Professional Documents
Culture Documents
BUTORPHANOL
Dysphoria Nightmares w/drawal in pts dependent on full opioid agonists AVOID MAOI
Potentially fatal
Partial agonist or antagonist @ opioid receptors Agonist @ receptors @ spinal & supraspinal sites Inhibits spinothalamic pain neurotransmission
DIHYDROERGOTAMINE
N, V Stiff neck, shoulder, extremities Leg weakness Numbness & tingling in fingers & toes
Presynaptic inhibition of trigeminal peptide neurotransmitter release Inhibitions brainstem activation of trigeminal neurons
Vascular HA
FENTANYL
Sedation Confusion Respiratory depression Anorexia N, V Constipation AVOID MAOI in past 14d
Transdermal patch
MEPERIDINE
Confusion Sedation Constipation N, V Dependence Toxic metabolite CNS excitation, convulsions, tremors AVOID MAOI
Potentially fatal
METHADONE
Respiratory depression Constipation Confusion Sedation AVOID MAOI
MORPHINE
Sedation Confusion Hypotension Constipation Respiratory depression AVOID MAOI w/ 14 d
Potentially fata
Activates receptors
cAMP
Active metabolite
Morphine glucuronate
NALOXONE
PROPOXYPHENE
Dizziness Weakness N dependence
Mid-moderate pain
SUMATRIPTAN
Dizziness Vertigo Tingling Warm sensation Tight feeling head & chest Coronary vasospasm AVOID
MAOI SSRI
Presynaptic inhibition of trigeminal peptide neurotransmitter release Inhibitions brainstem activation of trigeminal neurons
Vascular HA
TRAMADOL
Dizziness HA Constipation Lowers seizure threshold AVOID MAOI risk seizures w/ high doses
Penicillins Phenothiazines
ANESTHETICS
BENZOCAINE
Cross-sensitivity w/ other ester-type anesthetics
Topical anesthetic
Irritates skin when 1st applied Use caution w/ sunburn & large areas of skin
BUPIVACAINE
Cross-sensitivity w/ amide-type anesthetics
HALOTHANE
Sensitizes heart to catecholamine-induced cardiac arrhythmia Hepatotoxic
Fluoride metabolites
General anesthetic
KETAMINE
Delirium Hallucination Irrational behavior during recovery BP
LIDOCAINE
Cross-reactivity w/ amidetype anesthetics
Lidocaine & prilocaine Anesthetize intact skin for venipuncture IV cannulation Circumcism
MIDAZOLAM
Apnea Laryngospasm Respiratory depression Cardiac arrest
NITROUS OXIDE
PROPOFOL
Bradycardia Hypotension
NO analgesic effect
SEVOFLURANE
General anesthesia
ANTI-INFECTIVE
Foscarnet Fosfomycin Ganciclovir Gentamicin Griseofulvin Imipenem-cilastatin Isoniazid Itraconazole Ivermectin Levofloxacin
ACYCLOVIR
Dizziness Diarrhea N Nephrotoxicity Probenecid serum levels
Converted to acyclovir triphosphate by viral & host cell kinases Incorporated into DNA by viral DNA polymerase causing DNA chain termination
ALBENDAZOLE
GI distress Constipation or diarrhea Hepatitis & hematologic toxicity w/ high doses
Antihelmintic Benzimidazole
Trichinosis
Use w/ corticosteroid
AMANTADINE
Ataxia Dizziness Insomnia Skin mottling & livedo reticularis Blurred vision Dry mouth
Influenza A
AMOXICILLIN-CLAVULANATE
Diarrhea Superinfection Pseudomembranous colitis Allergic rxn
Rash Serum sickness anaphylaxis
Amoxicillin
Clavulanate
Bite wounds
AMPHOTERICIN B
Chills Fever Diarrhea N, V Nephrotoxicity Hypokalemia toxicity w/ cyclosporine, antineoplastics Thiazides, & corticosteroids hypokalemia
AZITHROMYCIN
Binds 50s ribosome Prevents peptide elongation & translocation from acceptor site to peptidyl site
AZTREONAM
Thrombophlebitis Allergic rxn
Drug resistant gram (-) infections including Pseudomonas aeruginosa & Enterobacteriaceae
CASPOFUNGIN
HA Fever Phlebitis Abnormal LFTs
Antifungal Echinocandin
-1,3-D-glucan
IV admin
CEFAZOLIN
Rash Diarrhea Pseudomembranous colitis Superinfection Probenecid inhibits excretion & serum levels
CEFEPIME
Rash Diarrhea Pseudomembranous colitis Superinfection Probenecid inhibits excretion & serum levels
Binds multiple PBP Inhibits cross-linking of cell wall peptidoglycan Resistant to many lactamases
Citrobacter Enterobacter
CEFTAZIDIME
Rash Diarrhea Pseudomembranous colitis Superinfection Probenecid inhibits excretion & serum levels
CETRIAXONE
Rash Diarrhea Pseudomembranous colitis Superinfection Probenecid inhibits excretion & serum levels
Infection d/t
CIPROFLOXACIN
Insomnia Diarrhea N Absorption by cations
Antacids Iron Zinc bismuth
Antibacterial Fluoroquinolone
Inhibits bacterial DNA topoisomerase type II (DNA gyrase) & type IV Prevents DNA replication & separation of chromosomes
Urinary tract, prostate, intraabdominal w/ metronidazole, bone or jt, skin Inhalational anthrax Gonorrhea Infectious diarrhea
CLINDAMYCIN
C. difficile superinfection Diarrhea Pseudomembranous colitis
Binds 50s ribosome Prevents translocation of nascent peptide from acceptor site to peptidyl site
DOXYCYCLINE
AVOID
Pregnancy & children > 8 y/o Outdated preparations are nephrotoxic
Binds 30s ribosome Reversibly inhibits binding of transfer RNA to acceptor site
Rickettsia, Chlamydia, Mycoplasma, Borrelia Acne Cholera Gonorrhea & syphilis in PCN allergic pts Brucellosis & ehrlichiosis
EFAVIRENZ
N Rash Drowsiness Depression
ENFUVIRTIDE
Injection site rxn
