Drugs up until Midterm #3 Flashcards Preview

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Flashcards in Drugs up until Midterm #3 Deck (60):
1

Diazepam

Treats Meniere disease. It is an anxiolytic.

2

Mesalamine

Used for Crohn's disease. Is an anti-inflammatory. Corticosteroids-act systemically and Metronidazole has an antibiotic mechanism and they can also be used for Crohn's. b. Ulcerative colitis • Similar to Crohn’s disease but limited to colon and more generalized (no strictures) • Medications are similar to Crohn's disease

3

Famotidine

Used for GERD. H2 receptor blockers-not effective at the H1 receptors (i.e., not good antihistamines)-reduce gastric secretions by blocking H2 receptors in gut. • Side effects: headaches, diarrhea, drowsiness.

4

Carisoprodol

Muscle relaxant/sedative; may have some dependence problems, works by blocking pain sensations.

5

Erythromycin

Antibiotic used for acne. macrolide antibiotic used to treat P. acnes.; antibiotic resistant strains are an ongoing complication of macrolides, especially when exposed to staphylococci. – Broad spectrum, generally well-tolerated – Local adverse effects include burning sensation, drying, & irritation.

6

Methyltrexate

Treats cancer, is an antimetabolite, anti-inflammatory. 1. Acts on intermediary metabolism of proliferating cells 2. E.g., methyltrexate-folic acid analog • Inhibits tetrahydrofolate--Interferes with formation of DNA, key proteins • Treats head and neck cancers, breast cancer • Toxicity: mucositis, diarrhea

7

Omeprazole

Used for GERD. Proton pump inhibitors (PPIs) –available OTC and by Rx • Mechanism: disrupts hydrogen exchange for K in parietal cells, which blocks production and release of HCl into gut. • Side effects: diarrhea, interferes with digestion, increases food allerges, oral sores/ulcers • Often combined with H2 blockers - Can also add sodium bicarbonate for fast release.

8

Metronidazole

Antibiotic used for acne. nitroimidazole antibiotic for anaerobic bacterial & parasitic infections and the inhibition of Demadex brevis (parasitic mites) – Demodex mites are ~3x more prevalent in acne vulgaris paDents than in healthy controls. – AnD-inflammatory effect (inhibits neutrophils) – Commonadverseeffectsincludelocaldryness,burningandsDnging. – Contraindicatedduringpregnancy,innursingmothers,orinchildrenduetoriskof carcinogenesis.

9

Cyclophosphamide

Treats cancer, is an alkylating agent. 1. E.g, Cyclophosphamide • Hodgkin’s lymphoma • Multiple myeloma • Leukemia • Breast cancer 2. Mechanism: Transfer their alkyl groups to various cell constituents such as DNA, alkylation of DNA in nucleus—cause miscoding—can break DNA strands 3. Resistance: increased capacity to repair damaged DNA 4. Adverse effects: • Nausea, vomiting • Damage to rapidly growing tissues (bone marrow, G.I. tract, reproductive tissue) • Carcinogenic in nature (increases risk of secondary cancer)

10

Fluorouracil

Treats cancer. 1.Inhibits thymidine synthase, decreases DNA synthase and decreases DNA synthesis and function 2. treats: colorectal, anal, breast, head & neck, and hepatocellular cancers

11

Bisacodyl

Laxative used for constipation. • Stimulant of smooth muscles • Fast acting • OTC • Suppository/oral • Cramps

12

D-tubocurarine

Is a non-depolarizing neuromuscular blocker. Blocks ganglionic nicotinic receptor.

13

Clindamycin

Antibiotic used for acne. antiribosomal antibiotic useful against gram positive and anaerobic bacteria; only ~10% absorbed topically. – Common side effects include GI upset and diarrhea. Rarely bloody diarrhea and coliDs have been reported, even with topical application.

14

Diazepam

An anti-spasmotic used as a muscle relaxant. Diazepam -Facilitates (Increases frequency of opening) GABAA receptor; central acting -Increased interneuron inhibition; central sedation -Spasms related to CP, stroke, spinal cord injury, acute muscle injury =Hepatic metabolism; 12-24h duraDon; sedaDon, depression, suppression of REM sleep

15

Bleomycin

Is an antitumor antibiotic, in the class of anthracyclines, that treat breast cancer. • Mechanism: formation of free radicals that bind to DNA, causing breaks • Treat: lymphomas, breast cancer and thyroid cancer • Toxicity: nausea and red (not blood) urine

16

Pilocarpine

Treats glaucoma. Cholinomimetic-contract ciliary muscle and increases outflow of aqueous humor. ACh1 agonist.

