Pharmacology Flash Cards 2017

Analgesic & Antimigraine
Butorphanol Naloxone
Dihydroergotamine Propoxyphene
Fentanyl Sumatriptan
Meperidine Tramadol
Methadone
Morphine
Butorphanol
Opioid analgesic Dysphoria
Mixed opioid agonist-antagonist Nightmares
w/drawal in pts dependent on full
opioid agonists
Partial agonist or antagonist @
opioid µ receptors AVOID MAOI
Agonist @ κ receptors @ spinal & Potentially fatal
supraspinal sites
Inhibits spinothalamic pain
neurotransmission
Moderate-severe pain
Admin intranasally
↓ respiratory depression, constipation,

dependence than full µ receptor
agonists
Dihydroergotamine
Antimigraine N, V
Ergot alkaloid Stiff neck, shoulder, extremities
5-HT 1B/1D receptor agonist Leg weakness
Numbness & tingling in fingers &
toes
Activates 5-HT 1B/1D receptors
Pial & dural vessel constriction
Presynaptic inhibition of trigeminal
peptide neurotransmitter release
Inhibitions brainstem activation of
trigeminal neurons
Vascular HA
Migraine & cluster
Injection or nasal spray

Fentanyl
Opioid analgesic Sedation
Phenylpiperidine Confusion
Respiratory depression
Activates opioid µ receptors Anorexia
Inhibits pain transmission @ N, V
spinal & supraspinal sites Constipation
Chronic pain AVOID MAOI in past 14d

Breakthrough for cancer pain
Transdermal patch
Meperidine
Opioid analgesic Confusion
Sedation
Strong opioid agonist Constipation
N, V
Activates opioid receptors Dependence
Inhibits pain transmission Toxic metabolite CNS
excitation, convulsions, tremors
Generalized CNS depression
AVOID MAOI
Moderate-severe pain Potentially fatal
Analgesia during labor
Preoperative sedation
Lacks antitussive activity

Methadone
Opioid analgesic Respiratory depression
Constipation
Strong opioid agonist Confusion
Sedation
Activates opioid receptors
Inhibits pain transmission AVOID MAOI
Suppresses opioid w/drawl
Sx w/ euphoria or
dependence
Prevention of opioid abuse
Orally, once per day

Morphine
Strong opioid µ receptor agonist Confusion
Hypotension
Constipation
Activates µ receptors
↑ cAMP
Opens K & closes Ca channels
↓ release substance P AVOID MAOI w/ 14 d
Potentially fata
Inhibits pain @ spinal & supraspinal
sites
Severe pain w/ MI
Pulmonary edema
Active metabolite
Morphine glucuronate
Naloxone
Opioid antagonist
Opioid receptor antagonist
Blocks opioid µ, δ, κ
receptors
Rapidly reverses effects of
opioid agonists
Opioid OD, dependence
Short half-life needs

repeated doses
Propoxyphene
Opioid analgesic Dizziness
Weak opioid agonist Weakness
N
dependence
Inhibits pain transmission
Mid-moderate pain
Combined w/
acetaminophen or aspirin
Sumatriptan
Antimigraine Dizziness
5-HT 1B/1D receptor agonist Vertigo
Tingling
Warm sensation
Tight feeling head & chest
Coronary vasospasm
Presynaptic inhibition of trigeminal
peptide neurotransmitter release
AVOID
Inhibitions brainstem activation of MAOI
trigeminal neurons SSRI
Vascular HA
Migraine & cluster
Oral, nasal, & subQ

Tramadol
Analgesic Dizziness
Dual action HA
Constipation
Activates µ opioid receptors Lowers seizure threshold
Inhibits neuronal reuptake 5-
HT & NE AVOID MAOI
↑ inhibition of pain
↑ risk seizures w/ high doses
Moderate pain Penicillins
Chronic pain Phenothiazines
Naloxone reverses some but

NOT all Sx
Anesthetics
Benzocaine Midazolam
Bupivacaine Nitrous oxide
Halothane Propofol
Ketamine Sevoflurane
Lidocaine
Benzocaine
Local anesthetic Cross-sensitivity w/ other ester-type
anesthetics
Ester-type
Blocks Na channels & nerve conduction
Topical anesthetic
Pain
Itching
Inflammation
Burns
Insect bites
Contact dermatitis
Wounds
Irritates skin when 1st applied

Use caution w/ sunburn & large areas of
skin
Bupivacaine
Local anesthetic Cross-sensitivity w/ amide-
type anesthetics
Amide-type
Blocks Na channels &

nerve conduction
Local or regional anesthetic

Surgical
Diagnostic
Obstetrical
therapeutic
Halothane
General anesthetic Sensitizes heart to catecholamine-
induced cardiac arrhythmia
Inhalational, halogenated Hepatotoxic
hydrocarbon Fluoride metabolites
Potentiates GABA binding to

GABA-A Cl ion channel
Suppresses sensory processing
in thalamus
General anesthetic
High blood:gas partition

coefficient
Slow rate of induction &
recovery
Ketamine
IV anesthetic Delirium
Glutamate antagonist Hallucination
Irrational behavior during recovery
↑ BP
Blocks glutamate NMDA receptors
Dissociate anesthesia
Analgesia
Immobility
Amnesia
Does NOT depression respiration

or cause LOC
Anesthesia
Minor surgical & diagnostic
procedures
Children
Lidocaine
Local anesthetic Cross-reactivity w/ amide-type
Amide-type anesthetics
Blocks Na channels & nerve

conduction
Topical
Infiltration
Nerve block
Epidural
Spinal anesthesia
Eutectic mixture
Lidocaine & prilocaine
Anesthetize intact skin for
venipuncture
IV cannulation
Circumcism
Midazolam
Sedative-hypnotic-anxiolytic Apnea
Short-acting BZDP Laryngospasm
Cardiac arrest
Sedation
Hypnosis
Amnesia
Preoperative sedation &

anxiolysis
Sedation of mechanically vented
pts
Nitrous Oxide
Inhalation general anesthetic
Anesthetic gas
Potentiates GABA binding

to GABA-A Cl ion channel
Suppresses sensory
processing in thalamus
Minor surgery & dental

procedures
Rapid induction & recovery

Euphoria – laughing gas
Propofol
General anesthesia Bradycardia
IV anesthetic Hypotension
Diisopropyl phenol

Hypnosis
Anesthesia
Amnesia
NO analgesic effect
Intubation & maintenance of

general anesthesia
Sedation of intubated pts in ICU
Sevoflurane
General anesthetic
Inhalation anesthetic

to GABA-A Cl channel
Suppresses sensory
Causes LOC
General anesthesia
Anti-infective
Acyclovir Cefepime
Albendazole Cetriaxone
Amantadine Ciprofloxacin
Amoxicillin-clavulanate Clindamycin
Amphotericin B Doxycycline
Azithromycin Efavirenz
Aztreonam Enfuvirtide
Caspofungin Erythromycin
Cefazolin Ethambutol
Foscarnet Linezolid
Fosfomycin Mefloquine
Ganciclovir Metronidazole
Gentamicin Mupirocin
Griseofulvin Nafcillin
Imipenem-cilastatin Nitrofurantoin
Isoniazid Oseltamivir
Itraconazole Paromomycin
Ivermectin Penicillin G
Levofloxacin
Pentamidine Rifampin
Piperacillin-tazobactam Ritonavir-lopinavir
Praziquantel Streptomycin
Primaquine Terbinafine
Pyrimethamine Trifluridine
Pyrantel TMP-SMX
Quinine Vancomycin
Quinpristein-dalfopristin Zidovudine
Ribavirin
Acyclovir
Antiviral Dizziness
Nucleoside analogue Diarrhea
N
Converted to acyclovir Nephrotoxicity
triphosphate by viral & host
cell kinases Probenecid ↑ serum levels
Incorporated into DNA by
viral DNA polymerase causing
DNA chain termination
HSV2
Herpes zoster
• Shingles
• Chickenpox – varicella
↓ viral shedding, pain, &

healing time
Albendazole
Antihelmintic GI distress
Benzimidazole Constipation or diarrhea
Hepatitis & hematologic toxicity
w/ high doses
Binds & inhibits polymerization of
tubulin dimmers to form
cytoplasmic microtubules
Impairs glucose uptake &
deplete glycogen stores
Intestinal nematode infections

• Hookworm
• Pinworm
• Whipworm
• Ascariasis
• Capillariasis
Trichinosis
• Use w/ corticosteroid
Cysticercosis & echinococcus
Microsporidiosis
Amantadine
Anti-influenza, Ataxia
antiparkinson Dizziness
Tricyclic amine Insomnia
Skin mottling & livedo
reticularis
Inhibits influenza-A M2
proton channel & Blurred vision
acidification of virus Dry mouth
particle
Prevents viral protein-
protein dissociation &
uncoating of viral
particles
Influenza A
Amoxicillin-clavulanate
β-lactam ABX Diarrhea
Extended spectrum aminopenicillin Superinfection
& β-lactamase inhibitor Pseudomembranous colitis
Allergic rxn
Amoxicillin • Rash
• Serum sickness
Binds PBP
• anaphylaxis
• Inhibits cross-linking of cell
wall peptidoglycan
Clavulanate Probenecid inhibits renal tubular
Inhibits class-A β-lactamase excretion
• ↑ serum levels
• Protects amoxicillin from
destruction
NOT antimicrobial by itself
Respiratory tract infections

• Otitis, sinusitis, pneumonia
Skin or skin structure infections
• Bite wounds
Amphotericin B
Antifungal Chills
Polyene ABX Fever
Diarrhea
N, V
Binds ergosterol & ↑ Nephrotoxicity
membrane permeability Hypokalemia
Leakage of cell contents
↑ toxicity w/ cyclosporine,
Candidiasis antineoplastics
Cryptococcal meningitis Thiazides, &
Aspergillosis corticosteroids ↑
hypokalemia
Blastomycosis
Coccidioidomycosis
Histoplasmosis
Mucormycosis
Azithromycin
Macrolide
Protein synthesis inhibitor
Binds 50s ribosome

Prevents peptide elongation &
translocation from acceptor
site to peptidyl site
Respiratory infections d/t

strep, pneumo, H. influenzae,
Legionella
• Otitis media, sinusitis
Single-dose Tx for chlamydial
urethritis, chancroid, MAI
infections
Aztreonam
β-lactam ABX Thrombophlebitis
Monobactam Allergic rxn
Binds PBP including

transpeptidase
Inhibits cross-linking of
cell wall peptidoglycan
Drug resistant gram (-)

infections including
Pseudomonas
aeruginosa &
Enterobacteriaceae
Caspofungin
Antifungal HA
Echinocandin Fever
Phlebitis
Inhibits synthesis of cell Abnormal LFTs
wall component
β-1,3-D-glucan
Candida albicans
Invasive aspergillosis
IV admin
• Not absorbed well by
gut
Cefazolin
β-lactam ABX Rash
2nd generation cephalosporin Diarrhea
Pseudomembranous colitis
Binds PBP including Superinfection
transpeptidase
Inhibits cross-linking of cell Probenecid inhibits excretion
wall peptidoglycan & ↑ serum levels
Surgical wound infections

Infections d/t
• Staph, strep, E. coli,
Klebsiella pneumoniae,
Proteus mirabilis
NOT active against MRSA

Cefepime
β-lactam ABX Rash
4th generation Diarrhea
cephalosporin Pseudomembranous
colitis
Superinfection
Binds multiple PBP
Inhibits cross-linking of Probenecid inhibits
cell wall peptidoglycan excretion & ↑ serum levels
Resistant to many β-
lactamases
Drug-resistant gram (-)

bacteria
• Citrobacter
• Enterobacter
Ceftazidime
β-lactam ABX Rash
3rd generation cephalosporin Diarrhea
transpeptidase
Gram (+), gram (-), &

anaerobics – Pseudomonas
aeruginosa
Pneumonia, meningitis, UTI,

skin structures, bones, jts
Cetriaxone
β-lactam ABX Rash
transpeptidase
Infection d/t
• Pneumococci, gonococci,
meningococci, H. influenzae,
Moraxella catarrhalis,
Borrelia burgdorferi
Single IM injection Tx acute

otitis media or gonorrhea
Ciprofloxacin
Antibacterial Insomnia
Fluoroquinolone Diarrhea
N
Inhibits bacterial DNA
topoisomerase type II (DNA Absorption ↓ by cations
gyrase) & type IV • Antacids
Prevents DNA replication & • Iron
separation of chromosomes • Zinc
• bismuth
Urinary tract, prostate,

intraabdominal w/ metronidazole,
bone or jt, skin
Inhalational anthrax
Gonorrhea
Infectious diarrhea
Gram (+), gram (-), Pseudomonas

aeruginosa
Clindamycin
Aminosugar ABX C. difficile superinfection
Protein synthesis inhibitor Diarrhea
Binds 50s ribosome
Prevents translocation of
nascent peptide from
acceptor site to peptidyl
site
Strep, staph, gram (+)

