USMLE Pharm

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Isoproterenol: b1=b2 agonist; treats AV block
Ouabain: inhibits sodium-potassium ATPase pump by binding to K+ site
Mirtazapine: antidepressant; alpha 2 antagonist (increases release of NE and serotonin) and potent 5-HT(2) and 5-HT(3) receptor antagonist
Cytarabine (ara-C): inhibits DNA polymerase; treats AML; can cause leukopenia, thrombocytopenia, and megaloblastic anemia
Azathiprine: precursor of 6-mercaptopurine that interferes with metabolism and synthesis of nucleic acids; used in kidney transplantation and autoimmune disorders; can cause bone marrow suppression
Levothyroxine, Triiodothyronine: thyroxine replacement; used to treat hypothyroidism, myxedema; can cause tachycardia, heat intolerance, tremors, arrhythmias
beta blockers: decrease cardiac output, decrease renin secretion, decrease heart rate and contractility, decrease in oxygen consumption; can cause impotence, exacerbation of asthma, bradycardia, AV block, CHF, sedation
Mannitol: osmotic diuretic, increases tubular fluid osmolarity, producing increased urine flow; used to treat shock, drug overdose, decrease intracrainial/intraocular pressure; can cause pulmonary edema, dehydration (contraindicated in anuria and CHF)
Celecoxib: selective reversible COX-2 inhibitor; treats rheumatoid arthritis and osteoarthritis; can increase risk of thrombosis, sulfa allergy
Dobutamine: b1 > b2 agonist; treats shock, heart failure, and used for cardiac stress testing; inotropic (not chronotropic)
Infliximab: monoclonal antibody to TNF; used to treat Crohn's disease and rheumatoid arthritis; can cause respiratory infection, fever, hypotension
TCA Toxicity: NaHCO3
Furosemide: sulfonamide loop diuretic that inhibits cotransport of (Na+, K+, 2 Cl) of thick acending limb, prevents concentration of urine, increases Ca2+ excretion; used to treat edematous states, hypertension, hypercalcemia; toxicity includes ototoxicity, hypokalemia, dehydration, allergy (sulfa), nephritis, gout
Organophosphates (Parathion): irreversible cholinesterase inhibitors; causes diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle, lacrimation, sweating, and salivation; antidote atropine plus pralidoxime
Ethosuximide: blocks thalamic T-type Ca2+ channels; first line treatment of absence seizures; can cause Stevens-Johnson syndrome, urticaria, GI distress, fatigue, headache
Caspofungin: inhibits cell wall synthesis; treats invasive aspergillosis
Antipsychotics: block dopamine D2 receptors; used to treat schizophrenia, psychosis, acute mania, Tourette's syndrome; can cause EPS side effects: 4h=acute dystonia (muscle spasm), 4d akinesia (parkinsonism), 4wk akathisia (restlessness), 4mo tardive dyskinesia; can cause galactorrhea, dry mouth, constipation, hypotension, and sedation; Neuroleptic Malignant Syndrome: rigidity, myoglobinuria, autonomic instability, hyperpyrexia (increased body temperature)-treat with dantrolene
Sulfamethoxazole (SMX): sulfonamide which is a PABA antimetabolite inhibiting dihydropteroate synthetase; combine with TMP to treat Pneumocystis jiroveci, gram-positive, gram-negative, Nocardia, Chlamydia; can cause hemolysis if G6PD deficient, nephrotoxicity, photosensitivity, kernicterus in infants
Penicillin: gram-positive cocci, gram-positive rods, gram-negative cocci, spirochetes
Ticarcillin, Carbenicillin, Piperacillin: Pseudomonas and gram-negative rods
Clomiphene: partial agonist at estrogen receptor in pituitary gland preventing normal feedback inhibition and increasing the release of LH and FSH from pituitary stimulating ovulation; used to treat infertility and PCOS
Opioid analgesics: act as agonists at opioid receptors to modulate synaptic transmission (mu=morphine, delta=enkephalin, kappa=dynorphin); treats pain, cough suppression (dextromethorphan), diarrhea (loperamide and diphenoxylate), acute pulmonary edema, maintenance programs for addicts (methadone); can cause addiction, respiratory depression, miosis, CNS depression (additive with other drugs), constipation; overdose treated with naloxone or naltrexone [Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine, Dextromethorphan]
Praziquantel: treats Taenia solium, Schistosoma, Clonorchis sinensis, Paragonimus westermani
Oxytocin: used to stimulates labor, uterin contractions, milk-let down, controls uterine hemorrhage
Methotrexate (MTX): S-phase specific antimetabolite, folic acid analog that inhibits dihydrofolate reductase resulting in decreased dMTP thus decreasing DNA and protein synthesis; used to treat leukemias, lymphomas, choriocarcinoma, sarcoma, as an abortofactant for ectopic pregnancy, for rheumatoid arthritis, and psoriasis; causes myelosuppression "rescued" by leucovorin (folinic acid), causes macrovesicular fatty change in liver, mucositis
Glyburide, Glimepiride, Glipizide: 2nd generation sulfonylureas
Estrogens: binds to estrogen receptors; used to treat hypogonadism or ovarian failure, HRT in postmenopausal, menstrual abnormalities, use in men with androgen dependent prostate cancer; causes increased risk of endometrial cancer, increase risk of thrombi, adenocarcinoma of vagina in females exposed to DES in utero (contraindicated in ER positive breast cancer)
Propylthiouracil, Methimazole: inhibits organification and coupling of thyroid hormone synthesis, decreases peripheral conversion of T4 to T3 (propylthiouracil); treatment for hyperthyroidism; can cause skin rash, aplastic anemia, agranulocytosis
Nitroprusside: increases cGMP via direct release of NO; treats malignant hypertension; can cause CN poisoning
Guaifenesin (Robitussin): removes excess sputum; does not suppress cough reflex
Albuterol: b2 > b1 agonist; treats acute asthma