Rotate sites daily
Binds HIV virus gp41 & blocks fusion of HIV w/ host cells CD4 Thelper lymphocytes
Drug-resistant HIV
ERYTHROMYCIN
Activates motilin receptors causing uncoordinated peristalsis
Anorexia N, V
Binds 50s ribosome Prevents peptide elongation & translocation from acceptor site to peptidyl site
ETHAMBUTOL
Dose-related retrobulbar optic neuritis Impaired red-green color discrimination
Monitor pts color discrimination regularly
Gouty arthritis
M. tuberculosis MAI
FOSCARNET
Antiviral Pyrophosphate
HA Diarrhea V Renal failure Hypocalcemia Hypokalemia Hypomagnesemia Anemia Arthralgia Myalgia
FOSFOMYCIN
Inhibits enopyruvyl transferase & addition of phosphenolpyruvate to N-acetylglucosamine to form Nacetylmuramic acid
GANCICLOVIR
visual acuity Neutropenia Thrombocytopenia Anemia
GENTAMICIN
Nephrotoxicity Ototoxicity
Vestibular & cochlear w/ loop diuretics
Gram (-) bacilli including Enterobacteriaceace & P. aeruginosa Strep, enterococcal, & staph infections
GRISEOFULVIN
HA Induces CYP450
Reduces plasma levels warfarin & OCP
Deposits in keratin precursor cells of skin, hair, & nails Disrupts microtubules & mitotis of dermatophytes
IMIPENEM-CILASTATIN
Allergic rxns Diarrhea V Seizures
risk w/ ganciclovir or cyclosporine
Imipenem
Cilastatin
ISONIAZID
Hepatitis
Toxic metabolite acetylhydrazine
Peripheral neuropathy
Vit. B6 deficiency
Reduces catalaseperoxidase
TB
ITRACONAZOLE
GI distress Rash Hepatitis
Inhibits 14-demethylase
IVERMECTIN
Vertigo Sedation
W. bancrofti
LEVOFLOXACIN
Antibacterial Fluoroquinolone
Inhibits bacterial DNA topoisomerase type II (DNA gyrase) & type IV Prevents DNA replication & separation of chromosomes
LINEZOLID
Inhibits MAO
MEFLOQUINE
Neuropsychiatric syn
Hallucination Anxiety Confusion Seizure Coma
METRONIDAZOLE
GI pain Anorexia N Dizziness Alcohol causes disulfiram-like effect
Antiprotozoal Nitroimidazole
Reduced by pyruvate:ferredoxin to form nitro-free radicals that attack DNA & proteins
MUPIROCIN
Competes w/ isoleucine for binding bacterial isoleucyl tRNA synthetase Prevents addition of isoleucine during protein synthesis
Impetigo by staph or strep Eradicate nasal colonization of MRSA Infected traumatic skin lesions
NAFCILLIN
Diarrhea Superinfection Pseudomembranous colitis Allergic rxn
Rash Serum sickness Anaphylaxis
Binds PBP
NITROFURANTOIN
Anorexia N, V Neurotoxicity Pneumonitis Probenecid inhibits urinary excretion
UTI
E. coli, S. saprophyticus
OSELTAMIVIR
Influenza A & B
PAROMOMYCIN
Nephrotoxic & ototoxic if given IV
PENICILLIN G
Diarrhea Superinfection Pseudomembranous colitis Allergic rxn
Rash Serum sickness Anaphylaxis
Binds PBP
PENTAMIDINE
Nephrotoxic Hematologic toxicity Hypoglycemia Allergic rxn
Anaphylaxis
PIPERACILLIN-TAZOBACTAM
Diarrhea Superinfection Pseudomembranous colitis Allergic rxn
Rash Serum sickness Anaphylaxis
Piperacillin
Binds PBP
Tazobactam
PRAZIQUANTEL
Malaise Anorexia Drowsiness dizziness
PRIMAQUINE
Hemolytic anemia in G6PD deficiency methemoglobinemia
Antimalarial 8-aminoquinoline
PYRIMETHAMINE
N Anorexia Hypersensitivity rxn
PYRANTEL
Abdominal cramps Anorexia Diarrhea V
QUININE
Abdominal cramps Diarrhea V Cinchonism
Tinnitus Blurred vision
Antimalarial 4-aminoquinoline
Binds plasmodial DNA & prevents replication & transcription during erythrocytic schizogony
Metabolism
Cimetidine inhibits Rifampin induce
Chloroquine-resistant malaria
QUINUPRISTIN-DALFOPRISTIN
Infusion site rxn
Dalfopristin
VRE, MS/MRSA
RIBAVIRIN
Anemia Hypotension Cardiac arrest
Converted to ribavirin triphosphate Depletes guanosine triphosphate Inhibits viral RNA & protein synthesis
RSV in infants or children Chronic hepatitis C Viral hemorrhagic fever Lass fever
RIFAMPIN
Red discoloration of tears, urine, saliva, sweat Abdominal pain V Diarrhea Hepatitis Induces CYP450 levels
Warfarin Theophylline Itraconazole Steroids Opioids Phenytoin Verapamil
RITONAVIR-LOPINAVIR
Anorexia V Altered taste Abnormal thinking Hyperlipidemia Hyperlgycemia
Inhibits HIV protease & conversion of gagpol polyprotein to functional proteins Ritonavir
lopinavir levels
STREPTOMYCIN
Nephrotoxic Ototoxic
w/ loop diuretics
IV admin
TERBINAFINE
Itching Rash Diarrhea Anorexia Metabolism
Cimetidine inhibits Rifampin induce
Antifungal Allylamine
Inhibits squalene oxygenase & formation of squalene epoxide during fungal membrane ergosterol synthesis
Topical
Oral
TRIFLURIDINE
Ocular irritation
Redness Itching
TRIMETHOPRIM-SULFAMETHOXAZOLE
N, V Rash Stevens-Johnson syn Allergic rxn Anemia
Hemolytic anemia Megalobalstic anemia
Sulfamethoxazole
Trimethoprim
VANCOMYCIN
Red man syn
Extensive rate of infusion Erythematous rash on face & upper body
Binds D-alanyl-Dalanine portion of peptidoglycan Prevents cross-linking of D-alanine & pentaglycine chain
ZIDOVUDINE
Anemia
ANTINEOPLASTIC
Anastrozole Bleomycin Busulfan Carmustine Cisplatin Cyclophosphamide Doxorubicin Etoposide Fluorouracil Gemtuzumab ozogamicin
ANASTROZOLE
N HA Hot flashes Back pain
