First Aid Pharm Flashcards
(545 cards)
1
Q
Cimetidine (drug class)
A
H2 Blocker
2
Q
Ranitidine (drug class)
A
H2 blocker
3
Q
Famotidine (drug class)
A
H2 blocker
4
Q
Nizatidine (drug class)
A
H2 blocker
5
Q
Side effects of H2 blockers
A
Cimetidine: INHIBIT P-450, antiandrogenic (prolactin relearse, gynecomastia, impotence), crosses blood-brain barrier.
Cimetidine AND Ranitidine: Decreases renal excretion of creatinine.
6
Q
Omeprazole (drug class)
A
Proton pump inhibitor
7
Q
Lansoprazole (drug class)
A
Proton pump inhibitor
8
Q
Esomeprazole (drug class)
A
proton pump inhibitor
9
Q
Pantoprazole (drug class)
A
Proton pump inhibitor
10
Q
Dexlansoprazole (drug class)
A
proton pump inhibitor
11
Q
Side effects of proton pump inhibitors
A
Increased risk of C. diff, pneumonia, hip fractures, decreased serum Mg
12
Q
Bismuth (drug class)
A
Binds to ulcer base
13
Q
Sucralfate (drug class)
A
Bind to ulcer base
14
Q
Misoprostol (drug class)
A
PGE1 analog.
15
Q
Misoprostol (use)
A
Prevent NSAID induced peptic ulcers, maintenance of PDA, and induce labor.
16
Q
Octreotide (drug class)
A
Long-acting somatostatin analog.
17
Q
Infliximab (drug class)
A
Anti-TNF-a monoclonal antibody
18
Q
Infliximab (side effect)
A
INFECTION (including reactivation of Tb)
19
Q
Ondansetron (drug class)
A
5-HT3 antagonist –> anti-emetic.
20
Q
Metoclopramide (drug class)
A
D2 receptor antagonist –> anti-emetic and gastroparesis…
21
Q
Febuxostat (drug class)
A
Xanthine Oxidase Inhibitor, ala Allopurinol…
22
Q
Ticlopidine (drug class and major side effect)
A
ADP receptor blocker (anti-platelet).
Neutropenia is a major side effect.
23
Q
Ketoconazole (side effect)
A
Inhibits Cytochrome P-450
24
Q
Streptokinase (drug class/use)
A
Thrombolytic agent –> binds to plasminogen and helps activate it to plasmin. Ala tPA…
25
Heparin (mechanism)
Cofactor for activation of AntiThrombin (decreases thrombin and factor Xa)
26
Enoxaprain (Drug class)
Low Molecular Weight Heparin
27
Dalteparin (drug class)
Low molecular weight heparin
28
How to reverse Heparin overdose?
Protamine Sulfate.
29
Lepirudin (drug class)
Hirudin derivative, natural anticoagulate used by leeches that inhibits thrombin.
30
Bivalirudin (drug class)
Hirudin derivative, natural anticoagulate used by leeches that inhibits thrombin.
31
Warfarin (mechanism)
Inhibits epoxide reductase --> inhibits vit. K synthesis and gamma carboxylation of factors II, VII, IX, X, and Protein C/S
32
Alteplase, reteplase, and tenecteplase (drug class)
Thrombolytics (tPA). Activate Plasmin
33
How to reverse alteplase, reteplase, or tenecteplase overdose?
Aminocaproic Acid (inhibits fibrinolysis).
34
Clopidogrel (drug class)
ADP receptor inhibitor
35
Ticlopidine (drug class)
ADP receptor inhibitor
36
Prasugrel (drug class)
ADP receptor inhibitor
37
Ticagrelor (drug class)
ADP receptor inhibitor
38
Ticlopidine major side effect
Neurtropenia
39
Cilostazol (drug class)
Phosphodiesterase III inhibitor. This increases cAMP in platelets, which inhibits their aggregation.
40
Dipyridamole (drug class)
Phosphodiesterase III inhibitor. This increases cAMP in platelets, which inhibits their aggregation.
41
Abciximab (drug class)
GP IIb/IIIa inhibitor
42
Eptifibatide (Drug class)
GP IIb/IIIa inhibitor
43
Tirofiban (drug class)
GP IIb/IIIa inhibitor
44
Methotrexate (mechanism)
Folic acid analog that inhibits dihydrofolate reductase.
45
Methotrexate side effects
Myelosuppression (reversible with leucovorin rescue), fatty liver, mucositis, Teratogenic.
46
5-Fluorouracil (mechanism)
Pyrimidine analog that is bioactivated to a molecule that complexes with folic acid. Overdose NOT reversible with leucovorin, rescue with Thymidine.
47
Cytarabine (drug class/mechanism)
Pyrimidine analog, inhibits DNA polymerase.
48
Azathioprine (mechanism)
Purine analog, inhibits de novo purine synthesis. (Antimetabolite)
49
6-mercaptopurine (mechanism)
Purine analog, inhibits de novo purine synthesis. (Antimetabolite)
50
Dactinomycin (mechanism/use)
Intercalates DNA, Cancer
51
Doxorubicin (mechanism/use)
Generate free radicals, noncovalently intercalate DNA, which inhibits replication. Cancer.
52
Daunorubicin (mechanism/use)
Generate free radicals, noncovalently intercalate DNA, which inhibits replication. Cancer.
53
Doxorubicin/daunorubicin major side effects
Cardiotoxicity… use dextrazoxane to prevent (iron chelation)
54
Bleomycin (mechanism/use)
Induces free radical formation, causes breaks in DNA. Used in Cancer.
55
Bleomycin (major side effects)
Pulmonary fibrosis
56
Cyclophosphamide/ifosfamide (mechanism/use)
Covalently X-link DNA. Requires liver bioactivation. Cancer.
57
How to prevent side effects of cyclophosphamide/ifosfamide?
MESNA
58
Nitrosoureas (mechanism and use)
Alkylating agents that cross BBB. CANCER
59
Busulfan (mechanism/use)
Alkylating agent. CANCER
60
Busulfan major side effects
Pulmonary Fibrosis!!! and hyperpigmentation.
61
Vincristine/Vinblastine (mechanism)
Bind to tubulin, prevent microtubule formation.
62
Paclitaxel/other taxols
Binds to tubulin and prevents its BREAKDOWN.
63
Side effects of Vincristine?
Neurotoxicity, paralytic ileus
64
Side effects of Vinblastine?
Bone marrow suppression.
65
Cisplatin (mechanism)
Cross-links DNA. Cancer
66
Carboplatin (mechanism)
Cross links DNA. Cancer
67
Etoposide, teniposide (mechanism/use)
Inhibit topoisomerase II, which increases DNA degredation.
68
Hydroxyurea (mechanism)
Inhibits Ribonucleotide reductase, decreases DNA synthesis.
69
Tamoxifen/raloxifene (mechanism)
Block binding of estrogen to estrogen receptor.
Tamoxifen has increased risk of endometrial cancer as partial agonist there. No risk with raloxifene.
70
Trastuzumab (Herceptin)
Monoclonal antibody against HER-2
71
Trastuzumab major side effect
Cardiotoxicity
72
Imatinib (Gleevac)
Bcr-abl tyrosine kinase inhibitor. CML.
73
Rituximab (mechanism)
monoclonal antibody against CD-20.
74
Vemurafenib (mechanism)
Inhibits B-Raf kinase with V600E mutation --> Metastatic melanoma.
75
Bevacizumab (mechanism)
Monoclonal antibody against VEGF.
76
Major side effects of cisplatin/carboplatin ?
Acoustic nerve damage and nephrotoxicity.
77
Ibuprofen (drug class)
NSAID
78
Naproxen (Drug class)
NSAID
79
Indomethacin (drug class) and use
NSAID. Used to close PDA...
80
Ketorolac (drug class)
NSAID
81
Diclofenac (drug class)
NSAID
82
Celecoxib (drug class) and major side effects
Reversible COX2 inhibitor. Increased risk of thrombosis and sulfa allergies.
