USMLE PHARM I

decrease SANS outflow , AE- edema and CNS dep , DI- TCA decrease antiHTN effects

alpha 2 agonist, opiate withdrawal

alpha 2 agonist, HTN in preg women , AE- + coombs

intereferes with storage vesicles, SEVERE DEPRESSION, increased GI secretions

inhibits NE release, AE- TCA block reuptake

decrease arteriloar ad venous resiscntace, reflexc tachycarida, -zosin, USE- HTN and BPH, AE- orthostatic hypotention and urinary incon, good lipid profile

CI- diabetics, vasopsoams, asthma

decrease TPR via arteriolrar dilation,SLE like syn, use for pregnancy , act via NO2

AE- CN toxicity, use- HTN emergecy , act via NO2

arteriolar vasoldation, open K channles , USE- male baldness(rogaine) AE- diabetogenic(decreases insulin)

antiartyhmic, HTN, angina, AE- ginigival hyperplasia(dipines), verampil

CCB that works on hrt , AE- constipation

CCB that works on blood vessel

CCB that can work on hert and blood vessel

ACEI, blocks form of Ang II, AE- dry cough, hyperkalemia, ARF, angioedema , USE- mild to mod HTN, CHF

block AT1 receptor, no dry cough , USE- mild to mod HTN, CHF

renin inhibitors, no dry cought, USE- mild to mod HTN

B blockers, CCBs

ACEI, ARBs

ACEI, ARBs, Beta blockers

B blockers

alpha blockers

alpha blockers, CCBs, ACEI/ ARB

vasoconstrictior, CI- pregnancy ,USE- pu; HTN

infusion pump for pul HTN

PDE inh, increased cGMP, USE- pul HTN

paraxysmal atrial tachycarida through vagal refelx

B1 and B3 agonist, USE- bronchospasm and AV block, AE0 flushing

B1 agonsit, USE- CHF

salemterol, albuterol, terbutaline used in asthma

use in narcolepsy and ADHD, displaces NE from mobile pool

cocaine and TCA

selective alpha 2 blocker, used as antidepressent, increases appetite- USE- anorexia

glaucoma , blocks action of NE, decrease aqueosu humor formation, for open glucoma

thyrotoxicosis, performance anxiety, essential tremor , essential trempor, agoraphobia, social phobia

K channel blocking and B blocking , slows phase III, B 1 blockage, USE- life threatening ventricular arrthmias

increases aqueous humor outflow, for glaucoma , M3- ocntraction of cilirary muscle

cinchonism(GI, ocular dysfunction, CNS exlciation), torsades, DI- hyperkalemia, toxic with digoxin, Class IA

IA antiarrthmic, AE- SLE like syn, torsades , hematoxcity, thrombocytopenia

block open or activated state Na channels

preference for damaged tissue, prefers partially depoalzied tissue, lidocaine, mexiletene

IB, post MI, AE- sexiures, less cardiotxoicity

IB antiarrthmic

IC, increased sudden death,

IV, acute SVTs, beta blocker

prophylasix post MI, SVTs , decrease slope of phase 4 of AP in SA node

IA, III

II, IV

decreas IK(delayed rectified) sloe down phase 3, amiodarone, sotalol

I, II, III, IV, long half life, AE- pul fibrosis, hepatoxicity, thyroid dysnfcion, blue skin( high Vd)

DOC for paroxysmal supraventricualr tachycardias and AV nodal arrythmias, short half life

USE- torsades

inh of cardiac Na K ATPase, increased intracellular CA, increased contractile force , inhibition of neuronal NaK ATPase-->increased diastolic filing, INCREASED CONTRACTILITY , long half life, large tissue protein bomding, USE- CHF, SVT, AE- anorexia, CNS, arrthmias, MANGEMENT- Fab antibodies

increase cAMP in hrt, increased ionotropy, increased cAMP in smooth muscle--> decreased TPR

recomb BNP, increased cGMP , use for acute decompensated CHF

AE- orthostatic hypertension, tachyphylaxis, cadiotox with digoxin, USE- angina

CCB used for vaspospastic angina

angina of effort

blocks late inward Na current in cardiac myocytes decreasing Ca acculumation( Ca accumulates in ischemic tissue to due increased Na)

PDE inhibitors, tx for status epilepticius, AE- carditoxicity

CA inh in PT, decreased H in PCT, increased Na and HCO3 in lumen,USE- galucoma, acute mountain sickes, metabolic alkalisis, AE- ACIDOSIS, RENAL STONES, SULFONAMIDE HYPERSENSITIVTY , dx- INCREASED HCO3 in urine

inhbits water reabsortions through out the tubule, increased urine volumne

loop diurecti, no allergies to sulfanamide, INCREASED Ca in urine

loop diurecti, allergies to sulfanamide, INCREASED Ca in urine , USE- acute pul edema

