Pharm drugs by system Flashcards Preview

Step 1 > Pharm drugs by system > Flashcards

Flashcards in Pharm drugs by system Deck (139):
1

Calcium-channel blockers

Block voltage-dependent L-type Ca channels, leads to decr. contractility

Dihydropyridines - act on vascular smooth muscle
- amlodipine, nifedipine, nicardipine

Non-DHP - act on cardiac muscle (aka Class IV)
- verapimil, diltiazem

2

Hydralazine

Vasodilates arterioles > veins, afterload reduction

Frequently co-administered with a B-blocker to prevent reflex tachycardia

3

Nitroprusside, fenoldopam

Meds in hypertensive emergency

Nitroprusside - short acting, incr. cGMP to incr. NO

Fenoldopam - D1 receptor agonist, systemic vasodilation to decr. BP

4

Nitroglycerin/nitrates

incr. NO to vasodilate vascular smooth muscle --> incr. cGMP

dilate veins >> arteries to decr. preload

treat reflex tachy with BBs

5

Statins

HMG-CoA reductase inhibs
stop conversion of HMG-CoA to mevalonate (competitive inhibitor)

SE: hepatotoxicity, myopathy

6

Cholecystyramine

Bile acid resins

prevent reabsorption of bile acids, liver uses cholesterol to make more

decr. absorption of fat-soluble drugs (incr. bleeding times)

7

Fibrates

upregulate lipoprotein lipase, increased TG clearance

also, activate PPAR-a to induce HDL synthesis

SE: myopathy, cholesterol gallstones

8

Classes of anti-arrhythmics

I: sodium channel blockers
II: B-blockers
III: potassium channel blockers
IV: calcium channel blockers

9

lidocaine, mexiletine

Class IB anti-arrhythmics

decr. AP duration - narrow the action potential graph

Best for post-MI

10

Pioglitazone/risoglitazone

Glitazones

Increase insulin sensitivity in peripheral tissue by binding PPAR-gamma transcription regulator

can cause weight gain from fluid retention

11

Exenatide

Linagliptin

GLP-1 analog

DPP-4 inhibitor

Both increase insulin and decrease glucagon

12

Demeclocycline

ADH antagonist (possibly competitive antag)

Used for SIADH

13

Omeprazole, lansoprazole, pantoprazole

Proton pump inhibitors

Irreversibly inhibit H/K ATPase in parietal cells

decr. serum Mg with chronic use

14

Ezetimibe

Prevent cholesterol absorption at brush border

15

Niacin

inhibits lipolysis

SE: red flushed face that decr. with NSAIDs
hyperglycemia, hyperuricemia

16

Digoxin

direct inhibition of Na/K ATPase

leads to increased contractility and decreased conduction through AV node

17

Orlistat

inhibits gastric/pancreatic lipase

used for weight loss

18

Milrinone

phosphodiesterase 3 inhibitor (normally metabolizes cAMP)

in cardiac muscle: incr. cAMP = incr. contractility

in vascular smooth muscle: incr. cAMP = vasodilation

19

Flutamide

Competitive antagonist for testosterone and DHT receptors in target cells

Used for prostate cancer (in combo with GnRH antags)

20

Flecainide, propafenone

Class IC anti-arrhythmics

Prolongs ERP in AV node- changes slope of graph, but no change in width

Use for SVTs

Contraindicated in ischemic heart disease

21

B-blockers

Class II anti-arrhythmics

Decr. cAMP --> decr. automaticity of pacemakers- decr. slope of funny current, wider graph

Use for AVT

SE: metop: dyslipidemia, propran: vasospasm in variant angina

22

Verapimil, diltiazem

Class IV anti-arrhythmics - L-type Ca channel blockers, non-DHP

slow funny current rise, prolonged repolarization

23

Aspirin

COX-1, COX-2 inhibitors (irreversible, lasts as long until new plts, 8-10 days)

