Pharmer Last

A

Diphenhydramine, dimenhydrinate, chlorpheniramine

H1 histamine inhibs

A

Loratadine, fexofenadine, desloratadine, cetirizine

H1 histamine inhibs

A

Loratidine

Low entry into cns

A

1st gen H1

SX Sedation, antimuscarinic, anti alpha adrenergic

A

Isoprotenerol

Non Spec beta agonist

A

Isoprotenerol

SX tachycardia

A

Albuterol

Use during acute exacerbation

A

Salmeterol

Long Acting B 2

A

Theophylline

inhibits phosphodiesterase Lowers cAMP hydrolysis

A

Irpatropium

competitive M3 block

A

irpatropium

used in COPD

A

irpatropium

sx dry mouth

A

Cromolyn

prevent release from mast cells

A

cromolyn

asthma prophylax

A

Beclomethasone

Inactivate NF kB

A

NF kb

induces TNFa

A

Zileuton

5 lipoxygenase pathway inhibitor

A

zileuton

asthma prophylax

A

zafirlukast, montelukast

block leukotriene receptors

A

zafirlukast, montelukast

good for asprin induced asthma ltd4

A

dextromethorphan

antitussive

A

codeine

antitussive, abuse potential

A

omalizumab

anti IgE

A

guanfenesin

expectorant

A

N-acetylcystein

mucolytic

A

bosentan

endothelin receptor antat, use in pulm htn

A

Finasteride

5 a reductase inhib

A

Flutamide

nonsteroidal comp inhib at testosterone recept

A

Ketoconazole

Inhibits steroid synth

A

spironolactone

inhibit steroid binding

A

leuprolide, goserellin

cause initial flare

A


use for uterine fibroids

A


use in prostate cnacer

A

sildenafil vardenavil

cGMP pde inhibitor

A

sildenafil vardenavil

impaired blue green color vision

A

Mifepristone

protestin inhibitor at progestin receptor

A

Dinoprostone

PGE2 analog induces labor

A

Ritodrine, terbutaline

b2 agonists RELAX uterous

A

Anastrazole

reversible

A

exemestane

irreversible

A

anastrazole, exemestane

aromatase inhibs

A

DES

causes adenocarcinoma of Vagina

A

Progestins

used n abnormal uterine bleeding

A

Clomiphene

partional estrogen receptor agonist in HYPOTHALAMUS

A

Tamoxifen

agonist on endometrial, antagonist on breast

A

raloxifene

agonist on bone, not agonist on breast or endometrial

A

mannitol

causes pulmonary edema, dehydration,

CONTRAINDICATED in anuria, CHF

A

acetazolamide

alkalinizes urine in salicylate poisoning

A

acetazolamide

use in glaucoma

A

acetazolamide

causes hyperchlormic metabolic acidosis

A

acetazolamide

sulfa allergy

A

acetazolamide

reduces total body hco3 stores

A

furosemide, butamide

Loops loose calcium

A


use in chf cirrhosis, nephrotic syndrome, hypercalcemia

A


sx ototoxicity, nephritis, hypokalemia, GOUT

A


sulfa allergy

A

ethacrynic acid

not a sulfamide, is a loop

A

ethacrynic acid

can be used in ini hyperuricemia, but not to treat gout

A

ethacrynic acid

greatest loop ototoxicity

A

hydrochlorothiazide

reduces diluting capacity of neprhon

A

hydrochlorothiazide

use in idiopathic hypercalciuria

A

hydrochlorothiazide

sx hyperglycemia, hyper lipidemia hyper uricemia

A

hydrochlorothiazide

lowers insulin release

A

hydrochlorothiazide

sulfa allergy

A

furosemide

best in severe renal failure

A

triamterine, amiloride

k+ sparers

A

eplenerone

newer spironalactone

A

spironolactone

activates p450

A

spironolactone

do not use in myoglobinuria b/c spares k+ further

A

spironalactone

only diuretic that decreases mortality in chf since it blocks

aldo mediated remodeling

A

contraction alkalosis

volume contraction leads to increased ATII, Shed H+ to save

Na

A

paradoxical aciduria

in low K state, trade out H for Na rather than K thus alkalosis,

aciduria

A

ACE inhibs

cause Cough, angioedema, proteinuria, taste changes

hypotension, pregnency problems hyperkalemia

A

ACE inhibs

avoid in ARF

A

ACE inhibs

can cause 1st dose hypotension

A

alcohol intox

disinhibition emotional lability, slured speech ataxia coma

blackouts GGT up

A

alcohol withdraw

tremor tachy htn malaise nausea seizures delirium tremens,

hallucinations formication tx with benxos

A

opoid intox

cns depression, constipation pinpoint pupils, seizures tx:

