Drugs 1

vixukuli's version from 2016-04-12 14:30

All Mabs

Question Answer
daclizumabmab @ IL-2 receptors
basiliximabmab @ IL-2 receptors
muromonabmab @ cd3 > blocks T-cells from interacting with macrophages
trastuzumabmab @ her2, cardiotox
imatinibmab @ BCR-abl RTK; CML
rituximabmab @ cd20, B-cell neoplasms and RA
adalimumabmab @ TNF; RA, psoriasis, AS
infliximabmab @ TNF; can reactivate TB
abciximabmab @ IIb/IIIa > prevents platelet aggregation

Tricky T's

Question Answer
TamsulosinFlomax; α1a blocker
TemazepamRx for inability to stay asleep
Terbutalineβ-2 agonist; asthma, suppression of premature labor
Tolazolinereversible α2 blocker
TolcaponeCOMT inhibitor
Tolterodineantimuscarinic t used to releive bladder spasms
Topiramateantiepileptic used for treating bipolar
TranylcypromineMAOI; direct sympathomimetic action and releases NE
Trazodoneatypical, NE and weak 5-HT reuptake inhibitor; active metabolite-CPP > causes 5-HT antagonism at low doses and agonist and high doses; priapism
TriazolamRx for recurring insomnia; tolerance, rebound insomnia
Ticlopidinelike clopidogrel
Thioridazinetypical antipsycotic
Triamerenepotassium sparing diuretic that works by by blocking Na channels
Tropicamideantimuscarinic for glaucoma


Question Answer
hydralazine↑cGMP > vasodilates arterioles > reduces afterload; anti-HTN for pregnant women
administer hydralazine with ____ because of ____.β blocker because of reflex tachycardia
hydralazine SElupus, compensatory tachycardia
SE of amlodipine/nifedipineperipheral edema
SE of all Ca channel blockerconstipation, flushing
isorbide dinatrate↑cGMP in veins, reduction in preload, agina, pulmonary edema
nitroprusside↑cGMP via direct release of NO; can cause cyanide tox
fenoldopamD1 agonist > relaxes renal vascular smooth muscle; HTN emergency
diazoxideK channel opener; hyperpolarizes vascular smooth muscle; hyperlgycemia
statin SEhepatotoxicity, rhabdomyolysis
niacin mechinhibits lipolysis in adipose tissues; reduces hepatic VLDL secretion
niacin SEhyperglycemia, gout (hyperuricemia), flushing (prostaglandin mediated)
cholestyramine, colestipol, colesevelam main effectresins=lower LDL
resins main SE other than GI upsetcholesterol gallstones (because causes more cholesterol to be made in bile)
ezetimibe main effectlower LDL (nothing else actually)
fibrates main effectlower TG
fibrates mechanismupregulate LPL
use of digoxinCHF and atrial fibrillation (because it decresses conduction of AV node)
digoxin SEcholinergic effects, yellow vision, gynecomastia
digoxin effects on ECG↑PR, ↓QT, hyperkalemia (pointed T waves)
digoxin and K?don't use with hypokalemia (will bind more to channel)
class IA drugsdouble quarter pounder; disopyramide, quinidine, procainamide
class IA effect on AP↑QT (like class III) and lengthen overall AP
procainamide SElupus
class IB drugstomato, lettuce, mayo; tocainide, lidocaine, mexiletine
class IB effect on APshorter AP
class IC drugsextra fries please; encainide, flecanide, propafenone
class IC indicationcan only give to pts without structural abnormalities (i.e. not after MI)
Class IC effect on APno effect
hyperkalemia and class I antiarrhythmicsincreased toxicity
sotalolclass III
ibutilideclass III
bretyliumclass III
dofetilideclass III
flecanideclass IC
amiodaroneclass III (with properties of other classes)
class III affect on APlooks like IA (↑AP and ↑QT) - used when others fail
amiodarone SEpulmonary fibrosis, hepatox, thyroid issues (remember iodine), blue skin!
antiarrhythmic that works on nodesclass IV
adenosine mechincreasaes K out of cells > hyperpolarization
adenosine SEflushing, chest pain, hypotension
theophyllineblocks effects of adenosine
Mg as Rx ____ toxdigoxin
combine statins and fibrates↑risk of myositis and rhabdomyolysis
No ____ in variant angina.β-blockers
Amiodarone and torsades?low incidence
Antidote for beta blocker overdose?glucagon
quinidine SEhemolytic anemia
nesiritiderecombinant B-type natriuretic peptide


