Gen Pharm - drugs Flashcards by Joanna Neel

Q

Acetazolamide (Diamox)

A

Carbonic Anhydrase Inhibitor (Diuretic) –po, inhibits CA enzyme, alkalinization of urine (increased HCO3- in urine), diuretic effect only lasts a few to several days, tx for alkalosis
-decrease in H+ for exchange w/Na+ results in Na+ loss (stops Na+ reabsorption)
-sulfa sensitivity!

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Q

Brinzolamide (Azopt)

A

topical Carbonic anhydrase inhibitor - glaucoma drop, decreases aqueous humor production and CSF
-orange cap

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Q

Dorzolamide (Trusopt)

A

topical Carbonic anhydrase inhibitor - glaucoma drop, decreases aqueous humor production and CSF
-orange cap

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Q

Methazolamide (Neptazane)

A

Carbonic anhydrase inhibitor - po, tx glaucoma, decreases aqueous humor production and CSF

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Q

Furosemide (Lasix)

A

Loop Diuretic - blocks the Na+/K+/2Cl- transporter in the thick ascending limb of the loop of Henle, induces kidney prostaglandins (vasodilation) can be used to tx HTN
-causes loss of Ca2+ and Mg2+, also Cl- and K+
-tx for heart failure (edema), and pulmonary edema, tx hypercalcemia
-can cause hypokalemic metabolic alkalosis, hyperuricemia, irreversible ototoxicity, NSAID interference

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Q

Ethacrynic acid (Edecrin)

A

Loop Diuretic
-used only when patient has sulfa allergy and can’t be given furosemide
-more likely to have irreversible ototoxicity side effect with aminoglycosides

-blocks the Na+/K+/2Cl- transporter in the thick ascending limb of the loop of Henle, induces kidney prostaglandins (vasodilation), causes a loss of Ca2+ and Mg2+, also Cl- and K+
-tx for heart failure (edema), and pulmonary edema, tx hypercalcemia
-can cause hypokalemic metabolic alkalosis, hyperuricemia, NSAID interference

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Q

Hydrochlorothiazide (Esidrix)

A

Thiazide, most used diuretic, also a common DOC for HTN (C/I for DM pt!)
-inhibits Na+ reabsorption at distal tubule -causes decrease of Na+, CO, decrease in blood volume and so decrease in BP
-increase in ATP-dependent K+ channel opening, causes hyperpolarization (vasodilation in smooth muscle) and also decreases insulin

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Q

Chlorothiazide (Diuril)

A

Thiazide diuretic, also a common DOC for HTN (C/I for DM pt!)
-inhibits Na+ reabsorption at distal tubule -causes decrease of Na+, CO, decrease in blood volume and so decrease in BP
-increase in ATP-dependent K+ channel opening, causes hyperpolarization (vasodilation in smooth muscle) and also decreases insulin

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Q

C/I for thiazides

A

causes dry eye, hyperglycemia (C/I for DM pts), hyperlipidemia, lithium toxicity, digitalis toxicity, hepatic coma in cirrhotic pts, hypokalemic metabolic alkalosis, hyperuricemia! (tell pts to stop thiazide before having a surgical procedure)

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Q

Diuretic drug that can be used for patients with a sulfa allergy

A

Ethacrynic acid (Edecrin)

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Q

Amiloride (Midamor)

A

Potassium-sparing Diuretic
-reduces the K+ loss caused by the other diuretics, used in combination as they are weak on their own
-inhibit Na+/K+ exchange independently of aldosterone
C/I for burn patients (already hyperkalemic!)

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Q

Triamterene (Dyrenium)

A

Potassium-sparing Diuretic
-reduces the K+ loss caused by the other diuretics, used in combination as they are weak on their own
-inhibit Na+/K+ exchange independently of aldosterone
C/I for burn patients (already hyperkalemic!)