83
Acetaminophen (drug class)
Reversible inhibitor of COX
84
Antidote for Acetaminophen overdose
N-acetylcysteine
85
Alendronate (drug class)
Bisphonsphonates. Inhibit osteoclast activity… think osteoporosis...
86
Allopurinol (drug class)
Xanthine Oxidase inhibitor
87
Febuxostat (drug class)
Xanthine Oxidase Inhibitor
88
Probenecid (drug class)
Inhibits resorption of Uric acid in PCT (and inhibits penicillin secretion) --> Gout
89
Colchicine (mechanism)
Binds and stabilizes tubulin to inhibit polymerization, impairing leukocyte chemotaxis and degranulation. --> GOUT
90
Major side effect of TNF-a inhibitors
INFECTION, including reactivation of latent Tb
91
Etanercept (drug class)
Fusion protein that acts as a TNF-a receptor.
92
Infliximab (drug class)
Anti-TNF-a monoclonal antibody
93
Adalimumab (drug class)
Anti-TNF-a monoclonal antibody.
94
Mannitol (mechanism and use)
Osmotic diuretic. Used for drug overdose and to decrease elevated intracranial/intraocular pressure.
95
Side effect of mannitol use?
Pulmonary edema
96
Acetazolamide (mechanism and use)
Carbonic Anhydrase inhibitor. Causes NaHCO3 diuresis and reduction in HCO3 stores.
Use for glaucoma, urinary alkalinization, metabolic alkalosis, etc.
97
Furosemide (drug class)
Loop diuretic. (Sulfonamide)
98
Ethacrynic Acid (drug class)
Loop diuretic (NON-sulfmonamide.)
99
Side effects of furosemide
```
Ototoxicity
Hypokalemia
Dehydration
Sulfa allergy
Interstitial Nephritis
Gout
```
100
Hydrochlorothiazide (drug class)
Thiazide diuretic (inhibits NaCl reabsorption in the early distal convoluted tubule).
101
Thiazide diuretics side effects?
```
Hypokalemic metabolic alkalosis
Hyponatremia
Hyperglycemia
Hyperlipidemia
Hyperuricemia
Hypercalcemia (increases Ca reabsorption)
```
Sulfa allergies.
102
Spironolactone (drug class)
K+ sparing diuretic
103
Eplerenone (drug class)
K+ sparing diuretic
104
Triamterene (drug class)
K+ sparing diuretic
105
Amiloride (drug class)
K+ sparing diuretic.
106
Side effects of K+ sparing diuretics?
Hyperkalemia
| Endocrine effects with spironolactone (gynecomastia, antiandrogen effects).
107
Side effects of ACE inhibitors?
```
Cough
Angioedema
Teratogen
Creatinine increase (due to decreased GFR)
Hyperkalemia
Hypotension.
```
108
How do penicillin derivatives work?
Bind to PBPs, block transpeptidase cross-linking of peptidoglycan.
109
Penicillin major use?
Gram + organisms. Plus Neisseria meningitidis and syphilis.
110
What are the penicillinase-resistant penicillins? What are they used for?
Oxacillin, nafcillin, dicloxacillin. Used for Staph aureus.
111
What do Ampicillin/Amoxicillin (extended spectrum penicillins) work against?
```
H influenzae
E coli
Listeria
Proteus
Salmonella
Shigella
enterococci
```
112
Which penicillins are used against Pseudomonas?
Ticarcillin and piperacillin
113
Clavulonic acid, sulbactam, and tazobactam are???
B-lactamase inhibitors.
114
How do cephalosporins work?
Inhibit cell wall synthesis
115
Cefazolin and cephalexin are ???
1st generation cephalosporins
116
1st generation cephalosporins are used for?
Proteus
E coli
Klebsiella (PEcK)
117
Cefoxitin, cefaclor, and cefuroxime are ???
2nd generation cephalosporins
118
2nd generation cephalosporins are used for???
```
H influenzae
Enterobacter
Neisseria
Proteus
E coli
Klebsiella
Serratia
```
HEN PEcKS
119
Ceftriaxone, cefotaxime, and ceftazidime are???
3rd generation cephalosporins
120
3rd generation cephalosporins are used for???
Serious gram - infections.
Ceftriaxone - Neisseria sp.
Ceftazidime - Pseudomonas
121
Aztreonam mechanism and use
Monobactam resistant to b-lactamase. Used for gram - rods only
122
Side effects of carbapenems and their use
GI distress, skin rash, and SEIZURES. Used for life-threatening infections...
123
Vancomycin mechanism
Inhibits cell wall peptidoglycan formation by binding D-ala-D-ala.
124
Use of vancomycin?
Gram + ONLY (incl. Clostridium difficile)
125
Aminoglycosides mechanism?
Inhibit formation of initiation complex (30S subunit) and cause misreading of mRNA. Bactericidal.
126
Gentamicin, neomycin, amikacin, tobramycin, streptomycin are what type of drug?
Aminoglycosides.
127
Aminoglycoside use?
Severe gram - rod infections.
128
Demeclocycline mechanism and use?
Type of tetracycline that acts as an ADH antagonist. Used for SIADH as a diuretic!
129
Mechanism of tetracyclines?
Bind to 30S and prevent attachment of aminoacyl-tRNA
130
Tetracyclines use?
Borrelia
M pneumoniae
Rickettsia
Chlamydia
131
How does resistance to tetracyclines develop?
Decreased uptake into cell or increase efflux out of cell by plasmid-encoded transport pumps.
132
How does resistance to aminoglycosides develop?
Transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.
133
Azithromycin, clarithromycin, and erythromycin are what drug type?
Macrolides
134
Macrolide mechanism
Bind to the 50S (23S rRna subunit) and inhibit translocation.
135
How does chloramphenicol work?
Blocks peptidyltransferase at 50S subunit. Bacteriostatic.
136
Use of chloramphenicol?
MENINGITIS. (H influenzae, N meningitidis, S pneumoniae). Not used more frequently due to side effects (anemia, aplastic anemia, and grey baby syndrome due to low levels of UDP-glucuronyl transferase).
137
How does resistance to chloramphenicol develop?
Plasmid encoded acetyltransferase that inactivates drug.
138
How does clindamycin work?
Blocks peptide transfer at 50S subunit. Bacteriostatic.
139
What do you use clindamycin for?
Anaerobic infections in aspiration pneumonia or lung abscesses. (eg. Bacteroides fragilis or C perfringens)
140
Main side effect of clindamycin???
Pseudomembranous colitis!!! (C diff overgrowth)
141
Sulfamethoxazole, sulfisoxazole, sulfadiazine are what type of drugs?
Sulfonamides
142
How do sulfonamides work?
By inhibiting dyhydropteroate synthase. Bacteriostatic. (Inhibit PABA + Pteridine --> Dihydropteroic acid).
143
Clinical use of sulfonamides?
Gram +, gram -, Nocardia, and Chlamydia.
144
How does trimethoprim work?
Inhibits bacterial dyhydrofolate reductase. Bacteriostatic.
145
Use of TMP-SMX???
UTI's, Shigella, Salmonella, PCP
146
Side effects of Trimethoprim?
Megaloblastic anemia, leukopenia, and granulocytopenia
147
Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, sparfloxacin, moxifloxacin, gatifloxacin, enoxacin are what type of drug?
Fluoroquinolones
148
Nalidixic acid is what type of drug?
Quinolone
149
Mechanism of Fluoroquinolones?
Inhibit DNA gyrase and topoisomerase IV. Bactericidal.
150
Use of fluoroquinolones?
Gram - rods of urinary and GI tracts (incl. Pseudomonas), Neisseria
151
Major side effects of fluoroquinolones?
Tendonitis, tendon rupture, leg cramps/myalgias. Prolong QT
152
How does resistance to fluoroquinolones develop?
Via chromosome encoded mutation in DNA gyrase, plasmid-mediated resistance, and efflux pumps.
153
Metronidazole mechanism
Forms free radical toxic metabolites that damage cell DNA. Bactericidal.
154
Use of metronidazole?
Giardia
Entamoeba
Trichomonas
Gardnerella vaginalis
Anaerobes (Bacteroides, C diff)
H pylori (in combo with PPI and clarithromycin)
GET GAP
155
Isoniazid mechanism
decreased synthesis of mycolic acids used in Mycobacterium cell wall.
