-
allopurinol
inhibits xanthine oxidase
-
isoniazid
- B6 pyridozine deficiency leading to peripheral neuropathy and sideroblastic anermia
- MOA nicotinic acid derivative that inhibits synthesis of mycolic acid in mycobacterial cell wall
-
succinylcholine
- depolarizing agent/muscle relaxant during sugery
- binds to nicotinic receptors in skeletal muscle causing persistent depolarizaiotn at motor end plate
- hydrolyzes plasma cholinesterase
- initial fasciculations followed by muscle paralysis
- duration of action 5-10min
- effects not reversed by cholinesterase inhibitors, no pharmacologic antidote to overdose
- soem pts ahve atypical cholinesterase and canot metabolize the drug - malignant hyperthermia -tx dandrolene?
-
acetylcholine
- activates muscarinic and nicotinic receptors.
- muscariniceffects -
- pupillary miosis (constracts iris sphincter),
- accommondation of lens for near vision (contracts ciliary muscles),
- bronchoconstrictor,
- slow HR (SA node effect),
- increase PR inverval (AV node affect),
- sitmulate GI secretions and motility
- micturation (stimulate detrusor muscle which relaxes internal sphincter of bladder)
-
nitric oxide
- potent casodilator synthesized in endothelial cells
- activates cGMP - which inactivates myosin light chain kinase in sm muscle cells leading to vasodilation
- Ach can lead to its synthesis when injected into vessels
-
Premature contractions
terbutaline - selective B2 adrenergic agonist tha tinhibits uterine contractions
-
aspirin effects on kidney
- decrease PGE2 synthesis (vasodialator) leading to unopposed AT II effect
- renal papillary necrosis
-
methotrexate
- blocks dihydrofolate reductase, S phase inhibitor
- leucovorin rescue
- side effects :
- macrocytic anemia due to folate deficiency
- intersitital fibrosis in lung
-
peripheral neuropathy and cancer drug
vincristine
-
MOA sucralfate
- ciscous polymer of sucrose octasulfate +aluminum hydroxide that adheres to ulcer crater
- stimulates PGE2 in mucous cells - responsible for mucus barrier
-
statin + niacin
rhabdomyolysis - remember each drug on its own can produce rhabdomyolysis
-
amphotericin B
- binds ergosterol in fungal cell membrane which increases its permeability
- nystatin has same mechanism
-
clotrimazole
- inhibits ergosterol synthesiss
- other azole compounds have similar action
-
flucytosine
inhibits nucleic acid synthesis
-
griseofulvin
inhibits microtubule function and mitosis
-
propylthiouracil
- DOC for decreasing synthesis of thyroid hormone in graves disease
- only drug that can be used in pregnancy
- side affect - agranulocytosis
-
fastest drugs that increases HR in shock
- isoproterenol
- dobutamin
- dopamine - in low dose best for renal vasodilation
-
dapsone
- sulfone that inhibits synthesis of folic acid by M leprae
- side effects
- hemolytic anemia in G6PD pts
- methemoglobinemia
- nephrotic syndrome
- peripheral neuropathy
-
-
anticonvulsant /antiepileptic wiht effect on epiphyseal plate
phenytoin via revving up cytochrome system in liver and causing vit D deficiency - increased metabolism of 25 hydroxy vit D
-
ondansetron
- selective serotonin 5ht3 receptor antagonist
- useful in bocking chemoreceptor trigger zone nausea in the area postrema
-
opioid overdose
- respiratory depression - respiratory acidosis
- miotic pupils - pin point
-
alcoholic in ER
IV thiamine to prevent acute wernickes encephalopathy
-
heparin
- mcc of thombocytopenia in hospital
- MOA - binds antithrombin III catalyzing inactivation of thrombin and other clotting factors
-
coumadin overdose
- fresh frozen plasma if serious
- IM vitamin K for less serious bleeds
-
nitrofurantoin
- concentrated in urine
- urinary tract antiseptic
-
cyclophosphamide
- activated in the liver
- side effects
- hemorrhagic cystitis
- transitional cell carcinoma
-
doxorubicin and prednisone
metabolized in the liver
-
gout after cancer therapy
- prevent by giving allopurinol - xanthine oxidase inhibitor
- danger of urate nephropathy
-
muscle fasciculations after neuromuscular block
initial effect of succinylcholine
-
levodopa
MOA blocks peripheral dopa decarboxylase
-
bronchial asthma
- albuterol inhaler most often for mild to moderate
- corticosteroid inhaler next
- then add long acting B2 agonist
-
paroxysmal supraventricular tachycardia
- tx adenosine
- including its association with WPW syndrome
-
clonidine
activates a2adrenergic and imidazole receptors in the CNS which reduces sympathetic outflow from the vasomotor center in the medulla
-
captopril
- blocks ACE which breaks down bradykinin
- bradykinin side effects - cough and angioedema
-
hydralazine
- HTN tx during pregnancy
- better tolerated in fast acetylators
- cause of drug induced SLE - antihistone antibodies . ( also procainamide)
-
HTN, Hypernatremia and hypokalemia
- tx: ARB - losartan a AT II receptor antagonist ....blocks aldo
- blocking aldo causes NA to be lost and K retained
-
tx of pulmonary edema
loop diuretics...decreases preload
-
tx of opiod overdose
naloxone - competative opioid receptor antagonist
-
urinary retention due to BPH
- selective alpha 1 blocker - relax sm muscle in bladder neck and prostate
- prazosin, terazosin
-
saw palmetto
antiandrogen effect - blocks androgen uptake and availability without alerting serum levels, shrinks transitional zone of prostate around urethra
-
-
premature labor an must deliever
before 32 wks ?, glucocorticoids to increase surfactant synthesis
-
hypercalcemia
loop diuretics
-
decrease calcium in urine in stone former
hydrochlorothiazide
-
cause of respiratory alkalosis and then metabolic acidosis
salicylate intoxication
-
s phase drug ued in tx of ALL
methotrexate
-
analog of hypoxanthine requiring HGPRTase for bioactivation
6 mercaptopurine, allopurinol could cause toxicity since th drug is a purine
-
drug that competes with dUMP for thymidylate synthase
5 flurorocuracil
-
tx wilms tumor
actinomycin D (dactinomycin)
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