Acne vulgaris
Anaerobes including
Bacteroides
Doxycycline
Tetracycline ABX AVOID
Protein synthesis inhibitor • Pregnancy & children > 8
y/o
• Outdated preparations are
Binds 30s ribosome nephrotoxic
Reversibly inhibits binding of
transfer RNA to acceptor site Permanent teeth
discoloration
Rickettsia, Chlamydia, Photosensitivity
Mycoplasma, Borrelia Diarrhea
Acne N, V
Cholera
Gonorrhea & syphilis in
PCN allergic pts
Brucellosis & ehrlichiosis
Efavirenz
Antiretroviral N
Non-nucleoside reverse Rash
transcriptase inhibitor Drowsiness
Depression
Binds reverse
transcriptase & disrupts
catalytic site
HIV in combo w/
nucleoside reverse
transcriptase inhibitor –
synergistic
High fat meal ↑ absorption

Enfuvirtide
Antiretroviral Injection site rxn

HIV fusion inhibitor • Rotate sites daily
Binds HIV virus gp41 &

blocks fusion of HIV w/
host cells CD4 Thelper
lymphocytes
Drug-resistant HIV
Erythromycin
Macrolide ABX Activates motilin receptors
Protein synthesis inhibitor causing uncoordinated
peristalsis
• Anorexia
Binds 50s ribosome • N, V
Prevents peptide elongation
& translocation from
acceptor site to peptidyl site
Pharyngitis, otitis media,

sinusitis, pneumonia d/t
• Strep, pneumococci,
Mycoplasma, Chlamydia,
Legionella, MAI
Ethambutol
Antitubercular Dose-related
Synthetic butanol retrobulbar optic
neuritis
derivative
Impaired red-green
color discrimination
Bacteriostatic against • Monitor pts color
mycobacteria discrimination
regularly
Inhibits RNA synthesis
Gouty arthritis
M. tuberculosis
MAI
Foscarnet
Antiviral HA
Pyrophosphate Diarrhea
V
Renal failure
Blocks pyrophosphate- Hypocalcemia
binding site on viral Hypokalemia
DNA polymerase Hypomagnesemia
Prevents attachment of Anemia
nucleotide precursors to Arthralgia
DNA
Myalgia
CMV retinitis in HIV pts
Acyclovir-resistant HSV in Pentamidine causes life-
immunocompromised threatening
hypocalcemia
Fosfomycin
ABX
Cell wall synthesis
inhibitor
Inhibits enopyruvyl
transferase & addition of
phosphenolpyruvate to N-
acetylglucosamine to form
N-acetylmuramic acid
Cystitis d/t E. coli or

Enterococcus faecalis
Single dose Tx for UTI

Ganciclovir
Antiviral ↓ visual acuity

Neutropenia
Nucleoside analogue
Thrombocytopenia
Anemia
Converted to
ganciclovir
triphosphate
Inhibits viral DNA
polymerase
CMV infection in
immunocompromised &
transplants
Gentamicin
Aminoglycoside ABX Nephrotoxicity
Protein synthesis inhibitor Ototoxicity
• Vestibular & cochlear
• ↑ w/ loop diuretics
Binds 30s ribosome
Prevents initiation of protein
synthesis
Misreading of genetic code
Gram (-) bacilli including

Enterobacteriaceace & P.
aeruginosa
Strep, enterococcal, & staph
infections
Monitor serum levels

Griseofulvin
Antifungal HA
Fungistatic ABX
Induces CYP450
• Reduces plasma
Deposits in keratin levels warfarin &
precursor cells of skin, OCP
hair, & nails
Disrupts microtubules
& mitotis of
dermatophytes
Dermatophyte
infections
NOT Candida
Imipenem-cilastatin
β-lactam ABX Allergic rxns
Carbapenem ABX & Diarrhea
dehydropeptidase inhibitor V
Seizures
Imipenem • ↑ risk w/ ganciclovir or
cyclosporine
Binds PBP & inhibits cross-
linking cell wall
peptidoglycan Probenecid inhibits secretion
& ↑ serum levels
Cilastatin
Inhibits renal
dehydropeptidase &
degradation of imipenem
Endocarditis, pneumonia,
UTI, pelvic, abdominal d/t
aerobic & anaerobic
Isoniazid
Antitubercular Hepatitis
Nicotinic acid derivative • Toxic metabolite acetyl-
hydrazine
Peripheral neuropathy
Reduces catalase- • Vit. B6 deficiency
peroxidase
Inhibits synthesis of
mycolic acid component
of cell wall
TB
Bimodal distribution d/t

fast & slow acetylation
Inactivates vit. B6
Itraconazole
Antifunal GI distress
Synthetic triazole Rash
Hepatitis
Inhibits 14-α-demethylase
CYP450 enzyme that
converts lanosterol
ergosterol
Blastomycosis,
candidiasis,
coccidioidomycosis,
histoplasmosis
Onychomycosis – nail
beds
Ivermectin
Antiparasitic Vertigo
Antihelmintic ABX Sedation
Activates glutamate-gated
Cl ion channel
Pharyngeal m.
hyperpolarization &
paralysis
Strongyloidiasis
Cutaneous larva migrans
Onchocerciasis filiariasis
• W. bancrofti
Levofloxacin
Antibacterial
Fluoroquinolone

topoisomerase type II (DNA
gyrase) & type IV
Prevents DNA replication &
separation of chromosomes
Community-acquired
pneumonia
UTI
Gynecologic & skin infections
Gram (+), gram (-), P.

aeruginosa, Mycoplasma,
Mycobacterium
Linezolid
Antibacterial Inhibits MAO

Oxazolidinone protein
synthesis inhibitor
Binds 23s ribosomal

RNA of 50S subunit
Prevents formation of
70s initiation complex
VRE, MS/MRSA, PCN-

sensitive pneumococci
Mefloquine
Antimalarial Neuropsychiatric syn
4-quinolone methanol • Hallucination
derivative • Anxiety
• Confusion
• Seizure
Inhibits erythrocytic • Coma
schizogony
Inhibit nucleic acid synthesis
Malaria
Chloroquine-
susceptible/resistant trains
of P. falciparum & P. vivax
Perform CBC during

chronic prophylactic Tx
Metronidazole
Antiprotozoal GI pain
Nitroimidazole Anorexia
N
Reduced by Dizziness
pyruvate:ferredoxin to
form nitro-free radicals Alcohol causes
that attack DNA & disulfiram-like effect
proteins
Amebiasis, giardiasis,
trichomoniasis
Balantidium coli, C.
difficile, B. fragilis
Mupirocin
ABX
Competes w/ isoleucine for

binding bacterial isoleucyl
tRNA synthetase
Prevents addition of
isoleucine during protein
synthesis
Impetigo by staph or strep

Eradicate nasal
colonization of MRSA
Infected traumatic skin
lesions
Nafcillin
Antistaphylococcal, Superinfection
penicillinase-resistant Pseudomembranous
colitis
penicillin Allergic rxn
• Rash
Binds PBP • Serum sickness
Inhibits cross-linking of • Anaphylaxis
Probenecid inhibits renal
Methicillin-sensitive tubular secretion & ↑
penicillinase producing serum levels
staph
• Bone, jt, UTI,
respiratory, skin,
endocarditis, meningitis
Nitrofurantoin
Urinary tract Anorexia

antibacterial N, V
Nitrofuran Neurotoxicity
Pneumonitis
Inhibits bacterial
enzymes Probenecid inhibits
urinary excretion
UTI
• E. coli, S.
saprophyticus
Oseltamivir
Antiviral
Neuraminidase
inhibitor
Inhibits influenza A &

B neuraminidase
Prevents release &
spreading of viral
particles
Influenza A & B
Paromomycin
Antiprotozoal Nephrotoxic &

Aminoglycoside ABX ototoxic if given IV
Inhibits protein
synthesis
Intestinal amebiasis
Cryptosporidiosis in
immunocompromised
pts
Penicillin G
Narrow-spectrum Superinfection
penicillin Pseudomembranous
colitis
Allergic rxn
Binds PBP
• Rash
Inhibits cross-linking • Serum sickness
of cell wall
• Anaphylaxis
peptidoglycan
Probenecid inhibits
Strep, pneumococcal, renal tubular secretion
meningococcal
Syphilis
Pentamidine
Antiprotozoal Nephrotoxic
Amidino-pentane Hematologic toxicity
derivative Hypoglycemia
Allergic rxn
• Anaphylaxis
Disrupts nucleic acid
synthesis in protozoa
Erythromycin ↑ fatal
arrhythmias
P. carinii
Early stage African
trypanosimiasis –
sleeping sickness
Piperacillin-tazobactam
Antipseudomonal penicillin Superinfection
Allergic rxn
• Rash
Piperacillin • Serum sickness
Binds PBP • Anaphylaxis
• Inhibits cross-linking of
Probenecid inhibits renal
Tazobactam tubular secretion
Inhibits class A β-lactamases
Gram (-) bacilli, P. aeruginosa

Praziquantel
Antihelmintic Malaise
Isoquinoline derivative Anorexia
Drowsiness
↑ Ca permeability of dizziness
schistosome tegument
Contraction &
exposing antigens to
host immunity
Schistosomiasis
Chinese liver fluke
Lung fluke
Cestodes – tapeworms
Primaquine
Antimalarial Hemolytic anemia in

8-aminoquinoline G6PD deficiency
methemoglobinemia
Converted to oxidizing
quinoline-quinone
intermediates
Eradicate exo-
erythrocytic forms of P.
vivax & P. ovale
Pyrimethamine
Antiprotozoal N
Folate reductase inhibitor Anorexia
Hypersensitivity rxn
Inhibits folate reductase
Folate deficiency in protozoa
Malaria in combo w/
sulfadoxine
Toxoplasmosis in combo w/
sulfadoxine
NOT effective against P.

vivax
Pyrantel
Antihelmintic Abdominal cramps
Pyrimidine analogue Anorexia
Diarrhea
Activates cholinergic V
nicotinic receptors in
somatic m. of
nematodes
Produces depolarizing
NM blockade
Ascariasis
Hookworm & pinworm
Quinine
Antimalarial Abdominal cramps
4-aminoquinoline Diarrhea
V
Binds plasmodial DNA &
prevents replication & Cinchonism
transcription during • Tinnitus
erythrocytic schizogony • Blurred vision
Metabolism
Chloroquine-resistant • Cimetidine inhibits
malaria
• Rifampin induce
Admin w/ doxycycline or
pyrimethamine-
sulfadoxine
Quinupristin-dalfopristin
Streptogramin ABX Infusion site rxn
Binds 50s ribosomal

subunit
Quinupristin
Inhibits aminoacyl tRNA
synthesis & addition of
AA
Dalfopristin
Inhibits peptidyl
transferase
VRE, MS/MRSA
Ribavirin
Broad-spectrum antiviral Anemia
Guanosine analogue Hypotension
Cardiac arrest
Converted to ribavirin
triphosphate
Depletes guanosine
triphosphate
Inhibits viral RNA &
protein synthesis
RSV in infants or children

Chronic hepatitis C
Viral hemorrhagic fever –
Lass fever
Rifampin
Antitubercular Red discoloration of tears,
Rifampin derivative urine, saliva, sweat
Abdominal pain
V
Inhibits DNA-dependent RNA
polymerase Diarrhea
Hepatitis
TB
Leprosy Induces CYP450
Prophylaxis meningococcal ↓ levels
meningitis & H. flu B • Warfarin
infections • Theophylline
• Itraconazole
• Steroids
• Opioids
• Phenytoin
• Verapamil
Ritonavir-lopinavir
Antiretroviral Anorexia
HIV protease inhibitor V
Altered taste
Inhibits HIV protease Abnormal thinking
& conversion of gag-pol Hyperlipidemia
polyprotein to Hyperlgycemia
functional proteins
Ritonavir
↑ lopinavir levels
HIV in combo w/
nucleoside reverse
transcriptase inhibitor
Streptomycin
Aminoglycoside Nephrotoxic
Protein synthesis inhibitor Ototoxic
• ↑ w/ loop diuretics
Binds 30s ribosome

Prevents initiation of
protein synthesis
Misreading of genetic
code
Drug-resistant TB
Plague
Tularemia
IV admin
Terbinafine
Antifungal Itching
Allylamine Rash
Diarrhea
Inhibits squalene Anorexia
oxygenase & formation of
squalene epoxide during Metabolism
fungal membrane • Cimetidine inhibits
ergosterol synthesis • Rifampin induce
Topical
• Tinea corporis, cruris,
pedis, versicolor
Oral
• Onychomycosis – fungal
nail infection
Trifluridine
Antiviral Ocular irritation