Inhibits aromatase & conversion to estrone precursor to estradiol Lowers estrogen levels Halts progression of estrogen-sensitive breast cancers
BLEOMYCIN
Pneumonitis & pulmonary fibrosis Hyperpigmentation Mucocutaneous toxicity Hematology toxicity
Complexes ironforming oxygen free radicals that cause single strand breaks G2 phase specific
BUSULFAN
N, V Myelosuppression Pulmonary fibrosis
Cross-links DNA strands by covalently bonding guanine residues Prevents DNA replication & transcription
CML
Use w/ cyclophosphamide prior allogenic hematopoietic progenitor cell transplant for CML
CARMUSTINE
N, V Hepatotoxicity Anemia Leucopenia Thrombocytopenia Pulmonary fibrosis
Cross-links DNA strands by covalently bonding guanine residues Prevents DNA replication & transcription
CISPLATIN
Severe N, V Ototoxicity & tinnitus Hypocalcemia Hypokalemia Hypomagnesemia Anemia
Forms reactive metabolites that covalently bond DNA bases & cross-link DNA strands
CYCLOPHOSPHAMIDE
Anorexia N, V Hemorrhagic cystitis & hematuria Alopecia Thrombocytopenia Leukopenia Anemia Rifampin induces CYP & toxicity
Cross-links DNA strands by covalently bonding guanine residues Prevents DNA replication & transcription
DOXORUBICIN
Colors urine red
Complexes iron forming hydroxyl free radicals that cause strand breaks Inhibits topoisomerase II
S phase specific
ETOPOSIDE
N, V Leukopenia Thrombocytopenia Alopecia
Inhibits mammalian topoisomerase II & prevents resealing of nicked DNA strands G2 phase specific
FLUOROURACIL
S phase specific
Colon, breast, rectal, gastric, pancreatic cancer Topical for basal cell carcinoma & actinic keratosis
GEMTUZUMAB OZOGAMICIN
Severe myelosuppression & hypersensitivity rxn
anaphylaxis
Gemtuzumab
Binds CD33 Ag on hematopoietic cells & sequesters lysosomes where calicheamicin is released
Calicheamicin
IMATINIB
Inhibits oncoprotein bcrabl tyrosine kinase expressed by Philadelphia chromosome Inhibits leukemic cell proliferation & induced apoptosis
CML
Cough Dyspnea Pharyngitis Pneumonia Abdominal pain V Petechiae Pruritis Rash Night sweats Myalgia Arthralgia Thrombocytopenia Neutropenia
LEUPROLIDE
Transient in testosterone w/ 1st dose
Use flutamide or other androgen antagonist
Pulsatile admin FSH & LH release Continuous admin downregulates GnRH receptors & FSH & LH
MERCAPTOPURINE
Cross-react w/ thioguanine Myelosuppression Hyperuricemia Hepatotoxicity Allopurinol inhibits degradation
Converted to nucleotide triphosphate by phosphoribosyl transferase Inhibits purine biosynthesis & salvage pathways S phase specific
METHOTREXATE
N, V Stomatitis Hepatotoxicity Anemia Leukopenia Thrombocytopenia Nephropathy
Inhibits dihydrofolate reductase Prevents formation of active folate & addition of single carbon units to DNA base precursors S phase specific
Choriocarcinoma, trophoblastic tumors Leukemia Breast, head, neck, lung cancers Severe psoriasis RA Mycosis fungoides
PACLITAXEL
Binds tubulin & prevents depolymerization of microtubules of mitotic spindle M phase specific
Advanced ovarian cancer w/ cisplatin Non-small-cell lung cancer Metastatic ovarian or breast cancer
TAMOXIFEN
CI during pregnancy & lactation N Hot flashes Menstrual irregularities
Competes w/ estrogen for receptors in breast & other tissues Suppresses breast tumor growth
Breast cancer & ductal carcinoma following surgery & radiation Advanced breast cancer
TRASTUZUMAB
Abdominal pain Anorexia Diarrhea V Back pain Chills Fever Allergic rxns Doxorubicin risk of cardiotoxicity
Antineoplastic Monoclonal Ab
Binds human epidermal growth factor-2 (HER2) receptor on breast cancer cells Prevents receptor stim. & cell proliferation Regression of breast cancer metastases
Combined w/ paclitaxel
blood levels
VINCRISTINE
N, V Alopecia Peripheral neuropathy
Binds tubulin & prevents polymerization of tubulin dimers forming microtubules of mitotic spindle M phase specific
ATENOLOL
Bronchoconstriction w/ high doses b/c 1 blockade Additive hypotension w/ nitrates
1 receptor antagonist
ATROPINE
DOBUTAMINE
Tachycardia Arrhythmia
1 > 2 > 1
EDROPHONIUM
Muscarinic effects
Miosis Salivation
Dx myasthenia gravis
EPINEPHRINE
HTN Tachycardia Ischemia Hyperglycemia
IP3 & cAMP 1 vasoconstrict & BP 1 HR, conduction, & contractility 2 vasodilate, BP, bronchodilate
PHENOXYBENZAMINE
Postural hypotension Hypotension w/ blockers & Ca channel blockers
PHENTOLAMINE
Hypotension Severe hypotension w/ Epi
IV admin only
PHENYLEPHRINE
Rebound nasal congestion HTN MAOI cause severe HTN
Vasocontrictor, decongestant
Selective 1 receptor
agonist
Activates 1 receptor
Nasal & ocular decongestant Dilate pupil for opthalmoscopy Mydriasis w/o cycloplegia
Paralysis of
PILOCARPINE
Miosis Blurred vision
Accommodative spasm
Sjogrens syn
Glaucoma
Xerostomia
PRALIDOXIME
PROPRANOLOL
Bronchoconstriction Inhibits glycogenolysis Nightmares & depression
PSEUDOEPHEDRINE
Tachycardia CNS stim. BP MAOI cause severe HTN
release NE directly activates adrenergic receptors causing vasoconstriction & cardiac stim.