Can cause gastric ulcers, tinnitus, Reye syndrome with viral infection

24

Aspart, lispro

Rapid-acting insulin

25

Cilostazol, dipyridamole

PDE III inhibitor

incr. cAMP --> decr. plt aggregation

26

Detemir, glargine

Long-acting insulin

27

Azathioprine/6-MP

purine analog --> block de novo purine synthesis

activated by HGPRT
metabolized by xanthine oxidase

Used to prevent organ rejection, RA, IBD, SLE

28

Glimepiride, glipizide, glyburide

Sulfonylureas

Close K channels in B cells to stimulate insulin release (so no good in Type 1 DM)

high risk of hypoglycemia

29

Methotrexate

Folate analog (DHF inhibitor)

Used for everything!

SE: myelosuppresion, hepatotoxicity, mucositis, pulmonary fibrosis

30

Methimazole

Blocks thyroid peroxidase

Contraindicated in pregnancy!

31

Conivaptan, tolvaptan

ADH antagonists, block action of ADH at V2 receptor

used in hyponatremia

32

Desmopressin

Used for central DI

33

Cinacalcet

Sensitizes CaSR in the parathyroid to serum Ca2+ therefore decreases PTH

34

Carmustine, lomustine

nitrosureas, alkylating (cross-links DNA)

requires bioactivation by liver

Used for brain tumors (accesses CNS)

35

Bismuth, sucralfate

Bind to stomach ulcer base, providing physical protection and allowing HCO3 secretion

36

Misoprostol

PGE1 analog --> incr. mucus barrier, decr. acid production

can cause diarrhea, is contraindicated in women of child-bearing potential

37

Octreotide

long-acting somatostatin analog

used for acute variceal bleeds, acromegaly, VIPoma, carcinoid tumors

38

AlOH, CaCO3, MgOH

Antacids

Can cause low K, affect other drugs by altering gastric pH

AlOH: constipation, low PO4
CaCO3: high Ca, rebound acid incr.
MgOH: diarrhea, hyporeflexia, cardiac arrest

39

Sulfasalazine

Combo of antibacterial and antiinflammatory

Uses for ulcerative colitis and colitis of Crohn's

40

Ondansetron

5-HT3 antagonist, decr. vagal stimulation

Central-acting anti-emetic (good for chemo patients)

SE: headache, constipation, QT interval prolongation

41

Metoclopramide

D2 receptor antagonist --> incr. tone/contractility in gut

Used for diabetic gastroparesis

Incr. risk of tardive dyskinesia

42

Heparin

Antithrombin activator (decr. II and decr. X)

HIT: development of IgG against PF4, activating platelets --> thrombosis and thrombocytopenia (4 T's)

43

Argatroban

direct thrombin inhibitors

Use in HIT sensitive patients

44

Warfarin

interfere w/ gamma-carboxylation of clotting factors

incr. PT (extrinsic pathway)

skin/tissue necrosis - small vessel microthromboses

45

Rivaroxaban

Directly inhibit factor Xa

No reversal agent available for bleeding

46

Alteplase (tPA), streptokinase

Thrombolytics

Incr. plasmin, incr. PT/PTT

47

Clopidogrel, ticlopidine

ADP receptor inhibitor (prevent expression of GpIIb/IIIa)

ticlopidine can cause neutropenia

48

Abciximab

GpIIb/IIIa inhibitor

prevent plt aggregation

made from Fab fragments

49

Cladribine

purine analog

used in hairy cell leukemia

50

Cytarabine

pyrimidine analog

Used for AML, lymphomas

51

5-FU

pyrimidine analog, covalently complexes folate (decr. dTMP, decr. DNA synthesis)

Used for colon cancer, pancreatic cancer

52

Bleomycin

antitumor antibiotic

free radical formation, creates breaks in DNA strand

can cause pulmonary fibrosis, skin hyperpigmentation

53

Actinomycin D

antitumor antibiotic

intercalates in DNA

used for childhood tumors

54

Doxorubibin, daunorubicin

antitumor antibiotic

generates free radicals and intercalates in DNA

55

Busulfan

alkylating (cross-links DNA)

used to ablate bone marrow before BMT

56

Cyclophosphamide

alkylating (cross-links DNA)

requires bioactivation by liver

can cause hemorrhagic cystitis

57

Paclitaxel

microtubule inhibitors (stabilized in M phase, no spindle breakdown)

