question

Epinehrine

answer

alpha 1, 2, beta 1,2 - anaphylactic shock, bronchospasm, glaucoma, vasoconstriction (in anesthetics) [Direct acting Adrenergic]

question

NE

answer

alpha 1, alpha 2, beta 1- vasoconstriction, hypotension (NE will inc BP), shock [Direct acting adrenergic]

question

Isoproterenol

answer

Beta 1, Beta 2- Bronchodilator [Direct acting adrenergic]

question

Dopamine

answer

D1=D2 > alpha 1,2, beta 1,2- shock [Direct acting adrenergic}

question

Dobutamine

answer

B1>B2- Congestive Heart Failure [Direct acting adrenergic}

question

Phenylephrine

answer

alpha 1 > alpha 2- nasal decongestion, pupil dilator [Direct acting adrenergic}

question

Methoxamine

answer

alpha 1> alpha 2- Treats BOTH Paroxysmal supraventricular tachycardia & hypotension [Direct acting adrenergic}

question

clonidine

answer

alpha 2 - hypertension [Direct acting adrenergic}

question

metaproterenol

answer

Beta 2 - bronchodilator, bronchospasm [Direct acting adrenergic}

question

albuterol

answer

Beta 2- bronchodilator [Direct acting adrenergic}

question

terbutaline

answer

beta 2- bronchodilator, reduces uterine contractions [Direct acting adrenergic}

question

Amphethamine

answer

Indirect acting general agonist- Narcolepsy, attention deficit disorder

question

Ephedrine

answer

Indirect acting general agonist & directing acting alpha and beta agonist [aka mixed action adrenergic] -hypotension, nasal decongestion, asthma

question

1. Alpha 1 2. Alpha 2 3. Beta 1 4. Beta 2

answer

1. Smooth muscle contraction (vasoconstriction) 2. Bind to receptors pre-synaptically to reduce NE release, they cause a drop in BP (hypotension) 3. Located on kidneys and inc renin thereby inc BP, also located on Heart muscle and inc contraction 4. Lung relaxation - smooth muscle relaxation

question

Phenoxybenzamine -irr or rev? -what type of drug? -txs what? -adverse side effects?

answer

-Irreversible -Nonselective alpha adrenergic blocker -Treats Pheochromocytoma -Adverse side effects: Postural hypotension, reflex tachycardia

question

Phentolamine -irr or rev? -what type of drug? -txs what? -adverse side effects?

answer

-Reversible -Nonselective alpha adrenergic blocker -Treats Pheochromocytoma -Adverse side effects: Postural hypotension, reflex tachycardia

question

Pheochromocytoma

answer

-benign tumor of adrenal gland -you have 2 adrenal glands, one above each kidney -if left untreated, it pumps hormones out continuously that cause high blood pressure

question

Doxazosin

answer

Beta 1 adrenergic blocker Uses: hypertension, urinary retention (makes it easier to pee) Adverse effects: postural hypotension, headache, dizzy Trick: If the drug ends in "sin"--> its a sin to hold it in

question

Prazosin

answer

Alpha 1 adrenergic blocker Uses: hypertension, urinary retention (makes it easier to pee) Adverse effects: postural hypotension, headache, dizzy

question

Terazosin

answer

Alpha 1 adrenergic blocker Uses: hypertension, urinary retention (makes it easier to pee) Adverse effects: postural hypotension, headache, dizzy

question

Propanolol 1) Treats 2) Adverse effects 3) type of drug

answer

1) Hypertension, Angina pectoris, myocardial infarction, glaucoma, migraine 2) Bronchoconstriction, arrhythmias, sexual impairment, fasting hypoglycemia 3) Beta nonselective blocker

question

Timolol 1) Treats 2) Adverse effects 3) type of drug

answer

1) Glaucoma, hypertension 2) More potent than propanolol 3) nonselective beta blocker

question

Nadolol 1) Treats 2) Adverse rxns 3) type of drug

answer

1) Glaucoma, hypertension 2) More potent than propanolol 3) nonselective beta blocker

question

Labetalol 1. type of drug 2. treats 3. ad rnxs 4. also blocks?

