Pharm

• Trigger insulin release via Ca+ influx by closing K+ channels
• DM II
• Release of endogenous insulin

• Decrease gluconeogensis
• Increase glycolysis
• Insulin Sensitizer

• Lactic Acidosis
• Contraindicated in Renal Failure

• Proglitazone , Rosiglitazone
• Increase insulin sensitivity in peripheral tissue
• DM II

• Cardiovascular Toxicity
• Hepatotoxity
• Edema
• Weight Gain

• Acarbose, Miglitol
• Delayed sugar hydrolysis and glucose absorption leads to decreases post-prandial hyperglycemia
• DM II

• Decrease Glucagon
• DM 2

• Increase insulin
• Decrease Glucagon

Pancreatitis

• Inhibit pancreatic lipase
• Obsesity managment

Decrease fat-vitamin absorption

• Serotonin and NE reuptake inhibitor-sympathomimetic
• Obesity management

Tachycardia

• Inhibit Iodide organification and coupling of thyroid synthesis
• Decrease T4 to T3 peripheral conversion

Hyperthyroid Rx

• Aplastic anemia
• Agranulocytosis
• Rash

Inhibit Iodide organification and coupling of thyroid synthesis

• Hyperthyroid Rx
• Aplastic anemia
• Agranulocytosis
• Rash

Thyroxine replacement

Artificial ADH

Central DI

ADH Antagonist

SIADH rx

• Nephrogenic DI
• Photosensitivity
• Bone/teeth abnormality

Hydrocortisone, Dexamethasone, beclomethasone

Inhibits phospholipase A2 and COX-2 -> Decreases production of leukotrienes and prostaglandins

RX: addison's, asthma, etc..

• Cushing's Syndrome
• Increases neutrophil-due to less adhension to vessel call
• Decrease lymphocytes, monocytes, basophil, eosinophil

Aromastase inhibitor-stops conversion of estrogen

RX: breast cancer

• Antifungal but.
• Decrease androgen synthesis

EGF-HER/her2 second messenger inhibitor

5-alpha reductase inhibitor to stop conversion of DHT

RX: Benign prostate hyperplasia and Baldness

Hair growth

Also blocks T4 to T3 conversion in the peripheral tissue

Does not decrease oxygen consumption of tissue

GnRH analog

Infertility, prostate cancer

Nausea, vomitting

• Hypogonadism
• Recovery after burns
• ER positive breast cancer

• Masculinization in females
• Gonadal Atrophy
• Increased LDL
• Decreased HDL

5-alpha-reductase inhibitor

BPH, male pattern baldness

Competitive inhibitor of androgens at testosterone receptor

Prostate cancer

Inhibit steroid synthesis by stopping demolase

Polcystic ovarian syndrome to prevent hirsutism

Gynecomastia and amenorrhea

Inhibit steroid binding

Polycystic ovarian syndrome to prevent hirsutism

Gynecomastia and amenorrhea

Estrogens

• Hypogonadism
• Mentral abonormalities
• Androgen dependent prostate cancer

• Do not give in DVT
• Do not give in ER-positive breast cancer

• Endometrial cancer
• Bleeding in post-menopause
• DES causes adenocarcinoma
• Increased thrombi

Partial Estrogen receptor agonist that prevents normal feedback and stimulate LH and FSH

Intertility and PCOS

• Hot flash
• Ovarian enlargement
• Visual disturbances

Estrogen antagonist on breast tissue

ER positive breast cancer

Estrogen agonist on bone

Osteoporisis to reduce bone resorption

Aromatase inhibitor

Postmenopasual women with breast cancer

Aromatase inhibitor

Postmenopasual women with breast cancer

Progesterone

• Oral contraceptive
• Endometrial cancer
• Abnormal uterine bleeding

Competitive inhibitor of progestins at progesterone receptor

Terminate pregnancy. Administer with misoprostol (PGE)

Heavy bleeding, Gi effects, abdominal pain

• Increases TG
• Hypercoagulable state

PGE2 analog

Induce labor by causing cervical dilation and uterine contraction

B2-agonist

Prevent premature uterine contraction by relaxing uterus

Selective Alpha-1-AD-antagonist on prostate

Treat BPH by inhibiting smooth muscle contraction

Inhibit cGMP phosphodiesterase therefore increasing cGMP causing smooth muscle relaxation in corpus cavernosum with increased blood flow

Erectile dysfunction

Contraindicated in people taking Nitrates due to life threatening hypotension.

