Module 3 drugs Flashcards
1
Q
Salvarsan
A
organic arsenic compounds used to treat syphilis and trypanosomiasis; discovered at turn of 20th century
2
Q
Prontosil
A
sulfanilamide; pro-drug sulfa antibiotic. First sulfa drug.
Drug gets converted into sulfanilamide in body
Inhibits folic acid synthesis in bacteria
3
Q
mercury compounds
A
used to be injected intraurethrally to treat syphilis
4
Q
sulfadiazine
A
modern sulfa antibiotic; one of main ingredients in silver sulfadiazine cream used extensively for burns
5
Q
sulfamethoxazole
A
sulfa antibacterial; one of main ingredients in Septra and Bactrim combination antibiotics
6
Q
penicillin V
A
“pen-vee”; acid stable penicillin so can be given orally
7
Q
amoxicillin
A
aminopenicillin; very similar to ampicillin
8
Q
ampicillin
A
aminopenicillin; very similar to amoxicillin
9
Q
Bicillin
A
penicillin antibiotic; given by IM or IV; first mass produced antibiotic in US (in 1940s)
10
Q
ticarcillin
A
4 gen penicillin; antipseudomonal penicillin given by IM or IV; has extended spectrum of action against gram negative bacteria
11
Q
Augmentin
A
amoxicillin/clavulanate combination; used against B-lactamase producing bacteria
12
Q
penicillins
A
bind to penicillin-binding proteins on bacteria cell wall and stop cell wall synthesis; have B-lactam rings
13
Q
quinolones
A
interfere with genetic duplication of bacteria by interfering with DNA gyrase and topoisomerase IV (the enzymes that untwist DNA so it can be read then fold it back up)
14
Q
aminoglycosides
A
inhibit bacterial protein synthesis; most given parenterally or topically and usually in hospital from kidney toxicity and hearing issues
15
Q
streptomycin
A
first aminoglycoside discovered
16
Q
gentamicin
A
modern prototype aminoglycoside; used systemically by parenteral admin for gram negative species
17
Q
cephalosporins
A
have B-lactam ring that interferes with bacterial cell wall synthesis
18
Q
Keflex
A
cephalexin; first gen cephalosporin. Good for staphylococcus and streptococcus infections
19
Q
Ceclor
A
cefaclor; second gen cephalosporin. Good for staphylococcus and streptococcus infections
20
Q
Rocephin
A
ceftriaxone; third gen cephalosporin. Good for STIs like chlamydia and gonorrhea (admin into urethra is painful so often given with lidocaine)
21
Q
carbapenems and monobactams
A
B lactam antibacterials that inhibit cell wall synthesis; used for complicated infections caused by organisms resistant to other agents
Only parenteral admin
22
Q
Azactam
A
aztreonam; best known monobactam. Works great against gram negative bacteria
23
Q
tetracyclines
A
inhibit protein synthesis; the original broad-spectrum antibiotic
24
Q
tetracycline
A
one specific drug in tetracycline family; sometimes used for treating acne but causes GI upset so often not well tolerated
*has high affinity for Ca2+ and can cause teeth staining in young children; cannot be taken with milk
25
Minocin
minocycline; tetracycline antibiotic that causes less side effects than tetracycline and used more often
26
Vibramycin
doxycycline; tetracycline antibiotic that causes less side effects than tetracycline and used more often
27
fluoroquinolones
broad spectrum antibiotics that inhibit DNA synthesis directly (not through folic acid inhibition). Some of best outpatient antibiotics for not run of the mill infections; used for severe eye infections, kidney, sinus, or anthrax infections
*but conclusively linked to tendinitis and tendon rupture
