Pharmacology Exam 2 - Medications

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1.

Acarbose/Miglitol

treatment for type 2 diabetes. inhibits

breakdown of complex starches to
glucose, slows absorption of glucose into
the bloodstream. alpha-glucosidase
inhibitor. AE: flatulence, diarrhea,
abdominal pain, should not cause
hypogylcemia when used as
monotherapy, but if it happens use oral
glucose. Caution when using with other
meds that lower glucose bc of
hypoglycemia. monitor renal function. 0.50.8% lowering A1C, not used as
monotherapy

2.

ACE Inhibitors hypertension

captopril, lisinopril, ramipril, benazepril.

maitenence therapy for CHF.
blocks conversion of angiotensin 1 to ii
(vasoconstrictor) and suppresses
aldosterone, limiting sodium reuptake in
the kidney. treatment of hypertension,
CHF, MI. can cause increasing K,
hypotension, dizziness, tachycardia,
headache, cough, bradykinin
accumulation. vision changes. BBW: do not
use in pregnancy

3.

Adenosine

PSVT, cardiac stress testing. ADE: dyspnea,

flushing, temporary asystole, chest pain.
short duration half life, parenteral form

4.

Albuterol/Levalbuterol/Pirbuterol

asthma, COPD,
emphysema. B2
adrenergic receptor
agonist causes
bronchodilation. ADEs:
vasodilation,
tachycardia,
palpitations, tremor,
CNS, stimulation. onset
of action - 15 min after
inhilation. PO and MDI
products available.
Duration approximately
4 hours. for acute
asthma.
Levalbuterol/Pirbuterol
- MDI form only.

5.

Aldosterone receptor antagonist hypertension

spironolactone,
eplerenone. blocks
aldosterone binding to
specific renal receptors.
spiro is a K sparing
diuretic. hypertension,
CHF, edema, hepatic
cirrhosis treatment. can
cause hyperkalemia.
decrease does for renal
impairment.
tumorigenic in rats BBW

6.

7.

8.

9.

Alendronate

Prevention and treatment of post

menopausal osteoporosis,
treatment of glucocorticoid induced
osteoporosis, osteoporosis in men,
Paget's disease. Biphosponate drug
which decreases the rate of bone
resorption, leading to indirect
increase in bone mineral density.
AE: changes in serum Ca++ and
PO4, serious GI side effects, muscle,
joint, bone pain, osteonecrosis of
jaw, atypical femur fractures. oral
daily v weekly. avoid in pts who
cant sit upright for 30 min, avoid in
renal impairment. food decreases
absorption. rare reports of
episcleritis, scleritis, and uveitis

alteration of cell
membrane
permeability/inhibition
of active transport

most antifungals

Aminoglycosides

inhibition of bacterial protein

synthesis by binding principally to
30 and 50S ribosomal subunits.
bacteriocidal - eventual cell death
through cytoplasmic membrane
disruption. limited activity against
MSSA but not generally against
gram positive. widely for gram
negative. no activity against atypical bacteria or anaerobic
effects. gentamicin, tobramycin,
neomycin. local irritation. caution
with MG bc of slight potential for
neuromuscular junction blockade
effe ts. swelling of eyelids, face,
appearance of rash

Amiodarone

Class III- atrial fibrillation and

ventricular arrhythmias. ADRS:
photosensitivity, CNS, GI sxs,
thyroid dysfxn, corneal
microdeposits >90%, visual
disturbances >10%, halo vision,
optic neuritis. BBW: pulmonary
fibrosis, hepatotoxicity. interacs
with macrolides, quinolones,
prolong QTc. oral and parenteral.
contains iodine, structurally related
to thyroxine.

10.

amoxicillin

effective against streptococci,

staphylococci, and listeria.
additional effectiveness against a
few gram negative rods and cocci.
many bacteria have acquired
resistance. oral form only. doesn't
work against pseudomonas. need
to be adjusted in renal
impairment.

11.

amoxicillin/clavulanate

clavulanate added to restore

effectiveness of amoxicillin against
some bacteria with resistance.
used orally for some strep and
staph, some gram negative rods
and cocci. does not work against
pseudomonas. need to be
adjusted in renal impairment.

12.

Amphetamines

facilitate NE release

13.

Angiotensin receptor
blockers

losartan, valsartan, irbesartan,

candesartan.
blocks angiotensin 2 receptor site
to control vasoconstriction.
suppresses aldosterone.
treatment of hypertension, CHF,
MI. hypotension, icreased K,
dizziness, conjunctivitis, blurred
vision. maitenance therapy for
CHF in those who can't tolerate
cough from ACEI. BBW: Do not use
in pregnancy.

14.

Asprin/NSAIDS

asprin reduces risk of AMI, stroke,

and TIAs. both aspirin and
NSAIDS are used for antipyretic/inflammatory and
analgesic indications. reduces
platelet aggregation via inhibition
of COX 1 and 2 which decreases
thromboxane A2. also inhibits
formation of prostaglandins. liver
metabolism. ADEs: GI ulceration,
bleeding, may worsen renal fxn.
visual disturbances or blurred
vision with some NSAIDS. can
reduce effects of anti HTN meds.
BBW: MI/stroke, GI bleeding. may
increase bleeding risk/GI effects

15.

