-
diphenhydramine
- first generation antihistamine
- reversible H1 inhibitor. Allergies, motion sickness, sleep aid
- sedation antimuscarinic, anti-alpha-adrenergic
-
dimenhydrinate
- first generation antihistamine
- reversible H1 inhibitor. Allergies, motion sickness, sleep aid
- sedation antimuscarinic, anti-alpha-adrenergic
-
chlorpheniramine
- first generation antihistamine
- reversible H1 inhibitor. Allergies, motion sickness, sleep aid
- sedation antimuscarinic, anti-alpha-adrenergic
-
loratadine
- 2nd generation antihistamine
- reversible H1 inhibitor with less CNS penetration
- allergies (not for motion sickness/sleep aid)
- reduced sedative effects
-
fexofenadine
- 2nd generation antihistamine
- reversible H1 inhibitor with less CNS penetration
- allergies (not for motion sickness/sleep aid)
- reduced sedative effects
-
desloratadine
- 2nd generation antihistamine
- reversible H1 inhibitor with less CNS penetration
- allergies (not for motion sickness/sleep aid)
- reduced sedative effects
-
cetirizine
- 2nd generation antihistamine
- reversible H1 inhibitor with less CNS penetration
- allergies (not for motion sickness/sleep aid)
- reduced sedative effects
-
guaifenesin
- expectorant
- thins respiratory secretions without suppression of cough reflex
-
N-acetylcysteine
- mucolytic
- disrupts disulfide bonds to liquify mucous. COPD
- also used as acetaminophen overdose (replenishes glutathione to detox NAPQI [oxidizer])
-
dextromethorphan
- antitussive
- NMDA glutamate antagonist, opioid
- synthetic codeine analog with mild opioid effects if used in excess->abuse (naloxone for overdose)
- serotonin syndrome if combined with other serotonergics
-
ephedrine
releases stored catecholamines. Nasal decongestant, urinary incontinence, hypotension
-
pseudoephedrine
- nasal decongestant
- alpha-adrenergic agonist. Reduce hyperemia, edema, nasal congestion
- used to make methamphetamine
- hypertension, CNS stimulation/anxiety
-
phenylephrine
- nasal decongestant
- agonist at alpha 1 more than alpha 2. Reduce hyperemia, edema, nasal congestion, hypotension, ocular procedures (dilator)
- doesn't work as well, but it can't be used to make meth, so you can't buy it straight off the shelf (easier to market)
- hypertension
-
bosentan
- competitive antagonism of endothelin-1 to reduce pulmonary vascular resistance. Pulmonary hypertension
- hepatotoxic (increased LFTs)
- bosENtan (endothelin-1)
-
sildenafil
- inhibits PDE-5, increasing cGMP, prolonging NO effect. Pulmonary hypertension and erectile dysfunction
- headache, flushing, dyspepsia(heart burn), cyanopia (blue vision), hypotension with nitrates(fatal)
-
vardenafil
- inhibits PDE-5, increasing cGMP, prolonging NO effect. Pulmonary hypertension and erectile dysfunction
- headache, flushing, dyspepsia(heart burn), cyanopia (blue vision), hypotension with nitrates(fatal)
-
tadalafil
- inhibits PDE-5, increasing cGMP, prolonging NO effect. Pulmonary hypertension, erectile dysfunction, and BPH(only tadalafil)
- headache, flushing, dyspepsia(heart burn), cyanopia (blue vision), hypotension with nitrates(fatal)
-
epoprostenol
- PGI2
- directly vasodilates pulmonary and systemic arterial vasculature and inhibits platelet aggregation. Pulmonary hypertension
- flushing, jaw pain
- epoPROSTenol (prostaglandin)
-
iloprost
- PGI2
- directly vasodilates pulmonary and systemic arterial vasculature and inhibits platelet aggregation. Pulmonary hypertension
- flushing, jaw pain
- iloPROST (prostaglandin)
-
albuterol
- beta 2 agonist
- short-acting relaxation of bronchial smooth muscle. Acute exacerbation of asthma and COPD
-
salmeterol
- beta 2 agonist
- long-acting relaxation of bronchial smooth muscle. Prophylaxis of asthma exacerbations and COPD
- tremor, arrhythmia
-
formoterol
- beta 2 agonist
- long-acting relaxation of bronchial smooth muscle. Prophylaxis of asthma exacerbations
- tremor, arrhythmia
-
fluticasone
- inhaled corticosteroid
- inactivates NFkappaB transcription factor of TNF alpha and most cytokines. 1st line (or budesonide[same class]) for chronic asthma
-
budesonide
- inhaled corticosteroid
- inactivates NFkappaB transcription factor of TNF alpha and most cytokines. 1st line (or fluticasone[same class]) for chronic asthma
