1. Acarbose/Miglitol treatment for type 2 diabetes. inhibitsbreakdown of complex starches toglucose, slows absorption of glucose intothe bloodstream. alpha-glucosidaseinhibitor. AE: flatulence, diarrhea,abdominal pain, should not causehypogylcemia when used asmonotherapy, but if it happens use oralglucose. Caution when using with othermeds that lower glucose bc ofhypoglycemia. monitor renal function. 0.5-0.8% lowering A1C, not used asmonotherapy

2. ACE Inhibitors -hypertension

captopril, lisinopril, ramipril, benazepril.maitenence therapy for CHF.blocks conversion of angiotensin 1 to ii(vasoconstrictor) and suppressesaldosterone, limiting sodium reuptake inthe kidney. treatment of hypertension,CHF, MI. can cause increasing K,hypotension, dizziness, tachycardia,headache, cough, bradykininaccumulation. vision changes. BBW: do notuse 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. B2adrenergic receptoragonist causesbronchodilation. ADEs:vasodilation,tachycardia,palpitations, tremor,CNS, stimulation. onsetof action - 15 min afterinhilation. PO and MDIproducts available.Duration approximately4 hours. for acuteasthma.Levalbuterol/Pirbuterol- MDI form only.

5. Aldosterone receptor antagonist -hypertension

spironolactone,eplerenone. blocksaldosterone binding tospecific renal receptors.spiro is a K sparingdiuretic. hypertension,CHF, edema, hepaticcirrhosis treatment. cancause hyperkalemia.decrease does for renalimpairment.tumorigenic in rats BBW

Pharmacology Exam 2 - MedicationsStudy online at quizlet.com/_14pqx6

6. Alendronate Prevention and treatment of postmenopausal osteoporosis,treatment of glucocorticoid inducedosteoporosis, osteoporosis in men,Paget's disease. Biphosponate drugwhich decreases the rate of boneresorption, leading to indirectincrease in bone mineral density.AE: changes in serum Ca++ andPO4, serious GI side effects, muscle,joint, bone pain, osteonecrosis ofjaw, atypical femur fractures. oraldaily v weekly. avoid in pts whocant sit upright for 30 min, avoid inrenal impairment. food decreasesabsorption. rare reports ofepiscleritis, scleritis, and uveitis

7. alteration of cellmembranepermeability/inhibitionof active transport

most antifungals

8. Aminoglycosides inhibition of bacterial proteinsynthesis by binding principally to30 and 50S ribosomal subunits.bacteriocidal - eventual cell deaththrough cytoplasmic membranedisruption. limited activity againstMSSA but not generally againstgram positive. widely for gramnegative. no activity against a-typical bacteria or anaerobiceffects. gentamicin, tobramycin,neomycin. local irritation. cautionwith MG bc of slight potential forneuromuscular junction blockadeeffe ts. swelling of eyelids, face,appearance of rash

9. Amiodarone Class III- atrial fibrillation andventricular arrhythmias. ADRS:photosensitivity, CNS, GI sxs,thyroid dysfxn, cornealmicrodeposits >90%, visualdisturbances >10%, halo vision,optic neuritis. BBW: pulmonaryfibrosis, hepatotoxicity. interacswith macrolides, quinolones,prolong QTc. oral and parenteral.contains iodine, structurally relatedto thyroxine.

10. amoxicillin effective against streptococci,staphylococci, and listeria.additional effectiveness against afew gram negative rods and cocci.many bacteria have acquiredresistance. oral form only. doesn'twork against pseudomonas. needto be adjusted in renalimpairment.

11. amoxicillin/clavulanate clavulanate added to restoreeffectiveness of amoxicillin againstsome bacteria with resistance.used orally for some strep andstaph, some gram negative rodsand cocci. does not work againstpseudomonas. need to beadjusted in renal impairment.

12. Amphetamines facilitate NE release13. Angiotensin receptor

blockerslosartan, valsartan, irbesartan,candesartan. blocks angiotensin 2 receptor siteto control vasoconstriction.suppresses aldosterone.treatment of hypertension, CHF,MI. hypotension, icreased K,dizziness, conjunctivitis, blurredvision. maitenance therapy forCHF in those who can't toleratecough from ACEI. BBW: Do not usein pregnancy.