Atropine

causes mydriasis and cycloplegia. used for

amblyopia, treatment of anterior uveitis,
and to decrease secretions preoperatively.
treatment of GI spasm, symptomatic
bradychardia and asystole. treatment of
organophosphate poisoning. ADE excessive cycloplegia/mydriasis, facial
flushing, xerostomia, confusion, urinary
retention, tachycardia. Contraindicated for
NAG. goes to muscarinic receptor parasympatholytic.

16.

Beta
adrenergic
blocking
agents hypertension

labetalol, carvedilol, propranolol, sotalol,

metoprolol, atenolol. competitive blockade
of B adrenergic receptors. specific for B1 or
B1 and B2. inhibit release of renin. some
use for cardiac arrhythmias, angina
pectoris, glaucoma, migraine prophylaxis,
MI prevention. dryness or eye soreness.
orthostatic hypotensio, exacerbate
bronchospasm

17.

Beta Blockers

angina prophylaxis, blocks beta adrenergic

receptors in the heart and smooth muscle
tissues. ADEs: orthostatic hypotension,
dizziness, can cause dry eye or soreness.
contraindicated in patients with asthma,
DM, severe bradycardia, PVD, and COPD.
maitenence therapy for CHF - negative
chronotropic activity - prevents changes
due to chronic activation of sympathetic NS
by decreasing heart rate and inhibiting
release of rennin. prevents effects of NE on
cardiac muscle fibers

18.

binding to DNA
interfereing
with
replication

most antivirals

19.

Biphosphonate
drugs for
osteoporosis

AIR - alendronate, ibandronate,

risendronate

20.

Bipyridine
derivatives milrinone

inotropic support in acute, decompensated

congestive heart failure. inhibits enzyme
breakdown cAMP, increase in cAMP will
increase Ca uptake. increases cardiac
contractility and vasodilation. PDE3 inhibitor
in cardiac and vascular tissue. ADR: HA,
worsening of angina. parenteral
administration

21.

calcium
channel
antagonists

angina prophylaxis. blocks calcium ion flow

during slow channel exchange, maintaining
smooth muscle cells in refractory period for
a longer amount of time. ADE's orthostatic
hypotension, dizziness, transient blindness
with nifedipine. avoid in heart failure

22.

Calcium channel
antagonists hypertension

Nifedipine, diltiazem, amlodipine.

blocks calcium influx during slow
channel exchange, dilates
peripheral arterioles,
antiarrhythmic properties, also for
angina prophylaxis.
supraventricular tachycardia.
transient blindess rarely reported
with nifedipine.

23.

Canagiflozin (w/met)

type 1 or type 2. inhibits sodium

glucose cotransporter 2 in the
proximal renal tubules, inhibiting
the reabsorption of filtered glucose
and increasing urinary glucose
excretion. can contribute to
dehydration, increase risk of yeast
infections, UTI. can increase LDL
cholesterol. renal function and
serum electrolytes should be
monitored. contraindicated in pts
with severe renal dysfunction, not
recommended in those with severe
liver impairment.

24.

Carbonic Anhydrase
Inhibitors

acetazolamide, brinzolamide,
dorzolamide. treatment of: edema,
acute mountain sickness, glaucoma.
inhibits carbonic anhydrase, lowers
IOP. ADR: stomach upset, metabolic
acidosis, dehydration. transient
myopia

25.

Cefaclor

second generation cephalosporin.

generally the same gram positive
coverage as first generation but a
little more gram negative coverage.
does not cover enterococci or
pseudomonas.

26.

centrally acting
adrenergic nerve
blockers antihypertensive

clonidine, guanabenz, guanfacine.

alpha 2 agonists, decrease
sympathetic outflow from brain to
lower blood pressure. orthostatic
hypotension, sedation, rebound
HTN, blurred vision, conjunctivitis,
and dry eye

27.

Cephalexin/Cefadroxil

first generation. effective against

gram positive, not good for gram
negative. will not cover anaerobic
bacteria, pseudomonas or
enterococci. many bacteria have
acquired resistance. available in oral
form only.

28.

29.

Cephalosporins

Cholestyramine/Colesevelam/colestipol

bacteriocidal:
inhibit bacterial cell
wall synthesis,
inhibit bacterial
enzymes which
assemble
peptidoglycan.
may need to be
dose adjusted for
renal impairment.
2-10% of pts
allergic to
penecillin will also
be allergic to
cephalosporins.
allergies occur in
5% of pts. fatigue,
dizziness, vertigo,
HA, rash,
exfoliative
dermatits, N/V/D,
hepatic and renal
effects rare.
eosinophilia,
thrombocytopenia,
neutropenia,
leukopenia
used to treat
elevated LDL
cholesterol. anion
exchange process
which forms
insoluble complex
with bile salts and
then fecally
excreted - bile acid
binding resin.
ADEs: GI problems,
gas, constipation,
N/V. May decrease
absorption of
other drugs
(statins, warfarin).
fat soluble
vitamins.

30.

