Drugs

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nataliekrier
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189342
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Drugs
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2012-12-13 18:34:34
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Cardiac/Pulmonary/PCL Drugs
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  1. Dobutamine
    • B1 adrenergic-agonist; selective
    • MOA: Beta1- increase cAMP, activation of calcium channels; primary cardiovascular effect is a rise in cardiac output as a result of increased myocardial contractility
    • Use: B1- Tx of cardiogenic shock, and HF; tx of cardiac decomposition; help increase CO
  2. Isoproterenol
    • B1&2 Beta-agonist
    • MOA: Beta1- increase cAMP, activation of calcium channels
    • Beta2- increase cAMP [cAMP increases HR and relaxation rate]
    • Use: B1- Tx of cardiogenic shock, and HF.
    • B2- Tx of asthma, emphysema
  3. Terbutaline
    • B2 Beta-agonist
    • MOA: Beta2- increase cAMP [cAMP increases HR and relaxation rate]
    • Use: B2- Tx of asthma, emphysema
  4. Nilrinone
    • Phosphodiesterase
    • MOA: Inhibit phosphodiesterase
    • Use: Tx of HF
    • Adverse Affects: Ventricular dysrhythmias
  5. Dopamine
    • Dopamine agonist
    • MOA: Activates dopanine receptors in renal, mesenteric, and cerebral vasculature; causes vasodilation. Dopamine is a precursor for norepinephrine which activates alpha receptors.
    • Use: dose dependant; Low (dopamine Rs) increased urine output, Mid (dopamine and alpha Rs) increase TPR, CVP, venous tone, High (alpha Rs) increased TPR and pulmonary resistance
  6. Digoxin (foxglove)
    • Cardiac glycosides
    • MOA: Directly inhibit Na-K-ATPase, increasing intracellular Na, reducing transmembrane Na gradient reducing Ca efflux
    • Use: Tx of HF
    • Adverse Affects: Adecreased QT interval, Increased PR interval, ST-segment depression
  7. Propranolol
    • Beta-blockers
    • MOA: Antagonist at B1&2 receptor; noncardioselective
    • Use: Tx of hypertension
    • Adverse affects: Reduced exercise tolerance; bradyarrhythmias; cardiac electrical conduction defects
  8. Nifedipine
    • Dyhidrophyridines
    • Calcium channel blockers
    • MOA: Block inward flow of Ca through the slow channels of the myocytes durring phase 2 (plateau) of cardiac action potential, decreases Ca influx into smooth muscle, decreases CO, TPR, and renal blood flow; most potent vasodilator; blocks the influx of Ca into vascular smooth muscle, reducing contractility
    • Use: Tx of hypertension, vasospastic angina, arrhythmias
    • Adverse affects: Edema, depresses cardiac function, may cause dysrrhythmias
  9. Verapamil
    • Phenylalkylamines
    • Calcium channel blockers
    • MOA: Block inward flow of Ca through the slow channels of the myocytes durring phase 2 (plateau) of cardiac action potential, decreases Ca influx into smooth muscle, decreases CO, TPR, and renal blood flow; suppresses HR, contractility, conduction velocity
    • Use: Tx of hypertension
    • Adverse affects: Edema
  10. Diltiazem
    • Venzothiazepines
    • Calcium channel blockers
    • MOA: Block inward flow of Ca through the slow channels of the myocytes durring phase 2 (plateau) of cardiac action potential, decreases Ca influx into smooth muscle, decreases CO, TPR, and renal blood flow
    • Use: Tx of hypertension
    • Adverse affects: Edema
  11. Levosimendan
    • Calcium sensitizers
    • MOA: Increase cardiac troponin Ca sensitivity, vasodilation by inhibiting PDE-III)
    • Use: Tx of HF
    • Adverse affects: Hypotension, reflex tachycardia
  12. Acetylcholine
    • (Vagas)
    • MOA: M1 & M3 receptors, activates phospholipase, increase IP3, IP3 mediated Ca release from endoplasmic reticulum
  13. Norepinephrine
    • Vasoconstrictor
    • MOA: Agonist at alpha1 adrenergic receptors, increasing smooth muscle contraction; B1&B2 in lungs, increase cAMP, phospholamban phosphorylation, Ca uptake by SR; inhibits release of ACh
    • Use: Tx of life threatening hypotension not caused by hypovolemia, nasal decongestant
