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Flashcards in MASTERTEST1 Deck (136):
1

Drug Name

Drug Class
Mechanism
Distinguishing Chem Characteristics (Unique or "weird" features)
Pharmacological characteristics
Side Effects
Special side effects
Use
[mnemonic] (put in brackets)

2

Bethanechol

-Muscarinic Cholinergic agonist
-
-CH3(down nicotinic) and NH2 (down AChE)
-oral or subQ
-
-treat depressed smooth muscle activity (ileus, megacolon)

3

carbachol

-muscarinic cholinergic agonist
-Stim M3 receptor on ciliary body & iris improving uveoscleral outflow
-NH2 grp. Poor substrate for AChE
-oral or subQ
-
-miotic. open or closed angle glaucoma.

4

methacholine

-muscarinic cholinergic agonist
-
-CH3 decreases nicotinic affinity
-oral or subQ
-
-often used to suppress tachycardia

5

muscarine

-muscarinic cholinergic agonist
-
-alkaloid
-oral or subQ
-
-

6

pilocarpine

-Muscarinic Cholinergic agonist
-Stim M3 receptor on ciliary body & iris improving uveoscleral outflow
-alkaloid
-topical use for eye
-sweat glands particularly sensitive
-acute closed or open angle glaucoma, increase salivary secretion
[tears, saliva on your "pillow"]

7

varenicline

-Nicotinic cholinergic agonist
-
-alkaloid
-
-
-

8

ambenonium

-cometitive inhibitor of cholinesterase
-carbamoylates AChE at esteratic site
-carbamate
-4-8 DOA
-
-myasthenia gravis, neuromuscular bloackade

9

edrophonium

-competitive cholinesterase inhibitor
-antagonize competitive inhibitor of NMJ
-alcohol w/ quaternary ammonium group
-short DOA
-
-myasthenia gravis, ileus, arrhythmias

10

neostigmine

-competitive cholinesterase inhibitor
-carbamoylates AChE at esteratic site, antagonize NMJ comp. inhibitors
-carbamate
-med DOA
-
-myasthenia gravis, neuromuscular blockade, ileus

11

physostigmine

-competitive cholinesterast inhibitor
-carbamoylates AChE at esteratic site
-carbamate
-med DOA
-
-glaucoma

12

diisopropylfluorophosphate

-noncompetitive cholinesterase inhibitor
-irreversible phosphoryl AChE at esteratic site
-
-
-
-insecticide

13

echothiophate

-Organophosphate Derivative
-Non - Competitive AChE inhibitor
-
-
-
-
- Used to treat glucoma

14

carbaryl

-noncompetitive cholinesterase inhibitor
-phoshphoryl group in AChE esteratic site
-
-
-
-insecticide

15

malathion

-noncompetitive cholinesterase inhibitor
-phoshphoryl group in AChE esteratic site
-
-
-
-insecticide

16

parathion

-noncompetitive cholinesterase inhibitor
-phoshphoryl group in AChE esteratic site
-
-
-
-insecticide

17

tetraethylpyrophosphate

-noncompetitive cholinesterase inhibitor
-phoshphoryl group in AChE esteratic site
-
-
-
-insecticide

18

sarin

-noncompetitive cholinesterase inhibitor
-
-
-
-nerve gas

19

soman

-noncompetitive cholinesterase inhibitor
-
-
-
-nerve gas

20

pralidoxime

-AChE reactivator
-release phosphoryl moeity in AChE esteratic site
-2-PAM
-Must B4 AChE aging occurs
-
-supplement atropine in O-P intoxication

21

atropine

-muscarinic cholinergic antagonist
-antagonize O-P by competitively bind muscarinics, block M3 on iris & ciliary muscle
-tertiary amine
-doses limited due to crosss BBB, long DOA, (salivary,bronch,sweat+++), bound by melanin in iris
-no alleviation of neuromusc hyperactivity, CNS effects!
-May elicit acute glaucoma
-O-P intoxication,block paraSNA, mydriasis/cycloplegia (7-10 days)

22

homatropine

-muscarinic cholinergic antagonist
-block M3 on iris & ciliary muscle
-tertiary amine
-med DOA
-
-mydriasis/cycloplegia (1-3 days) EYE EXAM!