Cilostazol

treatment of intermittent
claudication. phosphodiesterase III
inhibition. increases cAMP in
platelets and vasculature. Dilates
blood vessels in lower extremities.
taking meds with a fatty meal
increases absorption. ADEs:
palpitations, headache.
Contraindicated in heart failure.
Levels increased by macrolides,
diltiazem, omeprazole.

31.

class 1 antiarrhythmic

sodium channel blockade - reduce

phase 0 slope and peak of action
potential.
A: moderate - increase APD, increase
fERP
B: weak - reduce APD, decrease ERP
C: strong - no effect on APD or ERP

32.

class 2 antiarrhythmic

beta blockade - block sympathetic

activity and reduce rate and
conduction

33.

class 3 antiarrhythmic

potassium channel blockade - delay

repolarization and thereby increase
action potential duration and
effective refractory period

34.

class 4 antiarrhythmic

calcium channel blockade - block L

type calcium channels - most
effective at SA and AV nodes; reduce
rate and conduction

35.

Clopidogrel/Prasugrel

reduction of thrombotic events post

MI and Stroke, acute coronary
syndrome. blocks platelet aggregatio
by binding of ADP to receptor on
platelets which inhibits activation of
GP IIb/IIIA receptors. prodrugs that
require biotransformation to active
metabolite. ADEs: bleeding, blood
dyscrasias, serum cholesterol
changes, nausea. cataracts and
conjunctivitis with clopoidogrel.
Decreases effect in poor
metabolizers for clopidogrel.
increased bleeding risk.

36.

Cocaine

prevents NE uptake

37.

Commonly used
NSAIDS

diclofenac, indomethacin,
meloxicam, naproxen, bromfenac,
flurbiprofen, ibuprofen, ketorolac,
nepafenac, oxaprozin, sulindac,
piroxicam, nabumetone

38.

Cromolyn

prophylaxis of asthma attacks. maitenence

therapy only. mast cell stabilizers prevent
release of histamine. minimal ADEs - throat
irritation and unpleasant taste reported.
nubulized soln, oral liquid, may take several
weeks to occur. Not effective for treating
attacks.

45.

Dobutamine

inotropic support in acute,

decompensated heart failure. B1
receptor specific agonist. increase force
of contraction and heart rate. ADRs:
tachycardia, hypotension, nausea, HA,
palpitations, dyspnea, ventricular
arrhythmia. parenteral administration.

39.

Dabigatran

prevention of stroke and emboli in patients

with non-valvur atrial fibrillation. DVT/PE
prevention and treatment. reversible direct
thrombin inhibitor. inhibits free and fibrin
bound thrombin. inhibits coagulation by
preventing thrombin mediated effects. oral
capsule with renal dose adjustment needed.
ADE: bleeding, GI upset, hematoma, rash,
increased ALT. BBW: premature stoppage
results in spinal epidural hematoma.
NSAIDS, asprin, some herbs, verapamil,
ketoconazole, clarithromycin and other
antiplatelet thrombolytic agents may
increase anticoagulation. estrogens may
decrease anticoagulation.

46.

Dofetilide

Class III - atrial fibrillation. ADR:

proarrhythmic, dizziess, N/D,
respiratory tract/flu like, etc. oral form
only

47.

Dronedarone

class III - persistent or paroxysmal atrial

fibrillation. ADR: heart failure,
hepatic/renal effects, plumfibrosis, QTc
elongation, N/V/D. BBW:
contraindicated in symptomatic heart
failure, atrial fibrillation. interact with
macrolines quinolones, prolong QTc.
oral form. structuarally related to
amiodarone but does not contain
iodine.

48.

drugs acting
nonselectively on a
adrenergic
receptors sympathomimetics

norepinephrine

49.

drugs acting non

selectively on all
adrenergic
receptors sympathomimetics

epinephrine and ephedrine

50.

drugs acting non

selectively on B
adrenergic
receptors sympathomimetics

isoproterenol

51.

drugs on B1
adrenergic
receptors sympathomimetics

dobutamine, dopamine,
norepinephrine

52.

drugs on B2
adrenergic
receptors sympathomimetics

albuterol and terbutaline

40.

41.

42.

Dicloxacillin

Dipyridamole

direct
vasodilators hypertension

effective against some streptococci and

staphylococci. many bacteria have acquired
resistance, limiting its usefulness. oral form
only. doesnt work against pseudomonas.
doesnt need to be adjusted for renal
impairment.
prevention of thromboembolytic
complications of cardiac valve replacement.
phosphodiesterase inhibition. increase
cellular cAMP which decreases TXA2 which
dilates coronary arteries. taken orally. ADEs:
N/V, dizziness, headache, chest pain, rash,
syncope, GI upset. drug may increase the
effects of other anticoagulants and
antiplatelet agents.
hydralazine, minoxidil. relaxes arterioles,
peripheral vasculature, and or smooth
muscles independent of sympathetic effects.
usually reserved for hypertensive crisis,
accelerated hypertension or advanced
cases poorly controlled with other classes.
can cause lacrimation.

43.

Disopryramide

class 1a - atrial arrhythmias and ventricular

tachycardia. anticholinergic effects (dry
mouth, urinary retention, constipation),
blurred vision, dry eyes. interacts with
macrolides, quinolones, prolong QTc.
available oral only.

44.

diuretics hypertension,
edema, CHF

thiazide diuretics currently used as initial

medication for hypertension

53.