156
Side effects of isoniazid?
Neurotoxicity, hepatotoxicity
157
Rifampin mechanism
Inhibits DNA-dependent RNA polymerase
158
Side effects of rifampin
Hepatotoxicity and induces P-450. Also turns body fluids orange...
159
Pyrazidamide use?
M tuberculosis
160
Ethambutol mechanism?
Decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase.
161
Side effects of tetracyclines?
GI upset, discoloration of teeth, inhibition of growth in children, photosensitivity. Do not use in pregnancy.
162
Amphotericin B mechanism
Binds to ergosterol, forms membrane pores… anti-fungal!
163
When to use Amphotericin B?
For serious, systemic mycosis!
164
Major side effects of Amphotericin B?
Fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, and IV phlebitis. Yuck.
165
Mechanism of nystatin and use?
Same as Amphotericin B - binds to ergosterol and forms membrane holes. VERY TOXIC, so only used topically.
Used for oral candidiasis, optical diaper rash/vaginal candidiasis.
166
How do "azole" anti-fungals (ie fluconazole/ketoconazole) work?
By inhibiting fungal sterol synthesis (inhibit lanosterol --> ergosterol)
167
Use of "azole" anti-fungals?
Local and less serious systemic mycosis.
Fluconazole --> chronic suppression of cryptococcal meningitis in AIDS patients and all candidal infections
Itraconazole --> Blastomyces, coccidioides, and histoplasma
Clotrimazole/miconazole for topical fungal infections
168
Side effects of ketoconazole?
Gynecomastia and inhibition of P-450
169
Flucytosine mechanism and use?
Inhibits DNA/RNA biosynthesis by conversion to F-5U. Used for systemic fungal infections in combo with Amphotericin B
170
Caspofungin/micafungin mechanism and use?
Inhibit synthesis of b-glucan thus inhibiting fungal cell wall synthesis. Used for nvasive aspergillosis and Candida.
171
Mechanism of terbinafine? Use?
Inhibits fungal enzyme squalene epoxidase. Used for dermatophytoses
172
Mechanism and use of griseofulvin?
Interferes with microtubule function. Deposits in keratin containing tissues. Used for dermatophytes (particularly nails)
173
Major side effect of griseofulvin?
Induces P-450 metabolism.
174
Treatment of toxoplasma?
Pyrimethamine
175
Treatment of Trypanosoma brucei?
Suramin and melarsoprol
176
Treatment of Trypanosoma cruzi?
Nifurtimox
177
Treatment of leishmaniasis?
Sodium stibogluconate
178
Mechanism of chloroquine?
Inhibits heme metabolism
179
Mechanism of zanamivir?
Inhibits influenza neuraminidase, decreasing release of progeny virus.
180
Oseltamivir mechanism?
Inhibit influenza neuraminidase, decreasing release of progeny virus.
181
ribavirin mechanism? Use?
Inhibits synthesis of guanine nucleotides by inhibiting IMP dehydrogenase. Used for RSV and chronic HCV
182
Acyclovir mechanism and use?
Activated by viral thymidine kinase, which then inhibits viral DNA polymerase as a guanosine analog.
Used for HSV and VZV. For zoster, use famciclovir.
183
Ganciclovir mechanism and use?
Activated by viral kinase to a guanosine analog that inhibits viral DNA polymerase.
Used for CMV.
184
Foscarnet mechanism and use?
Viral DNA polymerase inhibitor, no activation necessary.
Use for CMV when gancyclovir fails and HSV when acyclovir fails.
185
Cidofovir mechanism and use?
Inhibits viral DNA polymerase, no activation necessary.
Used for CMV retinitis and acyclovir resistant HSV.
186
"-navir" drug class?
Protease inhibitors. Note that ritonavir used to boost other drugs by inhibiting cytochrome P-450 enzymes.
187
Side effects of protease inhibitors?
Hyperglycemia, GI intolerance, lipodystrophy, nephropathy, hematuria.
188
IFN-a is used for what?
Chronic HBV/HCV, Kaposi's sarcoma
189
IFN-b is used for what?
MS
190
IFN-gamma is used for what?
NADP oxidase deficiency.
191
Cyclosporine mechanism and use
Binds to cyclophilins. Blocks differentiation and activation of T cells by inhibiting calcineurin… (prevents production of Il-2 and its receptor)
Used to suppress organ rejection and for select autoimmune disorders.
192
Tacrolimus mechanism and use
Binds to FK-binding protein, inhibiting calcineurin and secretion of Il-2.
Used as immunosuppression post organ transplant.
193
Sirolimus (rapamycin) mechanism and use
Inhibits mTOR. Inhibits T cell proliferation in response to Il-2.
Used as immunosuppressant post kidney transplant.
194
Azathioprine mechanism and use
Purine analoge that inhibits DNA synthesis (precursor of 6-mercaptopurine).
Kidney transplantation and autoimmune disease.
195
Side effect of Azatioprine
Metabolized to 6-mercaptopurine, which is then metabolized by xanthine oxidase. Toxic effects thus increased with allopurinol, etc.
196
Muromonab-CD3 mechanism and use
Monoclonal antibody that binds CD3 (T cells), inhibits T cell signal transduction.
Used post-kidney transplantation.
197
Omalizumab drug class
Anti-IgE Monoclonal antibody used in severe asthma.
198
Bethanechol drug class and applications.
Direct cholinomimetic (ACh receptor agonist, either N or M). Used for postoperative ileus, neurogenic ileus, and urinary retention.
199
Carbachol drug class and applications
Direct cholinomimetic (ACh receptor agonist, either N or M). Used for glaucoma, pupillary contraction, and relief of intraocular pressure.
200
Pilocarpine drug class and applications
Direct cholinomimetic (ACh receptor agonist). Potent stimulator of sweat, tears, and saliva. Used for both open and closed angle glaucoma.
201
Methacholine drug class and applications
Direct cholinomimetic (ACh receptor agonist). Challenge test used for asthma. (via M3 receptors!)
202
Neostigmine drug class and applications.
Indirect cholinomimetic (Anticholinesterase that blocks ACh breakdown).
Used for postoperative and neurogenic ileus and urinary retention, myasthenia gravis, and reversal of neuromuscular junction blockade postop).
203
Pyridostigmine drug class and application
Indirect cholinomimetic (Anticholinesterase that blocks ACh breakdown).
Long acting agent for Myasthenia gravis,
204
Edrophonium drug class and application
Indirect cholinomimetic (Anticholinesterase that blocks ACh breakdown).
Used to diagnose myasthenia gravis. (symptoms should improve). Very short acting.
205
Physostigmine drug class and application
Indirect cholinomimetic (Anticholinesterase that blocks ACh breakdown).
Used for atropine overdose (anticholinergic toxicity, as crosses into CNS).
206
Donepezil drug class and application
Indirect cholinomimetic (Anticholinesterase that blocks ACh breakdown).
Used for Alzhaimer's disease.
207
What do organophosphates do?
Inhibit cholinesterase, thus flooding system with ACh (thing major parasympathetic response).
208
How to treat organophosphate toxicity?
Atropine and pralidoxime (regenerates active AChE).
209
Atropine drug class and application
Muscarinic antagonist.
Used in the eye to produce mydriasis (pupil opens) and cycloplegia. Also used for bradycardia.
210
Tropicamide drug class and application
Muscarinic antagonist.
Used in the eye to produce mydriasis (ala atropine)
211
Benztropine drug class and application.
Muscarinic antagonist.
Used in the CNS for Parkinson's
212
Scopolamine drug class and application
Muscarinic antagonist.
Used in the CNS for motion sickness!
213
Ipratropium drug class and application
Muscarinic antagonist.
Used in the respiratory tract for COPD and asthma.
214
Tiotropium drug class and application.
Muscarinic antagonist (long acting)
Used in the respiratory tract for COPD and asthma
215
Oxybutynin drug class and application.
Muscarinic antagonist.
Used in the GU tract to reduce urgency in mild cystitis and reduce bladder spasms
216
Glycopyrrolate drug class and application
Muscarinic antagonist.
