H2 Receptor Antagonist
Cimetidine
Proton Pump Inhibitors
Drugs that end in "-prazole
Prostaglandins
Misoprostol
Mucosal Protective Agents
Carafate
Phenothiazines
Phenergan
5-HT3 Receptor Antagonists
Zofran
Substituted Benzamides
Reglan
Butyrophenones
Drugs that end in "Peridol
Benzodiazepines
Xanax
Substance P/Neurokinin 1 Receptor Antagonist
Aprepitant
Antidiarrheals
Diphenoxylate
Adsorbents
Methlcellulose
Stimulant Laxatives
SennaCastor OilBisacodyl
Stool Softners
Docusate SodiumDocusate Calcium
Lubricant Laxatives
Mineral OilGlycerin Suppositories
Chloride Channel Activators
Lubiprostone
Opioid Induced Constipation Drugs
Naloxegol (Movantik)
COX-1 Inhibitors
Aspirin
ADP Inhibitors
Plavix
Direct Thrombin Inhibitors
HeparinPradaxaArgatroban
Indirect Thrombin Inhibitors
LovenoxXareltoArixtra
Vitamin K Antagonsit
Warfarin
Thrombolytics
AlteplaseTNKase
ACTH
CorticotropinCosyntropin
GH
Somatropin
Somatostatins
SandostatinSomavert
GNRH
Leuprolide (Lupron)Goserelin (Zoladex)Nafarelin (Synarel)Histrelin (Vantas)
ADH
Vasopressin (Pitressin)Desmopressin (DDVAP)
Adrenal corticosteroids
Dexamethasone (Decadron)
Aldosterone Antagonists
Spironolactone (Aldactone)Eplerenone (Inspra)Ketoconazole (Nizoral)
Androgen Antagonists
Flutamide (Eulexin)Finasteride (Proscar, Propecia)
Thyroid Hormone Replacements
LevothyroxineThyroglobulin
Rapid-acting Insulin
Insulin Aspart
Short-acting insulin
Regular insulin
Intermediate-acting insulin
Insulin NPH
Long-acting insulin
Insulin glargineInsulin degludec
Inhalation insulin
Afrezza
Non-insulin injection
Amylin AnalogIncretin Mimetics
Sulfonylureas
GlyburideGlipizide
Biguanides
Metformin
Dipeptidyl-peptodase-4 Inhibitors
Januvia
SGLT2 Inhibitors
Invokana
Preferential COX-2
Meloxicam (Mobic)Etodolac
Uricosuric Medications
Probenecid
Xanthine Oxidase Inhibitors
Allopurinol (Zyloprim)Febuxostat (Uloric)
5-HT1D Receptor Agonists (Serotonin Agonists)
TriptansDihydroergotamine
Calcitonin-Gene-Related Peptide Antagonists
Erenumab (Aimovig)
H1 Antihistamines - 1st Generation
BenadrylHydroxyzine (Atarax, Vistaril)
H1 Antihistamines - 2nd Generation
ClaritinAllegra
Calcineurin Inhibitors
CyclosporineTacrolimus
Costimulation Blockers
Belatacept
mTOR inhibitors
SirolimusEverolimus
Immunosuppressive Antimetabolites
Azathioprine (Imuran)Mycophenolate Mofetil (Cellcept)Mycophenolate Sodium (Myfortic)
Antibodies
Antithymocyte GlobulinsBasiliximab
Selective Estrogen Receptor Antagonists
TamoxifenRaloxifeneClomiphene
Biphosphates
Alendronate
Recombinant PTH
Teriparatide (Forteo)
Anorexiants
Phentermine, Diethypropion
Lipase Inhibitors
Orlistat
Phosphodiesterase-5 Inhibitors
Drugs that end in "-afil
5a Reductase Inhibitors
Drugs that end in "-steride
Retinoids - 1st generation
TretinoinIsotretinoin
Retinoids - 3rd generation
Adapalene, Tazarotene
Docusate sodium & Docusate calcium
Mineral oil
H1 Antihistamines
CNS depressants (including alcohol)MAOIsCholinesterase inhibitors (Especially 1st generation)
Allopurinol (Zyloprim)Febuxostat (Uloric)
6-mercaptopurineAzathioprineTheophylline
Phosphodiesterase-5 Inhibitors
Organic nitrates (nitroglycerin, isosorbide)Alpha adrenergic antagonists
a1-Adrenergic Antagonists
CYP2D6
Orlistat
Fat-soluble vitaminsAmiodaroneCyclosporineLevothyroxine
Substance P/Neurokinin-1 Receptor Blockers
Other medications metabolized by CYP3A4
Blocks receptors in CTZ, ↑ sensitivity of GI tract to actions of ACh
Metoclopramide (Reglan)
blocks dopamine receptors
Butyrophenones
Broken down into ricinoleic acid
Castor oil
Increase cGMP resulting in chloride and bicarbonate secretion into intestinal lumen
Linaclotide (Linzess)