Estrogen for
hormonal
replacement

increased risk of breast cancer and

myocardial infarction when taken with
medroxyprogesterone. inreased risk of
dementia, deep vein thrombosis,
pulmonary embolism, stroke, and gall
bladder disease. headache, abdominal
pain, breast tenderness, irritation, rash, and
weight changes. CL intolerance, corneal
steepening, and retinal vascular
thrombosis.

54.

Estrogen for
Oral
Contraceptives

increased risk of stroke, MI, deep vein

thrombosis, liver and gall bladder problems.
nausea, breast tenderness, breakthrough
bleeding, appetite and weight changes. CL
intolerance, corneal curvature steepening,
cataracts, and optic neuritis.

55.

Exenatide

type 2 diabetes. glucagon like peptide

receptor agonist to improve pancreatic beta
cell response, moderate glucagon secretion
and slow gastric emptying. AE: avoided in
pts with renal insufficiency, sever GI
disease, or gastroparesis, reports of
pancreatitis. dizziness, diarrhea, GI upset,
headache, GERD, hypoglycemia. SubQ
administration twice daily. not an insulin
substitute. 1% reduction in A1C

56.

ezetimibe

hyperlipidemia. inhibits GI cholesterol

absorption, decreases LDL. ADEs: HA,
myalgia, hepatic dysfunction, GI
disturbances. Caution in hepatic
insufficiency, increases ALT/AST with statins,
may increase cyclosporin levels

57.

Fenofibrate

hypertriglyceridemia. increased VLDL

catabolism, increased formation of HDL.
Derivative of fibric acid = fibrates.

58.

Flecainide

class 1 c - atrial arrhythmias and refractory

ventricular arrythmias. ADR: may worsen
arrhythmias, 16% report visual
disturbances, diplopia and blurred vision.
oral.

59.

Flunisolide/Fluticasone

chronic asthma maitenance.

decrease inflammation and edema
in the respiratory tract. enhance
sympathomimetic bronchodilator
activity. usually does not cause
systemic corticosteroid effects.
increased risk of oral candidiasis.
oral inh and oral. blurred vision,
change in IOP

60.

Fluoroquinolones

inhibitiion of DNA gyrase which

interferes with bacterial
reproduction.effects are
bacteriocidal. most are broad
spectrum. ciprofloxin, gatifloxacin,
moxifloxacin. bacterial
conjunctivitis - use for 7 days.
corneal ulcers or keratits - use for 5
to 14 days. Cross allergy between
all drugs. may cause white
precipitate of active drug at the site
of epithelial defect. renal dose
adjustments. photosensitivity,
burning/stinging sensation,
blurred vision, eye redness and
irritation, eye pian, FB sensation,
tearing, dry eye. potential caution
when taking with blood thinning
meds.

61.

Gemibrozil

hypertriglyceridemia

62.

63.

Glyburide/Glipizide/Glimepiride

Glycosides - digoxin

treatment of type 2
diabetes. sulfonylurea
agent to stiumulate acute
release of insulin from
functional beta cells. may
increase insulin
sensitivity in cell targets.
AE: hypoglycemia, wt
gain, hepatic and renal
complications, blood
dyscrasias, GI
disturbances, headache,
increased cardiac risk. Pt
monitored for hepatic
and renal function doses reduced in elderly
pts. blurred vision and
changes in
accommodation, best
effect as monotherapy
1.5% reduction in A1C
used for CHF, atrial
fibrilation, atrial flutter.
inhibits Na/K ATPase
pump and increases CA
influx for inotropic
support. increases
diuresis by increasing
renal perfusion. slows
ventricular rate in atrial
fibrillation by increasing
sensitivity of AV nodes to
vagal inhibition. ADRs: Gi
signs, dizziness, lathargy,
blurred or yellow vision.
low potassium levels.
caution in renal
impairment.

64.

Heparin

prevention and treatment of venous

thrombosis, treatment of pulmonary emboli,
acute coronary syndrome, PCI. used during
renal dialysis and open heart surgery to
prevent clotting. potentiates antithrombin III
and inactivates thrombin and clotting factors
to prevent conversion of fibrinogen to fibrin.
IV or SubQ administration. metabolized
hepatically, dosage is regulated and titrated
based on PTT results. ADEs: bleeding,
necrosis, thrombocytopenia, hematoma.
bleeding risk increased when used with
aspirin, NSAIDS, anticoagulants. antibiotics
can increase effects. doxy and tetra cyclines
and some antihistamines can decrease
anticoagulant effects. effects reversed by
protamine.

65.

HMG-CoA
Reductase
Inhibitors Statins

hyperlipidemia. inhibit cholesterol synthesis,

decreased concentration of cholestoral in
hepatic cells, decreases LDL. ADEs: myalgia,
diarrhea, rhabdomyolysis, HA, rash, GI upset,
dizziness. increased risk of hepatotoxicity and
rhabdomyolysis with some other lipid
lowering drugs. blurred vision, cataract
formation, extraocular muscle movement
impairment, and ophthalmoplegia have been
reported. most reduction in LDL, some
increase in HDL. Decreases triglycerides.

66.

