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buxapine's version from 2018-02-08 04:20

P450 interactions

Question Answer
Barbituatratesinducer
st. john's wortinducer
phenytoininducer
rifampininducer
griseofulvininducer
carbamazepineinducer
protease inhibitors (-navirs)inhibitor
ketoconazoleinhibitor
erythromycin (macrolides)inhibitor
grapefruit juiceinhibitor
sulfonamidesinhibitor
cimetidineinhibitor
isoniazideinhibitor
-azolesinhibitor
ciprofloxacininhibitor
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Autonomic

Question Answer Column 3
bethanecholdirect chol agonistpost-op ileus and urinary retention (bowel and bladder)
carbacholdirect chol agonistglaucoma, pupillary contraction
carpinedirect chol agonistopen angle and narrow angle glaucoma, resistant to AChE; (PILE on the tears and sweat)
methacholinedirect chol agonistchallenge test for asthmatics (closes down airways)
neostigmineanticholinesterase (indirect chol agonist)post-op, MG (no CNS penetration)
pyriodstigmineanticholinesterase (indirect chol agonist)MG (no CNS penetration)
edrophoniumanticholinesterase (indirect chol agonist)diagnosis of MG (very short acting)
physostigmineanticholinesterase (indirect chol agonist)glaucoma and atropine OD (PHYS for EYES)
echothiophateanticholinesterase (indirect chol agonist)glaucoma
atropinemuscarinic antagonistrelaxation of iris sphincter > mydriasis
tropicamidemuscarinic antagonistrelaxation of iris sphincter > mydriasis
benzotropinemuscarinic antagonistrelaxation of iris sphincter > mydriasis
scopolaminemuscarinic antagonistmotion sickness
ipratropiummuscarinic antagonistasthma and COPD help (I pray I can breathe soon!)
oxybutyninmuscarinic antagonistreduce urinary uregency
glycopyrrolatemuscarinic antagonistreduce urinary urgency
methscopolaminemuscarinic antagonistpeptic ulcer Rx
pirenzepinemuscarinic antagonistpeptic ulcer Rx
propathelinemuscarinic antagonistpeptic ulcer Rx
hexamethoniumnicotinic antagonist?
epinephrineallopen angle glaucoma, asthma
norepinephrinesympathetic agonist α more than βhypotension
isoproterenolsympathetic agonist isolates on βAV block
dobutaminesympathetic β agonist (β1 more)shock
phenylephrineα1 agonist (more than α2)pupillary dilation, vasoconstriction, nasal decongestion
metaproteranolselective β2 agonistacute asthma
albuterolselective β2 agonistacute asthma
salmeterolselective β2 agonistlong term Rx of asthma
terbutalineselective β2 agonistreduce pre-mature contractions of uterus
ritodrineβ2 agonistreduce pre-mature contractions of uterus
amphetaminereleases stored catecholaminesnarcolepsy, obesity, ADD
ephedrinereleases stored catecholaminesnasal decongestion, urinary incontinence, hypotension
cocainecatecholamine uptake inhibitorvasoconstriction, local anesthetic
clonidinecentral α2 agonist ∴ decreases adrenergic outflowhypertension
phenoxybenzamineirreversible nonselective α blockerpheochromocytoma
phentolaminereversible nonselective α blockerpheochromocytoma
prazosinα1 blockerHTN, BPH
terazosinα1 blockerHTN, BPH
doxazosinα1 blockerHTN, BPH
mirtazapineα2 blockerdepression
timololβ blockerreduces aqueous humor production in glaucoma
acebutololβ1 blockerbetter if PT. has coexisting pulmonary disease
betaxolol β1 blockerbetter if PT. has coexisting pulmonary disease
esmolol β1 blockerbetter if PT. has coexisting pulmonary disease
atenolol β1 blockerbetter if PT. has coexisting pulmonary disease
metoprololβ1 blocker better if PT. has coexisting pulmonary disease
carvedilolα and β blocker
labetalolα and β blockerHTN emergency
pindololβ blocker with partial β-agonismcontraindciated in angina
acebutulolβ blocker with partial β-agonismcontraindciated in angina
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Cardio

