MOA pharm Flashcards Preview

USLME Kiss my ass and pray > MOA pharm > Flashcards

Flashcards in MOA pharm Deck (472):
1

Digoxin

direct inhibition of Na/K ATPase
-> indirect inhibition of Na/Ca exchanger/ antiporter
-> increased Ca and contractility

2

Sucrafate

Binds to ulcer base providing PHYSICAL barrier, allowing HCO3 secretion to reestablish

- Bismuth also in this class

3

Misoprostol

PGE1 analog,
increases production of gastric mucous barrier and decreases acid production

Also used in : cervical ripening/labor inducing, maintaining PDA

4

Alteplase

tPA
directly aid in conversion of plasminogen to plasmin
->plasmin cleaves thrombin and fibrin clots

Also: reteplase and tenecteplase

5

Chloroquine

1st line antimalarial unless resistant

6

Methfloquine

2nd line antimalaria

7

Primaquine

Added to antimalrial treatment if Vivax or Ovale is suspected

Tx - hypnozoite

8

Atovaquone

Antimalarial for those allergic to chloroquine, often given w/ primaquine

Also for babesia

9

Clavulanic Acid/Clavulanate

beta lactamase inhibitor
given w/ amoxicillin or ticacillin

10

Sulbactam

beta lactamase inhibitor
given w/ ampicillin

11

Tazobactum

beta lactamse inhibitor
given w/ piperacillin

12

Lidocaine

blocks preferentially active voltage gated Na channels on the inner side of the channel -> local anesthetic

Amide

penetrated membrane uncharged then binds in charged form - problem w/ infected acidic tissue

may be given w/ vasoconstrictor to potentiate action

13

Mepivacaine

Amide
Na channel blocker -> local anesthetic
~lidocaine

14

bupivacaine

Amide
Na channel Blocker -> local anesthetic

15

Procaine

Ester
Na Channel Blocker -> local anesthetic

16

Tetracaine

Ester
Na Channel Blocker ->local anesthetic

17

Cimetidine

Reversible H2 blocker -> lower H secretion from parietal cell

Peptic Ulcer, Gastritis, mild refflux

Also: -'dines
Ranitidine
Famotidine
Nizatidine

18

D penicillamine

Chelates copper - wilson's disease

19

Terazosin

alpha 1 antagonist

- for BPH and HTN

20

Tamsulosin

selective alpha 1 antagonist

- BPH alone
vs. Terazosin - nonselective

21

Vinblastine

alkaloid that binds to tubulin in M phase

Blocks polymerization of microtubules so mitotic spindles cannot form

22

Vincristine

alkaloid that bind to tubulin in M phase,

Blocks polymerization of microtubules so mitotic spindle cannot form

23

Paclitaxel

hyper stabilizes polymerized microtubules so mitotic spindle cannot break down

24

5 fluororuacil

Pyrimidine analog that complexes w/ folic acid

Inhibits thymidate synthase -> less dTMP ad less DNA

SE: myelosuppression and photosynth

25

Methotrexate

Folic acid analog

Inhibits dihydrofolate reductase -> less dTMP -> less DNA and protein synth

SE: myelosuppression, macrovescular FA liver disease, teratogenic

26

Azathioprine

Purine analog ->less de novo purine Synth

Activated HGPRT

toxicity w/ allopurinol due to metabolization w/ xanthine oxidase

27

6 mercaptopurine

Purine analog -> less de novo purine Synth

Activated by HGPRT

toxicity w/ Allopurinol due to metabolization w/ xanthine oxidase

28

6 thioguanine

Purine analog -> less de novo Purine synth

Activated by HGPRT

toxicity w/ Allopurinol due to metabolization w/ xanthine oxidase

29

Cytarabine

Pyrimidine analog

inhibits DNA polymerase

SE: Thrombocytopenia, megaloblastic anemia

30

Sumatriptan

5 HT 1D/1B agonists inducing vasoconstriction

used in migraine w or w/out aura

31

Odansetron

5HT 3 block for antiemetic function

32

Trazadone

inhibits serotonin reuptake

33

Maprotiline

Blocks NE Reuptake

34

Mirtazapine

alpha 2 antagonist -> increase NE and serotonin

35

Buproprion

increases NE and dopamine via unknown mech

36

Bromocriptine

dopamine agonists (prolactinoma)

Parkinsons
(ergot - vasoconstrictor)

37

Cabergoline

dopamine agonist (Prolactinoma)

38

octreotide

Somatostatin analog - GH cell adenoma

39

Demeclocycline

Ab used to induce impaired renal response to ADH

Used for SIADH

40

Propylthiouracil

Blocks peroxidase in hyperthyroidism

Also blocks peripheral conversion of T4 to active T3

41

phenoxybenzamine

irreversible alpha blocker

(prior to surgical removal of pheo)

42

Docusate

aniionic surfactant - reduces surface tension allowing water and lipid to penetrate the stool

43

Clopidogrel

inhibit platelet aggregation by irreversible blocking ADP receptors.

Inhibit fibrinogen receptor binding by preventing glycoprotein IIb/IIIa from binding to fibrinogen

also: ticlopidine, ticagrelor, parasugrel

44

Ticlopidine

inhibit platelet aggregation by irreversible blocking ADP receptors.

Inhibit fibrinogen receptor binding by preventing glycoprotein IIb/IIIa from binding to fibrinogen

- Worry about neutropenia

45

Dimercarpol

chelator for arsenic, mercury and Pb

46

EDTA

Effective chelator of divalent and trivalent cations -> Na CaEDTA to avoid hypocalcemia

binds to mercury and lead

47

Cyclosporin

Binds to cyclophilins -> blocking of differentiation and activation of T cells by inhibiting calcineuron, preventing the production go IL2

Nephrotoxic, HTN, hyperlipidemia, gingival hyperplasia, hirsutism

48

Tacrolimus

binds to FK binding proteins -> inhibiting calcineurn and secretion of Il2

Nephrotoxic and HTN

NO gingival hyperplasia vs cyclosporin

49

Sirolimus

Binds to FKBP12 -> inhibits mTor, inhibits T cell proliferation in RESPONSE to IL2
(vs production in Tacrolimus and Cyclosporin)

NO nephrotoxicity

50

Azathioprine

antimetabolite precursor of 6 mercaptopurine
- interferes w/ metabolism and synthesis of nucleic acid (purine antimetabolite)
- toxic to lymphocytes

Bone marrow suppression, worry w/ allopurinol blocking metabolism and increased side effects

51

Muromonab CD3

Antcolonal antibody binding to CD3 of T cells - no signal transduction,, good for kidneys

Cytokine and hypersensitivity reaction

52

Phytonadione

Vitamin K analog - Warfarin overdose

53

Amphotericin B

Binds ergosterol - forming pores and allowing electrolyte leakage

-serious systemic mycoses

54

Nystatin

Binds ergosterol - forming pores and allowing electrolyte leakage

Topical though due to toxic systemic use- thrush and diaper rash/vaginal cndidiasis

55

fluconazole

inhibit fungal sterol (ergosterol synthesisi) by inhibiting P450 enzyme that converts lanosterol to ergosterol

Also Ketoconazole, clotimazole, miconazole, itraconazole, voriconazole

- gyenectomastia seen - inhibits 1st step desmolase in making testosterone

56

Flucytosine

Inhibits DNA nadn RNA biosynth by converting to 5 flurouracil by cytosine deaminase

-Systemic fungal infections- meningitis -> cryptococcus

- wary of bone marrow suppression (HIV)

57

Caspofungin

inhibits cell wall synth by inhibiting synthesis of beta glucan

-micafungin as well

-Invasive aspergillosis and Candida

58

Terbinafine

inhibits fungal enzyme squalene epoxidase

Rx for dematophytes

59

Griseofulvin

Interferes w/ microtubule function

Oral Rx for superficial infection - dematophytes

60

thiazolininediones

pioglitazone and rosiglitazone

increases insulin sensitivity in peripheral tissue by binding to PPAR-gamma nuclear transcription factor

-lowers serum glucose and lowers tryglycerides and C reactive protein levels and increases HDL

61

pioglitazone

increases insulin sensitivity in peripheral tissue by binding to PPAR-gamma nuclear transcription factor

-lowers serum glucose and lowers tryglycerides and C reactive protein levels and increases HDL