Thymidine analogue • Redness
• Itching
Inhibits HSV DNA

polymerase
Herpetic keratitis
Keratoconjunctivitis
Topical ocular admin

Trimethoprim-
sulfamethoxazole
Antibacterial N, V
Folate antagonist Rash
Stevens-Johnson syn
Allergic rxn
Sulfamethoxazole Anemia
Inhibits folate synthesis • Hemolytic anemia
Trimethoprim • Megalobalstic anemia
Inhibits folate reduction Leukopenia
Thrombocytopenia
UTI, traveler’s diarrhea Crystalluria
Shigella enteritis
P. carinii & Nocardia Added folate deficiency w/
pneumonia phenytoin or MTX
Vancomycin
Glycopeptide ABX Red man syn
Cell wall synthesis • Extensive rate of
infusion
inhibitor
• Erythematous rash on
face & upper body
Binds D-alanyl-D-alanine Ototoxicity
portion of peptidoglycan • Vestibular & cochlear
Prevents cross-linking of
D-alanine & pentaglycine
chain
MRSA, penicillin-resistant
enterococci, C. difficile
Zidovudine
Antiretroviral Anemia
Nucleoside reverse
Activated nucleotide
triphosphate incorporated into
DNA causing chain
termination
HIV
Prevent maternal-fetal HIV
transmission
1st line Tx for HIV infections

• Zidovudine w/ lamivudine
or emtricitabine &
efavirenz or lapinavir-
ritonavir
Antineoplastic
Anastrozole Imatinib
Bleomycin Leuprolide
Busulfan Meraptopurine
Carmustine Methotrexate
Cisplatin Paclitaxel
Cyclophosphamide Tamoxifen
Doxorubicin Trastuzumab
Etoposide Vincristine
Fluorouracil
Gemtuzumab ozogamicin
Anastrozole
Estrogen antagonist N
Nonsteroidal aromatase HA
inhibitor Hot flashes
Back pain
Inhibits aromatase &
conversion to estrone
precursor to estradiol
Lowers estrogen levels
Halts progression of
estrogen-sensitive breast
cancers
Breast cancer in
postmenopausal women
Bleomycin
Antitumor Pneumonitis & pulmonary
DNA intercalating fibrosis
Hyperpigmentation
Mucocutaneous toxicity
Complexes iron-forming
Hematology toxicity
oxygen free radicals that
cause single strand breaks
G2 phase specific
Lymphomas
SCC
Testicular carcinoma
Choriocarcinoma
Busulfan
Antineoplastic N, V
Alkyl sulfonate bifunctional Myelosuppression
alkylating agent Pulmonary fibrosis
Cross-links DNA strands by

covalently bonding guanine
residues
transcription
CML
Use w/ cyclophosphamide prior

allogenic hematopoietic
progenitor cell transplant for
CML
Carmustine
Antineoplastic N, V
Nitrosurea bifunctional Hepatotoxicity
akylating agent Anemia
Leucopenia
Cross-links DNA strands by Thrombocytopenia
covalently bonding guanine Pulmonary fibrosis
residues
transcription
Brain tumors
Myeloma
Lymphoma
Causes prolonged
myelosuppression
Cisplatin
Antineoplastic Severe N, V
Platinum compound Ototoxicity & tinnitus
Hypocalcemia
Forms reactive metabolites Hypokalemia
that covalently bond DNA Hypomagnesemia
bases & cross-link DNA Anemia
strands
Testicular, ovarian, cervical,

bladder, lung, head/neck
cancers
Less bone marrow suppression

Cyclophosphamide
Antineoplastic Anorexia
Nitrogen mustard bifunctional N, V
akylating agent Hemorrhagic cystitis & hematuria
Alopecia
Thrombocytopenia
Cross-links DNA strands by Leukopenia
covalently bonding guanine residues Anemia
transcription Rifampin induces CYP & ↑ toxicity
Hodgkin’s ds
Lymphomas, myeloma
Leukemia
Ovarian & breast tumors
RA
Converted to active metabolites by CYP

enzymes
Doxorubicin
Antitumor Colors urine red
DNA intercalating agent
Cardiomyopathy – dose-limiting
Inserts b/w DNA bases Anemia
Causes deformation & uncoupling Leukopenia
Complexes iron forming hydroxyl Thrombocytopenia
free radicals that cause strand Diarrhea
breaks V
Inhibits topoisomerase II Stomatitis
Causes strand breaks Alopecia
S phase specific
Breast, ovarian, bladder tumors

Bronchogenic carcinoma
Lymphoma & leukemia
Etoposide
Antineoplastic N, V
Podophyllotoxin, Leukopenia
topoisomerase inhibitor Thrombocytopenia
Alopecia
Inhibits mammalian
topoisomerase II & prevents
resealing of nicked DNA
strands
G2 phase specific
Testicular, small cell lung

carcinoma
Lymphoma
Leukemia
Fluorouracil
Antineoplastic Diarrhea
Pyrimidine antimetabolite V
Stomatitis
Converted to active Alopecia
nucleotide form Maculopapular rash
Inhibits thymidylate Anemia
synthetase Leukopenia
S phase specific Thrombocytopenia
Colon, breast, rectal, gastric,

pancreatic cancer
Topical for basal cell
carcinoma & actinic keratosis
Antineoplastic Severe myelosuppression &
Monoclonal Ab & cytotoxic hypersensitivity rxn
anaphylaxis
ABX calicheamicin
Severe pulmonary rxns
Chills
Gemtuzumab
Fever
Binds CD33 Ag on
N
hematopoietic cells & sequesters
lysosomes where calicheamicin Dyspnea
is released
Calicheamicin
Causes DNA dbl strand breaks
CD33 (+) AML

Imatinib
Antineoplastic Cough
Tyrosine kinase inhibitor Dyspnea
Pharyngitis
Inhibits oncoprotein bcr-abl Pneumonia
tyrosine kinase expressed by Abdominal pain
Philadelphia chromosome V
Inhibits leukemic cell Petechiae
proliferation & induced Pruritis
apoptosis Rash
Night sweats
CML Myalgia
Cause hematologic & Arthralgia
cytogenetic remission Thrombocytopenia
Neutropenia
Leuprolide
Antineoplastic, agent for precocious Transient ↑ in testosterone w/ 1st dose
puberty Use flutamide or other androgen
antagonist
GnRH analogue
Hot flashes
Pulsatile admin ↑ FSH & LH release

Continuous admin down-regulates
GnRH receptors & ↓ FSH & LH
Central precocious puberty

Advanced prostate cancer
Endometriosis
Uterine fibroids
IM depot & implants for prostate cancer

Mercaptopurine
Antineoplastic Cross-react w/ thioguanine
Purine antimetabolite
Myelosuppression
Hyperuricemia
Converted to nucleotide triphosphate Hepatotoxicity
by phosphoribosyl transferase
Inhibits purine biosynthesis & Allopurinol inhibits degradation
salvage pathways
S phase specific
Acute leukemia
CML
Lymphomas
Tumors that delete phosphoribosyl-

transferase acquire resistance
Methotrexate
Antineoplastic N, V
Folate reductase inhibitor Stomatitis
Hepatotoxicity
Anemia
Inhibits dihydrofolate reductase Leukopenia
Prevents formation of active folate & Thrombocytopenia
addition of single carbon units to Nephropathy
DNA base precursors
S phase specific
Choriocarcinoma, trophoblastic tumors

Leukemia
Breast, head, neck, lung cancers
Severe psoriasis
RA
Mycosis fungoides
Leucovorin used to minimized

hematologic toxicity & Tx OD
Paclitaxel
Antineoplastic D
Mitotic inhibitor N, V
Alopecia
Binds tubulin & prevents Anemia
depolymerization of Leukopenia
microtubules of mitotic Thrombocytopenia
spindle Peripheral neuropathy
M phase specific Arthralgia
Myalgia
Advanced ovarian cancer w/
cisplatin
Non-small-cell lung cancer
Metastatic ovarian or breast
cancer
Tamoxifen
Antineoplastic CI during pregnancy &
Estrogen receptor antagonist lactation
& partial agonist
N
Hot flashes
Competes w/ estrogen for
receptors in breast & other Menstrual irregularities
tissues
Suppresses breast tumor
growth
Breast cancer & ductal

carcinoma following surgery
& radiation
Advanced breast cancer
Trastuzumab
Antineoplastic Abdominal pain
Monoclonal Ab Anorexia
Diarrhea
Binds human epidermal growth V
factor-2 (HER2) receptor on Back pain
breast cancer cells Chills
Prevents receptor stim. & cell Fever
proliferation Allergic rxns
Regression of breast cancer
metastases Doxorubicin ↑ risk of
cardiotoxicity
Metastatic breast cancer w/
overexpression HER2
Combined w/ paclitaxel
↑ blood levels
Vincristine
Antineoplastic N, V
Vinca alkaloid, mitotic inhibitor Alopecia
Binds tubulin & prevents
polymerization of tubulin
dimers forming microtubules of
mitotic spindle
M phase specific
Hodgkin’s ds
Lymphoma
Leukemia
Neuroblastoma
Rhabdomyosarcoma
Wilm’s tumor
Autonomic & Neuromuscular
Atenolol Pralidoxime
Atropine Propranolol
Dobutamine Pseudoephrine
Edrophonium Pyridostigmine
Epinephrine Rocuronium
Phenoxybenzamine Sildenafil
Phentolamine Succinylcholine
Phenylephrine Tamsulosin
Pilocarpine Terazosin
Atenolol
Sympatholytic, Bronchoconstriction w/
antihypertensive high doses b/c β1
blockade
Β1 receptor antagonist
Additive hypotension w/
β1 receptor antagonist nitrates
Angina
Post MI
Hypertension
Atropine
Anticholinergic Mydriasis & cycloplegia
Muscarinic receptor Warm, dry, flushed skin
antagonist Tachycardia
Delirium
Hallucinations
Muscarinic receptor
blocker
Bradycardia
IBS
Anticholinesterase poisoning
Antisecretory agent
Dobutamine
Sympathomimetic, cardiac Tachycardia
stimulant Arrhythmia
β1 receptor agonist
Selective β1 receptor agonist

β1 > β2 > α1
Cardiac contractility & output

Acute heart failure
Cardiogenic shock
Synergistic on cardiac output w/

nitroprusside
Edrophonium
Diagnostic agent Muscarinic effects

Miosis
Cholinesterase
Salivation
inhibitor
Reversible
cholinesterase
inhibitor
Dx myasthenia gravis

Epinephrine
Sympathomimetic, HTN
bronchodilator, vasopressor Tachycardia
Nonselective adrenergic agonist Ischemia
Hyperglycemia
Activates α & β receptors
↑ IP3 & cAMP
α1 – vasoconstrict & ↑ BP
β1 – ↑ HR, conduction, &
contractility
β2 – vasodilate, ↓ BP,
bronchodilate
Cardiac arrest, V fib

Shock, asthma
COPD
Phenoxybenzamine
Vasodilator Postural hypotension
Irreversible α receptor
Hypotension w/ β
antagonist blockers & Ca channel
blockers
α receptor antagonist
α1 > α2
Presurgical Tx of HTN d/t

pheochromocytoma
Phentolamine
Vasodilator Hypotension
α receptor antagonist Severe hypotension w/ Epi
Blocks α1 & α2
receptors
Control BP during
surgical removal of
pheochromocytoma
IV admin only

Phenylephrine
Vasocontrictor, decongestant Rebound nasal congestion
Selective α1 receptor agonist HTN
MAOI cause severe HTN

Activates α1 receptor
Increase IP3 causing
contraction of vascular smooth
m.
Nasal & ocular decongestant

Dilate pupil for opthalmoscopy
Mydriasis w/o cycloplegia
Paralysis of accommodation
Pilocarpine
Antiglaucoma, sialogogue Miosis
Muscarinic receptor Blurred vision
agonist Accommodative spasm
Activates muscarinic
receptors in ciliary m. &
salivary gland
Sjogren’s syn
Glaucoma
• Ciliary m. ↑ aqueous
humor
Xerostomia
• Salivary gland ↑ salivation
Pralidoxime
Organophosphate antidote
Cholinesterase reactivator
Binds phosphorous &

breaks organophosphate
bond w/ cholinesterase
Organophosphate toxicity
Reverses muscle weakness
Propranolol
Sympatholytic, antihypertensive Bronchoconstriction
Nonselective β receptor Inhibits glycogenolysis
antagonist Nightmares & depression
Blocks β1 & β2 receptors
Angina
HTN
Benign tremor
Migraine prophylaxis
thyrotoxicosis
Post-MI
Highly lipophilic CNS effects

Pseudoephedrine
Decongestant Tachycardia
Indirect/direct-acting CNS stim.
adrenergic receptor ↑ BP
agonist
↑ release NE directly
activates adrenergic
receptors causing
vasoconstriction & cardiac
stim.
Allergic & viral rhinitis