Can cause alopecia, hypersensitivity

58

Vincristine, vinblastine

bind beta-tubulin and inhibit tubule formation (no spindle formation)

vincristine: periperal neuropathy

59

Cisplatin

cross-link DNA

high kidney and ear toxicity

prevent toxicity with amifostine (free radical scavenger) and chloride diuresis

60

Etoposide, teniposide

Inhibits topoisomerase II (dsDNA nicks), incr. DNA degradation

61

Irinotecan, topotecan

Inhibit topoisomerase I (single-strand nicks)

62

Hydoxyurea

Inhibit ribonucleotide reductase (decr. DNA synthesis)

good for melanoma, CML, sickle cell disease (incr. HbF)

63

Bevacizumab

VEGF monoclonal antibody

inhibits angiogenesis

64

Erlotinib

EGFR tyrosine kinase inhibitor

Used for non-small cell lung carcinoma

65

Trastuzumab

Herceptin, targets HER-2 overexpressing cells (breast/gastric cancer)

severe cardiotoxicity

66

Common chemotoxicities

Cisplatin/carboplatin - acoustic nerve damage, nephrotoxicity
Vincristine - peripheral neuropathy
Bleomycin, busulfan - pulmonary fibrosis
Trastuzumab - cardiotoxicity
Doxorubicin - cardiotoxicity
Cyclophosphamide - hemorrhagic cystitis
5-FU, 6-MP, MTX - myelosuppression

67

Albuterol

b2 > b1 (relaxes bronchial smooth muscle)

asthma

68

Dobutamine

B1 > B2

heart failure (incr. inotropy)

69

Dopamine

D1, D2

at intermediate doses, stimulates beta, stimulates inotropy, chronotropy

at high doses, stimulates alpha, vasoconstriction = decr. CO

70

Epinephrine

Beta > alpha (B1: renin --> increased vascular tone, B2: relaxes constricted airways)decreased mast cell degranulation, increased heart activity)

treat anaphylaxis, asthma, open-angle glaucoma

71

Isoproterenol

B1/B2

evaluation of tachyarrhythmias (positive chronotropy, inotropy)

72

Norepinephrine

alpha 1 > alpha 2 > beta 1

treats hypotension (alpha 1 causes vasoconstriction, used in shock)

73

Phenylephrine

alpha 1 > alpha 2

Hypotension (vasoconstrictor), ocular procedures (mydriatic), rhinitis (decongestant)

74

Clonidine

Alpha 2

central acting, leads to vasodilation

75

Ranitidine, cemetidine, famotidine

reversible H2 receptor blocker, decr. acid by parietal cells

Cemetidine = cytochrome p450 inhibitor, anti-androgen, cross BBB and placenta, incr. serum Cr.

Decr. gastric acid production

76

Acetaminophen

CNS Cox reversible inhibitor

not anti-inflammatory

tox: depletes glutathione, requires NAC to regenerate

77

Aspirin

COX 1/2 irreversible inhibitor via acetylation, decr. TxA2 and PGs

dose: low (anti-platelet), medium (antipyretic/analgesic), high (anti-inflammatory)

incr. bleeding time, no effect on PT/PTT

can cause gastric ulcers and tinnitus

78

Celecoxib

Reversibly inhibit COX-2

no effect on GI lining or platelet function

79

NSAIDs

reversibly inhibit COX1/2

note: can cause renal ischemia (prevent vasodilatory effects of prostaglandins)

80

Alendronate, -dronates

bisphosphonate, inhibit osteoclast activity

can cause erosive esophagitis

81

Teriparatide

PTH analog, increase osteoblast activity

(though chronic exposure to PTH bone resorption, intermittent will cause bone building)

causes transient hypercalcemia

82

Allopurinol

inhibit xanthise oxidase (decr. uric acid production)

chronic gout drug

note: incr. axathioprine/6-MP (usually metabolized by XO)