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, fluid retention; hydralupzine
SE of amlodipine/nifedipineperipheral edema (ca channel blockers that act more on peripheral vasculature)
SE of verapamil, diltiazam(ca channel blockers) cardiac depression, AV block (act more on heart)
SE of all CCBsconstipation
isorbide dinatratesame as nitroglycerin; increases cGMP in veins > reduction in preload, agina, pulmonary edema
nitroprusside↑ cGMP via direct release of NO; can cause cyanide tox nitrocyanide; malignant HTN
fenoldopamD1 agonist > relaxes renal vascular smooth muscle; malignant HTN
Nitroglycerin, isosorbide dinitrate SEsreflex tachy, HOTN, flushing, HA; also get these sx in ppl exposed to theses chemicals at work- develop tolerance; lose tolerance over weekend- Monday morning- sx
diazoxideK channel opener; hyperpolarizes vascular smooth muscle; hyperlgycemia
niacin mechinhibits lipolysis in adipose tissues; reduces hepatic vldl secretion, the best drug for raising HDL
niacin SEflushed face (hyper red). hyperglycemia (acanthosis nigricans), hyperuricemia, HOTN; I may be hyper but at least I'm nice
cholestyramine, colestipol, colesevelam main effectresins prevent intestinal reabsorption of bile acids so liver must use cholesterol=lower LDL
resins SEcholesterol gallstones (because causes more cholesterol to be made in bile), bad taste, GI discomfort
ezetimibe main effect and SEsprevents cholesterol absorption at brush border ("eats"); SEs- incr LFTs and diarrhea EMITS poo and LFTs
fibrates SEFinds muscle (myositis), incr lFts (hepatotox), Fills your GB with stones (chlesterol)
fibrates mechanismupregulate LPL- gets rid of tons of TGs
digoxindirectly inhibits Na/K ATPase- incr intracellular calcium- positive ionotrope, also stims vagus- decr HR; CHF and atrial fibrillation (because it decreases conduction of AV node)
digoxin SEcholinergic effects, blurry yellow vision, hyperkalemia, quinidine lowers its clearance; Quinton riding a vomiting ox with crazy glasses. They drag off K in the wagon behind them
digoxin effects on ECG↑ PR, ↓ QT, hyperkalemia (pointed T waves), AV block
digoxin and K?don't use with hypokalemia (will bind more to channel)
memorize

Cardio 2

Question Answer
Antiarrythmic classes1.Na channel blocker, 2.beta blocker, 3. Potassium channel blockers (Prolong APs), 4. Calcium channel blockers Some Block Potassium Channels
class IA drugs and SEsI wish this HA and tinnitus (cinchonism) would QUIT (quinidine); This one PROvokes SLE (procainamide); The fall of the pyramids would break my heart (Disopyramide- heart failure)
class IA effect on AP↑ QT (like class III) and lengthen overall AP
procainamide SElupus
class IB drugs and SEsI'd Buy Lidy's Mexican Tacos; (Lidocaine, mexiletine, tocainide); local anesthetic, CNS stim/depression, cardio depression Blunts pain, Brain sx, Blocks heart
class IB effectshorter AP Blazes through Best post MI
class IC drugs and SEsextra fries please; encainide, flecanide, propafenone; PROarrythmic, and PROlongs refractory period in AV node
class IC indicationContraindicated in px w/ structural abnormalities (i.e. not after MI); used only as a last resort in refractor tachyarrhythmias
Class IC effect on APno effect
hyperkalemia and class I antiarrhythmicsincreased toxicity
propanololclass II beta blocker; SE- can exacerbate vasospasm in Prinzmetal's angina
Class III drugsAIDS; Amiodarone, Ibutilide, Dofetilide, Sotalol; K channel blockers
Class IVCa channel blockers; verapamil, diltiazem
adenosine SEflushing, HOTN, chest pain
sotalol SEclass III; torsades (b/c QT is "SO LONG"); excessive beta block (hence the "lol")
amiodaroneclass III but has the mechanisms of All classes because it Alters the lipid membrane
ibutilide SEclass III; torsades
class III affect on APlooks like IA (↑ AP and ↑ QT) - used when others fail
amiodarone SEAlt/ast (hepatotox), Minimal poo (constipation), Iodine (component of drug- messes up thyroid), Odd colors (blue/ grey skin deposits), Deposits in corneas, Altered lungs (pulmonary fibrosis)
antiarrhythmic that works on nodesclass IV
adenosine mechincreasaes K out of cells > hyperpolarization; DOC for dx/ abolishing SVT
theophyllineblocks effects of adenosine; so does caffeine
Mg can be used to treatdigoxin toxicity and torsades de pointes
memorize

