Albin Drugs 2

mawuyozo's version from 2016-04-03 18:53


Question Answer
SildenaFILLInhibit cGMPphosphodiesterase or PDE 5 Sx- Dont take it with nitrates. Headache, Flushing, blue green color vision


: Renal
Question Answer
Urine NaCl increase inAll diuretics
Urine K increase in all exceptK sparing Diuretics
Blood ph – AcidemiaCarbonic Anhydrase
AlkalemiaLoop and thiazide
MannitolIncreases renal tubal osmolarity
Mannitol DXICP, IOP
Mannitol SXDo not give for CHF
Furosemide MOAInhibits Na/K/2CL in the thick ascending limb. ↑IGE1
Furosemife DxAcute pulmonary edema, CHF
Furosemide toxicity (OHHH DANG)Ototoxicity, Hypokalemia, Hypocalcemia, Hypomagnesemia, Dehydration, Allergy (sulfa), Nephritis (interstitial), Gout
ACIDazolamide↑Serum Acid ↑Lumen Bicarb by inhibiting carbonic anhydrase inhibitor in PCT. Dx Glaucoma, Mountain sickness and Metabolic alkalosis. Sx Metabolic acidosis
Hydrochlorothaizide MOAInhibit Na/Cl at early distal convoluted tubule
Hydrochlorothaizide Dx Hypertension,CHF, Calcium stones, nephrogenic diabetes inspidus. Makes urine more concentrated
Hydrochlorothaizide SxAlkalosis & Hyponatremia(Neurologic- Mental Status & Seizures), Hypokalemia(muscle weakness & cramping) & hyper GLUC – hyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalemia(Side effect used as treatment for pts with CHF or hypertension & OSTEOporosis)
Spirnolactone MOAAldosterone receptor blocked in the collecting duct
Spirnolactone Dxhyperaldosteronism(CONS SYNDROME), hirsutism, CHF – Increase Overall Survival
Spirnolactone SxHyperkalemia gyncomastia & prolonged qt interval
Spirnolactone decreaseshydrogen ion secretion from the intercalated cells of the collecting tubules
Eplerenone↓ incidence of anti-androgen side effects (e.g., gynecomastia) compared to spironolactone
Captopril, Enalapril, Lisnopril MOAInhibit ACE → ↓Angiotensin 2 also bradykinin increases → ↓ GFR. Dx Hypertension, CHF, Renal Disease due to diabetes, Prevent heart remodeling due to chronic hypertension.
ACE SxCough, Angioedema, Proteinuria, Taste, First dose hypOtension – Hyponatremia, hypovolemia and is contraindicated if patient is on thiazides, Pregnancy, Rash, Increased renin, Lower angiotensin,Increased creatinine, decreased GFR, and Hyperkalemia.
SX of ACEHyperkalemia & Cough
CandeSARTAN“LEAST sideffects”. Blocks Angiotensin II receptor. Does not increase Kallikrein → No cough. Dx Hypertension, CHF, renal disease due to diabetes. Sx Teratogenic.