-
ipratropium
- muscarinic antagonist
- blocks muscarinic receptors to prevent bronchoconstriction. Asthma and COPD
-
tiotropium
- muscarinic antagonist
- long-actingblockage of muscarinic receptors to prevent bronchoconstriction. Asthma and COPD
- long-acting version of ipratropium
-
montelukast
- antileukotriene
- blocks leukotriene receptors (CystLTI). Aspirin-induced asthma
-
zafirlukast
- antileukotriene
- blocks leukotriene receptors (CystLTI). Aspirin-induced asthma
-
zileuton
- prevents arachidonic acid to leukotriene to inhibit the 5-lipoxygenase pathway. Aspirin-induced asthma
- Hepatotoxic so use montelukast/zafirlukast instead (I would say)
-
omalizumab
- anti-IgE monoclonal antibody
- binds free serum IgE to prevent Fc binding, which reduces mast cell degranulation of leukotrienes and histamine. Allergic asthma with high IgE refractory to inhaled steroids and long-acting beta 2 agonists
-
theophylline
- methylxanthine
- likely inhibits phosphodiesterase to increase cAMP levels and induce bronchodilation
- narrow therapeutic index, cardiotoxicity, neurotoxicity, blocks adenosine (along with caffeine, oh and one thing adenosine does is causes bronchoconstriction, remember?)
- theorylline (good in theory, but narrow therapeutic index for two most important organs of life)
-
methacholine
- muscarinic agonist
- agonist at M3 receptors. Bronchial challenge for asthma diagnosis
-
mannitol
- osmotic diuretic
- tubule cannot absorb mannitol, increasing the drug overdose, elevated ICP or intraocular pressure
- pulmonary edema (contraindicated in HF), dehydration (contraindicated in anuria)
-
acetazolamide
- sulfa based carbonic anhydrase inhibitor
- prevents conversion of H2CO3 to water and CO2, which are easily reabsorbed in kidney, results in diruesis and decreased bicarb. Also reduces aqueous humor synthesis. Glaucoma, urinary alkalinization, metabolic alkalosis, altitude sickness (form of respiratory alkalosis), psuedotumor cerebri
- proximal renal tubular acidosis, NH3 toxicity, paresthesias, sulfa allergy
- acidazolamide (makes body acidic) (no pupillary or vision changes for glaucoma use)
-
furosemide
- solfonamide loop diuretic
- inhibits NKCC in TAL, reducing hypertonicity of medulla to reduce concentrating ability and increase Ca excretion. Also stimulates PGE release to vasodilate the afferent arteriole. Edema (HF, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, hypercalcemia
- PGE effect reduced by NSAIDs
- Ca loss
- ototoxicity, hypokalemia, dehydration, allergy (sulfa), alkalosis, interstitial nephritis, gout
- OH DANG (Ototoxicity, Hypokalemia, Dehydration, Allergy/Alkalosis, Nephritis, Gout)
-
bumetanide
- solfonamide loop diuretic
- inhibits NKCC in TAL, reducing hypertonicity of medulla to reduce concentrating ability and increase Ca excretion. Also stimulates PGE release to vasodilate the afferent arteriole. Edema (HF, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, hypercalcemia
- PGE effect reduced by NSAIDs
- Ca loss
- ototoxicity, hypokalemia, dehydration, allergy (sulfa), alkalosis, interstitial nephritis, gout
- OH DANG (Ototoxicity, Hypokalemia, Dehydration, Allergy/Alkalosis, Nephritis, Gout)
-
torsemide
- solfonamide loop diuretic
- inhibits NKCC in TAL, reducing hypertonicity of medulla to reduce concentrating ability and increase Ca excretion. Also stimulates PGE release to vasodilate the afferent arteriole. Edema (HF, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, hypercalcemia
- PGE effect reduced by NSAIDs
- Ca loss
- ototoxicity, hypokalemia, dehydration, allergy (sulfa), alkalosis, interstitial nephritis, gout
- OH DANG (Ototoxicity, Hypokalemia, Dehydration, Allergy/Alkalosis, Nephritis, Gout)
-
ethacrynic acid
- non-sulfonamide loop diuretic
- inhibits NKCC in TAL, reducing hypertonicity of medulla to reduce concentrating ability and increase Ca excretion. Also stimulates PGE release to vasodilate the afferent arteriole. Edema (HF, cirrhosis, nephrotic syndrome, pulmonary edema), hypertension, hypercalcemia
- PGE effect reduced by NSAIDs
- Ca loss
- higher ototoxicity than furosemide, hypokalemia, dehydration, no sulfa allergy alkalosis, interstitial nephritis, gout
- OH DANG (Ototoxicity!)