• Flushing
• Dyspepsia
• Impaired blue-green color vision

• Increase cGMP
• Aterioles>veins
• Afterload reduction

• Hypertension of pregnancy
• Give along with B-blocker to prevent reflex tachycardia

Lupus like syndrome

• K+ channel opener
• Hyper-polarizes and relaxes vascular smooth muscle

Severe Hypertension

• Hypertrichosis
• Pericardial Effusion
• Reflex Tachy

Block calcium channels of cardiac and smooth muscles

• Vascular smooth muscle-Nifedipine
• Heart-verapamil ("verrapamil=ventricle")

Raynauds, Arrhythmia (not nifedipine)

Cardiac Depression, AV block, Constipation

• Increase cGMP
• Dilate veins>arteries
• Decrease Preload

Pulomary edema, Angina, Erection enhancer

• Reflex tachycardia, flushing, Hypotension
• Monday's Disease

increase cGMP via direct release of NO

Malignant hypertension

Cyanide Toxicity

• Dopamine D1 agonist
• Relaxes Renal smooth muscle

Malignant hypertension

K channel opner

Malignant Hypertension

Hyperglycemia-decreases insulin release

HMG-coa reductase inhibitor-inhibit mevalonate

Decrease LDL

• Rhabdomyolysis
• Hepatotoxicity

Reduces VLDL secretion

Increases HDL

• Vasodilation
• Hyperglycemia-acanthosis nigricans
• Hyperuricemia-gout

Decreases intestinal absorption of bile acid

Decreases LDL

• GI discomfort
• Decreases fat soluble vitamins

Prevent cholesterol absorption

Decreased LDL

Increases LFTs

Upregulate LDL to increases TF clearance

Decreases TG

• Myositis
• Hepatotoxicity
• Cholesterol Gallstones

Inhibits Na/K ATPase which indirectly inhibits Na/CA exchanger which increases Ca+

Positive inotropy

CHF and atrial fibrillation

• Blurry yellow vision
• Increased PR
• Decreased QT
• T wave inversion
• Hyperkalemia

Don't give in hypokalemia, Renal failure, or with quinidine

Mg+ for antidote

Class IA Na+ channel blockers

• Increase AP duration
• Increase QT interval

• Both atrial and ventricular arrhymias
• Reentrant and ectopi supraventricular and ventricular tachycardia

• Quinidine= Thrombocytopenia, Torsades, Tinnitus
• Procainamide=SLE like syndrome

"the Queen proclaims Diso's Pyramide"

Class IB Na blocker

• Decrease AP duration
• Affects ischemic or depolarized Purkinje and ventricular tissue

Post-MI arrythmias and digitalis induced arrhythmias

• Local anesthetic
• Cadiovascular depression

"I'd Buy Lidy's Mexican Tacos"

Class IC Na blocker

No effect on AP duration

• Vtachs that progress to VF
• Intractable SVT

• Proarrhythmic in post MI patients
• Contraindicated in Post-MI

"Chipotle's Food has Excellent Produce"

• Decrease cAMP and Ca+ current
• Decrease slope of phase 4
• Increases PR interval

Afib and Aflutter

• Impotence, asthma, Masks hypoglycemia,
• Metoprolol can cause dyslipidemia

Treat overdose with Glucagon

K+ channel blockers

• Increase AP duration
• Increase QT interval

• Amiodarone: pulmonary fibrosis, Hepatotox, Hypothyroidism/hyperthyroidism (Check PFT, LFT, TFT)
• Coreal deposits
• Skin deposits (blue/gray) resulting in photodermatitis

Ca+ channel blockers

• Increase PR interval
• Decrease conduction velocity in primarily AV node

Prevention of Nodal Arrhymias

Constipation, Flushing, Edema

• Increase K+ out of cells and decrease Ca+ into cells
• Hyperpolarizes cells

Diagnose/abolish supraventricular tachycardia

Chest pain, flushing, hypotension

effect blocked by theophylline

• Stops Torsades de pointes
• Stops Digoxin toxicity