PYRIDOSTIGMINE
Muscarinic effects
Miosis Salivation
ROCURONIUM
Respiratory m. paralysis Apnea
SILDENAFIL
HA Nasal congestion Back pain Visual disturbances
vasodilation in corpus cavernosum d/t Ach release from sacral PNS neurons
Erectile dysfunction
SUCCINYLCHOLINE
Respiratory m. paralysis Apnea
Transient m. fasciculations
TAMSULOSIN
Dizziness HA Postural hypotension Cimetidine increases blood levels & effects
TERAZOSIN
1st dose syncope
Blocks 1 receptors
CARDIOVASCULAR
Acetazolamide Adenosine Amiloride Amiodarone Amlodipine Carvedilol Clonidine Digoxin Diltiazem Dofetilide Enalapril Esmolol Fenoldopam Furosemide Hydralazine
Hydrochlorothiazide Labetalol Mannitol Methyldopa Minoxidil Nesiritide Nitroglycerin Nitroprusside Propafenone Quinidine Sotalol Spironolactone Valsartan verapamil
ACETAZOLAMIDE
Parasthesia Urinary stone formation
Inhibits interconversion of carbonic acid & bicarbonate NaHCO3 excretion Inhibit aqueous humor formation Hyperchloremic metabolic acidosis
ADENOSINE
Transient asystole
Opens K channels & blocks Ca influx in SA & AV nodes Slows AV conduction AV refractory period
Terminate SVT
AMILORIDE
Hyperkalemia
AMIDARONE
Hypo/hyperthyroidism Photosensitivity Blue-gray skin Corneal microdeposits Pulmonary fibrosis
SVT, VT, VF
AMLODIPINE
HA Edema Hypotension Effects w/ grapefruit juice
Ca channel blocker in vascular smooth m. Arteriolar vasodilation & coronary blood flow
CARVEDILOL
Orthostatic hypotension Dizziness Bradycardia
remodeling
CLONIDINE
Abrupt w/drawal severe rebound HTN Sedation Dry mouth
sympathetic outflow from vasomotor center Inhibits pain neurotransmission in spinal cord
DIGOXIN
Arrhythmias N, V Blurred vision Yellow vision
DILTIAZEM
Dizziness Hypotension Peripheral edema Constipation Gingival hyperplasia Grapefruit juice serum levels
DOFETILIDE
QT prolongation Torsade de pointes
AF, A flutter
ENALAPRIL
Cough & angioedema
Inhibits bradykinin degradation
ESMOLOL
Hypotension Bradycardia
FENOLDOPAM
serum K levels
Monitor for hypokalemia
D1 receptor agonist
Arteriolar vasodilation
Hypertensive emergencies
FUROSEMIDE
Hypokalemia Metabolic alkalosis Hyperuricemia Hypomagnesemia ototoxicity of aminoglycoside ABX
HYDRALAZINE
Edema Reflex tachycardia & MI Lupus syndrome
Alters IC Ca metabolism
vasodilation
afterload
Moderate-severe HTN
HYDROCHLOROTHIAZIDE
Hypokalemia Metabolic alkalosis Hyperuricemia & gout excretion of lithium
LABETOLOL
Postural hypotension Abrupt w/drawal cause lifethreatening HTN, arrhythmias, or MI
HTN
MANNITOL
Electrolyte imbalances Transient volume expansion
Pulmonary edema or heart failure
Filtered by glomerulus
electrolyte excretion
METHYLDOPA
Positive direct Coombs test
MINOXIDIL
Systemic admin.