: Hematology
Question Answer
Aspirin MOAIrreversible COX1 and COX2 Inhibitor → Arachidonic acid can’t be converted to prostaglandin H2 → Noncompetitive inhibtion → Vmax goes down → Efficacy goes down → Antiplatelet, Acidic. COX2 enzymes is only found inflammatory cells 72kD.
Aspirin noteIncreased Activity of cyclooxygenase-2 in colon cancer but TAKING ASPIRIN regularly have shown to lower incidence of adenomas.
ASPIRIN RescueTreat overdose with base. ↑Bleeding time
Aspirin SxReyes Syndrome, Anion gap metabolic acidosis and respiratory alkalosis and Nasalpolyps in 10% asthma treatment
Indomethacin – ENDomethacinMost potent to END PDA
Ibuprofen MOAMC OVC – 1st line for Acute Gout
Celecoxib MOASelective Cox 2 Inhibitor – Inflammatory cells inhibited but spares Cox 1 → No corosive GI
Celecoxib Platelet MOANO platelet aggregation unlike other NSAIDS or Aspirin
Celecoxib DxRA, Osteoarthritis, pts with gastritis or ulcers Sx- ↑Thrombosis, Sulfa Allergy, Contrindicated in stable angina unlike nsaids
Zileuton DxAsthma. Inhibits 5-Lipoxygenase – ↓production of all leukotrienes(used to activate AA) – Fast onset
Zafirlukast / MontelukastLTD4 Antagonist – Prophylaxis for bronchospasm due to exercise or antigen or aspirin
Cromolyn Sodium/Nedocromil MOA↓degranulation of Mast cells → ↓histamine & leukotrienes → ↓Bronchoconstriction
Cromolyn Sodium/Nedocromi DxProphylaxis of bronchial hyperactivity Sx- Low Toxicity due to not absorbed systemically
Bosentan MOACompetitive anatagoinst of endothelin receptors
Bosentan DxIdopathic or Primary Pulmonary arterial Hypertension
AbciximabTarget inhibit Gycoprotein IIb/IIIa – Mimics Glanzmann Thrombasthenia
Abciximab DxUnstable Angina, STENT, Myocardial Infarct Patients
Warfarin (coumadin)ChronicAnticoagulation - 1972WAR Works by interfering with y-carboxylation of vitamin K clotting factors 1972 Protein C & S
Warfarin (coumadin)Contraindicated in pregnancy. Sx bleeding and skin/tissue necrosis.
Warfarin (coumadin) RescueGive Vit K & FFP(fastest recovery).
Heparin MOAPromotes Antithrombin and ↓ Thrombin and Xa, as well as Factors 9, 10, 11, and 12. Monitor USING PTT.
Heparin dxShort half life, ACUTE CONDITIONS – Pulmonary Embolism, Acute coronary syndrome, MI, DVT. Sx Heparin Induced Thrombocytopenia, Bleeding, Osteoporosis.
Heparin RescueTreat with Protamine Sulfate
ArgatrobanIts so ghetto its binds to thrombin
EnoxaparinBind to thrombin III and less anti-thrombic activity. Low molecular weight. Increase activity agianst Factor Xa than anti thrombin
Streptokinase MOAPlasminogen → Plasmin → Degrade Fibrin. Sx – Hemorrhage. Derived from Streptococci & can cause hypersensitivity.
Streptokinase SxContraindicated during pregancy
Streptokinase RescueOverdose treat with Aminocarproic Acid
Ticoldipine MOA↓GPIIb/IIIa Activation by blocking ADP receptors → ↓Platelet aggregation
Ticoldipine SxNeutropenia – Fever & Mouth Ulcers (Follow CBC biweekly for 3months), Agranulocytosis
ClopidoGREL DxAcute Coronary Syndrome, Coronary Stents, ↓Chance of thrombotic stroke
Phosphodiesterase III MOAIncrease cAMP in platelets and ↓platelet aggregation. Viagra uses phosphodiesterase V “sildanFill”.
Cilostazol DxIntermittent claudication, Coronary vasodilation, Prevent strokes, Angina Prophylaxis. Inhibit PLATELETS, ARTERIAL VASODILATION
Dipyridamole Sx Hypotension & Abdominal Pain


