19848601
Description
Flashcards by Killian McNeill, updated more than 1 year ago
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Created by Killian McNeill
about 5 years ago
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| Question | Answer |
| Levothyroxine | Treats Hypothyroidism Synthetic T4, 1/2 life 7 days 50-125mg daily, increase if pregnant or on estrogen therapy Noncompliance important issue |
| I-131 | Treatment for Hyperthyroidism Radioactive Iodine fairly selective for thyroid Painless killing of thyroid cells Low risk, treat for hypothyroidism post-treatment |
| Propylthiouracil (PTU) | Thionamide Treat Hyperthyroidism by inhibiting T3/4 synthesis (NOT release). Also inhibits T4 to T3 conversion in periphery Low risk of rash, arthralgia, agranulocytosis (discontinue if fever or sore throat develop), and hepatotoxicity Preferred in pregnancy |
| Methimazole | Thionamide Treat Hyperthyroidism by inhibiting T3/4 synthesis (NOT release). Low risk of rash, arthralgia, agranulocytosis (discontinue if fever or sore throat develop), and hepatotoxicity Longer 1/2 life and lower risk of agranulocytosis than PTU |
| Potassium Iodide (Lugol's solution/KI) | Iodide, treats hyperthyroidism Overloads thyroid, inhibits T3/4 synthesis and release Effect temporary Give after thionamides to prevent temporary increase in synthesis Side effects: rash, salivary gland swelling, metallic taste, sore teeth Can be used to treat radioactive iodide exposure |
| Alendronate | Bisphosphonate, treats osteoporosis and Paget's disease Inhibits pyrophosphatase enzymes in osteoclasts Increases bone density GI distress, esophageal erosion (low risk) Atypical femur fracture (AFF) osteonecrosis of the jaw (ONJ) over many years |
| Risedronate | Pyridinal Bisphosphonate, treats osteoporosis and Paget's disease Inhibits hydroxyapetite enzymes in osteoclasts Increases bone density GI distress, esophageal erosion (low risk), AFF and ONJ |
| Zoledronate | Bisphosphonate, treats osteoporosis, hypercalcemia, and Paget's disease Inhibits pyrophosphatase enzymes in osteoclasts and induces apoptosis Give once yearly. If treating hypercalcemia, repeat treatment in 1 week if Ca levels don't drop Fever, nausea, constipation, diarrhea, vomiting, GI pain, ONJ |
| Ibandronate | Bisphosphonate, treats osteoporosis and Paget's disease Inhibits pyrophosphatase enzymes in osteoclasts and induces apoptosis Once monthly>once daily dose constipation, flu-like symptoms AFF, ONJ, and pain in extremities |
| Raloxifene | Estrogen receptor agonist bone, antagonist breast/uterus Treat postmenopausal osteoporosis Risk of venous thromboembolism |
| Denosumab | Antiresorptive agent RANKL agonist, inhibits osteoclast proliferation/activity AFF, ONJ, severe hypocalcemia |
| Calcitrol | 1,25 dihydroxyvitamin D (potent vit D metabolite) Increases Ca absorption gut, decreases Ca, phosphorous excretion kidney Recruits osteoblast precursors to resorption sites Few side effects, reduces bone fractures |
| Pamidronate | Amino-substituted bisphosphonate IV only Treat hypercalcemia of malignancy, reduces bone pain/fracture. Sometimes used for Paget's disease Nausea, anorexia, leukopenia, pain at site of injection Expensive |
| Calcitonin | Parafollicular thyroid hormone Decreases Ca absorption, increases excretion Salmon derived can cause hypersensitivity Not effective for osteoporosis, treats Paget and hypercalcemia |
| Iron | Deficiency can cause microcytic anemia Oral preferred to injection, injection can cause allergic reaction Increased need in menstruating, pregnant, breastfeeding women Milk/eggs can block absorption |
| Folate | Necessary for DNA synthesis Deficiency leads to macrocytic anemia found in green vegetables, cereal, meat, fish, egg, NOT milk GI symptoms, mild rash with extended use Rule out B12 before administering, can mask B12 deficiency and cause nerve damage |
| B12 | Cofactor for two important enzymes. Methylmalonyl CoA mutase: leads to inappropriate fatty acids in spinal tract Methionine synthase: Stops recycling of Homocysteine, depletes folate, causes macrocytic anemia Optic nerve atrophy, severe allergic reaction, fever, diarrhea, cardiac and GI side effects may occur |
| Erythropoietin | Released by kidney in response to hypoxemia, can become impaired by renal disease Used for anemia of chronic disease, renal failure, AZT HIV treated patients, chemo patients, pre-surgery Increase risk of severe cardiovascular effects (MI, thromboembolism, stroke, etc.), dangerous in kidney failure so go for lowest dose possible, promotes growth of some forms of tumors |
| Filgrastim | Granulocyte colony stimulating factor Stimulates neutrophil growth and activity Useful post-chemo for replenishing neutrophils |