17

Tretinoin

Retinoid (vitamin A) used for acne. Tretinoin (Retin-A) topical retinoid cream available at 0.025%, 0.05% and 0.1%concentrations. • promotes epithelial cell turnover, causing the extrusion of the plugged material from the follicle and preventing the formaDon of new comedones • may cause dryness & increased sensitivity to sunlight, redness, scaling, itching, and burning.

18

Foscarnet

Used for shingles and herpes. selecDvely inhibits viral DNA polymerase enzymes (not kinases). -Unlike acyclovir and ganciclovir, foscarnet is not activated by viral protein kinases, making it useful in acyclovir- or ganciclovir-resistant HSV and CMV infections. -Do not require activation by viral thymidine kinase and thus have preserved activity against acyclovir-resistant strains of HSV and VZV.

19

Meclizine

Treats Meniere disease. H1 blocker, anticholinergic, CNS depressant-antimotion sickness medication, causes xerostomia.

20

Succinylcholine

Depolarizing neuromuscular blocker. Blocks ganglionic nicotinic receptors by desensitizing (overstimulating?) - fast acting, get initial twitching before paralysis -rapid onset (30sec) but very short duration of action (5–10 min); agonist at nicotinic ACh receptors, depolarizes the muscle fiber (similar to ACh), but in a biphasic manner: – Phase I (depolarizing phase) muscle twitches occur while depolarizing the muscle fibers. – Phase II (desensitizing phase) aqer sufficient depolarization has occurred the muscle is no longer responsive to ACh released by the motor neurons. At this point, full neuromuscular block (paralysis) has been achieved. • Effects are sustained under the influence of AChE inhibitor.(not reverse by administering the AChE inhibitor) • Adverse effects: Postoperative myalgia and fatigue, arrhythmia, hyperkalemia (burn patients), increased ocular pressure, increased risk of regurgitation/aspiration (obese patients, diabetic patients). – Rare, inheritable risk for interaction with volatile anesthetics causing malignant hyperthermia (abnormal release of Ca2+ from skeletal muscle stores.) – Treated with dantrolene.

21

Procarbazine

Treats cancer, is a nitrosourea. Used for combination regimens for Hodgkin's Lymphoma. Passes blood brain barrier and used to treat brain tumors.

22

Cisplatin

Treats cancer, is a platinum analog. Used for broad range of solid tumors. Is nephrotoxic.

23

Tetracyclines

Antibiotics for Acne Vulgaris. Minocycline is more lipophilic (may accumulate in sebaceous gland). • Chelated by dairy products, calcium, and magnesium so passes though gut without absorbtion with wrong foods/drinks. • hashigherincidenceofinnereardisturbanceswithassociated dizziness, ataxia, vertigo and Tinnitus (especially in women), and is more expensive than doxycycline. • Doxycycline may beassociated with more GI upset than minocycline. – Harder to chelate thus beNer absorbed with food. – All tetracycline antibiotics are associated with increased risk of irritable bowel syndrome. – If tetracyclines aren’t tolerated or effective, then 3rd line opDon is trimethaprim or trimethaprim-sulfamethoxazole (TMP-SMZ). - Category D pregnancy Risk

24

Esomeprazole

Used for GERD. Proton pump inhibitors (PPIs) –available OTC and by Rx • Mechanism: disrupts hydrogen exchange for K in parietal cells, which blocks production and release of HCl into gut. • Side effects: diarrhea, interferes with digestion, increases food allerges, oral sores/ulcers • Often combined with H2 blockers

-Protein Pump Inhibitors take a while to kick in, at least a few days, not immediate!!!

25

Docusate

Laxative used for constipation. • Water retention in stools, softens stools • OTC (e.g., Dulcelax)

26

Antacids

Used for GERD. Antacids-neutralize gastric HCl • Types: magnesium salts (can cause diarrhea); bicarbonate (causes gas); calcium carbonate (chalky and constipation); aluminum salts (not very effective)

27

Acetazolamide

Helps treat glaucoma. Carbonic anhydrase inhibitor. Reduces aqueous humor secretion.

