Albin Drugs 3

poxidicu's version from 2016-05-14 19:00


: Atypical
Question Answer
Atpical antipsychotics MOABlock 5ht2, dopamine, a, and h1 receptors → ↑extrapyramidial sideeffects. Dx - Shizophrenia
Clozapine sxSevere schizophrenic symptoms due to → Sx Agranulocytosis,Neutropenia, Seizures.
Olanzapine DxOCD anxiety disorder, depression, mania, &Tourette's disorder
Olanzapine sxObese/weightgain -> Lipid panel & blood glucose
RespiradoneSx Increase Prolactin → gynocomastia, galactorrhea, amenorrhea


: Parkinson Drugs – BALSA dance
Question Answer
Agonize Dopamine receptorsBromocriptine,Pregolide, pramipexole, ropinerole
Amantadine↑Dopamine by increase synthesis and enhance effect, release, reuptake &also antiviral against influenz Sx- Ataxia A man 2 Dine
Levodopa/carbidopaConverted to Dopamine by crossing BBB in CNS
Ldopa/cdopa SxAnxiety &Agitation. When given together → more dopamine in brain. Do NOT take with vitamins containing B6 due to INCREASE peripheral Metabolism.
CarbidopaDOPA Decarboxylase Inhibitor. Helps prevent the nausea AND PREVENTS peripheral conversion OF levidopa. On and Off phenomenon is unpredicable and is dose dependent.
COMT dxEntacapone, Tolcapone(Hepatotoxic)Dx - Catechol-Omethyl transferase Inhibitor → Decreases break down of levidopa in peripheral tissues
Selegeline - MAOi-BIrreversible MAOB inhibition leading to increased levels of dopamine by inhibiting central dopamine degradation. DELAY the progression of Parkinson Disease
Antimuscarnics – BENZtropineHelps with tremor &rigidity not Bradykinesia “PARK ur BENZ” Sx- Flushing and Mydriasis


: Huntington
Question Answer
Huntington MOA↑Dopamine, ↓GABA+ach
Manic DisorderValporate,Lithium,Carbamazepine
ResperineInhibits Vesicular monamine transporter → Inhibit dopamine entry into presynaptic vesicles → ↑Dopamine → Degradation by MAO
Valproate DXBipolar & Tonic Clonic seizure together treatment, Absence and tonic clonic seizure
Lithium/Valproate/carbamazepineBipolar dIsorder
Lithium SxNephrogenic Diabetes Insipidus, Hypothyroidism → Weightgain, dry skin, hairloss, constipation, bradycardia→ Monitor GFR & TSH. Risk of Ebstein’s cardiac anomaly opening of the tricuspid valve is displaced towards the apex of the right ventricle of the heart
Lithium ToxicityThiazide Diuritics, NSAIDS, ACE inhibitors
CimetiDINECross BBB → Confusion Dizziness headaches. Inhibit P450 → Gynecomastia, ↓Male Libido, Decrease Renal Clearance
ProtonInhibitors MOAIrreversibly blocks H+/K+ atpase in parietal cells.
ProtonInhibitors DXPeptic Ulcer, Gastritis, Esophageal Reflux, Zolinger Ellison Syndrome
Proton Pump Inhibitors SXIncreased risk for C difficile, Pneumonia, Hip Fractures, Decreased Serum Mg (Chronic)
OmePRAZOLEInhibits Vagal Stimulation, Histamine Infusion, Gastrin infusion
OctreotideLong acting Somatostain Analog Dx- Esophageal Varices, Acromegaly, Carcinoid, Gastrinoma, Glucagonoma, VIPoma
Ondansteron moa5HT3 serotonin anatagonist/ Anti-emetic in the GI and Central chemoreceptor trigger zone & solitary nucleus and tract.
ondanestron DxPost op vomiting, Cancer Chemotherapy Sx - Headache & Constipation
Metoclopramide/Prochlorperazine/ ChlorpromazineD2 receptor Antagonist, 5HT3 antagonist, and 5HT4 agonist → Increase tone and motility
Metoclopramide/Prochlorperazine/ Chlorpromazin DxDiabetic and post surgery Gastroparesis, Antiemetic
Metoclopramide/Prochlorperazine/ Chlorpromazin SxParkinson’s effects, Depression like symptoms, Interaction with Digoxin and Diabetes drugs Contradicated - Small Bowel Obstruction, Parkinson Disease
Appetite SuppressionFenfluramine, Phentermine Sx - Pulmonary Hypertension, Right ventricular Hypertrophy → Corpumonale


