovir, which is converted to the triphosphate form, which selectively inhibits viral DNA polymerase by competing with deoxyguanosine triphosphate
* Side Effects: headache, nausea
27
Benzoyl peroxide
•antiseptic
•MOA: is thought to have a three fold activity in treating acne - sebostatic, comedolytic and inhibits growth of C. Acnes
Side Effects: bleaching, local irritation
28
5-fluorouracil
* anti-metabolite
* MOA: a thymidylate synthase (TS) inhibitor; interrupting the action of this enzyme blocks synthesis of the pyrimidine thymidine, which is a nucleoside required for DNA replication
* Side Effects: topical, dramatic inflammation at site of application
29
Isotetinoin
* Acutane
* MOA: shrinks sebaceous glands, redefines the pilosebaceous unit
* Side Effects: teratogenicity, depression, dry skin
30
Permethrin
* biologic
* MOA: disrupt the sodium channel current in insect nerve cells that regulates the polarisation of the membrane
* Side Effects: local irritation
31
Spironolactone
* biologic
* MOA: aldosterone antagonist
* Side Effects: gynecomastia, ED
32
Tacrolimus
* Sirolimus
* biologic
* MOA: calcineurin inhibitor
* Side Effects: topical, local irritation
33
Lidocaine
* pain medication - local aesthetic
* MOA: blockade of voltage gated sodium channels (VGSC)
* use dependent
* medium acting
* side effects: death due to the blockade of respiration, cardiovascular problems, depression of smooth muscle contraction, seizures
34
Morphine
* pain medication - opiod
* MOA: acts at my GPCR to cause opening of K+ channels and block VGSC
* side effects: CONSTIPATION, nausea, emesis, sedation, somnolence, pruritic, respiratory depression, abuse potential
35
Methotrexate
* Rheumatrex, Trexall
* arthritis medication, also used for ANCA associated vasculitis
* traditional DMARD
* MOA: inhibits, irreversibly, Dihydrofolate Reductase (DHFR) - an enzyme involved in the metabolism of folic acid, inhibits the synthesis of DNA, RNA and proteins, supressing the immune system
* side effects: STOMATITIS (inflammation of mucus linings), alopecia, GI upset, major but rare - hepatic cirrhosis, PNEUMONITIS and severe myelosuppression
36
Leflunomide
* Arava
* arthritis medication
* traditional DMARD
* MOA: inhibits pyrimidines by inhibiting the enzyme dihydrorotate dehydrogenase and also inhibits inflammation
* side effects: LIVER DAMAGE (HEPATITIS, NECROSIS, CIRRHOSIS), intestinal pneumonitis, alopecia, severe myelosuppresion- making patients more susceptible to infection
37
Azathioprine
* Azasan, Imuran
* arthritis medication, also used for lupus and ANCA associated vasculitis
* traditional DMARD
* MOA: inhibits synthesis of purines (adenine and guanine), suppressing the immune system
* side effects: GI disturbances, fatigue, alopecia, rash, myelosuppression
38
Hydroxychloroquine
* Plasquenil
* arthritis medication, also used for lupus
* traditional DMARD
* MOA: block toll like receptors (TLR 9) on plasmacytoid dendritic cells (PDCs)
* side effects: altered eye pigmentation, corneal deposits, significant vision difficulties, bleaching of hair, acne, anemia, stomatitis, GI upset
39
Adalimumab (Humira)
Etanercept (Enbrel)
Infliximab (Remicade)
•arthritis medication, also used for ankylosing spondylitis
•biologic DMARD, ant-TNF
•MOA: inhibit TNF alpha/receptor interactions
•side effects: SERIOUS INFECTIONS including TB, viral, fungal, bacterial infections, drug induced lupus, lymphoma association, serious and sometime fatal blood disorders
-injection site reactions, cutaneous manifestations of infusion reactions, cutaneous infections, non melanoma skin cancer, psoriasis
-lupus like syndrome, SJS, EM, TENs
40
Focilzumab
* Actemra
* arthritis medication
* biologic DMARD, IL-6 inhibitor
* MOA: inhibits IL-6 receptor/IL-6 interactions
* side effects: RESPIRATORY TRACT infections, headaches, hypertension, elevation in liver enzymes
41
Abatacept
* Orencia
* arthritis medication
* biologic DMARD, co-stimulators blockade
* MOA: T cell costimulatory blocker, block interactions between antigen presenting cells and T lymphocytes
* side effects: SERIOUS INFECTIONS including TB, viral, fungal, bacterial infections, serious and sometime fatal blood disorders
42
Rituximab
* Rituxan
* arthritis medication, also used for scleroderma
* biologic DMARD, B cell depletion
* MOA: monoclonal antibody that binds the CD20 on B cells decreasing cytokines release, T cell interactions and reduction in autoantibody levels
* side effects: SERIOUS INFECTIONS including TB,hives, itching, swelling, difficulty breathing, fever, chills, and changes in BP
43
Tofactinib
* Xeljanz
* arthritis medication
* biologic DMARD, kinase inhibitor
* MOA: Janus Kinase 3 (JAK3) inhibitor- interfering with the JAK-STAT signaling pathway
* side effects: SERIOUS INFECTIONS including TB, viral, fungal, bacterial infections
44
Allopurinol
•Zyloprim
•gout medication
•xanthine oxidase inhibitor —> urate lowering drug
•MOA: purine analog inhibiting xanthine oxidase, inhibiting purine synthesis
•side effects: SERIOUS INFECTIONS including TB, upper respiratory tract infections, fatigue
-allopuriol induced hypersensitivity is a life threatening cutaneous adverse reaction, associated with significant mortality
-fever, skin rash, systemic involvement (liver, kidney, pulmonary, cardia, eosinophilia, atypical monocytosis)
-several types of rash - TENs, SJS, EM, generalised maculopapular exanthema, generalized exfoliative dermatitis (GED), DRESS
•accepted indications and dose adjustment for renal dysfunction are the only ways to decrease the incidence of potentially fatal toxic effects
45
Colchicine
* gout medication
* MOA: inhibits microtubule polymerisation, halting mitosis
* side effects: ANEMIA, LEUKOPENIA, hair loss, GI upset
46
DMARDs
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•disease modifying anti rheumatic drugs
•RA and inflammatory arthritis
•if NSAIDs don’t work, DMARDs are used
•traditional: try these first, if they don’t work, a combo of biologic + traditional or just biologic
-methotrexate, leflunomide, sulfasalazine, hydrochlorquine, —if those aren’t tolerated or are contraindicated —> azathioprine, minocycline, doxycycline, gold, cyclosporin
•biologic
-learn based on pathways
1)TNF inhibitors
-infliximab, etanercept, adalimumab, golimumab, certolizimab
2)costimulatory signal inhibitors
-abatacept
3)IL-6 inhibitors
-toculizumab, sarilumab
4)B cell depletion
-rituximab
5)Janus Kinase (JAK) inhibitors
-tofacinib, baricitinib
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