Reflex tachycardia Angina pericarditis Pulmonary HTN hypertrichosis
NESIRITIDE
Hypotension
Dilates venous & arterial smooth m. venous pressure, cardiac preload, vascular congestion, & dyspnea
NITROGLYCERIN
HA Hypotension Syncope Reflex tachycardia vasodilative effect of sildenafil, tadalafil, vardenafil
Angina pectoris
NITROPRUSSIDE
CN toxicity Hypotension HA
Antihypertensive Vasodilator
HTN crisis Acute heart failure or cardiogenic shock Controlled hypotension during pregnancy
PROPAFENONE
Proarrhythmic 1st 2 wks
Monitor ECG when starting Tx
Blocks Na channel in cardiac tissue conduction & prevent re-entry PR, QRS, & QT duration
QUINIDINE
Cinchonism
Blurred vision Tinnitus Photophobia
levels w/
Amiodarone Cimetidine Diltiazem Verapamil Grapefruit juice
SOTALOL
Torsades de pointes
SPIRONOLACTONE
Gynecomastia Impotence Hyperkalemia
VALSARTAN
HTN Nephropathy
VERAPAMIL
Peripheral edema Constipation Gingival hyperplasia
CNS DEPRESSANTS
BUSPRIONE
NO
Dizziness Drowsiness Fatigue HA Excitement Nervousness Blurred vision Tachycardia N Rash Myalgia Sweating levels by
Erythromycin Itraconazole Grapefruit juice
CARBAMAZEPINE
Ataxia Drowsiness Blurred vision Agranulocytosis Aplastic anemia Thrombocytopenia Induces its own metabolism
Partial seizures & generalized tonic-clonic seizures Bipolar disorders Trigeminal neuralgia Neuropathic pain
DIAZEPAM
Drowsiness Lethargy Physical/psychological dependence Tolerance
Antianxiety Benzodiazepine
channel affinity for GABA & frequency of channel opening Potentiates inhibitory effects of GABA
DISULFIRAM
Drowsiness
ETHOSUXIMIDE
Dizziness Drowsiness Gastric distress N
Anticonvulsant Succimide
Binds T-type Ca channels in thalamic neurons Suppresses nerve transmissions to motor cortex
FLUMAZENIL
Seizures Dizziness Emotional lability
CI in status epilepticus
GABAPENTIN
Ataxia Dizziness Drowsiness Nystagmus Tremor
LAMOTRIGINE
Skin rash in 1st 8 wk of Tx
Can progress to Stevens-Johnson syn
Anticonvulsant Phenyltriazine
LORAZEPAM
Dizziness Drowsiness Apnea & cardiac arrest w/ rapid IV admin Additive depression w/ alcohol & other depressants
channel affinity for GABA & frequency of channel opening Potentiates inhibitory effects of GABA
PHENOBARBITAL
Drowsiness Lethargy Delirium Hangover Physical & psychological dependence Induces CYP P450 metabolism of drugs
Tonic-clonic & partial seizures Febrile seizures in children Preoperative sedation Short-term hypnotic
PHENYTOIN
Ataxia Diplopia Nystagmus Gingival hyperplasia
Anticonvulsant Hydantoin
TOPIRAMATE
Ataxia Dizziness Drowsiness Fatigue Impaired concentration & memory Psychomotor slowing Speech problems Diplopia Nystagmus
VALPROATE
Indigestion N, V Dizziness Sedation Hepatotoxicity
Anticonvulsant Branched-chain FA
Simple & complex absence seizures Complex partial seizures Tonic-clonic seizures Myoclonic seizures Migraine prevention Manic phase of bipolar
ZOLPIDEM
Neuronal hyperpolarization
Insomnia
ENDOCRINE
Acarbose Alendronate Calcitonin Danazol Desmopressin Ergocalciferol Ethinyl estradiol & drospirenone Ethinyl estradiol & norethindrone Finasteride Fludrocortisone Glyburide Hydrocortisone
Insulin Levothyroxine Medroxyprogesterone Metformin Methimazole Mifepristone Octreotide Oxytocin Pioglitazone Prednisone Raloxifene Repaglinide Somatropin Testosterone
ACARBOSE
Intestinal bloating Flatulence oral bioavailability of metformin iron absorption
Inhibits intestinal enzyme that converts oligosaccharides & disaccharides to glucose digestion of starch & sucrose postprandial blood glucose & HbA1c
Type II DM
ALENDRONATE
Absorption by Ca supplements, antacids, foods, beverages (except water)
Prevents attachment of osteoclast precursor cells to bone metabolic activity of osteoclasts & ability to resorb bone
Prevent/Tx
CALCITONIN
DANAZOL
CI in pregnancy androgenic effects on female fetus Emotional lability Deepening voice Acne Hirsutism Amenorrhea breast size
Feedback inhibits pituitary FSH & LH secretion ovarian estrogen secretion & stim. endometrial & breast tissue.