answer

1. nonselective beta blocker 2. hypertension 3. orthostatic hypotension, dizziness, bradycardia, fatigue, drowsienss 4. alpha 1

question

Acebutolol 1. Type of Drug 2. Txs 3. Adverse Effects

answer

1. Beta 1 blocker 2. hypertension 3. hypotension, bradycardia, fatigue, drowsiness

question

Atenolol 1. Type 2. txs 3. adverse rxns

answer

1. Beta 1 blocker 2. hypertension 3. hypotension, bradycardia, fatigue, drowsiness

question

Metoprolol 1. Type 2. txs 3. ad rxns

answer

1. Beta 1 blocker 2. hypertension 3. hypotension, bradycardia, fatigue, drowsiness

question

Reserpine

answer

Blocks Mg ++/ATP-dependent transport of NE, SE, DA from cytoplasm into storage vesicles in adrenergic nerves

question

Guanethidine

answer

Inhibits response of adrenergic nerves to stimulation by blocking release of NE

question

Cocaine

answer

Inhibits the reuptake of NE by adrenergic neurons by blocking the Na+/K+ activated ATPase

question

Bethanechol 1. Type of drug 2. Action 3. Clinical Application

answer

1. Cholinergic Agonist (Direct Acting) - hint ends in "chol" 2. Increases intestinal motility and stimulates detrusor muscle of bladdar 3. Atonic bladder

question

Carbachol 1. Type of drug 2. Action 3. Clinical Application

answer

1. Cholinergic Agonist (Direct Acting) - hint ends in "chol" 2. Produces rapid miosis and contraction of ciliary muscles 3. Glaucoma

question

Pilocarpine 1. Type of drug 2. Action 3. Clinical Application

answer

1. Cholinergic Agonist (Direct Acting) - hint ends in "chol" 2. Produces rapid miosis and contraction of ciliary muscles 3. Glaucoma

question

Myasthenia gravis

answer

-skeletal muscle weakness -autoimmune disease which results from antibodies that block nicotinic acetylcholine receptors -prevents nerve impulses from triggering muscle contractions -treated with medications known as acetylcholinesterase inhibitors such as neostigmine and pyridostigmine.

question

Edrophonium 1. Actions 2. Clinical Application

answer

1. Inhibits acetylcholinesterase- increasing Ach in the Neuromuscular junction. 2. Urinary retention, Reversal of neuromuscular junction blockade, Myasthenia gravis, Glaucoma

question

Neostigmine 1. Actions 2. Clinical Application

answer

1. Inhibits acetylcholinesterase- increasing Ach in the Neuromuscular junction. 2. Urinary retention, Reversal of neuromuscular junction blockade, Myasthenia gravis, Glaucoma

question

Physostigmine

answer

1. Inhibits acetylcholinesterase- increasing Ach in the Neuromuscular junction. 2. Urinary retention, Reversal of neuromuscular junction blockade, Myasthenia gravis, Glaucoma

question

Echothiophate

answer

1. Inhibits acetylcholinesterase- increasing Ach in the Neuromuscular junction. 2. Urinary retention, Reversal of neuromuscular junction blockade, Myasthenia gravis, Glaucoma

question

Atropine 1. Clinical uses 2. Adverse effects 3. Type of drug

answer

Antispasmodic (GI and bladdar)- decreases spasms Mydriasis Antisecretory (eyes, airway)- decreases these secretions Antidote for cholinergic agonists 2. Dry mouth, tachycardia, blurred vision, constipation, disorientation 3. Antimuscarinic agent

question

Scopalamine 1. Type of drug 2. CLincial uses 3. Adverse

answer

1. Antimuscarinic agent 2. Antimotion sickness (decreases nerve signals that trigger your stomach to vomit. Scopolamine is used to prevent nausea and vomiting caused by motion sickness or from anesthesia given during surgery), Sedation 3. Same as Atropine

question

Ipratropium 1. type of drug 2. Clinical uses

answer

1. antimuscarinic agent 2. asthma, COPD tip- antimuscarinic drugs are all about stoping secretions

question

Succinylcholine 1. type of drug 2. Actions 3. Application

answer

1. Neuromuscular Blocker 2. Depolarizing neuromuscular junctional (NMJ) blockade 3. Rapid endotracheal intubation

question

Tubocurarine

answer

1. Neuromuscular Blocker 2. Nondepolarizing NMJ blockade 3. Adjunctive in anesthesia for relaxation of skeletal muscles

question

Atracurium

answer

1. Neuromuscular Blocker 2. Nondepolarizing NMJ blockade 3. Adjunctive in anesthesia for relaxation of skeletal muscles

question

Doxacurium

answer

1. Neuromuscular Blocker 2. Nondepolarizing NMJ blockade 3. Adjunctive in anesthesia for relaxation of skeletal muscles

question

Pancuronium

answer

1. Neuromuscular Blocker 2. Nondepolarizing NMJ blockade 3. Adjunctive in anesthesia for relaxation of skeletal muscles

question

Hexamethonium

answer

Nicotinic Ach receptor antagonist

question

Benzodiazepines 1. name a bunch 2. action 3. application 4. adverse effects 5. Type of drug