14. Asprin/NSAIDS asprin reduces risk of AMI, stroke,and TIAs. both aspirin andNSAIDS are used for anti-pyretic/inflammatory andanalgesic indications. reducesplatelet aggregation via inhibitionof COX 1 and 2 which decreasesthromboxane A2. also inhibitsformation of prostaglandins. livermetabolism. ADEs: GI ulceration,bleeding, may worsen renal fxn.visual disturbances or blurredvision with some NSAIDS. canreduce effects of anti HTN meds.BBW: MI/stroke, GI bleeding. mayincrease bleeding risk/GI effects

15. Atropine causes mydriasis and cycloplegia. used foramblyopia, treatment of anterior uveitis,and to decrease secretions preoperatively.treatment of GI spasm, symptomaticbradychardia and asystole. treatment oforganophosphate poisoning. ADE -excessive cycloplegia/mydriasis, facialflushing, xerostomia, confusion, urinaryretention, tachycardia. Contraindicated forNAG. goes to muscarinic receptor -parasympatholytic.

16. Betaadrenergicblockingagents -hypertension

labetalol, carvedilol, propranolol, sotalol,metoprolol, atenolol. competitive blockadeof B adrenergic receptors. specific for B1 orB1 and B2. inhibit release of renin. someuse for cardiac arrhythmias, anginapectoris, glaucoma, migraine prophylaxis,MI prevention. dryness or eye soreness.orthostatic hypotensio, exacerbatebronchospasm

17. Beta Blockers angina prophylaxis, blocks beta adrenergicreceptors in the heart and smooth muscletissues. 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 - negativechronotropic activity - prevents changesdue to chronic activation of sympathetic NSby decreasing heart rate and inhibitingrelease of rennin. prevents effects of NE oncardiac muscle fibers

18. binding to DNAinterfereingwithreplication

most antivirals

19. Biphosphonatedrugs forosteoporosis

AIR - alendronate, ibandronate,risendronate

20. Bipyridinederivatives -milrinone

inotropic support in acute, decompensatedcongestive heart failure. inhibits enzymebreakdown cAMP, increase in cAMP willincrease Ca uptake. increases cardiaccontractility and vasodilation. PDE3 inhibitorin cardiac and vascular tissue. ADR: HA,worsening of angina. parenteraladministration

21. calciumchannelantagonists

angina prophylaxis. blocks calcium ion flowduring slow channel exchange, maintainingsmooth muscle cells in refractory period fora longer amount of time. ADE's orthostatichypotension, dizziness, transient blindnesswith nifedipine. avoid in heart failure

22. Calcium channelantagonists -hypertension

Nifedipine, diltiazem, amlodipine.blocks calcium influx during slowchannel exchange, dilatesperipheral arterioles,antiarrhythmic properties, also forangina prophylaxis.supraventricular tachycardia.transient blindess rarely reportedwith nifedipine.

23. Canagiflozin (w/met) type 1 or type 2. inhibits sodiumglucose cotransporter 2 in theproximal renal tubules, inhibitingthe reabsorption of filtered glucoseand increasing urinary glucoseexcretion. can contribute todehydration, increase risk of yeastinfections, UTI. can increase LDLcholesterol. renal function andserum electrolytes should bemonitored. contraindicated in ptswith severe renal dysfunction, notrecommended in those with severeliver impairment.

24. Carbonic AnhydraseInhibitors

acetazolamide, brinzolamide,dorzolamide. treatment of: edema,acute mountain sickness, glaucoma.inhibits carbonic anhydrase, lowersIOP. ADR: stomach upset, metabolicacidosis, dehydration. transientmyopia

25. Cefaclor second generation cephalosporin.generally the same gram positivecoverage as first generation but alittle more gram negative coverage.does not cover enterococci orpseudomonas.

26. centrally actingadrenergic nerveblockers -antihypertensive

clonidine, guanabenz, guanfacine.alpha 2 agonists, decreasesympathetic outflow from brain tolower blood pressure. orthostatichypotension, sedation, reboundHTN, blurred vision, conjunctivitis,and dry eye

27. Cephalexin/Cefadroxil first generation. effective againstgram positive, not good for gramnegative. will not cover anaerobicbacteria, pseudomonas orenterococci. many bacteria haveacquired resistance. available in oralform only.

28. Cephalosporins bacteriocidal:inhibit bacterial cellwall synthesis,inhibit bacterialenzymes whichassemblepeptidoglycan.may need to bedose adjusted forrenal impairment.2-10% of ptsallergic topenecillin will alsobe allergic tocephalosporins.allergies occur in5% of pts. fatigue,dizziness, vertigo,HA, rash,exfoliativedermatits, N/V/D,hepatic and renaleffects rare.eosinophilia,thrombocytopenia,neutropenia,leukopenia

29. Cholestyramine/Colesevelam/colestipol used to treatelevated LDLcholesterol. anionexchange processwhich formsinsoluble complexwith bile salts andthen fecallyexcreted - bile acidbinding resin.ADEs: GI problems,gas, constipation,N/V. May decreaseabsorption ofother drugs(statins, warfarin).fat solublevitamins.