62

rosiglitazone

increases insulin sensitivity in peripheral tissue by binding to PPAR-gamma nuclear transcription factor

-lowers serum glucose and lowers tryglycerides and C reactive protein levels and increases HDL

63

flumazenil

competitive benzodiazapine antagonist
-blocking the action of GABA

64

Pralidoxime

acetylcolinesterase reactivater post organophosphorus actylecholinesterase activity

65

febuxostat

inhibits xanthine oxidase

66

cetirizine

2nd generation H1 blocker for allergy

less sedation, less anti muscarinic effects

-also loratadine and fexofenadine

67

demeclocycline

anti-ADH for SIADH Rx

68

lepirudin

inhibits thrombin, derivative of hirudin

Alternative to heparin for HIT
-bivalirudin as well

69

Bivalirudin

inhibits thrombin, derivative of hirudin

Alternative to heparin for HIT
-lepirudin as well

70

Atropine

competitive muscarinic antagonist

71

Bethanechol

cholinergic Agonist - postop illeus and urinary retention

72

Carbachol

cholinergic agonist - glaucoma

73

pilocarpine

cholinergic agonist - induce sweating, tears and saliva

74

methacholine

cholinergic agonist - asthma test

75

edrophonium

anti cholinesterase activity (short) - Dx myasthenia gravis

76

pyridiostigmine

Anticholinesterase activity (long) - Rx for myasthenia gravis

77

neostigmine

Anticholinesterase activity - neuromuscular blockade reverse (non depolarizing) and myasthenia gravis

78

physiostigmine

anti cholinesterase activity - Atropine antidote

79

donepezil

anticholinesterse activity - alzheimers

80

rivastigmine

anti cholinesterase activity - alzheimers

81

galantamine

anti cholinesterase activity - alzheimers

82

ecothiophate

anti cholinesterase activity - open angle glaucoma

83

homatropine

antimuscarinic- eye dialation

84

tropicamide

antimuscarinic - eye dialation

85

cyclopentolate

antimuscarinic - eye dialation

86

Benztropine

anti muscarinic

-Parkinsons disease has excess cholinergic activity and this blocks the rigidity and tremor somewhat, little w/ bradykinesia

CNS effects

87

Scopolamine

Anti muscarinic - motion sickness and decreased salivation (ICU)

88

ipratropium

Antimuscarinic - COPD/asthma

89

tiotropium

antimuscarinic - COPD/asthma

90

Oxybutynin

antimuscarinic - COPD/asthma

91

Toterodine

Antimuscarinic - urge incontinence

92

Darfenacin

Antimuscarinic - urge incontinence

also solifenacin

93

Trospium

antimuscarinic - urge incontinence

94

Epinephrine

alpha 1 and 2 and Beta 1 and 2 - anaphylaxis and hypotension; asthma maybe

95

norepinephrine

alpha 1 and 2 beta 1;
uses for hypotension - septic shock, worry about kidneys

96

Isoprotenerol

beta 1 and 2

no real clinical use - maybe torsades and bradycardias

97

Dopamine

alpha 1 and 2 at high does
beta 1 and 2 and med doses
dopamine 1 and 2 at low does
- dopamine receptors in the blood vessels and kidney

98

Dobutamine

beta 1 > beta 2
Used in heart failure
Chemical stress test
DoBETAm1ne

99

Phenylephrine

direct alpha 1 and 2
myodriatic
rhinitis - > vasoconstriction (nasal decongestant)

100

levabuterol

B2 > B1 - used in acute asthma, more selective for beta 2 than albuterol

101

salmeterol

B2 > B1 - used in long term asmtha

102

Terbutaline

B2>B1 - given sub Q and used as a tocolytic and asthma

103

Clonadine

alpha 2 agonist - lowers blood pressure, worry of rebound HTN

104

Amphetamine

releases stored NE (catecholamines)
- narcolepsy, obesity, ADHD

105

Ephedrine

releases stored NE (catecholamines)
-nasal decongestion, urinary incontence

106

Cocaine

blocks reuptake of NE - > vasoconstriction

- never give with Beta blockade

107

pindolol

weak beta 1 and agonists -> antagonist

108

acebutolol

weak beta 1 and agonists -> antagonist

109

esmolol

selective beta 1 blocker

110

atenolol

selective beta 1 blocker

111

metoprolol

selective beta 1 blocker

112

propranolol

nonselective beta blocker - NOT for COPD

113

timolol

nonselective beta blocker - glaucoma

114

nadolol

nonselective beta blocker - NOT for COPD

115

labetolol

alpha1 and beta 1 antagonist

116

carvediol

alpha1 and beta 1 antagonist

117

Clomipramine

TCA used in OCD

May also use an SSRI- fluoxetine

118

Riframpin MOA?

inhibits DNA dependent RNA polymerase

Used in TB, leprosy and meningococcal (H influenza B prophylaxis)

Orange body fluids - TB Rx and chemoprophylaxis for H influenza contact

119

Probenecid

inhibits uric acid absorption
Gout medication

120

Quinidine

Class 1a anti arrhythmic
- phase 0 of myocytes, blocking Na channels -> increased ERP

121

Procainamide

Class 1a anti arrhythmic
- phase 0 of myocytes, blocking Na channels -> increased ERP

122

Disopyramide

Class 1a anti arrhythmic
- phase 0 of myocytes, blocking Na channels -> increased ERP

123

Lidocaine

Class 1b anti arrhythmic
- phase 0 of myocytes, blocking Na channels -> increased ERP

124

Mexiletine

Class 1b anti arrhythmic
- phase 0 of myocytes, blocking Na channels -> increased ERP

125

tocainide

Class 1b anti arrhythmic
- phase 0 of myocytes, blocking Na channels -> increased ERP

126

Flecanide

class 1c anti arrhythmic
phase 0 of myocytes, blocking Na channels -> increased ERP

127

Propafenone

class 1c anti arrhythmic
- phase 0 of myocytes, blocking Na channels -> increased ERP

128

Amiodarone

class III anti arrhythmic
-phase 3 of myocytes, blocking K channels increasing ERP

129

Ibutilide

Class III Antiarrythmic
-phase 3 of myocytes, blocking K channels increasing ERP

130

Dofetilide

Class III anti arrhythmic
-phase 3 of myocytes, blocking K channels increasing ERP

131

Sotalol

Class III antiarrythmic
-phase 3 of myocytes, blocking K channels increasing ERP

132

verapamil

Class IV Antiarrhythmic
-phase 0 of nodes, blocking Ca channels increasing ERP

preferentially acts on heart w/ diltiazem

133

Dilatiazem

Class IV anti arrhythmic
-phase 0 of nodes, blocking Ca channels increasing ERP

134

Adenosine

decreases K out of the cell -> hyper polarization and also decreases Ca channel opening at the nodes -> AV node block

Used for SVT

135

Entanercept

TNF alpha inhibitor - differs from monoclonal antibody in that it is and TNP alpha pseudo receptor and IgG Fc fusion protein

decoy receptor

136

Infliximab

TNF alpha inhibitor
monoclonal Ab

137

adalimumab

TNF alpha inhibitor
monoclonal antibody

138

Golimumab

TNF alpha inhibitor
monoclonal antibody

139

Certoluzumab

TNF alpha inhibitor
monoclonal antibody

140

Prodenacid

increases uric acid secretion by blocking reabsorption in the proximal tubule

141

colchicine

stabilizes tubulin and inhibits polymerization leading to inhibition of leukocyte chemotaxis in acute gout exacerbation

142

allopurinol

xanthine oxidase inhibitor
- chronic use only for gout

143

febuxostat

xanthine oxidase inhibitor
- chronic use only for gout

144

finasteride

blocks 5 alpha reductase converting testosterone to DHT

- BPH and male pattern baldness

145

flutamide

anti androgen receptor (competitive antagonist) used in prostate cancer

146

ketoconazole - endocrine

(antifungal) inhibits steroid synthesis vis blocking 17, desmolase -> less testosterone and less hirutism in polycystic kidney disease

147

sprinolactone -endocrine

inhibits steroid binding leading to decreased hirutism due to androgens in polycystic kidney disease

148

Cyclophosphamide

Covalently x linked DNA at Guanine N7

-requires bioactivation by liver

-hemorragic cystitis

149

sildenafil

inhibits phosphodiesterase 5 -> increase in cGMP - > smooth muscle relaxation -> vasodialtion