answer

1. diazepam, lorazepam, chlonazepam, triazolam, midazolam, chlordiazepoxide!!!!!!?!, alprazolam, oxazepam 2. facilitates gamma-aminobutyric acid (GABA) receptor binding by increasing the frequency of Cl- channel opening 3. Anxiety, Sedation, Muscle spasticity, seizures, sleep disorder, alcohol withdrawal 4. Drowsiness and confusion, Dependence, Potentiate alcohol effects and other central nervous system (CNS) depressants 5. Anxiolytic/Hypnotic

question

Flumazenil

answer

Tx of benzodiazepine overdose. competitive GABA receptor.

question

Buspirone 1. Type 2. Action 3. Applicationi

answer

1. Anxiolytic 2. Mediated through SE receptors 3. Anxiety disorder

question

Hydroxyzine 1. Type 2. action 3. application

answer

1. Anxiolytic 2. antihistamine 3. antiemetic (preventing vomiting), anxiety disorder

question

Phenobarbital 1. Type 2. Action 3. Application 4. Adverse Effects

answer

1. Barbiturate 2. potentiates GABA receptor binding by inc the duration of CL channel opening 3. Anesthesia, seizures, anxiety 4. drowsiness, confusion, dependence, potentiate alcohol and other cns depressants, cario and respiratory depressant, drug interactions (induce cytochrome P450)

question

Pentobarbital

answer

1. Barbiturate 2. potentiates GABA receptor binding by inc the duration of CL channel opening 3. Anesthesia, seizures, anxiety 4. drowsiness, confusion, dependence, potentiate alcohol and other cns depressants, cario and respiratory depressant, drug interactions (induce cytochrome P450)

question

Thiopental

answer

1. Barbiturate 2. potentiates GABA receptor binding by inc the duration of CL channel opening 3. Anesthesia, seizures, anxiety 4. drowsiness, confusion, dependence, potentiate alcohol and other cns depressants, cario and respiratory depressant, drug interactions (induce cytochrome P450)

question

Secobarbital

answer

1. Barbiturate 2. potentiates GABA receptor binding by inc the duration of CL channel opening 3. Anesthesia, seizures, anxiety 4. drowsiness, confusion, dependence, potentiate alcohol and other cns depressants, cario and respiratory depressant, drug interactions (induce cytochrome P450)

question

Chloral hydrate

answer

1. Nonbarbituate sedative 2. used for short-term of insomnia (sedative before dental/medical procedures). Its rapidly metabolized into trichloroethanol and trichloroacetic acid Cardio and Respir depressant at high doses

question

Antihistamines 1. Type 2. Treats 3. Name two antihistamines?

answer

1. Nonbarbituate sedatives 2. Treats mild insomnia 3. Diphenhydramine & Doxylamine

question

Carbamazepine

answer

Anticonvulsant Blocks Na channels Adverse effects- Liver toxicity, Blood dyscrasia, Induction of cyt P450

question

Phenytoin

answer

Anticonvulsant blocks na channels adverse effects- gingival hyperplasia, SLE-like syndrome, diplopia (double vision), ataxia (loose muscle control), cyt P450

question

Gabapentin

answer

Anticonvulsant Increases presynaptic GABA release adverse effects: ataxia, sedation

question

Valproic Acid

answer

Anticonvulsant Blocks Na channels and increases GABA conc Adverse effcts: hepatotoxicity, neural tube defects

question

Benzodiazepines

answer

Anticonvulsants Facilitates GABA binding Adverse effects: Sedation, dependence, tolerance

question

Selective Serotonin Reuptake Inhibitors 1. Type of Drug 2. Name 3 of these drugs 3. Mechanism 4. Application 5. Adverse effects

answer

1. Antidepressant 2. Fluoxetine, Sertraline, Paroxetine Parrot serves the flu 3. Specifically inhibits serotonin reuptake 4. Depression 5. Anxiety, nausea, sexual dysfunction "Parrot Serves fruit"

question

Tricylclic Antidepressants 1. Name the 6 2. Mechanism 3. Application 4. Adverse Effects