Question Answer
diphenhydramine1st gen H1 blocker
SE of1st gen h1 blockerssedation, antimuscarininc
dimenhydrinate1st gen H1 blocker
cholrpheniramine1st gen H1 blocker
loratidine2nd gen. H1 blocker
fexofenadine 2nd gen. H1 blocker
desloratidine 2nd gen. H1 blocker
cetrizine 2nd gen. H1 blocker
Why not use isoproterenol much for asthma?β1 agonist > tachycardia
salmeterollong acting β agonist for asthma
theophylline inhibits phosphodiesterase > cAMP ↑ > bronchodilation; asthma
theophylline SEneurotox, cardiotox, seizures
ipratropiumblocks muscarinic receptors > prevents bronchoconstrict.; used in asthma and COPD
cromolynprevents mast cell degranulation; asthma PROPHYLAXIS only
beclomethasonecorticosteroid; inactivates NF-κB > no TNF-α
zileuton5-lipoxygenase inhibitor > no leukotrienes (C4, d4, e4 all cause bronchoconstriction); asthma
zafirlukastblock leukotriene receptors; asthma
montelukastblocks leukotrien receptors; asthma
guaifenesinremoves excess sputum
N-acetylcysteineloosens mucous plugs in CF patients
bosentanantagonizes ET-1 (endothelin 1, a vasoconstrictor) for pulmonary hypertension
omalizumabmab, binds free IgE


Question Answer
acetazolamide mechcarbonic anhydrase inhibitor; less bicarb resorbed > pee out bicarb
acetazolamide usesglaucoma, metabolic alkalosis, urinary alkalization, altitude sickness
acetazolamide toxsulfa drug, NH3 tox
bumetanideloop diuretic, sulfa
ethracrynic acidloop diuretic, NOT sulfa
torsemideloop diuretic, sulfa
furosemide SEototox, hypokalaemia, nephritis, gout, sulfa
loop di mechinhibits reabsorption of Na, K, and Cl in ascending LOH
SE of thiazideshyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, SULFA
spironolactonealdosterone blocker; anti-androgen
eplerenonealdosterone blocker, less anti-androgen
triamerenepotassium sparing diuretic that works by blocking Na channels in the cortical collecting duct
amiloridepotassium sparing diuretic that works by blocking Na channels in the cortical collecting duct
loop and thiazide effects on systemic pHalkalemia via increased aldosterone > increased H secretion
ACEi SEcough, decrease GFR by constricting efferent tubules ∴ must not use in bilateral renal stenosis


Question Answer
lisprorapid acting insulin
aspartrapid acting insulin
regular insulinquick (but not rapid) acting insulin
NPHintermediate insulin
glarginelong-acting insulin
detemirlong-acting insulin
tolbutamide1st generation sulfonylurea
chlorpropramide1st generation SU
1st generation SU SE?disulfiram rxn
mechanism of SU?closes K channels > cell membrane depolarizes > ca influx > release of insulin
metforminbiguinide; decreased gluconeogenesis, increased glucose uptake
SE of metforminlactic acidosis ∴ contraindicated in renal failure
glitazones mech↑ insulin sensitivity via PPAR-γ receptor (transcription factor)
glitazones SEweight gain, edema, hepatotox, CV tox
acarboseα-glucosidase inhibitor
miglitolα-glucosidase inhibitor
pramlintideamylin analog > ↓ glucagon
exenatideGLP-1 analog > ↑ insulin and ↓ glucagon
exenatide SEpancreatitis
propylthiouracilinhibits thyroperoxidase; also decreases peripheral conversion of T4 to T3!; use propylthiouracil if pregnant
SE of hyperthyroid drugsskin rash, agranulocytosis, aplastic anemia
methimazoleinhibits thyroperoxidase; safer but teratogen
demeclocyclineADH blocker; used for SIADH; can cause DI; member of tetracycline family > photosensitivity, bone and teeth abnormalities
glucocorticoid mechinhibits phospholipase A2 > less of all inflammatory molecules