Homatropine

cycloplegic/mydriatic for refraction, treatment

of acute uveal inflammation. ADE - blurred
vision, photophobia, local irritation, increased
IOP. goes to muscarinic receptor parasympatholytic.

67.

Ibandronate/Risendronate

prevention and treatement of

post menopausal osteoporosis.
Risedronate treats all kinds.
biophosphonate drug which
decreases the rate of bone
reabsorption, leading to
indirect increase in bone
mineral density. AE: possible
serious GI side effects, possible
severe muscle, joint and bone
pain, osteonecrosis of jaw,
atypical femur fractures.
Oral/IV dosage. avoid oral in pts
who cant sit upright for 60/30
mins. food decreases
absorption. iritis, ocular
irritation, scleritis, and uveitis
for ibandronate.
7% incidence of cataract
formation for risendronate.

68.

Ibutilide

Class III - atrial fibrillation and

flutter. ADR: may worsen
arrhythmias. inpatient IV med.
parenteral form only

69.

inhibition of cell wall

synthesis

penicillins, cephalosporins,
vancomycin, daptomycin

70.

inhibition of DNAgyrase or
polymerase

fluoroquinolones

71.

inhibition of nucleic acid

synthesis/replication

sulfonamides, metronidazole,
tinidazole

72.

inhibition of protein
synthesis via inhibition of
ribosomal subunit
transcription/translation

macrolides/ketolides,
tetracyclines, glycylcylines,
daptomycin, quinu/dalfo,
aminoglycosides, clindamycin,
linezolid

73.

Insulin Aspart

onset in 5 to 10 min, peak 1-3

hours, lasts for 3-5 hr

74.

Insulin Glulisine

10-15 minute onset, peak at 55

min, duration 3-5 hours

75.

Insulin Lispro

onset in 15 min, peak within

0.5-1.5 hr, duration 4-5 hours

76.

intermediate acting drugs

for diabetes

NPH - onset 1-2 hours, peak

after 6-14 hours, duration 1824 hours

77.

Ipratropium/Tiotropium

bronchospasm associated with

COPD in adults - tio for
maitenence use. Muscarinic
antagonist, reverses ACh
induced bronchospasm. cough,
dry mouth, and blurred vision
can occur. INH form only. Tio
once daily, longer lasting. Ipra
every 6 hours. Caution in NAG

78.

Isosorbide/mononitrate
- extended release preps

angina prophylaxis. reduces

cardiac preload by vasodilation
and relieves stress on cardiac
wall. ADEs: HA, flushing,
orthostatic hypotension,
tachycardia, peripheral edema,
dizziness, N/V, blurred vision.
avoid with phosphodiesterase
inhibitors.

79.

Levothyroxine

hypothyroidism - supplementa,
thyroxine (T4) - converted in the
peripheral tissues to T3
(triiodothyronine) AE: dose
related. chest pain, diarrhea, leg
cramps, appetite change,
fast/irregular heart rate, tremor,
headache, irritability, insomnia,
change in sensitivity to heat. slow
increase in dosage helps to
prevent adverse effects. food,
calcium, aluminum decreases
absorption. preffered treatment
with predictable effects. effects of
therapy may take months

80.

Lidocaine

class 1B - ventricular arrhythmias

only. ADR: CNS stimulation,
paresthesia, disorientation,
siezures, coma, diplopia and
visual changes. used parenterally
as IV push or drip. local and
topical anaesthetic.

81.

Liraglutide

type 2 diabetes, increases glucose

dependent insulin secretion,
decreases inappropriate
glucagon secretion, slows gastric
emptying increases B cell growth
& replication.Glucagon like
peptide receptor agonist. Thyroid
tumor warning, pancreatitis
warning. can cause N/V/D/C,
headache, hypoglycemia, rash,
and renal problems. SubQ once
daily. weight loss. 1% reduction in
A1C, not recommended as first
line therapy or type 1.

82.

long
acting
drugs for
diabetes

removes glucose spikes near meals.

Insulin Glargine - slow release over 24 hours, no
peak, lasts 24 hours
Insulin Detemir - slow release over 24 hours,
peak after 6-8 hours, lasts 12 - 24 hours
depending on dose per rate

83.

Loop
diuretics

furosemide, torsemide. treatment of edema,

CHF, hypertension, hypercalcemia. inhibits
electrolyte reabsorption in ascending loop of
Henle. decreases K and Mg, increased blood
glucose levels and uric acid, ototoxicity. blurred
vision. used in pts with low GFR, can be used
with other drugs in hypertensive crisis. cross
reactivity with sulfa.

84.

85.

86.

