yepugiga's 2016-06-28 20:34
SildenaFILL Inhibit cGMPphosphodiesterase or PDE 5 Sx- Dont take it with nitrates. Headache, Flushing, blue green color vision
Urine NaCl increase in All diuretics
Urine K increase in all except K sparing Diuretics
Blood ph – Acidemia Carbonic Anhydrase
Alkalemia Loop and thiazide
Mannitol Increases renal tubal osmolarity
Mannitol DX ICP, IOP SX -Do not give for CHF
Furosemide MOA Inhibits Na/K/2CL in the thick ascending limb. ↑IGE1
Furosemife Dx Acute 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 MOA Inhibit Na/Cl at early distal convoluted tubule
Hydrochlorothaizide Dx Hypertension,CHF, Calcium stones, nephrogenic diabetes inspidus. Makes urine more concentrated
Hydrochlorothaizide Sx Alkalosis & 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 MOA Aldosterone receptor blocked in the collecting duct
Spirnolactone Dx hyperaldosteronism(CONS SYNDROME), hirsutism, CHF – Increase Overall Survival Sx - Hyperkalemia gyncomastia & prolonged qt interval
Spirnolactone decreases hydrogen 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 MOA Inhibit ACE → ↓Angiotensin 2 also bradykinin increases → ↓ GFR. Dx Hypertension, CHF, Renal Disease due to diabetes, Prevent heart remodeling due to chronic hypertension.
ACE Sx Hyperkalemia, Cough, Angioedema, Proteinuria, Taste, First dose hypOtension – Hyponatremia, hypovolemia and is contraindicated if patient is on thiazides, Pregnancy, Rash, Increased renin, Lower angiotensin,Increased creatinine and decreased GFR
CandeSARTAN “LEAST sideffects”. Blocks Angiotensin II receptor. Does not increase Kallikrein → No cough. Dx Hypertension, CHF, renal disease due to diabetes. Sx Teratogenic.
Aspirin MOA Irreversible 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 note Increased Activity of cyclooxygenase-2 in colon cancer but TAKING ASPIRIN regularly have shown to lower incidence of adenomas.
ASPIRIN Rescue Treat overdose with base. ↑Bleeding time
Aspirin Sx Reyes Syndrome, Anion gap metabolic acidosis and respiratory alkalosis and Nasalpolyps in 10% asthma treatment
Indomethacin – ENDomethacin Most potent to END PDA, Prostaglandin Inhibitor
Ibuprofen MOA MC OVC – END the PDA
Celecoxib MOA Selective Cox 2 Inhibitor – Inflammatory cells inhibited but spares Cox 1 → No corosive GI
Celecoxib Platelet MOA NO platelet aggregation unlike other NSAIDS or Aspirin
Celecoxib Dx RA, Osteoarthritis, pts with gastritis or ulcers Sx- ↑Thrombosis, Sulfa Allergy, Contrindicated in stable angina unlike nsaids
Zileuton Dx Asthma. Inhibits 5-Lipoxygenase – ↓production of all leukotrienes(used to activate AA) – Fast onset
Zafirlukast / Montelukast LTD4 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 Dx Prophylaxis of bronchial hyperactivity Sx- Low Toxicity due to not absorbed systemically
Bosentan MOA Competitive anatagoinst of endothelin receptors
Bosentan Dx Idopathic or Primary Pulmonary arterial Hypertension
Abciximab Target inhibit Gycoprotein IIb/IIIa – Mimics Glanzmann Thrombasthenia
Abciximab/Epifibatide,tirofiban Dx Unstable 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) Rescue Give Vit K & FFP(fastest recovery).
Heparin MOA Promotes Antithrombin and ↓ Thrombin and Xa, as well as Factors 9, 10, 11, and 12. Monitor USING PTT.
Heparin dx Short half life, ACUTE CONDITIONS – Pulmonary Embolism, Acute coronary syndrome, MI, DVT. Sx Heparin Induced Thrombocytopenia, Bleeding, Osteoporosis.