83

Probenecid

decr. reabsorption of uric acid in proximal convoluted tubule (uricosuric agent)

chronic gout drug

can cause uric acid calculi (kidney stones)

84

Colchicine

bind and stabilize tubulin, impair neutrophil chemotaxis and degranulation

can be used acutely and prophylactically in gout treatment

85

Etanercept

fusion protein, TNF decoy receptor

used in rheumatoid arthritis, psoriasis, ankylosing spondylitis

incr. risk of infection, notably TB reactivation

86

Infliximab, adalimumab

anit-TNF monoclonal antibody

IBS, RA, ank spondy, psoriasis

incr. risk of infection, notably TB reactivation

87

Butorphanol

kappa-opioid receptor agonist and mu partial agonist

88

Tramadol

weak opioid agonist, also inhibits 5-HT and NE reuptake

also decreases seizure threshold

89

Ethosuximide

block T-type Ca channels in thalamus

absence seizures

watch for urticaria, SJS (prodrome then rash then necrosis/sloughing)

90

Phenytoin

Na channel inactivation

use for all seizures

Lots of side effects! SLE-like syndrome, SJS, gingival hyperplasia

91

Phenobarbital

incr. duration of Cl channel opening --> incr. GABA

use as sedative

induces cytochrome p450

92

Benzodiazepines

incr. frequency of Cl channel opening --> incr. GABA

less risk of resp. depression than barbs

treat overdose with flumazenil (competitive antagonist)

93

Zolpidem, zaleplon, eszopiclone

BZ1 subtype of GABA receptor

used for insomnia

short duration, decr. aftereffects

94

Ketamine

Block NMDA receptors

cardiovascular stimulants (dissociative anesthetics)

increase cerebral blood flow

95

Propofol

potentiates GABA-A

rapid induction

96

Succinylcholine

strong ACh receptor agonist, sustained depol and prevents muscle contraction

Phase 1 block: block potentiated by AChEis
Phase 2 block: desensitized Ach receptors, allows for cholinesterase inhibitors to be used an antidote

97

Vecuronium, rocuronium

Competitive ACh antagonist, use for patients with arrhythmias/electrolyte disturbances

reverse blockade with neostigmine+atropine, edrophonium

98

Baclofen

GABA-B agonist at spinal level

skeletal muscle relaxant (use for muscle spasms)

99

Cyclobenzaprine

Centrally acting skeletal muscle relaxant

100

Bromocriptine, ripinorole

Dopamine agonists

used in parkinson's

101

Amantadine

incr. dopamine release and decr. dopamine reuptake

use for Parkinson's

(also antiviral against influenza A/rubella)

102

Selegiline

MAO-inhibitor

blocks conversion of dopamine to 3-MT, incr. DA levels

103

Memantine

NMDA receptor antagonist

Alzheimer's

104

Donepezil

AChE inhibitor

Alzheimer's

105

Sumitriptan

5-HT 1B/1D

inhibit trigeminal nerve activation, induce vasoconstriction

acute migraine, cluster headaches

can cause coronary vasospasm

106

Mannitol

Osmotic diuretic (increases tubular fluid osmolarity)
Also decreases intracranial and intraocular pressure

107

Acetazolomide

carbonic anhydrase inhibitor

causes hyperchloremic metabolic acidosis

urinary alkalinization

108

Furosemide

Loop diuretic - inhibit Na/K/2Cl of thick ascending loop
Abolish medullary hypertonicity, preventing concentration of urine
Stimulate PGE release, vasodilates afferent arteriole

increased Ca secretion

toxicity: ototoxicity, hypoK, dehydration, allergy (to sulfa), Nephritis, Gout

if allergy, give ethacrynic acid

109

Hydrochlorothiazide

inhibit NaCl reabsorption in early DCT
decreases Ca excretion

tox: hyperGLUC (glycemia, lipidemia, uricemia, calcemia)