30. Cilostazol treatment of intermittentclaudication. phosphodiesterase IIIinhibition. increases cAMP inplatelets and vasculature. Dilatesblood vessels in lower extremities.taking meds with a fatty mealincreases absorption. ADEs:palpitations, headache.Contraindicated in heart failure.Levels increased by macrolides,diltiazem, omeprazole.

31. class 1 antiarrhythmic sodium channel blockade - reducephase 0 slope and peak of actionpotential.A: moderate - increase APD, increasefERPB: weak - reduce APD, decrease ERPC: strong - no effect on APD or ERP

32. class 2 antiarrhythmic beta blockade - block sympatheticactivity and reduce rate andconduction

33. class 3 antiarrhythmic potassium channel blockade - delayrepolarization and thereby increaseaction potential duration andeffective refractory period

34. class 4 antiarrhythmic calcium channel blockade - block Ltype calcium channels - mosteffective at SA and AV nodes; reducerate and conduction

35. Clopidogrel/Prasugrel reduction of thrombotic events postMI and Stroke, acute coronarysyndrome. blocks platelet aggregatioby binding of ADP to receptor onplatelets which inhibits activation ofGP IIb/IIIA receptors. prodrugs thatrequire biotransformation to activemetabolite. ADEs: bleeding, blooddyscrasias, serum cholesterolchanges, nausea. cataracts andconjunctivitis with clopoidogrel.Decreases effect in poormetabolizers for clopidogrel.increased bleeding risk.

36. Cocaine prevents NE uptake37. Commonly used

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

38. Cromolyn prophylaxis of asthma attacks. maitenencetherapy only. mast cell stabilizers preventrelease of histamine. minimal ADEs - throatirritation and unpleasant taste reported.nubulized soln, oral liquid, may take severalweeks to occur. Not effective for treatingattacks.

39. Dabigatran prevention of stroke and emboli in patientswith non-valvur atrial fibrillation. DVT/PEprevention and treatment. reversible directthrombin inhibitor. inhibits free and fibrinbound thrombin. inhibits coagulation bypreventing thrombin mediated effects. oralcapsule with renal dose adjustment needed.ADE: bleeding, GI upset, hematoma, rash,increased ALT. BBW: premature stoppageresults in spinal epidural hematoma.NSAIDS, asprin, some herbs, verapamil,ketoconazole, clarithromycin and otherantiplatelet thrombolytic agents mayincrease anticoagulation. estrogens maydecrease anticoagulation.

40. Dicloxacillin effective against some streptococci andstaphylococci. many bacteria have acquiredresistance, limiting its usefulness. oral formonly. doesnt work against pseudomonas.doesnt need to be adjusted for renalimpairment.

41. Dipyridamole prevention of thromboembolyticcomplications of cardiac valve replacement.phosphodiesterase inhibition. increasecellular cAMP which decreases TXA2 whichdilates coronary arteries. taken orally. ADEs:N/V, dizziness, headache, chest pain, rash,syncope, GI upset. drug may increase theeffects of other anticoagulants andantiplatelet agents.

42. directvasodilators -hypertension

hydralazine, minoxidil. relaxes arterioles,peripheral vasculature, and or smoothmuscles independent of sympathetic effects.usually reserved for hypertensive crisis,accelerated hypertension or advancedcases poorly controlled with other classes.can cause lacrimation.

43. Disopryramide class 1a - atrial arrhythmias and ventriculartachycardia. anticholinergic effects (drymouth, urinary retention, constipation),blurred vision, dry eyes. interacts withmacrolides, quinolones, prolong QTc.available oral only.

44. diuretics -hypertension,edema, CHF

thiazide diuretics currently used as initialmedication for hypertension

45. Dobutamine inotropic support in acute,decompensated heart failure. B1receptor specific agonist. increase forceof contraction and heart rate. ADRs:tachycardia, hypotension, nausea, HA,palpitations, dyspnea, ventriculararrhythmia. parenteral administration.

46. Dofetilide Class III - atrial fibrillation. ADR:proarrhythmic, dizziess, N/D,respiratory tract/flu like, etc. oral formonly

47. Dronedarone class III - persistent or paroxysmal atrialfibrillation. ADR: heart failure,hepatic/renal effects, plumfibrosis, QTcelongation, N/V/D. BBW:contraindicated in symptomatic heartfailure, atrial fibrillation. interact withmacrolines quinolones, prolong QTc.oral form. structuarally related toamiodarone but does not containiodine.