Ethambutol: TB-drug; causes optic neuropathy (red-green color blindness)
Tetracyclines: binds 30S rRNA and prevents attachment of aminoacyl-tRNA; treats Vibrio, Acne, Chlamydia, Ureaplasma, Urealyticum, Mycoplasma, Tularemia, Helicobacter, Borrelia, Rickettsia; can cause discoloration of teath and inhibition of bone growth in children...do not take with milk, antacids, or iron-containing preparations because divalent cations inhibit its absorption in the gut
Gentamicin: Aminoglycoside
Class 1C Antiarrhythmics: sodium channel blocker; no effect on action potential duration; useful in treating ventricular tachycardia that progress to VF, and intractable SVT (usually last resort for tachy arrhythmias); can cause arrhythmias especially post MI (contraindicated), significantly prolongs refractory period in AV node [Flecainide, Encainide, Propafenone]
Venlafaxine: treats generalized anxiety disorder; inhibits serotonin, NE, and dopamine reuptake
Cyclophosphamide, Ifosfamide: alkylating agents that covalently x-link DNA at guanine N-7, requires bioactivation in the liver; used to treat non-Hodgkin's lymphoma, breast and ovarian carcinomas, also used as an immunosuppressant; can cause myelosuppression and hemorrhagic cystitis which can be prevented with mesna
Acetazolamide: carbonic anhydrase inhibitor, causing NaHCO3 diuresis and reduction in total-body store of HCO3; used to treat glaucoma, to produce urinary alkalinization, to treat metabolic alkalosis, altitude sickness; can cause hyperchloremic metabolic acidosis, neuropathy, NH3 toxicity, sulfa allergy
Antacid Toxicity: Aluminum Hydroxide causes constipation, hypophosphatemia, proximal muscle weakness, osteodystrophy, seizures; Magnesium hydroxide causes diarrhea, hyporeflexia, hypotension, cardiac arrest; Calcium carbonate causes hypercalcemia and rebound acid secretion; all can cause hypokalemia
Nitroglycerin: releases nitric oxide in smooth muscle, causing increase in cGMP and smooth muscle relaxation; vasodilates veins>>arteries(decreasing preload); treats angina, pulmonary edema
Fibrates: decrease triglycerides by up regulating LPL thus increaseing TG clearance; can cause myositis and increased LFTs
Flutamide: nonsteroidal competitive inhibitor of androgens at the testosterone receptor; treats prostate carcinoma
Dinoprostone: PGE 2 analog causing cervical dilation and uterine contraction, inducing labor
Colchicine: depolymerizes microtubules, impairing leukocyte chemotaxis and degranulation; treats gout; can have GI side effects
Streptomycin: Aminoglycoside
Class 3 Antiarrhythmics: K+ channel blockers; increase action potential duration, increase ERP, increase QT interval; use when others fail, Amiodarone is safe to use in Wolff-Parkinson-White syndrome; multiple side effects amiodarone causes pulmonary fibrosis, hepatotoxicity, corneal and skin deposits hypo/hyperthyroidism; Sotalol, Ibutilide cause torsades de pointes [Sotalol, Ibutilide, Bretylium, Amiodarone]
Mesna: used with Cyclophosphamide to prevent hemorrhagic cystitis
ABVD regimen for Hodgkins: Doxorubicin (Adriamycin), Bleomycin, Vinblastine, Dacarbazine
Etanercept: recombinant form of human TNF receptor that binds TNF; treats rheumatoid arthritis, psoriasis, ankylosing spondylitis
MAO-Is: [Phenelzine, Tranylcypromine] nonselective MAO inhibition increases levels of 5-HT, NE, DA; treats atypical depression, anxiety, hypochondriasis; can cause hypertensive crisis with tyramine ingestion and beta agonists, contradicted with SSRI or meperidine to prevent "Serotonin syndrome"
ADH (Desmopressin): treats pituitary DI
Pilocarpine: muscarinic agonist; potent stimulator of sweat, tears, and saliva; used to treat open angle and narrow angle glaucoma
Polymyxins: bind to cell membranes of bacteria and disrupt osmotic properties; use for resistant gram-negative infections
Minoxidil: K+ channel opener which hyperpolarizes and relaxes vascular smooth muscle; treats severe hypertension; can cause hypertrichosis, pericardial effusion
Vincristine, Vinblastine: M-phase specific alkaloids that bind to tubulin and block polymerization of microtubules so that mitotic spindle cannot form; treats lymphoma, Wilms' tumor, choriocarcinoma; vincristine causes neurotoxicity, paralytic ileus, vinblastine causes bone marrow suppression
P-450 Inducers: Quinidine, Barbiturates, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, St. John's wort
GH: treats GH deficiency
Clarithromycin: Macrolide
Terbinafine: inhibits fungal enzyme squalene epoxidase; treats dermatophytoses, onychomycosis
Bethanechol: muscarinic agonist; activates bowel and bladder smooth muscles
Ethylene Glycol: causes metabolic acidosis, nephrotoxicity, and precipitation of oxalate crystals in the kidney
Zafirlukast, Montelukast: block leukotriene receptors; especially good for aspirin induced asthma
Metformin (Biguanides): unknown mechanism; may cause lactic acidosis
Sirolimus: inhibits T-cell proliferation in response to IL-2; used for immunosuppression after kidney transplantation
Methacholine: muscarinic agonist; challenge test for the diagnosis of asthma
Benztropine: treatment for Parkinson's Disease
Carbachol: muscarinic agonist; treats glaucoma by contracting pupils and realeasing intraocular pressure
Terazosin: a1 selective blocker; treats hypertension, and urinary retention in BPH; can cause 1st dose orthostatic hypotension, dizziness, and headache
Ganciclovir: preferentially inhibits viral DNA polymerase; treats CMV
Bile acid resins: Cholestyramine; decreases LDL by preventing intestinal reabsorption of bile acids; liver must use cholesterol to make more; patients dislike because tastes bad and causes GI discomfort and decrease absorption of fat soluble vitamins
Amphetamine Toxicity: NH4Cl