Pyridostigmine
Antimyasthenic Muscarinic effects
Miosis
Cholinesterase inhibitor,
Salivation
cholinergic agonist
Prolongs effects of
Reversibly inhibits succinylcholine
cholinesterase
Tx myasthenia gravis
Reverse nondepolarizing
NM blockers
Rocuronium
Paralytic agent Respiratory m. paralysis
Nondepolarizing NM Apnea
blockade
Blocks nicotinic receptors in

skeletal m.
Skeletal m. relaxation for

intubation, surgery, ECT
Effects reversed by
neostigmine & edrophonium
Sildenafil
Vasodilator HA
Phosphodiesterase Nasal congestion
inhibitor Back pain
Visual disturbances
Inhibits type 5
phosphodiesterase &
degradation of cGMP
vasodilation in corpus
cavernosum d/t Ach
release from sacral PNS
neurons
Erectile dysfunction
Succinylcholine
Depolarizing NM blockade Apnea
Binds nicotinic receptors

causing prolonged
depolarization of skeletal
m. & paralysis

intubation & surgery
Transient m. fasciculations
Tamsulosin
Urologic agent Dizziness

HA
Uroselective α1
Postural hypotension
receptor antagonist
Cimetidine increases
Blocks α1A receptors blood levels & effects
in prostate
Tx urinary outflow

obstruction d/t prostatic
hyperplasia
Terazosin
Antihypertensive, 1st dose syncope
urologic agent
Selective α1 receptor
antagonist
Blocks α1 receptors
HTN
Outflow obstruction d/t
prostate hyperplasia
Cardiovascular
Acetazolamide Hydrochlorothiazide
Adenosine Labetalol
Amiloride Mannitol
Amiodarone Methyldopa
Amlodipine Minoxidil
Carvedilol Nesiritide
Clonidine Nitroglycerin
Digoxin Nitroprusside
Diltiazem Propafenone
Dofetilide Quinidine
Enalapril Sotalol
Esmolol Spironolactone
Fenoldopam Valsartan
Furosemide verapamil
Hydralazine
Acetazolamide
Diuretic – Parasthesia
Carbonic anhydrase inhibitor – Urinary stone formation
Inhibits interconversion of
carbonic acid & bicarbonate
↑ NaHCO3 excretion
Inhibit aqueous humor
formation
Hyperchloremic metabolic
acidosis
– Tx open-angle glaucoma
– Mtn sickness
– Metabolic alkalosis
Adenosine
Antiarrhythmic – Transient asystole

Purine nucleoside, cardiac
node membrane stabilizer
Opens K channels & blocks

Ca influx in SA & AV nodes
Slows AV conduction
↑ AV refractory period
– Terminate SVT
Amiloride
K-sparring diuretic – Hyperkalemia

Epithelial Na channel blocker
Blocks Na Channel distal

tubule & collecting duct
– Inhibits Na reabsorption &
K excretion
– Prevent & Tx hypokalemia

Amidarone
Antiarrhythmic – Hypo/hyperthyroidism
Cardiac ion channel blocker – Photosensitivity
– Blue-gray skin
– Corneal microdeposits
Blocks K, Na, Ca channels &
β receptors – Pulmonary fibrosis
– Prolongs repolarization
– ↑ refractory period
– Slows HR
– ↑ PR & QT intervals
– SVT, VT, VF
Amlodipine
Antihypertensive, antianginal – HA
Dihydropyridine Ca channel – Edema
blocker – Hypotension
Ca channel blocker in – Effects ↑ w/ grapefruit juice

vascular smooth m.
– Arteriolar vasodilation & ↑
coronary blood flow
– HTN
– Angina pectoris
Carvedilol
Antihypertensive & heart – Orthostatic hypotension

failure Tx – Dizziness
Nonselective adrenergic – Bradycardia
receptor agonist
Blocks β1, β2, α1 receptors

– Cause vasodilation
– HTN
– Heart failure
↓ remodeling
Clonidine
Antihypertensive – Abrupt w/drawal severe

α2 receptor agonist rebound HTN
– Sedation
– Dry mouth
Central α2 receptor agonist
– ↓ sympathetic outflow from
vasomotor center
– Inhibits pain
neurotransmission in spinal
cord
– HTN
– Opioid w/drawal
Digoxin
Cardiac stimulant – Arrhythmias

Digitalis glycoside – N, V
– Blurred vision
Inhibits Na/K ATPase – Yellow vision
– ↑ IC Ca & cardiac
contractility
– ↓ AV conduction
– ↑ AV refractory period
– Heart failure
– Serum levels assess dosage &
toxicity
Diltiazem
Vasodilator, antiarrhythmic – Dizziness
Non-dihydropyridine Ca – Hypotension
channel blocker – Peripheral edema
– Constipation
Block Ca channels in cardiac – Gingival hyperplasia
tissue & vascular smooth m.
– Vasodilation
– Grapefruit juice ↑ serum levels
– ↓ HR & conduction
– ↓ contractility
– HTN
– Angina pectoris
– SVT
Dofetilide
Antiarrhythmic – QT prolongation
K channel blocker – Torsade de pointes
Blocks delayed K channels in

cardiac tissue
– Slows repolarization &
prolongs refractory period
– ↑ QT interval
– AF, A flutter
– Monitor QT interval during

initial dose titration
Enalapril
Antihypertensive – Cough & angioedema
ACE inhibitor Inhibits bradykinin
degradation
Inhibits ACE & formation of AT II
– Hypotension
– Vasodilation
– ↓ aldosterone secretion – Taste disturbances
– ↑ CO
– ↓ V remodeling
– ↑ survival in heart failure
– HTN
– Heart failure
– Post-MI
– ↓ progression of diabetic nephropathy
Esmolol
Antiarrhythmic – Hypotension
Class II
Selective β1 blocker – Bradycardia
Blocks SNS stim. SA & AV nodes

– ↓ HR
– ↓ AV conduction
– ↑ AV refractory period
– Sinus tachycardia & SVT during/after

surgery
– Rapidly metabolized by plasma

esterase
Fenoldopam
Antihypertensive – ↓ serum K levels

Monitor for hypokalemia
D1-like receptor agonist
D1 receptor agonist
– Arteriolar vasodilation
Afferent & efferent renal
arterioles
– ↑ renal blood flow
– Hypertensive emergencies
Furosemide
Loop-acting diuretic – Hypokalemia
Membrane ion transport inhibitor – Metabolic alkalosis
– Hyperuricemia
Inhibits Na/K/2Cl cotransporter in – Hypomagnesemia
ascending loop of Henle
– Blocks NaCl reabsorption – ↑ ototoxicity of aminoglycoside
ABX
– Edema
– Heart failure
– HTN
– Hypercalcemia
– ↑ Ca excretion
– ↑ Na/K exchange in collecting duct
Hydralazine
Antihypertensive. heart failure – Edema
Vasodilator – Reflex tachycardia & MI
– Lupus syndrome
Alters IC Ca metabolism
– Relaxes arteriolar smooth m.
vasodilation
– ↓ afterload
– Heart failure in combo w/

isosorbide dinitrate
More effective than ACEI in
black people
– Moderate-severe HTN
Hydrochlorothiazide
Antihypertensive – Hypokalemia
Thiazide diuretic – Metabolic alkalosis
– Hyperuricemia & gout
Inhibits NaCl transporter in
distal tubule – ↓ excretion of lithium
– ↑ excretion Na, K, Cl
– ↓ Ca excretion
– HTN
– Nephrogenic DI
– Nephrolithiasis
Labetolol
Antihypertensive – Postural hypotension

Adrenergic α & β – Abrupt w/drawal cause
life-threatening HTN,
receptor antagonist arrhythmias, or MI
Selective α1 &
nonselective β1, β2
blockers
– HTN
Mannitol
Diuretic – Electrolyte imbalances

Osmotic Diuretic – Transient volume expansion
Pulmonary edema or heart
failure
Osmotic attraction of
edematous & ocular fluid
Filtered by glomerulus
– ↑ electrolyte excretion
– Oliguric renal failure

– Cerebral edema – ↑ ICP
– Acute glaucoma
Methyldopa
Antihypertensive – Positive direct Coomb’s test
Adrenergic α2 receptor
agonist
Converted to active form

methyl-norepinephrine which
activates central α2 receptor
agonist
– ↓ SNS outflow from
vasomotor center
– HTN
– HTN in pregnancy
Minoxidil
Antihypertensive, hair growth – Systemic admin.
stimulant Reflex tachycardia
Vasodilator, K channel opener Angina pericarditis
Pulmonary HTN
Opens K channels in vascular hypertrichosis
smooth m.
– Hyperpolarization
– m. relaxation
– vasodilation
Stim. resting hair follicle
growth follicles
– Severe HTN
– Topical for alopecia
Nesiritide
Heart failure Tx – Hypotension
Recombinant human B-type
natriuretic peptide
Activate guanylate cyclase

↑ cGaMP
– Dilates venous & arterial
smooth m.
– ↓ venous pressure, cardiac
preload, vascular congestion,
& dyspnea
– Decompensated heart failure

Nitroglycerin
Antianginal – HA
Organic nitrate – Hypotension
– Syncope
– Reflex tachycardia
Releases NO in vascular
smooth m.
– Vasodilation – ↑ vasodilative effect of
– ↑ coronary blood flow sildenafil, tadalafil, vardenafil
– ↓ myocardial O2 demand
– Angina pectoris
Sublingual or lingual admin.
Short half-life
Nitroprusside
Antihypertensive – CN toxicity
Vasodilator – Hypotension
– HA
Relaxes venous & arteriolar
smooth m.
– Metabolized to CN & thiocyanate
Tx toxicity w/ sodium nitrite &
sodium thiosulfate
– HTN crisis
– Acute heart failure or cardiogenic
shock
– Controlled hypotension during
pregnancy
Propafenone
Antiarrhythmic – Proarrhythmic 1st 2 wks

Class IC Na channel blocker Monitor ECG when starting
Tx
– GI disturbances
Blocks Na channel in cardiac
tissue – ↑ digoxin levels
– ↓ conduction & prevent re-
entry
– ↑ PR, QRS, & QT duration
– SVT & life-threatening V

arrhythmias
Quinidine
Antiarrhythmic – Cinchonism
Class IA Na channel blocker Blurred vision
Tinnitus
Photophobia
Blocks Na & K channels in
cardiac tissue – ↑ levels w/
– ↓ conduction Amiodarone
– ↑ QRS & QT duration Cimetidine
Diltiazem
– SVT & VT Verapamil
Grapefruit juice
– D-isomer = quinine, used to
treat malaria pts
Sotalol
Antiarrhythmic – Torsades de pointes

Class III K channel blocker
Blocks K channels in cardiac

tissue
– Prolongs repol.
– ↑ refractory period & ↑ QT
interval
Blocks adrenergic β receptors
– SVT & life-threatening

arrhythmias
Spironolactone
K-sparring diuretic – Gynecomastia

Aldosterone antagonist – Impotence
– Hyperkalemia
Blocks aldosterone receptors
– ↑ Na excretion
– ↓ K excretion
– Primary hyperaldosteronism
– HTN
– hypokalemia
Valsartan
Antihypertensive
Angiotensin receptor antagonist
Blocks AT II receptor in
vascular smooth m. & adrenal
cortex
– Vasodilation & ↓ aldosterone
secretion
– HTN
– Nephropathy
– Less cough & angioedema than

ACEI
Verapamil
Antihypertensive, antianginal – Peripheral edema
Non-dihydropyridine Ca channel – Constipation
blocker
– Gingival hyperplasia
Blocks Ca channels in cardiac m. &
vascular smooth m.
– Vasodilation
– ↓ HR & conduction
– ↓ contractility
Suppress contractility more than
other Ca channel blockers
– HTN
– Angina pectoris
– SVT
– Prevent migraine HA
CNS Depressants
• Buspirone • Lorazepam
• Carbamazepine • Phenobarbital
• Diazepam • Phenytoin
• Disulfiram • Topiramate
• Ethosuximide • Valproate
• Flumazeil • Zolpidem
• Gabapentin
• Lamotrigine
Busprione
• Antianxiety – Dizziness
• 5-HT1A partial agonist – Drowsiness
– Fatigue
– HA
• Activates presynaptic 5-HT1A
receptors in dorsal raphe nucleus – Excitement
– ↓ firing serotonergic neurons – Nervousness
– Blurred vision
– Generalized anxiety disorder – Tachycardia
– N
– NO – Rash
• Drug dependence – Myalgia
• Significant sedation – Sweating
• Muscle relaxation
• Anticonvulsant effects – ↑ levels by
• Erythromycin
• Itraconazole
• Grapefruit juice
Carbamazepine
• Anticonvulsant – Ataxia
• Neuronal Na channel blocker – Drowsiness
– Blurred vision
• Blocks Na channels in CNS – Agranulocytosis
– Aplastic anemia
– ↓ firing of ectopic foci & spread
of epileptic seizures – Thrombocytopenia
– Partial seizures & generalized – Induces its own metabolism

tonic-clonic seizures
– Bipolar disorders
– Trigeminal neuralgia
– Neuropathic pain
Diazepam
• Antianxiety – Drowsiness
• Benzodiazepine – Lethargy
– Physical/psychological dependence
– Tolerance
• Binds ω receptors on GABA
operated Cl ion channel
– ↑ channel affinity for GABA &
frequency of channel opening
– Potentiates inhibitory effects of
GABA
– Anxiety
– Status epilepticus
– Muscle spasm
– Alcohol w/drawal
– Anterograde amnesia
– Long-lasting active metabolites