| Sargramostim | Granulocyte-macrophage colony stimulating factor Stimulates granulocyte and macrophage growth and activity Useful post-chemo for replenishing myeloid recovery |
| Oprelvekin | IL-11, thrombopoietic growth factor Stimulates megakaryocyte growth Increases platelet count, typically used for cancer patients |
| Aspirin | Antiplatelet agent Irreversibly acetylates COX-1, preventing TXA activity Prevent MI, arterial thrombosis, vein graft occlusion GI pain, nausea, bleeding, impaired hemostasis in pregnancy, and excessive bleeding with other blood thinners may occur |
| Dipyridamole | Antiplatelet agent Inhibits phosphodiesterase, increases cAMP production, which inhibits TXA activity |
| Clopidogrel | Antiplatelet agent Irreversibly binds to P2RY12 receptor on platelets, inhibiting platelet activation |
| Tirofiban | Antiplatelet agent Reversibly antagonizes fibrinogen binding to GP IIb/IIIa receptor, prevents platelet aggregation |
| Heparin | Anticoagulant Sulfated mucopolysaccharides Binds antithrombin III, activating it and inducing factor Xa and thrombin inactivation Rapid, treats arterial/venous thromboembolism, extracorporeal circulation, pregnancy, maintains patency of catheters Risk of excess bleeding, thrombocytopenia, alopecia, burning in feet, hypersensitivity, capillary rupture if given IM (Don't give IM). Suppresses aldosterone, insulin |
| Protamine Sulfate | Very basic, favorably binds heparin, instantaneous reversal of heparin Transient hypotension, hypersensitivity, and anticoagulant effects |
| Warfarin | Anticoagulant Blocks vitamin K, prevents factor II, VII, IX, X production in liver. Delayed effect. Prophylaxis of thrombus in various heart diseases Hemorrhage common, hypertension, necrotic skin lesions, GI, liver, and other more minor effects occasionally. TERATOGEN! Reverse with vitamin K, fresh frozen plasma |
| Dabigatrin Etexelate | Direct thrombin inhibitor Metabolism takes longer in elderly and renal failure pts Treat deep venous thrombosis, PE, atrial fibrillation, prophylaxis after surgery Premature discontinuation=thrombosis, spinal/epidural hematoma with spinal procedures. GI symptoms common |
| IdarCIZUmab | Monoclonal antibody Binds and inhibits Dabigatrin Rapid effects, highly specific |
| Rivaroxaban | Factor Xa inhibitor Longer 1/2 life in elderly Does not inhibit thrombin Treat deep venous thrombosis, PE, atrial fibrillation. Similar side effects to Dabigatrin |
| Andexanet | Inhibits rivaroxaban |
| Alteplase | Activates fibrin bound plasminogen to plasmin Dissolves clots |
| Aminocaproic acid | Inhibits fibrinolysis by inhibiting plasminogen |
| Factor VIII | Treat factor VIII deficiency (hemophilia type A) Derived from donor plasma screened for blood-borne pathogens |
| Factor IX | Treat factor IX deficiency (hemophilia type B) |
| Sodium Bicarbonate | Neutralizing agent Produces CO2, may cause stomach distension Well absorbed, may cause alkalosis and exacerbate fluid retention (CHF, hypertension, renal insufficiency) Can raise urine pH |
| Calcium Carbonate | Neutralizing agent Produces CO2 Can cause metabolic alkalosis, if taken with milk can cause alkalosis, renal insufficiency, and hypercalcemia Can raise urine pH |
| Aluminum Hydroxide | Neutralizing agent Does not produce CO2, poorly absorbed, can cause constipation Can complex with other drugs, decrease efficacy Typically given with magnesium hydroxide |
| Magnesium hydroxide | Neutralizing agent and osmotic diuretic Does not produce CO2, poorly absorbed, can cause diarrhea. Used for constipation as well, dangerous in renal insufficiency, cardiac disease, electrolyte imbalance Can complex with other drugs, decrease efficacy Typically given with aluminum hydroxide |
| Cemetidine | H2 receptor blocker Inhibits acid secretion, Peptic ulcer and GERD treatment Inhibits CYP450 pathway, adverse effects when taken with other drugs esp. warfarin Exaggerates estrogen effects |
| Ranitidine | H2 receptor blocker Inhibits acid secretion, Peptic ulcer and GERD treatment |
| Famotidine | H2 receptor blocker Inhibits acid secretion, Peptic ulcer and GERD treatment |
| Omeprazole | Proton pump inhibitor (PPI) Activated by protonation, irreversibly inhibits K+/H+ transporters GERD, Ulcer, Zolinger-Ellison syndrome Reduces B12, Mg, and Ca absorption, increases gastric colonization, strongly interferes with CYP2C19, Clopidogrel activation |
| Esmoprazole | Proton pump inhibitor (PPI) Activated by protonation, irreversibly inhibits K+/H+ transporters GERD, Ulcer, Zolinger-Ellison syndrome Reduces B12, Mg, and Ca absorption, increases gastric colonization, strongly interferes with CYP2C19, Clopidogrel activation |