28
Cipro
ciproflaxacin; fluoroquinolone antibiotic
29
Levaquin
levoflaxacin; fluoroquinolone antibiotic
30
macrolides
erythromycin-like drugs; broad-spectrum antibiotics that interfere with bacterial protein synthesis
Have large ring structures
*Alternative to penicillins (when they are allergic) and used orally mostly for common infections of skin and upper respiratory tract
31
erythromycin
macrolide antibiotic; not used much anymore
32
ketolide antibiotics
work by inhibiting bacterial protein synthesis
33
spinoff macrolides
synthetically produced and are much better than regular macrolides
34
Zithromax
azithromycin; synthetic macrolide
35
Biaxin
clarithromycin; synthetic macrolide
36
vancomycin
used to treat MRSA (methicillin resistant S. aureus); oral or IV
Kind of toxic so not used much besides MRSA
37
Flagyl
metronidazole; for anaerobic infections (such as vaginitis or skin infections), but will also treat protozoan infections like Giardia lamblia ('Bever Fever')
Makes GI very upset, so bad drug to take systemically
38
Cleocin
clindamycin; bacterial protein synthesis inhibitor; common topical acne medication
Another alternative to penicillin for allergic people
Have very large ring structures
Treat anaerobic infections like those that cause vaginitis or skin infections
39
clavulanic acid
clavulanate; B-lactam, but is suicide substrate for B-lactamase and has even greater binding affinity than penicillin so can block B-lactamase so B-lactams can actually work
40
Septra DS
trimethoprim and sulfamethoxazole; combination antibiotic used to treat uncomplicated UTIs
41
Bactrim
trimethoprim and sulfamethoxazole; combination antibiotic used to treat uncomplicated UTIs
42
trimethoprim
antibiotic that stops dihydrofolatase
43
imipenem-cilastatin
carbapenem antibiotic; given by IM or IV
44
timentin
combination antibiotic; ticarcillin/clavulanic acid
45
sulfisoxazole
sulfonamide antibiotic
46
chloramphenicol
bacterial protein synthesis inhibitor
47
methicillin
synthetic drug that is resistant to B-lactamase
48
neomycin
aminoglycoside antibiotic; used in many antibiotic ointments (too toxic for internal use)
49
bacitracin
topical antibiotic in ointments
50
polymyxin B
topical antibiotic in ointments
51
Claforan
cefotaxime; third gen cephalosporin used in ED a lot for treating STIs
52
piperacillin
fourth gen penicillin
53
tazobactam
B-lactamase inhibitor like clavulanic acid
54
antibiotic families and mechanisms
fluoroquinolones; direct inhibition of DNA/RNA synthesis
sulfonamide; folate synthesis inhibition to stop DNA synthesis
tetracycline, macrolides, aminoglycosides; inhibition of protein synthesis
penicillins, cephalosporins, carbapenems, monobactams; cell wall synthesis inhibitors
55
Symmetrel
amantadine; first of antivirals to prevent influenza
| Too many side e's so not used much anymore
56
Relenza
zanamivir; neuraminidase inhibitor to treat flu
57
Tamiflu
oseltamivir; neuraminidase inhibitor to treat flu
58
IIV3 and IIV4
two inactivated flu vaccines
59
LAIV; Fluzone
FluMist; new quadrivalent live vaccine (two types of influenza A and B)
60
TIV
trivalent influenza vaccine; good against two types of influenza A and one of B
61
Zovirax
acyclovir; treats herpes infections like Herpes Simplex Virus type 1 (cold sores/fever blisters) and type 2 (genital herpes). Originally a topical cream applied to sores, then more effect 5/day pill came out.