answer

1. Amitriptyline, Imipramine, Nortriptyline, Desipramine, Trimipramine, Doxepin has "trip" or "pra" in it 2. Inhibits reuptake of NE and SE into presynaptic nerve terminals 3. Depression and panic disorders 4. Antimuscarinic effects, postural hypotension, sedation, convulsions, arrhythmias

question

Monoamine Oxidase Inhibitors 1. Name 3 2. Mechanism 3. Applications 4. adverse effects 5. TYpe of drug

answer

1. Phenelzine, Isocarboxazid, Tranylcypromine 2. Increases monoamine (NE, SE, DA) stores within the neurons and subsequent release of excess neurotransmitters into the synapse 3. Depression, anxiety, phobic states 4. drowsniess, postural hypotension, dry mouth, dysuria (painful urination), constipation 5. Antidepressant

question

Lithium 1. Type of drug 2. Mechanism 3. Application 4. Adverse effect

answer

1. Antidepressant 2. Unknown 3. Bipolar disorder 4. Narrow therapeutic window, tremor, polyuria, hypothyroidism

question

Antipsychotics (Neuroleptics) 1. Name 5 2. Mechanism 3. Application 4. Adverse effects

answer

1. Haloperiodol, Chlorpromazine, Thioridazine, Fluphenazine, Prochlorperazine 2. Block DA D2 receptors 3. Psychosis, acute mania, schizophrenia 4. Extrapyramidal effects, tardive dyskinesia, antimuscarinic effects, postural hypotension

question

Antipsychotics (Atypical) 1. name 3 2. Mechanism 3. Application 4. Adverse

answer

1. Risperidone, Clozapine, Olanzapine 2. Block DA D2 and 5HT2 SE receptors 3. Schizophrenia, mania, depression 4. Lesser extrapyramidal and antimuscarinic effects than neuroleptics

question

There are two general types of antipsychotics

answer

1. Neuroleptics 2. Atypical

question

Cardiac Glycosides 1. Name two 2. Mechanism 3. Application 4. Adverse Effects

answer

1. Digitoxin, Digoxin 2. Inhibits Na+/K+ ATPase (normally pumps Na+ out of cells!) of cardiac cells, inc Na+ intracellularlly. This favors the Na+/Ca+ antiport causing an influx of Ca2++ inside--> increasing contractility! 3. Congestive heart failure 4. Dysrhythmia, nausea, vomiting, blurred vision, digoxin toxicity (narrow therapeutic index)

question

Antiarrhythmic Classes of Drugs

answer

Class I: Na+ channel blockers (either slows phase 0 depolarization or shortens phase 3 repolarization) Quinidine, Lidocaine, Procainamide, Flecainide, Disopyramide Class II: B-Blockers (propanolol, metoprolol, pindolol, esmolol)- Decrease phase 4 deplolarization Class III: K+ channel blockers causing prolonged phase 3 repolarization Sotalol, Amiodarone, Bretylium Class IV: Ca2++ channel blockers (Verapamil, Diltiazem) Shorter action potential

question

Diuretics 1.) 2 Types

answer

1. Loop Diuretics (Furosemide) -Sulfonamide loop diuretic that inhibits the Na+/K+/2Cl- triple co-transporter of the thick ascending loop of Henle -Treats Hypertension & edematous states (accumulation of fluid) -Adverse effects: Hyperuricemia (too much uric acid), ototoxicity (being toxic to the ear), hypokalemia, hypovolemia 2. Thiazide Diuretics (Hydrochlorothiazide) -Inhibits Na+/Cl- reabsorption in the distal convoluted tubules -Treats Hypertension & congestive heart failure - Adverse: Hyperuricemia, hypokalemia

question

B-Blockers

answer

Propanolol, Metoprolol, Atenolol, Labetalol -Lowers cardiac output by decreasing sympathetic outflow from the CNS and inhibits release of renin from kidney -First line drug therapy for hypertension! -Adverse: Bradycardia, hypotension, insomnia, sexual dysfunction

question

Alpha-1 Blockers

answer

Prazosin, Oxazosin, Terazosin - decrease in peripheral vascular resistance - adverse: first dose postural hypotension, headache, dizzy

question

ACE inhibitors

answer

Captopril, Enalapril, Lisinopril, Benazepril -Anti-hypertensives -Blocks angiotensin convertin enzyme resulting in decrease conversioni of angiotensin I to II- potent vasoconstrictor -Adverse: cough, hypotension, hyperkalemia, rashes, fever Side effects of ACE inhibitors: "CAPTOPRIL" -Cough -Angioedema -Potassium excess -Taste changes -Orthostatic hypotension -Pregnancy contraindication -Rash -Indomethacin inhibition -Liver toxicity