Heparin Rescue Treat with Protamine Sulfate
Argatroban Its so ghetto its binds to thrombin
Enoxaparin Bind to thrombin III and less anti-thrombic activity. Low molecular weight. Increase activity agianst Factor Xa than anti thrombin
Streptokinase MOA Plasminogen → Plasmin → Degrade Fibrin. Sx – Hemorrhage. Derived from Streptococci & can cause hypersensitivity.
Streptokinase Sx Contraindicated during pregancy
Streptokinase Rescue Overdose treat with Aminocarproic Acid
Ticoldipine MOA ↓GPIIb/IIIa Activation by blocking ADP receptors → ↓Platelet aggregation
Ticoldipine Sx Neutropenia – Fever & Mouth Ulcers (Follow CBC biweekly for 3months), Agranulocytosis
ClopidoGREL Dx Acute Coronary Syndrome, Coronary Stents, ↓Chance of thrombotic stroke
Phosphodiesterase III MOA Increase cAMP in platelets and ↓platelet aggregation. Viagra uses phosphodiesterase V “sildanFill”.
Cilostazol Dx Intermittent claudication, Coronary vasodilation, Prevent strokes, Angina Prophylaxis. Inhibit PLATELETS, ARTERIAL VASODILATION
Dipyridamole Sx Hypotension & Abdominal Pain
apiXaban Moa - Inhibit factor Xa Tx - DVT,PE, AF
Cyclosporine Binds to cyclophilins → inhibit calcineurin and IL-2(POTENT) → ↓ T lymphocyte
Cyclosporine Dx Block rejection of kidney, liver, cardiac transplant ALSO to treat rheumatoid arthritis & psoriasis
Cyclosporine Sx Nephrotoxcity, Gingival Hyperplasia and hirsutism
Calcipotriene Dx Psoriasis. Vit D binds and inhibits keratinocyte proliferation and stimulate Keratinocyte differentiation
Tacrolimus TacrolimBBus – aka Fk506 – Binds to cyclophilins → inhibit calcineurin and IL-2 (POTENT) secretion→ ↓ T lymphocyte
TacrolimusDx Block rejection of kidney, liver transplant.
TacrolimusSx Peripheral Neuropathy, Pleural Effusion, ↑ Blood pressure, ↑ Blood glucose, Nephrotoxicity
Sirolimus – aka rapamycin Sirolimus Fkbp12 inhibits mTOR → inhibits the action of IL-2 from activating T and B cells
SirolimusDx Used for kidney transplantation since no nephrotoxicity
SirolimusSx Hyperlipidemia, thrombocytopenia, and leukopenia
Daclizumab – DA Klizumab AntiboDy agianst IL-2. Dx – Used for kidney transplantation since decreases the chances for infections.
Azathioprine – AzaTOEprine Nitroimidazoloyl 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 Dx Kidney transplant, Glomerulonephritis, rheumatoid arthritis, hemolytic anemia
Azathioprine Sx Bone Marrow suppression due to active metabolite 6mercaptonurine is metabolized by Xanthine Oxidase. Allopurinol increases the toxicity.
Colchicine moa Inhibition of Microtubular polymerization(CYTOSKELETON DISRUPTION). Reduce the formation of Leukotriene B4
Colchicine Sx Nausea, Diarrhea, Abdominal pain
Colchicine Dx Second Line Acute gout, prophylaxis for recurrent gout arthritis
Febuxostat MOA New Xanthine oxidase inhibitor & less interactions than Allopurinol
Mycophenolate moa Target inosine monophosphate dehydrogenase. Prevents production of nucleoside Guanine. Leads to rapid arrest of B/T cell proliferation
Mycophenolate Dx Transplants, Lupus Glomernephritis.
Muromonab – MORONonab Anti-CD3 antibody → Monoclonal AB that binds to CD 3 on the surface of T cells → Blocks Tcell transduction.