Phenylalanine: ->Tyrosine->Dopa->Dopamine->NE->Epi [(Tyrosine ->Thyroxine) (Dopa->Melanin)]
Lepirudin, Bivalirudin: directly inhibit thrombin; used as an alternative to heparin for anticoagulating patients with HIT
Losartan: is an angiotensin II receptor antagonist; does not cause cough
Macrolides: binds 23S of 50S rRNA inhibiting protein synthesis by blocking translocation; treats URIs, STDs, and pneumonia; gram-positive cocci, Mycoplasma, Legionella, Chlamydia, Neisseria (Erythromycin, Azithromycin, Clarithromycin)
Ipratropium: treats Asthma, COPD
Doxazosin: a1 selective blocker; treats hypertension, and urinary retention in BPH; can cause 1st dose orthostatic hypotension, dizziness, and headache
Tolbutamide, Chlorpropamide: 1st generation sulfonylureas
Cisapride: no longer used; acts through serotonin receptors to increase ACh release at the myenteric plexus, increases esophageal tone, increases gastric and duodenal contratility improving transit time
Valproic acid: increases Na+ channel inactivation and increases GABA concentration; used as first line for tonic-clonic seizures, also myoclonic seizures; can cause GI distress, fatal hepatotoxicity, neural tube defects in fetus, weight gain
Cholesterol absorption blockers: Ezetimibe; decreases LDL by preventing cholesterol reabsorption at small intestine brush border; can increase LFTs
L-Dopa/Carbidopa: increases level of dopamine in the brain; treats parkinsonism; carbidopa is a peripheral decarboxylase inhibitor, given with L-dopa in order to increase the bioavailability of L-dopa in the brain and to limit peripheral side effects (arrhythmias), can cause dyskinesia following administration
Dantrolene: prevents the release of Ca2+ from sarcoplasmic reticulum, treats malignant hyperthermia (caused by the concomitant use of inhalation anesthetics and succinylcholine), and treats neuroleptic malignant syndrome
Cephalosporins: cross-hypersensitivity with penicillins, increases the nephrotoxicity of aminoglycosides, causes disulfiram-like reaction with ethanol
Acebutolol, Pindolol: partial beta-agonist; pindolol(non-selective), acebutolol (b1>b2)
SSRI: [Fluoxetine, Sertraline, Paroxetine, Citalopram] used to treat depression and OCD; usually takes 2-3 weeks for effect; can cause "Serotonin syndrome" with MAO inhibitors - hyperthermia, muscle rigidity, cardiovascular collapse
Methanol: retinal damage, blindness, metabolic acidosis, coma; converted to formaldehyde in liver
Glitazones: increases target cell response to insulin; can cause weight gain, edema, hepatotoxicity [Pioglitazone, Rosiglitazone]
Carvedilol, Labetalol: non-selective alpha and beta blocker
Atypical Antipsychotics: [Clozapine, Olanzapine, Risperidone, Quetiapine, Aripiprazole, Ziprasidone] block 5-HT(2) and dopamine receptors; treats schizophrenia both positive and negative symptoms, Olanzapine used for OCD, anxiety disorder, depression, mania, Tourette's syndrome; fewer EPS symptoms, Clozapine may cause agranulocytosis
Misoprostol: PGE1 analog that increases the production and secretion of gastric mucous barrier, as well as, decrease acid production; used to prevent NSAID induced peptic ulcers, also to maintain patent ductus arteriosus, and to induce labor
Barbiturates: increase GABA(A) action by increasing duration of Cl channel opening, thus decreasing neuron firing; used as sedative for anxiety, seizures, insomnia, induction of anesthesia; can cause CNS, respiratory, and cardiovascular depression [Phenobarbital]
Selegiline: selectively inhibits MAO-B thereby increases the availability of dopamine; used as an adjunctive agent to L-dopa in treatment of Parkinson's disease
Azoles: inhibit fungal ergosterol synthesis; fluconazole for cryptococcal meningitis in AIDS patients can cross BBB; ketoconazole for Blastomyces, Coccidioides, Histoplasma, Candida albicans; can cause gynecomastia and liver disfunction
Ethancrynic acid: phenoxyacetic acid derivative (not a sulfonamide) same action as furosemide; used for diuresis in patients allergic to sulfa drugs
Ultralente: longest acting insulin
Etoposide (VP-16): G2-phase specific agent that inhibits topoisomerase II and increases DNA degradation; used to treat small cell lung cancer, prostate and testicular carcinoma; can cause myelosuppression, GI upset, alopecia
Fluconazole: treats cryptococcal meningitis in AIDS patients (cross BBB)
Acyclovir: preferentially inhibits viral DNA polymerase; treats HSV, VZV, EBV
Disulfiram: inhibits acetaldehyde dehydrogenase (acetaldehyde accumulates contributing to hangover)
Allopurinol: inhibits xanthine oxidase, decreases the conversion of xanthine to uric acid; used to treat gout, as well as, lymphoma and leukemia to prevent tumor lysis syndrome; should not be used to treat acute episode of gout; interacts with azathioprine and 6-MP
Ethanol: causes nausea, vomiting, headache, hypotension, hypoglycemia, thiamine deficiency
Leuprolide: GnRH analog with agonist properties when used in pulsatile fashion and antagonist properties when used in continuous fashion; used to treat infertility (pulsatile), and prostate cancer (continuous), uterine fibroids; can cause nausea/vomiting, antiandrogen
Nystatin: binds ergosterol disrupting fungal membranes
Testosterone: agonist at receptor; treats hypogonadism and promote development of secondary sex characteristics, stimulates anabolism to promote recovery after burn or injury, treats ER-positive breast cancer; causes masculinization, leads to gonadal atrophy, premature closure of epiphyseal plates increased LDL and decreased HDL
Foscarnet: viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme; treats CMV retinitis
Scopolamine: treats motion sickness
Azithromycin: Macrolide