Used in the GI and respiratory tracts to reduce airway secretions (pre-op) and reduce drooling/peptic ulcer.
217
Epinephrine drug class and applications.
Both alpha1/2 and beta1/2 agonist (Direct sympathomimetic). Used for anaphylaxis, open angle glaucoma, asthma, and hypotension.
218
Norepinephrine drug class and applications
alpha1/2 agonist (direct sympathomimetic).
Used for hypotension, but decreases renal perfusion.
219
Isoproterenol drug class and applications
Beta-1/2 agonist (direct sympathomimetic).
Used for torsade de pointes (as tachycardia decreases QT interval), bradyarrhythmias
220
Dopamine drug class and applications.
dopamine agonist at low doses, beta agonist at medium doses, and alpha agonist at high doses (direct sympathomimetic).
Used for shock (protects renal profusion), heart failure (as both inotropic and chronotropic).
221
Dobutamine drug class and applications.
Beta-1 agonist (direct sympathomimetic).
Used for heart failure, cardiac stress testing; both inotropic and chronotropic.
222
Phenylephrine drug class and applications.
alpha 1 and 2 agonist (direct sympathomimetic).
Used for hypotension, ocular procedures (produces mydriasis), and rhinitis (decongestant).
223
Albuterol/salmeterol drug class and applications.
Beta-2 selective agonist (mild beta-1 activity) (direct sympathomimetic).
Used for acute asthma (albuterol) and long-term asthma/COPD control (salmeterol)
224
Terbutaline drug class and applications.
Beta-2 selective agonist (mild beta-1 activity) (direct sympathomimetic).
Used to reduce premature uterine contractions.
225
Ritodine drug class and applications.
Beta-2 selective agonist (direct sympathomimetic).
Reduces premature uterine contractions.
226
Amphetamine drug class and applications
Indirect sympathomimetic. Releases stored catecholamines and prevents their re-uptake.
Used for narcolepsy, obesity, and ADHD.
227
Ephedrine drug class and applications.
Indirect sympathomimetic. Releases stored catecholamines.
Used as a nasal decongestant, urinary incontinence, and hypotension.
228
Cocaine drug class and applications.
Indirect sympathomimetic. Inhibits catecholamine reuptake.
Causes vasoconstriction and local anesthesia...
229
Metformin mechanism
Unknown. But decreases gluconeogenesis, increases glycolysis, and increases peripheral glucose uptake.
230
Side effects of metformin
GI upset common. Lactic acidosis RARE.
231
Tolbutamide drug class
First generation sulfonylureas.
232
Chlorpropamide drug class
First generation sulfonylurea
233
Glyburide drug class
Second generation sulfonylureas
234
Glimepiride drug class
Second generation sulfonylureas
235
Glipizide drug class
Second generation sulfonylurea
236
Mechanism of sulfonylureas
Close K+ channel in beta cell membrane, depolarizing the cell, thus triggering insulin release via influx of Ca2+
237
Side effects of sulfonylureas
1st gen: disulfiram like reaction
2nd gen: hypoglycemia
238
Pioglitazone/Rosiglitazone drug class and mechanism
Glitazones/thiazolidinediones
Bind to PPAR-gamma nuclear transcription regulator, thus increasing insulin sensitivity in peripheral tissue.
239
Side effects of pioglitazone or rosiglitazone?
Weight gain, edema, hepatotoxicity, heart failure
240
Acarbose mechanism and use
Inhibit intestinal brush-border a-glucosidases, thus decreased glucose absorption --> decreasing post-prandial hyperglycemia.
DM type II
241
Miglitol mechanism and use
Inhibit intestinal brush-border a-glucosidases, thus decreased glucose absorption --> decreasing post-prandial hyperglycemia.
DM type II
242
Pramlintide mechanism and use
Decreases glucagon. Used in DM type I and II.
243
Exenatide drug class/mechanism
GLP-1 analog that increases insulin and decreases glucagon release
244
Liraglutide drug class/mechanism
GLP-1 analog that increases insulin and decreases glucagon release
245
Side effects of GLP-1 analogs?
Nausea, vomiting, and PANCREATITIS!!!
246
Linagliptin drug class/mechanism and use
DPP-4 inhibitor that increases insulin and decreases glucagon release. DPP-4 normally breaks down GLP-1
DM type II
247
Saxagliptin drug class/mechanism and use
DPP-4 inhibitor that increases insulin and decreases glucagon release. DPP-4 normally breaks down GLP-1
DM type II
248
Sitagliptin drug class/mechanism and use
DPP-4 inhibitor that increases insulin and decreases glucagon release. DPP-4 normally breaks down GLP-1
DM type II
249
Side effects of the DPP-4 inhibitors?
Mild urinary or respiratory infections
250
Propylthiouracil mechanism and use
Blocks peroxidase, thus inhibiting organification of iodide and coupling of thyroid hormone synthesis. Also decreases peripheral conversion of T4 to T3.
Used for hyperthyroidism
251
Methimazole mechanism and use
Blocks peroxidase, thus inhibiting organification of iodide and coupling of thyroid hormone synthesis.
Used for hyperthyroidism
252
Side effects of propylthiouracil/methimazole
Skin rash, agranulocytosis, aplastic anemia, hepatotoxicty.
253
Levothyroxine/triiodothyronine side effects
Tachycardia, heat intolerance, tremors, arrhythmias
254
Triiodothyronine mechanism and use
Thyroxine replacement. Used for hypothyroidism and myxedema!
255
Demeclocycline mechanism and use
ADH antagonist (also member of tetracycline antibiotic family). Used for SIADH.
256
Side effects of steroids?
Cushing's syndrome! Buffalo hump, moon facies, truncal obesity, muscle wasting, thin skin, easy brusability, osteoporosis, adrenocortical atrophy, peptic ulcers, diabetes
257
Clonidine mechanism and use
Centrally acting alpha-2 agonist. Useful to manage hypertension in renal disease, as renal perfusion maintained.
258
a-methyldopa mechanism and use
Centrally acting alpha-2 agonist. Useful to manage hypertension in renal disease, as renal perfusion maintained.
259
Phenoxybenzamine mechanism
Non-selective alpha blocker (irreversible)
260
Phenoxybenzamine use
Pheochromocytoma (make sure to use this and not phentolamine, which is REVERSIBLE). Can see orthostatic hypotension and reflex tachycardia.
261
Phentolamine mechanism and use
Non-selective alpha blocker (reversible). GIve to patients on MAOi's who eat tyramine containing food.
262
Prazosin, terazosin, doxazosin, and tansulosin ("-osin" ending) mechanism
a1-selective blocker.
263
Prazosin, terazosin, doxazosin, and tansulosin ("-osin" ending) use
Hypertension, urinary retention in BPH (tamsulosin).
264
Mirtazapine mechanism and use
a2-selective blocker. Used in DEPRESSION.
265
Side effects of mirtazapine?
Sedation, increased serum cholesterol, increased appetite.
266
Which beta blockers are used with SVT?
metoprolol and esmolol (decreased AV conduction velocity --> class II antiarrythmics!)
267
Which beta blocker is used with glaucoma?
Timolol (decreases secretion of aqueous humor)
268
Side effects of beta blockers?
Impotence, exacerbation of asthma, cardiovascular (bradycardia, AV block, CHF), CNS (seizures, sedation, sleep alterations).
269
Which beta blockers are B1-selective?
Acebutolol, betaxolol, esmolol, atenolol, metoprolol (A BEAM). Use in those with pulmonary disease.
270
Which beta blockers are non-selective (b1 and b2)?
Propranolol, timolol, nadolol, pindolol.
Please Try Not being Picky
271
Which beta blockers are nonselective for both beta and alpha receptors?
Carvedilol and labetalol
272
Which beta blockers have some partial beta agonist activity?
Pindolol, Acebutolol
273
Treatment for Acetaminophen OD?
N-acetylcysteine (replenishes glutathione)
274
Treatment for Salicylates (aspirin) OD?
NaHCO3 (alkalinize urine) and dialysis
275
Treatment for Amphetamines OD?