23

scopolamine

-Muscarinic Cholinergic antagonist
-block M3 on iris & ciliary muscle
-tertiary amine
-long DOA, quick CNS, (injection, oral, transdermal only)
-sedation/amnesisa, dry mouth
-anti-motion sickness, adjunct for pre-amnesia, mydriasis/cycloplegia (3-7 days)

24

methscopolamine

-Muscarinic Cholinergic antagonist
-
-quaternary ammonium
-longer DOA
-
-GI diseases, can inhibit respiratory tract secretions

25

trihexyphenidyl

-muscarinic cholinergic antagonist
-
-tertiary amine
-3-6hrs DOA
-
-anti-parkinson, excess salivation

26

tropicamide

-Muscarinic Cholinergic antagonist
-Block M3 on iris & ciliary muscle
-
-short DOA, only topically
-
-mydriasis and cycloplegia (1/4 day)

27

cyclopentolate

-muscarinic cholinergic antagonist
-block M3's on iris & ciliary muscle
-
-med DOA
-
-
-Elicit mydriasis & cycloplegia (1 day)

28

ipratropium

-Muscarinic Cholinergic antagonist
-
-quaternary ammonium
-shorter DOA, topical inhalant
-tachycardia, decreased salivation
-bronchodilation and min. mucociliary clearance problems

29

tiotropium

-Muscarinic Cholinergic antagonist
-
-
-longer DOA, topical
-
-bronchodilation and min. mucociliary clearance problems

30

darifenacin

- M3 selective cholinergic antagonist
-
-
-longer DOA
-
-

31

solifenacin

-M3 selective cholinergic antagonist
-
-
-longer DOA
-
-

32

tolterodine

-M3 selective cholinergic antagonist
-
-
- longer DOA
-
-

33

mecamylamine

-N1 non-depolarizing cholinergic competitive antagonist
-ganglionic blocker
-secondary amine (improve GI absorb)
-Med DOA 12 hours
-CNS-tremor, confusion, seizure, mania, depression
-hypertensive emergency,periph vasc disease

34

trimethaphan

-N1 non-depolarizing Cholinergic competitive antagonist
-ganglionic blocker
-sulfonium+
-shrot DOA, intravenous
-hypotension, brain anoxia
-surgically to reduce bleeding=controlled hypotension

35

succinylcholine

-N2 non-competitive depolarizing inhibitor
-agonist for Na channel and keeps it open
-
-hydrolysis from plasma ChE nor AChE!, short DOA
-K-->cardiac arrest, contraction of eye muscles
-relax muscles during surgery/vent

36

curare

-N2 competitive inhibitor
-
-quaternary nitrogens
-
-
-

37

atracurium

-benzylisoquinolines
-Competitive Nicotinic N2 blocker (N2 Specific)
-Non-depolarizing – Prevent Depolarization
-Intermediate in duration
-Histamine Release (hypotension) is side effect
-
-Muscle relaxation (e.g. before surgery)

38

cisatracurium

-benzylisoquinolines
-N2 competitive inhibitor
-Competitive Nicotinic N2 blocker (N2 Specific)
-quaternary nitrogens
-medium DOA
-histamine release
-

39

mivacurium

-benzylisoquinolines
-N2 competitive inhibitor
-Competitive Nicotinic N2 blocker (N2 Specific)
-
-short DOA
-histamine release
-

40

pancuronium

- Ammonio Steroids
- Competitive Nicotinic N2 blocker
-
-
-long DOA
-muscarinic block-vagal blockade, tachycardia
-

41

vecuronium

-N2 competitive inhibitor
-Competitive Nicotinic N2 blocker
-quaternary nitrogens
-med DOA
-muscarinic block-vagal blockade, tachycardia
-

42

albuterol

-Beta-2 agonist
-stim adenyl cyclase and cAMP-->relax bronch smooth m.
-
-short DOA
-tachycardia, muscle tremor, headache
-bronchodilate acute asthma