question

Angiotensin II Antagonist

answer

Losartan Angiotensin II receptor blocker Adverse: Fetal toxicity

question

Ca2++ channel Blocker

answer

Verapamil, Diltiazem, Nifedipine -Block L-type ca channels in smooth muscle of heart -Adverse: Dizzy, constipation, headache, fatigue, hypotension

question

Antianginal Drugs

answer

1) Nitroglycerin and Isosorbide Dinitrate -Nitric oxide release in smooth muscle cause increase cGMP resulting in relaxation and vasodilation. Affects VEINS greater than arteries -Applications: Angina and pulmonary edema -Adverse effects: dizzy, constipation, headache, fatigue, hypotension 2) B-Blockers -Lowers cardiac output -decreases heart workload (reduces freq and severity of angina attacks)

question

Anticoagulants -Go over everything plus their overdose reversal meds

answer

1) Heparin -Binds and activates antithrombin III resulting in inactivation of thrombin and factor Xa. -Txs: Pulmonary embolism, stroke, deep vein thrombosis. Follow PTT -Adverse: Bleeding, thrombocytopenia (dec in platelets) -Overdose reversal: Protamine sulfate 2) Warfarin -inhibits synthesis of Vit K-dependent clotting factors: II, VII, IX, X as well as regulatory factors protein C and protein S -txs: long term anticoagulation. Follow PT/INR -Adverse: Bleeding and teratogenic -Overdose reversal: Vit K.

question

Antihyperlipidemics

answer

HMG-CoA Reductase Inhibitor -Lovastatin, Pravastatin, Simvastatin, Fluvastatin -Competively inhibits HMG-CoA reductase, the rate-limiting step in de novo (new) cholesterol synthesis -Adverse effects: Rhabdomyolysis (damaged skeletal muscle breaks down rapidly), myopathy (dz of muscle tissue), liver failure

question

Penicillin

answer

-Cell wall synthesis inhibitor -Penicillin V & Penicillin G -Binds penicillin binding proteins; blocks transpeptidase cross linking of bacterial cell walls; activates autolysins in bacterias. Not resistant to beta lactamase. -Spectrum: gram + cocci, gram + rods, gram - cocci, spirochetes -Adverse effects: Hypersensitivity reactions, diarrhea, hemolytic anemia

question

Narrow Spectrum Penicillins

answer

Methicillin, Dicloxacillin, Nafcillin -Mechanism same as penicillin except beta lactamase resistant bc of bulkier R-group -Spectrum: Staph aureus -Adverse: Hypersensitivity reactions, nephritis (inflammation of kidneys)

question

Extended Spectrum Penicillins

answer

Amoxicillin, Ampicillin -Mech same as penicillin but is beta lactamse resistant. It is combined with beta lactamse inhibitors such as clavulanic acid to enhance spectrum. Amoxicillin has more oral bioavailability -Spectrum: gram + (enterococci) and certain gram - rods (H. infuenzae, E. coli, P. Mirabilis, L. Monocytogenes, Salmonella) -Adverse: hypersensitivity rxns, pseudomembranous colitis

question

Clavulanic acid

answer

beta lactamase inhibitor

question

Antipseudomonas Penicillins

answer

Piperacillin, Carbenicillin, Ticarcillin -Same as penicillin but is beta lactamase resistant. Combined with beta lactamase inhibitors such as tazobactam to enhance spectrum -Spectrum: Many gram - bacilli and also pseudomonas aeruginosa -adverse: hypersensitivity rxns

question

tazobactam

answer

beta lactamase inhibitor

question

Cephalosporins

answer

Cell wall synthesis inhibitors -Beta lactam drugs that inhibit cell wall synthesis but more resistant to beta lactamase 1st generation: Cefazolin, cephalexin, cefadroxil Effective against gram + cocci and proteus mirabilis, E.coli, Kleb pneumoniae 2nd generation: Cefaclor, cefoxitin, cefuroxime, cefamandole Has some decreased gram + activity but has inc gram - activity to three additional organisms (Entero aerogenes, H. influenzae, Neisseria species) 3rd generation: Cefotaxime, ceftazidime, ceftriaxone, cefdinir, cefixime Has some dec gram + but compared to 1st and 2nd generation has enhanced gram + and serratia marcescens 4th generation: Cefepime Increased against Pseudomonas and gram + (strep and staph) Adverse effects: Hypersensitivity Cross hypersensitivity with penicillins (5-10%). Disulfiram-like effect with cefamandole. Anti vitamin K effects with cefamandole and cefoperazone causing bleeding.