Does not cure disease, but makes break outs heal in 3-4 days instead of 2-3 weeks
62
Valtrex
valacyclovir; much more popular herpes drug than Zovirax b/c it is 1-2 pills a day instead of 5
63
Famvir
famciclovir; much more popular herpes drug than Zovirax b/c it is 1-2 pills a day instead of 5
64
NRTIs
nucleoside reverse transcriptase inhibitors; nukes; prevent HIV replication through inhibiting RNA to DNA
65
AZT
zidovudine; first NRTI found to be effective for lessening severity of AIDS
66
NNRTIs
non-nucleoside reverse transcriptase inhibitors; bind directly to reverse transcriptase (at a site different than the nucleoside binding site)
67
PIs
```
protease inhibitors; target viral protease enzyme needed in final stages of viral replication to get proteins into correct forms to yield new viruses
Most potent class of HIV antiviral drugs
```
68
HAART
highly active antiretroviral therapy; combination of NARTIs, NNARTIs, and PIs;
69
Atripla
two nukes and one non-nuke AIDS combination; created to reduce pill burden and simplify dosing schedule but very expensive
70
ribavirin
synthetic nucleoside anti-metabolite drug that interferes with gene duplication of viruses; used to treat deadly viruses like RSV, hemorrhagic fevers (like ebola), Hantavirus (hantavirus pulmonary syndrome), and Hepatitis C (used in combination with interferons)
71
interferons
produced by WBCs to modulate immune system and used to treat diseases like hep C or MS (B-interferon)
72
B-interferon
used to treat diseases like MS, but very expensive
73
Megace
megestrol; progesterone-like hormone that is an appetite stimulator used for pts. with cachexia
74
Marinol
dronabinol; THC drug that stops nausea/vomiting and increases appetite equal to actual marijuana; used for pts. with cachexia
75
Nystatin
one of first antifungals; never given systemically b/c very toxic
*not absorbed in GI well, so can be given orally for local effect along GI tract w/o entering systemic ciruclation
76
miconazole
azole antifungal; good for topical use (like thrush, vaginal yeast infections, and ringworm), don't use systemically
77
clotrimazole
azole antifungal; good for topical use (like thrush, vaginal yeast infections, and ringworm), don't use systemically
78
Lotrisone
betamethasone and clotrimazole; combo of two potent drugs to treat either allergy or fungal infection
Basically no side e's from topical use
79
betamethasone
corticosteroid; potent drug
80
Lamisil
terbinafine; azole systemic antifungal; treats toenail fungus as go-to oral systemic antifungal
Well tolerated and OTC
81
Sporanox
treats toenail fungus as systemic oral antifungal
82
Difulcan
fluconazole; azole systemic antifungal, well tolerated and common go-to
83
amphotericin B
"amphoterrible"; first antifungal for systemic infections, but so toxic that it is not used except for the very worst infections
84
Gardasil vaccine
antiviral vaccine that prevents development of human papilloma virus, which causes cervical cancer
85
loop diuretics
Treats CHF; inhibit Na/water reabsorption in ascending loop of Henle; cause huge loss of K so must be given with K supplement
LT: change Na balance in walls of vasculature of kidneys that eventually leads to relax of arteries and decrease in their resistance
86
thiazide diuretics
treats HTN; sulfa drugs that work on early part of DCT; cause moderate K loss, so often combined with K sparring diuretic to even K out
LT: change Na balance in walls of vasculature of kidneys that eventually leads to relax of arteries and decrease in their resistance
87
K sparring diuretics
treats HTN; work on late part of DCT and collecting ducts; cause rise in K levels in blood
88
HCTZ
hydrochlorothiazide; prototype thiazide diuretic
89
chlorathalidone
prototypical thiazide-like diuretic
90
Lasix
furosemide; loop diuretic that lasts six hours
91
K-lyte; Slow-K
K supplements; given to patients on loop diuretics to avoid hypokalemia. Given orally unless emergency then IV; Rx preparations have 10x the absorbable K as a banana