43

salmeterol

-Beta-2 agonist
-stim adenyl cyclase and cAMP-->relax bronch smooth m
-
-long DOA
-tachycardia, muscle tremor, headache
-bronchodilate

44

salmeterol with fluticasone

-Beta-2 agonist with corticosteroid
-stim adenyl cyclase and cAMP-->relax bronch smooth m
-
-combination necessary in maintenance therapy
-
-maintenance bronchodilation

45

beclomethasone

-corticosteroid
-inhibit inflam. response system thru gene expression
-
-topical inhalation
-generally none
-long term asthma reduction

46

budesonide

-corticosteroid
-inhibit inflam. response system thru gene expression
-
-topical inhalation
-generally none
-long term asthma reduction

47

fluticasone

-corticosteroid
-inhibit inflam. response system thru gene expression
-
-topical inhalation
-generally none
-long term asthma reduction

48

prednisone

-corticosteroid
-inhibit inflam. response system thru gene expression
-
-oral or intravenous
- glucose metab.,Cushing's, hypert, increased infection
-asthma

49

triamcinolone

-corticosteroid
-inhibit inflam. response system thru gene expression
-
-topical inhalation
-generally none
-long term asthma reduction

50

montelukast

-leukotriene modulator
-receptor antagonist of LTD4
-
-oral
-
-long-term controller of asthma

51

zafirlukast

-leukotriene modulator
-receptor antagonist of LTD4
-
-oral
-
- long term controller of asthma

52

zileuton

-leukotriene modulator
-inhibitor of 5-lipoxygenase inhibiting synthesis of LTB/D4
-
-oral
-liver toxicity, and inhibits some CYPs
-long term controller of asthma

53

cromolyn

-degranulation inhibitor
- possible inhibit of Ca channels in Mast cell degranulation
-poorly soluble salt
-Topical
-well tolerated
-long term prophylactic maintenance of asthma

54

nedocromil

-degranulation inhibitor
- possible inhibit of Ca channels in Mast cell degranulation
-poorly soluble salt
-Topical
-well tolerated
-long term prophylactic maintenance of asthma

55

ipratropium

-muscarinic cholinergic antagonist
-
-quaternary ammonium
-shorter DOA, topical inhalant
-tachycardia, decreased salivation
-bronchodilation and min. mucociliary clearance problems

56

theophylline

-Misc. Bronchodilator
-inhibit phosphodiesterase degradation of cAMP
-methylxanthine
-oral, LongDOA
-tachycardia and CNS stimulation
-long-term maintenance of asthma

57

Drug Name

Drug Class
Mechanism
Distinguishing Chem Characteristics (Unique or "weird" features)
Pharmacological characteristics
Side Effects
Special side effects
Use
[mnemonic] (put in brackets)

58

metaraminol

Alpha-1 Selective Agonist
-
-
- Long acting beta 1 and alpha 1 stimulant, Displaces NE
-
-
-

59

methoxamine

Alpha-1 Selective Agonist (less alpha 2)
-
-
-
-
-
- treat hypotensive crisis

60

phenylephrine

Alpha-1 Selective Agonist (less alpha 2)
-
- Long acting
-
-
-
- Vasoconstriction, prevent shock, nasal decongestant, treat hypotensive crisis, reduce drug diffusion, reduce mucus membrane congestion, mydriasis

61

alpha-methyldopa

*α2 selective agonist/false transmitter
*MNE (α-methyl NE) causes potent stimulation in vasomotor area of brainstem
*converted to MNE by NE synthetic pathway (partially replaces DOPA); MNE replaces NE in vesicles but greatly reduced efficacy than NE
*
*sedation, xerostomia, anorexia, fluid retention, vivid dreams, & CNS stimulation (all diminish over time)
*dizziness, sleep disturbances, impotence, dry mouth, nasal congestion (diminish after 2 weeks), postural hypotension; chronic therapy may result in hemolytic anemia, leukopenia, hepatitis, lupus-like problems
*hypertension

62

clonidine

*α2 selective agonist
*stimulate both PNS & CNS α2 receptors - inhibit NE release by nerve terminal (elicit hypotension by decr. TPR, HR, CO)
*
*
*sedation, xerostomia, anorexia, fluid retention, vivid dreams, & CNS stimulation (all diminish over time)
*
*hypertension

