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Pharm Study Cards for Droid
Courtesy of Jennifer Neeper (UCLA), Rafael Buerba and Jorge Ramallo (Yale) 
Monoclonal antibody to the platelet glycoprotein IIb/IIIa receptor
that binds fibrin. Used to prevent clotting after coronary
angioplasty and in acute coronary syndrome. Eptifibatide and
tirofiban act similarly
Antipyretic analgesic: very weak cyclooxygenase inhibitor; not
anti-inflammatory. Less GI distress than aspirin but dangerous
in overdose. Tox: hepatic necrosis. Antidote: acetylcysteine.
Diuretic inhibits carbonic anhydrase in the proximal tubule; self-
limited diuresis due to bicarbonate depletion. Used in glaucoma
and mountain sickness. Dorzolamide and brinzolamide used
topically for glaucoma.
Cholinomimetic prototype: transmitter in CNS, ENS, all ANS
ganglia, parasympathetic postganglionic synapses,
sympathetic postganglionic fibers to sweat glands, and skeletal
muscle endplate synapses.
Antiviral: inhibits DNA synthesis in herpes simplex virus (HSV)
and varicella-zoster virus (VZV). Activated by viral thymidine
kinase (TK -  strains are resistant). Tox:  nephrotoxicity
(crystalluria). Famciclovir, penciclovir, and valacyclovir are
similar but with longer half-lives.
Antiarrhythmic: unclassified (miscellaneous group); parenteral
only. Hyperpolarizes AV nodal tissue, blocks conduction for
10–15 s. Used for nodal reentry arrhythmias. Tox:
hypotension, flushing, chest pain
Typical beta-2 agonist; important use in asthma. Tox:
tachycardia, arrhythmias, tremor. Other drugs with similar
action: metaproterenol, salmeterol, terbutaline.
Bisphosphonate; stabilizes bone structure and increases bone
mineral density. Used in postmenopausal and steroid-induced
osteoporosis. Tox:  esophageal ulceration. Other
bisphosphonates (eg, etidronate, pamidronate) are used in
Paget’s disease.
Antigout: suicide inhibitor of xanthine oxidase; reduces
production of uric acid. Used in gout and adjunctively in cancer
Benzodiazepine sedative-hypnotic: used in anxiety states.
Tox:  psychological and physiologic dependence, additive
effects with other CNS depressants.
Alteplase (t-PA)
Thrombolytic: human recombinant tissue plasminogen
activator. Used in acute MI (to recanalize the occluded
coronary artery), pulmonary embolism, stroke. Tox:  bleeding.
K + -sparing diuretic: blocks Na + channels in cortical collecting
tubules. Tox:  hyperkalemia.
Class III (and other classes) antiarrhythmic: broad spectrum;
blocks sodium, potassium, calcium channels, beta receptors.
High efficacy and very long half-life (weeks to months). Tox:
deposits in tissues; skin coloration; hypo- or hyperthyroidism;
pulmonary fibrosis.
Penicillin: wider spectrum than penicillin G with activity similar
to ampicillin but greater oral bioavailability; fewer adverse
effects on GI tract than ampicillin. Susceptible to penicillinases
unless used with clavulanic acid. Tox:  penicillin allergy.
Indirectly acting sympathomimetic: displaces stored
catecholamines in nerve endings. Marked CNS stimulant
actions; high abuse liability. Used in attention deficit
hyperactivity disorder, for short-term weight loss, and for
narcolepsy. Tox:  psychosis, HTN, MI, seizures. Other indirect-
acting sympathomimetics: ephedrine, pseudoephedrine.
Amphotericin B
Antifungal: polyene drug of choice for some systemic mycoses;
binds to ergosterol to disrupt fungal cell membrane
permeability. Tox:  chills and fever, hypotension, nephrotoxicity
(dose limiting; less with liposomal forms).