Inhibition of thromboxane A2 synthesis from arachidonic acid (AA) in platelets
Aspirin
block thyroid hormone release, inhibits thyroid hormone biosynthesis, ↓ size & vascularity of gland
Iodides
Pancreatic islet peptide that decreases postprandial hyperglycemia
Amylin Analog
Activate PPAR gamma receptor to ↓ peripheral insulin resistance
Thiazolidinediones
Slows the inactivation of incretin hormones (works similar to incretin mimetic)
Sitagliptin (Januvia)
TNFα inhibitors ↓ signs and symptoms of RA, ↓ structural damage, and improve physical function
Biologic DMARDS
↓ leukocyte mobility, ↓ phagocytosis in joints, deposition of urate crystals
Colchicine
↑ renal excretion of uric acid by inhibiting renal tubular reabsorption of uric acid in the kidney
Uricosuric Medications(Probenecid)
human monoclonal antibody antagonizes calcitonin gene-related peptide (CGRP) receptor function
Erenumab (Aimovig)
↑ platelet aggregation & vascular tone (vasoconstriction) maintains balance with PGI2
Thromboxane (TXA2)
↓ platelet aggregation and vascular tone (vasodilation)
Prostacyclin (PGI2)
↑ leukocyte chemotaxis and bronchoconstriction
Leukotrienes (LTB, LTC, LTD, etc)
vasodilation, ↑ uterine contractions, ↓ gastric acid secretion, and ↑ gastric mucus production
Prostaglandins (PGE1&2)
↑ uterine contraction, ↑ aqueous humor outflow
PGF2a
After diffusion into T-cell, binds to calcineurin, decreases IL-2
Cyclosporine (Neoral, Sandimmune)
Same as cyclosporine except it binds to FKBP-12 (FK-binding protein)
Tacrolimus
bind to surface of T lymphocytes, antibody-bound cell phagocytosed in the liver and spleen resulting in lymphopenia and impaired t-cell responses
Antithymocyte Globulins (ATGAM, Thymoglobulin)
anti-CD25 antibody binds to the α chain of IL-2 receptor on activated T cells
Basiliximab
Competes with estrogen for receptors in breast tissue
Tamoxifen (Nolvadex)
partial estrogen agonist and interferes with the negative feedback loop of estrogen
Clomiphene (Clomid, Serophene)
Inhibits ovulation, suppresses LH surge. thickens cervical mucus, alters fallopian tube peristalsis
Progestin-only "mini-pills
Decrease osteoclastic bone resorption, resulting in an increase in bone mineral density
Alendronate (Fosamax, Binosto)
Lower estrogen levels after menopause promote proliferation and activation of osteoclasts
Raloxifene (Evista)
↓ bone resorption (less effective than bisphosphonates) for pain associated with osteoporotic fracture
Calcitonin (Fortical, Miacalcin)
Stimulates bone formation by stimulating osteoblastic activity (all others inhibit bone resorption)
Teriparatide (Forteo)
↑ NE and dopamine from nerve terminals and inhibiting reuptake, ↑neurotransmitters in brain
Anorexiants
Pentanoic acid ester that inhibits gastric and pancreatic lipases, ↓ breakdown of dietary fat into smaller molecules
Orlistat
Selectively activates 5-HT2C receptors, ↑ POMC, melanocortin receptor activation
Lorcaserin
↑ nitric oxide, ↑ cGMP = smooth muscle relaxation and inflow of blood to corpus cavernosum
Drugs that end in "-afil
inhibit 5α reductase which converts testosterone to dihydrotestosterone (DHT) (more active)
Drugs that end in "-steride
topical skin whitening agent that inhibits tyrosinase enzyme required for melanin synthesis
Hydroquinone
inhibits cell proliferation and promotes cell differentiation of epithelial cells
Methoxsalen
Inhibit keratinocyte proliferation and ↑ keratinocyte differentiation
Vitamin D Analogs
High levels of DHT cause hair follicle to miniaturize and atrophy
Finasteride (5 α-reductase inhibitor)
Which has opioid-like actions on the gut?