92
Dyrenium
triamterene; K sparring diuretic
93
Inderal
propranolol; non-selective B blocker
94
Coreg
carvedilol; B-1 blocker often used to treat CHF mainly
95
cardioselective B blockers
selectively block B1 to slow down heart and decrease sympathetic output to make people be less anxious/fearful; good for CHF, HTN, and PTSD
Have negative chronotropic and positive inotropic effect on heart
96
CCBs
calcium channel blockers; block Ca channels in walls of heart and BVs to relax smooth muscle to decrease BP and increase BF
angina/MI: decrease BP, decrease HR, and increase coronary BF
dysrhythmia: slows HR and suppresses aberrant activity
Good for those with CAD or HTN
Also used for migraines
Has low side effects
97
Calan
verapamil; CCB
98
Norvasc
amlodipine; most commonly Rx'ed CCB b/c of long lasting effect
99
ACE-Is
ace-inhibitors; stop formation of angiotensin II to lower BP; causes cough
Increases survival of pts. after MI (only Capoten, Vasotec)
100
Capoten
captopril; first ACE-I; ACE I used to increase pt. survival post MI
101
Zestril
lisinopril; ACEi go to, often used with diuretic
102
ARBs
angiotensin 2 receptor blockers; directly block the rc so have similar effect to ACEi but do not cause cough
103
RASi
renin-angioensin-[aldosterone[-system inhibitors; ACE-Is and ARBs
104
Cozaar
losartan; ARB
105
irbesartan
ARB
106
Tenormin
atenolol; selective B1 blocker
107
Lopressor
metoprolol; B1 blocker
108
Tenoretic
atenolol and a thiazide diuretic combination
109
NO
nitroglycerine; used for angina mostly but also for severe HTN
110
Apresoline
hydralazine; direct arterial vasodilator used for HTN and angina
111
BilDil
NO and hydralazine combination; race-based drug for black males with CHF or HTN
112
Rogaine
minoxidil; topical K channel opener vasodilator with too many side e's to use systemically routinely, but used as OTC hair loss treatment
113
Capozide
captopril, diuretic, and HCTZ combination for HTN
114
zestoretic
denotes combination of Zestril and mild diuretic
115
HTN drug summary
RASi, ss, thiazide-like diuretic (step 2); B-blockers and combinations (step 3); big vasodilators like NO or hydralazine (step 4)
116
CAD drug summary
nitrates, B blockers, CCBs, platelets inhibitors, lipid-lowering agents (like statins)
117
HF drug summary
loop diuretics, specific B blockers (carvedilol), vasodilators like RASi's, and sometimes big vasodilators (like NO or hydralazine), aldosterone antagonists, and digoxin
118
dysrhythmia drug summary
B-blockers, CCBs, and digoxin to slow HR, and atropine to increase HR
119
spironolactone
aldosterone antagonist; treats HF
120
NTG
nitroglycerin; potent vasodilator. Admin sublingual, as topical cream, long-acting capsules, or IV
121
Isordil
isosorbide dinitrate; longer acting NTG preparation
122
Nitrostat
emergency NTG; sublingual
123
B blockers
angina/MI: lower HR and make heart pump more efficiently, reducing its need for oxygen (CCB used when there are other comorbidities though)
dysrhythmia: slows HR and stabilizes twitchy myocardium areas
Other uses: migraines, CHF (some B blockers), PTSD, and HTN
124
Procardia
nifedipine; CCB
125
Lanoxin
digoxin; most common cardiac glycoside; prevents calcium moving ATPase enzyme so more Ca stays in sarcomeres available for contraction so contraction strength is increased
Very low TI; mainly just used as backup therapy for CHF if patient does not respond to diuretic, RASi's, or carvedilol
No effect on quantity of life, but improves quality
Negative chronotropic effect, positive inotropic
126
Vasotec
enalapil; ACE-I used to increase pt. survival post MI
127
ASA
acetylsalicylic acid; given prophylactically for those with previous MI and used in emergency situations by chewing two 325 mg tablets before help can arrive
128
epinepherine
positive chronotropic and inotropic effect on heart
129
atropine
prototype anticholinergic drug; increases HR
130
statins
HMG Co-A reductase inhibitors; enzyme that produces cholesterol gets blocked.