Na Cl transport inhibitor in EARLY DISTAL, USE- calcium stones, AE- HYPERCALCEMIA, nephrogenic DI , CI in diabetics but can be given as antihypertinces(works well with AA men) , drugs- indapamide, metolazone, hydrocholrothiazide

early collecting duct , aldosterone antagonist, uSE- antiandrogenic, CHF, AE- hyperkalemia+acidosis

Na channel blockers, USE-LI induced nephrogenic diabetes(amiloride), AE- hyperkalemia+acidosis

Na/K/Cl transport inhibitor in ASCENDING LIMB, INCREASED Ca in urine , ethacrinic acid, furosemide , USE- acute pul edema, ARF , AE- otoxicity, DI- aminoglycosides(increased otoxictiy), lithium, digoxin

HMG CoA reductase, MOA- decreased VLDL synthesis and decreased LDL, AE- rhabdomyolysis, hepatoxicity, DI with gemfibrozil(increased rhabdomyolsis), increased toxcitiy with CYP 450 inh

bile acid sequenstrant, increaed LDL expression, AE- increased VLDL and TAGs, MALABSORPTION OF FAT SOLUBLE VITAMINS , CI- hypertriglycerderimia

inhibition of VLDL syntehsis, decreased VLDL, AE- intesse PRURITIS made better with aspirin

fibrates, bind to PPAR alpha and increase expression of lipoprotein lipases, increases HDL in most pts, USE- hypertriglycedemia, AE- gall stones, myositis

prevents intestinal reabsorption of cholestrol

cholestryamine, colestipol, ezetimibe

gemfibrozil

statins, niacin, ezetimibe

anxiety, panic phobias

anxiety, muscle relaxant

anxiety, status epilepticus , not metabolized by liver

preop sedation, anesthesia

sleep disorder benzo , not metabolized by liver

barbituate, DOC for epilepsy during pregnancy

short acting, anesthesia, barbituate

BZ1 receptor agonist, sleep disorders(less effect on cognition)

CYP inducer, CI in porphyria

5HTA partial agonist, used for GAD

results in formaldehyde- irreversible tisue damage, ocular damage, resp failure

reumts in production of oxalic acid, nephrotoic acid, CNS depression

results in acetic acid, acetaldehyde combines with folate to inactivate it, combies with thiamine to decrease availability

inhibits acetaldehyde dehydrogenase, similar rxn with- metronidazole, griseofulvin, cefoperazone, cefotetan, chlorpropramide

msucle wasting, gout, fatty liver, hypoglycemia

blocks Na channel in their inactivated state, USE- seziures except absence, PK- zero order kinetics, AE- gingival hyperlasia, hirsuitism, osteomalacia, megaloblastic anemia, TERATOGENIC( cleft lip and palate)

blocks Na chaniinel in activated state, DOC- trigem neuralgia, used for manic bipolar disorder, PK- CYP 450 inducer, AE- INCREASED ADH, steven johnson syndrome, TERATOGENIC( spina bifida and cleft lip and palate)

GABA transaminas inibitor, blcokage of T type Ca channels, USE- migraine prophylaxis, mania of bipolar disorders, AE- pancreatitis, alopecia, TERATOGEIC( spina bifida)

blockage of T type Ca, USE- absence seizure, AE- decreased efficacy of oral contraceptives via CYP induction

block Na channels and glutamate receptors , AE- hepattoxcitiy and aplastic anemia(felbamate), steven johnson( lamotrigine)

increased GABA effects, USE- neuropathic pain

diffusion hypoxia, spon abortion, low blood gas, rapid onset and recovery, high MAC

low MAC, higher blood gas ratio, malignant hyperthermia, cardiac arrythmias

antiemetic, anesthesia- initation and maitaines

opiate, anesteha

dissociative anethesia, NMDA receptor antagonist, hallucination, increased ICP, vivid nightmares

anesthetic blocking NMDA receptor

puffer fish. Block inactivated Na channels, decreased Na influex

bind to activated Na channle, cause inactvation, prolong Na influx, desesensitixe and inactivate

procaine, cocaine, cause allergeis due to PABA(paraaminobenzoic acid)

lidocaine, bupivacaine

nonionized form crosses axoimanl membrane, from within ionized form blocks the inacticated Na channel, slows recovery and prevents propogation of action potentials, esters and amides, AE- cadiotxoic,, neruotoxic

vasocontiction by blocking NE uptake

competitive, non depol, reversible with AcHE, no CNS effects

nondepol blocker, safe in hepatic and renal impariment because spon inactiavation to laudanosine( this could cause seizures)

short duration nondepol blockers

nicotinic agonist, noncome depol blocker, no effect of AchE when desenstivzed, AE- malignant hyperthermia, hyeperkalemia, genetic polymorphism(slow metabs could be problematic)