63

apraclonidine

*α2 selective agonist
*stimulate both PNS & CNS α2 receptors - inhibit NE release by nerve terminal (elicit hypotension by decr. TPR, HR, CO).
*
*
*sedation, xerostomia, anorexia, fluid retention, vivid dreams, & CNS stimulation (all diminish over time)
*
*hypertension, EXTREME open angle glaucoma

64

guanabenz

*α2 selective agonist
*stimulate both PNS & CNS α2 receptors - inhibit NE release by nerve terminal (elicit hypotension by decr. TPR, HR, CO)
*
*
*sedation, xerostomia, anorexia, fluid retention, vivid dreams, & CNS stimulation (all diminish over time)
*
*hypertension

65

amphetamine

Alpha and beta adrenergic agonist
-
- Releasing agent (increases NE release), also releases intraneuronal NE – reverse transport
-
-
-
-

66

ephedrine

Alpha and beta adrenergic agonist
-
-
- Releasing agent, Stimulant of most adrenergic receptors, Long acting – Displaces NE
-
-
- Increase CO and arterial pressure, treat orthostatic hypotension, reduce mucus membrane congestion, stress incontinence

67

epinephrine

Alpha and beta adrenergic agonist
-
-
- Binds all adrenergic receptors equally
-
-
- Potent vasoconstrictor and cardiac stimulant, hemostasis during surgery, reduce drug diffusion, anaphylaxis

68

norepinephrine

-Alpha and beta adrenergic agonist (except beta 2)
-
-
- Binds Beta-2 a lot less than all other adrenergics
-
-
- IV infusion for shock, increase CO and cause vasoconstriction (increase BP, treat hypotensive crisis), reduce drug diffusion

69

dipivefrin

*Mixed alpha, beta agonist
*stim alpha 2 on ciliary body, alpha 1 on ciliary vessels
*Prodrug metabolized to Epi.
*
*
*
*Open angle glaucoma

70

dobutamine

Beta 1 Selective agonist
-
-
-(Less binding to beta-2)
-
-
- Cardiogenic shock, heart failure

71

isoproterenol

Beta 1 and 2 agonist
-
-
-
-
-
- Used for relaxation of bronchial smooth muscle, also cardiac stimulation (potent vasodilator)

72

albuterol

Beta 2 Selective agonist
-
-
-(Less binding to beta-1)
-
-
- Bronchial asthma

73

metaproterenol

Beta 2 Selective agonist
-
-
-(Less binding to beta-1)
-
-
- Bronchial asthma

74

terbutaline

Beta 2 Selective agonist
-
-
-(Less binding to beta-1)
-
-
- Bronchial asthma, relax pregnant uterus

75

bromocriptine

Dopamine Agonist
-
-
-
- postural hypotension and cardiac arrhythmia
-
- Anti-parkinson agent (for its CNS effects)

76

dopamine

Dopamine Agonist
-
-
- Binds Alpha and Beta 1 at high concentrations, Enhance NE release (displaces it)
-
-
- IV for shock, vasoconstriction, increase CO and dilate renal arteries

77

fenoldopam

Dopamine Agonist, DA-1 selective
-
-
-
-
-
- Vasodilation of renal and mesenteric vessels

78

doxazosin

Alpha-1 Selective antagonist
-
-
-
-
-
- Urinary obstruction from BPH

79

prazosin

Alpha-1 Selective antagonist (Highly selective)
-
-
- Oral admin
-
- Little to no tachycardia because doesn’t bind beta receptors
- Antihypertensive (mild / moderate), urinary obstruction from BPH

80

tamsulosin

Alpha-1 Selective antagonist
-
-
-
-
-
- Urinary obstruction from BPH

81

terazosin

Alpha-1 Selective antagonist
-
-
-
-
-
- Urinary obstruction from BPH

82

phenozybenzamine

Alpha-1 and Alpha-2 Selective antagonist
- Non-competitive – alkylates alpha receptors (~24 hrs)