Macrolides

Metformin

Mexiletine

inhibit protein synthesis by binding to 50S

ribosomal subunit. activity against some gram
positive backteria (strep, listeria) but resistance is
an increasing problem. gram negative (niesseria,
catarrhalis, influenzae, legionella). good for
mycoplasma, chlamydia, rickettsia, and clostridia
(not deficile). azithromycin - eyelid infections and
chlamydial eye disease. azi doesnt need to be
dose adjusted for renal, clarithromycin and
erythromycin should be adjusted. hepatits,
jaundice, renal complications, GI effects,
ototoxicity, allergic reactions. caution with blood
thinning meds. monitor for appearance of super
infection.
treatment of type 2 diabetes - combo drug with
glyburide, glipizide, lina-,saxa-, sita, alogliptin,
pioglit, rosiglit, repaginide, canagliflozin.
potentiates the effect of endogenous insulin.
may work by decreasing hepatic glucose
production and improving insulin sensitivity.
(doesnt promote secretion).
AE: N/V/D, flatulence, rash, weakness,
hypoglycemia, lactic acidosis, myalgia, blood
dyscrasias, chest discomfort.
caution with other drugs because of
hypoglycemia. Drug usually discontinued in
renal dysfunction. med held before surgeries
and use of contrast media. Best effect is 1-2%
reduction in A1C.
class 1 B - ventricular only. ADR: may worsen
arrhythmias, hepatic ADEs, CNS effects, blurred
vision, nystagmus. oral only.

87.

mixtures of
intermediate/rapid
acting diabetes drugs

humalog mix - 75% insulin lispro

protamine/25% insulin lispro
onset under 30 minutes, peak 16.5 hours, duration up to 24 hours
Novolog - 70% insulin aspart
protamine/30% insulin aspart.
onset under 30 minutes, peak 1-4
hours, effective 15-18 hr, up to 24
hours

88.

mixtures of
intermediate/short
acting diabetes drugs

humulin - 70% NPH/30% regular.

Novalin - 70% NPH/30% regular
onset after 30-60 minutes. peak
1.5-16 hours. effective 10-16
hours, max up to 18-24 hours

89.

MOA

hormone that controls the storage

and metabolism of carbohydrates,
protein, and fats. subsitutes for
endogenous insulin in patients
with type 1 diabetes, possibly type
2. AE: hypoglycemia, weight gain,
and rarely edema and
lipohypertrophy.

90.

Monoamine oxidase
inhibitors

prevent NE biotransformation.

91.

Montelukast

chronic asthma
prevention/maitenance.
leukotriene receptor antagonist,
HA, GI puset, increase in liver
enzymes. new CNS/psych
warnings. PO forms, once or BID.
increase in respiratory infections
in elderly.

92.

Nateglinide/Repaglinide
(combo w/ met)

type 2 diabetes. stimulates the

release of insulin from functioning
beta cells. meglitinide derivative.
AE: hepatic function impairment,
hypoglycemia, upper respiratory
infections, blood dyscrasias, blood
pressure changes, cardiac
complications. Not used as
monotherapy. take with or 30 min
prior to meal. meds which
increase blood glucose levels may
lessen the efffects

93.

94.

95.

96.

Niacin (combo w/
statins)

Nitrogylcerin

Oral acyclovir and

valacyclovir

Osmotic diuretics

hyperlipidemia. may reduce VLDL

synthesis and increase VLDL
catabolism. Increase HDL. ADEs: HA,
itch, flushing, peptic ulcer disease,
impair glucose tolerance, increase
insulin resistence, increase uric acid,
hepatotoxicity. blurred vision, cystoid
macular edema, toxic amblyopia.
Ethanol can impact liver/HA, flushing.
caution with anticoagulants and
statins.
sublingual tablets, patches, IV - acute
angina, prophylaxis, unstable angina,
heart failure, MI. reduces cardiac
preload by vasodilation and dilates
large myocardial arteries. relieves
stress on myocardial wall. ADEs: HA,
flushing, orthostatic hypotension,
tachycardia, peripheral edema, N/V,
blurred vision. avoid with
phosphodiesterase inhibitors.
herpes zoster. inhibit DNA replication.
cross sensitivity occurs. can cause renal
failure. ADEs: blood dyscrasias,
coagulation problems, hepatic
complications, severe skin reactions,
visual changes, GI disturbances,
headache, encephalopathy, agitation,
confusion, dizziness, myalgia,
parethesias, liver function. use with
caution and monitoring.
mannitol. uses in acute glaucoma,
diuresis, reduce intracranial pressure,
reduce renal toxicity with some chemo
drugs. osmosis effects to inhibit Na and
water absorption. ADR: headache, N/V,
dehydration, dizziness. can cause
blurred vision. used more for PCOL
actions than diuretic. cross reactivity
with sulfa.

97.

Parasympatholytics
that act on
muscarinic
receptors

atropine, scopolamine, homatropine,

oxybutinin, flavoxate, tolterodine,
benztropine

98.

Penicillins

inhibit bacterial cell wal synthesis,

inhibit bacterial enzymes which
assemble peptidoglycan and activate
autolysis. bacteriocidal

99.

Phenylephrine

induces mydriasis but not cycloplegia.

mydriasis prior to ocular surgery. non
prescription strength to relieve eye redness
but shouldn't be used longer than 72
hours. caution if used w/i 21 days of MOA
inhibitor. ADEs: increased BP, headache,
dizziness. a1 adrenergic receptors sympathomimetic.

100.

Pioglitazone
(combo w/
met,
glimepiride,
alogliptin)

treatment of type 2 diabetes. decreases

insulin resistance at peripheral sites and in
the liver. AE: caution in pts with edema or
heart failure due to fluid retention. avoid in
hepatic impairment. can cause edema, wait
gain, induce CHF, tooth disorders,
headache, myalgia, sinusitis, anemia, newer
bladder cancer warning. can contribute to
hypoglycemia with other drugs. rare
reports of decreased VA, macular edema.
0.5-1.4% reduction in A1C. used in
monotherapy and in combo

101.