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Q

Spironolactone (Aldactone)

A

Potassium-sparing Diuretic - competitive inhibitor of aldosterone (anti-androgen)
-tx edema w/HF, hyperaldosteronism, hirsutism, PMS
-SE: occasional hyperkalemia w/ACEI and ARBs
-C/I: liver damage, renal insufficiency

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Q

Mannitol (Osmitrol)

A

Osmotic Diuretic
IV only, keeps water in tubules, large amount of water diuresis, keeps water flowing and protects kidney, can be used as prophylaxis of acute renal failure
-decreases IOP and ICP quickly
-SE: cellular dehydration, edema
-C/I: DON’T USE WITH HF pts!

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Q

What is the order of effectiveness for diuretic drugs?

A

Loops&raquo_space; thiazides&raquo_space;> K+ sparing drugs

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Q

Sodium nitroprusside (Nitropress)

A

Antihypertensive - acts through nitric oxide to cause vasodilation
IV only, rapid (minutes), decreases BP for HTN emergencies
-SE: cyanide accumulation

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Q

Hydralazine

A

Antihypertensive - acts through nitric oxide to cause vasodilation - used during pregnancy for long-term tx of severe HTN in combo with other BP-lowering meds and as a last resort
-SE: Lupus!

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Q

Minoxidil (Loniten)

A

Antihypertensive - acts through opening potassium channels (hyperpolarizes membrane) to cause vasodilation
SE: Hypertrichosis

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Q

Nifedipine (Procardia)

A

Calcium Channel Blocker - Dihydropiridine type
-strong vasodilator, more vascular effects, increases HR

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Q

Amlodipine (Norvasc)

A

Calcium Channel Blocker - Dihydropiridine type

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Q

Felodipine (Plendil)

A

Calcium Channel Blocker - Dihydropiridine type

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Q

Verapamil (Calan)

A

Calcium Channel Blocker - strong cardiac effect, decreases HR

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Q

Diltiazem (Cardizem)

A

Calcium Channel Blocker - effects in between Verapamil and Dihydropiridines

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Q

Captopril (Capoten)

A

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts

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Enalapril (Vasotec)

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system -good choice of anti-HTN med for DM pts

Quinapril (Accupril)

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system -good choice of anti-HTN med for DM pts

Lisinopril (Zestril)

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system -good choice of anti-HTN med for DM pts

Benazepril (Lotensin)

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system -good choice of anti-HTN med for DM pts

Losartan (Cozaar)

Angiotensin receptor blocker - anti HTN blocks AT1 receptor but not AT2 (difference from ACEIs)

Valsartan (Diovan)

Angiotensin receptor blocker - anti HTN blocks AT1 receptor but not AT2 (difference from ACEIs)

Clonidine (Catapres)

Alpha 2 agonist, sympatholytic, anti-HTN

Methyldopa (Aldomet)

Alpha 2 agonist, sympatholytic, anti-HTN -used in pregnancy

Prazosin (Minipress)

Alpha 1 adrenergic blocker, anti-HTN also good for tx BPH

Doxazosin (Cardura)

Alpha 1 adrenergic blocker, anti-HTN

Terazosin (Hytrin)

Alpha 1 adrenergic blocker, anti-HTN

Propranolol (Inderal)

nonspecific Beta-blocker, anti-HTN -reduces sympathetic vasomotor tone but doesn't cause vasodilation unless with NO -SE: bronchoconstriction, decreased insulin release, increase of lipids and atherogenesis, masks hypoglycemia -C/I: asthmatics, DM, hypercholesterolemia, heart block end stage HF

Carvedilol (Coreg)

Combined alpha and beta blocker to tx HTN

Labetalol (Trandate)

Combined alpha and beta blocker to tx HTN, used in pregnancy, HTN emergencies -SE: hepatotoxicity

Metoprolol (Lopressor)

Cardio specific or B1 blocker for treating HTN

Nebivolol (Bystolic)