Disulfiram
• Alcohol abuse Tx – Drowsiness
• Acetaldehyde dehydrogenase
inhibitor
• Inhibits acetaldehyde degradation

following alcohol ingestion
– Blurred vision
– Chest pain
– Dizziness
– Palpitations
– N, V
– HA
– Weakness
– Reinforcement of alcohol abstinence

Ethosuximide
• Anticonvulsant – Dizziness
• Succimide – Drowsiness
– Gastric distress
– N
• Binds T-type Ca channels
in thalamic neurons
– Suppresses nerve
transmissions to motor
cortex
– Generalized absence seizures

• Petit mal epilepsy
Flumazenil
• Antidote – Seizures
• Benzodiazepine receptor – Dizziness
antagonist – Emotional lability
• Blocks benzodiazepine
receptors
– Counteract adverse effects of

benzodiazepines
• Respiratory depression d/t IV
OD
– CI in status epilepticus
Gabapentin
• GABA analogue – Dizziness
– Drowsiness
– Nystagmus
• ↑ GABA release from – Tremor
central neurons
– Inhibits neuronal discharges
from seizure foci
– Inhibits pain
neurotransmission
– Partial seizures
– Chronic pain
– Migraine prophylaxis
Lamotrigine
• Anticonvulsant – Skin rash in 1st 8 wk of Tx
• Can progress to Stevens-
• Phenyltriazine Johnson syn
– Ataxia
• Blocks voltage-sensitive
– Dizziness
Na channels – Drowsiness
– Release of glutamate – Photosensitivity
– Prevents spread of seizure foci
discharges – ↓ metabolism & ↑ ADR w/
valproate
– Adjunct/monotherapy for
partial seizures in adults
Lorazepam
• Sedative-hypnotic, anxiolytic – Dizziness
– Drowsiness
• Benzodiazepine – Apnea & cardiac arrest w/ rapid IV
admin
• Binds benzodiazepine ω receptors
on GABA operate Cl ion channel – Additive depression w/ alcohol & other
depressants
– Potentiates inhibitory effects of
GABA
– Anxiety
– Insomnia
– Preoperative sedation
– Light anesthesia
– Anterograde amnesia
– Flumazenil used to counteract severe

OD
Phenobarbital
• Sedative-hypnotic, anticonvulsant – Drowsiness
• Barbiturate – Lethargy
– Delirium
– Hangover
• Binds GABA operated Cl ion – Physical & psychological dependence
channel increasing duration of
channel opening – Induces CYP P450 ↑ metabolism of
– ↑ Cl influx in absence of GABA drugs
– Tonic-clonic & partial seizures

– Febrile seizures in children
– Preoperative sedation
– Short-term hypnotic
– ↑ folate requirement during long-

term Tx
Phenytoin
• Hydantoin – Diplopia
– Nystagmus
– Gingival hyperplasia
• Blocks voltage-sensitive Na
channels
– Release glutamate
– Prevents spread of seizure foci
discharges
– Partial seizures
– Generalized tonic-clone seizures
– Status epilepticus following IV
diazepam
– Zero-order @ high doses

– Fosphenytoin for IV use
Topiramate
• Monosaccharide derivative – Dizziness
– Drowsiness
• Block voltage-sensitive Na – Fatigue
channels – Impaired concentration &
memory
– Augments GABA activation of
GABA receptors – Psychomotor slowing
• Blocks glutamate receptors – Speech problems
– Diplopia
– Partial & tonic-clonic seizures – Nystagmus
– Decrease dose in pts w/ renal

impairment
Valproate
• Anticonvulsant – Indigestion
• Branched-chain FA – N, V
– Dizziness
• ↑ GABA levels by ↑ release or ↓ – Sedation
metabolism or reuptake – Hepatotoxicity
– Reduced Na dependent action
potentials
– Simple & complex absence

seizures
– Complex partial seizures
– Tonic-clonic seizures
– Myoclonic seizures
– Migraine prevention
– Manic phase of bipolar
Zolpidem
• Non-benzodiazepine hypnotic
• Imidazopyridine
• Activates ω BZBP receptors on

GABA operated Cl ion channel
• Neuronal hyperpolarization
– Insomnia
Endocrine
Acarbose Insulin
Alendronate Levothyroxine
Calcitonin Medroxyprogesterone
Danazol Metformin
Desmopressin Methimazole
Ergocalciferol Mifepristone
Ethinyl estradiol & drospirenone Octreotide
Ethinyl estradiol & norethindrone Oxytocin
Finasteride Pioglitazone
Fludrocortisone Prednisone
Glyburide Raloxifene
Hydrocortisone Repaglinide
Somatropin
Testosterone
Acarbose
Antidiabetic Intestinal bloating
α-glucosidase inhibitor Flatulence
↑ oral bioavailability of
Inhibits intestinal enzyme that
metformin
converts oligosaccharides &
↓ iron absorption
disaccharides to glucose
↓ digestion of starch & sucrose
↓ postprandial blood glucose &
HbA1c
Type II DM
Alendronate
Bone resorption inhibitor Absorption ↓ by Ca supplements,
Bisphosphonate antacids, foods, beverages
(except water)
Prevents attachment of
osteoclast precursor cells to
bone
↓ metabolic activity of
osteoclasts & ability to resorb
bone
Prevent/Tx
Osteoporosis
Corticosteroid-induced
osteoporosis
Paget’s ds of bone
hypercalcemia
Calcitonin
Ca hormone
Thyroid gland hormone
Binds calcitonin receptor on

osteoclasts
↑ cAMP & inhibits osteoclast
activity
↓ bone resorption, bone pain, &
serum [Ca]
Postmenopausal osteoporosis
hypercalcemia
Danazol
Ovarian inhibitor CI in pregnancy – androgenic
Synthetic androgen, effects on female fetus
antiestrogen
Emotional lability
Deepening voice
Feedback inhibits pituitary FSH
Acne
& LH secretion ↓ ovarian
estrogen secretion & stim. Hirsutism
endometrial & breast tissue. Amenorrhea
↓ breast size
Endometriosis
Fibrocystic breast ds
Hereditary angioedema
↑ C1 esterase inhibitor & C4
complement component
Desmopressin
Posterior pituitary hormone
Vasopressin, ADH analogue
Mimics natural vasopression

Increases water reabsorption in
kidneys
Vasoconstriction
DI
Nocturnal enuresis
Control bleeding in hemophilia
& wWF’s ds
Intranasal, oral, or IV
Ergocalciferol
Vit. D Hypercalcemia
Fat-soluble Hypercalciuria
Activated in liver & kidneys to Cholestyramine inhibits vit. D

absorption
form calcitriol
Induce vit. D metabolism
↑ Ca & phosphorus absorption Phenytoin
from gut
Barbiturates
Vit. D deficiency
Rickets, osteomalacia
Chronic renal failure
Familial hypophosphatemia
Hypocalcemia d/t
hypoparathyroidism
Postoperative & idiopathic tetany
Ethinyl estradiol & drospirenone
OCP Drospirenone
Estrogen & progesterone Antiandrogenic
Blocks aldosterone
↓ salt & water retention
Feedback inhibit GnRH
↓ BP
Estrogen
↓ FSH secretion & maturation
of dominant follicle Thromboembolism
↑ risk w/ smoking
Progesterone
Inhibits midcycle LH surge & Edema
ovulation
Efficacy ↓ w/
Contraception ABX
Regulate menstrual cycle Carbamazepine
Acne in women phenytoin
Ethinyl estradiol & norethindrone
OCP Norethidrone
Estrogen & progesterone Slightly androgenic
Feedback inhibit GnRH Thromboembolism

Estrogen Edema
↓ FSH secretion & maturation Depression
of dominant follicle Gallbladder ds
Progesterone
Inhibits midcycle LH surge &
ovulation
Contraception
Regulate menstrual cycle
Acne in women
Finasteride
Androgen synthesis inhibitor CI pregnancy
5-α-reductase inhibitor Risk to male fetus
Do NOT handle tablets
Inhibits conversion testosterone

Impotence
dihydrotestosterone & ↓
androgenic stimulation of
prostate & skin
↓ prostate size & promotes hair
growth
BPH
Male pattern baldness
Fludrocortisone
Corticosteroid Hypokalemia
Mineralocorticoid ↑ by thiazide & loop diuretics
Activates aldosterone receptors

in renal distal tubule
↑ Na reabsorption
↑ K & H excretion
Adrenal insufficiency
Addison’s ds
Congenital adrenogenital syn
Tx idiopathic orthostatic
hypotension w/ ↑ Na intake
Glyburide
Antidiabetic Photosensitivity
Sulfonylurea hypoglycemia Hypoglycemia
Closes ATP-sensitive K
channels preventing K efflux &
depolarizing pancreas B cells
Influx Ca & relaxing insulin
↑ amount of insulin secreted
during each pulse
Type II DM
Hydrocortisone
Short-acting corticosteroid, low-
potency topical corticosteroid
Glucocorticoid
Replaces endogenous cortisol in

deficiency states
Suppresses inflammation &
immune response – topical
Adrenocortical insufficiency
Topical
Insect bites
Contact dermatitis
Insulin
Antidiabetic Hypoglycemia
Pancreatic hormone
β-blockers mask signs of
hypoglycemia & prolong
Replaces endogenous recovery
insulin
DM
Rapid acting – lispro

Intermediate acting – lente
Long acting – ultralente
Levothyroxine
Thyroid hormone Insomnia
Tetraiodothyronine Irritability
Tachycardia
Wt loss
Binds nuclear receptors &
↑ gene transcription Bile acid sequestrants ↓
↑ metabolic rate, protein absorption
synthesis, gluconeogenesis,
cell growth &
differentiation, & CNS
development
Converted to T3 in tissues
Hypothyroidism
Medroxyprogesterone
Progestin, contraceptive Amenorrhea
Progesterone analogue Breakthrough bleeding
Dysmenorrhea
↓ endometrial hyperplasia in
women receiving estrogen
Prevents conception by
thickening cervical mucus
Estrogen-progestin HRT
Injectable contraceptive
Progestin-only injectable
contraceptive
IM depot injection lasts 3mo

Metformin
Antidiabetic N, V, D
Biguanide, antihyperglycemic Abdominal bloating
↑ # & affinity of insulin

receptors in peripheral tissues
↓ hepatic glucose output
↓glucose absorption from gut
↑ glucose uptake & utilization in
skeletal m. & adipose tissue
Type II DM
Used in combo w/ sulfonylureas

Methimazole
Antithyroid Rash
Thiourea, thyroid Agranulocytosis
hormone synthesis
inhibitor
Inhibits peroxidase &

iodination & coupling of
tyrosine residue of
thyroglobulin
↓ thyroxine secretion
Hyperthyroidism – Grave’s ds
Mifepristone
Abortificient Abdominal pain
Progesterone antagonist Diarrhea
N, V
Uterine bleeding
Partial agonist or antagonist
progesterone receptors Cramping
Medical termination of
pregnancy through 49d gestation
Single dose + prostaglandin for

48hr stim. uterine contractions
Octreotide
GH inhibitor, antidiarrheal Arrhythmias
Somatostatin analogue w/ greater Hyperglycemia
effects on GH than insulin secretion Hypoglycemia
Constipation
Suppresses secretion of GH, Diarrhea
insulin-like growth factors, 5-HT & Flatulence
GI peptides – gastrin, motilin, N
secretin, & VIP
Acromegaly
Severe diarrhea & flushing d/t
carcinoid tumors & VIP tumors
Bleeding GE varices
Complications of pancreatic surgery
Oxytocin
Oxytocic Excessive & painful uterine
Posterior pituitary hormone contractions
Stim. Uterine smooth m. &

induce labor
Stim. mammary gland smooth
m. & lactation
Induce labor @ term

Facilitate uterine contractions
Postpartum control of uterine
bleeding
Promote milk let-down
IV for uterine stim.