48. drugs actingnonselectively on aadrenergicreceptors -sympathomimetics

norepinephrine

49. drugs acting nonselectively on alladrenergicreceptors -sympathomimetics

epinephrine and ephedrine

50. drugs acting nonselectively on Badrenergicreceptors -sympathomimetics

isoproterenol

51. drugs on B1adrenergicreceptors -sympathomimetics

dobutamine, dopamine,norepinephrine

52. drugs on B2adrenergicreceptors -sympathomimetics

albuterol and terbutaline

53. Estrogen forhormonalreplacement

increased risk of breast cancer andmyocardial infarction when taken withmedroxyprogesterone. inreased risk ofdementia, deep vein thrombosis,pulmonary embolism, stroke, and gallbladder disease. headache, abdominalpain, breast tenderness, irritation, rash, andweight changes. CL intolerance, cornealsteepening, and retinal vascularthrombosis.

54. Estrogen forOralContraceptives

increased risk of stroke, MI, deep veinthrombosis, liver and gall bladder problems.nausea, breast tenderness, breakthroughbleeding, appetite and weight changes. CLintolerance, corneal curvature steepening,cataracts, and optic neuritis.

55. Exenatide type 2 diabetes. glucagon like peptidereceptor agonist to improve pancreatic betacell response, moderate glucagon secretionand slow gastric emptying. AE: avoided inpts with renal insufficiency, sever GIdisease, or gastroparesis, reports ofpancreatitis. dizziness, diarrhea, GI upset,headache, GERD, hypoglycemia. SubQadministration twice daily. not an insulinsubstitute. 1% reduction in A1C

56. ezetimibe hyperlipidemia. inhibits GI cholesterolabsorption, decreases LDL. ADEs: HA,myalgia, hepatic dysfunction, GIdisturbances. Caution in hepaticinsufficiency, increases ALT/AST with statins,may increase cyclosporin levels

57. Fenofibrate hypertriglyceridemia. increased VLDLcatabolism, increased formation of HDL.Derivative of fibric acid = fibrates.

58. Flecainide class 1 c - atrial arrhythmias and refractoryventricular arrythmias. ADR: may worsenarrhythmias, 16% report visualdisturbances, diplopia and blurred vision.oral.

59. Flunisolide/Fluticasone chronic asthma maitenance.decrease inflammation and edemain the respiratory tract. enhancesympathomimetic bronchodilatoractivity. usually does not causesystemic corticosteroid effects.increased risk of oral candidiasis.oral inh and oral. blurred vision,change in IOP

60. Fluoroquinolones inhibitiion of DNA gyrase whichinterferes with bacterialreproduction.effects arebacteriocidal. most are broadspectrum. ciprofloxin, gatifloxacin,moxifloxacin. bacterialconjunctivitis - use for 7 days.corneal ulcers or keratits - use for 5to 14 days. Cross allergy betweenall drugs. may cause whiteprecipitate of active drug at the siteof epithelial defect. renal doseadjustments. photosensitivity,burning/stinging sensation,blurred vision, eye redness andirritation, eye pian, FB sensation,tearing, dry eye. potential cautionwhen taking with blood thinningmeds.

61. Gemibrozil hypertriglyceridemia

62. Glyburide/Glipizide/Glimepiride treatment of type 2diabetes. sulfonylureaagent to stiumulate acuterelease of insulin fromfunctional beta cells. mayincrease insulinsensitivity in cell targets.AE: hypoglycemia, wtgain, hepatic and renalcomplications, blooddyscrasias, GIdisturbances, headache,increased cardiac risk. Ptmonitored for hepaticand renal function -doses reduced in elderlypts. blurred vision andchanges inaccommodation, besteffect as monotherapy1.5% reduction in A1C

63. Glycosides - digoxin used for CHF, atrialfibrilation, atrial flutter.inhibits Na/K ATPasepump and increases CAinflux for inotropicsupport. increasesdiuresis by increasingrenal perfusion. slowsventricular rate in atrialfibrillation by increasingsensitivity of AV nodes tovagal inhibition. ADRs: Gisigns, dizziness, lathargy,blurred or yellow vision.low potassium levels.caution in renalimpairment.

64. Heparin prevention and treatment of venousthrombosis, treatment of pulmonary emboli,acute coronary syndrome, PCI. used duringrenal dialysis and open heart surgery toprevent clotting. potentiates antithrombin IIIand inactivates thrombin and clotting factorsto prevent conversion of fibrinogen to fibrin.IV or SubQ administration. metabolizedhepatically, dosage is regulated and titratedbased on PTT results. ADEs: bleeding,necrosis, thrombocytopenia, hematoma.bleeding risk increased when used withaspirin, NSAIDS, anticoagulants. antibioticscan increase effects. doxy and tetra cyclinesand some antihistamines can decreaseanticoagulant effects. effects reversed byprotamine.