naloxone, naltrexone

A

opoid withdraw

anxiety insomnea, sweating, dilated pupils rhinorrhea, diarrhea,

yawning

A

barb intox

respiratory depression

A

barb withdraw

anxiety seizures, deliurum CV collapse

A

benzo intox

amnesia, ataxia somnolence, additive effects with alcohol, tx

flumanzenil

A

benzo withdraw

rebound anxiety seizures tremor insomnia tx lorazepam

A

amphet tox

psychomotor agitation, pupil dilation, htn, euphoria,

tachycardia, arrythmea, psychosis

A

amphet withdraw

depression ,lethargy HUNGER, hypersomnolence

A

cocaine tox

euprhoria, puil dilation, hallucinations, sudden cardiac

death cocaine bugs

A

cocaine withdraw

crash depression, hypersomnolence, psychological

craving, resembles major depressive episode

A

caffeine tox

restlessness insomnia diuresis cardiac arrythmea

A

caffeine withdraw

headache lethargy weight gain

A

nicotine tox

restlessness incomnia test for Cotinine

A

nicotine withdraw

irritiability headache anxiety weight gain craving

A

PCP tox

belligerence, impulsivness vertical nystagmus, tachy ataxia

homicidality psychosis deliurium

A

PCP withdraw

depression anxiety irritability restlessness anergia

A

LSD intox

anxietey flashbacks pupil dilation

A

Marij tox

appetite increase, dry mouth hallucinations

A

marij withdraw

insomnia nausea irritabilty depressoin

A

alcohol witdrawal

tx benzos

A

anorexia bulemia

tx ssris NO Bupropion

A

anxiety

tx benxos buspirone (GAD) ssris

A

ADHD

tx methyphenidate, amphetamines

A

atypical depression

tx with mao, ssris

A

bipolar mood stabilizers

lithium (mania + maintenance) Valproic acid (rapid cyclers mania

only) carbamazepine

A

bipolar

tx atypical antipsychotics

A

depression

tx with ssris snris tcas

A

depression w insomnia

tx with mirtazapine(a2 antagonist)

A

ocd

tx with ssris, clomipramine (tca)

A

panic disorder

tx ssris tcas benzos

A

panic disorder

alprazolam for acute attack

A

ptsd

tx with ssris

A

schizoprhenia

tx with antipsychotics (halperidol, respirodol)

A

tourettes

tx with antipsychotis (halperidol)

A

methylphenidate

increases presynaptic NE vesicular release

A

High Potency Antipsyhch

halperidol, trifluoperazine fluphenazine (Neurologic side

effects)

A

low potency antipsychotics

thioridazine chlorpromazine (non neurologic side effects anti musc

anti ach)

A

Typical antipsych

block D2, musc, a1 and histamine receptors

A

Atypical Antisphcy

cause hyperprolatinemia

A

Atypical Antisphcy

sx dry mouth constipation (anti musc) hypotension (alpha block)

sedation (histamine block)

A

Atypical Antisphcy

Neuroleptic malignant syndrome rigidity myoglobinuria

hyperpyrexia tx w dantrolene

A

Atypical Antisphcy

sx tardive dyskinesia lip smacking, sterotypic oral facial

movements resemble huntingtons

A

atypical antipsych

colozapine, olanzapine risperidone aripiprazole quietapine ziprasidone

A

clozapine

most wieght giaine

A

ziprasidone

least weight gain

A

atypical antipsych

block 5ht alpha h1 and dopamine receptors, less eps

A

clozapine

causes agranulocytosis

A

clozapine

most effective atypical

A

olanzapine

also used for ocd, anxiety depression mania and tourettes

A

lithium

used in SIADH, causes Nephrogenic diabetes insipidus

A

lithium

sx hypotyroid, ebstein's anomlly, tremor

A

Buspirone

non benzo anxiolitic

A

buspirone

stims 5ht1a receptors

A

buspirone

no sedation or addiction

A

tcas

imipramine, amitryptiline, desipramine, nortryptiline,

clomipramine, doxepin amoxapine

A

tcas

block reuptake of ne and serotonin

A

imipramine

use in enuresis

A

amitryptiline

use in depression w insomnia, chronic pain

A

desipramine

least sedating, use in panic disorder

A

nortryptiline

use in depression for elderly

A

clomipramine

use for ocd

A

doxepan

use for GAD

A

amitryptilyne

has most anticholinergic effects

A

tcas

block uptake of NE and serotonin

A

tcas

sx sedation alpha blocking anticholinergic, seight gain

sedation

A

tcas

cause convulsions coma cardiotox, use NaHCO3 for CV tox

A

imipramine amitryptiline

cause long qt

A

SSRIS

fluoxetine paroxetine sertraline citalopram

A

ssris

cause gi distress, anorgasmia

A

ssris

can cause serotonin syndrome (Flushing ,diarrhea, hyperthermia

muscle rigidity CV collapse)

A

bupropion

increases NE and dopamine

A

buproprion

tox tachycardia insomnia headache seizure in buleic patiens

A

SNRI

venlafaxine duloxetine

A

snri

toxicity increase bp

A

duloxetine

used in diabbetic peripheral neuopathy

A

mirtazapine

a2 antagonist, 5ht2 antagonist

A

mirtazapine

causes sedation increase appetite dry mouth

A

mirtazapine

use in depression w insomnia, chronic pain

A

maprotiline

blocks ne reuptake

A

trazodone

prohibits serotinin reuptake,

A

trazodone

used for insomnia, high dose needed for antidepressant

A

trazodone

causes priapism, postural hypotension

A

MAO

phenelzine, tranylcypromine

A

MAO

htn crisis with tyramine ingestion, serotonin syndrome with ssris

A

MAO

use in atypical depressoin

A

epineprhine

decreases aq humor synthesis due to vasocinstriction

A

epinephrine

not for closed angle glaucoma

A

brimonidine

decrease aq humor secretion (alpha agonist)

A

timolol betaxolol cartelol

decrease aq humor secretion For chronic open angle

A

acetazolamide

decrease aq humor secretion for acute open angle

A

pilocarpine, carbachol

increase outlflow of aq humor contract ciliary muscle, open trabecular meshwork (musc

agonists)

A

physostigmine echothiophate

ache inthibitors very effective at opening canal of schlem

A

latanoprost

pgf2 increases outflow of aq humor

A

latanoprost

darkens color of iris

A

Mu receptor

open k channels close ca channels

A

mu receptor agonists

open k channels close ca channels decrease synaptic transmission (depolarize w/o transmission)