150

vardenafil

inhibits phosphodiesterase 5 -> increase in cGMP - > smooth muscle relaxation -> vasodialtion

151

tadafenil

inhibits phosphodiesterase 5 -> increase in cGMP - > smooth muscle relaxation -> vasodialtion

152

Leuprolide

GnRH agonist (early flare)

used for infertility - pulsitile

continuous: (chemical menopause) -> down regulates FSH and LH release
-prostate CA,
-precocious puberty,
-uterine fibroids
-endometriosus

153

Clomiphene

partial estrogen agonist in hypothalamus
- stimulates receptors but not enough to cause a negative feedback like normal estrogen -> increase of LH and FSH

induce pregnancy

154

Letrozole

aromatase inhibitor -> decreased peripheral androgen conversion

- postmenopausal ER positive breast CA

155

Anastrozole

aromatase inhibitor -> decreased peripheral androgen conversion

-postmenopausal ER positive breast CA

156

Amitriptyline

Block reuptake of NE and serotonin (biogenic amines)
-TCA

- Anticholinergic
- Sedation

157

Imipramine

Block reuptake of NE and serotonin (biogenic amines)
-TCA

- Anticholinergic
- Sedation

158

Desipramine

Block reuptake of NE and serotonin (biogenic amines)
-TCA

- Anticholinergic
- Sedation

159

Clomipramine

Block reuptake of NE and serotonin (biogenic amines)
-TCA

- Anticholinergic
- Sedation

160

doxepin

- Odd end of a TCA
Block reuptake of NE and serotonin (Biogenic amines)
-TCA

- Anticholinergic
- Sedation

161

Nortriptyline

Block reuptake of NE and serotonin (biogenic amines)
-TCA

- Anticholinergic
- Sedation

162

lovastatin

statins in general

inhibit conversion of HMG Co A to mevalonate

also secondarily increases LDL receptors to the cell surface for cells to take in LDL and lowering levels (decreases LDL mainly)

- rhabdomyolysis and hepatotoxicity
-myalgia,

163

Niacin

inhibits lipolysis in adipose tissue
reduces VLDL secretion

Flushed face concerns w/ hypoglycemia and hyperuricemia

itchy

164

Cholestryramine

Prevents intestinal reabsorption of bile acids
-decreases LDL mainly

unique in that it binds to C dif toxin from other bile acid resins

colestipol, colesevelam

GI discomfort and gallstones

165

colestipol

Prevents intestinal reabsorption of bile acids
decreases LDL mainly

GI discomfort and gallstones

Cholestryamine, Colesevelam

166

colesevelam

Prevents intestinal reabsorption of bile acids
Decreases LDL mainly

GI discomfort and gallstones

Cholestryramine, colestipol

167

ezetimibe

prevent cholesterol reabsorption at the small intestine brush border

Decreases LDL

Rarely may have increased liver enzymes, 2nd line to a statin
Diarrhea

168

gemfibrozil

fibrate

Upregulates LPL to increase tryglyceride clearance

May have RUQ pain w/ gallstones

169

clofibrate

fibrate

Upregulates LPL to increase tryglyceride clearance,
-activate peroxisome proliferator activated receptor alpha (PPAR alpha)

May have RUQ pain w/ gallstones

170

Mifepristone

competitive inhibitor of progesterone -> abortion

heave bleeding and GI/ Nausea experienced

171

Sulfonamides(sulfamethoxazole)

works on the first step of folate synthesis acting as a PABA antimetabolite blocking dihydropteroate synthase

-bacterialstatic

gram +/- UTIs, GIs, PCP prophylaxis

172

Trimethoprim

works on the second step of folate synthesis by blocking dihydrofolate reductase (methotrexate also acts here in humans)

Rx- supplemental folinic acid - leucovorin rescue

UTIs, GIs use

worry of anemia

173

Ciprofloxacin

Floroquinolones

inhibit DNA gyrase (topoisomerase II) and topo IV

bactericidal
not to be taken antacids/supplements (Ca, Fe, Mg)

Gram - rods, UTIs and GI, including pseudomonas, tessera and some gram +

174

levofloxacin

Floroquinolones - 3rd gen

inhibit DNA gyrase (topoisomerase II) and topo IV

bactericidal
not to be taken antacids/supplements (Ca, Fe, Mg)

Gram - rods, UTIs and GI, including pseudomonas, tessera and some gram +

175

moxifloxacin

Floroquinolones - 4th gen

inhibit DNA gyrase (topoisomerase II) and topo IV

bactericidal
not to be taken antacids/supplements (Ca, Fe, Mg)

Gram - rods, UTIs and GI, including pseudomonas, tessera and some gram +

176

metronidazole

forms free radicals that damage bacterial DNA

GET GAP on the Metro
Giardia
Entamoeba
Trichomona
Gardenella
Anaerobes
h Pylori

didsulfiram reaction

177

Nitrofurantoin

bactericidal
reduced by bacterial proteins to reactive intermediates that inactivates bacterial ribosomes

Used for UTIs

178

Isoniazid

decreases synth of mycolic acids.

bacterial catalase (KatG) needed to convert INH to active metabolite

Give w/ pyridoxine (B6) to prevent neurotoxicity
- lupes
-hepatotoxicity

179

Pyridoxine

vitamin B6

prevent neurotoxicity w/ INH

180

Rifampin Rs (4)

RnA polymerase inhibitor

Revs up microsomal p450
(increase warfarin and be wary of birth control)

Red/orange body fluids

Rapid resistance if used alone

-minor hepatic toxicity

181

Pyrazinamide

TB medication that acts by inhibiting my colic acid production by blocking mycobacterial pyrazinamidase -> decreased FA synth

effective in acidic pH of phagolysosomes

worry of
-hyperuricemia*
-hepatotoxicity

182

Ethambutol

decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

Worry of
-red/green colorblindness - optic neuropathy

183

Aldesleukin

IL2 analog given to encourage T cells in fighting renal cell carcinoma and metastatic melanoma

184

Erythropoeitin

Given to encourage RBC production with Renal failure leading to anemia

185

Filgrastim

GM-CSF ~ IL3
recovery of Bone marrow

186

sargramostim

GM-CSF ~ IL3
recovery of bone marrow

187

alpha interferon (exogenous)

Ramp up antiviral set _> ribonuclease activation

given to fight off Hep A and C, kaposis, leukemiasm malignant melanoma, hairy cell leukemia and genital warts

188

gamma interferon (exogenous)

given for chronic granulomatous disease to stimulate macrophages deficient in NADPH oxidase

189

Oprelvekin

~IL11
Used for thrombocytopenia

190

Thrombopoietin

Used to thrombocytopenia

191

Daclizumab

Binds to CD25, the IL 2 receptors in activated T cells for immune suppression

192

Mycophenolate mofetil

immune suppressor that inhibits purine synthesis through blocking IMP dehydrogenase (inosinemonophosphate dehydrogenase)
-> decrease guanine synthesis

Increase of lymphoma risk, teratogen

193

Thalidomide

immune suppressor that is historically important as a teratogen (phocomelia- limb agenisis)

Also used in immune suppression: anti-angiogenic

MOA- affects TNF alpha

194

Abciximab

Glycoprotein IIb/IIIa monoclonal antibody that is anti platelet,

Used post anioplasty and prevent cardiac ischemia in unstable angina

195

trastuzumab

HER/erb 2 neu receptor blocker in over expressing positive breast cancer

196

Rituximab

CD 20 monoclonal antibody that attacks B cells in non-hodgkin's lymphoma

197

Omalizumab

IgE monocolonal antibody that is used in severe asthma relief,

Expensive

198

Tetrabenazine

inhibits DA release

used in huntingtons

199

pramipexole

dopamine receptor agonist
- Parkinsons

~Ropinirole, bromocriptine

200

ropinirole

dopamine receptor agonist
- Parkinsons

~Pramipexole, bromocriptine

201

Amantadine

Increases DA release in Parkinsons

used to be an antiviral

202

Levoadopa

dopamine precursor (L-DOPA) that is converted to Dopamine after crossing the BBB by dopamine decarboxylase

Given w/ carbidopa

Has tolerance- where it wears off and akinesia sets in

203

Carbidopa

simemet -blocks peripheral conversion of L Dopa to Dopamine minimizing SE of HTN, arrhythmia, hallucinations, psychosis