    • Adverse affects: Increase cardiac oxygen consumption, last resort for ischemic heart disease
  14. Epinephrine
    • (Adrenal)
    • MOA: B1&B2 in lungs, increase cAMP, phospholamban phosphorylation, Ca uptake by SR; inhibits release of ACh
  15. Noradrenaline
    • Vasoconstrictor
    • MOA: Agonist at alpha1 adrenergic receptors, increasing smooth muscle contraction
    • Use: Tx of life threatening hypotension not caused by hypovolemia, nasal decongestant
    • Adverse affects: Increase cardiac oxygen consumption, last resort for ischemic heart disease
  16. Phenylephrine
    • MOA: Alpha-1 agonist
    • Use: Tx of hypertension and nasal congestion
  17. Yohimbine
    • MOA: Alpha-2 antagonist
    • Use: Tx of erectile dysfunction
  18. Clonidine
    • Sympatholytics
    • MOA: Alpha2 agonist, inhibits vasomotor center in medulla oblongata, reducing sypathetic activity
    • Use: Tx of hypertension
    • Adverse affects: Can constrict corronary vessels; caution with corrinary insuficiency, recent MI, conduction disturbances
  19. Prazosin
    • Alpha-blockers
    • MOA: Alpha1 antagonist, blocks receptor binding sites, causing vasodilation
    • Use: Tx of hypertension
    • Adverse affects: Othrostatic (postural) hypotension
  20. Captopril
    • ACE inhibitors
    • MOA: Inhibits angiotensin converting enzyme (ACE) reducing angiotensin II production, decreasing Na retension and degradation of vasodilatory prostaglandins and Nitric Oxide 
    • Use: Tx of hypertension, CHF, MI
    • Adverse affects: Acute renal failure, cough (due to increased bradykinin in the lungs)
  21. Losartan
    • Angiotensen-II receptor blockers (ARBs)
    • MOA: Antagonist at Ang II receptor
    • Use: Tx of hypertension, CHF
    • Adverse affects: Acute renal failure
  22. Nitroglycerine
    • Nitrate vasodilator
    • MOA: Increases production of nitric oxide, increasing cGMP, which inactivates MLCK in smooth muscle, causing relaxation; decreases resistance resulting in less venous return
    • Use: Tx and prophylaxis of angina, Tx of CHF, MI
    • Adverse affects: Hypotension
  23. Furosemide
    • Diuretics; 1 of 4 subclasses
    • MOA: Increased renal excretion of Na and thus water, reducing plasma volume; loop diuretic
    • Use: Tx of hypertension, edema, CHF, renal failure
    • Adverse affects: Increased excretion of key electrolytes (Na, K, Mg, Ca)
  24. Acetazolamide
    • Diuretics; 1 of 4 subclasses
    • MOA: Increased renal excretion of Na and thus water, reducing plasma volume; carbonic anhydrase inhibitor
    • Use: Tx of hypertension, edema, CHF, renal failure
    • Adverse affects: Increased excretion of key electrolytes (Na, K, Mg, Ca)
  25. Hydroclorothiazide
    • Diuretics; 1 of 4 subclasses
    • MOA: Increased renal excretion of Na and thus water, reducing plasma volume; thyizide
    • Use: Tx of hypertension, edema, CHF, renal failure
    • Adverse affects: Increased excretion of key electrolytes (Na, K, Mg, Ca)
  26. Spironalactone
    • Diuretics; 1 of 4 subclasses
    • MOA: Increased renal excretion of Na and thus water, reducing plasma volume; K-sparing agent
    • Use: Tx of hypertension, edema, CHF, renal failure
    • Adverse affects: Increased excretion of key electrolytes (Na, K, Mg, Ca)
  27. Acebutolol
    MOA: Beta-1 antagonist; partial agonist; cardioselective
  28. Pindolol
    MOA: Beta antagonist; partial agonist; non-cardioselective
  29. Carteolol
    MOA: Beta antagonist; partial agonist; non-cardioselective
  30. Penbutolol
    MOA: Beta antagonist; partial agonist; non-cardioselective
  31. Atenolol
    MOA: Beta-1 antagonist; cardioselective
  32. Carvedilol
    MOA: Beta antagonist; non-cardioselective
  33. Labetolol
    MOA: Beta antagonist; non-cardioselective
  34. Alpha antagonists
    • Prazosin: A1
    • Yohimbine: A2
  35. Alpha agonists
    • Phenylephrine: A1
    • Clonidine: A2
  36. Nadolol
    MOA: Beta antagonist; non-cardioselective
  37. Beta agonists
    • Isoproterenol: B1&2
    • Dobutamine: B1
    • Terbutaline: B2
  38. Phosphodiesterase inhibitors