: Lipid
Question Answer
Fibrates + Bile acid resinsCholesterol Gallstones due to DECREASED activity of 7a-hydroxylase activity
Statins + Bile acid resinsDecreased statin absorption/Give 4hrs apart
Simvastatin Decreases & Bile acid Increases Hepatic Cholesterol Synthesis
“Statins” MOAInhibit HMG-Coa reductase but Increase LDL Receptor Density
Statins Dx↓ LDL, ↓ Triglycerides, ↑HDL
Statins SxHepatotoxicity, Rhabdomyolysis
SimvaSTATIN10x Potent and Myopathy
Niacin MOADECREASE synthesis of hepatic triglycerides
Niacin (B3)(Nicotinic Acid)Inhibits lipolysis, ↓VLDL secretion & VLDL
Niacin Dx↓ LDL, ↓ Triglycerides, ↑HDL
Niacin SxRedness/Flushing(Aspirin)- Prostaglandin induced, Hyperglycemia(insulin resistance), Hyperuricemia, Anti-Hypertensive Properties.
Niacin Sx ANTIDOTEProstaglandin release can be inhibited by giving niacin with aspirin or with meals.
Bile acid ResinsBlock Intestinal reabsorption of bile salts → Liver takes up cholesterol to make more bile salts.
Bile acid ResinsDx↓ LDL, ↑HDL
Bile acid ResinsSxRedness/Flushing, Hyperglycemia, Hyperuricemia,↑Triglycerides, GALLSTONES
Bile acid ResinsCholestyramine, Colestipol, Colesevelam
EzetimbeBlocks cholesterol absorption like asscarbose at the brush borders.
Ezetimbe SxDiarrhea, Hepatotoxic when given with fibrates
EzetimbeDx↓ LDL
Fibrates MOAUpregulate LPL → ↑ Triglyceride clearance. Decrease 7a-hydroxylase activity → reduced conversion of cholestrol into bile acids
Fibrates Dx↓ LDL, ↓ Triglycerides, ↑HDL
Fibrates SxGALLSTONES & Hepatic Cholesterol Synthesis
FibratesGemfibrozil, Clofibrate, Bezafibrate,Fenofibrate
Statins Best effectMost effective for preventing future cardiovascular events
Bile Resin Acid vs StatinsStatins DO NOT ↑Hepatic Cholestrol Synthesis


: Neuroscience
Question Answer
Gabapentin"Geriatrics" → Blocks voltage gated Ca Channels affecting the FusIon & ReLease oF Neurotransmitter VeSiCles
Gabapentin DxUsed among elderly because of very little side effects
Gabapentin ContraindicatedIf they have heart problems
CarbamazepineIf they have shooting/Stabbing pain. Sx Agranulocytosis, aplastic anemia
ButorphanolPartial agonist Mu receptors/Agonist Kappa receptors. Dx Pain, Less respiratory depression than full agonists. Sx Withdrawal if on full opoid agonist.
Halothane SxHepatic Necrosis – Increase aminotransferase levels, Prothrombin Time, Eosinophilia, Leukocytosis
Thiopental↑Potency, ↑Lipid Solubility,↓cereberal blood flow. Dx Induce Anesthesia, Redestribution into skeletal muscles and adipose tissue
Midazolam – MC drug used for endoscopy.
Question Answer
Arylcyclohexylamines(ketamine)↑ Cerebral Flow, PCPanalog, Block NMDA receptors, Stimulate the heart
ketamine SxDisorientation, Hallucination, Bad Dreams. Contraindicated – Pts with ICP
SuccinylcholineDepolarizing Sx Hypercalcemia or Hyperkalemia. In pts with burn, demylinatation, crush injury. Antidote – Cholinsterase inhibiors
DantrolenePrevents release calcium from the SR of skeletal muscle. Dx Tx hyperthermia. Tx Neuroleptic Malignant Syndrome = ↑Plasma Creatine Phosphate, ↑WBC, Muscle cramps, tremors, fever cramps, unstable blood pressure, & alterations in mental status.
Bupropion DXDepression better than SSRI due to NO SEXUAL SX, tobacco dependance Sx- High Dose Seizures
Bupropian ContraindicatedPts with Aneorexia or bullemia -> No weight gain OR Seziures pts due to -> Seizure problems
SumatriptanSerotonin Agonists