GABA B receptors, use for spasticity

tx for malig hyperthermia

lower MAC- more potennt

high- slower onset and slower recovery

thiopental, midozolam, propodol, fentanyl, ketamine

blocks Ca release from muscle SR, tx for NMS

head injuries, pul dysfunction(except pul edema), hepatic and renal dysfucntion, adrenal or thyroid def, pregnancy

opioid full agnosit, antimuscardinic, met to normepridine-->serotonin syndrome and seziures

maintains opioid addiction

cough supressant

opid related, cough supressant

opoid rel, diarrhea

methadone and clonidine(decreases NE release)-->decreases SANs response

IC nalazone

yawning, lacrimation, salivation, rhinorea, CNS origin, pain, anxiety, sweating, G I coulple, u- strongest

K agonist- spinal analgesia and dysphoria, u antagonist- preciptation of withdrawal

opoid antagonist, IV, reverse resp dep

decrease craving of alc and opiate addiction

opioid anatgonist, opioid rel constipation

dyskinesia(hyper movement)

pseudoparkinsosm(nigrostriatal) , gynecopastia, amenoreha/galactorreha (tuveroinfedibular)

cell bodies in midbrain, reiforcement of behavior increased DA in nucelus accumbens

DA agonsit, emetic

Gs

Gi

nigrostriatal

mesolimbic , clozapine

prodrug, converted by decarbozylase, give with carbidopa(inhbits peripheral decarboxylase) AE- dyskinesia, psychosis, hypotension

inhibit COMT and enhances uptake and effciacy, tolcapone- hepatoxic

MAO B selective inhbitor, NO TYRAMINE INTERACTION AE- dyskeniea, psychosis, amnesia(met by aphetamine- will test + in drug test)

hyperprolactinoma and acromegaly , DA receptor acgonist , AE- psychosis and dyskinesia

DA receptor agonist

decreases Ach function, muscarinic blocker, decreases tremor and rigidity, AE- antimuscarinic(atropine like)

antiviral, blocks muscarinin increased DA release, AE- LIVEDO RETICULARIS

for acute EPS( pseduoparkinsonism, akathesia, dystonia)

chronic EPS for tardive dyshyemia

EPS, dysphoria(decreases compliance), endocrine( NMS, increased prolactin, wt gain) , hypotnesion due to alpha blockage

chlorpromazine, thioridazine, fluphenazile, haloperidol

clozapine, olanzapine, risperidone, aripiprazole

better antimusacrin, incrased sedation, increased alpha blockate, cardiac toxicity(quinidine like), retinal deposits, allergies , typical antipsych

NMS and TD, typical antipsych

block D2C and 5HT2, AE- agranulocystosis, NO TD, increased salivation(due to serotnin) , seziures(due to antimuscarinic) , atypical antipsychotic

atypical, blocks 5HT2 improves negative symptoms

partial agonist of D2, blocks 5HT2 receptors

MAOI , use- atypical depression, AE- HYPERTENSIVE CRISSI, DI with tyramine, TCA, levodopa, alpha 1 agonist, SEROTONIN SYN

sweating, rigidity, myoclonus, hyperthermia, ANS instabiliy, seizures , Drugs- SSRI, TCA, meperidine

amitriptiline, imipramine, clomipramine, non specific block of 5HT and NE, DI- hypertensive crisis with MAOI, seronin syn, AE- 3 Cs(coma, convusion, cardiotoxic)

TCA for OCD

TCA for neuropathic pain, can also use carbemazepine

decreased slow wave sleep, works on phase IV of sleep, night terrors

slective blockade of 5HT reuptake , USE- depression, anxiety, DI- CYP inh(fluvoxamine and fluxetine), benzo

safe for interactions

5HT agonist, AE- arrthmias, pirapism

nonselective reuptake blocker devoid of ANS effects

DA reuptake blocker, used in smoking cessation

alpha 2 antagonist, wt gain and anorexia

DOC for bipolar, decreases PIP2 and camp, AE- life threatining sezures, hypothyroidsimwith goiter(decreased TSH), NDI(decreased ADH)- tx with amiloride, chronic thazide decreases clearance of LI, use K sparing, teratogenic(ebsteins- malformed tricuspid)

amphetatime like, AE- cardio toxicity, use- ADHD

selective NE reuptake inhibitor, USE- ADHD

block reuptake of NE and DA, relase amines from mobule pool

tx with flumazenil, cant use for barbituate toxcitiy

potnetiate GABA with GABA A (BZ1 and BZ2)

lif threatening seziure

interact of CB 1 and CB2

NMDA antagonist, AE- rhabdomylosysi, convulsions and edeath

hallucinations, glutamate receptro antagonist

5HT, excstasy, raves

solvent abuse, multiple organ damage

erythromycin, azithromycin clarithromycin, USE- g+, atypicals, C jejuni, MAC, H pylori, CYP inh, AE- stim gut motilin

macroline with less GI symptosm

macrolide with least CYP inh , H pyroli

ketoline, macrolide resistn S pneumona

not macrolide but same mechanism and resistance, G+, b fragilis and anarobes, use in osteomylitis with g+, AE- C DIFFICLE COLITIS