Penicillin: wider spectrum than penicillin G, susceptible to
penicillinases unless used with sulbactam. Activity similar to
that of penicillin G, plus E coli, H influenzae, P mirabilis,
Shigella. Synergy with aminoglycosides versus Enterococcus
and Listeria. Tox: penicillin allergy; more adverse effects on GI
tract than other penicillins; maculopapular skin rash.
Prototype aromatase inhibitor used in estrogen-dependent
cancers (eg, breast cancer). Letrozole is similar.
NSAID prototype: inhibits cyclooxygenase (COX)-1 and -2
irreversibly. Antiplatelet agent as well as antipyretic, analgesic
and anti-inflammatory drug. Tox: GI ulcers, allergy,
bronchoconstriction, salicylism. Other NSAIDs: ibuprofen,
indomethacin, ketorolac, naproxen, and piroxicam
Beta 1  selective blocker: low lipid solubility, less CNS effect;
used for HTN. (Names of b 1  selective blockers start with A
through M except for carteolol, carvedilol, and labetalol.)
Tox:  asthma, bradycardia, AV block, heart failure.
Muscarinic cholinoceptor blocker prototype: lipid-soluble, CNS
effects. Tox:  “red as a beet, dry as a bone, blind as a bat, mad
as a hatter,” urinary retention, mydriasis.
Macrolide antibiotic: similar to erythromycin but greater
activity against H influenzaenfluenzae,,  chlamydiae, and
streptococci; long half-life because of tissue accumulation;
renal elimination. Tox:  GI distress but no inhibition of drug
metabolism. Clarithromyin is similar but has a shorter half-life,
inhibits drug metabolism, and is contraindicated in pregnancy.
GABA analog, orally active: spasmolytic; activates GABA- B
receptors in the spinal cord.
Centrally acting antimuscarinic prototype for parkinsonism.
Tox:  excess antimuscarinic effects.
Toxins produced by Clostridium botulinum ;  enzymes that
cleave nerve terminal proteins (synaptobrevin, others) and
block release of acetylcholine from vesicles. Injected to treat
dystonia, smooth wrinkles, and reduce excessive sweating.
Tox:  neuromuscular paralysis.
Ergot derivative: prototype dopamine agonist in CNS; inhibits
prolactin release. Alternative drug in parkinsonism and
hyperprolactinemia. Tox:  CNS, dyskinesias, hypotension.
Pergolide is similar.
Long-acting amide local anesthetic prototype: Tox:  greater
cardiovascular toxicity than most local anesthetics.
Anxiolytic: partial agonist that interacts with 5-HT 1A  receptors;
slow onset (1–2 weeks). Minimal potentiation of CNS
depressants, including ethanol; negligible abuse liability.
Angiotensin-converting enzyme (ACE) inhibitor prototype: used
in HTN, diabetic nephropathy, and CHF. Tox:  hyperkalemia,
fetal renal damage, cough (“sore throat”). Other “prils” include
benzepril, enalapril, lisinopril, quinapril.
Anticonvulsant: used for tonic-clonic and partial seizures;
blocks Na +  channels in neuronal membranes. Drug of choice
for trigeminal neuralgia; backup drug in bipolar disorder. Tox:
CNS depression, myelotoxic, induces liver drug-metabolizing
enzymes, teratogenicity.
Adrenoceptor blocker: racemic mixture, one isomer a
nonselective b-blocker and the other an a 1  blocker. Possible
antioxidant actions. Prolongs survival in CHF. Tox:
cardiovascular depression. Labetalol is similar.
First-generation cephalosporin prototype: bactericidal beta-
lactam inhibitor of cell wall synthesis. Active against gram-
positive cocci, E coli, K pneumoniae,  but does not enter CSF.
Tox:  potential allergy; partial cross-reactivity with penicillins.
Second-generation cephalosporin: active against a wide
spectrum of gram-negative bacteria, including anaerobes (B
fragilis ). Does not enter the CNS. Cefotetan is similar.