Cardio specific or B1 blocker for treating HTN, has NO (vasodilation)

Atenolol (Tenormin)

Cardio specific or B1 blocker for treating HTN

Nitroglycerin

DOC for tx acute anginal attack

Isosorbide dinitrate (Isordil)

tx angina, decreases oxygen demand SE: headaches, tolerance

Sildenafil (Viagra)

phosphodiesterase type 5 (PDE5) inhibitor tx - ED, pulmonary HTN C/I: Nitrates CYP3A4 interactions

Vardenafil (Levitra)

phosphodiesterase type 5 (PDE5) inhibitor - faster onset than sildenafil

Tadalafil (Cialis)

phosphodiesterase type 5 (PDE5) inhibitor - longer duration

Lovastatin (Mevacor)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Atorvastatin (Lipitor)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Rosuvastatin (Crestor)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Pravastatin (Pravachol)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Simvastatin (Zocor)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Fluvastatin (Lescol)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Cholestyramine (Questran)

bile acid binding resins, very safe but can inhibit other drug absorption

Niacin (Nicotinic acid, Vitamin B3)

impairs synthesis of lipoproteins, effective at increasing HDL and treating hypercholesterolemia

Gemfibrozil (Lopid)

fibric acid derivative - increases catabolism of VLDL, effective at treating hypertriglyceridemia

Fenofibrate (Tricor)

fibric acid derivative - increases catabolism of VLDL, effective at treating hypertriglyceridemia

Warfarin (Coumadin)

clotting factor synthesis inhibitor - anticoagulant, prevention of emboli development -INR(2-3)

Heparin sodium (Liquaemin)

immediate onset anticoagulant, high-molecular weight heparin PTT 2-2.5

Enoxaparin (Lovenox)

low molecular weight heparin, anticoagulant

Dabigatran (Pradaxa)

direct thrombin inhibitor, anticoagulant -antidote: Idarucizumab (Praxbind)

Rivaroxaban (Xarelto)

direct inhibitor of factor Xa, anticoagulant

Apixaban (Eliquis)

direct inhibitor of factor Xa, anticoagulant

Protamine sulfate

binds and inhibits heparin

Idarucizumab (Praxbind)

antidote to Dabigatran (a direct inhibitor of thrombin)

Factor Xa (Andexxa)

needed for clot formation - antidote to factor Xa inhibitors: rivaroxaban (Xarelto) and apixaban (Eliquis)

Alteplase / t-PA (Activase)

fibrinolytic - converts plasminogen to plasmin to lyse clots

Aminocaproic acid (Amicar)

inhibits tPA, treatment for bleeding disorders (pro-clotting) can be used for hemophilia

Aspirin

inhibitors of prostaglandin production, antiplatelet agent -secondary prevention of CV events

Clopidogrel (Plavix)

inhibitor of ADP-induced platelet aggregation, irreversible, used for pts with aspiring allergy -interacts w/omeprazole -DOC after coronary stent sx

Ticlopidine (Ticlid)

inhibitor of ADP-induced platelet aggregation, irreversible, used for pts with aspiring allergy -interacts w/omeprazole -DOC after coronary stent sx

Abciximab (ReoPro)

decreases platelet aggregation by inhibiting GPIIb/IIa receptor

Dipyridamole

coronary vasodilator, combine with aspirin

Esmolol (Brevibloc)

Beta 1 selective blocker drug, short acting, IV

Betaxolol (Betoptic)

beta 1 selective blocker, can be used topically in eye to tx glaucoma

Carteolol (Cartol)

partial agonist, beta-blocker, can be used in eye said to have intrinsic sympathetic activity

Tamsulosin (Flomax)

Alpha 1 adrenergic blocker, little effect on BP but used to tx BPH

Phentolamine (Regitine)

alpha-receptor blocker can be used to prevent necrosis after accidental NE injection

Phenoxybenzamine (Dibenzyline)

alpha-receptor blocker, irreversible, very long acting

Leuprolide (Lupron)

GnRH agonist, suppresses LH/FSH release (long term), DOC for endometriosis, IVF, precocious puberty, etc.