: Immunology
Question Answer
CyclosporineBinds to cyclophilins → inhibit calcineurin and IL-2(POTENT) → ↓ T lymphocyte
Cyclosporine DxBlock rejection of kidney, liver, cardiac transplant ALSO to treat rheumatoid arthritis & psoriasis
Cyclosporine SxNephrotoxcity, Gingival Hyperplasia and hirsutism
Calcipotriene DxPsoriasis. Vit D binds and inhibits keratinocyte proliferation and stimulate Keratinocyte differentiation
TacrolimusTacrolimBBus – aka Fk506 – Binds to cyclophilins → inhibit calcineurin and IL-2 (POTENT) secretion→ ↓ T lymphocyte
TacrolimusDxBlock rejection of kidney, liver transplant.
TacrolimusSxPeripheral Neuropathy, Pleural Effusion, ↑ Blood pressure, ↑ Blood glucose, Nephrotoxicity
Sirolimus – aka rapamycinSirolimus Fkbp12 inhibits mTOR → inhibits the action of IL-2 from activating T and B cells
SirolimusDxUsed for kidney transplantation since no nephrotoxicity
SirolimusSxHyperlipidemia, thrombocytopenia, and leukopenia
Daclizumab – DA KlizumabAntiboDy agianst IL-2. Dx – Used for kidney transplantation since decreases the chances for infections.
Azathioprine – AzaTOEprineNitroimidazoloyl side chain attached to the sulfur of 6-mercaptopurine → 6-mercaptopurine is then converted thioinosinic acid (TIMP) by hypoxanthine-guanine phosphoribosyl transferase → TIMP a fraudulent nucleotide disrupts the proliferation of T & B cells.
Azathioprine DxKidney transplant, Glomerulonephritis, rheumatoid arthritis, hemolytic anemia
Azathioprine SxBone Marrow suppression due to active metabolite 6mercaptonurine is metabolized by Xanthine Oxidase. Allopurinol increases the toxicity.
Colchicine moaInhibition of Microtubular polymerization(CYTOSKELETON DISRUPTION). Reduce the formation of Leukotriene B4
Colchicine SxNausea, Diarrhea, Abdominal pain
Colchicine DxSecond Line Acute gout, prophylaxis for recurrent gout arthritis
Febuxostat MOANew Xanthine oxidase inhibitor & less interactions than Allopurinol
Mycophenolate moaTarget inosine monophosphate dehydrogenase. Prevents production of nucleoside Guanine. Leads to rapid arrest of B/T cell proliferation
Mycophenolate DxTransplants, Lupus Glomernephritis.
Muromonab – MORONonabAnti-CD3 antibody → Monoclonal AB that binds to CD 3 on the surface of T cells → Blocks Tcell transduction.
MuromonabDxImmunosuppression after kidney transplant
MuromonabSxCytokine Release Syndrome, Hypersensitivity
Trustuzumab/Herceptin - “TRUSTuzumab”Targets erb-B2 “dont TRUST her”
Trustuzumab/HerceptinDxHer 2 expressing breast cancer
Trustuzumab/HerceptinSxShe will hurt your heart and breathing ability
Etanercept→ Decoy TNF ALPHA receptor which is the main cause for Cachexia.
EtanerceptDx RAP Rheumatoid Arthritis, Ankylosing Spondylitis, Psoriatic Arthritis
EtanerceptSx ↑Risks for reinfection with tuberculosis and for malignancy due to immunosuppression.
Omalizumab – OMY cant breath MOABlocks the ability of IgE to bind to the Fc receptor on mast cells and basophils.
Omalizumab DxTreatment option for SEVERE Asthma.
Aldesleukin MOAInterleukin 2 recombinant cytokine → Turn on IL-2 → T cell proliferation.
Aldesleukin DxRenal Cell Carcinoma, Metastatic Melanoma
RasburicaseTumor Lysis syndrome prevention - Converts uric acid to allantoin
SteroidsUsed in pts nsaid or colchenie are contraindicated.
AllopurinolChronic gout(3 or more acute attacks or torphs) tx with high uric renal exertion
Probenecid & sulfinpyrazoneInhibits reabsorption of uric acid & penicillin in PCT
Chronic GoutAllopurinol, Febuxostat, Pegloticase, Probenecid
Acute GoutNSAIDS, Glucocorticosteroids, Colchicine
Methotrexate MOAInhibits DiHydrofolate reductase(pyrimidine synthesis) → ↓ tetrahydrofolate ↑dihydrofolate. Dx Molar pregnancies and RA. Inhibit S phase
Methotrexate SxTeratogenic, ^AST^ALT, Painfull mouth ulcers/nausea
Methotrexate RescueLeucovorin – Folate in Folinic Acid which is recognized by the body not by cancer.
Methotrexate RATreat with methotrexate and relieve symptoms with steroids. Sx – Pulmonary Fibrosis
Hydroxyurea – hydRoxyuRea moaInhibits Ribonucleotide Reductase → Decrease DNA synthesis(pyrimidine synthesis).
Hydroxyuread DxIncrease HbF in sickle cell disease, Melanoma, CML.
Cladribine moaPurine Analog high intracellular concentration because resistant to degradation by adenosine deamination
Cladribine DxHairy Cell Leukemia


: Anti-tumor antibodies
Question Answer
Adriamycin(Doxorubicin) – ATRIA-mycinFree radical Formation → DNA Breakage. Sx- Dilated cardiomyopathy and cardiac fibrosis.
Adriamycin(Doxorubicin) RescueDexrazoxone.
Bleomycin MOAFree radical Formation → DNA Breakage. Inhibits G2 phase. Dx Lymphomas (Hodgkin’s and non-Hodgkin’s), testicular cancer, melanoma, squamous cell carcinoma.
Bleomycin SxPulmonary Fibrosis.
CisplatinPLATINum complexes bind and crosslink DNA → apoptosis.
Cisplatin DxBladder, testicular and ovarian cancer
Cisplatin SxNephrotoxicity and Ototoxicity
Cisplatin RescueAmifostine
Cyclophosphamide moaProdrug activated by the liver → covalently cross-links DNA strands at guanine N-7 → cell death.
Cyclophosphamide DxLymphomas (Hodgkin’s and non-Hodgkin’s), leukemias (ALL/AML/CLL/CML), breast, testicular, and ovarian cancer.
Cyclophosphamide SxHemorrhagic Cystitis, penetrates the bladder
Cyclophosphamide RescueMesna