110

Amiloride

K sparing diuretic, block ENaC in cortical collecting tubule

can cause hyperkalemia (peaked T waves)

111

Enalapril, captopril

Inhibit ACE conversion to AT-II, decr. GFR (prevents constriction of efferent arteriole)

incr. renin, prevents inactivation of bradykinin (leads to vasodilation and cough)

tox: cough, angioedema, teratogen, incr. Cr, hyperK, hypotension (avoid in bilateral renal artery stenosis)

112

Losartan, candesartan

block binding of AT II to AT-1 receptor

no effect on bradykinin

113

Aliskiren

Direct renin inhibitor

contraindicated in DM pts taking ACEis or ARBs

114

Leuprolide

GnRH analog; agonist when pulsatile, antagonist when used continuously

pulsatile use: infertility
continuous use: prostate cancer, uterine fibroids, precocious puberty

115

Clomiphene

in hypothalamus, estrogen receptor antagonist. leads to incr. LH, FSH secretion from ant. pit.

used to stimulate ovulation (in PCOS)

116

Anastrozole, exemestane

aromatase inhibitors

used in post-menopausal women with ER-positive breast cancer

117

Mifepristone

competitive inhibitor at progesterone receptors

used to terminate pregnancy

118

Terbutaline, ritodrine

B2-agonists that relax the uterus

119

Danazol

partial androgen agonist

used for endometriosis, hereditary angioedema

120

Testosterone

Agonists at androgen receptors

121

Finasteride

5a-reductase inhibitor (prevent conversion of testosterone to DHT)

used in BPH and baldness

122

Flutamide

Competitive inhibitor at androgen receptor

used for prostate cancer

123

Ketoconazole

inhibit steroid synthesis (inhibits 17,20 desmolase)

treats PCOS to reduce androgen symptoms

can cause gynecomastia and amenorrhea

124

Tamsulosin

alpha-1 antagonist (inhibit smooth muscle contraction)

used to treat BPH, selective for prostate alpha-1 receptors vs. vascular alpha-1 receptors

125

Diphenhydramine, chlorpheniramine

H1 reversible receptor blocker (1st gen)

tox: sedation, antimuscarinic, anti- alpha adrenergic

126

Loratidine, fexofenadine

H1 reversible receptor blocker (2nd gen)

Far less sedating than 1st generation, decr. entry into CNS

127

Guaifenesin

expectorant, thins respiratory secretions

128

Dextramethorphan

NMDA glutamate receptor antagonist

codeine analog, mild opioid effect when used in excess

Antitussive

may cause serotonin syndrome

129

Pseudoephedrine, phenylephrine

alpha agonist

nasal decongestant

130

Bosentan

Endothelin-1 antagonist

used to treat pulmonary hypertension

131

Epoprostenol

PGI2 analog

direct vasodilatory effect on pulmonary and systemic arterial vascular beds

used to treat pulmonary hypertension

132

Ipratropium

muscarinic antagonist

Prevents bronchoconstriction

used for asthma and COPD

133

Theophylline

phosphodiesterase inhibitor, incr. cAMP (decr. cAMP hydrolysis)

narrow therapeutic index (cardio/neurotoxic)

blocks adenosine

134

Tacrolimus

Antitumor antibiotic

Inhibits calcineurin-mediated transcription of IL-2 (binds FK506 binding protein)

135

Cyclosporine

Binds cyclophillin

Inhibits calcineurin-mediated transcription of IL-2

136

Acyclovir, valcyclovir

Guanosine analog, phosphorylated in infected cells

Used against HSV, VZV (have the required phosphorylase)

137

Ganciclovir

Guanosine analog, phosphorylated only in CMV cells

138

Foscarnet

Viral RNA/DNA polymerase inhibitor and HIV reverse transcript inhibitor

Pyrophosphate analog

Causes hypocalcemia and hypomagenesemia

139

Cidofovir

inhibits viral DNA polymerase, NO phosphorylation required!

2nd line for CMV and HSV