Amiodarone: class 1a and class 3 antiarrhythmic; safe to use in Wolff-Parkinson-White syndrome; multiple side effects amiodarone causes pulmonary fibrosis, hepatotoxicity, corneal and skin deposits hypo/hyperthyroidism; remember to check LFTs, PFTs, TFTs
Chloramphenicol: inhibits 50S peptidyltransferase; used for treatment of meningitis; causes anemia, aplastic anemia, gray baby syndrome
Ritodrine: b2 agonist; reduces premature uterine contraction
Propranolol, Timolol, Nadolol: non-selective beta blocker
IFN-alpha: chronic hepatitis B and C, Kaposi's sarcoma
Fluoroquinolones: inhibit DNA gyrase; treats Gram-negative rods of urinary and GI tracts; can cause tendonitis and tendon rupture in adults (ciprofloxacin, norfloxacin, ofloxacin, sparfloxacin, moxifloxacin, gatifloxacin, enoxacin, nalidixic acid)
Cefepime: 4th generation cephalosporin; Pseudomonas and gram-positive organisms
Tamoxifen: antagonist at breast tissue; used to treat and prevent recurrence of ER-positive breast cancer
Vancomycin: treats serious gram-positive multidrug-resistant organisms; S. aureus and C. difficile; can cause Nephrotoxicity, Ototoxicity, Thrombophlebitis
Heparin Toxicity: Protamine sulfate
Mycophenolate mofetil: inhibits de novo guanine synthesis and blocks lymphocyte production
H2 blockers: reversible block of histamine H2 receptors decreasing H+ secretion by parietal cells; treats peptic ulcers, gastritis, mild GERD; cimetidine is a potent P-450 inhibitor and causes gynecomastia [Cimetidine, Ranitidine, Famotidine, Nizatidine]
Aspart: short acting insulin
Pirenzepine, Propantheline: muscarinic antagonists, block M1 receptors on ECL cells decreasing histamine secretion and blocks M3 receptors on parietal cells decreasing acid secretion; used to treat peptic ulcers; can cause tachycardia, dry mouth, and difficulty focusing eyes
Azotreonam: use for gram-negative rods, can be used in patients allergic to penicillin or with renal insufficiency
Beta-blocker Toxicity: Glucagon
Diazoxide: opens K+ channels resulting in hyperpolarization and relaxation of vascular smooth muscle; threats malignant hypertension
Tobramycin: Aminoglycoside
Phenoxybenzamine: nonselective alpha blocker (irreversible); treats pheochromcytoma; can cause orthostatic hypotension and reflex tachycardia
Nifedipine, Verapamil, Diltiazem: calcium channel blockers; block voltage-dependent L-type calcium channels of cardiac and smooth muscle and thereby reduce muscle contractility; vascular smooth muscle=nifedipine>diltiazem>verapamil; Heart=verapamil>diltiazem>nifedipine; treats hypertension, angina, arrhythmias, Prinzmetal's angina, Raynaud's
Adenosine: increases K+ out of cells hyperpolarizing the cell; drug of choice in diagnosing/abolishing AV nodal arrhythmias; toxicity include flushing, hypotension, chest pain
Selective b2 agonists: Metaproterenol, Albuterol, Salmeterol, Terbutaline
Acarbose, Miglitol: alpha glucosidase inhibitors
Lispro: short acting insulin
Clopidogrel, Ticlopidine: inhibit platelet aggregation by irreversibly blocking ADP receptors, prevents fibrinogen binding; treats acute coronary syndrome, decreases incidence of thrombotic stroke, used after coronary stenting; can cause neutropenia
Warfarin: interferes with normal synthesis and gamma carboxylation of vitamin K dependent factors 2, 7, 9, 10, protein C and protein S; affects extrinsic pathway and increases PT; not used in pregnant women teratogenic, can cause bleeding and skin/tissue necrosis; reverse effects with fresh frozen plasma and vitamin K
Methylphenidate (Ritalin): increases presynaptic NE vesicular release; treats ADHD
Griseofulvin: interferes with microtubule funciton, disrupts mitosis; treat dermatophytes; teratogenic, carcinogenic, confusion, headaches and increases P-450 and warfarin metabolism
Cefazolin, Cephalexin: 1st generation cephalosporin; gram-positive cocci and Proteus, E. coli, Klebsiella (PEcKS)
Arsenic, Mercury, Gold Toxicity: Dimercaprol, Succimer
Erythromycin: Macrolide
Carbon monoxide poisoning: 100% oxygen, hyperbaric oxygen
Methanol, Ethylene Glycol Poisoning: Ethanol, Dialysis, Fomepizole
Digoxin and Digitoxin: inhibit sodium-potassium ATPase, causing increased cardiac contractility; treats CHF, atrial fibrillation; can cause increase PR, decrease QT, scooping ST segment, inversion of T-wave, blurry yellow vision, arrhythmia (can also cause diarrhea by poisoning the Na+/K+ ATPase in the basolateral membrane of the small bowel)
Cyclosporine: inhibits calcineurin preventing production of IL-2 and its receptor which blocks differentiation and activation of T cells; used to suppress organ rejection after transplantation; can cause nephrotoxicity which is preventable with mannitol diuresis
Methscopolamine, Oxybutynin, Glycopyrrolate: reduces urgency in mild cystitis and reduces bladder spasms
Bupropion: used for smoking cessation
Benzodiazepines: facilitates GABA(A) action by increasing the frequency of Cl channel opening; used to treat anziety, spasticity, STATUS EPILEPTICUS, detoxification, night terrors, sleepwalking; can cause CNS depression, less risk of respiratory depression and coma than with barbiturates; treat overdose with flumazenil [Diazepam, Lorazepam, Triazolam, Temazepam, Oxazepam, Midazolam, Chlordiazepoxide, Alprazolam]
Trimethoprim (TMP): inhibits bacterial dihydrofolate reductase; used in combination with sulfonamides [TMP-SMX] to treat UTIs, Shigella, Salmonella, and Pneumocystis jiroveci; can cause megaloblastic anemia, leukopenia, and granulocytopenia
Trazodone: antidepressant; inhibit serotonin reuptake
Intravenous Anesthetics: Barbiturates (used for induction of anesthesia), Benzodiazepines, Arylcyclohexylamines [Ketamine] (PCP analog that acts as dissociative anesthetic), Opiates, Propofol (used for rapid anesthesia induction and short procedures)