: Epilepsy Drugs
Question Answer
CarbamazepineMOA - ↓Na channel Activation affecting AxOnAL propAgaTion of ThE actIon Potential. Dx 1st Line for Simple Partial, 1st Line Complex Partial, 1st line Generalized tonic clonic, Trigeminal Neurologia.
Carbamazepine SxDiplopia, Ataxia, Agranulocytosis, Aplastic Anemia, SIADH, Steven Johnsons Syndrome.
Phenyton MOA↑Na channel Activation affecting AxOnAL propAgaTion of ThE actIon Potential. Dx Simple Partial, Complex Partial, 1st line Tonic Clonic Generalized, 1st line for Status prophylaxis.
Phenyton SxLymphadenopathy Nystagmus, Diplopia, Hirsuitism, Megaloblastic Anemia, Ataxia, SLE, teratogenic. Ethanol and Aspirin and phenyton exhibit zero order Kinetics.
LamotrigineDx – Refractory Seizures. Blocks voltage gated Na channels & Ca channels. Dx Simple Partial, Complex Partial, Tonic Clonic Generalized. Sx Stevens- Johnson Syndrome
Gabapentin↑GABA, Blocks voltage gated Ca Channels. Dx Simple Partial, Complex Partial,Tonic Clonic Generalized,. Sx Sedation, Ataxia. Sx Less side effects so used among elderly.
TopiramateBlocks Na channels. Enhances the effect of GABA. Dx Simple Partial, Complex Partial, Tonic Clonic Generalized, Migraine Prevention. Sx Sedation, Kidney Stones & weight loss.
TiagabineInhibits GABA reuptake. Dx Simple Partial, Complex Partial.
VigabatrinInhibits GABA transaminase → ↑GABA. Dx Simple Partial, Complex Partial. Sx Vision lose mild.
PhenobarbitalIncrease action of GABA. Dx Simple Partial, Complex Partial, Tonic Clonic Generalized,. Sx Sedation, Tolerance, Dependance, Induce P450.
Primidone1st line for benign essential tremor that is metabolized to phenobarbital or phenylethylmalonamide.
Valporic Acid↑Na channel Inactivation, ↑ GABA. Dx Simple Partial, Complex Partial, 1st line Tonic Clonic Generalized & Absence Seizures together. Sx GI Disturbances, Neural tube defects, tremor, Hepatic Necrosis
Valporic Acid ContraindicatedPregnancy - Neural Tube Defects
Valporic Acid dx No loss of consciousness, jerky movements and caused usually by food deprivation or stress
LevetiracetamDisrupts vesicle fusion Dx Simple Partial, Complex Partial, Tonic Clonic Generalized
EThosuximideBlocks thalamic T type Ca channels. 1st line Absence Seizures. Sx EFGH. Fatigue, GI distress, Headache, Uriticaria, Steven Johnsons syndrome.