This block lowers LDL and increases HDL
Good side e profile, but must watch liver and muscle toxicity
131
Lipitor
atorvastatin; HMG Co-A reductase inhibitor
132
Zocor
simvistatin; HMG Co-A reductase inhibitor
133
Bile acid sequestrants
bile-acid binding resins; bind fat in gut before it can be absorbed to lower body lipid levels
"inert" b/c it is neither digested or absorbed, it just binds things in gut hen comes out the other end
134
Questran
cholestyramine; bile acid sequestrant
135
oameal
has similar action to bile acid sequestrants
136
omega 3 fatty acids
found in fish mostly; lower blood cholesterol levels, raise HDL levels, and are mild anticoagulants
137
Niaspan
niacin time release; raises HDL and lowers LDL and triglycerides
Lowers risk of MI
When used with a bile-acid binding resin or a statin, this can slow down plaque build up in arteries
138
vitamin B3
niacin
139
CV drugs with significant vasodilator properties
NTG, diuretics, L-type CCBs, ACEi, ARBs, and niacin
140
Plavix
clopidogrel; thienopyrindine drug that is more hardcore than ASA and often used if person has already can MI
Big selling, high cost drug that inhibits platelets and helps prevent stroke and recurrent MI
141
dopamine
sympathetic agonist that functions like epinepherine which increases BP through vasopressor action
142
dobutamine
sympathetic agonist that functions like epinepherine which increases BP through vasopressor action
Also has positive inotropy effect
143
Duramorph
morphine; used to treat pain and anxiety of heart attack
144
cardioplegia solution
high potassium solution used to induce cardiac arrest in open heart surgery
145
Activase
alteplase; first tissue-type plasminogen activator
| Very expensive and dangerous clot-busting drug only used in ED or cath lab after a MI is diagnosed
146
antiplatelet drugs
inhibit the initiation of a clot; prevent platelet activation so they do not aggregate and stick together (do not effect the deep coagulation cascade)
Increased bruising and nosebleeds
147
anticoagulant drugs
prevent the formation of mature clots by hindering one or more of the soluble clotting factors that lead to enzymatic conversion of fibrinogen to fibrin
Increased deep bleeding (do effect deep coagulation cascade)
148
thrombolytic drugs
dissolve clots that have already formed by augmenting action of natural tPA's found in the body
*must be very careful when giving to stroke patient b/c stroke may be from clot or bleeding
149
tPA
tissue plasminogen activators; drugs that dissolve clots by converting plasminogen into plasmin which breaks apart clots.
Must be given within 3 hours of first symptoms of MI/stroke or detriments outweigh benefits
Works on large artery occlusions, lacunar strokes, and pts. with frostbite (reduces number of amputations)
150
NSAIDs
have antiplatelet effect, but ASA has the most pronounced effect
151
heparins
best in the moment anticoagulants (only 2 minutes for effect) and given as soon as bleeding is under control from initial injury
Stimulates antithrombin III of deep clotting cascade; inhibits the intrinsic coagulation cascade (measured by aPTT test)
152
Coumadin
warfarin; 'rat poison'; anticoagulant inhibits formation of vitamin K dependent clotting factors made in liver (mainly factor VII) for the extrinsic pathway
Can be given orally and used long-term (unlike heparin); measured by INR (PT) test
*very low TI and hundreds of drug interactions so patients require close checking in on
153
Pradaxa
dabigatran; direct thrombin inhibitor (inhibits the final common coagulation pathway)
154
unfractioned heparins
heparins of differents molecular sizes; always required hospital stay b/c used to be given by IV and required monitoring by aPTT
155
LMWH
low molecular weight heparins; better than unfractioned heparins b/c they can be given by IM one/two times a day and can be done at home, so patients don't have to stay at hospital just b/c they need anticoagulation
156
Lovenox
enoxaparin; LMWH
| Stimulates antithrombin III; natural deep clotting cascade anticoagulant
157
vitamin K injection or FFP admin used for...
vitamin K IM/IV injections or fresh frozen plasma admin helps counter warfarin overdose. Coumadin inhibits vitamin K so giving more overpowers it, or supplying more anticoagulants in plasma helps pts. to clot even with warfarin
158
Xarelto
rivaroxaban; oral factor Xa inhibitor (anticoagulant)
159
Eliquis
apixaban; oral factor Xa inhibitor (anticoagulant)
160
factor Xa inhibitors
new group of anticoagulants; have started to replace warfarin as standard oral outpatient anticoagulant
161
DTIs
direct thrombin inhibitors; new anticoagulant group
162
streptokinase
earliest thrombolytic; produced naturally by B-hemolytic streptococcal bacteria, but is highly antigenic and yields high allergic reaction rates