28

Mifepristone

Mifepristone is a synthetic, steroidal anti-progestogen and anti-glucocorticoid pharmaceutical drug. Morning after contraceptive: blocks progesterone and glucocorticoid receptors. Ends a pregnancy that is less than 7 weeks along (49 days or less since the start of your last menstrual period). Also used to control high blood sugar in patients with Cushing syndrome who also have type 2 diabetes and have failed surgery or are not candidates for surgery.

29

Dapsone

Antibiotic used for acne. 5% gel, sulfone antibiotic for Acne vulgaris, antibacterial mechanism unclear, anti-inflammatory effects. – ShouldnotbeusedorallyinpaDentswithglucose-6-phosohatedehydrogenase(G6PD) deficiency due to risk of hemolysis, but risk is minimal with topical preparaDons. – AdverseeffectsincludeDryness,redness,skinpeeling. – Dapsone+benzoylperoxidemaytemporarilydiscolorskinandhairyellow.

30

Danazol

Danazol is a derivative of the synthetic steroid ethisterone that suppresses the production of gonadotrophins and has some weak androgenic effects. Suppresses ovarian function (has a masculinizing effect). Treats endometriosis, fibrocystic breast disease, and hereditary angioedema.

31

Promethazine

Treats Meniere disease. H1 blocker, anticholinergic, antinausea and motion sickness, xerostomia.

32

Clomiphene

Clomifene or clomiphene is a selective estrogen receptor modulator that has become the most widely prescribed drug for ovulation induction to reverse anovulation or oligoovulation. Ovulation-inducing; for promoting fertilization and pregnancy (increased risk of multiple births—e.g., twins).

33

Loperamine

Treats diarrhea. Imodium; mild opioid agonist: if severe, can use strong opioid agonists

34

Imatinib

Cancer treatment strategy. Tyrosine hydroxylase inhibitor used for multiple types of cancers such as myelogenous leukemia.

35

Doxorubicin

Is an antitumor antibiotic, in the class of anthracyclines, that treat breast cancer. • Mechanism: formation of free radicals that bind to DNA, causing breaks • Treat: lymphomas, breast cancer and thyroid cancer • Toxicity: nausea and red (not blood) urine

36

Tamoxifen

Estrogen receptor antagonist. Blocks actions of estrogen in breast-used to treat breast cancers.

37

Linaclotide

Used for irritable bowel syndrome. b. Treatment: (1) Typically symptomatic (i.e., deal with diarrhea or constipation with diet and anti-stress changes) (2) Drugs: only linaclotide (Linzess) is FDA-approved for IBS with constipation • It is a guanylate cyclase-C agonist-it increases bowel movement, fluid secretion and reduces pain • Side effects: diarrhea, gas

38

Isotretinoin

Retinoid (Vitamin A) used for acne. Isotretinoin (Accutane) – oral retinoid used for severe cystic acne and acne that has not responded to other treatments. • Considered the only true “cure” for acne. It also reduces the amount of oil secreted by glands in the skin. • Isotretinoin has been associated with bowel diseases (Crohn’s disease), liver damage, depression, teratogenicity and miscarriage. • contraindicated during pregnancy as they have been shown to cause CNS, craniofacial, cardiovascular and other birth defects. – At least two negative pregnancy tests are required and either signed statement of abstinence (iPledge contract) or confirmation of 2 forms of contraception is required to obtain a prescription.

39

Bismuth subsalicylate

Treats diarrhea. Is Pepto-Bismol. (3) Anti-cholinergics such as atropine can also be used to treat diarrhea.

40

Milk of Magnesia

Used to treat peptic ulcer disease. (2) Cure if H pylori-related –H pyloria is contagious especially within family members • Prevpac; combination of lansoprazole (a PPI) and the antibiotics amoxicillin and clarithromycin • Milk of Magnesia (magnesium based) may also help kill bacteria

41

Prevpac

Used to treat peptic ulcer disease. (2) Cure if H pylori-related –H pyloria is contagious especially within family members • Prevpac; combination of lansoprazole (a PPI) and the antibiotics amoxicillin and clarithromycin

42

Timolol

Treats glaucoma. Beta blocker-decreases aqueous humor secretion (popular for open angle glaucoma).