-
-
- Can cause postural hypotension and tachycardia – due to decreased MAP
-
- Used to treat hypertension associated with pheochromocytoma

83

phentolamine

Alpha-1 and Alpha-2 Selective antagonist
- Competitive antagonist
-
- Dirty drug, binds histamine and muscarinic receptors
- Increases NE release, will cause tachycardia and increased CO
-
- Diagnostic for pheochromocytoma, also for its assoc. hypertension

84

labetalol

Alpha and beta antagonist
-
- Binds beta receptors better than alpha
-
-
-
-

85

atenolol

*β1 selective antagonist
*inhibit CO; class generally pure antagonist (binds but does not activate receptor)
*β1 >>> β2; t1/2=6-9 hours; diminished ability to cross BBB
*combination with diuretics and other antihypertensive agents
*
*less prone to induce bronchial smooth muscle constriction in asthma patients; fewer CNS effects
*hypertension

86

betaxolol

*β1 selective antagonist
*block B1 receptors on ciliary body to reduce aq. humor production; inhibit CO; class generally pure antagonist
*β1 >>> β2; ; t1/2=14-22 hours
*combination with diuretics and other antihypertensive agents
*
*less prone to induce bronchial smooth muscle constriction in asthma patients
*Open angle glaucoma; hypertension

87

metoprolol

*β1 selective antagonist
*inhibit CO; class generally pure antagonist
*β1 >>> β2; t1/2=3-4 hours
*combination with diuretics and other antihypertensive agents
*
*ataxia, dizziness; less prone to induce bronchial smooth muscle constriction in asthma patients
*hypertension, angina pectoris; prophylaxis for MI recurrence

88

nadolol

*β non-selective antagonist
*inhibit CO & dilation/relaxation
*β1 = β2; t1/2=14-24 hours; diminished ability to cross BBB
*combination with diuretics and other antihypertensive agents
*may inhibit dilation of bronchioles (significant in asthma patients); may induce cardiac failure (significant in cardiac insufficiency patients); fewer CNS side effects
*
*hypertension

89

pindolol

*β non-selective antagonist
*inhibit CO & dilation/relaxation
*β1 = β2; t1/2=3-4 hours
*combination with diuretics and other antihypertensive agents
*may inhibit dilation of bronchioles (significant in asthma patients); may induce cardiac failure (significant in cardiac insufficiency patients)
*
*hypertension

90

propranolol

*β non-selective antagonist
*inhibit CO & dilation/relaxation
*β1 = β2; t1/2=3-6 hours
*
*may inhibit dilation of bronchioles (significant in asthma patients); may induce cardiac failure (significant in cardiac insufficiency patients)
*ataxia, dizziness
*hypertension, arrhythmia, angina pectoris, migraine headache; prophylaxis for MI recurrence

91

timolol

*B non-selective antagonist
*block B1R's on ciliary body to reduce aq. humor production ->lower intraocular pressure;
*t1/2=4-5 hours
*topical for glaucoma
*may inhibit dilation of bronchioles (significant in asthma patients); may induce cardiac failure (significant in cardiac insufficiency patients)
*
*Open angle glaucoma, antihypertensive, angina pectoris; prophylaxis for MI recurrence

92

carteolol

*B non-selective antagonist
*block B1R's on ciliary body to reduce aq. humor production
*
*topical
*
*
*Open angle glaucoma

93

levobunolol

*B non-selective antagonist
*block B1R's on ciliary body to reduce aq. humor production
*
*topical
*
*
*Open angle glaucoma

94

metipranolol

*B non-selective antagonist
*block B1R's on ciliary body to reduce aq. humor production
*
*topical
*
*
*Open angle glaucoma

95

guanethidine

*pre-junctional inhibition of NE release
*stabilizes neuronal membranes, interfering with exocytosis of NE vesicles
*transported into adrenergic neurons via Amine I transport; does not cross BBB
*orally effective
*
* chronic administration->depleting NE within synaptic vesicles; minimal adverse CNS effects; minimal effects with other biogenic amines
*hypertension – reserved for therapy of most severely elevated arterial pressures