Given w/ levodopa

204

Selegiline

selective MAO typeB inhibitor blocking the breakdown of dopamine in Parkinsons

205

Entacapone

COMT inhibitor preventing L dopa degradation increasing availability of DA

~tolcapone

206

tolcapone

COMT inhibitor preventing L dopa degradation increasing availability of DA

~entacapone

207

riluzole

decreases presynaptic glutamate release in ALS

208

Memantine

NMDA receptor antagonist -> decreased levels of excitotoxity
-Glutamate receptor

Helps with alzheimers

209

Ondansetron

5HT3 antagonist used to block nausea post chemo, pregnant and post op

210

Omeprazole

Irreversible binds to the K/H ATPase in the stomach blocking H production

Used for Peptic ulcers, gastritis, Zollinger ellison, GERD

211

Bismuth

binds to ulcer base providing a physical barrier allowing the HCO3 secretion to reestablish pH gradient

Promotes healing

212

Misoprostol

PgE1 analog that is used in increased production of HCO3 and decreased gastric acid secretion

also increases uterine tone -> abortifant

213

Aluminum hydroxide

Antiacid that leads to constipation and hypokalemia and hypophosphatemia

214

Magnesium hydroxide

Antiacid that leads to diarrhea and hypokalemia

magnesium relaxes smooth muscles in general body wide

215

Calcium carbonate

Antiacid that leads to hypercalcemia (rebound acid secretion) and hypokalemia

216

Metoclopramide

Decreases D2 stim as an antagonists and stimulates 5HT4

Helps w/ gastroparesis - post surgical or diabetic

217

Mesalamine

5 ASA - activated in the colon by bacterial cleavage

218

Sulfasalazine

5 ASA - activated in the colon by bacterial cleavage

219

Ursodiol

natural bile acid that decreases synthesis of cholesterol in the liver and changes the composition of bile in the gallbladder

Delays progression in primary biliary cirrosis

220

bosentan

decreases pulmonary hypertension by competitively antagonizing endothelian receptor type 1

221

ambriesentan

decreases pulmonary hypertension by competitively antagonizing endothelian receptor type 1

222

etoposide

inhibits topo II -> increase in DNA degradation

223

teniposide

inhibitys topo II -> increase DNA degradation

224

Cisplatin

cross links DNA

Toxicity -> nephrotoxic, acuoustic nerve damage -amifostine prevents

225

carboplatin

cross links DNA

Toxicity -> nephrotoxic, acoustic nerve damage
-amifostine prevents

226

levabuterol

beta 2 agonists for acute Asthma attack
- less beta 1 spill than albuterol

227

Theophylline

inhibits phosphodiesterase thereby decreasing cAMP hydrolysis and causing bronchodialation

narrow TI -> cardiotoxic, neurotoxic, metabolized by p 450

228

Ipatropium

blocks M3 muscarinic receptor leading to bronchodialation - More for COPD

blocks vagal stimuation in general -> smooth muscle dialalation

229

Tiatropium

blocks M3 muscarinic receptor leading to bronchodialation - more for COPD

blocks vagal stimuation in general -> smooth muscle dialalation

230

fluticasone

inhaled steroid that blocks production of cytokines and TNF alpha by inactivating NF kappaB (transcription factor)

Used for chronic prophylactic asthma management

beclomethazone, budesinode

231

Beclomethasone

inhaled steroid that blocks production of cytokines and TNF alpha by inactivating NF kappaB (transcription factor)

Used for chronic prophylactic asthma management

-budesinode, fluticasone

232

budesinode

inhaled steroid that blocks production of cytokines and TNF alpha by inactivating NF kappaB (transcription factor)

Used for chronic prophylactic asthma management

-beclomethazone, fluticasone

233

Montelukast

blocks leukotriene receptors -> asthma, especially w/ allergic rhinits

234

zafirlukast

blocks leukotriene receptors-> asthma, especially w/ allergic rhinits

235

Zileuton

5 lipoxygenase pathway inhibitor blocking the formation leukotirenes

236

Cromolyn

blocks the mast cell release of mediators. Used prophylactically for asthma
- not to common anymore

237

Guaifenesin

expectorant - thins respiratory secretions

238

n acetylcystine(3)

acetaminophen overdose
expectorant - especially w/ mucous plugs in CF patients
Prophylactic protection of kidney function from contrast

239

diphenhydramine

H1 antagonist - 1st gen
- used for allergy motion sickness and sleep aid

- be wary of: sedation(enters CNS), antimuscarinic, and anti alpha adrenergic

240

demenhydrinate

H1 antagonist - 1st gen
- used for allergy motion sickness and sleep aid

- be wary of: sedation(enters CNS), antimuscarinic, and anti alpha adrenergic

241

chlorpheniramine

H1 antagonist - 1st gen
- used for allergy motion sickness and sleep aid

- be wary of: sedation(enters CNS), antimuscarinic, and anti alpha adrenergic

242

loratidine

H1 antagonist - 2nd gen

Used for allergy, less sedating

243

fexofenazine

H1 antagonist - 2nd gen

Used for allergy, less sedating

244

cetirizine

H1 antagonist - 2nd gen

Used for allergy, less sedating

245

desloratidine

H1 antagonist - 2nd gen

Used for allergy, less sedating

246

hydroxizine

H1 antagonist - 1st gen
- used for allergy motion sickness and sleep aid

- be wary of: VERY sedating (enters CNS),
antimuscarinic, and anti alpha adrenergic

247

meclizine

Antihistamine used for vertigo

248

Promethazine

antihistamine used for N/V

249

cyproheptadine

antihistamine used as an appetite stimulant

250

Dextromethorphan

derivative of morphine that antagonizes the NMDA glutamate receptor

used as a cough suppressant

mas mild opiod effect in excess

251

Pseudophederine

sympathomimetic alpha agonist used in nonprescription nasal decongestants

constricts dilated arterioles -> decreased airway resistance

- some CNS stimulation and anxiety


-phenylephrine is another

252

Minoxidil

opens K channels and hyper polarizes smooth muscles -> relaxation of vascular smooth muscle

(Ca channels stay closed, less contraction)

Used in HTN and topical hair loss (hypertichosis is S Fx)

253

Nifedipine

blocks voltage dependent L type Ca channels of smooth muscle and thereby reduce muscle contractility preventing formation of Ca Calmodulin complex

-> HTN

Also amlodipine

254

Hydralazine

increases cGMP directly -> increase myosin phosphatase activity and less myosin phophorylated -> smooth muscle relaxation

reduces after load by preferentially dilating arterioles

Co -administered w/ beta blocker frequently to prevent reflex tachy

255

Nitroprusside

short acting increases cGMP via direct release of NO (activates guanylyl cyclase); leads to increased myosin phosphatase activity

Risk of cyanide poisoning

Used for malignant HTN

256

Captopril

ACE inhibitor

inhibits angiotension II formation
-> decreased vasoconstriction
-> decreased aldosterone (less Na and fluid retention)

used for HTN and CHF and diabetic renal disease

Concern w. cough, andioedema, teratogen, creatine increase and hyperkalemia

257

enalapril

ACE inhibitor

inhibits angiotension II formation
-> decreased vasoconstriction
-> decreased aldosterone (less Na and fluid retention)

used for HTN and CHF and diabetic renal disease

Concern w. cough, andioedema, teratogen, creatine increase and hyperkalemia

258

Losartan

ARB

blocks angitenision II effect on its receptor leading to less aldosterone and decreased vasoconstriction