43

Balcofen

An anti-spasmotic used as a muscle relaxant. GABA B agonist. -GABAB agonist; central acting -Pre- & post- synaptic inhibition of motor output -Severe spasticity due to CP, MS, stroke -p.o., i.t.; sedation, weakness

44

Cimetidine

Used for GERD. H2 receptor blockers-not effective at the H1 receptors (i.e., not good antihistamines)-reduce gastric secretions by blocking H2 receptors in gut. • Side effects: headaches, diarrhea, drowsiness.

45

Dantrolene

-An anti-spasmotic that is used as a muscle relaxant. is a postsynaptic muscle relaxant that lessen excitation-contraction coupling in muscle cells by inhibiting Ca2+ ions release from sarcoplasmic reticulum stores by antagonizing ryanodine receptors. -It is the primary drug used for the treatment and prevention of malignant hyperthermia, a rare, life-threatening disorder triggered by general anesthesia. -Its direct effect is peripheral only.

46

Lantanoprost

Treats glaucoma. Prostaglandin-increase outflow of aqueous humor (popular for Open angle glaucoma).

47

Salicylic Acid

Is a keratolytic used for acne vulgaris. Topical keratolytics-removes keratin layer and opens sebaceous glands (also used as wart removers). has been extensively used in dermatologic therapy . Salicylic acid works as a keratolytic, comedolytic, and bacteriostatic agent, causing the cells of the epidermis to shed more readily, opening clogged pores and neutralizing bacteria within, preventing pores from clogging up again by constricting pore diameter, and allowing room for new cell growth.

48

Epinephrine

Alpha-agonist non-selective that can help treat glaucoma.

49

Lansoprazole

Used for GERD. Proton pump inhibitors (PPIs) –available OTC and by Rx • Mechanism: disrupts hydrogen exchange for K in parietal cells, which blocks production and release of HCl into gut. • Side effects: diarrhea, interferes with digestion, increases food allerges, oral sores/ulcers • Often combined with H2 blockers

50

Dexamethasone

Treats Meniere disease. Long-acting steroid/inject into the ear—it reduces fluid.

51

Acyclovir

-(Zovirax, Denavir ointments): most effective for herpes simples virsus (HSV-1 and HSV-2)-cold sores on mouth and nose; less potent on Varicella-zoster virus (VZV-chickenpox--shingles). -Requires activation by the HSV thymidine kinase enzyme.

52

Tizanidine

An anti-spasmotic used as a muscle relaxant. -Alpha2 adrenoreceptor agonist (spinal cord) ; central acting -Pre- & post- synaptic inhibition of reflex motor output -Spasms related to ALS, stroke, MS -Renal & hepatic elimination; 3-6h duration; weakness, sedation, hypotension

53

Vinblastine or Vincristine

Is a natural product cancer, chemotherapy drug. 2. Inhibits tubulin polymerization-cytoskeleton component—arrests in cell division and causes cell death 3. Toxicity: mucositis, myelosuppression 4. Treat: breast cancer and Kaposi’s lymphoma

54

Ranitidine

Used for GERD. H2 receptor blockers-not effective at the H1 receptors (i.e., not good antihistamines)-reduce gastric secretions by blocking H2 receptors in gut. • Side effects: headaches, diarrhea, drowsiness.

55

Hydrochlorothiazide

Treats Meniere disease. Diuretic-regulate fluid volume and pressure in inner ear.

56

Benzoyl Peroxide

Is a keratolytic used for acne vulgaris. Topical keratolytics-removes keratin layer and opens sebaceous glands (also used as wart removers). containing preparations also work as peeling agents to increases skin turnover, clearing pores (comedolytic) and reducing the bacterial count (P. acnes) as well as acting directly as an antimicrobial.

57

Erlotinib

Cancer treatment strategy. Blocks ECGR (epidermal growth factor receptor): treatment, non-small cell lung and pancreatic cancer.

58

Famciclovir

-Effective against VZV virus and shingles and herpes viruses. Longer acting than acyclovir -Requires activation by the HSV thymidine kinase enzyme.

59

Amoxicillin or Amoxicillin + Clavulanate or Cefaclor

Antibiotics used to treat acute otitis media. Second level drugs include Trimethoprim or macrolides.

60

Infliximab

Treatment of orofacial granulomatosis (an oral lesion from IBD).  TNF-alpha blocker.  

Treatmentofgranulomatosis: not well established, but some success with infliximab— TNF-α blocker

-blocks inflammatory reactions to mycobacterial infections (exclude TB as cause)