med chem top 200

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med chem top 200
2013-05-01 09:17:45
med chem top 200

med chem top 200
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  1. opiate agonist
    less effect as an analgesic and less respiratory depression than morphine
  2. opiate agonist
    equipotent as morphine as an analgesic and cause of respiratory depression and constipation
  3. central analgesic agent
    moa - antipyretic activity, direct inhibition of hypothalamic heat regulating center
    pain - inhibits prostaglandin synthase in the CNS with minimal peipheral inhibition
    Warfarin interactions
  4. anti depressant
    moa - selectively inhibits serotonin reuptake and potentiates 5-hydroxytryptophan
    ind-depression,alcoholism, aggressive behavior, cocaine withdrawal
    SE prolonged erections
  5. leukotriene receptor antagonist
    ind - chronic asthma
    moa - selective and competitive CysLT1 receptor antagonist C3,D4 & E4
    montelukast - singulair
  6. PPi
    ind - gerd
    CYP450 inhibitor
    reacemic mixture
    humans of asian descent show prolonged plasma levels
    omerprazole - prilosec
  7. s-enantiomer of omeprazole
    esomeprazole - nexium
  8. HMG-CoA reductase inhibitor
    compactin class
    prodrug activated by liver hydrolysis of the lactone ring
    ind - hypercholesterolemia
    extensive first pass by CYP3A4
    can be taken without regard to meals
    80mg/day max
    simvastin - zocor
  9. HMG-CoA reductase inhibitor
    compactin class
    ind - hypercholesterolemia
    extensive first pass via sulfation
    food decreases absorption
    hepatic disease = huge increase in plasma levels
    pravastatin - pravachol
  10. sympathomimetic bronchodilator
    short acting
    most widely used agent via nebulizer
  11. anti-platelet
    oral thienopyridine
    moa 1. inhibits ADP
           2. inhibits induction of adhesion receptor
           3. effective for life of platelet
           4. does not inhibit cAMP
    ind - reduction of artherosclerotic events associated with MI, stroke, PAD or stents
    acute coronary syndrome
    clopidogrel - plavix
  12. HMG-CoA reductase inhibitio
    ind - hypercholesterolemia
    very minor first pass CYP2C9
    2 hr antacid rule
    rosuvastatin - crestor
  13. HMG-CoA reductase inhibitor
    ind - hypercholesterolemia
    extensive first pass CYP3A4
    hepatic disease = increse in plasma levels
    take without regard to meals
    SE phototoxicity
    atorvastatine - lipitor
  14. RAS antagonist
    use caution in renal failure
    ethyl ester prodrug
    enalapril - vasotec
  15. RAS antagonist
    100% urinary excretion
    reduse dosage by CrCl
    lisinopril - prinvil
  16. anti-depressant
    enantiopure drug
    T 1/2 27-30hs
    highly selective
    10mg recommended dosage in hepatic impairment
    escitalopram - lexapro
  17. anti-anxiety 3
    • alprazolam - xanax
    • clorazepate - genXene
    • chlordiazepoxide - librium
  18. central analgesic
    non-schedule narcotic agonist
    opiod activity
    moa - binds mu-receptors and prevents reuptakd of NE and 5HT in the CNS
    modify dose if CrCl < 30
    watch with CYP2D6 inhibitors
    tramadol - ultram
  19. antidepressant
    potent inhibitor of neuronal 5HT and NE reuptake and a less potent inhibitor of DA
    ind - fibromyalgia
    off label - stress and urinary incontinence
    duloxetine - cymbalta
  20. anti-psychotic
    second gen
    tabs and orally disintegrating
    heavily sedating with less weight gain
    olanzapine - zyprexa
  21. anticoagulant
    vitamin K reductase inhibitor
    dosage must be individualized
    routine monitoring of INR
    watch for signs of bleedin - petechiae
    displacement a major cause of DI
    do not switch brands
    close communication between MD and dentist necessary
    warfarin - coumadin
  22. most potent enantiomer of warfarin and metabolized by
    • S - 5X
    • CYP2C9
  23. less potent enantiomer of warfarin and metaboilsm of
    • R
    • CYP3A4
  24. antiadrenergic/sympatholytic
    selective beta1 blocker
    ind - HTN,MI, anging pectoris
    reduce dose in renal failure CrCl
    atenolol - tenormin
  25. antiadrenergic/sympatholytic
    selective beta 1 blocker
    not FDA approved for CHF but used extensively to prevent cardiac remodeling