DESMOPRESSIN
Intranasal, oral, or IV
ERGOCALCIFEROL
Hypercalcemia Hypercalciuria
Vit. D Fat-soluble
Vit. D deficiency
Rickets, osteomalacia
Chronic renal failure Familial hypophosphatemia Hypocalcemia d/t hypoparathyroidism Postoperative & idiopathic tetany
Estrogen
Progesterone
Thromboembolis m
risk w/ smoking
Edema Efficacy w/
ABX Carbamazepine phenytoin
Estrogen
Progesterone
Contraception
FINASTERIDE
CI pregnancy
Risk to male fetus Do NOT handle tablets
Inhibits conversion testosterone dihydrotestosterone & androgenic stimulation of prostate & skin prostate size & promotes hair growth
Impotence
FLUDROCORTISONE
Hypokalemia
by thiazide & loop diuretics
Corticosteroid Mineralocorticoid
Adrenal insufficiency
Addisons ds
GLYBURIDE
Photosensitivity Hypoglycemia
Type II DM
HYDROCORTISONE
Replaces endogenous cortisol in deficiency states Suppresses inflammation & immune response topical
INSULIN
Hypoglycemia
DM
LEVOTHYROXINE
Insomnia Irritability Tachycardia Wt loss Bile acid sequestrants absorption
metabolic rate, protein synthesis, gluconeogenesis, cell growth & differentiation, & CNS development
Converted to T3 in tissues
Hypothyroidism
MEDROXYPROGESTERONE
Amenorrhea Breakthrough bleeding Dysmenorrhea
endometrial hyperplasia in women receiving estrogen Prevents conception by thickening cervical mucus
METFORMIN
N, V, D Abdominal bloating
# & affinity of insulin receptors in peripheral tissues hepatic glucose output glucose absorption from gut glucose uptake & utilization in skeletal m. & adipose tissue
Type II DM
METHIMAZOLE
Rash Agranulocytosis
Inhibits peroxidase & iodination & coupling of tyrosine residue of thyroglobulin thyroxine secretion
Hyperthyroidism Graves ds
MIFEPRISTONE
Abdominal pain Diarrhea N, V Uterine bleeding Cramping
OCTREOTIDE
Arrhythmias Hyperglycemia Hypoglycemia Constipation Diarrhea Flatulence N
Suppresses secretion of GH, insulin-like growth factors, 5-HT & GI peptides gastrin, motilin, secretin, & VIP
Acromegaly Severe diarrhea & flushing d/t carcinoid tumors & VIP tumors Bleeding GE varices Complications of pancreatic surgery
OXYTOCIN
Excessive & painful uterine contractions
Stim. Uterine smooth m. & induce labor Stim. mammary gland smooth m. & lactation
Induce labor @ term Facilitate uterine contractions Postpartum control of uterine bleeding Promote milk let-down
PIOGLITAZONE
Activates peroxisome proliferator-activated receptor- in adipose tissue, skeletal m., & liver gene transcription, insulin sensitivity, & glucose transports in muscle & adipose tissue Suppresses hepatic glucose output
Type II DM
Used w/ metformin
PREDNISONE
Anti-inflammatory Corticosteroid
Inflammatory, allergic, autoimmune, & neoplastic ds Prevent organ transplant rejection Asthma
Depression or euphoria HTN Acne Impaired wound healing Adrenal suppression Muscle wasting Osteoporosis Cushingoid appearance
Moon facies Buffalo hump
susceptibility to infection
RALOXIFENE
Hot flashes Cholestyramine inhibits absorption
Estrogen-like effect on bone & lipid metabolism Estrogen antagonist in breast & uterine tissue bone mineral density & vertebral fractures
REPAGLINIDE
Hypoglycemia
Closes ATP-sensitive K channels & insulin secretion postprandial blood glucose & [HbA1c]
SOMATROPIN
GH Recombinant somatotropin
Stim. skeletal growth, AA transport, protein synthesis, nucleic acid synthesis & cell prolif.
Short stature in children d/t GH deficiency Turner syn Chronic renal failure Prader-Will syn
TESTOSTERONE
Edema Acne Gynecomastia Impotence Oligospermia Priapism
Activated gene transcription & development of male sex organs & secondary sex characteristics lean body mass Stim. skeletal growth Accelerates epiphyseal closure sebaceous gland sebum production EPO secretion HDL levels
GASTROINTESTINAL
BISACODYL
Cramping N Fluid & electrolyte depletion
Hypokalemia
Stimulant laxative
CALCIUM CARBONATE
Constipation absorption of drugs
Tetracyclines Fluoroquinolones Phenytoin Iron salts
DICYCLOMINE
Constipation Dyspepsia Dry mouth Urinary retention Blurred vision Decreased sweating
Blocks PNS stim. intrinsic nervous system & GI tone & motility
DOCUSATE
LACTULOSE
Cramping Abdominal distention Flatulence
Converts ammonia ammonium ion & ammonia absorption & blood levels
LOPERAMIDE
Constipation Drowsiness Additive effects
Kava Chamomile Valerian
Mild-moderate acute diarrhea Chronic diarrhea d/t IBD volume of ileostomy drainage
AVOID
MESALAMINE
Inhibits prostaglandin synthesis & migration of inflammatory cells into bowel wall Scavenges superoxide-free radicals
IBD UC Proctitis
METOCLOPRAMIDE
CI in Parkinsons ds & seizure disorders Drowsiness EPS rxns restlessness
Blocks relaxant effect of D on GI smooth m. Blocks presynaptic D receptors & Ach release & stim. smooth m. Blocks D2 receptors in chemoreceptor trigger zone & vomiting center
MISOPROSTOL
CI in pregnancy Abdominal pain D Miscarriage
OMEPRAZOLE
Abdominal pain Inhibits metabolism
Diazepam Cyclosporine Phenytoin
ONDANSETRON
HA Constipation D
Blocks 5-HT3 receptors in GI vagal afferent nerves, solitary tract nucleus, & chemoreceptor trigger zone
PROMETHAZINE
Neuroleptic malignant syn Sedation Confusion Disorientation
Blocks H1 & M1 receptors Inhibits stim. chemoreceptor trigger zone & vomiting center
RANITIDINE
SUCRALFATE
Constipation absorption
Fat soluble vitamins fluoroquinolones
Adheres ulcer crater & forms protective barrier Prevents acid secretion & pepsin hydrolysis of mucosal proteins Stim. prostaglandin synthesis
TEGASEROD
Diarrhea Ischemic colitis
HEMATOLOGIC
Abciximab Alteplase Aspirin Atorvastatin Bivalirudin Cholestyramine Cilostazol Clopidogrel Cyclosporine Enoxaparin
Epoetin Eptifibatide Ezetimibe Filgrastim Folic acid Gemfibrozil Heparin Niacin Sirolimus Warfarin
ABCIXIMAB
Bleeding Thrombocytopenia
Antithrombotic Monoclonal Ab
ALTEPLASE
Reperfusion arrhythmia Contraindications
Internal bleeding Recent CNS surgery or trauma
ATORVASTATIN
Myalgia Myositis Rhabdomyolysis Hepatitis GI distress Effects w/
Grapefruit juice Azole antifungals cyclosporine
Hypercholesterolemia
BIVALIRUDIN
Bleeding
Inhibits thrombin
CHOLESTYRAMINE
Constipation Abdominal discomfort
LDL levels
CILOSTAZOL
HA Effects w/ CYP3A4 inhibitors
Azole antifungals Erythromycin Grapefruit juice
Intermittent claudication
CLOPIDOGREL
Hypersensitivity reaction
CYCLOSPRINE
HTN Nephrotoxic Gingival hyperplasia Hirsutism Tremor Induce metabolism
Rifampin Barbiturates Carbamazepine
Bind immunophilins
Inhibits metabolism
Grapefruit juice
ENOXAPARIN
Thrombocytopenia
Prevent
DVT Pulmonary embolism after knee, hip, or abdominal surgery Thrombosis in unstable angina & non Q-wave MI
EPOETIN
HTN
Binds receptors on erythroid progenitor cells & stim. cell maturation & prolif.