- ETHIC RHINNEc Acid (debate of ototoxicity vs sulfa Allergy)
-
hydrochlorothiazide
- sulfa-based thiazide diuretic
- inhibit NaCl reabsorption in DCT, reducing the nephron diluting capacity and decreasing Ca excretion. 1st line hypertension, HF, idiopathic hypercalciuria (stones), nephrogenic DI (weirdest thing ever), osteoporosis
- hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy
- HyperGLUC (hyper...Glycemia, Lipidemia, Uremia, Calcemia)
-
chlorthalidone
- sulfa-based thiazide diuretic
- inhibit NaCl reabsorption in DCT, reducing the nephron diluting capacity and decreasing Ca excretion. 1st line hypertension, HF, idiopathic hypercalciuria (stones), nephrogenic DI (weirdest thing ever), osteoporosis
- hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy
- HyperGLUC (hyper...Glycemia, Lipidemia, Uremia, Calcemia)
-
metolazone
- sulfa-based thiazide diuretic
- inhibit NaCl reabsorption in DCT, reducing the nephron diluting capacity and decreasing Ca excretion. 1st line hypertension, HF, idiopathic hypercalciuria (stones), nephrogenic DI (weirdest thing ever), osteoporosis
- hypokalemic metabolic alkalosis, hyponatremia, hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy
- HyperGLUC (hyper...Glycemia, Lipidemia, Uremia, Calcemia)
-
spironolactone
- potassium-sparing diuretic
- competitive inhibition of aldosterone receptor in CCT, reducing Na channels on apical membrane, decreasing K+ release by principal cells and H+ release by alpha intercalated cells. Hyperaldosteronism ("Conn syndrome" if primary), hypokalemia, HF, hepatic ascites (spironolactone only). Also inhibits steroid binding of 17alpha hydroxylase and 17,20 desmolase. Used in PCOS to reduce androgenic symptoms
- hyperkalemic arrhythmias, gynecomastia, antiandrogenic effects, acidemia (less H+ excretion, increased K+ in blood increases K/H exchange)
- the K STAEs(stays) (Spironolactone, Triamterene, Amiloride, Eplerenone)
-
eplerenone
- potassium-sparing diuretic
- competitive inhibition of aldosterone receptor in CCT, reducing Na channels on apical membrane, decreasing K+ release by principal cells and H+ release by alpha intercalated cells. Hyperaldosteronism ("Conn syndrome" if primary), hypokalemia, HF
- hyperkalemic arrhythmias, reduced gynecomastia and antiandrogenic effects compared to spironolactone, acidemia (less H+ excretion, increased K+ in blood increases K/H exchange)
- the K STAEs(stays) (Spironolactone, Triamterene, Amiloride, Eplerenone)
-
triamterene
- potassium-sparing diuretic
- blocking Na channels in CCT, decreasing K+ release by principal cells and H+ release by alpha intercalated cells. Hyperaldosteronism ("Conn syndrome" if primary), hypokalemia, HF
- hyperkalemic arrhythmias, acidemia (less H+ excretion, increased K+ in blood increases K/H exchange)
- the K STAEs(stays) (Spironolactone, Triamterene, Amiloride, Eplerenone)
-
amiloride
- potassium-sparing diuretic
- blocking Na channels in CCT, decreasing K+ release by principal cells and H+ release by alpha intercalated cells. Hyperaldosteronism ("Conn syndrome" if primary), hypokalemia, HF, nephrogenic DI (only K sparing drug for it)
- hyperkalemic arrhythmias, acidemia (less H+ excretion, increased K+ in blood increases K/H exchange)
- the K STAEs(stays) (Spironolactone, Triamterene, Amiloride, Eplerenone)
-
ACEIs
- captopril, enalapril, lisinopril, ramipril
- inhibit ACE to reduce ATII, decreasing efferent constriction (decreasing GFR) and increasing bradykinin levels (vasodilator). Hypertension (esp. in DM b/c less GFR means less GBM thickening), diabetic nephropathy (same thing), HF (reduces mortality by preventing heart remodeling), proteinuria