- used in HTN and CHF and post mI and diabetic renal disease

No Cough Sideeffect

Still have angioedema and teratogen,

259

Aliskern

renin inhibitor
- used for HTN, old drug

Causes hyperkalemia and renalinsufficency,

NOT for pregnancy, CHF, MI

260

Omega 3 FA

decreases tryglycerides

261

morphine

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

262

fentanyl

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

263

heroin

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

264

Methadone

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

265

meperidine

acts as an agonist at opiod receptors (mu, delta and kappa) - G protein linked

opens K channels and closes Ca channels -> decrease synaptic transmission through hyper polarization

inhibiting the release of ACh, NE, 5-HT and glutamate and substance P

266

Penicillin G - 3 MOA

IV - bactericidal

binds penicillin binding proteins preventing wall formation

binds to transpeptidase preventing cross linking

Increase autolytic enzymes

syphilis

267

Penicillin V - 3 MOA

Oral - bactericidal

binds penicillin binding proteins preventing wall formation

binds to transpeptidase preventing cross linking

Increase autolytic enzymes

268

Oxacillin

narrow spectrum

w/ naficillin, dicloxacilin

penicillinase resistant blocking degradtion

Used for MSSA; not MRSA

269

naficillin

narrow spectrum

w/ oxacillin, dicloxacilin

penicillinase resistant blocking degradtion

Used for MSSA; not MRSA

270

dicloxacilin

narrow spectrum - same 3 MOA as penicillin

w/ naficillin, oxacillin

penicillinase resistant blocking degradtion

Used for MSSA; not MRSA

271

Ampicillin

IV mainly
same 3 MOA of penicillin but wider spec

Gram +

HELPSS
Haemophilus
E Coli
Listeria
Proteus mirabilis
Salmonella
Shigella

ampicillin rash w/ EBV
-neonatal infect/ URI/UTI

272

Amoxicillin

Oral - given w/ clavulanic acid
same 3 MOA of penicillin but wider spec

Gram +

HELPSS
Haemophilus
E Coli
Listeria
Proteus mirabilis
Salmonella
Shigella

ampicillin rash w/ EBV
-neonatal infect/ URI/UTI

273

Ticarcillin

antipseuedomonal penicillin

274

piperacillin

antipseuedomonal penicillin

275

carbenicillin

antipseuedomonal penicillin

276

Clavulanic acide

beta lactamase inhibitor

given w/ amoxicillin and ticarcillin

277

Sulbactam

beta lactamase inhibitor

given w/ ampicillin

278

Tazobactam

beta lactamase inhibitor

given w/ piperacillin

279

cefazolin

1st gen cephalosporin

gram + and PEcK

Proteus mirabilis
E Coli
Klebiella

280

cephalexin

1st gen ceph

gram + and PEcK

Proteus mirabilis
E Coli
Klebiella

281

cefoxitin

2nd gen ceph
gram + and HEN PEcKS

Haemophilus
Enterobacter
nesseiria (not gon)
Proteus mirabilis
E Coli
Klebsiella
Serratia

282

cefaclor

2nd gen ceph
gram + and HENS PEcK

Haemophilus
Enterobacter
nesseiria (not gon)
Serratia
Proteus mirabilis
E Coli
Klebsiella

283

cefuroxime

2nd gen ceph

gram + and HENS PEcK

Haemophilus
Enterobacter
nesseiria (not gon)
Serratia
Proteus mirabilis
E Coli
Klebsiella

284

cefprozile

2nd gen ceph

gram + and HENS PEcK

Haemophilus
Enterobacter
nesseiria (not gon)
Serratia
Proteus mirabilis
E Coli
Klebsiella
Serratia

285

ceftriaxone

3rd gen ceph

only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria ****
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia

286

ceftiazidime

3rd gen ceph
ANTIPSEUDOMONIAL

only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia

287

cefotaxime

3rd gen ceph
only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia

288

cefdinir

3rd gen ceph
only gram + is strep pneumo

serious gram -

Haemophilus
Enterobacter
nesseiria
Proteus mirabilis
E Coli
Citrobacter (new)
Klebsiella
Serratia

289

cefepime

4th gen ceph

BIG GUN - wide spectrum
antipseudomonial and gram + again

290

Aztreonam

Cell wall inhibitor that binds to PBP3

prevents peptidoglycan cross linking in gram - only

monobactum resistant to beta lactamase as well

291

Imipenem

Carbapenem that binds to penicillin binding proteins inhibiting cell wall synthesis

Broad spectrum covering everything except MRSA

CNS toxicity (seizures); GI; Skin Rash

Given w/ Cilastatin to decrease renal breakdown (inactivates renal dehydropeptidase)

292

Cilastatin

given w/ imipenem to block renal breakdown of the drug via blocking renal dehydropeptidase I

293

Meropenam

Carbapenem that binds to penicillin binding proteins inhibiting cell wall synthesis

Broad spectrum covering everything except MRSA

CNS toxicity (seizures); GI; Skin Rash

294

Vancomycin

binds to D-ala D-ala moitey to inhibit cell wall synthesis in Gram + peptidoglycan polymerization

MRSA, enterococci, and oral 2nd line for C Dif

bactericidal

NOTs
Nephrotoxic
Ototoxic
thrombophelbitis

Red man syndrome

295

Gentamicin(3)

aminoglycoside

inhibits formation of initiation complex- binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal - severe gram (-)

296

Neomycin (3)

aminoglycoside

inhibits formation of initiation complex- binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal -severe gram (-)

297

Streptomycin (3)

aminoglycoside

inhibits formation of initiation complex - binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal - severe gram (-)

298

Tobramycin (3)

aminoglycoside

inhibits formation of initiation complex - binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal - severe gram (-)

299

Amikacin (3)

aminoglycoside -

inhibits formation of initiation complex - binds to 30s
causes misreading of mRNA
blocks transloction

Bactericidal - severe gram (-)

300

Tetracycline

Bacteriostatic- tetracycline

binds to 30s subunit and prevents attachment of aminoacyl TRNA,

limited CNS penetration

Fecal elimination limits renal concerns

Do not tale w/ antacids/Vitamins
VACUUM The BedRoom

301

doxycycline

Bacteriostatic - tetracycline

binds to 30s subunit and prevents attachment of aminoacyl TRNA,

limited CNS penetration

Fecal elimination limits renal concerns

Do not tale w/ antacids/Vitamins
VACUUM The BedRoom

302

demeclocycline

Bacteriostatic - tetracycline

binds to 30s subunit and prevents attachment of aminoacyl TRNA,

limited CNS penetration

Fecal elimination limits renal concerns

Do not tale w/ antacids/Vitamins
VACUUM The BedRoom

MORE ADH Antagonist -> dieuretic in SIADH

303

minocycline

Bacteriostatic - tetracycline

binds to 30s subunit and prevents attachment of aminoacyl TRNA,

limited CNS penetration

Fecal elimination limits renal concerns

Do not tale w/ antacids/Vitamins

VACUUM The BedRoom

304

Azithromycin

Macrolide - bacteriostatic

Binds to 23s unit of 50s subunit blocking translocation (macroslide) in protein synthesis

Prolonged QT, p450 inhib, cholestatic hep

PUS- atyp Pneumonia; URI; STD (chlamydia)
Resistance w/ methylation of the side

305

Erythromycin

Macrolide - bacteriostatic

Binds to 23s unit of 50s subunit blocking translocation (macroslide) in protein synthesis

Prolonged QT, p450 inhib, cholestatic hep

PUS- atyp Pneumonia; URI; STD (chlamydia)
Resistance w/ methylation of the side

306

Clarithromycin

Macrolide - bacteriostatic

Binds to 23s unit of 50s subunit blocking translocation (macroslide) in protein synthesis

Prolonged QT, p450 inhib, cholestatic hep

PUS- atyp Pneumonia; URI; STD (chlamydia)
Resistance w/ methylation of the side

307

Chloramphenical

bacteriostatic

binds to 50s subunit blocking the peptidyltransferase (formation of peptide bond)

Old use - meningitis

ALOT of side effects
-gray baby, dose dependent aplastic anemia

308

Clindamycin

bacteriostatic

Blocks peptide transfer (transpeptidation) at 50s ribosomal subunit

used in Anaerobes primary

Worry of C dif post use

309

Quinupristin/dalfoprisitin

a streptogramin

Synthesized by Strep virginias
- binds to the 23S portion of the 50s ribosome,

Used for MRSA, VRE, staph and skin infections

SE- hepatoxicity, pseudomonas colitis, p450 inhibit

310

polymyxin

cationic detergent (disrupts cell membranes)

Used for very serious gram - IV
-Neurotoxic and nephrotoxic

More likely used topical

311

methylphenidate

ritalin

CNS stimulant that increases NE release

~dextroamphetamine

312

dextroampthetamine

adderol

CNS stimulant that increases NE release

~ethyphenidate

313

Atomoxetine

NE reuptake inhibitor

Strattera

used in adult ADHD

314

Haloperidal

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

315

fluphenazine

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

316

trifluoperazine

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

317

loxapine

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

318

thiothixene

typical antipsychotic - HP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX - extrapyramidal
endocrine dysruption
Neuroleptic malignant syndrome risk
Tardive dyskenesia