96

reserpine

*pre-junctional inhibition of NE release
*depletes stores of biogenic amines (Epi, NE, DA, serotonin) in both CNS & PNS by blocking transport into storage vesicles
*long DOA; very potent
*orally effective
*
*increased GI motility (>ulcers); CNS: sedation, depression, parkinsonian symptoms
*hypertension

97

cocaine

*Amine I transport (NET) inhibitor
*NE levels rise in synapse -> mimic sympathetic nerve stimulation
*
*
*vasoconstriction, tachycardia, mydriasis
*
*hemostasis during surgery

98

DMI (desmethylimipramine)

*Amine I transport (NET) inhibitor
*NE levels rise in synapse -> mimic sympathetic nerve stimulation
*
*
*vasoconstriction, tachycardia, mydriasis
*
*

99

tyramine

Releasing Agent
-
-
- Enhance NE release via Amine 1 transporter
-
-
-

100

pseudoephedrine

Releasing Agent
-
-
-
-
-
- Reduces congestion of mucus membranes

101

Drug Name

Drug Class
Mechanism
Distinguishing Chem Characteristics (Unique or "weird" features)
Pharmacological characteristics
Side Effects
Special side effects
Use
[mnemonic] (put in brackets)

102

Azathioprine

- General Growth Inhibitors
- Metabolized to 6-mercaptopurine then 6 thioguanine (blocks purine synthesis). Also incorporates into DNA
-
- Inactivated by xanthine oxidase
- Myelosuppression, nausea, vomiting
-
- Used for renal and other tissue transplantation, autoimmune disease, and gout

103

Cyclophosphamide

-General Growth Inhibitors
-Cross links DNA, kills all proliferating cells
-
-
- Myelosuppression, nausea, vomiting,
- Infertility
- Used for autoimmune diseases, bone marrow transplant

104

Leflunomide

*General Growth Inhibitors
- Decreases pyrimidine synthesis
-
-
- Diarrhea, modest hepatotoxicity, reduced myelosuppresion
-
- Used for Rheumatoid arthritis, some autoimmune disease

105

Methotrexate

*-General Growth Inhibitors
- Inhibits dihydrofolate reductase, prevents thymidide and purine synthesis
-
-
- Causes nausea, mucosal ulcers, modest hepatotoxicity, reduced myelosuppression
-
- Rheumatoid arthritis, some autoimmune disease

106

Mycophenolate Mofetil

*-General Growth Inhibitors
- prevents purine synthesis
-
-Prodrug of mycophenolic acid, active form
- myelosuppression, nausea, vomiting
-
- Used for solid organ transplant (cyclosporine alternative) autoimmune disease

107

Prednisone

*-Glucocorticoid
-Upregulates / Downregulates expression of genes assoc. with inflammation and immunosuppression (e.g. IL2 and IFN-gamma). Inhibition of annexins genes (thus phospholipase A2). Esp. affects IL-2 & IFNgamma
- No serious bone marrow toxicity
-
-
- Cushings syndrome, osteoporosis, glucose intolerance, hypertension, susceptibility to infection
- Used for solid organ transplantation (first line), stem cell transplantation, autoimmune diseases, asthma, allergic reactions, systemic inflammation

108

Sirolimus

*- mTOR inhibitor
- Binds FKBP12 to form complex that inhibits IL2 activation
-
- Antagonizes tacrolimus, synergistic with cyclosporine
- Myelosuppression, hyperlipidemia, hypertension, edema, hepatotoxicity
-
- Solid organ transplants, steroid resistant graft v. host disease

109

Cyclosporin

*- Calcineurin inhibitor
- Binds Cyclophilin to form complex that inhibits NFAT activation
-
- Often combined with other immunosuppressant agents
- Nephrotoxicity, hypertension, hyperglycemia, liver dysfunction.
- Increased cancer incidence documented
- Kidney, liver and cardiac transplants, inflammatory diseases (asthma) & autoimmune

110

Tacrolimus

*- Calcineurin inhibitor
- Binds FKBP12 to form complex that inhibits NFAT activation
-
- 10-100 X more potent than cyclosporine
- Nephrotoxicity, hypertension, hyperglycemia, liver dysfunction.
- Increased cancer incidence documented
- Kidney, liver and cardiac transplants, inflammatory diseases (asthma)