    Nilrinone
  39. Dopamine agonists
    Dopamine
  40. Cardiac glycosides
    Digoxin (foxglove)
  41. Beta-blockers
    • Cardioselective partial agonists:
    • Acebutolol
    • Non-cardioselective partial agonists:
    • Penbutolol
    • Carteolol
    • Pindolol
    • Cardioselective antagonists:
    • Metoprolol: B1
    • Atenolol
    • Non-cardioselective antagonists:
    • Carvedilol
    • Labetolol
    • Nadolol
    • Propranolol
  42. Calcium channel blockers
    • Dyhidrophyridines: Nifedipine (vasodilator)
    • Phenylalkylamines: Verapamil (suppresses HR, contractility, conduction velocity)
    • Benzothiazepines: Diltiazem
  43. Calcium sensitizers
    Levosimendan
  44. Cholinergic receptor drugs
    • Mecamylamine (nicotinic antagonist)
    • Ambenonium
    • Demecarium
    • Pilocarpine (muscarinic agonist)
    • Atropine (muscarinic antagonist)
    • Tolderodine (muscarinic antagonist)
  45. Vasoconstrictors
    • Norepinephrine
    • Noradrenaline
  46. Sympatholytics
    Clonidine
  47. ACE inhibitors
    Captopril
  48. Angiotensin-II receptor blockers (ARBs)
    Losartan
  49. Nitrate vasodilator
    Nitroglycerine
  50. Diuretics
    • Furosemide (loop diuretic)
    • Acetazolamide (carbonic anhydrase inhibitor)
    • Hydroclorothiazide (thyazide)
    • Spironalactone (K-sparing agent)
  51. Leukotrienes
    MOA: Inflammation mediator that actively constricts smooth muscle
  52. Platelet activating factor
    MOA: Inflammation mediator that actively constricts smooth muscle
  53. Serotonin
    MOA: Inflammation mediator that actively constricts smooth muscle
  54. Histamine
    MOA: Inflammation mediator that actively constricts smooth muscle; edema mediator that increases vascular permeability
  55. Corticosteroids
    • Inhaled and systemic; glucocorticoids and mineralocorticoids
    • Beclomethasone/Beclovent (inhaled)
    • Fluticasone/Flovent (inhaled)
    • Prednisone (systemic)
    • MOA: Anti-inflammatory or block inflammatory mediators; assist inhaled rapid acting bronchodilators used during bronchospasm
    • -Glucocorticoids: Anti-inflammatory
    • --Indications: Inflammatory autoimmune diseases and allergic and asthmatic diseases
    • -Mineralocorticoids: Electrolyte/fluid regulation
    • Use: Long-term control medication to prevent inflammation
  56. Beclomethasone
    Beclovent
    • Corticosteroid, inhaled
    • MOA: Anti-inflammatory or block inflammatory mediators; assist inhaled rapid acting bronchodilators used during bronchospasm
    • Use: Long-term control medication to prevent inflammation
  57. Fluticasone
    Flovent
    • Corticosteroid, inhaled
    • MOA: Anti-inflammatory or block inflammatory mediators; assist inhaled rapid acting bronchodilators used during bronchospasm
    • Use: Long-term control medication to prevent inflammation
  58. Rapidly acting bronchodilators
    • Beta-adreneric agonists: Albuterol/Proventil/Ventolin
    • Anticholinergics: Ipratropium bromide/Atrovent
    • MOA: Rapidly acting bronchodilator
    • Use: Terminate episodes of bronchospasm
  59. Albuterol
    Proventil
    Ventolin
    • Beta-adrenergic agonist
    • MOA: Relax airway smooth muscle via B2-adrenergic receptor
    • Use: Terminate episodes of bronchospasm
  60. Ipratropium bromide
    Atrovent
    • Anticholinergic
    • MOA: Relax airway smooth muscle by blocking muscarinic receptors
    • Use: Terminate episodes of bronchospasm, not effective against allergen- or exercise-induced brochospasm
    • Adverse affects: Can increase mucus viscosity and cause mucus plugging
  61. Long-acting bronchodilators
    • Mediator inhibitors: Cromolyn sodium/Intal
    • Beta-adrenergic agonists: Salmeterol/Serevent
    • Leukotriene antagonists: Zafirlukast/Accolate, Montelukast/Singulair
    • Phosphodiesterase inhibitors: Theophylline/Theo-Dur
    • MOA: Actively dilate airways
    • Use: Long-term control medication to bronchodilate
  62. Cromolyn sodium
    Intal
    • Long-acting bronchodilator, mediator inhibitor
    • MOA: Actively dilate airways, prevent mast cell degranulation (histamine release)