Polymyxin
and Bacitracin

bacterialcidal agent that works by binding

to cytoplasmic membranes, disrupting the
structure and altering membrane
permeability. mostly against gram negative
bacteria. Bacitracin works by binding to
bacterial cell membranes and interfering
with cell wall synthesis - gram +. not for long
term treatment. local adverse effects

102.

Potassium
Sparing
Diuretics

spironolactone, amiloride, triamterene.

treatment of edema, hypertension, cirrhotic
ascites, CHF. promotes Na excretion, spares
K. Spiro antagonizes aldosterone.ADR:
hyperkalemia possible, Na or water
depeletion. other than spiro, not as
effective as other diuretics when used
alone.

103.

Pramlintide

type 1 and type 2. slows rate of food

absorption, modulates gastric emptying.
helps prevent post meal rise in blood
glucose and increases satiety. synthetic
analog of amylin. AE: Severe hypoglycemia
with insulin. N/V, abdominal pain,
arthralgia, cough, headache, hypoglycemia,
fatigue, dizziness. SubQ administration
prior to meals. Contraindicated in pts with
gastroparesis.

104.

Procainamide

class 1A - atrial and ventricular

arrhythmias. ADR: can cause arrhythmias,
V/B, allergic rxns, hepatic and renal ADEs.
BBW: lupus like syndrome, blood
dyscrasias. interacts with macrolides,
quinolones, prolong QTc. metabolized to
NAPA (class III). oral and parenteral forms
available.

105.

Propafenone

class 1c - atrial or
ventricular arrhythmias.
ADR: may worsen
arrhythmias. blurred
vision. oral only.

106.

Propranolol/Metoprolol

class 11 - sinus
tachycaardia, atrial
arrhythmias. oral and
parenteral form.

107.

Propylthiouracil/Methimazole

hyperthyroidism - inhibits
synthesis of thyroid
hormone within thyroid
gland. AE: fever, blood
dyscrasias, skin rash/itch,
arthralgia, peripheral
neuropathy, dizziness, loss
of taste, N/V, stomach pain,
renal and hepatic
complications. Watch for
bleeding episodes. given
in divided doses every 8
hours.

108.

Rapid acting drugs for

diabetes

take in relation to meal. log. insulin aspart, insulin

ispro, insulin glulisine,
regular

109.

Regular insulin

onset 30-60 min, peak

after 2-4 hours, onset 5-7+
hours

110.

Rivaroxaban/Apixaban

prevention of post
operative thromboemboli,
prevention of stroke and
emboli in patients with
non-valvular atrial
fibrillation, treatment of
DVT/PE. inhibits platelet
activation and fibrin clot
formation by inhibiting
factor Xz. oral tablet renal
adjustment or avoidance
with severe liver
impairment. ADEs:
bleeding, GI upset HA.
BBW: premature stoppage
results in spinal epidural
hematomas. NSAIDS,
aspirin, some herbs,
macrolid antibiotics and
other antiplatelet agents
may increase anticoag
effect. estrogens may
decrease anticoag effect.

111.

Salmeterol
(combo w/
fluticasone)

maitenence in chronic asthma, COPD. long

acting B2 adrengergic receptor agonist. ADE:
vasodilation, tachycardia, palpitations,
tremor, CNS stimulation, nasopharyngitis,
HA, cough. Asthma related death and
increased hospitalization. INH form only powder. BID - duration is 12 hours. Not for
acute attacks.

112.

Scopolamine

cycloplegia and mydriasis. used

transdermally to prevent N/V. associated
with xerostomia, confusion, increased body
temp, facial flushing, urinary retention,
tachycardia. contraindicated in NAG. goes to
muscarinic receptor - . parasympatholytic

113.

selective
alpha
adrenergic
antagoists hypertension

prazosin, doxazosin. competitve blockade of

alpha 1 receptors. hypertension, dox for
BPH. orthostatic hypotension, vision
abnormalities (blurred vision), conjunctivitis

114.

115.

Sitagliptin/Saxagliptin/Linagliptin
(w/met)

Sotalol

type 2 diabetes.
inhibits
dipeptidylpeptidase,
and enzyme that
breaks down incretin
hormones. increases
in incretins leads to a
rise in insulin levels
and a corresponding
decrease in blood
glucose levels. use
with caution in pts
with renal
dysfunction, monitor
for appearance of
pancreatitis. can
contribute to
hypoglycemia.
weight gain, upper
respiratory tract
infections, sore throat,
diarrhea, headache
rash - sitagliptin
abdominal pain,
peripheral edema,
UTI - saxagliptin
linagliptin - type 1 or
type 2
Class III - used for
ventricular
tachycardia. ADE:
proarythmia, fatigue,
dyspnea, visual
disturbance in 5% of
pts. BBW: renal
impairment. interacts
with macrolides,
quinolones, prolong
QTc. oral form only.
and racemic mixture.

116.