A

ketamine

inhibits glutamate and thus prevents tolerence of morphine

A

pentacozine

can precipitate opoid withdraw

A

miosis and constipation

opoid effects to which tolerance does not develop

A

butorphanol

partial mu agonist, full kappa agonist

A

tramadol

weak opoid agonist, inhibits serotonin and ne uptake

A

tramadol

use in chronic pain

A

tramadol

Causes seizures

A

tramadol

is an snri plus and partial agonist

A

Phenytoin

1st line tonic clonic

A

carbamazepine

first line tonic clonic

A

valproic acid

A

phenytoin, carbamazepine phenytoin

A

ethosuximide and valproate

first line absence

A

benzos

first line for acute status epilepts

A

phenytoin

prophylax for status epileptis

A

phenytoin

increass na channel inactivation

A

carbamazepine

increases na channel inactivation

A

lamotrigine

blocks voltage gated na channels

A

gabapentin

increases gaba release

A

topiramate

blocks na channels AND increases gaba action

A

phenobarbitol

increases GABAA DURATION OF opening

A

valproic acid

increases na channel inactivation, increases gaba concentration

A

ethosuximide

blocks thalamic t type ca channels

A

benzo

increases frequency of gaba action

A

carbamazepine

first line for tic douleroaux

A

gabapentin

used for peripheral neruopathy

A

topiramate

causes kidney stones

A

phenobarbitol

safe in pregnancy

A

valproate

use in myoclonic seizures

A

benzos

used in seizures of eclampsia

A

mgso4

used to prevent seizures of eclampsia

A

carbamazepine

induction of p450

A

carbamazepine

sx agranylocytosis, liver toxicity teratogeniss

A

ethosuximide

causes SJS

A

phenobarbitol

induction of p450, exacerbates ACUTE intermittent prophyria

A

valproate

causes neuroal tube defects

A

primidone

metabolized to phenobarbitol

A

phenytoin

can cause nystagmus, lupus

A

phenytoin

causes gingival hyperplasia

A

phenytoin

blocks intestinal conjugase

A

phenyhtoin

blocks glutamate release

A

barbs

bind at GABA receptor not at Chloride channel

A

Barbs

terminats reaction by redistribution to tissues

A

benzos

short acting triazolam, oxazepam midazolam, highest addictive

potential

A

benzos

use for nignt terrors, sleepwalking because DECREASE stage 3/4

sleep

A

benzos

decrease rem sleep

A

triazolam oxazepam midazolam

short acting benzos

A

diazepam lorazepamm chlordiazepoxide

longer acting, use in alchohol detox

A

alprazolam

use in panic attacks ultra short acting

A

drugs with decrease solubility in blood

rapid induction and recovery times

A

drug with high solubility in lipids

increased potency = 1/minimal alveolar concentration

A

halothane

hepatotoxic, causes fulminant liver failure

A

enflurane

proconvulsant

A

methoxyflurane

nephtrotoxic

A

nitrous oxide

low blod and lipid solubility

A

halothane enflurane isoflurane sevoflurane methoxyflurane

nitrous oxide

inhaled anesthetics

A

thipental

rapid entry into brain, induction of anestesia

A

thiopental

decrease cerebral blood flow

A

midazolam

used in endoscopy ans anesthetics

A

arylcyclohexylamines (Ketamine)

block NMDA receptors, cause hallucination

A

Ketamine, arylcyclohex

increase cerebral blood flow

A

propofol

rapid anesthesia induction, potentitates GABAa

A

Procaine cocaine tetracaine lidocaine mepivacacaine

bupivacaine

block na channesl

A


bupivacaine

bind to activated na channels

A


bupivacaine

order of nerve blockatde small myelinated> small unmyelanted

>large m yelanated > large unmyelenated

A


bupivacaine

order of loss pain, temp, touch (meiissners) pressure (paccinian)

LOSE PRESSURE LAST

A


bupivacaine

given with vasocinstrictors (except cocaine)

A

succinylcholine

phase 1 no antidoted, block potentiated by cholinesterase

inhibitors

A

succinylcholine

phase 2 (repolarized but blocked) antidote is ache inhibitor

A

succinylcholine

depolarizing neuromuscular blocking drug

A

turocurarine atacurium mivacurium pancuronium vecuronium rocuronium

nondepolarizing compettive neuromuscular blocking drugs

A

dantrolene

binds ryanodine recept, prevents release of ca from sarcoplasmic

retic

A

dantroliene

use in malig hypothermia

A

inhaled anesthetic + succinylcholine

can cause malig hyperthermia

A

Bromocriptine, pramipexole, ropinarole

dopamine receptor agonists

A

amantadine

increase dopamine release

A

amantadine

causes ataxia

A

selegeline

mao b, used in parkinsons

A

entacapone tolcapone

COMT inhibitors

A

levodopa

effects wane, increasing on-off phenomena

A

levodobpa carbidopa

do not give Vit B6 because that causes increased metab of DOPA

A

carbidopa

blocks doba decarboxylase

A

sumatriptan

5ht agonist, causes vasoconstriction

A

sumatriptan

inhibits trigeminal activatoin and vasoactive peoptide release

A

sumatriptan

causes coronary vasospasm

A

memantine

blocks nmda, prevents gultamate excitotoxicity in alzheimers

A

donepezil

ache inhib use in alzhemiers

A

essential tremor

use b blocker

A

alzheimers

increased glutamate, decreased ach

A

ketorolac

parenteral nsaid

A

indomethacin

close pda

A

ccelecoxib

cox 2 inhib

A

cox 2

inflammatory cells and vascular endothelium, mediates inflammation and pain

A

cox 1

helps maintain gastric mucosa

A

cox 2 inhibs

sulfa allergy, increase risk of thrombosis (blocks pgi2 more)