Nasal for milk let-down
Pioglitazone
Antidiabetic
Thiazolidinedione
antihyperglycemic
Activates peroxisome proliferator-

activated receptor-γ in adipose
tissue, skeletal m., & liver
↑ gene transcription, insulin
sensitivity, & glucose transports in
muscle & adipose tissue
Suppresses hepatic glucose output
Type II DM
Used w/ metformin
Prednisone
Anti-inflammatory Depression or euphoria
Corticosteroid HTN
Acne
Impaired wound healing
Suppresses inflammation Adrenal suppression
& immune response Muscle wasting
Osteoporosis
Inflammatory, allergic, Cushingoid appearance
autoimmune, & neoplastic ds Moon facies
Prevent organ transplant Buffalo hump
rejection ↑ susceptibility to infection
Asthma
Raloxifene
Bone resorption inhibitor Hot flashes
Selective estrogen receptor
modulator – SERM Cholestyramine inhibits
absorption
Estrogen-like effect on bone &
lipid metabolism
Estrogen antagonist in breast &
uterine tissue
↑ bone mineral density & ↓
vertebral fractures
Osteoporosis in postmenopausal
women
Used in woman @ risk for

breast cancer
Repaglinide
Meglitinide hypoglycemic
channels & ↑ insulin secretion
↓ postprandial blood glucose &
[HbA1c]
Taken before meals to control

postprandial hyerglycemia
Used w/ metformin
NOT sulfonylureas
Somatropin
GH
Recombinant somatotropin
↑ release of insulin-like growth

factors in liver & cartilage
Stim. skeletal growth, AA
transport, protein synthesis,
nucleic acid synthesis & cell
prolif.
Short stature in children d/t GH

deficiency
Turner syn
Prader-Will syn
Testosterone
Androgen Edema
Gonadal steroid Acne
Gynecomastia
Impotence
Activated gene transcription &
development of male sex organs & Oligospermia
secondary sex characteristics Priapism
↑ lean body mass
Stim. skeletal growth
Accelerates epiphyseal closure
↑ sebaceous gland sebum
production
↑ EPO secretion
↓ HDL levels
Hypogonadism in androgen-deficient
men
Delayed puberty in males
Gastrointestinal
Bisacodyl Misoprostol
Calcium carbonate Omeprazole
Dicyclomine Ondansetron
Docusate Promethazine
Lactulose Ranitidine
Loperamide Sucralfate
Mesalamine Tegaserod
Metoclopramide
Bisacodyl
Stimulant laxative Cramping
N
Fluid & electrolyte
Inhibits GI fluid depletion
reabsorption & Hypokalemia
stimulates peristalsis
Bowel evacuation prior

colonoscopy or surgery
Acute constipation
Calcium carbonate
Antacid, Ca supplement Constipation
Ca salt
↓ absorption of drugs
Tetracyclines
Neutralizes gastric acid Fluoroquinolones
Provides Ca supplementation Phenytoin
Iron salts
Dyspepsia
Hypocalcemia
Prevention of osteoporosis
Admin 1-1.5hr after meals & @

bedtime
Dicyclomine
Antispasmodic Constipation
Muscarinic receptor Dyspepsia
antagonist Dry mouth
Urinary retention
Blurred vision
Blocks PNS stim. intrinsic Decreased sweating
nervous system & ↓ GI
tone & motility
Directly relaxes GI smooth
m.
IBS – cramping & pain

Docusate
Stool softener, laxative
Surface-active agent
Facilitates hydration of
fecal material & softens
feces
Constipation
Fecal impaction – rectal
enema
Lactulose
Laxative Cramping
Osmotic agent Abdominal distention
Flatulence
↑ water content & softens feces
Lowers pH of colon
Converts ammonia
ammonium ion & ↓ ammonia
absorption & blood levels
Chronic constipation
Hepatic encephalopathy
Improves mental status
Loperamide
Antidiarrheal Constipation
Opioid analogue Drowsiness
Additive effects
Activates opioid receptors in GI smooth Kava
m. Chamomile
Segmental contraction & inhibits Valerian
peristalsis
Mild-moderate acute diarrhea

Chronic diarrhea d/t IBD
↓ volume of ileostomy drainage
AVOID
Pregnancy
Lactation
Children < 2 y/o
Mesalamine
GI anti-inflammatory
Salicylate – 5-ASA
Inhibits prostaglandin synthesis &

migration of inflammatory cells
into bowel wall
Scavenges superoxide-free radicals
IBD
UC
Proctitis
Sulfasalazine mesalamine &

sulfapyridine
Metoclopramide
Promotility & antiemetic CI in Parkinson’s ds & seizure
D2 receptor antagonist disorders
Drowsiness
Blocks relaxant effect of D on GI EPS rxns
smooth m. restlessness
Blocks presynaptic D receptors & ↑
Ach release & stim. smooth m.
Blocks D2 receptors in
chemoreceptor trigger zone &
vomiting center
Chemotherapy-induced emesis
Gastric stasis – postsurgical &
diabetic
GE reflux
Misoprostol
Cytoprotective CI in pregnancy
Synthetic PGE1 analogue
Abdominal pain
D
↓ gastric mucosal secretion Miscarriage
& ↑ secretion of
bicarbonate & mucus
Prevent gastric mucosal injury

from NSAIDs
Abortificient in combo w/
mifepristone
Omeprazole
Antiulcer Abdominal pain
Proton pump inhibitor
Inhibits metabolism
Diazepam
Irreversibly inhibits H/K ATP Cyclosporine
pump in gastric parietal cells Phenytoin
Prevents gastric acid secretion
Peptic ulcer ds
GE reflux
Zollinger-Ellison syn
dyspepsia
Ondansetron
Antiemetic HA
5-HT3 receptor antagonist Constipation
D
Blocks 5-HT3 receptors in GI
vagal afferent nerves, solitary
tract nucleus, & chemoreceptor
trigger zone
Prevent N, V from chemotherapy

& radiation therapy
Postoperative N, V
Promethazine
Antiemetic, antihistamine, Neuroleptic malignant syn
sedative
H1 receptor antagonist, Sedation
phenothiazine Confusion
Disorientation
Blocks H1 & M1 receptors
Inhibits stim. chemoreceptor
trigger zone & vomiting center
N, V
Allergic rxns
Ranitidine
Antiulcer
H2 receptor antagonist
Blocks H2 receptors in
gastric parietal cells
↓ gastric acid secretion
Peptic ulcer ds
GE reflux
Dyspepsia
Sucralfate
Antiulcer Constipation
Cytoprotective, sulfated
polysaccharide ↓ absorption
Fat soluble vitamins
fluoroquinolones
Adheres ulcer crater & forms
protective barrier
Prevents acid secretion & pepsin
hydrolysis of mucosal proteins
Stim. prostaglandin synthesis
Peptic ulcer ds
GE reflux
Prevent NSAID-induced gastric
injury
Tegaserod
GI motility agent Diarrhea
Partial agonist @ 5-HT4 Ischemic colitis
receptors
Activates 5-HT4 receptors

on sensory neurons in
enteric nervous system
Release neurotransmitters
& ↑ peristalsis
IBS in women w/ constipation

Hematologic
Abciximab Epoetin
Alteplase Eptifibatide
Aspirin Ezetimibe
Atorvastatin Filgrastim
Bivalirudin Folic acid
Cholestyramine Gemfibrozil
Cilostazol Heparin
Clopidogrel Niacin
Cyclosporine Sirolimus
Enoxaparin Warfarin
Abciximab
Antithrombotic Bleeding
Monoclonal Ab Thrombocytopenia
Inactivates platelet gp
llb/llla receptors
Prevents platelet
aggregation
Prevent thrombosis during

coronary angioplasty &
stent placement
Alteplase
Thrombolytic Reperfusion arrhythmia
Plasminogen activator
Contraindications
Internal bleeding
Converts plasminogen Recent CNS surgery or
plasmin trauma
Degrades fibrin & fibrinogen
AMI
Acute ischemic stroke
Occluded central venous
access devices
Streptokinase & urokinase for

pulmonary embolism
Atorvastatin
Cholesterol lowering agent Myalgia
HMG-CoA reductase Myositis
inhibitor Rhabdomyolysis
Hepatitis
HMG-CoA reductase, rate- GI distress
limiting enzyme for
cholesterol Effects ↑ w/
↑ hepatic cholesterol uptake Grapefruit juice
↓ LDL levels Azole antifungals
cyclosporine
Hypercholesterolemia
Cholesterol-lowering effects ↑
w/ ezetimibe & bile acid-
binding agents
Bivalirudin
Anticoagulant Bleeding
Hirudin analogue
Inhibits thrombin
Prevents blood coagulation
Thrombosis in unstable angina

AMI
Stent insertion
Used in pts w/ heparin-induced

thrombocytopenia
Cholestyramine
Cholesterol-lowering Constipation
agent Abdominal discomfort
Bile-acid binding resin
Binds intestinal bile

acids
Prevents reabsorption
↑ cholesterol utilization
↓ LDL levels
Diarrhea d/t excess bile
acids
Cilostazol
Antiplatelet HA
Platelet aggregation inhibitor
Effects ↑ w/ CYP3A4
Inhibits phosphodiesterase III inhibitors
& ↑ cAMP in platelet & blood Azole antifungals
vessels Erythromycin
Inhibit platelet aggregation Grapefruit juice
Causes vasodilation
Intermittent claudication
Improves blood flow &
walking distance
Additive effects w/ aspirin

Clopidogrel
Antiplatelet Hypersensitivity reaction
Platelet aggregation inhibitor
Irreversibly inhibits binding

of ADP to platelet receptors
↓ gp IIb/IIIa mediated
aggregation
Stroke
MI
Peripheral vascular ds

Cyclosprine
Immunosuppressant HTN
IL2 expression inhibitor Nephrotoxic
Gingival hyperplasia
Hirsutism
Bind immunophilins Tremor
Complex binds
calcineurin inhibits
transcription of IL2 gene Induce metabolism
Rifampin
Barbiturates
Prevent rejection of renal, Carbamazepine
cardiac or hepatic allografts
Severe RA & psoriasis
Inhibits metabolism
Grapefruit juice
Enoxaparin
Parenteral anticoagulant Thrombocytopenia
LMWH
Binds/potentiates antithrombin
III on factor Xa
Prevent
DVT
Pulmonary embolism after knee,
hip, or abdominal surgery
Thrombosis in unstable angina &
non Q-wave MI
Effects reversed w/ protamine

sulfate
NO monitoring w/ PTT
Epoetin
Hematopoietic growth factor HTN
Recombinant human EPO
Binds receptors on erythroid

progenitor cells & stim. cell
maturation & prolif.
Reticulocytosis & ↑ Hct
Anemia d/t
CRF
Chemotherapy
Zidovudine therapy
Hematologic malignancy
lymphoma
Used as performance-enhancing
drug by athletes
Eptifibatide
Antiplatelet Bleeding
GP IIb/IIIa receptor
antagonist
Reversibly inhibits fibrinogen

binding to gp IIb/IIIa
receptors
Prevents platelet aggregation
Prevent coronary thrombosis in

Unstable angina or non-ST
segment elevation MI
Coronary angioplasty or stent
placement
Ezetimibe
Cholesterol-lowering agent
Cholesterol absorption inhibitor
Disrupts annexin-caveolin
complex mediating cholesterol
transport intestinal brush border
Inhibits absorption of biliary
dietary cholesterol
Pro-drug converted to active

glucuronide metabolite
Additive effect w/ statins

Filgrastim
Hematopoietic growth factor Bone pain
Recombinant human GCSF
Binds receptors on myeloid

progenitor cells & stim.
Accelerates neutrophil recovery
after myelosuppressive
chemotherapy
↓ infection incidence
Neutropenia assoc/ w/
chemotherapy & bone marrow
transplants
Avoid 24 hrs prior & after

chemotherapy
Folic acid
Vitamin, hematologic agent Absorption ↓ by
Metabolic cofactor for DNA Phenytoin
synthesis Cholestyramine
Folate reductase inhibited by

Activated folate transfer one- MTX
carbon units to purine &
pyrimidine precursors
Megaloblastic anemia
Fetal neural tube defects
Coronary artery ds
Pregnant woman have ↑

requirements
Gemfibrozil
Lipid-lowering agent GI distress
Fibric acid derivative Myositis
Activates peroxisome Statins ↑ risk

rhabdomyolisys
proliferator activated
receptor-α
Oxidizes FA & apo-AI & AII
↓ plasma triglycerides
↑ HDL
Hypertriglyceridemia
↓ HDL levels
Monitor LFTs throughout Tx