MuromonabDx Immunosuppression after kidney transplant
MuromonabSx Cytokine Release Syndrome, Hypersensitivity
Trustuzumab/Herceptin - “TRUSTuzumab” Targets erb-B2 “dont TRUST her”
Trustuzumab/HerceptinDx Her 2 expressing breast cancer
Trustuzumab/HerceptinSx She will hurt your heart and breathing ability
Etanercept → Decoy TNF ALPHA receptor which is the main cause for Cachexia.
Etanercept Dx RAP Rheumatoid Arthritis, Ankylosing Spondylitis, Psoriatic Arthritis
Etanercept Sx ↑Risks for reinfection with tuberculosis and for malignancy due to immunosuppression.
Omalizumab – OMY cant breath MOA Blocks the ability of IgE to bind to the Fc receptor on mast cells and basophils.
Omalizumab Dx Treatment option for SEVERE Asthma.
Aldesleukin MOA Interleukin 2 recombinant cytokine → Turn on IL-2 → T cell proliferation.
Aldesleukin Dx Renal Cell Carcinoma, Metastatic Melanoma
Rasburicase Tumor Lysis syndrome prevention - Converts uric acid to allantoin
Steroids Used in pts nsaid or colchenie are contraindicated.
Allopurinol Chronic gout(3 or more acute attacks or torphs) tx with high uric renal exertion
Probenecid & sulfinpyrazone Inhibits reabsorption of uric acid & penicillin in PCT
Chronic Gout Allopurinol, Febuxostat, Pegloticase, Probenecid
Acute Gout NSAIDS, Glucocorticosteroids, Colchicine
Methotrexate MOA Inhibits DiHydrofolate reductase(pyrimidine synthesis) → ↓ tetrahydrofolate ↑dihydrofolate. Dx Molar pregnancies and RA. Inhibit S phase
Methotrexate Sx Teratogenic, ^AST^ALT, Painfull mouth ulcers/nausea
Methotrexate Rescue Leucovorin – Folate in Folinic Acid which is recognized by the body not by cancer.
Methotrexate RA Treat with methotrexate and relieve symptoms with steroids. Sx – Pulmonary Fibrosis
Hydroxyurea – hydRoxyuRea moa Inhibits Ribonucleotide Reductase → Decrease DNA synthesis(pyrimidine synthesis).
Hydroxyuread Dx Increase HbF in sickle cell disease, Melanoma, CML.
Cladribine moa Purine Analog high intracellular concentration because resistant to degradation by adenosine deamination
Cladribine Dx Hairy Cell Leukemia
: Anti-tumor antibodies
Adriamycin(Doxorubicin) – ATRIA-mycin Free radical Formation → DNA Breakage. Sx- Dilated cardiomyopathy and cardiac fibrosis.
Adriamycin(Doxorubicin) Rescue Dexrazoxone.
Bleomycin MOA Free radical Formation → DNA Breakage. Inhibits G2 phase. Dx Lymphomas (Hodgkin’s and non-Hodgkin’s), testicular cancer, melanoma, squamous cell carcinoma.
Bleomycin Sx Pulmonary Fibrosis.
Cisplatin PLATINum complexes bind and crosslink DNA → apoptosis.
Cisplatin Dx Bladder, testicular and ovarian cancer
Cisplatin Sx Nephrotoxicity and Ototoxicity
Cisplatin Rescue Amifostine
Cyclophosphamide moa Prodrug activated by the liver → covalently cross-links DNA strands at guanine N-7 → cell death.
Cyclophosphamide Dx Lymphomas (Hodgkin’s and non-Hodgkin’s), leukemias (ALL/AML/CLL/CML), breast, testicular, and ovarian cancer.
Cyclophosphamide Sx Hemorrhagic Cystitis, penetrates the bladder
Cyclophosphamide Rescue Mesna
: Microtubule Inhibitors
Vincristine, Vinblastine & Vinorelbine MOA Blocks polymerization therefore mitotic spindle cant form. Inhibits Mitosis
Vincristine, Vinblastine & Vinorelbine Dx Wilms’ tumors, lymphomas, leukemias, and testicular cancer.