319

thioridazine

typical antipsychotic - LP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX
more antimuscarinic
- dry mouth, constipation
alpha1 block -> hypotenison
histamine block -> sedation

320

Chlopromazine

typical antipsychotic - LP
-> blocks D2 receptors in the brain (increase in cAMP)

SFX
more antimuscarinic
- dry mouth, constipation
alpha1 block -> hypotenison
histamine block -> sedation

321

Olanzaprine

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

UNIQUE- more concern w metabolic disorder and DM

322

Clozapine

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

UNIQUE - agranulocytosis (weekly CBC checks)

323

Quetiapine

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

UNIQUE - used for psychotic symptoms brought on due to parkinson medications, less side effect profile

324

Risperadone

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

325

Aripiprazole

atypical antipsychotic
-> varied effects blocking 5HT2, Dopamine, alpha and H1

SFX
- less extrapyramidal and fewer anticholinergic effects that typical antipsychotics

326

Fluoxetine

SSRI

concern w/ sexual dysfunction and serotonin syndrome
(MSC, neuromuscular abnormalities, autonomic instability)

useful in bulimia

327

Paroxetine

SSRI

concern w/ sexual dysfunction and serotonin syndrome
(MSC, neuromuscular abnormalities, autonomic instability)

328

Sertraline

SSRI

concern w/ sexual dysfunction and serotonin syndrome (MSC, neuromuscular abnormalities, autonomic instability)

329

citalopram

SSRI

concern w/ sexual dysfunction and serotonin syndrome (MSC, neuromuscular abnormalities, autonomic instability)

330

venlafaxine

SNRI

concern w/ stimulant effects and increased BP

331

duloxetine

SNRI

also used for diabetic peripheral nueropathy and fibromyalgia

concern w/ stimulant effects and increased BP

332

Amytriptyline

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

used for fibromyalgia mainly

333

nortriptyline

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

334

imipramine

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

Used for bedwetting

335

clomipramine

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

Used in OCD

336

doxepin

TCA - blocks NE and 5 HT reuptake

but also alpha1 blocker, antimuscarinic, sedation

concern w/ overdose -> cardiotoxicity, convulsions, coma, fever, confusions/hallucinations - Rx NaHCO3

337

tranylcypromine

MAOI - blocks the breakdown of NE, 5Ht and Dopamine

Concern w/ hypertensive crisis in the presence of tyramine and excess NE

338

Phenelzine

MAOI - blocks the breakdown of NE, 5Ht and Dopamine

Concern w/ hypertensive crisis in the presence of tyramine and excess NE

339

Isocarboxazid

MAOI - blocks the breakdown of NE, 5Ht and Dopamine

Concern w/ hypertensive crisis in the presence of tyramine and excess NE

340

Buproprion

NDRI - blocks the reuptake of dopamine and NE, synergistic w/ SSRI

Useful in smoking cessation and NO sexual side effects

Concern w/ seizures in bulemics, some stimulant effects

341

Mirtazapine

tetracyclic antidepressant that blocks alpha2
increasing the release of NE and 5 HT

also potent 5Ht2 and 5 Ht3 receptor antagonist

concern w/ sedation and weight gain (may be a good thing)
- dry mouth

342

Trazodone

tetracyclic that blocks serotonin reuptake

Used primarily for insomnia

concern w/ priaprism and sedation

343

Buspirone

Stimulates 5 HT1a receptors

Used in GAD

takes 2 weeks work

No real side effects, can be used w/ alcohol, non sedating or addictive

344

Mannitol

osmotic diuertic -> increased vascular osmolarity and tubular fluid osmolarity (works in proximal tubule)

helps w/ shock, increased Intracranial pressure and as a diuretic, glaucoma

345

acetazolamide

carbonic anhydrase inhibitor -> self limited NaHCO3 diuresis (works in the proximal tubule)

used in glaucoma, urinary alkalization, fix metabolic acidosis, altitude sickness

Worry of hyperchloremic metabolic alkalosis and SULFA allergy

346

Furosimide

SULFA loop dieuretic

inhibits cotransport of Na/K/2Cl in the ascending loop of hence thus disrupting the medullary hypertonicity and leads diuresis of water (in addition to the electrolytes)

Loops lose Ca

Ototoxic, Nephrotoxic, hypokalemia, dehyd, gout,

347

toresemide

SULFA loop dieuretic

inhibits cotransport of Na/K/2Cl in the ascending loop of hence thus disrupting the medullary hypertonicity and leads diuresis of water (in addition to the electrolytes)

Loops lose Ca

Ototoxic, Nephrotoxic, hypokalemia, dehyd, gout,

348

bumetanide

SULFA loop dieuretic

inhibits cotransport of Na/K/2Cl in the ascending loop of hence thus disrupting the medullary hypertonicity and leads diuresis of water (in addition to the electrolytes)

Loops lose Ca

Ototoxic, Nephrotoxic, hypokalemia, dehyd, gout,

349

ethycrynic acide

inhibits cotransport of Na/K/2Cl in the ascending loop of hence thus disrupting the medullary hypertonicity and leads diuresis of water (in addition to the electrolytes)

Loops lose Ca

NO SULFA ALLERGY

350

Hydrochlothiazide

prevents Na/Cl reabsorption in the distal convoluted tubule reducing the diluting capacity of the nephron

retains Ca from the lumen

Use in HTN,
nephrogenic DI(encourages earlier reabsorption in the proximal tubule?)
idiopathic hypercalciuria

351

metolazone

prevents Na/Cl reabsorption in the distal convoluted tubule reducing the diluting capacity of the nephron

retains Ca from the lumen

Use in HTN,
nephrogenic DI(encourages earlier reabsorption in the proximal tubule?)
idiopathic hypercalciuria

352

chorthalidone

prevents Na/Cl reabsorption in the distal convoluted tubule reducing the diluting capacity of the nephron

retains Ca from the lumen

Use in HTN,
nephrogenic DI(encourages earlier reabsorption in the proximal tubule?)
idiopathic hypercalciuria

353

chlorothiazide

prevents Na/Cl reabsorption in the distal convoluted tubule reducing the diluting capacity of the nephron

retains Ca from the lumen

Use in HTN,
nephrogenic DI(encourages earlier reabsorption in the proximal tubule?)
idiopathic hypercalciuria

354

spironolactone

k sparing dieuretic - aldosterone receptor antagonist

also used in acne and polycystic kidney disease

tox- hyperkalemia and antiandrogen (worse than eplerenone)

355

eplerenene

k sparing dieuretic - aldosterone receptor antagonist

toxicity - hyperkalemia

356

amiloride

K sparing dieuretic - blocks Na channel

concern of hyperkalemia

357

triamterene

K sparing dieuretic - blocks Na channel

concern of hyperkalemia

358

Hydrocortisone

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox
- iatagenic Cushing's syndrome
-Adrenal insufficiency
-osteoprosisi
-ulcers
-DM

~ cortisol

359

prednisone

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox
- iatagenic Cushing's syndrome
-Adrenal insufficiency
-osteoprosisi
-ulcers
-DM

360

triamcinolone

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox
- iatagenic Cushing's syndrome
-Adrenal insufficiency
-osteoprosisi
-ulcers
-DM

Topical

361

dexamethasone

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox
- iatagenic Cushing's syndrome
-Adrenal insufficiency
-osteoprosisi
-ulcers
-DM

Used dexamethasone suppression test

362

beclomethasone

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox
- iatagenic Cushing's syndrome
-Adrenal insufficiency
-osteoprosisi
-ulcers
-DM


Inhaled for asthma

363

fluticasone

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox
- iatagenic Cushing's syndrome
-Adrenal insufficiency
-osteoprosisi
-ulcers
-DM

inhaled for asthma

364

prednisolone

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox
- iatagenic Cushing's syndrome
-Adrenal insufficiency
-osteoprosisi
-ulcers
-DM

IV

365

methylpredisiolone

glucocorticoid
blocks the production of leukotriene and prostaglandins by inhibiting phospholipase A2 and expression of COX2

Tox
- iatagenic Cushing's syndrome
-Adrenal insufficiency
-osteoprosisi
-ulcers
-DM