Antimuscarininc, Anticholinergic Toxicity: Physostigmine Salicylate
Hydroxyurea: S-phase specific, inhibits ribonucleotide reductase, decreases DNA synthesis; treats melanoma, CML, sickle cell disease; can cause bone marrow suppression, GI upset
Amikacin: Aminoglycoside
Buspirone: stimulates 5-HT(1A) receptors; used to treat generalized anxiety disorder; does not cause sedation or addiction, or interact with alcohol
5-fluorouracil (5-FU): S-phase specific antimetabolite, pyrimidine analog bioactivated to 5F-dUMP, which covalently complexes folic acid and thus inhibits thymidylate synthase, resulting in decreased dTMP; used to treat colon cancer, solid tumors, basal cell carcinoma; synergistic with MTX; causes myelosuppression "rescue" with thymidine
TCAs: [Imipramine, Amitriptyline, Desipramine, Nortiptyline, Clomipramine, Doxepin, Amoxapine] blocks reuptake of NE and serotonin; used to treat major depression, bedwetting (imipramine), OCD (clomipramine); can cause sedation, alpha blocking effects, anticholinergic effects, convulsions, coma, cardiotoxicity, respiratory depression, hyperpyrexia
Sildenafil, Vardenafil: inhibit cGMP phosphodiesterase, causing increase in cGMP, smooth muscle relaxation in corpus cavernosum, increase blood flow, and penile erection; teats erectile dysfunction; can cause blue-green color vision, flushing, dyspepsia, hypotension (in patients taking nitrates)
P-450 Inhibitors: Isoniazid, Sulfonamides, Cimetidine, Ketoconazole, Erythromycin, Grapfruit
Norepinephrine: a1, a2 > b1 agonist; treats hypotension but decreases renal perfusion
Raloxifene: agonist on bone; reduces reabsorption of bone; used to treat osteoporosis
Class 1A Antiarrhythmics: sodium channel blocker; increases action potential duration, increases ERP, increases QT interval; treats atrial and ventricular arrhythmias, recurrent ectopic SVT, ventricular tachycardia; can cause torsades de pointes due to increased QT interval, cinchonism, thrombocytopenia (procainamide can cause SLE-like syndrome) [Quinidine, Amiodarone, Procainamide, Disopyramide
Tacrolimus: inhibits secretion of IL-2 by binding to FK-binding protein; used in organ transplant recipients; can cause nephrotoxicity, peripheral neuropathy, hypertension, hyperglycemia
Edrophonium: acetylcholinesterase inhibitor; used to diagnose myasthenia gravis
Anti-TB Drugs: Streptomycin, Pyrazinamide, Isoniazid, Rifampin, Ethambutol
Bleomycin: induces formation of free radicals, which cause breaks in DNA strands; treats testicular cancer, lymphomas; can cause pulmonary fibrosis, skin changes, minimal myelosuppression
Copper, Arsenic, Gold Toxicity: Penicillamine
Ribavirin: inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase; treats RSV and chronic hepatitis C
Anticholinesterases, Organophosphates Toxicity: Atropine and Pralidoxime
Sibutramine: sympathomimetic serotonin and norepinephrine reuptake inhibitor; short-term and long-term obesity management; may cause hypertension and tachycardia
Pyridostigmine: acetylcholinesterase inhibitor; treats myasthenia gravis (does not penetrate CNS)
Pirenzepine, Propantheline: treats peptic ulcer
Imipenem/Cilastatin: drug of choice for enterobacter; broad spectrum for gram-positive cocci, gram-negative rods, and anaerobes; significant side effects can cause CNS toxicity (seizures)
Nitrosoureas: alkylate DNA, requires bioactivation, can cross the BBB and enter CNS; used to treat brain tumors; can cause CNS toxicity [Carmustine, Lomustine, Semustine, Streptoxocin]
Anastrozole: aromatase inhibitor used in postmenopausal women with breast cancer
Abciximab: monoclonal antibody that binds to the glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation; treats acute coronary syndromes, percutaneous transluminal coronary angioplasty; can cause bleeding, thrombocytopenia
Heparin: catalyzes the activation of antithrombin III, decreases thrombin (factor 2) and decreases factor 10; used for anticoagulation in pulmonary embolysm, stroke, angina, MI, DVT (can be used in pregnancy does not cross placenta); can cause HIT for reversal of heparin use protamine sulfate
Ritodrine/Terbutaline: Beta 2 agonists that relax the uterus
NPH: intermediate acting insulin
Aminoglycosides: treats severe gram-negative rod infections, by inhibiting formation of initiation complex and causing misreading of mRNA (binds 30S rRNA); Requires O2 for uptake, thus ineffective against anaerobes; can cause nephrotoxicity, ototoxicity, teratogen (Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin)
Ampicillin/Amoxicillin: Extended spectrum penicillin; Haemophilus, E. coli, Listeria, Proteus, Salmonella (HELPS); causes pseudomembranous colitis
Paclitaxel: M-phase specific agents that bind to tubulin and hyperstabilize polymerized microtubules so that mitotic spindle cannot break down; treats ovarian and breast carcinomas; can cause myelosuppression and hypersensitivity
Cyanide Toxicity: Nitrite, Hydroxocobalamin, Thiosulfate
tPA, Streptokinase Toxicity: Aminocaproic acid
Busulfan: alkylates DNA; treats CML; can cause pulmonary fibrosis, hyperpigmentation
Benzodiazepine Toxicity: Flumazenil
Iron Toxicity: Deferoxamine
Other Antiarrhythmics: K+ used to depress ectopic pacemakers in hypokalemia and digoxin toxicity; Mg2+ is effective in treating torsades de pointes and digoxin toxicity
Clonidine, alpha-methyldopa: centrally acting a2-agonist, decreases central adrenergic outflow; treats hypertension especially with renal disease ( does not decrease renal blood flow)
Digitalis Toxicity: Stop dig, normalize K+, Lidocaine, Digibind, Mg2+
Parkinson Drugs: Bromocriptine (agonize dopamine receptors), Amantadine (increase dopamine release), L-dopa/carbidopa (converted to dopamine in CNS), Selegiline (selective MAO type B inhibitor), Benztropine (Antimuscarinic; improves tremor and rigidity but little effect on bradykinesia)