question

Carbapenems

answer

Imipenem -Beta lactam drug -inhibits cell wall synthesis - they are beta lactamase resistant -Spectrum: broadest beta lactam antibiotic spectrum! effective against pencillinase producing gram + and -, anaerobes, and pseudomonas aeruginosa -Adverse: GI upset

question

Antimicrobials- Cell wall synthesis inhibitors

answer

Penicillins, Cephalosporins, Carbapenems, Monobactams, Vancomycin

question

Monobactam

answer

Aztreonam -Beta lactam drug, resistant to beta lactamase -narrow spectrum primarily against enterobacteria, especially useful against aerobic gram - rods -adverse: skin rash, abnormal liver functions, no cross hypersensitivity with penicillin

question

Vancomycin

answer

inhibits synthesis of cell wall phospholipids by binding D-ala and D-ala portions of cell wall precursors. Bactericidal and resistance occurs with amino acid change of D-ala and D-ala to D-ala and D-lac. spectrum: multi drug resistant gram + (staph and clostridium difficile- pseudomembraneous colitis) Adverse: diffuse flushing (red man syndrome), nephrotoxicity, ototoxicity, phlebitis (inflammation of veins)

question

Protein synthesis inhibitors (antimicrobials)

answer

Clindamycin, Tetracyclines, Macrolies, Aminoclycosides, Chloramphenicol, Fluoroquinolones FATMCC

question

Clindamycin

answer

-Works at 50S ribosomal subunit, Prevents peptide formation -Bacteriostatic -Spectrum: Anaerobic organisms such as bacteroides fragilis and clostridium perfringens -Adverse: pseudomembranous colitis

question

Tetracyclines

answer

Tetracycline, Demeclocycline, Doxycycline, Minocycline -Binds to 30S blocks access of tRNA inhibiting bacterial protein synthesis -avoid taking milk antacids or iron bc divalent cations inhibit its absorption in the gut -spectrum: wide! active against vibrio cholerae, acne, chlamydia, ureaplasma urealyticum, mycoplasma pneumoniae, borrleia burgdorferi, rickettsia, tularemia -adverse: discoloration of teeth, inhibits bone growth in children, photosensitivity, GI irritation, fatal hepatotoxicity in pregnant women

question

Macrolides

answer

Azithromycin, Clarithromycin, Erythromycin (ACE) -Binds to 50S and inhibits translocation steps of protein synthesis -spectrum: upper respiratory infections, pneumonias, mycoplasma, legionella, chlamydia, neisseria, gram + cocci (strep infections in pts allergic to penicillins) (MULPCNS*) -adverse effects: cholestatic hepatitis, GI irritation, ototoxicity

question

Aminoglycosides

answer

Amikacin, Gentamicin, Neomycin, Netilmicin, Streptomycin, Tobramycin - all end in "micin or mycin" -binds to separated 30s interfering with assembly of ribosomal apparatus (requires O2 for uptake) -spectrum: aerobes only. gram - rods and synergistic with beta lactam antibiotics -adverse: teratogen, ototoxicity, nephrotoxicity

question

Chloramphenicol

answer

-Binds 50S inhibits protein synthesis at the peptidyl transferase rxn -spectrum: broad spectrum antibacterial active against H. influenzae, Neisseria meningitidis, and streptococcus pneumoniae. Also active against Rickettsiae -adverse: hemolytic anemias and gray baby syndrome

question

Fluoroquinolones

answer

Ciprofloxacin, Enoxacin, Levofloxacin, Norfloxacin, Ofloxacin, Trovafloxacin -Inhibits DNA gyrase (Topoisomerase II) -Spectrum: Gram negative rods of GI and urinary tracts including Pseudomonas aeruginosa, Neisseria. Has some activity against some gram + -adverse effects: tendonitis and tendon rupture, GI irritation

question

Who needs AB Prophylaxis? Also - drug of choice? Allergic?