IV

366

lispro

rapid acting insulin

367

aspart

rapid acting insulin

368

gluisine

rapid acting insulin

369

regular insulin

regular acting insulin

370

NPH

intermediate acting insulin

371

Glargine

long acting insulin

372

Determir

long acting insulin

373

Metformin

decreases gluconeogenisis, increases glycolysis, increases peripheral glucose uptake

lowers LDL and triglycerides

Tox: lactic acidosis, contraindicated in renal failure

374

glyburide

sulfonylureas

close K channel in the beta cell membrane -> depolarization of the cell-> triggering insulin release via Ca influx

risk of hypoglycemia, some weight gain

375

glimepiride

sulfonylureas

close K channel in the beta cell membrane -> depolarization of the cell-> triggering insulin release via Ca influx

risk of hypoglycemia, some weight gain

376

glipizide

sulfonylureas

close K channel in the beta cell membrane -> depolarization of the cell-> triggering insulin release via Ca influx

risk of hypoglycemia, some weight gain

377

pioglitazone

increases insulin sensitivity by binding to PPAR-gamma nuclear TF which is responsible for regulating FA storage and glucose metabolism

-> increased response to insulin

Risk
-Bladder CA
-osteoperosis
-hepatoxicity
-weight gain/edema
- Heart failure

378

rosiglitazone

increases insulin sensitivity by binding to PPAR-gamma nuclear TF which is responsible for regulating FA storage and glucose metabolism

-> increased response to insulin

Risk
-hepatotoxicity
-weight gain/edema
- Heart failure*

379

acarbose

alpha glucosidase inhibitors

delays sugar hydrolysis and glucose absorption
-thus passed in the stool
-> less postprandial hyperglycemia

Toxicity: GI disturbance (diarrhea/flatulence)

380

miglitol

alpha glucosidase inhibitors

delays sugar hydrolysis and glucose absorption
-thus passed in the stool
-> less postprandial hyperglycemia

Toxicity: GI disturbance (diarrhea/flatulence)

381

pramlintide

amylin analog

acting as a amylin which is normally secreted w/ insulin that leads to depression of glucagon secretion and delaying gastric emptying

Used only in patients taking insulin (type I or Type II)
- injected after every meal

risk of hypoglycemia, nausea, diarrhea

382

Exenatide

GLP 1 analog (an incretin)

analog of exendin which acts like GLP 1 ->
-decreases glucagon secretion
-increases insulin secretion
-delays gastric emptying

do not use while on insulin

Risk of pancreatitis and N/V

383

liraglutide

GLP 1 analog (an incretin)

analog of GLP 1 ->
-decreases glucagon secretion
-increases insulin secretion
-delays gastric emptying

do not use while on insulin

Risk of pancreatitis and N/V

384

Sitagliptin

inhibits dipeptidyl peptidase IV (DPP-IV) which affects glucagon like peptide (GLP-1)
-Normally DPP-IV breaks down GLP but this allows the incretin to remain

Prolongs insulin actions
-decreases glucagon secretion
-increases insulin secretion
-delays gastric emptying

385

heparin

cofactor for increasing the efficacy of antithrombin inhibiting the intrinsic pathway cascade

elevated PTT

worry of heparin induced thrombocytopenia ( binds to platelet factor 4 - IgG then binds and removes)

386

enoxaparin

LMWH

acts more on factor Xa than inducing antithrombin

2-4x the half life, not easily reversible
does on weight

387

dalteparin

LMWH

acts more on factor Xa than inducing antithrombin

2-4x the half life, not easily reversible
does on weight

388

lepirudin

derivative of hirudin (leeches) and it inhibits thrombin via another mech (not inducing antithrombin)

alternative to heparin w/ HIT complications

389

bivalirudin

derivative of hirudin (leeches) and it inhibits thrombin via another mech (not inducing antithrombin)

alternative to heparin w/ HIT complications

390

desirudin

derivative of hirudin (leeches) and it inhibits thrombin via another mech (not inducing antithrombin)

alternative to heparin w/ HIT complications

391

Fondaparinux

activates antithrombin and inhibits factor Xa

not the same as LWMH

392

rivaroxaban

direct factor Xa inhibitor

393

apixaban

direct factor Xa inhibitor

394

Alteplase

thrombolytic

activates plasminogen ->plasmin to lyse clots

395

streptokinase

thrombolytic

activates plasminogen ->plasmin to lyse clots

396

reteplase

thrombolytic

activates plasminogen ->plasmin to lyse clots

397

tenecteplase

thrombolytic

activates plasminogen ->plasmin to lyse clots

398

Clopidogrel

ADP receptor inhibitor,

blocks ADP released from activated platelets from binding and up regulating Gp IIb/IIIa receptors up to the cell surface and allowing aggregation

399

ticlopidine

ADP receptor inhibitor,

blocks ADP released from activated platelets from binding and up regulating Gp IIb/IIIa receptors up to the cell surface and allowing aggregation

Tox - neutropenia

400

prasugrel

ADP receptor inhibitor,

blocks ADP released from activated platelets from binding and up regulating Gp IIb/IIIa receptors up to the cell surface and allowing aggregation

401

ticagrelor

ADP receptor inhibitor,

blocks ADP released from activated platelets from binding and up regulating Gp IIb/IIIa receptors up to the cell surface and allowing aggregation

402

Abciximab

binds to glycoproetien receptor IIb/IIIa directly inhibiting fibrinogen from binding preventing cross linking

403

eptifibatide

binds to glycoproetien receptor IIb/IIIa directly inhibiting fibrinogen from binding preventing cross linking

404

tirofiban

binds to glycoproetien receptor IIb/IIIa directly inhibiting fibrinogen from binding preventing cross linking

405

Acyclovir

monophophorylated guanosine analog that is phosphorylated by HSV/VZV thyrimidine kinase

preferentially inhibits viral DNA polymerase

Used for HSV and VZV, weak EBV

valacyclovir is oral viral prodrug

406

Famciclovir

acycyclic guanosine analog
prodrug of peniclovir

needs to be phosphorylated by thymidine kinase to work inhibit viral DNA polymerase in HSV and VZV

407

ganciclovir

monophosphate formed by CMV viral kinase leads to active guanine analog that inserts itself in viral DNA via DNA polymerase, inhibiting it

valgancyclovir is oral viral prodrug

toxicity: bone marrow suppression and renal toxicity

408

Foscarnet

Viral DNA polymerase inhibitor that does NOT require activation by a viral kinase

Used for CMV retinitis and acyclovir resistant HSV

Concern w/ Nephrotoxicity and anemia

409

Zanamivir

inhibits influenza neurmainidase, blocking viral release

used in rx and prevention of influenza A and B
-need to be used w/in 24-48 hrs

410

oseltamivir

inhibits influenza neuraminidase, blocking viral release

used in rx and prevention of influenza A and B
need to be used in 24-48hrs

411

Ribavirin

inhibits synthesis of guanine nucleotides by competively inhibing IMP dehydrogenase

used in RSV (adults mainly), and hep C*

Toxicity : hemolytic anemia and teratogen

412

maraviroc

CCR5 co-receptor antagonists,

Bonds to host cell co-receptor preventing HIV gp100 from binding and infusiion

413

lopinovir

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

414

atazanivir

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

*nephrolithias convern
*increased bilirubin

415

darunavir

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

416

fosamprenavir

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

417

Saquinavir

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

418

ritonavir

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

Especially used to BOOST other PI functions
*pancreatitis

419

indinavir

Protease inhibitor (HIV 1- protease; gag gene)

blocks maturation of HIV viral proteins post translation

Concern of lipodystrpohy, hyperglycemia, GI intolerance, p450 inhibition

*nephrolithias concern

420

Tenofovir

NRTI - nucleotide vs nucleoside
- DOES NOT need phosphorylation from thrymidine kinase to work like other NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain

lactic acidosis

421

Emtricitabine

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis

422

Abacavir

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis
*life threatening hypersensitivity

423

lamivudine

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis

424

Zidovudine

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

-prophylactically given to moms peri-delivery if not on HAART prior

lactic acidosis
*bone marrow suppression
*anemia

425

Didanosine

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis
*Pancreatitis
*hepatic steatosis
*peripheral neuropathy