65. HMG-CoAReductaseInhibitors -Statins

hyperlipidemia. inhibit cholesterol synthesis,decreased concentration of cholestoral inhepatic cells, decreases LDL. ADEs: myalgia,diarrhea, rhabdomyolysis, HA, rash, GI upset,dizziness. increased risk of hepatotoxicity andrhabdomyolysis with some other lipidlowering drugs. blurred vision, cataractformation, extraocular muscle movementimpairment, and ophthalmoplegia have beenreported. most reduction in LDL, someincrease in HDL. Decreases triglycerides.

66. Homatropine cycloplegic/mydriatic for refraction, treatmentof acute uveal inflammation. ADE - blurredvision, photophobia, local irritation, increasedIOP. goes to muscarinic receptor -parasympatholytic.

67. Ibandronate/Risendronate prevention and treatement ofpost menopausal osteoporosis.Risedronate treats all kinds.biophosphonate drug whichdecreases the rate of bonereabsorption, leading toindirect increase in bonemineral density. AE: possibleserious GI side effects, possiblesevere muscle, joint and bonepain, osteonecrosis of jaw,atypical femur fractures.Oral/IV dosage. avoid oral in ptswho cant sit upright for 60/30mins. food decreasesabsorption. iritis, ocularirritation, scleritis, and uveitisfor ibandronate.7% incidence of cataractformation for risendronate.

68. Ibutilide Class III - atrial fibrillation andflutter. ADR: may worsenarrhythmias. inpatient IV med.parenteral form only

69. inhibition of cell wallsynthesis

penicillins, cephalosporins,vancomycin, daptomycin

70. inhibition of DNAgyrase orpolymerase

fluoroquinolones

71. inhibition of nucleic acidsynthesis/replication

sulfonamides, metronidazole,tinidazole

72. inhibition of proteinsynthesis via inhibition ofribosomal subunittranscription/translation

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

73. Insulin Aspart onset in 5 to 10 min, peak 1-3hours, lasts for 3-5 hr

74. Insulin Glulisine 10-15 minute onset, peak at 55min, duration 3-5 hours

75. Insulin Lispro onset in 15 min, peak within0.5-1.5 hr, duration 4-5 hours

76. intermediate acting drugsfor diabetes

NPH - onset 1-2 hours, peakafter 6-14 hours, duration 18-24 hours

77. Ipratropium/Tiotropium bronchospasm associated withCOPD in adults - tio formaitenence use. Muscarinicantagonist, reverses AChinduced bronchospasm. cough,dry mouth, and blurred visioncan occur. INH form only. Tioonce daily, longer lasting. Ipraevery 6 hours. Caution in NAG

78. Isosorbide/mononitrate- extended release preps

angina prophylaxis. reducescardiac preload by vasodilationand relieves stress on cardiacwall. ADEs: HA, flushing,orthostatic hypotension,tachycardia, peripheral edema,dizziness, N/V, blurred vision.avoid with phosphodiesteraseinhibitors.

79. Levothyroxine hypothyroidism - supplementa,thyroxine (T4) - converted in theperipheral tissues to T3(triiodothyronine) AE: doserelated. chest pain, diarrhea, legcramps, appetite change,fast/irregular heart rate, tremor,headache, irritability, insomnia,change in sensitivity to heat. slowincrease in dosage helps toprevent adverse effects. food,calcium, aluminum decreasesabsorption. preffered treatmentwith predictable effects. effects oftherapy may take months

80. Lidocaine class 1B - ventricular arrhythmiasonly. ADR: CNS stimulation,paresthesia, disorientation,siezures, coma, diplopia andvisual changes. used parenterallyas IV push or drip. local andtopical anaesthetic.

81. Liraglutide type 2 diabetes, increases glucosedependent insulin secretion,decreases inappropriateglucagon secretion, slows gastricemptying increases B cell growth& replication.Glucagon likepeptide receptor agonist. Thyroidtumor warning, pancreatitiswarning. can cause N/V/D/C,headache, hypoglycemia, rash,and renal problems. SubQ oncedaily. weight loss. 1% reduction inA1C, not recommended as firstline therapy or type 1.

82. longactingdrugs fordiabetes

removes glucose spikes near meals. Insulin Glargine - slow release over 24 hours, nopeak, lasts 24 hoursInsulin Detemir - slow release over 24 hours,peak after 6-8 hours, lasts 12 - 24 hoursdepending on dose per rate

83. Loopdiuretics

furosemide, torsemide. treatment of edema,CHF, hypertension, hypercalcemia. inhibitselectrolyte reabsorption in ascending loop ofHenle. decreases K and Mg, increased bloodglucose levels and uric acid, ototoxicity. blurredvision. used in pts with low GFR, can be usedwith other drugs in hypertensive crisis. crossreactivity with sulfa.