A

acetamenophen

lacks anti inflammatory properties

A

n acetylsystine

anditode to acetamenophen tox by regenerating glutahtione

A

acetamentophen

toxicity shose ^^ AST ^^ALT normal alk phos

A

etidronate, pamidronate, alendronate, risendronate

bisphosphonates, inhibit osteoclast activity

A

bisphosphonates

reduce formation and resoprtion of hydroxyapatite

A

bisphosphanates

resemble pyrophosphate

A

bisphosphonates

cause corrosive esophagitis

A

bisphosphonates

poor oral availabiliyt

A

colchicine

binds tubuilin to inhibit microtubule, impairing leuko

chemotaxis

A

colchicine

causes diarrhea

A

propenicid

inhibits resorption of uric acid in PCT,

A

prbenicid

inhibits secretion of penicillin

A

allopurionol

inhibits axanthine oxidase

A

allopurinol

increases concentrations of azathioprine and 6 mp

A

propenicid and allopurionol

do not use in acute gout

A

salicylates

depress uric acid clearence

A

hctz furosimide

increase gout

A

etanercept

recombinant tnf receptor, binds tnf

A

etanercept

causes infections, TB

A

infliximab

anti tny antibody

A

infliximab

often causes reactivation of latent tb

A

methotrexate

blocks DHF, first line in RA

A

methotrexate

causes stomatitis

A

prednisone

use for RA in elderly

A

heparin

used during pregnancy, does not cross placenta

A

heparin

follow PTT because really inhibits xa

A

heparin

reverse with protamine sulfate

A

heparin

risk of hit increases with tx lenght and platelet factor 4

A

antithrombin three

inhibites 2,7,9,10,11

A

lepirudin, bivalrudin, argatroban

direct thrombin inhibitors

A

protamine sulfate

treat heparin overdose but NOT direct thrombin inthibitors

A

warfarin

follow PTT because really inhibits xa

A

warfarin

not used in pregnant women

A

warfarin

watch out for proein c deficiency, causes clotting early in tx

A

cholestyramine

binds warfarin

A

warfarin

slow onset of action (3 days)

A

warfarin tox

give fresh frozen plasma

A

cryoplasma

only Factor 8 fibrinogen

A

streptokinase

much cheaper than tpa

A

streptokinase, tpa, urokinase, anistreplase

increase pt and ptt, no change in platelet count

A

aminocaproic acid

inhibits plasmin activation

A

sagramostin

recombinant GMCSF used in chemo

A

filgastrim

only affects GRANULOCYTES

A

asprin

causes tinnitus

A

asprin

causes acute resp. alkalosis, followed by metabolic acidosis

A

abciximab

monoclonal antibody to gpII/III (binds fibrinogen)

A

abciximab

similar in effect to GLANZMAN's

A

abciximab

used in coronary angioplasty

A

cilastazol/dipyridamole

inhibits plt phosphodiesterase, decreases plt aggregatoin and

vasodilates

A

desmopressin acetate

synthetic adh, RELEASES factor 8 from entothelium, use in

hemophilia A

A

clopidogril

adp receptor blocer

A

ticlopidine

adp receptor blocker

A

clopidogril ticlopidine

used in coronary stenting

A

ticlodipine

causes neutropenia

A

methotrexate

s phase specific

A

methotrexate

inhibits DHF reducatse, decreasing dTMP

A

methotrexate

rescue with leucovorin

A

methotrexate,

causes fatty change, mucositis, ulcer

A

methotrexate

can use in abortion, ectopic pregnancy

A

methotrexate

can use in rheumatoid arthritis, psoriasis

A

5fu

s phase specific, inhibits thymidylate synthase

A

5fu

use in colon cancer, solid tumor

A

5fu

rescue with thymidine

A

cladribine

cyttoxic purine analog, resistent to degradation by ADA use in hairy

cell

A

fludrabine

purine, resistant to ada, use in CLL

A

6mp

block de novo purine, activated by HGPRTase

A

6mp

use in leukemia lymphoma

A

6mp

metabolized by xanthine oxidase, toxic with allopurinol

A

cytarabine, ara-c

inhibits dna polym (pyrimidine analog

A

cytarabine, ara-c

use in aml, all, non hodgkin's lymphoma

A

cyclophosphamide, ifosfamide

alkylating agents, crosslink at guannine N7, require activation by

liver

A


used in nhl, breast ovarian, also for PAN

A


cause hemorahgic cystitis, prevent with MESNA

A

mesna

prevents hemorhagic cystitis from cyclophos

A

Carmustine, lo mustine, semustin streptozocin

cross link dna, cross blood brain

A

Carmustine, lo mustine, semustin streptozocin

use in Brain tumors

A

Cisplatin, carboplatin

cross link dna use in testic bladder, ovar, lung

A

amifostine

use with platinum drugs to gather free radicals, prevent nephrotox

A

Cisplatin, carboplatin

sever nephrotox, acoustic nerve damage

A

busulfan

alylate dna, ablates bone marrow in transplants, use in cml

A

busulfan

causes pulm fibrosis, hyperpigmentation

A

doxorubicin, daunorubicin

intercalate dna, use in hodkink, myeloma, solid tumor

A

doxorubicin, daunorubicin

dilated cardiomyopathy, alopecia, leg swelling, cardiotoxicity

A

dactinomycin

intercalates, use in wilms ewings, rhabdomyo

A

bleomycin

forms free radicals, use in testicular , hodgkins

A

bleomycin

causes pulm fibrosis, skin changes

A

hydroxyruea

inhibits ribonuceide reductase

A

hydroxyurea

use in melanoma, cml, sickle cell

A

hydroxyurea

increases HbF synthesis

A

tamoxifen, raloxifen

antagonists in breast, agonsist in bone

A

tamoxifen, raloxifen

increase risk of endometrial carcinoma

A

anastrazole

reversible aromatase inhib

A

exemestane

irreversible aromatase inhib DON"T MESS WITH MESTANE

A

trastuzamab

antaibody against her2 erb b2 (tyrosine kinase)

A

trastuzamab

causes cardiotoxicity

A

imatinib

tyrosine kinase inhibitr

A

imatinib

causes cardiotoxicity

A

vincristine, vinblastine

bind tublin block microtubule formation

A

vincristine

causes neurotoxicity, peripheral neuritis

A

vinblastine

blasts bone marrow (bone marrow suppression)