NH4Cl (acidify urine)
276
Treatment for organophosphate (AChEi) OD?
Atropine and Pralidoxime
277
Treatment for antimuscarinic/anticholinergic OD?
Physostigmine salicylate
278
Treatment for b-blocker OD?
Glucagon
279
Treatment for digitalis OD?
Normalize K+, Lidocaine, Anti-dig Fab, and Mg2+ (KLAM)
280
Treatment for iron OD?
Deferoxamine, deferasirox
281
Treatment for lead OD?
CaEDTA, dimercaprol, succimer, penicillamine
282
Treatment for mercury, arsenic, gold OD?
Dimercaprol, succimer
283
Treatment for copper, arsenic, gold OD?
Penicillamine
284
Treatment for cyanide OD?
Nitrite + thiosulfate, hydroxocobalamin
285
Treatment for Methemoglobin OD?
Methylene blue, Vit C
286
Treatment for CO OD?
100% O2, hyperbaric O2
287
Treatment for methanol/ethylene glycol OD?
Fomepizole (or ethanol), dialysis
288
Treatment for opioids OD?
Naloxone/naltrexone
289
Treatment for benzodiazepine OD?
flumazenil
290
Treatment for TCAs OD?
NaHCO3 (plasma alkalinization)
291
Treatment for Heparin OD?
Protamine
292
Treatment for Warfarin OD?
Vit K, fresh frozen plasma
293
Treatment for tPA/streptokinase/urokinase OD?
Aminocaproic acid
294
Treatment for theophylline OD?
b-blocker
295
Diphenhydramine mechanism and use
1st generation H1 blocker. Used for allergy, motion sickness, and sleep aid.
296
Dimenhydrinate mechanism and use
1st generation H1 blocker. Used for allergy, motion sickness, and sleep aid.
297
Chlorpheniramine mechanism and use
1st generation H1 blocker. Used for allergy, motion sickness, and sleep aid.
298
Loratadine mechanism and use
2nd generation H1 blocker. Used for allergies.
299
Fexofenadine mechanism and use
2nd generation H1 blocker. Used for allergies.
300
Desloratadine mechanism and use
2nd generation H1 blocker. Used for allergies.
301
Cetirizine mechanism and use
2nd generation H1 blocker. Used for allergies.
302
Side effects of salmeterol/fometerol?
Tremor and arrhythmia
303
Formoterol mechanism
Long acting b2-agonist. Used for asthma.
304
Theophylline mechanism and use
Inhibits phosphodiesterase, increasing cAMP, causing bronchodilation. Blocks adenosine. Used for asthma, but rarely due to side effects
305
Side effects of theophylline?
Cardiotoxicity, neurotoxicity, narrow TI
306
Beclomethasone mechanism and use
Corticosteroid (inhibits synthesis of cytokines via inactivation of NF-kB). Use for chronic asthma.
307
Fluticasone mechanism and use
Corticosteroid (inhibits synthesis of cytokines via inactivation of NF-kB). Use for chronic asthma.
308
Montelukast mechanism and use
Anti-leukotrienes.
Helps with late-inflammatory response in asthma, particularly aspirin-induced asthma.
309
Zafirlukast mechanism and use
Anti-leukotrienes.
Helps with late-inflammatory response in asthma, particularly aspirin-induced asthma.
310
Zileuton mechanism and use
5-Lipoxygenase pathway inhibitor. Blocks conversion of arachadonic acid to leukotrienes. Good for the late-inflammatory response of asthma.
Used of rasthma.
311
Guaifenesin mechanism and use
Expectorant- thinks respiratory secretions w/o suppressing cough reflex
312
N-acetylcysteine mechanism and use
Mucolytic- loosens mucus plugs in CF patients. Also antidote for acetominophen OD...
313
Bosentan mechanism and use
Endothelin-1 receptor antagonist, leading to decreased pulmonary vasc. resistance.
Used for Pulmonary Artery Hypretension
314
Dextromethorphan mechanism and use
NMDA receptor antagonist. Codiene analog, so mild abuse potential.
Used as an anti-tussive.
315
Pseudophedrine mechanism and use
Sympathomimetic a-agonist.
Nasal decongestant.
316
Risedronate mechanism and use
Bisphosphonate (anti-osteoclast) used for osteoporosis.
317
Zoledronic acid mechanism and use
Bisphosphonate (anti-osteoclast) used for osteoporosis.
318
Denosumab mechanism and use
monoclonal antibody against the Estrogen RANK ligand, which prevents osteoclastic activation via osteoblasts.
Used for osteoporosis
319
Raloxifene mechanism and use
Selective estrogen receptor (antagonist for both breast and endometrium) used for osteoporosis (reduces resorption of bone)!
320
Teriparatide mechanism and use
Parathyroid hormone analog given in spikes that help BUILD bone. Only osteoporosis drug that is anabolic!
321
Side effects of Bisphosphonates?
GERD, jaw osteonecrosis, fractures.
322
Modafinil effect on P-450?
Inducer (+)
323
Barbiturates effect on P-450?
Inducer (+)
324
St. John's Wart effect on P-450?
Inducer (+)
325
Phenytoin effect on P-450?
Inducer (+)
326
Rifampin effect on P-450?
Inducer (+)
327
Griseofulvin effect on P-450?
Inducer (+)
328
Caramazepine effect on P-450?
Inducer (+)
329
Chronic alcohol use effect on P-450?
Inducer (+)
330
Macrolides effect on P-450?
Inhibitor
331
Amiodarone effect on P-450?
Inhibitor
332
Grapefruit juice effect on P-450?
Inhibitor
333
Isoniazid effect on P-450?
Inhibitor
334
Cimetidine effect on P-450?
Inhibitor
335
Ritonavir effect on P-450?
Inhibitor
336
Acute alcohol abuse effect on P-450?
Inhibitor
337
Ciprofloxacin effect on P-450?
Inhibitor
338
Ketoconazole effect on P-450?
Inhibitor
339
Sulfonamides effect on P-450?
Inhibitor
340
Gemfribrozil effect on P-450?
Inhibitor
341
Quinidine effect on P-450?
Inhibitor
342
What are the Sulfa drugs?
```
Probenecid
Furosemide
Acetazolamide
Celecoxib
Thiazides
Sulfanamide antibiotics
Sulfasalazine
Sulfonylureas
```
343
Nifedipine drug class
Calcium channel blocker
344
Verapamil drug class
Calcium channel blocker
345
Diltiazem drug class
Calcium channel blocker
346
Amlodipine drug class
Calcium channel blocker
347
Calcium channel blockers mechanism
Block voltage gated Calcium channels of cardiac and smooth muscle cells. Reduce muscle contractility.
Vascular smooth muscle - Amlodipine=nifedipine>diltiazem>verapamil
Heart- Verapamil>diltiazem>amlodipine=verapamil
348
Use of Calcium channel blockers
Hypertension, angina, arrhythmias (not nifedipine), Prinzmetal's angina, and Raynaud's
349
Side effects of Calcium channel blockers?
Cardiac depression, AV block, peripheral edema, flushing, dizziness, and constipation
350
Hydralazine mechanism
Increases cGMP, causing smooth muscle relaxation. Vasodilates arterioles more than veins --> reduces afterload.
351
Use of hydralazine?
Severe hypertension and CHF. Give with b-blocker to prevent reflex tachycardia.
352
Side effects of hydralazine?
Compensatory tachycardia, fluid retention, nausea, headache, angina. Lupus like symptoms.
353
What drugs treat malignant hypertension?
Nitroprusside, nicardipine (Ca channel blocker), clevidipine (Ca channel blocker), labetalol, and fenoldopam.
354
Nitroprusside mechanism
Short acting agent that increases cGMP via direct release of NO. Causes cyanide toxicity!
355
Fenoldopam mechanism
Dopamine D1 agonist. Results in coronary, peripheral, renal, and splanchnic vasodilation.
356
Nitroglycerine mechanism and use
Venodilator (via NO --> increased cGMP). Decreases preload. Used for Angina and pulmonary edema.
357
Which b-blockers are contraindicated in angina?