84. Macrolides inhibit protein synthesis by binding to 50Sribosomal subunit. activity against some grampositive backteria (strep, listeria) but resistance isan increasing problem. gram negative (niesseria,catarrhalis, influenzae, legionella). good formycoplasma, chlamydia, rickettsia, and clostridia(not deficile). azithromycin - eyelid infections andchlamydial eye disease. azi doesnt need to bedose adjusted for renal, clarithromycin anderythromycin should be adjusted. hepatits,jaundice, renal complications, GI effects,ototoxicity, allergic reactions. caution with bloodthinning meds. monitor for appearance of superinfection.

85. Metformin treatment of type 2 diabetes - combo drug withglyburide, glipizide, lina-,saxa-, sita, alogliptin,pioglit, rosiglit, repaginide, canagliflozin.potentiates the effect of endogenous insulin.may work by decreasing hepatic glucoseproduction and improving insulin sensitivity.(doesnt promote secretion).AE: N/V/D, flatulence, rash, weakness,hypoglycemia, lactic acidosis, myalgia, blooddyscrasias, chest discomfort.caution with other drugs because ofhypoglycemia. Drug usually discontinued inrenal dysfunction. med held before surgeriesand use of contrast media. Best effect is 1-2%reduction in A1C.

86. Mexiletine class 1 B - ventricular only. ADR: may worsenarrhythmias, hepatic ADEs, CNS effects, blurredvision, nystagmus. oral only.

87. mixtures ofintermediate/rapidacting diabetes drugs

humalog mix - 75% insulin lisproprotamine/25% insulin lisproonset under 30 minutes, peak 1-6.5 hours, duration up to 24 hoursNovolog - 70% insulin aspartprotamine/30% insulin aspart.onset under 30 minutes, peak 1-4hours, effective 15-18 hr, up to 24hours

88. mixtures ofintermediate/shortacting diabetes drugs

humulin - 70% NPH/30% regular. Novalin - 70% NPH/30% regularonset after 30-60 minutes. peak1.5-16 hours. effective 10-16hours, max up to 18-24 hours

89. MOA hormone that controls the storageand metabolism of carbohydrates,protein, and fats. subsitutes forendogenous insulin in patientswith type 1 diabetes, possibly type2. AE: hypoglycemia, weight gain,and rarely edema andlipohypertrophy.

90. Monoamine oxidaseinhibitors

prevent NE biotransformation.

91. Montelukast chronic asthmaprevention/maitenance.leukotriene receptor antagonist,HA, GI puset, increase in liverenzymes. new CNS/psychwarnings. PO forms, once or BID.increase in respiratory infectionsin elderly.

92. Nateglinide/Repaglinide(combo w/ met)

type 2 diabetes. stimulates therelease of insulin from functioningbeta cells. meglitinide derivative.AE: hepatic function impairment,hypoglycemia, upper respiratoryinfections, blood dyscrasias, bloodpressure changes, cardiaccomplications. Not used asmonotherapy. take with or 30 minprior to meal. meds whichincrease blood glucose levels maylessen the efffects

93. Niacin (combo w/statins)

hyperlipidemia. may reduce VLDLsynthesis and increase VLDLcatabolism. Increase HDL. ADEs: HA,itch, flushing, peptic ulcer disease,impair glucose tolerance, increaseinsulin resistence, increase uric acid,hepatotoxicity. blurred vision, cystoidmacular edema, toxic amblyopia.Ethanol can impact liver/HA, flushing.caution with anticoagulants andstatins.

94. Nitrogylcerin sublingual tablets, patches, IV - acuteangina, prophylaxis, unstable angina,heart failure, MI. reduces cardiacpreload by vasodilation and dilateslarge myocardial arteries. relievesstress on myocardial wall. ADEs: HA,flushing, orthostatic hypotension,tachycardia, peripheral edema, N/V,blurred vision. avoid withphosphodiesterase inhibitors.

95. Oral acyclovir andvalacyclovir

herpes zoster. inhibit DNA replication.cross sensitivity occurs. can cause renalfailure. ADEs: blood dyscrasias,coagulation problems, hepaticcomplications, severe skin reactions,visual changes, GI disturbances,headache, encephalopathy, agitation,confusion, dizziness, myalgia,parethesias, liver function. use withcaution and monitoring.

96. Osmotic diuretics mannitol. uses in acute glaucoma,diuresis, reduce intracranial pressure,reduce renal toxicity with some chemodrugs. osmosis effects to inhibit Na andwater absorption. ADR: headache, N/V,dehydration, dizziness. can causeblurred vision. used more for PCOLactions than diuretic. cross reactivitywith sulfa.