Anemia d/t
lymphoma
EPTIFIBATIDE
Bleeding
EZETIMIBE
Disrupts annexin-caveolin complex mediating cholesterol transport intestinal brush border Inhibits absorption of biliary dietary cholesterol
Hypercholesterolemia
FILGRASTIM
Bone pain
Binds receptors on myeloid progenitor cells & stim. maturation & prolif. Accelerates neutrophil recovery after myelosuppressive chemotherapy
infection incidence
FOLIC ACID
Absorption by
Phenytoin Cholestyramine
GEMFIBROZIL
GI distress Myositis Statins risk rhabdomyolisys
HEPARIN
Thrombocytopenia
Venous thromboembolism Pulmonary embolism AF w/ embolism Consumptive coagulopathies In vitro & catheter coagulation
NIACIN
Flushing Pruritis GI distress, peptic ulcer Hyperglycemia Hepatotoxicity Statins risk rhabdomyolysis
Inhibits lipolysis & release of FA hepatic triglyceride synthesis & VLDL secretion
SIROLIMUS
Leukopenia Thrombocytopenia Hyperlipidemia Rash blood levels
Cyclosporine Azole antifungals Erythromycin Grapefruit juice Cimetidine
Prevent
WARFARIN
Fetal malformations Abnormal bone development
Prevents vit. K dependent carboxylation of glutamate residues of factors II, VII, IX, X, proteins C & S
MUSCULOSKELETAL
ACETAMINOPHEN
OD cause fatal hepatic failure hepatotoxicity w/ alcohol renal toxicity w/ salicylates & NSAIDs
ALLOPURINOL
Rash Inhibits metabolism
Mercaptopurine
Inhibits xanthine oxidase & catabolism of purines xanthine & uric acid
CELECOXIB
GI bleeding risk stroke & MI
OA RA Inflammatory jt ds
CYCLOBENZAPRINE
Dizziness Drowsiness Dry mouth AVOID MAOI
Acts on brainstem & spinal cord to reduce tonic somatic m. activity via & motor neurons
ETANERCEPT
URI HA Ab response to live virus vaccines
Antirheumatic agent, antitumor necrosis factor Antitumor necrosis factor p57 combined w/ Fc of IgG
RA
IBUPROFEN
GI bleeding N, V Dyspepsia Allergic rxns Hepatitis & renal failure
Inhibits COX-1 & COX-2 & synthesis of PG causing pain, fever, & inflammation
OA RA
INDOMETHACIN
Inflammatory disorders
INFLIXIMAB
Fatigue N, V URI
RA Crohns ds
KETOROLAC
Aspirin-allergy Allergic rxn in pt w/ asthma Nasal polyps
Inhibits COX-1 & COX-2 & synthesis of PG causing pain, fever, & inflammation
Probenecid
Colchicine
NEURODEGENERATIVE
BACLOFEN
Drowsiness Dizziness Fatigue Weakness Additive effects
Alcohol Kava Valerian Chamomile
Spasticity
BENZTROPINE
Blurred vision Dry eyes Constipation Dry mouth Urinary retention
DONEPEZIL
N, D HA
Alzheimers ds
ENTACAPONE
Rhabdomyolysis Neuroleptic malignant syndrome
INTERFERON-BETA-1B
Relapsing-remitting MS
SubQ daily
LEVODOPA-CARBIDOPA
Dyskinesia involuntary movements N, V Hallucinations arrhythmia w/ halothane
Levodopa
Converted to D in CNS
Carbidopa
Parkinsons ds
MEMANTINE
Prevent excitotoxic effects of glutamate causing neuronal loss Slows decline in cognitive function
Alzheimers ds
PERGOLIDE
Dyskinesia Hallucination Orthostatic hypotension Constipation
SELEGILINE
AVOID Meperidine & opioids
Fatal rxn Excitation Rigidity HTN coma
SSRI
Serotonin syn
Tricyclics
Asystole HTN Syncope Rigidity seizures
response to levodopa/carbidopa Tx
Parkinsons ds w/ levodopa/carbidopa
OTHER DRUGS
ALPROSTADIL
IV infusion
Apnea Hypotension Arrhythmia
Vasodilator Prostaglandin E1
Local products
Activates PG EP receptors
IV infusion
BOSENTAN
CI in pregnancy
Causes birth defects
Blocks endothelin A & B receptors pulmonary vascular resistance & dyspnea Improves walking distance
EPOPROSTENOL
Flushing Hypotension Tachycardia Diarrhea N, V
LATANOPROST
Alters color of iris causing permanent eye color change by amount of melanin in melanocytes
Activates prostaglandin FP receptors aqueous humor outflow via uveoscleral pathways Lowers intraocular pressure
MESNA
SUCCIMER
Chelates lead
PSYCHOTHERAPEUTICS
Amitriptyline Amphetamine & dextroamphetamine Atomoxetine Buproprion Desipramine Fluoxetine Haloperidol Lithium
AMITRIPTYLINE
Lethargy Sedation Blurred vision Constipation Urinary retention appetite & wt gain OD wide QRS complex VT Altered effects by drugs that inhibit/induce CYP450
Carbamazepine Quinidine Rifampin
Antidepressant Tricyclic