| Lansoprazole | Proton pump inhibitor (PPI) Activated by protonation, irreversibly inhibits K+/H+ transporters GERD, Ulcer, Zolinger-Ellison syndrome Reduces B12, Mg, and Ca absorption, increases gastric colonization, interferes with CYP2C19, Clopidogrel activation |
| Dexlansoprazole | Proton pump inhibitor (PPI) Activated by protonation, irreversibly inhibits K+/H+ transporters GERD, Ulcer, Zolinger-Ellison syndrome Reduces B12, Mg, and Ca absorption, increases gastric colonization, interferes with CYP2C19, Clopidogrel activation |
| Pantoprazole | Proton pump inhibitor (PPI) Activated by protonation, irreversibly inhibits K+/H+ transporters GERD, Ulcer, Zolinger-Ellison syndrome Reduces B12, Mg, and Ca absorption, increases gastric colonization, weakly interferes with CYP2C19, Clopidogrel activation |
| Sucralfate | Cytoprotective Forms sticky material in stomach, binds to and protects ulcers May cause constipation, reduce efficacy of some drugs |
| Misoprostol | Cytoprotective agent Prostaglandin analogue, stimulates mucus production Severe side effects, diarrhea, cramping, uterine contractions and abortion. Rarely used |
| Colloidal Bismuth Compounds | Cytoprotective agent Coats stomach, kills H. pylori Blackens stool, can cause Reye's syndrome |
| Fiber | Bulk Forming Laxative Distends colon, forms gel Prevents colon cancer Can cause constipation with inadequate water intake May cause bloating, flatulence |
| (Carboxy)methylcellulose | Bulk Forming Laxative Distends colon, forms gel Synthetic cellulose derivative Can cause constipation with inadequate water intake |
| Polycarbophil | Bulk Forming Laxative Distends colon, forms gel Can cause constipation with inadequate water intake insoluble, hydrophilic, polyacrylic resin |
| Docusate | Stool Softener Detergent effect, stimulates fluid/electrolyte secretion Used for hospitalized patients Low efficacy Increases drug absorption |
| Mineral oil | Stool softener Penetrates/softens stool, prevents water absorption Treats fecal impaction Lipid pneumonitis, reduced soluble vitamin absorption (ADEK), anal leakage possible side effects |
| Polyethelene glycol | Osmotic laxative Colonic cleansing prior to endoscopic, surgical, radiological procedures Nausea, cramping, bloating |
| Sodium phosphate | Osmotic laxative Not recommended to use with constipation, phosphate can cause nephropathy Contraindicated in elderly, bowel pathology, renal insufficiency |
| Lactulose, Sorbitol, Mannitol | Osmotic Laxatives Abdominal discomfort/flatulence common, resolve with extended use |
| Phenolphthalein | Stimulant Laxative Inhibits water absorption, promotes peristalsis Systemic effects similar to lupus, fluid and electrolyte imbalances, turns urine red Possible carcinogen, no longer on market |
| Bisacodyl | Stimulant Laxative Treats constipation, cleanses colon prior to colonoscopy Risk of colon inflammation, ischemia, and atonic colon (use no more than 10 days) |
| Anthraquine derivatives | Stimulant Laxative Nausea and cramping Potential carcinogen, can cause colon to turn brown Can't be marketed as a laxitive |
| Castor Oil | Stimulant Laxative Stimulates peristalsis and water secretion Intense, painful, watery evacuation very rapidly. Potentially toxic |
| Bethanechol | Prokinetic agent Stimulates M3 receptors Treat postoperative ileus, esophageal sphincter tone Cramping, diarrhea, salivation, sweating, urinary incontinence |
| Neostigmine | Prokinetic agent Acetylcholinesterase inhibitor Enhances gastric emptying, treat Ogilvie's disease in children Cholinergic side effects (DUMBELS) |
| Metoclopramide | Prokinetic agent Dopamine, 5-HT3 antagonist, 5-HT4 agonist Enhances upper GI motility/tone, antiemetic effect Parkinson's, dystonia, extrapyramidal side effects |
| Cisapride | Prokinetic agent 5-HT3/4 antagonist Similar to metoclopramide, but no antiemetic/parkinsonian effects Can cause severe arrhythmias with other drugs, withdrawn from market |
| Erythromicin | Prokinetic agent Treats diabetic gastroparesis, upper GI hemorrhage emptying prior to surgery Can cause small intestine cramping |
| Methylnatrexone | Prokinetic agent Mu-receptor antagonist (GI only) Treat constipation in chronically ill treated with opioids |
| Alvimopan | Prokinetic agent Mu-receptor antagonist (GI only) Treat post-operative ileus Short-term use due to cardiotoxicity |
| Naloxegol | Prokinetic agent Mu-receptor antagonist (GI only) Can cause abdominal pain, diarrhea, nausea, flatulence, vomiting, CYP3A4 inactivation Do not use with other laxatives, try other laxatives first |
| Naldemedine | Prokinetic agent Mu-receptor antagonist (GI only) Can cause abd pain, nausea, diarrhea |
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