allopurinol
inhibits xanthine oxidase
isoniazid
B6 pyridozine deficiency leading to peripheral neuropathy and sideroblastic anermiaMOA nicotinic acid derivative that inhibits synthesis of mycolic acid in mycobacterial cell wall
succinylcholine
depolarizing agent/muscle relaxant during sugerybinds to nicotinic receptors in skeletal muscle causing persistent depolarizaiotn at motor end platehydrolyzes plasma cholinesteraseinitial fasciculations followed by muscle paralysisduration of action 5-10mineffects not reversed by cholinesterase inhibitors, no pharmacologic antidote to overdosesoem 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 cellsactivates cGMP - which inactivates myosin light chain kinase in sm muscle cells leading to vasodilationAch 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 effectrenal papillary necrosis
methotrexate
blocks dihydrofolate reductase, S phase inhibitorleucovorin rescueside 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 craterstimulates 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 permeabilitynystatin has same mechanism
clotrimazole
inhibits ergosterol synthesissother 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 diseaseonly drug that can be used in pregnancyside affect - agranulocytosis
fastest drugs that increases HR in shock
isoproterenoldobutamindopamine - in low dose best for renal vasodilation
dapsone
sulfone that inhibits synthesis of folic acid by M lepraeside effects hemolytic anemia in G6PD pts methemoglobinemia nephrotic syndrome peripheral neuropathy
prolong QRS
quinidine
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 antagonistuseful in bocking chemoreceptor trigger zone nausea in the area postrema
opioid overdose
respiratory depression - respiratory acidosismiotic pupils - pin point
alcoholic in ER
IV thiamine to prevent acute wernickes encephalopathy
heparin
mcc of thombocytopenia in hospitalMOA - binds antithrombin III catalyzing inactivation of thrombin and other clotting factors
coumadin overdose
fresh frozen plasma if seriousIM vitamin K for less serious bleeds
nitrofurantoin
concentrated in urineurinary tract antiseptic
cyclophosphamide
activated in the liverside effects hemorrhagic cystitis transitional cell carcinoma
doxorubicin and prednisone
metabolized in the liver
gout after cancer therapy
prevent by giving allopurinol - xanthine oxidase inhibitordanger 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 moderatecorticosteroid inhaler nextthen add long acting B2 agonist
paroxysmal supraventricular tachycardia
tx adenosineincluding 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 bradykininbradykinin side effects - cough and angioedema
hydralazine
HTN tx during pregnancybetter tolerated in fast acetylatorscause of drug induced SLE - antihistone antibodies . ( also procainamide)
HTN, Hypernatremia and hypokalemia
tx: ARB - losartan a AT II receptor antagonist ....blocks aldoblocking 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 prostateprazosin, terazosin
saw palmetto
antiandrogen effect - blocks androgen uptake and availability without alerting serum levels, shrinks transitional zone of prostate around urethra
narcolepsy
amphetamines
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)