A

paclitaxol

prevents disassembly of mitotic spinle

A

flutamide

androgen receptor antagoneist in prstate cander

A

leuprolide goserelin

gnrh agonists for prostate cancer

A

ifn a

use in hairy cell cml kaposis

A

rituximab

binds cd20 on b cells, monocolonal ab treat low grade

nhl

A

m phase specific

vinca alkaloids, taxols

A

S phase specific

etoposide, antimetabolites

A

g phase specific

bleomycin

A

etoposide

topo 2 blocker

A

cimetidine ranitidine famotidine nizatidine

h2 blockers, decreases h+ secretion by parietal cells

A

cimetidine

inhibis p450

A

cimetidine

causes gynecomastia, prolactin releae

A

cimetine and ranitidine

decrease renal exretion of creatinine

A

omeprazole lansoprazole

irreversible inhibit h k atpase on luminal side

A

omeprazole lansoprazole

cause reflex gastrin secretion

A

mperidine

leas likely to cause contraction of sphincter of oddi

A

megestrol

pro apetite

A

phentyramine

appetite suppresant

A

sibutramine

mao inhibitor, reduces appetite

A

sucralfate

requires acid activtion, cannot be used with antacis or h2 blockers

A

misoprostol

pge1 analog, prevents nsaid induced ulcers

A

misoprostol

keeps patent ductus arteriosis

A

pirenzepine, propantheline

block m1 recepors on ecl cells (less histamine) and m3 receptors

on parietal cells

A

aluminum hydroxide

causes constipation and hypophosphatemia

A

mg oh

causes diarrhea and hyporeflexia, hypotension and cardiac arrest

A

calcium carbonate

causes hyupercalcemia, rebound acid and milk alkali (hyercalcemic

alkalosis)

A

MgOH AlOH CaCo3

all antacids can cause hypokalemia since lose acid, loose k+

A

CAco3

reduces effectiveness of tetracyclines

A

infliximab

antibody to tnf

A

sulfasalazine

sulfapyridine plus mesalamine, use in crohns uc

A

sulfasalazine

causes oligospermia

A

loperamide

opoid , suppreses gi matility, use in diahhrea

A

ipecac

proemetic, acts on chemotactic trigger zone

A

ondesetron

5ht3, central antiemetic

A

metoclopramide

d2 antagonist, increass contractility, PROEMETIC

A

metoclopramide

causes parkinsonian side effects

A

cisapride

prokenitec, promotes release of AcH

A

octreatide

somatostain, used in varceal blleding, and carcinoid diarrhea

A

docusate

detergent, water + fatty acid, stool softener

A

psyllium, methyl celluslose

bulk forming laxatives

A

irritant laxatives

castor oil, senna, bisacodyl

A

lubricating laxatives

mineral oil, glycerin

A

ursodial

bile acid derrivative, used to dissolve cholesterol stones

A

lispro aspart

short acting insulin

A

regular

regular inulin use in DKA

A

glargine, determir ultralente

long acting insulin

A

tolbutamide chlorpropamide

first gen sulfonureas, close k channel

A

glyburide, glimepride glipizide

second gen sulfonyl

A

tolbutamide chlorpropamide

causes disulfiram like effects

A

Metformin

decreases gluconeo, increase glycolysi in liver

A

metformin

causes lactic acidosis from excess glycolytic pathway activation

A

pioglitazone rosiglitazone

ppar gamma nuclear recepor increases response to insulin

A

pioglitazone rosiglitazone

causes edema weight gain, hepatotoxicity

A

acarbose, miglitol

inhibit brush border alpha glucosidases

A

pramlintide

decreases glucagon

A

exenatide

glp1 mimetic, inhibits glucagon release, increase insulin

A

orlistatt

get's rid of fat, inhibits pancreatic lipase

A

sibutramine

snri, appetite suppresant

A

Propylthiouracil

inhibits organification, decreases peripheral coversion of t4 to t3

A

propylthiouracil, methimazole

can cause skin rash agranulocytosis, aplastic anema

A

beta blockers

prevent t4 to t3

A

perchlorate

block iodide uptake, use in radioactive fallout

A

methmimazole

blocks organification

A

somatostatin

use in carcinoid gastrinoma, glucagonoma

A

levothyroxine, triiodothyronine

do not releive exopthalomus

A

metyrapone

blocks 11 alpha hydroxylase

A

democlocycline

adh antagonist, use in SIADH

A

democycline

can cause photosensitiveit abnormalities of bone and teeth

A

finasteride

blocks 5 alpha reductase

A

reserpine

blocks ne from getting into vessibles, anti htn

A

guanethidine

blocks ne from into vessilces, anti htn

A

methyldopa

a2 agonist, anti htn

A

nitroprusside

releases cn

A

diazoxide

increases K, causes hyperglycemia

A

hydralazine

increases cGMP vasodilates arterioles > vins

A

hydralizine

first line for pregnancy with methyldopa

A

hydralazine

causes rebound tachy, lupus, fluid retention

A

minoxidil

k channel operner, hyperpolarizes and relaxes vascular smooth

muscle

A

minoxidil

causes hair growth, reflex tachy, pericardial effusion, salt retention

A

Nifedipine

ca blocker more peripheral

A

verapamil diltiazem

more heart

A

ca channel blockers,

use in prinzmetals, raynaud

A

ca channel blockers,

cause flushing dizziness constipation

A

verapamil diltiazem

causes constipation

A

nitroglycerin, isosorbide dinitrate

increase cGMP relax blood vessels

A

nitroglycerin, isosorbide dinitrate

dilate veins>>arteris, preload down

A

nitroprusside

cGMP up direct release of NO, decrease preload and after load

A

Fenoldopam

D1 agonist, Gs relaxes renal vascular smooth muscle

A

Diazoxide

k channel operner relaxes vascular smooth muscle

A

nitroprusside, fenoldopam, diazoxide

malignant htn tx

A

Nitrates

cause increase contractilyt and rebound tachy

A

beta blockers

cause increase EDV and incrase ejection time

A

Nifedipine

similiar to nitrates (reflex tachy)