Muromonab-CD3: monoclonal antibody that binds to CD3 blocking T-cell signal transduction; used for kidney transplantation
Inhaled Anesthetics: cause myocardial depression, respiratory depression, nausea/emesis, increased cerebral blood flow; toxicity includes hepatotoxicity (halothane), nephrotoxicity (methoxyflurane), proconvulsant (enflurane), malignant hyperthermia [Halothane, Enflurane, Isoflurane, Sevoflurane, Methoxyflurane, Nitrous oxide]
Epinephrine: a1, a2, b1, b2 agonist; treats anaphylaxis, glaucoma (open angle), asthma, hypotension
Fomepizole: inhibits alcohol dehydrogenase
Methylene Blue: treats methemoglobin
Rifampin: inhibits DNA-dependent RNA polymerase; treats TB and is used as prophylaxis in contacs of children with Haemophilus and Meningococcal; causes hepatotoxicity, orange body fluids
Amphotericin B: binds ergosterol and forms membrane pores that allow leakage fo electorlytes; used for systemic mycoses, intrathecally for fungal meningitis (does not cross BBB)
Phenobarbital: increases GABA(A) action; first line for seizures in pregnant women and children with tonic-clonic seizures; can induce P-450, cause sedation, dependence, tolerance
Fusion Inhibitors: bind viral gp41 subunit; inhibit conformational change required for fusion with CD4 cells (Enfuvirtide)
HMG-CoA reductase inhibitors: Statins; decrease LDL and increase HDL by inhibiting cholesterol precursor mevalonate; can cause myositis and increase LFTs
Dopamine: D1=D2 > b > a agonist; treats shock increases renal perfusion and heart failure; inotropic and chronotropic
Mebendazole, Thiabendazole: treats Enterobius vermicularis, Ascaris lumbricoides, Trichinella spiralis, Strongyloides stercoralis, Ancylostoma duodenale, Necator americanus
Warfarin Toxicity: Fresh Frozen Plasma, Vitamin K
Protamine Sulfate: treatment for Heparin toxicity; positively charged molecule that acts by binding negatively charged heparin
Phenylephrine: a1 > a2 agonist; causes pupillary dilation, vasoconstriction, treats nasal decongestion
Phenytoin: use dependent blockade of Na+ channels, inhibition of glutamate release from excitatory presynaptic neurons; used to treat tonic-clonic seizures, also a class 1B antiarrhythmic; can cause nystagmus, ataxia, diplopia, sedation , SLE-like syndrome, induction of cytochrome P-450, chronic use can produce gingival hyperplasia, peripheral neuropathy, hirsutism, megaloblastic anemia (decrease folate absorption), and malignant hyperthermia, teratogenic
Sulfasalazine: a combination of sulfapyridine (antibacterial) and mesalamine ( anti-inflammatory) activated by colonic bacteria; used to treat Ulcerative Colitis and Crohn's disease; can cause oligospermia, malaise, nausea
Echothiophate: acetylcholinesterase inhibitor; glaucoma
Niacin: increase HDL and decrease LDL by inhibiting lipolysis in adipose tissue; reduces hepatic VLDL secretion into circulation; can cause red flushed face...treat with aspirin
Glaucoma drugs: epinephrine, brimonidine, timolol, betaxolol, carteolol, acetazolamide, pilocarpine, carbachol, physostigmine, echothiophate, latanoprost (causes darkening of iris)
Imatinib (Gleevec): philadelphia chromosome bcr-abl tyrosine kinase inhibitor; treats CML, GI stromal tumors; can cause fluid retention
Doxyrubicin, Daunorubicin: generates free radicals and noncovalently intercalate in DNA; treats Hodgkin's, myelomas, sarcomas, and solid tumors; can cause cardiotoxicity, myelosuppression, alopecia
Acetaminophen: reversibly inhibit cyclooxygenase mainly in CNS; used as an antipyretic, and analgesic (lacks anti-inflammatory properties); can deplete glutathione and forms toxic metabolites in liver; treat overdose with N-acetylcysteine
Zileuton: 5-lipoxygenase pathway inhibitor, blocks conversion of arachidonic acid to leukotrienes
Zanamivir, oseltamivir: inhibit influenza neuraminidase
Cisplatin, Carboplatin: act like alkylating agents; used to treat testicular, bladder, ovary, and lung carcinomas; can cause nephrotoxicity and acoustic nerve damage
Fenoldopam: D1 receptor agonist; treats malignant hypertension and relaxes renal vascular smooth muscle
Carbamazepine: increases Na+ channel inactivation; first line treatment for trigeminal neuralgia, also used to treat tonic-clonic seizures; can cause agranulocytosis, aplastic anemia, induction of cytochrome P-450, liver toxicity diplopia, ataxia, teratogenic
Hydrochlorothiazide: inhibits NaCl reabsorption in early distal tubule and decreases Ca2+ excretion; used to treat hypertension, nephrogenic DI, hypercalciuria (stones), CHF; can cause hypokalemia, metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, and hypercalcemia, as well as sulfa allergy
Tryptophan: ->Niacin->NAD+/NADP+ or ->Seretonin->Melatonin
Diethylcarbamazine: treats Loa loa, Wuchereia bancrofti, Toxocara canis
Cromolyn: prevents release of mediators from mast cells; effective only for prophylaxis of asthma
Prazosin: a1 selective blocker; treats hypertension, and urinary retention in BPH; can cause 1st dose orthostatic hypotension, dizziness, and headache
NSAIDs: [Ibuprofen, Naproxen, Indomethacin, Ketorolac], reversibly inhibit cyclooxygenase 1 and 2, blocking prostaglandin synthesis; used as an antipyretic, analgesic, anti-inflammatory, indomethacin used to close PDA; can cause renal damage, aplastic anemia, GI distress, and ulcers
Phentolamine: nonselective alpha blocker (reversible); treats pheochromcytoma; can cause orthostatic hypotension and reflex tachycardia
alpha glucosidase inhibitors: inhibit intestinal brush border alpha glucosidases, decreaseing sugar hydrolysis and glucose absorption leading to decreased postprandial hyperglycemia; can cause GI disturbances [Acarbose, Miglitol]