97. Parasympatholyticsthat act onmuscarinicreceptors

atropine, scopolamine, homatropine,oxybutinin, flavoxate, tolterodine,benztropine

98. Penicillins inhibit bacterial cell wal synthesis,inhibit bacterial enzymes whichassemble peptidoglycan and activateautolysis. bacteriocidal

99. Phenylephrine induces mydriasis but not cycloplegia.mydriasis prior to ocular surgery. nonprescription strength to relieve eye rednessbut shouldn't be used longer than 72hours. caution if used w/i 21 days of MOAinhibitor. ADEs: increased BP, headache,dizziness. a1 adrenergic receptors -sympathomimetic.

100. Pioglitazone(combo w/met,glimepiride,alogliptin)

treatment of type 2 diabetes. decreasesinsulin resistance at peripheral sites and inthe liver. AE: caution in pts with edema orheart failure due to fluid retention. avoid inhepatic impairment. can cause edema, waitgain, induce CHF, tooth disorders,headache, myalgia, sinusitis, anemia, newerbladder cancer warning. can contribute tohypoglycemia with other drugs. rarereports of decreased VA, macular edema.0.5-1.4% reduction in A1C. used inmonotherapy and in combo

101. Polymyxinand Bacitracin

bacterialcidal agent that works by bindingto cytoplasmic membranes, disrupting thestructure and altering membranepermeability. mostly against gram negativebacteria. Bacitracin works by binding tobacterial cell membranes and interferingwith cell wall synthesis - gram +. not for longterm treatment. local adverse effects

102. PotassiumSparingDiuretics

spironolactone, amiloride, triamterene.treatment of edema, hypertension, cirrhoticascites, CHF. promotes Na excretion, sparesK. Spiro antagonizes aldosterone.ADR:hyperkalemia possible, Na or waterdepeletion. other than spiro, not aseffective as other diuretics when usedalone.

103. Pramlintide type 1 and type 2. slows rate of foodabsorption, modulates gastric emptying.helps prevent post meal rise in bloodglucose and increases satiety. syntheticanalog of amylin. AE: Severe hypoglycemiawith insulin. N/V, abdominal pain,arthralgia, cough, headache, hypoglycemia,fatigue, dizziness. SubQ administrationprior to meals. Contraindicated in pts withgastroparesis.

104. Procainamide class 1A - atrial and ventriculararrhythmias. ADR: can cause arrhythmias,V/B, allergic rxns, hepatic and renal ADEs.BBW: lupus like syndrome, blooddyscrasias. interacts with macrolides,quinolones, prolong QTc. metabolized toNAPA (class III). oral and parenteral formsavailable.

105. Propafenone class 1c - atrial orventricular arrhythmias.ADR: may worsenarrhythmias. blurredvision. oral only.

106. Propranolol/Metoprolol class 11 - sinustachycaardia, atrialarrhythmias. oral andparenteral form.

107. Propylthiouracil/Methimazole hyperthyroidism - inhibitssynthesis of thyroidhormone within thyroidgland. AE: fever, blooddyscrasias, skin rash/itch,arthralgia, peripheralneuropathy, dizziness, lossof taste, N/V, stomach pain,renal and hepaticcomplications. Watch forbleeding episodes. givenin divided doses every 8hours.

108. Rapid acting drugs fordiabetes

take in relation to meal. -log. insulin aspart, insulinispro, insulin glulisine,regular

109. Regular insulin onset 30-60 min, peakafter 2-4 hours, onset 5-7+hours

110. Rivaroxaban/Apixaban prevention of postoperative thromboemboli,prevention of stroke andemboli in patients withnon-valvular atrialfibrillation, treatment ofDVT/PE. inhibits plateletactivation and fibrin clotformation by inhibitingfactor Xz. oral tablet renaladjustment or avoidancewith severe liverimpairment. ADEs:bleeding, GI upset HA.BBW: premature stoppageresults in spinal epiduralhematomas. NSAIDS,aspirin, some herbs,macrolid antibiotics andother antiplatelet agentsmay increase anticoageffect. estrogens maydecrease anticoag effect.

111. Salmeterol(combo w/fluticasone)

maitenence in chronic asthma, COPD. longacting B2 adrengergic receptor agonist. ADE:vasodilation, tachycardia, palpitations,tremor, CNS stimulation, nasopharyngitis,HA, cough. Asthma related death andincreased hospitalization. INH form only -powder. BID - duration is 12 hours. Not foracute attacks.