A

verapamil

siiilar to effect in beta blockers

A

pindolol and acebutol

partial beta agonists, contraindicated in angina

A

statins

lower ldl mostly

A

statins

cause increase in lfts, rhabdomyolyis esp w/ fibrates

A

niacin

incredase hdl, inhibit lipolysis in adipose, reduces hepatic vldl

A

niacin

red flush face is decreased by aspirin

A

cholestyramin, colestipol and colesevalm

decrease ldl, contraindicated wi gallstones

A

cholestyramin, colestipol and colesevalm

can increase triglycerides

A

ezetimibe

lowers ldl, prevents cholest reabsorption at small intestine

brush border

A

gemfibrazil, clofibrate, bezafibrate fenofibrate

lower TGs dramatically

A


upregulate LPL

A


cause myositis w statins and gallstones with bile acid resins

A

b1 are gs

they activate PKA, phosphyrlates Ltype Ca and phospholamban, Increase Ca during contraction

A

digoxin

direct inhibiton of na ka atpase, indrect inhibition of na ca exchanger, increases ca

intracellular concentration

A

digoxin

stimulates vagus nerve

A

digoxin

use in chf because it increases contractility

A

digoxin

use in a fib since it decreases conduction through vagal

stimulation

A

digoxin

increases parasympathetic activity

A

digoxin

tox worse in renal failure

A

digoxin

causes hypokalemia, competes with k at binding site

A

digoxin

quinidine reduces digoxin clearence

A

digoxin

antidote is lidokane, normalize k anti dig Fab fragments and mg

A

Class 1

usualy block conduction in depolarized cells

A

class 1a

increase action potential lenth

A

class 1 b

decrease action potential length

A

class 1c

no change in action potential length

A

class 1

all decrease slope of phase 4 deplarization by working on

sodium channels

A

Quinidine procainamide disopyramide

class 1a

A

class 1a

increase effective refrac period and increase q ti interval. Affect both atrial and ventricular arrythmias

A

class 1a

used in reentrant and extopic supraventricular tachy

A

quinidine

causes cinchonism, headache tinnitus thrombocytopenia,

torsades de pointes

A

procainamide

drug inducded lupus

A

lidocaine, mexiletine, tocainide

class 1b

A

class 1b

all affect ischemic or depolarized tissue, used in acute ventricular

arrythmias

A

class 1b

use POST MI

A

class 1b

shortest duration time

A

class 1b

use in digitalis induce arrythmia

A

flecainide, encainide, prpafenone

class 1c

A


use in vtachs that progress to vfib

A


proarrythmic

A


used for intractable arrythmias

A


never use post mi

A


verytight binding and slow rlease

A

lidocaine, mexiletine, tocainide

low affinity ver rapid binding and release, only act on active tissue

A

beta blockers

may mask signs of hypoglycemia

A

sotalol, ibutilide, amiodarone, dofetlide

k channel block, increase AP duration increase Effective refractory period increase qt

interval

A

soltalol

causes torsades de pointes and excessive beta block

A

ibutilide

torsades

A

amiodarone

causes pulm fibrosis, corneal deoposits, hepatotoxicity, skin

deposits, constipatoin, bradycarida

A

amiodarone

cause HYPOor HYPER thyroid

A

amiodarone

check pfts lfts and thyroidfts

A

verapamil, diltiazem

class 4 mostly affect av nodal cells

A


decrease conduction velocity, increase effective refractory period, increase PR interval

A


increase PR interval

A

adenosine

releases k from cell, hyperpolarizing cell, decreasing ca

conductance

A

adenosine

abolishes av nodal arrythmias, reduces spontaneus depolarization

depresses ectopic pacemakers in hypokalemia

effective in torsades de pointes and digoxin toxicity

A

acetycholine

opens k channels, hyperpolarize

A

milrinone

increases cardiac contractiliyt by inhibiting phosphodiesterase

A

milrinone

increases cAMP, camp increases ca channel conductance, thus increase

contractility and vasodilate

A

p450 inducers

quiidine barbs st johns phenytoin rifampin griseofulvin carbamaz

(alcohol)

A

p450 inhibitors

sulfonamides inh cimetidine ketoconazole erythromycin

grapefruit

A

quinidine, barbs, st johns phenytoin rifampin griseofulvin

carbamaz

p450 inducers

A


grapefurit

p450 inhibitors

A

atropine like side effects

tricyclics (less is nortriptyline, more is amytryptiline)

A

coronary vasosasm

cocaine sumatripan

A

cutaneuos flushing

niacin ca 2 channel blockers adenosine vancomycin

A

dilated cardiomyopathy

doxorubicin daunorubicin, alcohol

A

torsades

class 3 sotalol, class 1a quinidine, cisapride (a prokinetic increase

ach)

A

agranulocytosis

clozapine carbamazepine colchicine propylthiouriacil

methimazole

A

aplastic anemia

chloramphenicol, benzene, nsaids propylthiouracil methimazole

A

direct coombs positive hemolytic anemia

methyldopa (a2 agonist)