: Microtubule Inhibitors
Question Answer
Vincristine, Vinblastine & Vinorelbine MOABlocks polymerization therefore mitotic spindle cant form. Inhibits Mitosis
Vincristine, Vinblastine & Vinorelbine DxWilms’ tumors, lymphomas, leukemias, and testicular cancer.
Vincristine, Vinblastine & Vinorelbine SxBlasts Bone marrow(Vinblastine), Paralytic ileus & Neurotoxicity(Vincristine) – Finger numbness and tingling
Paclitaxel MoaHyperstabilizes polymerized microtubules in M-phase so that mitotic spindle cannot break down → No ANAphase. Inhibits Mitosis
Paclitaxel DxBreast cancer, ovarian cancer, lung cancer, and Kaposi sarcoma.
Alendronate DxOsteoporosis, Pagets Disease, Malignancy induced hypercalcemia
Alendronate SxVery Poor Gastro absorption, Esophageal Erosive
Tamoxifen MOAAntagonist breast/Agonist bones.
Tamoxifen Dx Recurrent Er positive breast cancer, osteoporosis
Relaxifen DxWith biphosphonates for Post Menopausal women for osteoporosis. No risk of endometrial carcinoma because its a endometrial antagonist.
Dactinomycin MOAIntercalates between guanine and cytosine → Inhibits DNA/RNA synthesis. Dx Rhabdomyosarcoma, Wilms tumor, Ewings sarcoma, testicular tumors. “Solid organ tumors”
Imatinib MesylateInhibits Bcr-Abl Tyrosine Kinase → Blocks proliferation and induce apoptosis. Dx - CML(Philadelphia chromosome), GISTs (GI stromal tumors)
eTOPOsideInhibition of TOPOisomerase II → DNA breakage → Cell death between S & G2 phase → prepare cell for mitosis. “Solid organ tumors”
eTOPOside SxMyelosupression, Alopecia


: Psychiatry
Question Answer
Tricyclic Anti-depressants MOABlocks catcholmaine uptake, Blocks Alpha 1, Anticholinergic, Anithistamine, Interfere with AV nodal conduction. Presynaptic serotonin & norepinephrine reuptake inhibiton – Prophalyxis Migraine
Amytriptyline – AMY-TRIPT-ylineFirst line for peripheral neuropathy(Diabetes)
Amytriptyline SxUrinary Retention
ImipramineSecond Line for Bed wetting &decreases stage 3 sleep
NOrtriptylineLeast amount of side effects on blood pressure
AmoxapineTreats both psychotic & depression
Clomipramine2ND LINE for OCD
Tricyclic Anti-depressants Sx3C's –Convulsions,Coma,Cardiotoxicity (due to inhibition of fast Na+ channels → slowed cardiac conduction → prolonged QRS), Antimuscuranic – flushing/Mydrasis
TCA RescueIV Sodium Bicarbonate to treat the Cardiotoxicity
ModafinilTreats Narcolepsy – day time sleepiness
Stimulant AntidoteNh4Cl – Ammonium chloride
ssrisDx – 1ST Line Panic Disorders, 1ST Line OCD, 1ST Line Depression, Generalized Anxiety, Bulimia Nervosa
Flashbacks PARalyze SEnior CITizensInhibit serotonin reuptake2-4 weeks to take effect.
ssri MOAPresynaptic Selective Serotonin Reuptake inhibiton
FluoxetineTreat Depression. Sx Longest half life.
ParoxetineTreat social phobia & pre mature ejaculation Sx – ↑ appetite & weight gain treat Anorexia
Sertaline SxSexual Dysfunction, GI disturbances
ssri AntidoteCyproheptadine
Monoamine Oxidase Inhibitors DX↑Serotonin, NE &Dopamine
MAO Inhibitors MOAInhibit Monoamine oxidase
MAO CHEESEIncrease tyramine leading to decreased degradation at the presynaptic nerve
Phenelzine Atypical DepressionMood Reactivity, Leaden Fatigue – arms & legs feel heavy, Rejection Senestivity, Increased sleep & appetite
VarencilinePartial agonist nicotonic acetylcholine receptors. Decreases pts having cravings & smoking cessation