111

Anti-T cell globulin

*- Antibody / Fusion Protein
- Blocks T cell surface receptors and opsonizes T cells
- Product of repeated injection of human T cells into animals
-
- Cytokine release syndrome (reduce w/ pretreat. With acetaminophen and antihistamine, serum sickness
- Anaphylaxis potential (with repeat use)
- Prevent maternal (Rh-) from attacking fetus

112

Alemtuzumab (anti CD52)

*- Antibody / Fusion Protein
- Depletes cells expressing CD52 (T and B cells, monocytes, macrophages, NK cells)
- Prolonged depletion (1 yr) of T cells and other immunecells
-
- Myelosuppresion, flu like symptoms
-
-

113

Basiliximab (Anti CD25)

*- Antibody / Fusion Protein
- Blocks and opsonizes alpha chain of IL-2 (CD25), found only on activated T cells
- Depletes only antigen activated T cell , reduced incidence of infection and malignancy
- Moderate effect relative to anti-T cell globulin
- Well tolerated
-
-

114

Rh(D) immune globulin

*- Antibody / Fusion Protein
- Binds and clears up D-antigen, prevents mother’s immune rxn
-
-
-
-
- Prevent maternal (Rh-) from attacking fetus

115

Belatacept

*- Antibody / Fusion Protein
- Fusion of IgG and high-affinity B7 ligand, so without this signal acting on CD28 T cells go into anergy when presented with an antigen. (Binds and clears up D-antigen, prevents mother’s immune rxn?)
-
- Comparable to calcineurin inhibitors in preventing transplant rejection
- Anemia, neutropenia, peripheral edema
- Increased risk of infection and malignancy, especially post-transplant lymphoproliferative disorder
- Use for kidney transplant

116

Interleukin-2

*- Cytokines
- Increases proliferation of activated T cells, increases IFN-gamma and cytotoxic killer cell activity
-
-
- Capillary leak syndrome, hypotension, reduced organ perfusion, can be fatal
-
- Used to treat metastatic melanoma, renal cell carcinoma

117

IFN-gamma

*- Cytokines
- Stimulates activity of cytotoxic cells
-
-
-
-
- Severe recurrent infections

118

BCG

*-Adjuvant
- Increases APC activity by binding pattern recognition receptors
- Live attenuated bacillus calmette-guerin
- Can’t use systemically, will cause septic shock
-
-
- Used topically for bladder cancer

119

Drug Name

Drug Class
Mechanism
Distinguishing Chem Characteristics (Unique or "weird" features)
Pharmacological characteristics
Side Effects
Special side effects
Use
[mnemonic] (put in brackets)

120

acetazolamide

*Carbonic anhydrase inhibitor
*reduce HCO3 production to slow aq. humor production
*
*
*diuretic
*
*Open angle glaucoma

121

dichlorphenamide

*Carbonic anhydrase inhibitor
*reduce HCO3 production to slow aq. humor production
*
*
*diuretic
*
*Open angle glaucoma

122

dorzolamide

*Carbonic anhydrase inhibitor
*reduce HCO3 production to slow aq. humor production
*TOPICAL
*
*diuretic
*
*Open angle glaucoma

123

botulinum toxin A

*Miscellaneous
*Paresis of skeletal muscle (relaxation 3-6 wk duration) because presynaptic vesicles can't exocytose
*Injected
*Use EMG to confirm needle placement
*diuretic
*
*extraocular muscles (squint) & blepharospasm of eyelid.