Diphenoxylate
PPI's increase risk of fractures and lower B12 levels
TRUE
Warfarin (Coumadin) requires monitoring of INR levels on a regular basis.
TRUE
Which oral medication class works by slowing the inactivation of incretin hormones?
DPP4 Inhibitors
Which is likely to cause glucose to be present in the urine when taking?
SGLT2 Inhibitors
Low molecular weight heparin
Enoxaparin (Lovenox)
Recombinant versions of tPA and urokinase
Thrombolytics
Most common oral iron supplement - low cost with good effectiveness and tolerability
Ferrous sulfate (Feosol)
20% elemental iron
Ferrous sulfate (Feosol)
12% elemental iron
Ferrous gluconate (Fergon)
used to differentiate between primary and secondary adrenal insufficiency
Corticotropin
used for diagnosis of adrenal insufficiency
Cosyntropin
Major prolactin-inhibiting factor
Dopamine
Insulin typical units?
100 U per mL
Never mix any insulin in the same syringe with what meds?
insulin glargine or insulin detemi
Primary precursor of prostaglandins
arachidonic acid
Commonly used to bridge time until DMARDs are effective
Glucocorticoids
Triple therapy for H. pylori
PPI + amoxicillin + clarithromycinMetronidazole can be used in PCN allergic patientsDo not use single antibiotic therapy
Most antiemetic activity
serotonin antagonistsubstituted benzamidephenothiazine
Least antiemetic activity
antihistamineanticholinergicbenzodiazepine
activation of thrombin and formation of fibrin
Thromboxane A2 (TXA2)
occurs in medium-sized vessels; platelet-rich clots (white clots)
Arterial thrombosis
rich in fibrin with fewer platelets (red clot)
Venous thrombosis
extrinsic pathway is inhibited by?
clotting factor VII
intrinsic pathway is inhibited by?
clotting factor XII
degrades fibrin and dissolves fibrin clots, ↑ blood flow
Plasmin
Necessary for RBC production
Iron, folic acid and vitamin B-12
Inherited red blood cell disorder in which RBCs contain abnormal hemoglobin S that causes them to dehydrate and become hard and sticky and to take on the shape of a farmers' sickle
Sickle cell disease
what increases the amount of hemoglobin F in RBC's?
Hydroxyurea
emergency hypothyroid condition
Myxedema Coma
treatment for thyroid storm
beta-blockers, IV fluids, PTU and Iodides
Results in absolute deficiency of insulinAll patients require insulin
Type 1 Diabetes
mimic pancreatic secretion of insulin throughout the day
Basal
mimic pancreatic response to glucose load (food)
Bolus
What have largely replaced colchicine in the treatment of acute gouty attacks?
NSAIDs
What should you avoid with gout?