Vincristine, Vinblastine & Vinorelbine Sx Blasts Bone marrow(Vinblastine), Paralytic ileus & Neurotoxicity(Vincristine) – Finger numbness and tingling
Paclitaxel Moa Hyperstabilizes polymerized microtubules in M-phase so that mitotic spindle cannot break down → No ANAphase. Inhibits Mitosis
Paclitaxel Dx Breast cancer, ovarian cancer, lung cancer, and Kaposi sarcoma.
Alendronate Dx Osteoporosis, Pagets Disease, Malignancy induced hypercalcemia
Alendronate Sx Very Poor Gastro absorption, Esophageal Erosive
Tamoxifen MOA Antagonist breast/Agonist bones.
Tamoxifen Dx Recurrent Er positive breast cancer, osteoporosis
Relaxifen Dx With biphosphonates for Post Menopausal women for osteoporosis. No risk of endometrial carcinoma because its a endometrial antagonist.
Dactinomycin MOA Intercalates between guanine and cytosine → Inhibits DNA/RNA synthesis. Dx Rhabdomyosarcoma, Wilms tumor, Ewings sarcoma, testicular tumors. “Solid organ tumors”
Imatinib Mesylate Inhibits Bcr-Abl Tyrosine Kinase → Blocks proliferation and induce apoptosis. Dx - CML(Philadelphia chromosome), GISTs (GI stromal tumors)
eTOPOside Inhibition of TOPOisomerase II → DNA breakage → Cell death between S & G2 phase → prepare cell for mitosis. “Solid organ tumors”
eTOPOside Sx Myelosupression, Alopecia
Tricyclic Anti-depressants MOA Blocks catcholmaine uptake, Blocks Alpha 1, Anticholinergic, Anithistamine, Interfere with AV nodal conduction. Presynaptic serotonin & norepinephrine reuptake inhibiton – Prophalyxis Migraine
Amytriptyline – AMY-TRIPT-yline First line for peripheral neuropathy(Diabetes)
Amytriptyline Sx Urinary Retention
Imipramine Second Line for Bed wetting &decreases stage 3 sleep
NOrtriptyline Least amount of side effects on blood pressure
Amoxapine Treats both psychotic & depression
Clomipramine 2ND LINE for OCD
Tricyclic Anti-depressants Sx 3C's –Convulsions,Coma,Cardiotoxicity (due to inhibition of fast Na+ channels → slowed cardiac conduction → prolonged QRS), Antimuscuranic – flushing/Mydrasis
TCA Rescue IV Sodium Bicarbonate to treat the Cardiotoxicity
Modafinil Treats Narcolepsy – day time sleepiness
Stimulant Antidote Nh4Cl – Ammonium chloride
ssris Dx – 1ST Line Panic Disorders, 1ST Line OCD, 1ST Line Depression, Generalized Anxiety, Bulimia Nervosa
Flashbacks PARalyze SEnior CITizensInhibit serotonin reuptake 2-4 weeks to take effect.
ssri MOA Presynaptic Selective Serotonin Reuptake inhibiton
Fluoxetine Treat Depression. Sx Longest half life.
Paroxetine Treat social phobia & pre mature ejaculation Sx – ↑ appetite & weight gain treat Anorexia
Sertaline Sx Sexual Dysfunction, GI disturbances
ssri Antidote Cyproheptadine
Monoamine Oxidase Inhibitors DX ↑Serotonin, NE &Dopamine
MAO Inhibitors MOA Inhibit Monoamine oxidase
MAO CHEESE Increase tyramine leading to decreased degradation at the presynaptic nerve
Phenelzine Atypical Depression Mood Reactivity, Leaden Fatigue – arms & legs feel heavy, Rejection Senestivity, Increased sleep & appetite
Varenciline Partial agonist nicotonic acetylcholine receptors. Decreases pts having cravings & smoking cessation
Citalopram SSRI -> Anxiolytic
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