112. Scopolamine cycloplegia and mydriasis. usedtransdermally to prevent N/V. associatedwith xerostomia, confusion, increased bodytemp, facial flushing, urinary retention,tachycardia. contraindicated in NAG. goes tomuscarinic receptor - . parasympatholytic

113. selectivealphaadrenergicantagoists -hypertension

prazosin, doxazosin. competitve blockade ofalpha 1 receptors. hypertension, dox forBPH. orthostatic hypotension, visionabnormalities (blurred vision), conjunctivitis

114. Sitagliptin/Saxagliptin/Linagliptin(w/met)

type 2 diabetes.inhibitsdipeptidylpeptidase,and enzyme thatbreaks down incretinhormones. increasesin incretins leads to arise in insulin levelsand a correspondingdecrease in bloodglucose levels. usewith caution in ptswith renaldysfunction, monitorfor appearance ofpancreatitis. cancontribute tohypoglycemia. weight gain, upperrespiratory tractinfections, sore throat,diarrhea, headacherash - sitagliptinabdominal pain,peripheral edema,UTI - saxagliptinlinagliptin - type 1 ortype 2

115. Sotalol Class III - used forventriculartachycardia. ADE:proarythmia, fatigue,dyspnea, visualdisturbance in 5% ofpts. BBW: renalimpairment. interactswith macrolides,quinolones, prolongQTc. oral form only.and racemic mixture.

116. Sulfonamides static - structural analogs of PABA thatinhibit bacterial enzyme that formsfolic acid. bacteria cant synthesizeamino acids and DNA. broadspectrum. some resistance.Sulfamethoxazole and trimethoprimmay be very effective against MRSA.used for bacterial conjunctivitis,trachoma, chlamydial. causesstinging/burning, cross reactivity withother sulfa drugs. dermatologic rxnsfrom swelling to hives and rash.

117. sympatholytics - a1 prazocin, terazocin118. sympatholytics - a2 none119. sympatholytics - b1 beta blockers like atenolol that are

cardioselective120. sympatholytics - b2 none121. sympatholytics -

nonselectively on areceptors

phentolamine

122. Sympathomimeticsacting on a2adrenergicreceptors

inhibit NE release in CNS - clonidine,guanfacine, guanabenzlocal vasoconstrictive effects -naphazoline, oxymetazolone

123. Sympathomimeticsthat act on a1adrenergicreceptors

phenylephrine, pseudoephrine

124. symptholytics -non selective

non cardio selective like propranolol

125. Systemiccorticosteroids

acute asthma and COPDexacerbation. decrease inflammationand edema in respiratory tract,enhance sympathomimeticbronchodilator activity. Na+/waterretention, elevate blood glucose, canalter electrolytes, GI irritation, CNSeffects. blurred vision. IOP changes.PO/IV/IM administration. acutesituations, not controlled withbronchodilators. taper as soon aspossible to avoid adrenal suppression.increases IOP, PSC, caution inglaucoma

126. Teriparatide for pts with high risk of fracture; treatmentof post menopausal, glucocorticoidinduced, treatment of primary orhypogonadal in men. parathyroidhormone analog, stimulates osteoblastfunction and can increase bone mineraldensity, mass, and strength. increased riskof osteosarcoma. dont use longer than 2years. subQ. Ocular ADEs - lacrimationand vitreous detachment.

127. Testosterone male hypogonadism, delayed malepuberty. promotes growth anddevelopment of male sex organs indelayed male puberty, maintainssecondary sex characteristics in androgendeficient 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 followingsecondary exposure. Lacrimation, vitreousdetachment.

128. Tetracyclines inhibit bacterial protein synthesis bybinding to 30S ribosomal subunit.bacteriostatic effects against some grampositive. relaible against listeria. somegram negative like neisseria and legionella.mycoplasma, chlamydia and rickettsia.doesnt work against c. difficile.photosensitivity, GI effects (pseudomonascolitis, N/V, abdominal pain) pancreatitis,hepatic effects. avoid use in pregnancyand children

129. Thiazidediuretics

hydrochlorothiazide, metolazone,chlorthalidone. for edema, hypertension,CHF. inhibits Na and Cl reabsorption indistal renal tubule. ADR causes loss of Na,Cl, K, and other electrolytes. increasesblood glucose, cholesterol and uric acidlevels. decreases urinary ca. transientmyopia. caution in pts with diabetes,history of gout, hypercholesterolemia.allergic cross reactivity with sulfa.

130. Tricyclicantidepressants

prevent NE reuptake

131. Trifluridine herpes simplex keratitis andkeratoconjunctivitis. incorporating in place ofthymidine into viral DNA weakening its abilityto infect tissue. kept refrigerated. can causehyperemia, epithelial keratopathy, increasedIO{P, dry eye, irritation. can causeburning/stinging with application

132. Vasodilators- isosorbide,dinatriate,hydralazine

treatment of CHF, angina. increases venouscapacitance/decreases preload. hydralazinedecreases systemic arteriolar resistance,decreases afterload. parenterally indecompensated CHF

133. Verapamil Class IV - atrial flutter and tachycardia, PSVT.ADE: gingival hyperplasia, constipation,headache, plured vision, rotary nystagmus