426

Stavudine

NRTI

competitively inhibits nucleotide binding to reverse transcriptase and terminate the DNA chain, needs to phosphorylated by thrimidine kinase to work

lactic acidosis
*peripheral neuropathy
*hepatic steastosis

427

Nevirapine

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

428

efavirenz

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash
*neuropsychiatric disorders
* false + cannaboid
* teratogenic

429

delavirdine

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

430

etravine

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

431

rilpivirine

NNRTI

noncompetative inhibitor of the reverse transcriptase, binds to another site, does not need phosphorylation like NRTI

Rash

432

Raltegravir

HIV viral integrase inhibitor, prevents the viral DNA from combing w/ host DNA

SFX : hypercholesterolemia, Nausea, vomitting, rash

433

Enfuvirtide

HIV fusion inhibitor blocking gp41 binding and infection of a cell

injection site reaction and increased risk of bacterial pneumonia

434

Griseofulvin

interferes w/ microtubule function, disrupts mitosis, deposits in keratin containing tissues

Used in oral Rx for superficial infection (inhibits dermatophyes)

concern w/ teratogen, HA and increased p450 metabolism (rarely confusion)

435

Terbinafine

inhibits fungal enzyme squalene epoxidase
(sqaulene -> lamosterol)

used for dermatophytes (onchomycosis esp)

Concerne w/ abnormal LFTs/hepatotoxicity and GI

436

Amphoteracin B

binds to ergosterol and forms holes in fungal cell membrane

Serious systemic mycoses
-cryptococcal, blastomyces, coccidiodes, histoplasma, mucor

Concern w/ fever, chills, hypotension, nephrotoxicity * (supplement K and Mg w/ hypokalemia), arrythmias, aneima

437

Nystatin

binds to ergosterol and forms holes in fungal cell membrane

Used topically b/c otherwise it is too toxic for use

thrush, diaper rash, vaginal candidiasis

438

Fluconazole and other azoles

inhibits fungal sterol (elgosterol synth) by blocking p450 conversion of lamosterol -> ergosterol

local and lass serious systemic mycoses use

Fluconazole for chronic suppression of cryptococcal meningitis

concern w/
-testosterone synth inhib (impotence and gynectomastia)
-liver dysfunciton ( blocks p450 metab)

439

Flucytosine

inhibits DNA/ RNA biosynthesis by converting to 5 fluorouracil by cytosine demaninase
-> nucleoside analog

used in systemic fungal infections, like cryptoccocal (w/ amphoteracin B)

concern w/ cone marrow suppression and GI

440

Caspofungin

inhibits cell wall synthesis by inhibition synthesis of beta glucan
-> cell lysis and death

used in invasive aspergillus and candid

Concern w/ GI upset and flushing

441

micafungin

inhibits cell wall synthesis by inhibition synthesis of beta glucan
-> cell lysis and death

used in invasive aspergillus and candid

Concern w/ GI upset and flushing

442

Cyproheptadine

antihistamine w/ 5HT2 receptor antagonist

used in serotonin syndrome

443

Methotrexate

folic acid analog that inhibits dihydrofolate reductase
(s phase)

inhibiting conversion of DHF back to THF -> less dTMP and ultimately less DNA

used in: ALL/AML, immune supp (RA, psoriasis), and Uterine path (ectopic, choriocarcinoma, hydradidiform mole)

Tox: myelosuppresion, fibrotic lung disease
teratogenic

give leucovorin

444

leucovorin

folinic acid used in methotrexate rescue

445

5 fluororacil

pyrimidine analog (S phase) that covalently complexes to folic acid, the complex then inhibits thymidylate synthase -> decreases dTMP and less DNA in general

used in colon and pancreatic CA
especially topically basal cell and actinic keratosis

Tox: myelosuppression and photosensitivity

446

cytarabine

pyrimidine analog (s phase) -> inhibition of DNA polymerase

used in leukemia and lymphoma

concern w/ leukopenia

447

6 mercaptopurine

purine (thiol analog) (s phase) -> less purine synthesis
blocks PRPP amidotransferase

used in leukemias

Metabolized xanthine oxidase -> increased toxicity w/ allopurinol ( myelosuppression and hepatotoxicity)

448

6 thioguanine

purine (thiol analog) (s phase) -> less purine synthesis
blocks PRPP amidotransferase

used in leukemias

differs from 6 mercaptopurine in that it is not metabolized by xanthine oxidase

449

Dactinomycin

antibiotic that intercalates DNA

used in Ewing sarcoma, rhabdomyosarcomas and Wilms

450

Doxorubicin

(adriamycin) antibiotic that
1. generates free radicals
2. noncovalently intercalates in DNA -> DNA breaks

used in solid tumors

Risk of cardiotoxicity - rx w/ dexrazoxane

451

Daunorubicin

antibiotic that
1. generates free radicals
2. noncovalently intercalates in DNA -> DNA breaks

used in solid tumors

Risk of cardiotoxicity - rx w/ dexrazoxane

452

bleomycin

antibiotic that induces free radicals -> DNA strand breaks

Used in testicular CA and Hodgkins lymphoma

Pulmonary fibrosis toxicity

453

cyclophosphamide

alkalating agent that covertly cross links DNA at Guanine N-7, needs bioactivation by liver

Uesd in
1. Solid tumors
2. Immune suppression : lupes nephritis and PAN

Toxicity: hemorragic cystits, Rx w/ Mensa
increased transitional cell CA risk

454

Mensa

used in hemorragic cystitis caused by cyclophosphamide's metabolite acrolein

455

Nitrosourease (carmustine etc..)

alkylating agent used in brain tumors

Crossed the BBB

Concern w/ CNS toxicity - dizzy, ataxia

456

Busulfan

alkylates DNA

used in CML

Concern w/ pulmonary fibrosis and hyperpigmentation

457

ifosphamide

similar to cyclophosphamide

alkalating agent that covertly cross links DNA at Guanine N-7, needs bioactivation by liver

Used in testicular CA

458

vincristine

binds to tubulin in the M phase to block polymerization so microtubules can't form

used in: hodgkin lymphoma, wilma, ewing, choricarcinoma

Worry of: neurotoxicity and peripheral neuritis

459

vinblastine

binds to tubulin in the M phase to block polymerization so microtubules can't form

used in: hodgkin lymphoma, wilma, ewing, choricarcinoma

Worry of myelosuppression (Blasts bone marrow0

460

Paclitaxel

hyperstabilize polymerized microtubules in the M phase so mitotic spindles cannot break down

used in ovarian and breast

worry of myelosuppression and hypersensitivity

461

Cisplatin

cross links w/ DNA - damage

used in testicular, bladder, ovary cA

causes nephrotoxicity and acoustic nerve damage

462

carboplatin

cross links w/ DNA - damage

used in testicular, bladder, ovary cA

causes nephrotoxicity and acoustic nerve damage

463

oxaliplatin

cross links w/ DNA - damage

used in testicular, bladder, ovary cA

causes nephrotoxicity and acoustic nerve damage

464

Etoposide

inhibits topoisomerase II -> unwinds supercoiling usually -> DNA degradation

Used in call cell Lung, prostate, and testicular CA

concern are usual w/ CA myelosup, GI and aloplecia

465

teniposide

inhibits topoisomerase II -> unwinds supercoiling usually -> DNA degradation

Used in call cell Lung, prostate, and testicular CA

concern are usual w/ CA myelosup, GI and aloplecia

466

Irinotecan

inhibits topoisomerase I

used in METS Colon Ca

467

topotecan

inhibits topoisomerase I

used in
-small cell lung CA,
-ovarian CA
Cervical CA

468

Hydroxyurea

inhibits ribonucleotide reductase -> decreased DNA synthesis in antineoplastic function

Increases HbF in sickle cell

469

Prednisone antineoplastic MOA

may trigger apoptosis

used in CLL and NHL

worry of BAM CUSHINGOID

470

Trastuzumab

monoclonal ab against her-2 Neu, a tyrosine kinase

needs to be her2 + breast CA

worry of cardiotoxicity

471

Rituximab

monoclonal Ab against CD20, found on most B cell neoplasms

Used in Non hodgkin lymphoma, RA, phemigus vulgaris, ITP and vasculitis

472

imatinib

enzyme inhibitor for chromosome bcr-abl tyrosine kinase

Used in CML (ALL and AML if positive)