Heparin
Antithrombotic
III
↑ inactivation factor Xa &
thrombin
Venous thromboembolism
Pulmonary embolism
AF w/ embolism
Consumptive coagulopathies
In vitro & catheter coagulation
Monitor PTT
Protamine sulfate for OD
Niacin
Vitamin, lipid-lowering agent Flushing
G-protein coupled receptor Pruritis
ligand GI distress, peptic ulcer
Hyperglycemia
Activates G-protein coupled Hepatotoxicity
receptor
Inhibits lipolysis & release of Statins ↑ risk
FA rhabdomyolysis
↓ hepatic triglyceride
synthesis & VLDL secretion
↑ HDL
Pellagra
Sirolimus
Immunosuppressant Leukopenia
T-lymphocyte inhibitor Thrombocytopenia
Hyperlipidemia
Rash
Inhibits regulatory
kinase in cytokine- ↑↑ blood levels
driven T-cell prolif. Cyclosporine
Combo w/ corticosteroid & Azole antifungals
cyclosporine Erythromycin
Grapefruit juice
Prevent Cimetidine
Rejection renal allograph
Coronary stent restenosis
Warfarin
Oral anticoagulant Fetal malformations
Coumarin vit. K antagonist Abnormal bone development
Inhibits reduction of oxidized

vit. K
Prevents vit. K dependent
carboxylation of glutamate
residues of factors II, VII,
IX, X, proteins C & S
Delayed onset d/t circulating

coagulation factors
Monitor INR
Give vit. K if bleeding
Musculoskeletal
Acetaminophen Indomethacin
Allopurinol Infliximab
Celecoxib Ketorolac
Cyclobenaprine Probenecid &
Etanercept colchicine
Ibuprofen
Acetaminophen
Analgesic, antipyretic OD cause fatal hepatic
COX-3 inhibitor failure
↑ hepatotoxicity w/ alcohol
Inhibits COX-3 selectively
↑ renal toxicity w/ salicylates
Inhibits synthesis of PG & NSAIDs
causing pain & fever
Mild-moderate pain
Fever
Lacks anti-inflammatory
& antiplatelet activity
Allopurinol
Antigout Rash
Xanthine oxidase
inhibitor Inhibits metabolism
Mercaptopurine
Inhibits xanthine
oxidase & catabolism of
purines xanthine &
uric acid
↓ uric acid levels
Prevent hyperuricemia &

gout
Celecoxib
NSAID GI bleeding
COX-2 inhibitor ↑ risk stroke & MI
Inhibits COX-2 &

synthesis of PG causing
pain, fever, &
inflammation
OA
RA
Inflammatory jt ds
Cyclobenzaprine
Skeletal m. relaxant Dizziness
Tricyclic central-acting Drowsiness
m. relaxant Dry mouth
AVOID MAOI
Acts on brainstem &
spinal cord to reduce
tonic somatic m.
activity via γ & α motor
neurons
Acute muscle spasm

Etanercept
Antirheumatic agent, URI
antitumor necrosis factor HA
Antitumor necrosis
factor – p57 combined ↓ Ab response to live
w/ Fc of IgG virus vaccines
Binds TNF-α & ↓ jt

inflammation & pain
Slows progression of
RA
RA
Ibuprofen
NSAID GI bleeding
Nonselective COX inhibitor N, V
Dyspepsia
Inhibits COX-1 & COX-2 & Allergic rxns
synthesis of PG causing Hepatitis & renal failure
pain, fever, & inflammation
Mild-moderate pain or
dysmenorrhea
Inflammatory disorders
OA
RA
↓ risk colon, breast, lung, &

prostate cancers
Indomethacin
NSAID GI bleeding
Dyspepsia
Allergic rxns
Inhibits COX-1 & COX-2
Dizziness
Drowsiness
HA
Gouty arthritis
OA
RA
Ankylosing spondylitis
PDA in premature
neonates
Infliximab
Ds modifying Fatigue
antirheumatic N, V
Monoclonal Ab to URI
TNF-α
Inactivates TNF-α & ↓

jt inflammation, pain,
& destruction
↓ Sx of Crohn’s ds
RA
Crohn’s ds
Ketorolac
NSAID Aspirin-allergy
Nonselective COX inhibitor Allergic rxn in pt w/ asthma
Nasal polyps
Inhibits COX-1 & COX-2 &
Short-term pain management
Prolongs bleeding time

Limit use to < 5d
Probenecid & Colchicine
Antigout Probenecid
Uricosuric – probenicid Inhibits renal tubular
secretion of Penicillins
Anti-inflammatory – colchicine Used to ↑ penicillin serum
levels
Probenecid Colchicine
Inhibits renal reabsorption of D
uric acid & ↑ uric acid N, V
secretion Agranulocytosis & aplastic
Colchicine anemia
Inhibits leukocyte response to
monosodium urate crystals in
jt
Acute gouty arthritis

Prevent gouty arthritis
Neurodegenerative
Baclofen Levodopa-carbidopa
Benztropine Memantine
Donepezil Pergolide
Entacapone Selegiline
Interferon-beta-1b
Baclofen
Antispasticity • Drowsiness
GABA-B receptor agonist • Dizziness
• Fatigue
↓ neuronal cAMP & Ca • Weakness
influx
• ↑ K influx • Additive effects
• ↓ motor neuron excitability • Alcohol
& inhibits spinal reflexes • Kava
• Valerian
• Spasticity
• Chamomile
• MS
• Spinal cord injury
• ALS
Benztropine
Anti-Parkinson • Blurred vision
Central anticholinergic • Dry eyes
• Constipation
Blocks cholinergic receptors • Dry mouth
& restores neurotransmitter • Urinary retention
balance in basal ganglia
• Parkinson’s ds
• Drug-induced EPS
• ↓ tremor > bradykinesia &

rigidity
Donepezil
Anti-Alzheimer • N, D
Cholinesterase inhibitor • HA
Inhibits cholinesterase in
CNS
• ↑ Ach neurotransmission
• Slows decline in cognitive
function
• Alzheimer’s ds
• Does NOT prevent ds

progression
Entacapone
Anti-Parkinson • Rhabdomyolysis
• Neuroleptic malignant syndrome
Catechol-O-
methyltransferase inhibitor
Inhibits catechol-o-
methyltransferase
inactivation of levodopa
• ↑ levodopa in CNS
• Prolongs response to levodopa
& ↓ S/Sx Parkinson’s ds
• Adjunct to levodopa/carbidopa for

Parkinson’s ds
• AVOID nonselective MAOI

Interferon-beta-1b
Anti-multiple sclerosis • HA
Interferon • Weakness
• GI distress
Binds cell surface
• Sweating
receptors producing • Neutropenia
immuno-suppressive • Myalgia
effects • Chills
• ↓ relapse & slows physical • Fever
disability in MS
• Relapsing-remitting MS
• SubQ daily
Levodopa-carbidopa
Anti-Parkinson • Dyskinesia – involuntary movements
Dopamine precursor, decarboxylase • N, V
inhibitor • Hallucinations
• ↑ arrhythmia w/ halothane
Levodopa
• Converted to D in CNS
• Augments neurotransmission in
basal ganglia
Carbidopa
• Inhibits peripheral dopa-decarboxylase
• ↑ levodopa availability in CNS
• Parkinson’s ds
• HTN crisis w/ MAOI

Memantine
Anti-Alzheimer
Glutamate antagonist
Glutamate NMDA
receptor antagonist
• Prevent excitotoxic effects
of glutamate causing
neuronal loss
• Slows decline in cognitive
function
• Alzheimer’s ds
Pergolide
Anti-Parkinson • Dyskinesia
Dopamine receptor • Hallucination
agonist • Orthostatic hypotension
• Constipation
Activates D receptors in
basal ganglia
• Parkinson’s ds in
conjunction w/
levodopa/carbidopa
Selegiline
Anti-Parkinson • AVOID
• Meperidine & opioids
Type B MAOI • Fatal rxn
• Excitation
• Rigidity
Converted to active form by • HTN
• coma
MAO • SSRI
Irreversibly inhibits D • Serotonin syn
degradation by MAO • Tricyclics
• Asystole
• ↑ response to levodopa/carbidopa • HTN
Tx • Syncope
• Rigidity
• Parkinson’s ds w/ • seizures
levodopa/carbidopa
• Slows progression of Parkinson’s

ds
Other Drugs
• Alprostadil • Latanoprost
• Bosentan • Mesna
• Epoprostenol • Succimer
Alprostadil
• Vasodilator – IV infusion
• Prostaglandin E1 • Apnea
• Hypotension
• Arrhythmia
• Activates PG EP receptors – Local products
– Vascular smooth m. • Prolonged/painful erection
relaxation & vasodilation • lightheadedness
– Maintain PDA in neonates

awaiting surgery
• IV infusion
– Male erectile dysfunction
• Local injection or pellets
Bosentan
• Vasodilator – CI in pregnancy
• Endothelin-1 receptor • Causes birth defects
antagonist
– ↑ serum aminotransferase
levels
• Blocks endothelin A & B
receptors
• ↓ pulmonary vascular
resistance & dyspnea
• Improves walking distance
– Pulmonary arterial HTN

Epoprostenol
• Vasodilator – Flushing
• Naturally occurring – Hypotension
prostacyclin (PGI2) – Tachycardia
– Diarrhea
• Activated prostaglandin IP – N, V
receptors
– Vascular smooth m.
relaxation
• ↑ pulmonary blood flow &
reduces dyspnea
– Pulmonary arterial HTN

Latanoprost
• Ocular hypotensive agent – Alters color of iris causing
• Prostaglandin F2α analogue permanent eye color change
by ↑ amount of melanin in
melanocytes
• Activates prostaglandin FP
receptors
• ↑ aqueous humor outflow via
uveoscleral pathways
• Lowers intraocular pressure
– Chronic open-angle glaucoma
– Topical ocular admin

Mesna
• Antidote
• Sulfhydryl compound
• Detoxifies urotoxic
metabolites acrolein of
ifosfamide &
cyclophosphamide
– Hemorrhagic cystitis d/t

ifosfamide &
cyclophosphamide
Succimer
• Antidote
• Metal chelating agent –
dimercaptosuccinic acid
• Chelates lead
– Water-soluble chelates to
excreted in urine
• ↓ blood lead levels
Pharmacology
Analgesic & Antimigraine
Butorphanol Naloxone
Dihydroergotamine Propoxyphene
Fentanyl Sumatriptan
Meperidine Tramadol
Methadone
Morphine
Butorphanol
Opioid analgesic Dysphoria
Mixed opioid agonist-antagonist Nightmares
w/drawal in pts dependent on full
opioid agonists
Partial agonist or antagonist @
opioid µ receptors AVOID MAOI
Agonist @ κ receptors @ spinal Potentially fatal
& supraspinal sites
Inhibits spinothalamic pain
neurotransmission
Admin intranasally
↓ respiratory depression,
constipation, dependence than full
µ receptor agonists
Dihydroergotamine
Antimigraine N, V
Ergot alkaloid Stiff neck, shoulder, extremities
5-HT 1B/1D receptor agonist Leg weakness
Numbness & tingling in fingers
& toes
Presynaptic inhibition of
trigeminal peptide
neurotransmitter release
Inhibitions brainstem activation
of trigeminal neurons
Vascular HA
Migraine & cluster
Injection or nasal spray

Fentanyl
Phenylpiperidine Confusion
Activates opioid µ receptors Anorexia
Inhibits pain transmission N, V
@ spinal & supraspinal Constipation
sites
AVOID MAOI in past 14d
Chronic pain
Breakthrough for cancer
pain
Transdermal patch
Meperidine
Opioid analgesic Confusion
Strong opioid agonist Sedation
Constipation
N, V
Activates opioid receptors Dependence
Inhibits pain transmission Toxic metabolite CNS
Generalized CNS excitation, convulsions,
depression tremors
AVOID MAOI
Potentially fatal
Analgesia during labor
Lacks antitussive activity

Methadone
Opioid analgesic Respiratory depression
Strong opioid agonist Constipation
Confusion
Sedation
Inhibits pain transmission AVOID MAOI
Suppresses opioid w/drawl
Sx w/ euphoria or
dependence
Prevention of opioid abuse
Orally, once per day

Morphine
Strong opioid µ receptor Confusion
agonist Hypotension
Constipation
Activates µ receptors Respiratory depression
↑ cAMP
Opens K & closes Ca AVOID MAOI w/ 14 d
channels Potentially fata
↓ release substance P
Inhibits pain @ spinal &
supraspinal sites
Severe pain w/ MI
Pulmonary edema
Active metabolite
Morphine glucuronate
Naloxone
Opioid antagonist
Opioid receptor antagonist
Blocks opioid µ, δ, κ
receptors
Rapidly reverses effects of
opioid agonists
Opioid OD, dependence
Short half-life needs

repeated doses
Propoxyphene
Opioid analgesic Dizziness
Weak opioid agonist Weakness
N
dependence
Activates opioid
receptors
Inhibits pain transmission
Mid-moderate pain
Combined w/
acetaminophen or aspirin
Sumatriptan
Antimigraine Dizziness
5-HT 1B/1D receptor agonist Vertigo
Tingling
Warm sensation
Tight feeling head & chest
Coronary vasospasm
Presynaptic inhibition of
trigeminal peptide
neurotransmitter release AVOID
MAOI
Inhibitions brainstem activation SSRI
of trigeminal neurons
Vascular HA
Migraine & cluster
Oral, nasal, & subQ