Sulfonamides

static - structural analogs of PABA that

inhibit bacterial enzyme that forms
folic acid. bacteria cant synthesize
amino acids and DNA. broad
spectrum. some resistance.
Sulfamethoxazole and trimethoprim
may be very effective against MRSA.
used for bacterial conjunctivitis,
trachoma, chlamydial. causes
stinging/burning, cross reactivity with
other sulfa drugs. dermatologic rxns
from swelling to hives and rash.

117.

sympatholytics - a1

prazocin, terazocin

118.

sympatholytics - a2

none

119.

sympatholytics - b1

beta blockers like atenolol that are

cardioselective

120.

sympatholytics - b2

none

121.

sympatholytics nonselectively on a
receptors

phentolamine

122.

Sympathomimetics
acting on a2
adrenergic
receptors

inhibit NE release in CNS - clonidine,

guanfacine, guanabenz
local vasoconstrictive effects naphazoline, oxymetazolone

123.

Sympathomimetics
that act on a1
adrenergic
receptors

phenylephrine, pseudoephrine

124.

symptholytics non selective

non cardio selective like propranolol

125.

Systemic
corticosteroids

acute asthma and COPD

exacerbation. decrease inflammation
and edema in respiratory tract,
enhance sympathomimetic
bronchodilator activity. Na+/water
retention, elevate blood glucose, can
alter electrolytes, GI irritation, CNS
effects. blurred vision. IOP changes.
PO/IV/IM administration. acute
situations, not controlled with
bronchodilators. taper as soon as
possible to avoid adrenal suppression.
increases IOP, PSC, caution in
glaucoma

126.

127.

128.

129.

130.

Teriparatide

Testosterone

Tetracyclines

Thiazide
diuretics

Tricyclic
antidepressants

for pts with high risk of fracture; treatment

of post menopausal, glucocorticoid
induced, treatment of primary or
hypogonadal in men. parathyroid
hormone analog, stimulates osteoblast
function and can increase bone mineral
density, mass, and strength. increased risk
of osteosarcoma. dont use longer than 2
years. subQ. Ocular ADEs - lacrimation
and vitreous detachment.
male hypogonadism, delayed male
puberty. promotes growth and
development of male sex organs in
delayed male puberty, maintains
secondary sex characteristics in androgen
deficient males. AE: deep vein thrombosis,
CNS changes, hirsutism, rash, pruritis,
appetite and weight changes,
hyperlipidemia, prostatic hyperplasia,
prostatic carcinoma, liver dysfunction,
anemia, increased HgB, increased SCr.
Injectable forms, topical patches, pallets,
gels. Virilization of persons following
secondary exposure. Lacrimation, vitreous
detachment.
inhibit bacterial protein synthesis by
binding to 30S ribosomal subunit.
bacteriostatic effects against some gram
positive. relaible against listeria. some
gram negative like neisseria and legionella.
mycoplasma, chlamydia and rickettsia.
doesnt work against c. difficile.
photosensitivity, GI effects (pseudomonas
colitis, N/V, abdominal pain) pancreatitis,
hepatic effects. avoid use in pregnancy
and children
hydrochlorothiazide, metolazone,
chlorthalidone. for edema, hypertension,
CHF. inhibits Na and Cl reabsorption in
distal renal tubule. ADR causes loss of Na,
Cl, K, and other electrolytes. increases
blood glucose, cholesterol and uric acid
levels. decreases urinary ca. transient
myopia. caution in pts with diabetes,
history of gout, hypercholesterolemia.
allergic cross reactivity with sulfa.
prevent NE reuptake

131.

Trifluridine

herpes simplex keratitis and

keratoconjunctivitis. incorporating in place of
thymidine into viral DNA weakening its ability
to infect tissue. kept refrigerated. can cause
hyperemia, epithelial keratopathy, increased
IO{P, dry eye, irritation. can cause
burning/stinging with application

132.

Vasodilators
- isosorbide,
dinatriate,
hydralazine

treatment of CHF, angina. increases venous

capacitance/decreases preload. hydralazine
decreases systemic arteriolar resistance,
decreases afterload. parenterally in
decompensated CHF

133.

Verapamil

Class IV - atrial flutter and tachycardia, PSVT.

ADE: gingival hyperplasia, constipation,
headache, plured vision, rotary nystagmus
<1%. several possible interactions, macrolides
and azole antifungal decrease metabolism,
rifampin decreases serum levels. PO and
pareteral form.

134.

Warfarin

used for DVT, atrial fibrillation, pulmonary

emboli. after heart valve replacement and in
some pts with rheumatic or ischemic heart
disease. interferes with hepatic synthesis of
vitamin K (antagonizes). administered orally,
highly protein bound, long half life,
metabolized hepatically. ADEs: bleeding,
necrosis, GI upset. Effects reversed by use of
vitamin K

135.

Warfarin
drug
interactions

NSAIDS, aspirin, several antibiotics, heparin

and other drugs can increase bleeding risk.
increased intake of green leafy veggies (high
in vitamin K) decreases effect

136.

which
diuretics
cause
transient
myopia?

thiazide, carbonic anhydrase inhibitors.

administered parenterally.

137.

Which meds
have BBW
for causing
spinal
epidural
hematomas?

Dabigatran, Rivaroxaban, Apixaban