    metoprolol - lopressor
  26. calcium channel blocker
    1,4 dihydropyridine
    ind - HTN,stable and prinzmetals angina
    avoid abrupt withdrawal
    caution in heptic dysfuntion
    pass into mother milk
    food interactions - grapefruit juice
    amlodipine - norvasc
  27. diuretic agent
  28. antibiotic
    beta lactam
    less diarrhea
    oral only
    not penicillinase resistant
    ped - administer with milk,juice or cold drink
    amoxicillin - amoxil
  29. antibiotic
    penicillinase resistant
    take with food if GI upset
    clavulanate potassium - augmentin
  30. antibiotic
    ind - COPD, one dose Tx for ped otitis media
    IV and oral use only, NO bolus or IM
    does not inhibit CYP enzymes
    azithromycin - zithromax
  31. antibacterial action
    sulfonamide (4)
    • sulfadiazine
    • sulfamethoxazole
    • sulfisoxazole
    • sulfamethizole
  32. RAS antagonist
    40-50% food effect on absorption
    can cause a 20% increase in serum K levels
    valsartan - diovan
  33. non-barbiturate sedative & hypnotic
    ind - short term insomnia
    moa - non benzo modulation of GABA-BZ receptor
    zolpidem - ambien
  34. anti-depressant
    ind - OCD
    T 1/2 21 hours
    40 mg max for elderly or devilitated pts
    caution with withdrawal, may cause severe behavioral symptons
    paroxetine - paxil
  35. anti-depressant
    ind - OCD, PTSD
    T 1/2 26-104hrs
    7 days to reach steady state
    sertraline - zoloft
  36. diabets med
    first drug of choice in TII
    moa - decrease hepatic gluconeogenesis & intestinal glucose absorption
    does not cause insulin release in the pancreas
    watch for MI and septicemia
    no protein binding or metabolism with rapid renal excretion
    metformin - glucophage
  37. azole antifungal
    ind - oropharyngeal vaginal candidiasis
    potent inhibitor of CYP3A4, many drug interactions
    fluconazole - diflucan
  38. anti-convulsant
    ind - myoclonic seizures
    adult dosage max of 20mg/day
    clonazepam - klonopin
  39. oral diabetes
    increases activity of the PPARy, increaseing tissue sensitivity
    tightly controlled dispensing
    take with or without food
    metab by CYP3A4
    use alternate BC
    monitor ALT
    pioglitazone - actos
  40. SSRI
    ind - ocd, ptsd
    t 1/2 26-104
    takes 7 days to reach steady state
    sertraline - zoloft
  41. adjunct anticonvulsant
    ind - adjunct in children 3-12 with partial
    management of postherpetic neuralgia
    restless leg syndrome in adults
    > 12 dose on creatinine clearance
    moa - structurally related to GABA but not an agonist
    gabapentin - neurontin
  42. SSRI
    ind - ocd, depression, bulimia nervosa
    7% of pts will develop a rash, may alter glycemic control in diabetics
    t 1/2 - 1-348 h
    fluoxetine - prozac
  43. diuretic acting on thick ascending loop of henle
    ind - edema due to CHF
    5-sulfamoyl - 2 and 3-aminobenzoic acid
    furosemide - lasix
  44. SSRI
    genetic markers that link to suicide
    QT elongation
    ind - social anxiety disorders, panic disorders
    t 1/2 - 35h
    claim to have favorable side effect profile
    citalopram - celexa
  45. fluoroquinoline
    DOC for inhalation anthrax
    ind - acute sinusitis
    admixture incompatable with alkaline solutions
    ciprofloxacin - cipro
  46. NSAID sulfonamide
    meloxicam - mobic
  47. NSAID
    COX - 2 selective
    at therapeutic concentrations no cox -1
    use linked to risk of MI
    celecoxib - celexa
  48. SNRI
    phototsensitivity possible
    notify MD if a rash or hives occur
  49. CNS agent for pain relief
    structural analog of GABA but does not bind to these receptors or BZ receptors
    first drug approved for fibromyalgia
    moa - binds a2delta site
    metab - negligible in humans
    schedule 5 agent, catergory C
    pregabalin - lyrica
  50. skeletal muscle relaxant
    not used as adjunct for general anesthesia
    centrally acting agent
    similar structurally to TCA's
    moa - central 5ht descending pathways
  51. antibiotic
    1st gen cephalosporin
    oral only
    >90% excreted renally unchanged
    cephalexin - keflex
  52. anti-psychotic
    2nd gen
    ind - schizo
    moa - partial agonist at D2 and 5ht1a and antagonist at 5ht2a
    SE - orthostatic hypotension
    aripiprazole - abilify