Blocks neuronal reuptake of serotonin > norepinephrine Blocks muscarinic & adrenergic receptors
AVOID
MAOI SSRI
AMPHETAMINE
ADHD
Narcolepsy
ATOMOXETINE
appetite Insomnia Levels & effects altered by drugs that inhibit/induce CYP2D6
ADHD in children/adults
BUPROPION
Agitation HA Dry mouth N Tremor Impaired motor & cognitive skills MAOI adverse effects Seizure risks w/ phenothiazines
DESIPRAMINE
Lethargy Sedation Blurred vision Constipation Urinary retention appetite & wt gain OD wide QRS complex VT
Antidepressant Tricyclic
Blocks neuronal reuptake NE > 5-HT Blocks muscarinic & adrenergic receptors
AVOID
MAOI SSRI
FLUOXETINE
Antidepressant SSRI
Anxiety Drowsiness Insomnia Nervousness Sexual dysfunction Sweating Tremor levels metabolized by CYP2D6
Depression OCD Bulimia nervosa Anorexia nervosa Fibromyalgia Panic attacks Phobias Prementsrual dysmorphic disorder
HALOPERIDOL
Neuroleptic malignant syn
Fever Respiratory distress Tachycardia Seizures Severe m. stiffness Altered BP
Blocks D2 receptors in mesolimbic area, chemoreceptor trigger zone, solitary tract, & basal ganglia Blocks muscarinic & adrenergic receptors
Psychotic disorders
Schizophrenia
Extrapyramidal rxns Tardive dyskinesia Blurred vision Constipation Dry mouth Urinary retention Hypotension
Tourettes syn
LITHIUM
Polyuria Impaired memory Acne Tremor ECG changes GI distress Hypothyroidism Leukocytosis
METHYPHENIDATE
neuronal release NE
ADHD
Tachycardia HTN Anorexia Irritability Insomnia Tremor Growth inhibition Dependence HTN crisis w/ MAOI
Narcolepsy
MIRTAZAPINE
appetite & wt gain Constipation Dry mouth Drowsiness
Antidepressant Tetracyclic
AVOID MAOI
OLANZAPINE
Blocks D2 & 5-HT2 receptors in CNS Blocks H1, muscarinic, & adrenergic receptors
Agitation Dizziness Restlessness Sedation Amblyopia Orthostatic hypotension Tachycardia Constipation Dry mouth Wt gain Tremor
Avoid in phenylketonuria
PHENELZINE
Antidepressant MAOI
Dizziness Insomnia Restlessness Blurred vision Orthostatic hypotension Diarrhea Potentially fatal
SSRI Tricyclics
Avoid
Fluoxetine Tyramine
HTN crisis
Tyramine Amphetamines Methyldopa Levodopa
RISPERIDONE
Aggressive behavior Extrapyramidal rxns Sleep disturbances Insomnia Sedation Constipation or diarrhea Wt gain
THIORIDAZINE
Extrapyramidal rxns Tardive dyskinesia Photosensitivity Potential for V arrhythmias & sudden death Retinal pigmentation w/ high doses
melanosis
Blocks D2 receptors in mesolimbic area, chemoreceptor trigger zone, solitary tract, & basal ganglia Blocks muscarinic receptors
VENLAFAXINE
Sexual dysfunction GI distress Dizziness Insomnia Nervousness
Antidepressant Phenethylamine
AVOID MAOI
RESPIRATORY
ALBUTEROL
Muscle tremor Nervousness Restlessness Tachycardia HTN crisis w/ MAOI
Asthma
CROMOLYN
Nasal & throat irritation
DIPHENHYDRAMINE
Drowsiness Blurred vision Dry mouth Urinary retention Anorexia
Prevents histamineinduced allergic rxns Prevents vestibular stim. of vomiting center Sedation
FLUTICASONE
Nasal & throat irritation Oral candidiasis
Anti-inflammatory Corticosteroid
Inhibits cytokine production by Thelper cells Prevents mediator release from mast cells, basophils, eosinophils Stabilizes lysosomal membranes Vasoconstriction & capillary permeability
IPRATROPIUM
Cough Nasal dryness & irritation
Blocks muscarinic receptors in bronchial smooth m. & nasal mucosa Prevents vagalstimulated bronchoconstriction
Inhalation admin
LORATADINE
MONTELUKAST
Blocks cysteinyl leukotriene-1 receptor for leukotrienes C4, D4, E4 Prevent airway inflammation, edema, bronchoconstriction, & secretion viscous mucus Inhibits early/late phase bronchoconstriction
Oral admin
OMALIZUMAB
Allergic rxns
anaphylaxis
Blocks IgE
SALMETEROL
Tachycardia Nervousness HA
Bronchodilator 2 agonist
Asthma
Inhalation admin
THEOPHYLLINE
N, V Anxiety Insomnia Tachycardia
Bronchodilator Methylxanthine
Inhibits phosphodiesterase isoenzymes & cAMP Relaxes bronchial smooth m. Inhibits T-lymphocyte proliferation & cytokine production
Half-life
ZILEUTON
Flu-like syn HA Drowsiness Dyspepsia serum aminotransferase levels & hepatitis Inhibits CYP450 & 3A4
theophylline & warfarin levels