- cough, angioedema (bradykinin)(contraindicated in C1 esterase inhibitor deficiency), renal malformations in embryogenesis, elevated creatinine (reduced GFR can cause renal failure if bilateral stenosis), hyperkalemia, hypotension
- captopril's CATCH (Cough, Angioedema, Teratogen, Creatinine, Hyperkalemia/Hypotension)
-
captopril (class)
ACE inhibitor
-
enalapril (class)
ACE inhibitor
-
lisinopril (class)
ACE inhibitor
-
ramipril (class)
ACE inhibitor
-
ARBs
- losartan, sandesartan, valsartan
- inhibit ATII binding to AT1 receptor without increase in bradykinin. Hypertension (esp. if ACEI intolerance w/ DM b/c less GFR means less GBM thickening), diabetic nephropathy (same thing), HF (reduces mortality by preventing heart remodeling), proteinuria
- renal malformations in embryogenesis, elevated creatinine (reduced GFR can cause renal failure if bilateral stenosis), hyperkalemia, hypotension
- SpARTAN ABs (-sartan, ArBs)
- take the ACE (1st C and A) out of CATCH->TCH (teratogen, creatinine, hyperkalemia/hypotension)
-
losartan (class)
- ARB
- SpARTAN ABs (-sartan, ArBs)
-
candesartan (class)
- ARB
- SpARTAN ABs (-sartan, ArBs)
-
valsartan (class)
- ARB
- SpARTAN ABs (-sartan, ArBs)
-
aliskiren
- direct inhibition of renin preventing ATI->ATII. Hypertension
- elevated creatinine (reduced GFR can cause renal failure if bilateral stenosis), hyperkalemia, hypotension (contraindicated if already on ACEI/ARB)
-
acetaminophen
- reversible inhibition of CNS cyclooxygenase but inactivated peripherally. Antipyretic (use instead of aspirin for kids), analgesic, not anti-inflammatory
- hepatic necrosis (CYP3A4[induced by chronic alcoholism] and CYP2E1 form NAPQI, an oxidizer that depletes glutathione[reformed by N-acetylcyteine])
-
aspirin
- aka acetylsalyclic acid
- irreversible NSAID
- covalent acetylation of COX1 and COX2 (irreversible) reducing TXA2 and prostaglandins. Low dose (<300mg/day) inhibits platelet aggregation, intermediate (300-2400mg/day) antipyretic/analgesic, high (>2400-4000mg/day) anti-inflammatory
- increased bleeding time (no effect on PT/PTT), gastric ulceration (GI bleed with chronic use), tinnitus by CNVIII damage, interstitial nephritis/renal failure with chronic use, Reye syndrome (child with virus), reduced uric acid clearance (don't take if you have gout pain!)
- acid/base chemistry initial respiratory alkalosis, late mixed metabolic acidosis (gap and non-gap) with respiratory alkalosis
-
celecoxib
- sulfa-based selective and reversible NSAID
- inhibits COX2, which reduces prostaglandin formation but does not reduce TXA2 (COX1 function). RA, OA
- increased thrombosis risk, less risk of GI ulceration sulfa allergy
-
General NSAIDs
- ibuprofen, naproxen, indomethacin, ketorolac, diclofenac, meloxicam, piroxicam
- reversible inhibition of COX1 and COX2 blocking prostaglandin and TXA2. Antipyretic, analgesic, anti-inflammatory
- gastric ulcer (prostaglandins help the mucosa), interstitial nephritis, renal ischemia (PGE keeps the afferent arteriole open)
-
ibuprofen (class/special?)
NSAID
-
naproxen (class/special?)
-
indomethacin (class/special?)
- NSAID
- closes patent ductus arteriosus, actue gout pain
- endomethacin (end a PDA, indomethacin)
-
ketoralac (class/special?)
NSAID
-
diclofenac (class/special?)
NSAID
-
meloxicam (class/special?)
NSAID
-
piroxicam (class/special?)
NSAID
-
leflunomide
- reversible inhibtion of dihydroorotate dehydrogenase, preventing pyrimidine synthesis to suppress T cell proliferation. RA, psoriatic arthritis
- diarrhea, hypertension, hepatotoxicity, teratogenicity
- I lefT a rotating pyle of diarrhea in the loo when the baby crying made my BP go up (leflunomide T cell/LFT, dihydroorotate, pyrimidine, teratogen, hypertension)
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