IFN-beta: Multiple Sclerosis
Methicillin, Nafcillin: Staph aureus, gram-positive cocci, gram-positive rods, gram-negative cocci, spirochetes
Reverse Transcriptase Inhibitors: prevent incorporation of DNA copy of viral genome into host DNA; (nucleosides: Zidovudine, stavudine, lamivudine) (Non-nucleosides: Nevirapine, Efavirenz, Delavirdine)
Orlistat: alters fat metabolism by inhibiting pancreatic lipases; used for longterm obesity management; can cause steatorrhea, GI discomfort, decreased absorption of fat soluble vitamins
Ceftriaxone, Cefotaxime, Ceftazidime: 3rd generation cephalosporin; gram-negative infections
Physostigmine: acetylcholinesterase inhibitor; glaucoma and atropine overdose (crosses BBB)
Tamoxifen, Raloxifene: receptor antagonists in breast, agonists in bone, blocks the binding of estrogen to estrogen receptor-positive cells; used to treat breast cancer, and prevent osteoporosis; tamoxifen may increase the risk of endometrial carcinoma via partial agonist effects, "hot flashes", raloxifene does not cause endometrial cancer (endometrial antagonist)
Bismuth, Suralfate: binds to ulcer base, providing physical protection and allow HCO3- secretion; used to increase ulcer healing and travelers diarrhea; triple therapy for H. pylori=Metronidazole, Amoxicillin, Bismuth
Local Anesthetics: block Na+ channels by binding to specific receptors on inner portion of channel, preferentially binding to activated channels so most effective in rapidly firing neurons; small myelinated > small unmyelinated > large myelinated > large unmyelinated and pain(lose first) > temperature > touch > pressure; used for minor surgical procedures, spinal anesthesia if allergic to esters [Procaine, Cocaine, Tetracaine] give amides [Lidocaine, Mepivacaine, Bupivacaine]; can cause CNS excitation, cardiovascular toxicity (bupivacaine), hypertension, hypotension, and arrhythmias (cocaine)
Daclizumab: monoclonal antibody with high affinity for the IL-2 receptor on activated T cells
Sulfonylureas: close K+ channel in beta-cell membrane, resulting in depolarization of cell triggering insulin release via Ca2+ influx; first generation [Tolbutamide, Cholorpropamide] disulfiram like effects, second generation [Glyburide, Glimepiride, Glipizide] can cause hypoglycemia
Ondansetron: 5-HT3 antagonist a powerful central antiemetic; used to treat vomiting postoperatively and in patients undergoing cancer chemotherapy; can cause headache and constipatioin
Cefoxitin, Cefuroxime: 2nd generation cephalosporin; gram-positive cocci and Haemophilus, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia (HEN PEcKS)
Probenecid: inhibits the reabsorption of uric acid in the PCT (also inhibits secretion of penicillin); treats chronic gout
Infliximab: anti-TNF antibody; treats Crohn's disease, rheumatoid arthritis, ankylosing spondylitis; can predispose to infections, reactivate latent TB
Prednisone: may trigger apoptosis, may work on nondividing cells; used in CLL, Hodgkin's lymphomas, and immunosuppressant in autoimmune diseases; can cause iatrogenic Cushing's, immunosuppression, cataracts, acne, osteoporosis, hypertension, peptic ulcers, hyperglycemia, psychosis
Salicylate Toxicity: NaHCO3 and dialysis
Topiramate: blocks Na+ channels and increases GABA action; treats tonic-clonic seizures; can cause sedation , mental dulling, kidney stones, weight loss
Hydralazine: increases cyclic GMP resulting in smooth muscle relaxation; vasodilates arterioles > veins (afterload reduction); first line therapy for hypertension in pregnancy, with methyldopa, also treats CHF; use with beta blockers to prevent reflex tachycardia, and with diuretics to block salt retention
Finasteride: 5 alpha-reductase inhibitor decreasing the conversion of testosterone to DHT; treats BPH also promotes hair growth
Class 1B Antiarrhythmics: sodium channel blockers that affect ischemic or depolarized Purkinje and ventricular tissue; decreases action potential duration; useful in treating acute ventricular arrhythmias especially post MI and in digitalis-induced arrhythmias [Lidocaine, Mexiletine, Tocainide]
Amantadine: blocks viral penetration/uncoating; prophylaxis and treatment of influenza A rubella; can treat Parkinson's disease (causes the release of dopamine from intact nerve terminals)
K+ sparing diuretic: [Spironolactone, Triamterene, Amiloride, Eplerenone] Spironolactone is a competitive aldosterone receptor antagonist in the cortical collecting tubule, Triamterene and Amiloride act at the same part of tubule by blocking Na+ channels; used to treat hyperaldosteronism, K+ depletion, CHF, polycystic ovarian syndrome; can cause hyperkalemia, gynecomastia (spironolactone), antiandrogen effects (spironolactone), metabolic acidosis
6-mercaptopurine (6-MP): blocks de novo purine synthesis, activated by HGPRTase; treats leukemias, lymphomas; bone marrow, GI, liver toxicity, metabolized by xanthine oxidase, thus increased toxicity with allopurinol
Maprotiline: antidepressant; blocks NE reuptake
Metoprolol, Atenolol, Acebutolol, Betaxolol, Esmolol: b1 selective blocker (b1>b2)
Atropine: muscarinic antagonist; causes pupil dilation, decreases secretion, decreases acid secretion, decreases motility, decreases urgency in cystitis, increase body temperatue, dry mouth; can cause acute angle-closure glaucoma in elderly, urinary retention in men with prostatic hypertorphy, and hyperthermia in infants
Lente: long acting insulin
Mifepristone (RU-486): competitive inhibitor of progestins at progesterone receptors; termination of pregnancy administered with misoprostol; can cause heavy bleeding, GI effects, abdominal pain
Amphetamine: releases stored catecholamines; treats narcolepsy, obesity, ADD