answer

1. Hx of prosthetic cardiac valve 2. Hx of previous infective endocarditis 3. Hx of CHD: Unrepaired cyanotic CHD, Completely repaired CHD with prosthetic material during first 6 months, Repaired CHD with residual defects 4. Hx of cardiac transplantation who develop valvulopathy Drug of choice: Amoxicillin 2 grams 30-60 minutes prior to dental procedures If Allergic: -Clind 600 mg 30-60 min -Ceph 2 g 30-60 min -Azithromycin 500 mg 30-60 -Clarithromycin 500 mg 30-60 * IF dosage is not administered before procedure, up to 2 hours after is ok

question

Amphotericin B

answer

-Antifungal -Binds to ergosterol in cell membrane of fungi and forms pores that allows electrolytes and small molecules to leak from the cell causing cell death -Spectrum- wide spectrum of systemic mycoses such as Candida albicans, Histoplasma capsulatum, cryptococcus neoformans, coccidiodes immitis, strains of aspergillus and blastomyces dermatitdis -adverse: nephrotoxicity, arrhythmias, fevers/chills

question

Nystatin

answer

Antifungal similar to amphotericin B spectrum: oral candidiasis adverse: nausea and vomiting

question

Azoles

answer

-Antifungal -Fluconazole, ketoconazole, itraconazole, miconazole, voriconazole -Blocks synthesis of ergosterol -systemic mycoses with same spectrum as ampho B with addition of histoplasmosis -Adverse: Endocrine effects (gynecomastia, impotence, menstrual irregularities, decreased libido) liver dysfunction, fevers/chills

question

Flucytosine

answer

Antifungal Inhibits DNA synthesis by conversion to fluorouracil and inhibiting thymidylate synthetase spectrum: systemic mycoses (cryptococcosis, candidiasis, chromoblastomycosis) adverse: bone marrow depression, hepatic dysfunction, GI irritation

question

Name all antifungals

answer

Amphotericin B, Nystatin, Azoles, Flucytosine, Griseofulvin

question

Griseofulvin

answer

Antifungal Interacts with microtubules to disrupt the mitotic spindle and inhibits mitosis Spectrum: Dermatophytes -(Trichophyton, Microsporum, Epidermophyton) Adverse: well tolerated

question

Amantadine

answer

-Antiviral -Blockade of viral membrane matrix protein, M2, which is required for fusion of the viral membrane with cell membrane - prevents viral penetration and uncoating -Spectrum: Influenza A and Parkinsons disease -Adverse: insomnia, ataxia, and dizzy

question

Ribavirin

answer

Antiviral -Inhibits synthesis of viral mRNA by inhibiting synthesis of guanine nucleosides -Spectrum: broad spec of RNA and DNA viruses including respiratory syncytial virus and hepatitis C -adverse: Hemolytic anemia and teratogenic

question

Oseltamivir and Zanamvir

answer

Antiviral -Influenza neuraminidase inhibitors -Spectrum: Influenza A and B -Adverse: GI irritation

question

Acyclovir

answer

Antiviral -Phosphorylated by herpes virus encoded enzyme, thymidine kinase, and inhibits viral DNA polymerase -Spectrum: herpes viruses HSV-1, HSV-2, VZV (chicken pox), EBV (Ebstein Barr aka herpes 4) -Adverse: Nephrotoxicity, tremors, local irritation depending on route of administration

question

Ganciclovir

answer

Antiviral -Similar mechanism to acyclovir but with a preference for inhibition of CMV DNA polymerase -Spectrum: CMV -Adverse: neutropenia, nephrotoxicity

question

Reverse Transcriptase Inhibitors

answer

HIV Therapy -Nucleosides: Zidovudine (AZT), Didanosine, Zalcitabine, Abacavir -Nonnucleosides: Nevirapine, Delaviridine, Efavirenz -Protease Inhibitors: Ritonavir, saquinavir, nelfinavir, ampreavir Mechanism for Nonnucleosides: -Inhibits HIV reverse transcriptase and thus preventing the incorporation of HIV into host genome. -Adverse effects: bone marrow suppression, megaloblastic anemia, peripheral neuropathy, rash, lactic acidosis Mechanism for Protease Inhibitors: -Blocks protease enzyme thereby inhibiting assembly of virus -Adverse: Thrombocytopenia, GI irriation, hyperglycemia, and lipid abnormalities

question

Insulin

answer

-Diabetes -Mechanism: Binds to insulin receptors. In muscles stimulates uptake of glucose, stimulates glycogen and protein synthesis, stimulates K+ uptake. In adipose tissues, stimulates uptake of glucose and stimulates triglyceride storage. In liver, stimulates storage of glucose to glycogen -Used for diabetes and life-threatening hyperkalemia -toxicities: hypoglycemia