A

gray baby

chloramphenicol

A

hemolysis in g6pd

inh, sulfonamides primaquine aspirin, ibuprofen nitrofurantoin

A

megaloblastic anemia

phenytoin methotrexate sulfa drugs

A

thrombosis

A

cough

A

pulm fibrosis

bleomycin busulfan amiodarone

A

acute cholestatic hepatitis

macrolides

A

hepatic necrosis

halothane, valproate, acetamenophen amanita phalloides

A

hepatitis

A

psudomembranous colits

clindamycin ampiciln

A

adrenocortical insufficiney

glucocorticoid withdrawal

A

hot flases

tamoxifen clomiphene

A

gingival hyperplasia

phenytoin methotrexate sulfa drugs

A

gout

furosemide thiazides

A

osteoporosis

corticosteroids heparin

A

gynecomastia

spironolactone digitalis cimetidine chronic alcohol use estrogens

ketoconazole

A

photosensitivity

sulfonamides amiodarone tetracycline

A

rash SJS

ethosuximide lamotrigine carbamazepine phenobarbitol, phenytoin sulfa drugs penicllin

allopurinol

A

sle drug induced

hydralazine inh procainamde phenytoin

A

tendonitis

fluorquinolones bad for the bones

A

fanconi (can't resorb in proximal renal tubule

expried tetracycline lead

A

interstitial neprhitis

methicillin nsaids furosimide

A

hemorrhagic systitis

cyclophosphamide isofosmaide

A

cinchonims

quinidine quinine

A

diabetes insipidus

lithium democycline

A

parkinson like

halperidol, chlorpromazine, reserpine, metoclopramide, mptp

A

seizures

bupropion, imipenem/cilastin inh

A

tardive dyskinesia

antipsychotics

A

disulfiram like

metronidazole, cephalosporins, procarbazine, first generation

sulfonylureas

A

nephrotox/neurotox

polymyxins

A

neprhotox ototox

aminoglycosides vancomycin, loop diuretics, cisplatin

A

acetomenophen

antidote n acetylcystein

A

salicylate

antidote NaHCO3 (alkalinaize urine) , dialysis

A

amphetamines

antidote NH4 cl acitify urine

A

anticholinesterases, organophosphates

antidote atropine or pralidoxime

A

antimuscarine or anticholinergeic

antidote physostigmine salycylate

A

beta blockers

antidote glucagon

A

digitalis

antidot, normalize k, lidocaine , anti dig fab, mg2

A

iron

antidot deferoxamine

A

lead

antidote caEDTA dimercaprol, succimer, penicillamine

A

mercury, arsenic gold

dimercaprol, succimer

A

arsenic

see mees lines in posoning

A

copper arsinic gold

anditode penicillamine

A

cyanide

antidote nitrate, hydroxyobalmin, thiosulfate

A

methmeglobin

antidote, methylene blue , vit c

A

carbon monoxide

antidote 100% o2 or hyperbaric o2

A

methanol, ethylene glycol

antidote, ethanol, dialysis, fomepizole

A

opoids

antidote naloxone naltrexone

A

benzos

antidote flumenazil

A

tcas

antitode naHCO3 serum alkalinzation

A

heparin

antidote protamine

A

warfarin

antidoet vitamin k fresh frozen plasma

A

tpa, streptokinase

antidote aminocaproic acid

A

theophylline

antidote beta blocker

A

alpha 1

A

alpha 2

A

beta 1

A

a1 a2 b1 b2 m1 m2 m3 d1 d2 h1h2 v1 v2

qiss qiq siq sqs

A

a1 gq

increase vasc cmooth muscle contraction, pupilary dilatro

contraction (mydriasis) baroreceptor reflex

A

a2 gi

decrease symp outflow decrease insulin release

A

b1 gs

increase heart rate increase contractility increase renin release

increase lipolysis

A

b2 gs

vasodilation bronchodilation increase heart rate increase

contractility increase lipolysis increase glucagon release

DECREASE uterine tone

A

m1 gq

cns enteric nervous system

A

m2 gi

decrease heart rate and contractility of atria

A

m3 gq

increase exocrine gland secretions increase gut peristalsis, increase

bladder contraction sweat, bronchoconstriction, increase

pupillary sphincter muscle contraction (miosis, ciliary muscle

contraction (accomidation)