Lithium: mood stabilizer for bipolar affective disorder, blocks relapse and acute manic events; can cause tremor, hypothyroidism, polyuria (ADH antagonist causing nephrogenic DI), teratogenesis
Sumatriptan: 5-HT(1D) agonist, causing vasoconstriction; used to treat acute migraine, cluster headache attacks; toxicity includes coronary vasospasm, mild tingling, hypertensive emergencies
Mirtazapine: a2 selective blocker; treats depression; causes sedation, increases serum cholesterol, increases appetite
Aspirin: irreversibly inhibits cyclooxygenase 1 and 2 preventing the conversion of arachidonic acid to thromboxane A2; used as an anitpyretic, analgesic, anti-inflammatory, antiplatelet agent; can cause gastric ulceration, bleeding, hyperventilation, Reye's syndrome, tinnitus
Ephedrine: releases stored catecholamines; used for nasal decongestion, treats urinary incontinence, hypotension
Indomethacin: helps close patent ductus arteriosus
Opioid Toxicity: Naloxone/Naltrexone
Flucytosine: Inhibits DNA synthesis by conversion to fluorouracil, which competes with uracil; used in systemic fungal infections
Pancuronium, Vecuronium, Rocuronium: nondepolarizing neuromuscular blocker competitive with ACh for receptors; used for muscle paralysis in surgery or mechanical ventilation, selective for motor nicotinic receptor; reversal of blockade with neostigmine, edrophonium and other cholinesterase inhibitors
Metronidazole: forms toxic metabolites in the bacterial cell that damage DNA; antiprotozoal; Giardia, Entamoeba, Trichomonas, Gardnerella, Anaerobes below the diaphragm, "triple therapy" with bismuth and amoxicillin against H. pylori
Neomycin: Aminoglycoside
N-acetylcysteine: loosen mucous plugs in cystic fibrosis (chromosome 7)
Dipalmitoyl phosphatidylcholine: surfactant
Thrombolytics: streptokinase, tPA aid in the conversion of plasminogen to plasmin the major fibrinolytic enzyme; treat toxicity with aminocaproic acid
Succinylcholine: depolarizing neuromuscular blocker; used for muscle paralysis in surgery or mechanical ventilation, selective for motor nicotinic receptor; Phase 1 (prolonged depolarization):no antidote, Phase 2 (repolarized but blocked): antidote consists of cholinesterase inhibitors
Clindamycin: blocks peptide bond formation at 50S ribosomal subunit, trat anaerobic infections; Bacteriodes fragilis, Clostridium perfringens; causes pseudomembranous colitis
Progestins: bind to progesterone receptors, reduce growth, and increase vascularization of endometrium; used as oral contraceptive and treatment of endometrial cancer, treats abnormal uterine bleeding
ACE Inhibitors: [Captopril, Enalapril, Lisinopril] inhibit angiotensin converting enzyme, reducing levels of angiotensin II and preventing inactivation of bradykinin a potent vasodilator, Renin release is increased due to loss of feedback; used to treat hypertension CHF, diabetic renal disease; can produce cough, angioedema, proteinuria, taste changes, hypotension, pregnancy problems, rash, increased renin, lower angiotensin II, and hyperkalemia
IFN-gama: NADPH oxidase deficiency
Trastuzumab (Herceptin): monoclonal antibody against HER-2, helps kill breast cancer cells that overexpress HER-2, possibly through antibody-dependent cytotoxicity; treats metastatic breast cancer; can cause cardiotoxicity
Neostigmine: acetylcholinesterase inhibitor; treats postoperative and neurogenic ileus and urinary retention, myasthenia gravis, and reverses neuromuscular junction blockade (postoperative)
Methemoglobin: Methylene blue
Omeprazole, Lansoprazole: proton pump inhibitors; irreversibly inhibit H+/K+ ATPase in stomach parietal cells; treats peptic ulcers, gastritis, esophageal reflux, Zollinger-Ellison syndrome
Glucocorticoids: decreases the production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and inhibiting the expression of COX-2; used to treat Addison's disease, inflammation, asthma, and induce immune suppression; can result in iatrogenic Cushing's syndrome [Hydrocortisone, Prednisone, Triamcinolone, Dexamethasone, Beclomethasone]
Somatostatin (Octreotide): treats acromegaly, carcinoid gastrinoma, glucagonoma
Isoniazid (INH): decreases synthesis of mycolic acids used to treat TB; can cause hemolysis if G6PD deficient, neurotoxicity due to vitamin B6 depletion, hepatotoxicity, SLE-like syndrome
Acetaminophen Toxicity: N-acetylcysteine
Class 4 Antiarrhythmics: Ca2+ channel blockers; used to prevent nodal arrhythmias such as SVT; bepridil can cause torsades de pointes [Verapamil, Diltiazem]
Protease Inhibitors: inhibit assembly of new virus by blocking protease in progeny virions (Saquinavir, Ritovir, Indinavir; -navir (NEVER) tease a protease)
Ivermectin: treats Strongyloides stercoralis, Onchocerca volvulus
Ketoconazole: treats Blastomyces, Coccidioides, Histoplasma, Candida albicans, and polycystic ovarian syndrome
Cocain: uptake inhibitor; vasoconstriction and local anesthesia
Class 2 Antiarrhythmics: Beta Blockers; decreases cAMP and Ca2+ currents; treats V-tach, SVT, and slows ventricular rate during atrial fibrillation and atrial flutter
Terbutaline: b2 > b1 agonist; reduces premature uterine contractions
Lead Toxicity: CaEDTA, Dimercaprol, Succimer (for kids), Penicillamine
Metoclopramide: D2 receptor antagonist, increases resting tone, contractility, LES tone, motility, does not influence colon transit time; used to treat diabetic and post surgery gastroparesis; can cause parkinsonian effects, restlessness, drowsiness, fatigue, depression, nausea, diarrhea (contraindicated in patients with small bowel obstruction)
Dactinomycin: intercalates in DNA; treats childhood tumors: Wilms' tumor, Ewing's sarcoma, rhabdomyosarcoma; can cause myelosuppression

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Number of cards 292