124

Drug Name

Drug Class
Mechanism
Distinguishing Chem Characteristics (Unique or "weird" features)
Pharmacological characteristics
Side Effects
Special side effects
Use
[mnemonic] (put in brackets)

125

cetirizine (Zyrtec®)

- Second-Generation H1 Antihistamine
- Block histamine at H1 receptors
-
- High selectivity for H1 sites and has few anti-cholinergic side effects; Penetrates poorly into CNS, reducing sedative effects
-
-
- allergies
[mnemonic] (put in brackets)

126

cyclizine (Marezine®)

- First-Generation H1 Antihistamine
- Block histamine at H1 receptors
-
-
- Sedation
- Anticholinergic effects (Atropine-like effects toward muscarinic receptors, dry mouth, urinary retention, tachycardia)
- motion sickness
[mnemonic] (put in brackets)

127

dimenhydrinate (Dramamine®)

- First-Generation H1 antihistamine
- Block histamine at H1 receptors
-
-
- Sedation
- Anticholinergic effects (Atropine-like effects toward muscarinic receptors, dry mouth, urinary retention, tachycardia)
- motion sickness
[mnemonic] (put in brackets)

128

diphenhydramine (Benadryl®)

- First-Generation H1 antihistamine
- Block histamine at H1 receptors
-
-
- Sedation
- Anticholinergic effects (Atropine-like effects toward muscarinic receptors, dry mouth, urinary retention, tachycardia); Local anesthesia: Block sodium channels
- motion sickness
[mnemonic] (put in brackets)

129

fexofenadine (Allegra®)

- Second-Generation H1 Antihistamine
- Block histamine at H1 receptors
-
- High selectivity for H1 sites and has few anti-cholinergic side effects; Penetrates poorly into CNS, reducing sedative effects
-
-
- Allergies
[mnemonic] (put in brackets)

130

loratadine (Claritin®)

- Second-Generation H1 Antihistamine
- Block histamine at H1 receptors
-
- High selectivity for H1 sites and has few anti-cholinergic side effects; Penetrates poorly into CNS, reducing sedative effects
-
-
- Allergies
[mnemonic] (put in brackets)

131

promethazine (Phenergan®)

- First-Generation H1 Antihistamine
- Block histamine at H1 receptors
-
-
- Sedation
- Anticholinergic effects (Atropine-like effects toward muscarinic receptors, dry mouth, urinary retention, tachycardia); Local anesthesia: Block sodium channels
- antiemetic
[mnemonic] (put in brackets)

132

adalimumab (Humira®)

- anti-TNFalpha agent
- Binds to TNFalpha, prevents it from binding to its receptor and reduces circulating levels
- Human antibody to TNFalpha
- Parenteral administration required
- increased frequency of infections (upper
respiratory, urinary)
-
-Rheumatoid arthritis, Crohn's
[mnemonic] (put in brackets)

133

etanercept (Enbrel®)

- anti-TNFalpha agent
- Binds to TNFalpha, prevents it from binding to its receptor and reduces circulating levels
- Fusion protein containing the ligand binding domain of the
TNFalpha receptor and the Fc domain of human IgG.
- Parenteral administration required
- increased frequency of infections (upper
respiratory, urinary)
-
-Rheumatoid arthritis, Crohn's
[mnemonic] (put in brackets)

134

infliximab (Remicade®)

- anti-TNFalpha agent
- Binds to TNFalpha, prevents it from binding to its receptor and reduces circulating levels
- Humanized antibody to TNFalpha
- Parenteral administration required
- increased frequency of infections (upper
respiratory, urinary)
-
-Rheumatoid arthritis, Crohn's
[mnemonic] (put in brackets)

135

anakinra (Kineret®)

- Anti-IL1 agent
- Competitive IL-1 receptor antagonist (IL-1Ra analog)
-
- Short half-life, daily injection required
Increased susceptibility to infection
-
- Rheumatoid Arthritis, possibly other inflammatory diseases
[mnemonic] (put in brackets)

136

tofacitinib (Xeljanz®)

- Jak kinase inhibitor
- Inhibits all activity of cytokines required for adaptive immunity (eg., IL-2, IL-4, etc.) and inhibits all activities for many inflammatory cytokines (eg., IL-6)
Distinguishing Chem Characteristics (Unique or "weird" features)
- oral administration; therapeutic doses chosen to produce incomplete Jak inhibition, because higher doses expected to produce potent
immunosuppression AND adverse effects.
- Anemia, neutropenia, general myelosuppression, increased risk of infection (especially Herpes Zoster)
-
- RA: Currently second line therapy for those failing methotrexate
[mnemonic] (put in brackets)