Third-generation cephalosporin: active against many bacteria,
including pneumococci, gonococci (a drug of choice), and gram-
negative rods. Enters the CNS and is used in bacterial
meningitis. Cefotaxime and ceftazidime are other third-
generation cephalosporins.
Selective COX-2 inhibitor: acts mainly on enzymes of cells
involved in inflammation. Used in rheumatoid arthritis and other
inflammatory disorders. Tox:  GI toxicity, but less than that of
aspirin and other NSAIDs; nephrotoxicity similar to other
NSAIDs, increased risk of CV events. Rofecoxib is similar.
Antibiotic: broad-spectrum agent; inhibits protein synthesis
(50S); uses restricted to backup drug for bacterial meningitis,
infections due to anaerobes, Salmonella.  Tox:  reversible
myelosuppression, aplastic anemia, gray baby syndrome.
Antimalarial: used for treatment and as a chemosuppressant
where P falciparum  is susceptible. Binds to hemin, causing
dysfunctional cell membranes; resistance resulting from efflux
via P-glycoprotein pump. Tox:  GI distress, skin rash at low
doses; peripheral neuropathy, auditory and visual impairment,
quinidine-like cardiotoxicity at high doses.
Antihistamine first-generation H 1  blocker prototype: Tox:  mild
sedation, little antimuscarinic action.
Phenothiazine antipsychotic : blocks D2 dopamine receptors. Tox:
atropine-like, EPS dysfunction, hyperprolactinemia, postural hypotension,
sedation, seizures (in OD), additive effects with other CNS depressants.
Other phenothiazines: fluphenazine and trifluoperazine
(antipsychotics), prochlorperazine (antiemetic), promethazine
(preoperative sedation)
Bile acid-binding resin: sequesters bile acids in gut and diverts
more cholesterol from the liver to bile acids instead of
circulating lipoproteins. Tox:  constipation, bloating; interferes
with absorption of some drugs. Colestipol is similar.
H 2  blocker prototype: used in acid-peptic disease. Tox:  inhibits
hepatic drug metabolism; antiandrogen effects. Less toxic
analogs: ranitidine, famotidine, nizatidine.
Second-generation fluoroquinolone antibiotic: bactericidal
inhibitor of topoisomerases; active against E coli, H influenzae,
Enterobacter, Pseudomonas, Shigella. Tox: CNS dysfunction,
GI distress collagen dysfunction (avoid in children and pregnant
women). Interactions: inhibits metabolism of caffeine,
theophylline, warfarin.
Platinum-containing alkylating anticancer drug. Used for solid
tumors (eg, testes, lung). Tox:  Neurotoxic and nephrotoxic.
Carboplatin is similar.
Lincosamide antibiotic: bacteriostatic inhibitor of protein
synthesis (50S); active against gram-positive cocci, B fragilis.
Tox:  GI distress, pseudomembranous colitis.
Tissue-selective estrogen receptor antagonist: synthetic, used
in infertility to induce ovulation by blocking pituitary estrogen
receptors. May result in multiple births.
Alpha2 agonist: acts centrally to reduce SANS outflow, lowers
BP. Used in HTN and in drug dependency states. Tox: mild
sedation, rebound HTN if stopped suddenly.
Blocks platelet ADP receptors irreversibly and inhibits platelet
aggregation. Used in transient ischemic attacks and to prevent
strokes and restenosis after placement of coronary stents.
Tox:  bleeding, neutropenia. Ticlopidine similar, but higher risk
of neutropenia and thrombotic thrombocytopenic purpura
Atypical antipsychotic: low affinity for dopamine D2 receptors,
higher for D4 and 5-HT2A receptors; fewer EPS adverse
effects than other antipsychotic drugs. Tox: ANS effects,
agranulocytosis (infrequent but significant).
Indirectly acting sympathomimetic: blocks amine reuptake into
nerve endings. Local anesthetic (ester type). Marked CNS
stimulation, euphoria; high abuse and dependence liability.
Tox: psychosis, cardiac arrhythmias, seizures.
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