Goserelin (Zoladex)

GnRH Agonist

Estradiol (Estraderm)

estrogen given in cream/patches

Ethinyl estradiol

estrogen used in oral contraceptives (not available individually)

Premarin

conjugated estrogens, used for HRT

Tamoxifen (Novaldex)

Antiestrogen - SERM (selective estrogen receptor modulator) tx. pre-menopausal breast cancer, AE: can cause crystalline retinopathy

Raloxifene (Evista)

Antiestrogen, SERM, tx: osteoporosis

Clomiphene (Clomid)

Antiestrogen, SERM, used for fertility but can cause multiple pregnancies

Anastrozole (Arimidex)

aromatase inhibitors (stops conversion to estrogen) tx: postmenopausal breast cancer

Progesterone (generic)

Progestins - used in contraceptives

Medroxyprogesterone (Provera)

progestin

Levonorgestrel (Plan B)

progestin

Mifepristone (RU 486, Mifeprex)

anti-progestin, taken to terminate a pregnancy

Danazol (Danocrine)

anti-progestin, can treat endometriosis but not DOC

Drospirenone/ethinyl estradiol (Yasmin, Yaz)

combination oral contraceptive, the only one approved to treat PMDD

Testosterone (generic, Testoderm transdermal)

Androgen

Flutamide (Eulexin)

Anti-androgen (androgen receptor antagonist) tx: prostate cancer w/GnRH agonist

Finasteride (Propecia)

5a-reductase inhibitor (stops conversion to DHT) tx: BPH and male pattern baldness

Insulin lispro (Humalog)

Rapid-acting insulin - IV

Insulin, inhaled (Afrezza)

Rapid-acting insulin

Regular insulin (Novolin R, Humulin R)

Short-acting insulin, IV

NPH Insulin (Humulin N, Novolin N, isophane)

Intermediate-acting insulins

Insulin glargine (Lantus)

Long-acting insulins

Insulin detemir (Levemir)

Long-acting insulins

Metformin

a biguanide, oral, DOC, only used in type 2 DM, decreases glucose levels (euglycemia), does not increase weight, decreases risk of CV events C/I: renal failure AE: lactic acidosis, diarrhea

Exenatide (Byetta)

glucagon-like peptide-1 receptor agonist (GLP-1 RA), incretin mechanism, stimulates pancreas beta cells, causes weight loss AE/caution w/pancreatitis injected

Sitagliptin (Januvia)

dipeptidyl-peptidase-IV (DPP-4) inhibitor, inhibits DPP-4 so glucose gets to beta cells better, no effect on weight

Canagliflozin (Invokana)

SGLT-2 inhibitor, oral, weight loss, decrease risk of CV events AE: UTIs C/I: renal impairment

Pioglitazone (Actos)

thiazolidinedione derivative, increases insulin sensitivity AE: edema, increased heart failure risk, macular edema

Acarbose (Precose) Miglitol (Glyset)

alpha-glucosidase inhibitors, delays carb absorption, causes gas and GI issues, no effect on weight

Glyburide, Glipizide, Glimepiride, Tolbutamide, Chlorpropamide

Sulfonylureas, stimulate insulin release from pancreas beta cells. AE: weight gain, hypoglycemia C/I: sulfa allergy

Repaglinide

meglitinides - bind K+ channels, increases insulin release

Pramlintide (Symlin)

amylin-like peptide (synthetic analogue), only used as an insulin adjunct, can be used in Type 1 DM, injected, causes weight loss

Glucagon injection

hyperglycemic agent to treat hypoglycemia in patients with sufficient glycogen stores, increases glucose levels. produced by alpha cells (pancreas)