Question Answer
leuprolideGnRH analog for infertility (pulsatile) or prostate cancer (continuous); anti-androgen
finasteride5a-reductase inhibitor; BPH and allopecia (male pattern)
flutamideblocks androgen receptors; prostate cancer
ketoconazoleinhibits desmolase; Rx for PCOS to prevent hirsuitism (same with spironolactone)
clomipheneestrogen activity at hypothalamus > increases release of LH and FSH, which stimulates ovulation; also used to Rx PCOS; can cause visual disturbances
anastrazolearomatase inhibitor used in postmenopausal women with breast cancer
mifepristonecompetitive inhibitor of progesterone; used in abortions, administered with misopristol; SE=heavy bleeding and pain
contraindications of OCPsmoker >35, Hx of thromboembolism, Hx of estrogen dependent tumor
tamsulosinα1 antagonist used to Rx BPH (and HTN); selective for α1A,D receptor
sildenafil SEimpaired blue green vision; interaction with nitrates
danazolpartial androgen agonist; used for endometriosis; weight gain, virilization.
ritodrineβ2 agonist > relaxes uterus during premature labor
terbuatalineβ2 agonist > relaxes uterus during premature labor


Question Answer
cimetidineH2 blocker; anti-androgenic effects; potent inhibitor of P-450; decreases creatinine clearance
ranitidineh2 blocker; decreases creatinine clearance
famotidineH2 blocker
nizatidineH2 blocker
omeprazoleproton pump inhibitor
lansoprazoleproton pump inhibitor
triple therapy of H. pyloriazithromycin, metronidazole or amoxicillin, PPI
sucralfatelike bismuth
misoporstolPGE analog; increases mucous and decreases acid; prevent NSAID ulcers
pirenzepineECL M1 blocker > decreased histamine & parietal cell M3 blocker; antimuscarininc SE
octreotide usesvariceal bleeds, acromegaly, VIPoma, carcinoid tumors
all antacids causehypokalemia
infliximab and etanercept SEreactivation of TB
sulfasalazinecombination of antibiotic and anti-inflammatory; used to Rx UC and Crohn's
ondansetron5-HT3 blocker; antiemtic
metoclopramideD2 receptor blocker; increases motility of GI tract; gastroparesis
metoclopramide SE↑ parkinsonian effects, diarrhea
phenoxylateanti-diarrhea (motility) narcotic
prochloroperazine D2 receptor blocker; increases motility of GI tract; gastroparesis
promethazine D2 receptor blocker; increases motility of GI tract; gastroparesis


Question Answer
monitor heparinPTT
monitor warfarinPT
anticoagulant during pregnancyheparin (low lipid solubility, do not cross placenta)
HITheparin induced thrombocytopenia; use lepirudin or bivalirudin instead
antidote to heparinprotamine sulfate
antidote to enoxaparinnone
heparin mechactivates antithrombin > ↓thrombin and Xa
enoxaparinlow-molecular-weight heparin
low-molecular-weight heparin featurebetter bioavailability; more activity on activated X than thrombin
-rudinleech; directly inhibit thrombin
SE of warfarinskin necrosis (temporary hypercoagulatory state due to ↓protein C)
warfarin inhibits production of these six factors. Which goes first?II, VII, IX, X, C, S
streptokinaseactivates plasmin
urokinaseactivates plasmin
anistreplaseactivating plasmin
aminocaproic acidreversing tPA
ASAacetylates Cox-1 and cox-2 (irreversible); ↑ bleeding time
clopidogrelirreversibly blocks ADP receptors > inhibits platelet aggregation; inhibits IIb/IIIa expression > inhibits fibrinogen binding
ticlopidinesee clopidogrel, SE: neutropenia
abciximabbinds to IIb/IIIa > prevents platelet aggregation
argatrobandirectly inhibit thrombin, treat HIT