Pindolol and Acebutolol as partial b-agonists.
358
What effect on lipids do Statins have?
Significantly decrease LDL, increase HDL, and decrease TG
359
Side effects of statins?
Hepatotoxicity and rhabdomyolysis!
360
Mechanism of statins?
Inhibit HMG-CoA reductase, which inhibits conversion of HMG-CoA to mevalonate, a cholesterol precursor
361
Niacin (Vit. B3) mechanism and use
Lipid lowering agent by inhibiting lipolysis in adipose and reducing hepatic VLDL secretion.
Moderately lowers LDL, moderately increases HDL, and decreases TG.
362
Side effects of Niacin?
Red, flushed face (improved by aspirin/long term use).
Hyperglycemia (acanthosis nigricans)
Hyperuricemia (exacerbates gout)
363
Cholestyramine drug class
Bile acid resin
364
Colestipol drug class
Bile acid resin
365
Colesevelam drug class
Bile acid resin
366
Bile acid resins mechanism and use
Prevent intestinal reabsorption of bile acids, reduces cholesterol recycling.
Moderately decreases LDL, slightly increases HDL, slightly increases TG.
367
Side effects of bile acid resins?
Tastes bad, GI discomfort, decreased absorption of fat-soluble vitamins, cholesterol gallstones.
368
Exetimibe mechanism/drug class
Inhibits cholesterol absorption in intestine. Lipid-lowering agent.
369
What effect on lipids does exetimibe have?
Moderately decreases LDL, no effect on HDL/TG.
370
Side effects of exetimibe
Rare increase in LFT's, diarrhea
371
Gemfibrozil drug class
Fibrate
372
Clofibrate drug class
Fibrate
373
Bezafibrate drug class
Fibrate
374
Fenofibrate drug class
Fibrate
375
What effect on lipids do Fibrates have?
Lower LDL, increase HDL, significantly lower TG.
376
Fibrate mechanism
Upregulates Lipoprotein lipase which increases TG clearance.
377
Side effects of Fibrates
Myositis, hepatotoxicity, cholesterol gallstones.
378
What is a Cardiac Glycoside?
Digoxin!
379
Mechanism of Digoxin?
Direct inhibition of Na/K ATPase leading to indirect inhibition of Na/Ca exchanger. Increased Ca intracellularly is a positive inotrope. Also stimulates vagus nerve, causing a decreased HR
380
Use of digoxin?
CHF (increases contractility); A fib (decreases conduction at AV node and depression of SA node).
381
Quinidine is what type of drug, has what mechanism, and is used for what conditions?
Class IA Antiarrhythmic. (blocks Na channels).
Increases Action Potential duration, increases effective refractory period, increases QT interval.
Used for atrial and ventricular arrhythmias, esp. reentrant and ectopic supraventricular and ventricular tachycardia.
382
Procainamide is what type of drug, has what mechanism, and is used for what conditions?
Class IA Antiarrhythmic. (blocks Na channels).
Increases Action Potential duration, increases effective refractory period, increases QT interval.
Used for atrial and ventricular arrhythmias, esp. reentrant and ectopic supraventricular and ventricular tachycardia.
383
Disopyramide is what type of drug, has what mechanism, and is used for what conditions?
Class IA Antiarrhythmic. (blocks Na channels).
Increases Action Potential duration, increases effective refractory period, increases QT interval.
Used for atrial and ventricular arrhythmias, esp. reentrant and ectopic supraventricular and ventricular tachycardia.
384
Side effects of quinidine?
Cinchonism- headache and tinnitus. Also thrombocytopenia and torsades de pointes due to increased QT interval.
385
Side effects of Procainamide?
Reversible SLE-like syndrome. Also thrombocytopenia and torsades de pointes due to increased QT interval.
386
Side effects of Disopyramide
Heart failure. Also thrombocytopenia and torsades de pointes due to increased QT interval.
387
Lidocaine is what type of drug, has what mechanism, and is used for what conditions?
Class IB Antiarrhythmic. (blocks Na channels).
Decreases action potential. Preferentially affects ischemic or depolarized Purkinje and ventricular tissue.
Useful in acute ventricular arrhythmias (esp. post-MI) and in digitalis-induced arrhythmias.
388
Mexiletine is what type of drug, has what mechanism, and is used for what conditions?
Class IB Antiarrhythmic. (blocks Na channels).
Decreases action potential. Preferentially affects ischemic or depolarized Purkinje and ventricular tissue.
Useful in acute ventricular arrhythmias (esp. post-MI) and in digitalis-induced arrhythmias.
389
Tocainide is what type of drug, has what mechanism, and is used for what conditions?
Class IB Antiarrhythmic. (blocks Na channels).
Decreases action potential. Preferentially affects ischemic or depolarized Purkinje and ventricular tissue.
Useful in acute ventricular arrhythmias (esp. post-MI) and in digitalis-induced arrhythmias.
390
Flecainide is what type of drug, has what mechanism, and is used for what conditions?
Class IC Antiarrhythmic. (blocks Na channels).
No effect on Action Potential duration.
Useful in ventricular tachycardias that progress to ventricular fibrillation and in intractable supraventicular tachycardia. Only used in patients without structural abnormalities.
391
Propafenone is what type of drug, has what mechanism, and is used for what conditions?
Class IC Antiarrhythmic. (blocks Na channels).
No effect on Action Potential duration.
Useful in ventricular tachycardias that progress to ventricular fibrillation and in intractable supraventicular tachycardia. Only used in patients without structural abnormalities.
392
Side effects of class IC antiarrhythmics?
Proarrhythmic, esp. post-MI. Significantly prolongs refractory period in AV node.
393
What are class II antiarrhythmic drugs, what is their mechanism, and what are they used for?
B-blockers!
Work by decreasing SA and AV nodal activity by decreasing cAMP and Ca currents. Suppress abnormal pacemakers by decreasing slope of phase 4.
Used for Ventricular tachycardia, supraventricular tachycardia, and for slowing ventricular rate during a fib and a flutter.
394
Side effects of b-blockers?
Impotence, exacerbation of asthma, cardiovascular (bradycardia, AV block, CHF), CNS (sedation, sleep alterations). May mask signs of hypoglycemia.
395
Amiodarone is what type of drug, has what mechanism, and is used for what conditions?
Class III Antiarrhythmic. (blocks K channels).
Increases action potential, increases effective refractory period.
Use when other antiarrhythmics fail, as it increases QT interval.
396
Ibutilide is what type of drug, has what mechanism, and is used for what conditions?
Class III Antiarrhythmic. (blocks K channels).
Increases action potential, increases effective refractory period.
Use when other antiarrhythmics fail, as it increases QT interval.
397
Dofetilide is what type of drug, has what mechanism, and is used for what conditions?
Class III Antiarrhythmic. (blocks K channels).
Increases action potential, increases effective refractory period.
Use when other antiarrhythmics fail, as it increases QT interval.
398
Sotalol is what type of drug, has what mechanism, and is used for what conditions?
Class III Antiarrhythmic. (blocks K channels).
Increases action potential, increases effective refractory period.
Use when other antiarrhythmics fail, as it increases QT interval.
399
Side effects of sotalol?
Torsades de pointes, excessive b-block
400
Side effects of ibutilide?
Torsades de pointes
401
Side effects of Amiodarone
Pulmonary fibrosis, hepatotoxcity, hypothyroidism/hyperthyroidism, corneal deposits, skin deposits (blue/grey) resulting in photodermatitis, neurologic effects, constipation, cardiovascular (bradycardia, heart block, CHF).
CHECK PFTs, LFTs, and TFTs (thyroid function) when using!
402
Verapamil is what type of drug, has what mechanism, and is used for what conditions?
Class IV Antiarrhythmic. (blocks Ca channels).
Decreases conduction velocity, increases effective refractory period, increases PR interval.
Used to prevent nodal arrhythmias (eg supraventricular tachycardia).
403
Diltiazem is what type of drug, has what mechanism, and is used for what conditions?
Class IV Antiarrhythmic. (blocks Ca channels).
Decreases conduction velocity, increases effective refractory period, increases PR interval.