A

d1 gs

relaxes renal vascular smooth muscle

A

d2 gi

moduclates transmitter rlease esp in brain

A

h1 q

increase nasal and bronchial mucus production, contraction of

bronchioles, pruritis and pain

A

h2 s

increase gastric acid secretion

A

v1q

increase vascular smooth muscle contraction

A

v2 s

hwo permability and reabsorption in collecting tubes of kidney

A

hemicholinium

blocks uptake of choline

A

reserpine

blocks dopamine packaging into vessicles

A

guanetidine

prevents norepi rlease

A

bethanechol

cholinomimetci resistant to chilinesterase

A

bethanechol

use for post op ileus and urinary retention

A

carbachol

use in glaucoma, pupillary contraction release of intraocular

pressure

A

pilocarpine

use in glaucoma emergency

A

pilocarbine

potent stimulator of sweat tears and saliva

A

pilocarpine

contract ciliary muscle of eye, pupillary sphincter, narro

A

pilocarpine

use in both open and closed angle glaucoma

A

methacholine

challenge test for asthma

A

succinylcholine

nicotinic agonist, facilitates intubation and skeletal muscle

relaxant

A

neostigmine

ache inhibitor, no cns penetratoin

A

pyridostigmine

ache inhibitor

A

pyridostigmine

no cns penetration, use for MG

A

edrophonium

compettive ache inhib, diagnose for MG, short acting

A

Physostigmine

long acting penetrates CNS, atropine antidote

A

echothipate

ache inhib use in glaucoma

A

pralidoxime

chamical antagonist used to regenerate active cholinesterase

A

atropine

muscarinic antagonist pupil dilation, cycloplegia

A

homatropine

musc antag

A

tropicamide

musc antag

A

Benzotropine

cns musc antag, use in parkinsons

A

benzotropine

reduces parkinsonian tremor

A

scopalamine

cns musc antag, use for motion sickness

A

irpatropium

musc antag, use in asthma, copd

A

oxybutynin, glycopyrolate

musc antag, reduce urinary urgency and bladder spasms

A

methscopalmin, pirenzipine, propantheline

musc antag, use in peptic ulcer (m1 and m3

A

atropine

can cause acute angle closure glaucoma in elderly, urinary

retention in men with prostatic hyperplasia, hyperthermia in

infants

A

hexamethonium

nicotinic angagonist, prevents vagal reflex response, prevents

reflex bradycardia

A

hexamethonium

used to help smokers quit

A

epinephrine

low dose selective for b1

A

nor epi

a1, a2 >b1

A

isoproternerol

A

dopamine

d1=d2>b>a inotropic and chronotopic

A

dopamine

use in shock to increase renal perfusion

A

dobutamine

b1>b2 inotropic but not chornotopic

A

dobutamine

increases contractility and cardiac conduction velocity

A

phenylephrine

use for pupillary dilation, vasal constriction, nasal decongestion

A

albuterol

b2>b1 use for acute asthma

A

terbutamine

b2>b1 use to reduce premature uterine contractions

A

ritrodrine

b2 use in premature uterine contractions

A

amphetamines

release stored catecholamines

A

ephedrine

release stored catecholamines, use in nasal decongestion,

intontinence, hypotension

A

clonidine

central a2 agonist decreases adrenergic, use in hypertension

A

alpha methyldopa

central a2 agonist decrease central adrenergic outflow

A

selective b2 agonists

metaprotenerol, albuterol, salmetrol, terbutaline

A

phenoxybenzamine

irreversible a blocker

A

phentolamine

reversible a blocker

A

parazosin, terazosi, doxazosin

a1 selective blockers

A

parazosin, terazosi, doxazosin

1st dose orthostatic hypotension

A

mirazapine

a2 selective use in depression w insomnia

A

mirtazapine

causes sedation, increases serum cholesetrol increases appetite

A

beta blockers

decrease av conduction velocity use in afib and aflutter

A

betablockers

decrease secretion of aq humor (use timolol)

A

beta blockers

cause impotence, bradycaria sedation sleep alterations

A

beta blockers

can't feel effect of hypoglycemia

A

betaxolol, esmolol, atenolol, metorpolol

beta 1 seletive

A

esmolol

short acting

A

metoprolol

causes dislipidemia

A

carvedilol lebetelol

nonseletive a and b antagonists

A

pindolol, acebutol

partial b agonists

A

cyclosproine

blocks differentiation and activation of t cells, inhibits

calcinueron

A

cyclosprine

prevetns production fo il 2 and its receptor

A

tacrolimus

binds to fk binding protein, inhibtis SECRETION of IL2

A

cyclosproine and tacrolimus

nephrotoxic

A

tacrolimus

causes hyperglycemia peripheral neuropathy, hypertenion and

pleural effusion

A

azathipruine

antimetabolite, toxic to proliferating lymphosityes

A

azathiburine

metabolized by xanthine oxidase, toxic effects increased by

allopurinol

A

muronomab

antibody to cd3 on surface o f tcells, blocks cd3 signal

transduction

A

sirolimus

binds mtor inhibits tcell proliferation in response to il2

A

sirolimus

causes hyperlipidemia, thrombocytopenia, leukopenia

A

muromonab

causes cytokine release syndrome, hsn reaction

A

myclophenolate mofetil

blocks denovo guanine synthesis

A

daclizumab

anti cd 25, high affinity for IL 2 receptor

A

aldesleukin

il 2 use in renal cell carcinoma metastatic melanoma

A

epo

use in anemia

A

filgastrim

use in recovery of bone marrow

A

sagramostim

use in recovery of bone marrow

A

alpha interferon

use in hep b c kaposi leukemia, malig melanoma

A

b interferon

use in ms

A

gamma ifn

use in chronic granulomatous disease

A

oprelvekin

il 11 use in thrombocytopenia

A

amantadine

blocks viral penetration and uncoating (m2

A

amatnatine

use in influenza a

A

zanamivir, oseltaivir

neuramidanse inhibs, prevents release of progeny virus

A

Ribavarin

rsv, hep c w interferon

A

ribavarin

inhibits GTP synth, competively inhibts IMP dehydrogenase

A

ribavarin

causes hemolytic anemia and severe birth defects

A

acyclovir, famciclovir

monophos by herpes thymidine kinase, is guanosine analog, causes

chain termination

A

famciclovir

for herpes zoster only

A

ganciclovir

formed by viral kinase or thymidine kinase, triphosphate

formed by cellurlar kinase

A

ganciclovir

causes leukopenia, neutropenia, thromocytopenia, renal tox

A

foscarnet

viral dna polym inhibitor,

A

foscarnet

does not require activation by viral kinase

A

foscarnet

use in cmv retinits

A

foscarnet

ca and mg wasting, it chelates calcium

A

Saquinavir, ritonavir, indinavir nelfinavir amprenavir

Protease inhibitors

A

protease inhibitors (navir)

block gag and pol cleavage

A

indinavir

causes thrombocytopenia

A

protease inhibitors (navir)

cause hyperglycemia, lipodystrophy

A

adidovudine, didanosine, zalcitabine, stavudine, lamivudine

abacavir

A

lamivudine

good for HBV

A

Nevirapine, efavirenz, delvaridine

A

NNRTI (efavirenz)

do not require phosphyrlation to become active

A

enfuvirtide

blocks gp41

A

raltegravir

hiv integrase

A

maraviroc

binds ccr receptor, prevents hiv binding

A


grapefurit

cause kernicterus

A

aminoglycosides

cause baby ototox

A

fluroquinolones

cause bone and cartilage damge in babies

A

ertytrhomycin

cause acute cholestatic hepatits in mom

A

metronidazole

causes mutagensis in babies

A

tetracyclines

discolored teath inhibit bone growth in pabies

A

griseofulvin

teratogenic

A

ribavarin

teratonogenic

A

chloramphenicol

aplastic anemia in babies, gray baby

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