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Trazodone
- "trazoBONE"
- mech: atypical antidepressant - Inhibits 5HT reuptake
- uses: insomnia; high doses for depression
- tox: sedation, nausea, priapism, postural hypotension
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Cyproheptadine
- mech: antihistamine/anticholinergic/antiserotonergic
- 5HT2 receptor antagonist
- uses: allergy, serotonin syndrome, carcinoid syndrome.
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Paroxetine
- mech: SSRI
- others: fluoxetine, sertraline, citalopram
- uses: depression, OCD, bulemia, social phobias
- tox: GI, sexual (anorgasmia)
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Sildenafil/vardenafil
- FILLS the penis!
- mech: cGMP phosphoDE inhibitor (increases cGMP) and relaxes smooth muscle in corpus cavernosum
- uses: erectile dysfunction
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Vincristine/Vinblastine
- mech: bind tubulin and block MT polymerization
- uses: hodgkin's lymphoma, wilm's tumor, choriocarcinoma
- tox: neurotoxicity, paralytic ileus, BM suppression
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Caspofungin
- mech: blocks glucan synthesis (inhibits cell wall synthesis)
- uses: candida and aspergillus
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ciprofloxacin
- FQ: inhibits DNA gyrase
- uses: Gram - rods of GU/GI (pseudomonas, neisseria)
- CI in pregnancy and children d/t tendonitis/tendon rupture.
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oral hypoglycemics
- sulfonylureas (tolbutamide, chlorpropamide, glyburide...)
- biguanides (metformin)
- glitazones/thiazolidinediones (pio/rosiglitazone)
- a-glucosidase inhibitors (acarbose, miglitol)
- mimetics (pramlintide)
- GLP-1 mimetics (exenatide aka byetta)
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Sulfonylureas
- tolbutamide, chlorpropamide (1st gen)
- glyburide, glimepiride, glipizide (2nd gen)
- close K+ channel in Beta CM to depolarize and triggers insulin release via increased Calcium influx
- **requires islet function**
- tox: 1st (disulfiram like effects), 2nd (hypoglycemia)
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Biguanides
- Metformin
- decrease GNG, increase glycolysis, decrease serum glucose
- overall insulin sensitizer
- can be used without islet function
- TOX: Lactic acidosis!!! CI in renal failure. GI is MC se
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glitazones/thiazolidinediones
- PPAR gamma agonist (upreg transcription of DNA)
- increases insulin sensitivity in peripheral tissue
- tox: weight gain, hepatotox, CV tox
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alpha glucosidase inhibitor
- acarbose, miglitol
- *sugar shits*
- inhibit intestinal brushborder alpha glucosidases
- decreases absorp of glucose, decreased postprandial hyperglycemia
- tox: gi disturbances
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GLP-1 mimetics
- Exenatide
- increases insulin, decreases glucagon release
- tox: n/v; pancreatitis
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orlistat
- LT obesity management
- MOA: inhibits pancreatic lipases
- tox: steatorrhea, GI discomfort, reduced absorp of fat-sol vitamins
- **fat shits**
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Isoproterenol
- Beta agonist (sympathomimetic)
- uses: AV block
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Beta 2 agonists
- MAST: Metaproterenol, albuterol, salmeterol, terbutaline
- M & A: acute asthma
- S: LT asthma treatment
- T: reduces premature uterine contrax
-
SSRI's
fluoxetine, paroxetine, sertraline, citalopram
-
Fluoxetine/sertraline/citalopram/paroxetine
- SSRI's
- uses: depression, OCD, bulimia, social phobias
- tox: gi, anorgasmia, SEROTONIN SYNDROME (don't take with maoi)
-
serotonin syndrome
- taking drugs that increase serotonin together (ex maoi and ssri)
- sx: hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea, seizures
- tx: cyproheptadine (serotonin receptor antagonist)
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nifedipine
- Ca channel blocker (alsop verapamil, diltiazem)
- moa: block voltage gated ca channels in smooth and skeletal muscle, reduce muscle contractilityvsm> heart
- uses: hypertension, angina, prinzmetal's angina, raynauds
- tox: cardiac depression, AV block, peripheral edema, flushing, dizzy, constipation
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clonidine
- centrally acting alpha 2 agonist
- decreases central adrenergic outflow
- uses: hypertension (especially with renal disease, no decrease in renal blood flow)
-
bosentan
- moa: competitive antagonist of endothelin-1 receptors
- decreases pulmonary vascular resistance
- uses: pulmonary hypertension
-
buspirone
- 5HT 1A receptor agonist/stimulator
- treats generalized anxiety (no alcohol interactions)
- give with benzos since takes 2w to work
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Flutamide
- non-steroid anti-androgen competetive antagonist at testosterone receptor
- used in prostate cancer
-
Finasteride
- (propecia)
- 5a-reductase inhibitor (decreases conversion of testost to DHT)
- used in BPH
- also promotes hair growth (decreases peripheral androgen reduction to dht
- DHT is a mediator of prostate enlargement
-
Calcium channel blockers
- verapamil, diltiazem, nifedipine
- class IV - mostly work at NODES (AV/SA)
- decrease conduction velocity, contractility, cardiac output (can exacerbate CHF)
- increase ERP and PR interval
- tox: constipation, flushing, edema, CV (chf, av block, etc)
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atropine
- anti-muscarinic
- blocks DUMBBELSS
- tox: hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter
- can cause acute angle closure glaucoma in elderly
-
neostigmine
- anticholinesterase
- postop and neurogenic ileus and urinary retention, MG, reversal of NMJ blockade (post op)
- NO CNS PENETRATION
- increases endogenous ACh
-
physostigmine
- anticholinesterase
- glaucoma, atropine overdose
- crosses BBB - CAN ENTER CNS
- increases endogenous ACh
-
edrophonium
- anticholinesterase
- diagnosis of myashthenia gravis dt short duration of action
-
cholinesterase inhibitor poisoning
- opposite of sympathetics!
- DUMBBELSS
- Diarrhea
- Urination
- Miosis (pinpoint pupils)
- Bronchospasm
- Bradycardia
- Excitation of skeletal muscle and CNS
- Lacrimation
- sweating
- salivation
- tx: ATROPINE plus pralidoxime to regenerate active cholinesterase
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