: Tetracyclins
Question Answer
Tetracyclins - +etracyclinsPrevents Amino-acyl from binding to A site of the 30S subunit by binding to it, Limited CNS penetration. Do not take with milk, Antacids, or an Iron containing.
Tetracyclins DxBorrelia Burgdorferi, Leptospira, T.pallidum, Mycoplasma Pneumonia, Acumulates intracellularly Rickettsia & Chlamydia, Severe acne,
DoxycyclineHepatic Excretion used in kidney failure
DemelocyclineADH antagonist for SIADH/ Renal Toxic. Sx - Nephrogenic Diabetes Insipidus
Minocycline“Mi-NO-like acne women” /Renal Toxic
Penicillin sxHemolytic anemia & Hypersensitivity
: Pencillnase
Question Answer
Pencillinase Resistant Penicillins DxS.Aureus – except MRSA – DUE to altered binding protein target site.
Methicillin sxInterstitial Nephritis, Hypersensitivity reactions.
Beta Lactamase/Penicillinase InhibitorsAdded with penicillins to protect destruction by B-Lactamase
Beta Lactamase/Penicillinase Inhibitors CASTClavulanic Acid, SulBACTAM, TazoBACTAM
CephalosporinsBeta Lactam drugs that inhibit cell wall synthesis & less susceptible to Penicillinase ->G+ disintegrate rapidly when placed in a hypotonic solution -> Damage to peptidoglycan cell wall
Cephalosporins SxHypersensitivity, Vit Kdeficiency, Cross hypersensitivity with penicillins 5-10% of pts, ↑Nephrotoxicity of Aminoglycosides.
Cephalosporins 1 GenerationPEcK – Proteus mirabilis, E.coli, Klebsiella pneumonia.
Cephalosporins 1 Generation drugsCefazoLIN, CephaLEXin
Cephalosporins 1 Generation“Jeremy LIN drives a LEXus”
Cephalosporins 2 GenerationHEN PEcKS – H.Influenza, Enterbacter aerogenes, Nisseria Spp, Proteus Mirabilis, E.coli, Klebsiella Pneumonia, Serratia Marcescens
Cephalosporins 2 Generation drugsCeFAKlor, CeFOXitin, CeFURoxime(
Cephalosporins 3 GenerationGram- infections resistant to other B-lactams - ↑ CNS penetration
Cephalosporins 3 GenerationCefTRIaxone – Meningitis Except Listeria Monocytogenes(Ampicillin), NonGonococcal urethritis(Chlamydia) – Inhibits cell wall synthesis, CefoTAXime, CefTAZidime – Pseudomonas
ChloraMphENicol moaBlocks peptidyl transferase function of 23S rRNA OF THE 50s ribosomal subunit. Dx MENingitis.
ChloraMphENicol SxAplastic Anemia, Dose dependent Bone marrow supression, Dose independent aplastic anemia, Gray baby syndrome → Babies not able to metabolize drug due to lack of UDP-glucuronyl transferase.
Macrolides – mac-RO-SLIDESBinds and Blocks tanslocation at 50s → Blocks Transpeptidation and amino-acyl translocation → Inhibit Protein synthesis
Macrolides DxAtypical pneumonias – Mycoplasma, Chlamydia, Legionella. URI, STD's, Streptococcal infections in pts allergic to penicillin.Community Acquired Pneumonia – Outpatient Setting
Macrolides SxProlonged Qt → Erythemia, GI discomfort, Acute cholestatic hepatitis, Eosinophilia, Skin rashes, ↑Serum concentrations of theophyllines and oral anti-coagulants.
FluoroquinoLONES “bONES”Entry through porins → Inhibit bacterial DNA gyrase(Topoisomerase II in DNA replication) & Topoisomerase IV → Bacterial DNA can not separate → inhibiton of cell replication → Death(bactericidal drug target DNA)(DNA winding and unwinding affected).
FluoroquinoLONES DxUrinary and GI tracts (Acidic → Nephrotoxic → Gfr dependant → charged → water soluble → short half life)
FluoroquinoLONES SxTendonitis and tendon ruptures.
MetrondiazoleAntiprotozoal, and antibacterial. Require oxygen & Form free radicals → Reduced Ferredoxin which is generated by Pyruvate Oxido reductase → Anaerobe cell death.
Metrondiazole GETGiardia, Entamoeba, Trichomonas
Metrondiazole GAPGardenella, Anaerobes, h.Pylori
Metrondiazole SxAVOID ALCOHOL - Metallic Taste, Disulfiram Reaction with alcohol → inhibit Aldehyde Dehydrogenase → Ethanol not metabolized → ↑Aldehyde, Headache. “Facial Flushing, Headache, Nausea, Vomiting, Abdominal Cramp
Linezolid“SOLID 50” Inhibits Bacterial Protein synthesis by binding to 50S subunit.
Linezolid DxMRSA
Linezolid SxThrombocytopenia, optic neuritis, High risk for serotonin syndrome 39.2C, 220/130BP, 140hr.
VancomycinInhibits cell wall peptidoglycan Formation by binding to D-ala-d-ala
Vancomycin dxGram+ only because large size for -grams, Resistant organisms, C.Difficile(oral vanco), First line for MRSA, Enterococci. Bactericidal, Used in Staph Epidermis
VancomycinSxFlushing - Histamine, Nephrotoxicity, Ototoxicity, thrombophlebitis, red man syndrome → activation of mast cells → histamine release.
Bacteria have modified penicillin binding proteins in there pepditoglycan wallsMethicillinResistantStaphAureus
Bacteria produce beta-lactamase to destroy beta lactam ring of penicillinsTREAT with Cephalosporins, carbapenems, naficillin, methicillin
d-alanin-d-lactateVancomycin Resistant Enterococcus


Question Answer
FluoroquinoloneDNA Gyrase with altered A subunit
AminoglycosideOuter membrane of porin structure(pseudomonas)
Methicillin resistant Staph AureusPenicillin binding protein with reduced antibiotic affinity - Transpeptidases
VancomycinPeptidoglycan cell wall with amino acid modification
Extended spectrum Beta lactamasePlasmid ocngugation with drug resistance gene
MacrolidesRibosome with methylated 16s RNA

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