    • Use: Long-term control medication to bronchodilate
  63. Salmeterol
    Serevent
    • Long-acting bronchodilator, beta-adrenergic agonist
    • MOA: Actively dilate airways, relax airway smooth muscle via B2 adrenergic receptor
    • Use: Long-term control medication to bronchodilate
  64. Zafirlukast
    Accolate
    • Long-acting bronchodilator, leukotriene antagonist
    • MOA: Actively dilate airways, block leukotriene receptors
    • Use: Long-term control medication to bronchodilate
  65. Montelukast
    Singulair
    • Long-acting bronchodilator, leukotriene antagonist
    • MOA: Actively dilate airways, block leukotriene receptors
    • Use: Long-term control medication to bronchodilate
  66. Theophylline
    Theo-Dur
    • Long-acting bronchodilator, phosphodiesterase inhibitor
    • MOA: Actively dilate airways, prevent breakdown of cAMP (activated by B2 adrenergic receptor)
    • Use: Long-term control medication to bronchodilate
    • Adverse affects: Require monitoring of plasma levels to prevent toxicity
  67. Prednisone
    • Mineralcorticoid
    • MOA: Decrease inflammation by suppressing the production of inflammatory proteins and increase anti-inflammatory proteins
    • Use: Reduce inflammation
  68. Methotrexate
    • Antineoplastic agent
    • MOA: Inhibits dihydrofolate reductase, which is needed to convert folic acid to tetrahydrofolic acid, which is needed for thymine production
    • -Blocks DNA synthesis (rapidly dividing cells); inhibits purine metabolism (prevents protein expression)
    • Use: Tx of cancer, inflammation due to decrease in cell proliferation; RA (in combo with TNF-alpha blockers) and other inflammatory autoimmune diseases
  69. Ibuprofen
    • NSAID
    • MOA: Inhibits COX-1 and COX-2
    • Use: Inhibit inflammation, reduce pain, fever, and headache
  70. Folic Acid
    • Vitamin B complex (B9)
    • MOA: Needed for precursor for tetraydrofolic acid to be converted to thymine
    • Use: Tx of folate deficiency, megaloblastic anemia (B9 or B12 deficiency)
  71. Glucosamine/Chondroitin
    • Herbal
    • MOA: Increase cartilage rebuilding, may draw fluid into joint
    • Use: Tx of osteoarthritis
  72. Ibuprofen
    • Analgesic, NSAID, propionic acid
    • MOA: Non-steroidal antiinflammatory drug (NSAID) that inhibits prostaglandin synthesis
    • Use: Tx of fever, pain, headache, migraine, arthritisdysmenorrhea
  73. Acetaminophen
    • Antipyretic and analgesic
    • MOA: Unknown, possibly Cox inhibitor (COX-1 and COX-2)
    • Use: Reduce fever and mild pain
  74. Echinacea
    • Herbal
    • MOA: Increase number of phagocytic cells; increase amount of proinflammatory interleukins (IL-1, IL-6, and TNF-alpha)
    • Use: Immune system stimulant
  75. Ferrous Sulfate
    • Iron Preparation
    • MOA: Corrects erythropoietic abnormalities caused by an iron deficiency
    • Use: Prevention and treatment of iron deficiency
  76. Heparin
    • Heparins
    • MOA: Neutralizes thrombin and activated factor X; prevents conversion of fibrinogen to fibrin
    • Use: Prevents DVT and pulmonary embolism, prevents blood clots
  77. Sumatriptan
    • Selective Serotonin Agonist
    • MOA: Binds with high affinity 5-HT type 1-like receptors; may constrict cranial blood vessels or inhibit neurogenic inflammatory processes in the CNS
    • Use: Acute tx of migraine and cluster headaches
  78. Aspirin
    • Salicylates
    • MOA: Inhibits COX-1 and COX-2; binds COX-1 irreversibly
    • Use: Relief of mild pain, fever, imflammation, ischemic attack, and stroke; prevention of CAD and MI
  79. Metoprolol
    • Beta-1 Antagonist
    • MOA: Beta-1 antagonist; cardioselective; inhibits response to adrenergic stimuli by blocking receptors within the myocardium; high doses block beta-2 receptors within bronchial and vascular smooth muscle
    • Use: Tx of hypertension, angina, and acute MI
  80. Mecamylamine
    • Ganglionic blocker
    • MOA: Nicotinic antagonist
    • Use: Tx of severe hypertension; BP control durin aortic surgery
  81. Ambenonium
    • Cholinergic
    • MOA: Inhibit acetylcholinesterase