question

Sulfonylureas

answer

Glipizide, Glyburide, Tolbutamide, Chlorpropamide -Stimulation of insulin release from beta cells of pancreas, stimulates binding of insulin to target tissues, decreases serum glucagon levels -Used for type II diabetes (requires presence of beta cells) -Toxicity: hypoglycemia and disulfiram reactions (tolbutamide and chlorpropamide)

question

Biguanides

answer

Metformin -Decrease hepatic gluconeogenesis -used for type II diabetes -toxicity: lactic acidosis

question

Glitazones

answer

Rosiglitazone, Pioglitazone -Increases target cell response to insulin -Used for: Type II diabetes -Toxcitiy: hepatotoxic, weight gain

question

Alpha-Glucosidase Inhibitor

answer

Acarbose, Miglitol -Inhibits alpha-glucosidase in intestinal brush border and therefore decreasing the absorption of starch and disaccharides -Uses: Type II diabetes -Toxicities: Flatulence, diarrhea, abdomina cramping

question

Hyperthyroidism

answer

Propylthiouracil, Methimazole -Inhibition of the coupling and organification steps of thyroid hormone synthesis -Propythiouracil also decreases the peripheral conversion of T4 to T3 -Toxicities: aplastic anemia, agranulocytosis, rash

question

Steroid Therapy

answer

Glucocorticoids- Prednisone, Triamcinolone, Dexamethazone, Beclomethasone, Hydrocortisone Mechanism: Binds to specific intracellular cytoplasmic receptors in tissues. Promotes normal intermediary metabolism to provide increased resistance to stress. Decrease the production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of Cox-2. Uses: inflammation, addisons disease, immune suppression, asthma (aka they are anti-infammatories) toxicities: iatrogenic cushings syndrome Addisons disease- hyposecretion of adrenocortical hormone Cushings syndrome- hypersecretion of adrenocortical hormone

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Opiods -there is 8 of them

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Analgesics -Fentanyl, Morphine, Meperidine, Methadone Sulfentanil, Codeine, Heroin, Dextromethorphan -interact with opioid receptors (mu, delta, kappa) in the CNS and GI tract to modulate synaptic transmission -Uses: pain, reduce cough reflex (dex), diarrhea (loperamide) -Toxicities: respiratory depression, constipation, miosis, additive CND depression and addiction

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NSAIDs

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Analgesics -Aspirin, Ibuprofen, Indomethacin, Naproxen, Etodolac -Aspirin irreversibly inhibits Cox-1 and Cox-2 while the other NSAIDs are reversible inhibitors of 1 & 2. Prostaglandin synthesis is also blocked. -uses: Analgesia, anti-inflammatory, and antipyretic -Toxicity: aplastic anemia, GI ulcers, GI irritation, and Reye's syndrome

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Acetaminophen

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-Inhibition of cyclooxygenase in CNS -Clinical: Antipyretic and analgesic -Toxicities: Hepatotoxicity with overdose. Acetaminophen metabolite depletes glutathione and forms toxic metabolite, NAPQI, in liver. N-acetylcysteine is antidote.

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Cox-2 inhibitors

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Celecoxib, Valdecoxib -Preferential inhibition of cox 2 isoform that is found in inflammatory cells and mediates pain and inflammation. Spares cox-1, which is helpful in maintaining gastric mucosa cells. -uses: rheumatoid and osteoarthritis -toxicities: risk of MI and strokes

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Autacoids

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Prostaglandins -they all end in "prost" (Misoprostol, Carboprost, Dinoprost, Dinoprostone) - Uses: Abortions, induction of labor, prevention of peptic ulcers and maintenance of patent ductus arteriousus -Toxicities: Diarrhea

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Antihistamines

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1) H1 Blockers: Reversible H1 histamine receptor blockers 1st Generation: Diphenhydramine, Dimenhydrinate -Uses: Allergy, motion sickness and nausea, and sedatives 2nd Generation: Fexofenadine, Loratidine -Uses: Allergy, far less sedating that 1st generation -Toxicities: Sedation, antimuscarinic, antialpha adrenergic effects 2) H2 Blockers: Reversible H2 histamine receptor blockers Cimetidine, Ranitidine, Nizatidine, Famotidine -Uses: Peptic ulcers, esophageal reflux, gastritis -Toxicities: potent inhibitor of P450 (cimetidine)

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