Question Answer
M phase drugsvinca alkaloids and taxols
G1 drugsnone
S phase drugsantimetabolites, etoposide
G2 drugsetoposide, bleomycin
methotrexatefolic acid analog > inhibits DHF reductase > ↓ dTMP
non-onc MTX usesabortion, ectopic pregnancy, RA, psoriasis
MTX SEreversible myelosuppression, fatty change in liver (↑LFTs), mucositis/mouth ulceration, teratogen
leucorvinfolinic acid; reverses MTX myeloid suppression
MTX vs. 5-FU usageleukemias vs. adenocarcinomas
5-FUbioactivated to 5F-dUMP > complexes folic acid > ↓ dTMP, Adenocarcinomas
5-FU tox reversalNOT leucovorin, thmidine!
5-FU SEphotosensitivity
6-MPthiol analog > down de novo purine synth
6-MP drug interaction?metabolized by xanthine oxidase ∴ increased when taking allopurinol
6-MP SEbone marrow, GI, liver, tox
cytarabine (ara-C)inhibits DNA polymerase
ara-C SEpancytopenia - leukopenia, thrombocytopenia, megaloblastic anemia
dactinomycinintercalates into DNA; childhood-tumors
doxorubicingenerates free radicals > breaks DNA; Hodgkins, cardio tox
adriamycinsame as doxorubicin
bleomycininduces free radicals > breaks DNA; used to Rx testicular ca and Hodkins; pulmonary fibrosis
etoposideinhbits topoisomerase II; alopecia
cyclophosphamidecross-links DNA at guanine N-7; Rx tumors & autoimmune diseases
cyclophosphamide SE? Rx with?hemorrhagic cystis (Rx mesna), transitional cell carcinomas
Rx brain tumors?nitrosureas (-mustines and streptozocin)
-mustinesanti-brain tumor nitrosureas, get activated by liver; CNS toxicity (dizziness, ataxia)
busulfanalkylates DNA, CML, pulmonary fibrosis, hyperpigmentation
vincristine SEneurotoxicity (peripheral neuropathy), paralytic ileus, no bone marrow suppression
vinblastine SEbone marrow suppression
vinca alkaloid mechanismbind to tubulin in M-phase - mitosis spindles cannot form
paclitaxelhyperstabilize already built microtubules (anaphase cannot occur); breast & ovarian cancer
cisplatincross-links DNA; GU tumors; nephrotox, acoustic nerve damage
carboplatincross-links DNA; GU tumors; nephrotox, acoustic nerve damage
hydroxyureainhibits ribonucleotide reductase > ↓ DNA synth; ↑HbF
why is raloxifene better than tamoxifen for breast cancer?antagonist at endometrium > no higher risk of endometrial cancer
trastuzumabmab @ her2, cardiotox
imatinibmab @ BCR-abl RTK; CML
rituximabmab @ cd20, B-cell neoplasms and RA

Immune System

Question Answer
Cyclosporin mechbinds to cyclophilin > inhibits calcineurin > less production of IL-2 and its receptor
cyclosporin SEnephrotoxicity
tacrolimus mechbinds to FKBP > inhibits calcineurin > less production of IL-2 and receptor
tacrolimus SEnephrotox, peripheral neuropathy, HTN, pleural effusion, hyperglycemia
sirolimus mechbinds to mTOR > inhibits T-cell proliferation
sirolimus SEhyperlipidemia, thrombocytopenia, leukopenia
daclizumabmab @ IL-2 receptors
basiliximabmab @ IL-2 receptors
azathioprineprecursor to 6-MP > antimetabolite > toxic to proliferating lymphocytes
azathioprine drug interactiontox ↑ in presence of allopurinol because allo inhibits xanthine oxidase, which metabolizes aza
muromonabmab @ cd3 > blocks T-cells from interacting with macrophages
filgrastimrecovery of bone marrow
sargramostimrecovery of bone marrow
α-INFhepatits B and C, kaposi sarcoma, leukemia
β-INFmultiple sclerosis
γ-INFchronic granulomatous disease