Used to prevent nodal arrhythmias (eg supraventricular tachycardia).
404
Side effects of verapamil?
Constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression)
405
Side effects of diltiazem?
Constipation, flushing, edema, CV effects (CHF, AV block, sinus node depression)
406
Leuprolide mechanism and use
GnRH analog. Agonist when used in pulsatile fashion, antagonist when used continuously.
Used for Infertility (pulsatile), prostate cancer (continuous), uterine fibroids (continuous), precocious puberty (continuous).
407
Side effects of testosterone therapy?
Increases LDL, decreases HDL. Also premature closure of epiphyseal plates in children.
408
Finasteride mechanism and use
Anti-androgen via inhibition of 5a-reductase (inhibits production of DHT). Used for BPH and male pattern baldness...
409
Flutamide mechanism and use
Non-steroidal competitive inhibitor of androgens at the testosterone receptor. Used for prostate cancer.
410
Ketoconazole mechanism and use (NON-antifungal)
Inhibits steroid synthesis (via 17, 20-desmolase). Used to treat PCOS to prevent hirsutism.
411
Spironolactone mechanism and use (non-diuretic)
Inhibits steroid binding. Used to treat PCOS to prevent hirsutism.
412
Clomiphene mechanism and use
Partial agonist at estrogen receptors in hypothalamus, thus preventing normal feedback inhibition and increasing LH/FSH.
Used to treat infertility and PCOS.
413
Anastrozole mechanism and use
Aromatase inhibitor used in postmenopausal women with breast cancer
414
Exemestane mechanism and use
Aromatase inhibitor used in postmenopausal women with breast cancer
415
Mifepristone (RU-486) mechanism and use
Competitive inhibitor of progestins and progesterone receptor. Used to terminate pregnancy in combo with misoprostol (PGE1).
416
Tamsulosin mechanism and use
a1-antagonist used to treat PBH by inhibiting smooth muscle contraction. Selective for a1A,D receptors found on prostate (as opposed to A1b found on vasculature).
417
Sildenafil/vardenafil mechanism and use
Inhibit phosphodiesterase 5, causing an increase in cGMP, smooth muscle relaxation in the corpus cavernosum, increased blood flow, and penile erection… used for erectile dysfunction.
418
Side effects of Sildenafil/vardenafil
headache, flushing, dyspepsia, impaired blue-green color vision. Risk of life-threatening hypotension in those taking nitrites.
419
Danazol mechanism and use
Synthetic androgen that acts as partial agonist at androgen receptors. Used for endometriosis and hereditary angioedema.
420
Brimonidine mechanism and use
alpha 2 agonist. Decreases aqueous humor production. Used for glaucoma.
421
Betaxolol use
Glaucoma (decreases aqueous humor production)
422
Carteolol use
Glaucoma (decreases aqueous humor production)
423
Echothiophate mechanism and use
indirect cholinomimetic. Used for glaucoma.
424
Latanoprost mechanism and use (plus side effect)
PGF2a analog that increases outflow of aqueous humor. Used for glaucoma. Side effect: darkens color of iris.
425
Mechanism of opioid analgesics
Agonists at opioid receptors (mu, delta, and kappa) to modulate synaptic transmission. Open K+ channels and close Ca2+ channels, which decreases synaptic transmission. Inhibits release of ACh, NE, 5-HT, glutamate, and substance P.
426
Butorphanol mechanism and use
Mu-opioid PARTIAL agonist and kappa-opioid agonist. Used for severe pain (migraines, labor, etc), but does not cause as much respiratory depression!
427
Side effects of Butorphanol?
Opioid withdrawal if used with full opioid agonist (as competitive binding). Overdose is not easily reversed with naloxone.
428
Tramadol mechanism and use
Very weak opioid agonist. Also inhibits serotonin and NE uptake. Used for chronic pain.
429
Side effects of tramadol?
Similar to opioids. Decreases seizure threshold.
430
Mechanism of phenytoin
Increases Na+ channel inactivation.
431
Use of phenytoin?
1st line for tonic-clonic seizures and status epilepticus prophylaxis. Also used for simple and complex partial seizures.
432
Carbamazepine mechanism?
Increases Na+ channel inactivation.
433
Use of carbemazepine?
1st line for simple and complex partial seizures as well as tonic-clonic generalized seizures.
434
Mechanism of lamotrigine
Blocks voltage gated Na+ channels.
435
Use of lamotrigine?
Used for simple and complex partial seizures as well as tonic-clonic generalized seizures.
436
Mechanism of gabapentin
Designed as GABA analog, but primarily inhibits high-voltage activated Ca2+ channels.
437
Use of gabapentin?
Used for simple and complex partial seizures as well as tonic-clonic generalized seizures.
Also used for peripheral neuropathy, postherpetic neuralgia, migraine prophylaxis, and bipolar disorder.
438
Mechanism of topiramate
Blocks Na+ channels, increases GABA action.
439
Use of topiramate?
Used for simple and complex partial seizures as well as tonic-clonic generalized seizures.
Also used for migraine prevention.
440
Mechanism of phenobarbital?
Increases GABAa action.
441
Use of phenobarbital?
Used for simple and complex partial seizures as well as tonic-clonic generalized seizures.
1st line in children.
442
Mechanism of Valproic Acid
Increases Na+ channel inactivation, increases GABA concentration.
443
Use of valproic acid?
1st line for tonic clonic generalized seizures (as well as phenytoin and carbamazapine). Used for simple and complex partial seizures as well as Absence and myoclonic generalized seizures.
444
Mechanism of ethosuximibe
Blocks thalamic T-type Ca2+ channels.
445
Use of ethosuximibe?
1st line for Absence seizures.
446
Mechanism of benzodiazepines for seizures
Increase GABAa action.
447
Use of benzodiazepines for seizures?
1st line for acute status epilepticus. Also used for seizures of eclampsia (after trying MgSO4).
448
Tiagabine mechanism
Inhibits GABA reuptake.
449
Use of tiagabine?
Used for simple and complex partial seizures.
450
Vigabatrin mechanism
Irreversibly inhibits GABA transaminase --> increases GABA.
451
Use of vigabatrin?
Used for simple and complex partial seizures.
452
Levetiracetam mechanism
Unknown. May modulate GABA and glutamate release.
453
Use of levetiracetam?
Used for simple and complex partial seizures as well as tonic-clonic generalized seizures.
454
Side effects of Carbamazepine?
```
Diplopia
ataxia
blood dyscrasias (agranulocytosis, aplastic anemia)
liver toxicity
teratogenesis
induction of cytochrome P-450
SIADH
Stevens-Johnson syndrome
```
455
Side effects of ethosuximide?
```
GI distress
Fatigue
Headache
Urticaria
Steven-Johnson syndrome
```
456
Side effects of phenobarbital?
Sedation
Tolerance
Dependence
Induction of P-450
457
Side effects of phenytoin?
```
Nystagmus
Diplopia
Ataxia
Sedation
Gingival hyperplasia
Hirsutism
Megaloblastic anemia
Teratogenesis
SLE-like syndrome
Induction of P-450
Lymphadenopathy
Steven-Johnson syndrome
Osteopenia
```
458
Side effects of Valproic acid?
```
GI distress
Fatal hepatotoxicity (rare)
Neural tube defects in fetus (spina bifida)
Tremor
Weight gain
```
459
Side effect of lamotrigine?
Steven-Johnson syndrome
460
Side effects of Gabapentin?
Sedation and ataxia
461
Side effects of topiramate?
Sedation
mental dulling
Kidney stones
Weight loss
462
Thiopental is what drug class?
Barbiturates. Used for induction of anesthesia.
463
Mechanism of barbiturates?
Increase duration of Cl- channel openings which facilitates GABA, decreasing neuron firing.
464
Mechanism of benzodiazepines?
Increases frequency of Cl- channel opening which facilitates GABA, decreasing neuron firing.
465
Zolpidem mechanism and use
Act via the BZ1 subtype of GABA receptor. Used for insomnia.
466
Zaleplon mechanism and use
Act via the BZ1 subtype of GABA receptor. Used for insomnia.
