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Albin Drugs 2

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zomovefa's version from 2017-10-03 18:18

Section

: Renal
Question Answer
Blood ph – AcidemiaCarbonic Anhydrase
AlkalemiaLoop and thiazide
Mannitol↑ renal tubal osmolarity
Mannitol DXICP, IOP SX -Do 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, hyperUricemiakidney Xray shows no abnormality, 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 – ↑Overall Survival Sx - Hyperkalemia gyncomastia & prolonged qt interval
Spirnolactone ↓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 MOAInhibit ACE → ↓Angiotensin 2 also bradykinin ↑→ ↓ GFR. Dx Hypertension, CHF, Renal Disease due to diabetes, Prevent heart remodeling due to chronic hypertension.
ACE SxHyperkalemia, CAPT First dose hypOtension – Hyponatremia, hypovolemia and is contraindicated if patient is on thiazides, Pregnancy, Rash, ↑renin, Lower angiotensin, ↑creatinine and ↓GFR
CandeSARTAN“LEAST sideffects”. Blocks Angiotensin II receptor. Does not ↑Kallikrein → No cough. Dx Hypertension, CHF, renal disease due to diabetes. Sx Teratogenic.
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: Hematology
Question Answer
SildenaFILLInhibit cGMPphosphodiesterase or PDE 5 Sx- Dont take it with nitrates. Headache, Flushing, blue green color vision
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 note↑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 Sxfat soluble -> too much of it causes -> Sx reyes syndrome in the liver but since our body pH is 7.4 it can give up its protons and be base or charged or watersoluble -> going to kidney causing -> interstitial nephritis. Anion gap metabolic acidosis and respiratory alkalosis and Nasalpolyps in 10% asthma treatment
Indomethacin – ENDomethacinMost potent to END PDA, Prostaglandin Inhibitor
Ibuprofen MOAMC OVC – END the PDA
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. Dx- Idopathic or Primary Pulmonary arterial Hypertension
AbciximabTarget inhibit Gycoprotein IIb/IIIa – Mimics Glanzmann Thrombasthenia
Abciximab/Epifibatide,tirofiban DxUnstable Angina, STENT, Myocardial Infarct Patients
WarfarinChronicAnticoagulation - 1972WAR Works by interfering with y-carboxylation of vitamin K clotting factors 1972 Protein C & S
WarfarinContraindicated in pregnancy. Sx bleeding and skin/tissue necrosis ~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. Dx- Short half life, ACUTE CONDITIONS – Pulmonary Embolism, Acute coronary syndrome, MI, DVT.
Heparin Sx1 Bleeding, 2 Hyperlipidemia due to activation of hormone sensitive lipase, 3 HIT. Rescue-Treat with Protamine Sulfate
Heparin HIT substituteLepirudin or agatroban(block thrombin directly), OR Fondaparinox/ApixaBAN(factor Xa inhibitor)
ArgatrobanIts so ghetto its binds to thrombin
EnoxaparinBind to thrombin III and less anti-thrombic activity. Low molecular weight. ↑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 MOAIrreversible 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 MOA↑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
apiXabanMoa - Inhibit factor Xa Tx - DVT,PE, AF
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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–KlizumabAntiboDy agianst IL-2 receptor Dx – Used for kidney transplantation since ↓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 ↑the toxicity.
Colchicine moaInhibition of Microtubular polymerization(CYTOSKELETON DISRUPTION). Reduce the formation of Leukotriene B4
Colchicine SxNausea, Diarrhea, Abdominal pain
Febuxostat MOANew Xanthine oxidase inhibitor & less interactions than Allopurinol
Mycophenolate moaTarget inosine monophosphate dehydrogenase ->Targets Purine synthesis -> Prevents production of nucleoside Guanine. Leads to rapid arrest of B/T cell proliferation. Dx- Transplants, 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. Sx- Cytokine Release Syndrome, Hypersensitivity
Trustuzumab/Herceptin - “TRUSTuzumab”Targets erb-B2 “dont TRUST her”
Trustuzumab/HerceptinDxHer 2 expressing breast cancer. Sx - She 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. Sx- ↑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. Dx- Treatment 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(ENHANCE) 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. Rescue- Leucovorin – 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 → ↓DNA synthesis(pyrimidine synthesis).
Hydroxyuread Dx↑HbF in sickle cell disease, Melanoma, CML. Increase HbF to make the body think there is a lot of oxygen and not sickle
Cladribine moaPurine Analog high intracellular concentration because resistant to degradation by adenosine deamination. Dx-Hairy Cell Leukemia
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: Anti-tumor
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. Sx- Nephrotoxicity and Ototoxicity. Rescue- Amifostine
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
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: 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. Sx- Very Poor Gastro absorption, Esophageal Erosive
Tamoxifen MOAAntagonist breast/Agonist bones. 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”. Sx- Myelosupression, Alopecia
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: Psych
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 – TCAFirst line for peripheral neuropathy(Diabetes) -> MOA - Blocks reuptake of catecholamine(levels ↑) -> Anti-cholinergic -> (Sx - Urinary Retention)
ImipramineSecond Line for Bed wetting & ↓ 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
ssrisMOA- Presynaptic Selective Serotonin Reuptake inhibiton / Dx – 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.
FluoxetineTreat Depression. Sx Longest half life.
ParoxetineTreat social phobia & pre mature ejaculation Sx – ↑ appetite & weight gain treat Anorexia
Sertaline SxSexual Dysfunction, GI disturbances
Monoamine Oxidase Inhibitors DX↑Serotonin, NE & Dopamin / MOAInhibit Monoamine oxidase
MAO CHEESE↑ tyramine leading to ↓degradation at the presynaptic nerve
Phenelzine Atypical DepressionMood Reactivity, Leaden Fatigue – arms & legs feel heavy, Rejection Senestivity, ↑sleep & appetite
VarencilinePartial agonist nicotonic acetylcholine receptors. ↓pts having cravings & smoking cessation
CitalopramSSRI -> Anxiolytic
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