AlcoholHigh purine foods - liver, gracy, game meats, herring
Unilateral headache lasting 2-72 hours that is aggravated by physical activity
Migraine without aura
Headache preceded by visual, sensory, and/or speech or motor disturbances
Migraine with aura
headache that is bilateral in band around head
Tension type headache
body's ability to recognize infectious disease and protect the body from them
Immunity
any foreign substance that can stimulate an immune reaction
Antigen (Ag)
Y-shaped protein that binds to antigen marks for phagocytosis, stimulates immune system
Antibody (Ab)
primary cell of immune system that interacts with antigens
Lymphocyte
signals the lymphocyte to reproduce making more of the same Ab specific for that Ag
Ag/Ab Complex
T cell trigger at CD# receptor complex by an antigen on the surface of an antigen-presenting cell
Signal 1
CD80 and CD86 on surface of APC engage CD28 on T-cells
Signal 2
Stimulus for T-cell proliferation
Stimulus 3
progressive loss of bone mass and skeletal fragility
Osteoporosis
bone remodeling that results in disorganized bone formation and enlarged or misshapen bone
Paget Disease
softening of the bones mostly attributed to Vitamin D deficiency (called Rickets in children)
Osteomalacia
cells which break down bone (aka bone resorption)
Osteoclasts
cells which build bones
Osteoblasts
still widely used due to effectiveness & low cost; CNS penetration - Cause sedation
1st generation antihistamines:Diphenhydramine (Benadryl)Hydroxyzine (Atarax, Vistaril)
1st IV maintenance immunosuppressant; dosed in 2 phases
Belatacept (Nulojix)
Mostly replace azathioprine in therapeutic use
Mycophenolate Mofetil (Cellcept) and Mycophenolate Sodium (Myfortic)
most commonly used contraceptive
Synthetic estrogen + synthetic progestin
same tablet taken every day (same strength of estrogen/progestin in each tablet)
Monophasic
tablets alter the strength of progestin to more closely mimic the natural hormone cycle
Triphasic
Used when estrogen is contraindicated
Progestin-only "mini-pills":NorethindroneDrospirenone
more potent and causes greater decrease in DHT than finasteride
Dutasteride
Proton Pump Inhibitors
Gastric ulcers↓ risk of GI bleeds from Aspirin or NSAIDs
Oxytocin
Stimulate uterine contractionsInduction/ reinforcement of labor (IV)Reduction of postpartum bleedingEjection of breast milk (nasal spray)
Desmopressin (DDAVP)
Diabetes InsipidusNocturnal enuresis
Glucocorticoids (Cortisol)
Metabolism action and resistance to stressAnti-inflammatory action
Alprostadil
EDKeep ductus arteriosus open in neonates with congenital heart conditions
Levothyroxine
Hypothyroidism
Methimazole (Tapazole)
Hyperthyroidism
Propylthiouracil (PTU)
Pregnant with hyperthyroidism
Dexamethasone (Decadron)
Cushing's syndrome
Misoprostol
Chronic NSAID useLabor induction
5-HT1D Receptor Agonists
Treatment of acute migraine (not prophylaxis)
Cyclosporine
Prevention of allogeneic transplants
Allopurinol (Zyloprim)
urinary stones or impaired renal function
Tacrolimus
Prevents liver and kidney rejection and treats severe atopic dermatitis
Azathioprine (Imuran)
1st widespread use in organ transplant
Corticosteroids
Mainstay to use once rejection to a transplant is happening
Raloxifene (Evista)
Postmenopausal women intolerant to bisphosphonates Prevention and treatment of osteoporosis
3rd generation retinoids
First-line therapy for comedonal and inflammatory acne
Adrenal corticosteroids
Adrenocortical insufficiencyCushing's syndrome - Dexamethasone (Decadron)
Antithymocyte Globulins (ATGAM, Thymoglobulin)
Used at time of transplantation; prevents allograft rejection or corticosteroid-resistant acute rejection