467
Eszopiclone mechanism and use
Act via the BZ1 subtype of GABA receptor. Used for insomnia.
468
Ketamine mechanism and use
PCP analog that blocks NMDA receptor. Used for IV anesthesia.
469
Propofol mechanism and use
Potentiates GABA. Used for sedation in ICU, rapid anesthesia induction, and short procedures as less postoperative nausea than thiopental.
470
Mechanism of Lidocaine derivatives (local anesthetics)
Block Na+ channel by binding to receptors on INNER portion of channel. Preferentially bind to activated Na+ channels. Bind as charged form, but enters cells as uncharged amine.
471
Order of loss of sensation with local anesthetics?
1. Pain
2. Temperature
3. Touch
4. Pressure.
472
Side effects of bupivacaine?
Severe cardiovascular toxicity
473
Succinylcholine mechanism and use?
Depolarizing neuromuscular blocker. Strong ACh receptor agonist. Produces a sustained depolarization and prevents muscle contraction.
Phase I: prolonged depolarization. No antidote. Potentiated by cholinesterase inhibitors.
Phase II: repolarized but blocked. Give cholinesterase inhibitors to overcome (neostigmine).
474
Tubocurarine mechanism
Nondepolarizing neuromuscular blocker. Competitive ACh antagonist. Give a cholinesterase inhibitor to reverse (neostigmine)
475
Atracurium, mivacurium, etc. mechanism
Nondepolarizing neuromuscular blocker. Competitive ACh antagonist. Give a cholinesterase inhibitor to reverse (neostigmine)
476
Dantrolene mechanism and use
Prevents the release of Ca2+ from Sarcoplasmic reticulum of skeletal muscle. Used in the treatment of malignant hyperthermia (from inhaled anesthetics and succinylcholine) and neuroleptic malignant syndrome.
477
Bromocriptine mechanism and use
Dopamine agonist. Used for Parkinson's
478
Pramipexole mechanism and use
Dopamine agonist. Used for Parkinson's
479
Ropinirole mechanism and use
Dopamine agonist. Used for Parkinson's
480
Amantadine mechanism and use
Increases dopamine release. Used for Parkinson's. Also used as an antiviral against influenza A and rubella.
481
L-dopa/carbidopa mechanism and use
Increases dopamine in CNS. Used for Parkinson's
482
Selegiline mechanism and use
Selective MAO type B inhibitor that prevents dopamine breakdown. Used for Parkinson's
483
Entacapone mechanism and use
COMT inhibitors, prevents L-dopa degradation, thereby increasing dopamine availability. Used for Parkinson's
484
Tolcapone mechanism and use
COMT inhibitors, prevents L-dopa degradation, thereby increasing dopamine availability. Used for Parkinson's
485
Benztropine mechanism and use
Antimuscarinic. Improves tremor and rigidity but little effect on bradykinesia. Used for Parkinson's
486
Memantine mechanism and use
NMDA receptor antagonist. Helps to prevent excitotoxicity. Used for Alzheimer's.
487
Galantamine mechanism and use
Acetylcholinesterase inhibitor. Used for Alzheimer's
488
Rivastigmine mechanism and use
Acetylcholinesterase inhibitor. Used for Alzheimer's
489
Tetrabenazine mechanism and use
Inhibit VMAT; limit dopamine vesicle packaging and release. Used for Huntington's.
490
Reserpine mechanism and use
Inhibit VMAT; limit dopamine vesicle packaging and release. Used for Huntington's.
491
Sumatriptan mechanism and use
5-HT1b/1d agonist. Inhibits trigeminal nerve activation, prevents vasoactive peptide release, and induces vasoconstriction. Used for Acute migraines and cluster headaches.
Do NOT use in patients with CAD or Prinzmetal's angina, as it can induce coronary vasospasm.
492
Haloperidol drug class
High potency Antipsychotic
493
Trifuoperazine drug class
High potency Antipsychotic
494
Fluphenazine drug class
High potency Antipsychotic
495
Chlorpromazine drug class
Low potency Antipsychotic
496
Thioridazine drug class
Low potency Antipsychotic
497
Side effects of high potency Antipsychotics?
Extrapyramidol side effects
498
Side effects of low potency Antipsychotics?
Anticholinergic (dry mouth, constipation), antihistamine (sedation), and a1-blockade (hypotension).
499
What is Neuroleptic Malignant Syndrome and how do you treat?
Rigidity, myoglobinuria, autonomic instability, hyperpyrexia.
Treat with Dantrolene, D2 agonists (bromocriptine)
500
Olazapine drug class
Atypical antipsychotic
501
Clozapine drug class
Atypical antipsychotic
502
Quetiapine drug class
Atypical antipsychotic
503
Risperidone drug class
Atypical antipsychotic
504
Aripiprazole drug class
Atypical antipsychotic
505
Ziprasidone drug class
Atypical antipsychotic
506
Mechanism of typical antipsychotics?
BLock D2 receptors (increasing cAMP)
507
Mechanism of atypical antipsychotics?
Unknown. Varied effects of 5-HT2, dopamine, and a/H1 receptors.
508
Side effects of Clozapine?
Weigh gain, AGRANULOCYTOSIS (monitor weekly), and seizure
509
Side effects of Olanzapine?
Weight gain
510
Side effects of Ziprasidone?
May prolong QT interval
511
Side effects of Lithium
Tremor, sedation, edema, heart block, hypothyroidism, polyuria (nephrogenic diabetes insipidus), teratogenic (causes Ebstein anomaly and malformation of the great vessels).
512
Buspirone drug class and use
Stimulates 5-HT1A receptors. Used for generalized anxiety disorder.
513
Side effects of buspirone?
Does NOT interact with alcohol!
514
Fluoxetine drug class
SSRI
515
Paroxetine drug class
SSRI
516
Sertraline drug class
SSRI
517
Citalopram drug class
SSRI
518
Side effects of SSRI's?
GI distress
Sexual dysfunction
SEROTONIN SYNDROME
519
What is serotonin syndrome and how do you treat?
```
Hyperthermia
Confusion
Myoclonus
Cardiovascular collapse
Flushing
Diarrhea
Seizures
```
Treat with Cyproheptadine (5-HT2 antagonist)
520
Venlafaxine drug class
SNRI
521
Duloxetine drug class
SNRI
522
Use of Venlafaxine?
Depression and generalized anxiety/panic disorders
523
Use of Duloxetine?
Depression and diabetic peripheral neuropathy.
524
Amitriptyline drug class
TCA
525
Nortriptyline drug class
TCA
526
Imipramine drug class
TCA
527
Desipramine drug class
TCA
528
Clomipramine drug class
TCA
529
Doxepin drug class
TCA
530
Amoxapine drug class
TCA
531
Mechanism of TCA
Block reuptake of NE and serotonin
532
Use of TCA's?
Major depression, fibromyalgia. Imipramine - bedwetting, Clomipramine - OCD
533
Side effects of TCA's?
Sedation
Postural hypotension
Anticholinergic (dry mouth, tachycardia, urinary retention).
Toxicity = Convulsions, Coma, Cardiotoxicity (arrhythmias), respiratory depression, hyperpyrexia, confusion/hallucinations.
534
How to treat TCA toxicity?
NaHCO3
535
Tranylcypromine drug class
MAOi
536
Phenelzine drug class
MAOi
537
Isocarboxazid drug class
MAOi
538
Selegiline drug class
MAOi
539
Side effects of MAOi's?
Hypertensive crisis when ingest tyramine foods
540
Bupropion drug class and use
Atypical antidepressant. Used for smoking cessation and depression.
541
Side effects of Buproprion?
Tachycardia, insomnia
Headache
Seizure in bulimic patients
NO SEXUAL SIDE EFFECTS!
542
Mirazapine mechanism and use
a2-antagonist and 5-HT2/5-HT3 receptor antagonist.
Used for depression
543
Maprotiline mechanism and use
Blocks NE reuptake. Used for depression
544
Trazodone mechanism and use
Inhibits serotonin reuptake. Used for insomnia, as very high doses needed for antidepressant effects...
545
Side effects of Trazodone
Sedation, nausea, Priapism!, postural hypotension.