    • Use: Tx of myasthenia gravis, open angle glaucoma
  82. Demecarium
    • Cholinergic
    • MOA: Inhibit acetylcholinesterase
    • Use: Tx of myasthenia gravis, open angle glaucoma
  83. Pilocarpine
    • Cholinomimetic
    • MOA: Muscarinic agonist
    • Use: Tx of ocular hypertension glaucoma
  84. Atropine
    • Anticholinergic
    • MOA: Muscarinic antagonist
    • Use: Tx of overactive bladder; reduce airway secretions during endotracheal intubation
  85. Tolderodine
    • Anticholinergic
    • MOA: Muscarinic antagonist
    • Use: Tx of overactive bladder; reduce airway secretions during endotracheal intubation
  86. Prostaglandin E1
    Alprostadil
    • Vasodilating agent
    • MOA: Relaxes arterial smooth muscle, producing vasodilation; inhibits platelet aggregation
    • Use: Palliative Tx in maintaining patency of ductus arteriosus in neonates with various ductal-dependent congenital heart defects; Tx of erectile dysfunction
  87. Dexamethasone
    • Adrenals; synthetic glucocorticoids
    • MOA: Systemic anti-inflammatory; immunosuppressant
    • Use: (case specific) Increase respiratory function on preterm baby
  88. Ampicillin
    • Aminopenicillin
    • MOA: Inhibition of bacterial cell wall synthesis through beta-lactam
    • Use: Tx of bacterial infections in the respiratory tract, UTI, and others
  89. Gentamicin
    • Aminoglycoside
    • MOA: Inhibits protein synthesis by irreversibly binding to 30S ribosomal subunit
    • Use: Tx of bone and joint infections, endocarditis, and (case specific) respiratory infection
  90. Fluticasone
    • Corticosteroid; adrenals
    • MOA: Anti-inflammatory, vasoconstriction, reduces number of mediator cells and also secretion; improves lung function
    • Use: Long-term prevention of bronchospasm in patients with asthma, Tx of airflow obstruction in patients with COPD
    • Adverse affects: Possible adrenal insufficiency with withdrawn, glaucoma, musculoskeletal effects, category C pregnancy, immunosuppressant
  91. Exogenous Surfactant
    • Lung surfactant
    • MOA: Replaces deficient or ineffective endogenous lung surfactant in neonates with respiratory distress syndrome (RDS). Surfactant prevents the alveoli from collapsing during expiration by lowering surface tension between air and alveolar surfaces. 
    • Use: Tx of neonatal RDS
  92. Dextrose
    • Nutritive agent, osmotherapy agent
    • MOA: Source of water and carbs; minimize liver glycogen depletion and provide protein-sparing action
    • Use: Tx of hypoglycemia; IV feeding
  93. Amoxicillin
    • Penicillin
    • MOA: Analog of ampicillin, semi-synthetic; inhibits biosynthesis of cell wall mucopeptide; broad spectrum bactericidial activity against aerobic gram +/-; inhibit cross linking
    • Use: Tx of bacterial infections
  94. Anti-T cell cytotoxic drugs
    • Cyclophosphamide
    • Cyclosporine A and tacrolimus (FK506)
    • Rapamycin
  95. Inhibition of B cells
    • Cyclosporin A (FK06)
    • Drugs that inhibit antibody synthesis:
    • -Rapamycin
    • -15-Deoxyspergualin
  96. Anti-lymphocytic drugs of broad specificity
    • Cyclophosphamide
    • Methotrexate
  97. Cyclophosphamide
    • Alkylateing agent tageting dividing cells
    • -Interstrand DNA crosslinking and intrastrand DNA crosslinking at guanine N-7
    • High dose: highly toxic to all dividing cells
    • -Indications: lymphomas, leukemias, some solid tumors, autoimmune diseases
    • Low dose: immunomodulatory; elimination of CD4+CD2+ T regs; induction of T cell growth factors
  98. Cyclosporine A and tacrolimus (FK506)
    MOA: Inhibits IL-2 driven proliferation by blocking transcription of IL-2 gene (binds calcineurin); inhibition of T cell activation by blocking Ca activation of calcineurin and then NFAT
  99. Rapamycin
    Sirolimus
    MOA: Inhibits T cell growth; inhibits T cell responses to IL-2; not a calcineurin inhibitor
  100. 15-Deoxyspergualin
    Gusperimus
    MOA: Inhibits IL-2-stimulated maturation of T cells; polarizes toward Th1 response, blocking B cell activation and antibody production

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