Argatroban
Prophylaxis or treatment of VTE in patients with HIT
Benzoyl Peroxide
1st line agent for mild to moderate acne with no inflammation
Calcitonin (Fortical, Miacalcin)
osteoporosis in women who are at least 5 years postmenopausal
Colchicine
Recurrent gout attacks
Dabigatran (Pradaxa)
Stroke and systemic embolism with nonvalvular afibCaution in patients >75 years old
Danazol
Endometriosis Fibrocystic breast disease
Dexamethasone
Cushing's syndrome
Estrogens
NEVER use alone unless have had hysterectomyPost-menopausal hormone replacement therapy (HRT)Decrease risk of osteoporosisNOT to be used for prevention of osteoporosis↓ frequency of "hot flashes"Reverses postmenopausal arophy of the vulva, vagina, urethra, and trigone of the bladder
Ferrous sulfate (Feosol)
Most common oral iron supplement
H2 Receptor Antagonists
Aspiration pneumonitisGERD symptom relief, Prophylaxis of ulcer recurrence
Linaclotide (Linzess)
Irritable bowel syndrome with constipationChronic idiopathic constipationDo not use in pediatric patients <6 year of age or with known or suspected mechanical GI obstruction
Lubiprostone (Amitiza)
Chronic idiopathic constipationDo not use with known or suspected mechanical bowel obstruction
Metoclopramide (Reglan)
5HT3 receptor antagonistic effectsOpioid-induced nauseaNausea due to gastroparesis
Methotrexate (MTX)
PsoriasisRA
Mucosal Protective Agents
Duodenal ulcers
Mupirocin Retapamulin
Impetigo
NSAIDs
Inflammation & accompanying pain
Permethrin
lice and scabies
Phentermine and Topiramate (Qsymia)
Long term treatment of obesity
Radioactive Iodides
Do not give anti-thyroid medications afterWait at least 3-7 days to prevent interference
Retinoids
Severe cystic acne
Rivaroxaban (Xarelto)
DVT and PE
Synergized pyrethrins
Pediculosis
Tadalafil
BPH
Thrombolytics
MI, acute ischemic stroke and PE
Xanthine Oxidase Inhibitor
Chronic Gout
Parenteral Iron Therapy
Fe deficiency anemiaUnable to tolerate PO ironDo not respond to PO iron supplementation
H2 Receptor Antagonists
Minimal, but medications that require very acidic gastric environment for absorption
MeglitinidesColchicineWarfarinCimetidine
CYP 450
PPIs
Clopidogrel
Antacids
↓absorption of acidic drugs↑ absorption of basic drugsMetal ions chelate other drugs
Tadalafil
Avanafil
Naloxegol (Movantik)Aprepitant (Emend)Alprostadila1-Adrenergic Antagonists
CYP3A4
Docusate sodium & Docusate calcium
Mineral oil
Aspirin
protein bindingOther antiplateletsEthanol
Warfarin (Coumadin)
Foods high in vitamin K content - dark green leafy veggies
Warfarin (Coumadin)
FAB5 - Flagyl, Fluoroquinolones, Azole Antifungals, Amiodarone, Bactrim
Mucosal Protective Agents
H2 blockersPPIsAntacids
Iron
Fluoroquinolones, Tetracyclines, PhenytoinSeparate the interacting drugs by 2-4 hours
LevothyroxineCyclosporineCimetidine
MANY DRUG INTERACTIONS
NSAIDsIndomethacin (Indocin)
Anticoagulants & AntiplateletsCorticosteroids, bisphosphonatesAntihypertensives
H1 Antihistamines
CNS depressants (including alcohol)MAOIsCholinesterase inhibitors (Especially 1st generation)
Allopurinol (Zyloprim)Febuxostat (Uloric)
6-mercaptopurineAzathioprineTheophylline
Synthetic estrogen + synthetic progestin
AntibioticsBarbituratesBenzodiazepinesPhenytoin (Dilantin)Sulfonamides
Phosphodiesterase-5 Inhibitors
Organic nitrates (nitroglycerin, isosorbide)Alpha adrenergic antagonists
a1-Adrenergic Antagonists
CYP2D6
Mycophenolate Mofetil (Cellcept) Mycophenolate Sodium (Myfortic)
Concomitant admin with antacids (Mg, Al) or cholestyramine
Orlistat
Fat-soluble vitaminsAmiodaroneCyclosporineLevothyroxine
Substance P/Neurokinin-1 Receptor Blockers
Other medications metabolized by CYP3A4