MOA- inhibits initation complex in bac translation, prevents formation of tRNA complex, USE- tx for VRSA and VRE, drug resist penumoccoa, 50 S

50S, like tetracycline, streptogramins, binding to 50S prevent interaction of amino acyl tRNA with acceptor site , USE- VRE, VRSA

inhibit dihydropteroate synthetase , DON’T USE ALONE- resistance

inhibit dihdrofolate reductase , Bone marrow suprresion, problemtatic in HIV pts

ulcertative coilitis and rheumatoid arthritis

burns

carbamezipine and phenytoin, allows for transport of folate

trimethoprim-sulfamethoxazole, DOC for nocardia, listeria, g- infections, g+ infections, PCP, toxoplasm, AE- allergies, take with lots of water( to avoid stones), kernicterus in babeis, phototoxciiy

bacteriostatic, met by hepatic glucorination, CYP inh, dose dep marrow supreesion, back up for salmonella and ricettksa, AE- GRAY BABY SYN

lipid soluble, proststis(gonorhea+chlamydia, boreilla , hepatic met

menigicoocal carrier state( rifampin more frequent- organge body fluids)

SIADH

MRSA and VRE skin and complicated infections

increased by carbamazepine, decreased by LI , decreased by demeclocyline

chelators, bacteriostatic, borad- atypicas, h pylori, ricketsia, boreilla, brucella, vibrio, treponema(back up) , AE- tooth enamel dysplsia and decreased bone , CI in preggers( liver issues)

tetracucline, sulfonamide, quinolones

aminoglycosides, AE- nephrotoxicity(ATN) , otoxicity, NEUROMUSCLAR BLOCKADE , once daily dosing

TB, DOC for bubonic plague and tularemia

aminoglycosides, fluroquinolones, sulfonamides, tetracycline

interenes with initiation, misreading of code(aminoglycosdies only- cidal)

blocks attachemnt of aminoacyl tRNA to acceptor site(static)

inhibit the activity of peptidyl transferase(-static)

ihibits translocation of peptidyl tRNA from acceptor to donor site

aminoglycosides, loop diuretics(ethycrinic acid more) , vancomycin

binds Dala Dala and hinders the transglyclation and invovlved in the elognation of peptidoglycan chains, NO ROLE IN PBPs, USE- MRSA, enterococci C difficiel(not DOC, metronizadle is) , resistance- termanial Dala is replaced by D lactate, orally for colitis, AE- red man syndrome, otoxotic

resistant to B lactmases, no cross allogeniencity, ONLY G-

Reistant to B lactams, nosocmial epiric for life threathening, give with CILASTATIN to prevent RENAL TOXCITIY , USE- enterobacter and pseudomonas, AE- seizures

first gen cephalosporin, surgical prolylacis, g+, NO ENTRY INTO CNS, long half life

second gen cephalospin, cefuroxime enters CNS

g+, g- rods and coci, epiric for menginitis and spesisi

IV, reistant to beta lactamase, wide spect, enters CNS

bile eleminated

disulfiram like

pencillins, cephalosporin, imipenem/meropenem, aztrenam, vancomycin

aminoglycosides, chloramphenicol, macrolindes, tetraclylines, strepgtamins, linezolid, clindamycin

fluoroquinilone, rifampin

sulfonamide, trimethoprim, prymethamine

production of B lactamases, which cleave the beta lactam ring structure, change in PBPs, change in porin

conjugate rxns that transfer acetyl, phosphoryl, adenyl groups

formation of methyltransferases that alter drug binding sites on 50S, active transport out of cells

increased pumping drug out of cell

change in sensitivty of inhibiton of target enzyme, increased PABA formation, exogenous folic acid

change in sensivity to ninhbition of target enzymes, increased activity of transport systems that promote drug efflux

formation of activating acetyl transferase

interacts with cytoplasmic membrane binding proteins to inhibit transpeptidation reaction invovled in cross linking, AE- hypersensivity, interstitial nephritis with methicillin, JHR rxn with tx of syphulis(flushing joint pain, proof tht drug is working- used to be assessment too in olden days)

betalacatase resistant, staph

long acting , pencillin G

boreilla, H pylori

listeria

extended spectrum, antipseudomonal, betalactamase sensitive

irreversible B lactamase inhibitors

eliminated via bile