Endocrine

Question Answer
lisprorapid acting insulin; LISten, how FAST can you tear APART this GLUe?
aspartrapid acting insulin
regular insulinquick (but not rapid) acting insulin
NPHintermediate insulin
glarginelong-acting insulin; it lasts awhile, I'm DETERmined not to GLARe
detemirlong-acting insulin I can't determine when this will end
tolbutamide1st generation sulfonylurea; CHLORa paid the PROPer TOLl by herSULF to close the K gate
chlorpropramide1st generation SU
1st generation SU SE?disulfiram rxn
mechanism of SU?closes K channels > cell membrane depolarizes > ca influx > release of insulin; ShUt K channels
metforminbiguinide; decreased gluconeogenesis, increased glucose uptake; amBIGUous; FORMs a state like insulin
SE of metforminlactic acidosis because it increases glycolysis ∴ contraindicated in renal failure
glitazones mech↑ insulin sensitivity via PPAR-γ receptor (transcription factor); look at all the glitz and glamour at this PARty. I'm sensitive to all these bright lights.
glitazones SEweight gain, edema, hepatotox, heart failure; Gain weight, Liver tox, Idema, Ticker stops
acarboseα-glucosidase inhibitor- delayed sugar hydrolysis and thus glucose absorption so decr prostprandial hyperglycemia; Anti CARBose
miglitolα-glucosidase inhibitor; sounds like sorbITOL
pramlintideamylin analog > ↓ glucagon; amylin is a friend of insulin- it inhibits inappropriate glucagon secretion
exenatideGLP-1 analog > ↑ insulin and ↓ glucagon; Glucagon Lowering but Pancreatitis; Also insulin can EXEt the pancreas
exenatide and liraglutide SEpancreatitis
liraglutideGLP-1 analog- Lira's insulin can GLIDE out of the pancreas
propylthiouracilinhibits thyroperoxidase; also decreases peripheral conversion of T4 to T3 by blocking 5 deiodinase!; use propylthiouracil if pregnant
SE of hyperthyroid drugsskin rash, agranulocytosis, aplastic anemia
methimazoleinhibits thyroperoxidase; safer but teratogen no meth babies please
demeclocyclineADH blocker; used for SIADH; can cause DI; member of tetracycline family > photosensitivity, bone and teeth abnormalities; Sharp-toothed demon cycling, gets a DuI and his PHOTO on his license doesn't match; he's A Demonic Hater
glucocorticoid mechinhibits phospholipase A2 > less of all inflammatory molecules
Second gen sulfonylureasGlyburide, glimepride, glipizide; Glyb, Glip, and Glim; SUcks less to be them (no disulfiram effects)
linagliptin, saxagliptin, sitagliptinDPP-4 Inhibitors- increase insulin, decrease glucagon release; SEs- mild urinary or respiratory infections; Glip slips insulin out, Glip clips glucagon's escape; Glip Does cause PP (and respiratory) Infections; DPP-4 degrades GLPs
levothyroxine, triiodothyroxinethyroxine replacement
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