Tramadol
Analgesic Dizziness
Dual action HA
Constipation
Activates µ opioid receptors Lowers seizure threshold
Inhibits neuronal reuptake
5-HT & NE AVOID MAOI
↑ inhibition of pain
↑ risk seizures w/ high
Moderate pain doses
Chronic pain Penicillins
Phenothiazines
Naloxone reverses some

but NOT all Sx
Anesthetics
Benzocaine Midazolam
Bupivacaine Nitrous oxide
Halothane Propofol
Ketamine Sevoflurane
Lidocaine
Benzocaine
Local anesthetic Cross-sensitivity w/ other ester-
Ester-type type anesthetics

conduction
Topical anesthetic
Pain
Itching
Inflammation
Burns
Insect bites
Contact dermatitis
Wounds
Irritates skin when 1st applied

Use caution w/ sunburn & large
areas of skin
Bupivacaine
Local anesthetic Cross-sensitivity w/
Amide-type amide-type anesthetics
Blocks Na channels &

nerve conduction
Local or regional
anesthetic
Surgical
Diagnostic
Obstetrical
therapeutic
Halothane
General anesthetic Sensitizes heart to
Inhalational, halogenated catecholamine-induced
cardiac arrhythmia
hydrocarbon
Hepatotoxic
Fluoride metabolites
Suppresses sensory
General anesthetic
High blood:gas partition

coefficient
Slow rate of induction &
recovery
Ketamine
IV anesthetic Delirium
Glutamate antagonist Hallucination
Irrational behavior during
Blocks glutamate NMDA recovery
receptors ↑ BP
Dissociate anesthesia
Analgesia
Immobility
Amnesia
Does NOT depression

respiration or cause LOC
Anesthesia
Minor surgical & diagnostic
procedures
Children
Lidocaine
Local anesthetic Cross-reactivity w/ amide-type
Amide-type anesthetics

conduction
Topical
Infiltration
Nerve block
Epidural
Spinal anesthesia
Eutectic mixture
Lidocaine & prilocaine
Anesthetize intact skin for
venipuncture
IV cannulation
Circumcism
Midazolam
Sedative-hypnotic-anxiolytic Apnea
Short-acting BZDP Laryngospasm
Potentiates GABA binding to Cardiac arrest
Sedation
Hypnosis
Amnesia
Preoperative sedation &

anxiolysis
Sedation of mechanically
vented pts
Nitrous Oxide
Inhalation general anesthetic
Anesthetic gas

Suppresses sensory
Minor surgery & dental
procedures
Rapid induction & recovery

Euphoria – laughing gas
Propofol
General anesthesia Bradycardia
IV anesthetic Hypotension
Diisopropyl phenol

Hypnosis
Anesthesia
Amnesia
NO analgesic effect
Intubation & maintenance of

general anesthesia
Sedation of intubated pts in
ICU
Sevoflurane
General anesthetic
Inhalation anesthetic
Potentiates GABA
binding to GABA-A Cl
channel
Suppresses sensory
Causes LOC
General anesthesia
Anti-infective
Acyclovir Cefepime
Albendazole Cetriaxone
Amantadine Ciprofloxacin
Amoxicillin-clavulanate Clindamycin
Amphotericin B Doxycycline
Azithromycin Efavirenz
Aztreonam Enfuvirtide
Caspofungin Erythromycin
Cefazolin Ethambutol
Foscarnet Linezolid
Fosfomycin Mefloquine
Ganciclovir Metronidazole
Gentamicin Mupirocin
Griseofulvin Nafcillin
Imipenem-cilastatin Nitrofurantoin
Isoniazid Oseltamivir
Itraconazole Paromomycin
Ivermectin Penicillin G
Levofloxacin
Pentamidine Rifampin
Piperacillin-tazobactam Ritonavir-lopinavir
Praziquantel Streptomycin
Primaquine Terbinafine
Pyrimethamine Trifluridine
Pyrantel TMP-SMX
Quinine Vancomycin
Quinpristein-dalfopristin Zidovudine
Ribavirin
Acyclovir
Antiviral Dizziness
Nucleoside analogue Diarrhea
N
Nephrotoxicity
Converted to acyclovir
triphosphate by viral & host cell
kinases Probenecid ↑ serum levels
Incorporated into DNA by viral
DNA polymerase causing DNA
chain termination
HSV2
Herpes zoster
Shingles
Chickenpox – varicella
↓ viral shedding, pain, & healing

time
Albendazole
Antihelmintic GI distress
Benzimidazole Constipation or diarrhea
Hepatitis & hematologic toxicity w/ high
doses
Binds & inhibits polymerization of
tubulin dimmers to form
cytoplasmic microtubules
Impairs glucose uptake & deplete
glycogen stores
Intestinal nematode infections

Hookworm
Pinworm
Whipworm
Ascariasis
Capillariasis
Trichinosis
Use w/ corticosteroid
Cysticercosis & echinococcus
Microsporidiosis
Amantadine
Anti-influenza, Ataxia
antiparkinson Dizziness
Tricyclic amine Insomnia
Skin mottling & livedo
reticularis
Inhibits influenza-A M2 Blurred vision
proton channel & Dry mouth
acidification of virus
particle
Prevents viral protein-
protein dissociation &
uncoating of viral
particles
Influenza A
Amoxicillin-clavulanate
Extended spectrum aminopenicillin Superinfection
Allergic rxn
Rash
Amoxicillin Serum sickness
Binds PBP anaphylaxis
Inhibits cross-linking of cell wall
peptidoglycan
Probenecid inhibits renal tubular
Clavulanate excretion
Inhibits class-A β-lactamase ↑ serum levels
Protects amoxicillin from
destruction
NOT antimicrobial by itself
Respiratory tract infections

Otitis, sinusitis, pneumonia
Skin or skin structure infections
Bite wounds
Amphotericin B
Antifungal Chills
Fever
Polyene ABX Diarrhea
N, V
Binds ergosterol & ↑ Nephrotoxicity
membrane permeability Hypokalemia
Leakage of cell contents
↑ toxicity w/ cyclosporine,
antineoplastics
Candidiasis
Thiazides, & corticosteroids ↑
Cryptococcal meningitis hypokalemia
Aspergillosis
Blastomycosis
Coccidioidomycosis
Histoplasmosis
Mucormycosis
Azithromycin
Macrolide
Binds 50s ribosome

Prevents peptide elongation &
translocation from acceptor site
to peptidyl site
Respiratory infections d/t strep,

pneumo, H. influenzae, Legionella
Otitis media, sinusitis
Single-dose Tx for chlamydial
urethritis, chancroid, MAI
infections
Aztreonam
β-lactam ABX Thrombophlebitis
Monobactam Allergic rxn
Binds PBP including

transpeptidase
Inhibits cross-linking of
Drug resistant gram (-)

infections including
Pseudomonas aeruginosa
& Enterobacteriaceae
Caspofungin
Antifungal HA
Echinocandin Fever
Phlebitis
Abnormal LFTs
cell wall component
β-1,3-D-glucan
Candida albicans
Invasive aspergillosis
IV admin
Not absorbed well by gut
Cefazolin
β-lactam ABX Rash
2nd generation cephalosporin Diarrhea
Superinfection
Binds PBP including
transpeptidase
Probenecid inhibits excretion & ↑
Inhibits cross-linking of cell serum levels
wall peptidoglycan
Surgical wound infections

Infections d/t
Staph, strep, E. coli, Klebsiella
pneumoniae, Proteus mirabilis
NOT active against MRSA

Cefepime
β-lactam ABX Rash
4th generation Diarrhea
cephalosporin Pseudomembranous colitis
Superinfection
Binds multiple PBP Probenecid inhibits excretion

Inhibits cross-linking of & ↑ serum levels
Resistant to many β-
lactamases
Drug-resistant gram (-)

bacteria
Citrobacter
Enterobacter
Ceftazidime
β-lactam ABX Rash
Superinfection
Binds PBP including
transpeptidase
wall peptidoglycan
Gram (+), gram (-), & anaerobics

– Pseudomonas aeruginosa
Pneumonia, meningitis, UTI, skin

structures, bones, jts
Cetriaxone
β-lactam ABX Rash
Superinfection
Binds PBP including
transpeptidase
wall peptidoglycan
Infection d/t
Pneumococci, gonococci,
meningococci, H. influenzae,
Moraxella catarrhalis, Borrelia
burgdorferi
Single IM injection Tx acute

otitis media or gonorrhea
Ciprofloxacin
Antibacterial Insomnia
Fluoroquinolone Diarrhea
N
Inhibits bacterial DNA Absorption ↓ by cations
topoisomerase type II (DNA gyrase) Antacids
& type IV
Iron
Prevents DNA replication & Zinc
separation of chromosomes bismuth
Urinary tract, prostate, intraabdominal

w/ metronidazole, bone or jt, skin
Inhalational anthrax
Gonorrhea
Infectious diarrhea
Gram (+), gram (-), Pseudomonas

aeruginosa
Clindamycin
Aminosugar ABX C. difficile superinfection
Protein synthesis Diarrhea
inhibitor Pseudomembranous colitis
Binds 50s ribosome

Prevents translocation of
nascent peptide from
acceptor site to peptidyl
site
Strep, staph, gram (+)

Acne vulgaris
Anaerobes including
Bacteroides
Doxycycline
Tetracycline ABX AVOID
Protein synthesis inhibitor Pregnancy & children > 8 y/o
Outdated preparations are
nephrotoxic
Binds 30s ribosome
Reversibly inhibits binding of Permanent teeth discoloration
transfer RNA to acceptor site Photosensitivity
Diarrhea
Rickettsia, Chlamydia, N, V
Mycoplasma, Borrelia
Acne
Cholera
Gonorrhea & syphilis in PCN
allergic pts
Brucellosis & ehrlichiosis
Efavirenz
Antiretroviral N
Non-nucleoside reverse Rash
transcriptase inhibitor Drowsiness
Depression
Binds reverse
transcriptase & disrupts
catalytic site
HIV in combo w/ nucleoside

reverse transcriptase inhibitor
– synergistic
High fat meal ↑ absorption

Enfuvirtide
Antiretroviral Injection site rxn
HIV fusion inhibitor Rotate sites daily
Binds HIV virus gp41 &

blocks fusion of HIV w/
host cells CD4 Thelper
lymphocytes
Drug-resistant HIV
Erythromycin
Macrolide ABX Activates motilin receptors
causing uncoordinated
Protein synthesis inhibitor peristalsis
Anorexia
Binds 50s ribosome N, V
Prevents peptide elongation

& translocation from
acceptor site to peptidyl site
Pharyngitis, otitis media,

sinusitis, pneumonia d/t
Strep, pneumococci,
Mycoplasma, Chlamydia,
Legionella, MAI
Ethambutol
Antitubercular Dose-related
retrobulbar optic
Synthetic butanol
neuritis
derivative
Impaired red-green
color discrimination
Bacteriostatic against Monitor pts color
mycobacteria discrimination
regularly
Inhibits RNA synthesis Gouty arthritis
M. tuberculosis
MAI
Foscarnet
Antiviral HA
Diarrhea
Pyrophosphate V
Renal failure
Blocks pyrophosphate- Hypocalcemia
binding site on viral Hypokalemia
DNA polymerase Hypomagnesemia
Prevents attachment of Anemia
nucleotide precursors to Arthralgia
DNA Myalgia
CMV retinitis in HIV pts Pentamidine causes life-

Acyclovir-resistant HSV in threatening hypocalcemia
immunocompromised
Fosfomycin
ABX
Cell wall synthesis
inhibitor
Inhibits enopyruvyl
transferase & addition of
phosphenolpyruvate to N-
acetylglucosamine to
form N-acetylmuramic
acid
Cystitis d/t E. coli or

Enterococcus faecalis
Single dose Tx for UTI

Ganciclovir
Antiviral ↓ visual acuity
Nucleoside Neutropenia
analogue Thrombocytopenia
Anemia
Converted to
ganciclovir
triphosphate
Inhibits viral DNA
polymerase
CMV infection in
immunocompromise
d & transplants
Gentamicin
Aminoglycoside ABX Nephrotoxicity
Protein synthesis inhibitor Ototoxicity
Vestibular & cochlear
↑ w/ loop diuretics
Binds 30s ribosome
Prevents initiation of protein
synthesis
Gram (-) bacilli including

Enterobacteriaceace & P.
aeruginosa
Strep, enterococcal, & staph
infections

Griseofulvin
Antifungal HA
Fungistatic ABX
Induces CYP450
Reduces plasma levels
Deposits in keratin warfarin & OCP
precursor cells of skin,
hair, & nails
Disrupts microtubules
& mitotis of
dermatophytes
Dermatophyte infections
NOT Candida
Imipenem-cilastatin
β-lactam ABX Allergic rxns
Carbapenem ABX & Diarrhea
dehydropeptidase inhibitor V
Seizures
↑ risk w/ ganciclovir or
Imipenem cyclosporine
Binds PBP & inhibits cross-
linking cell wall peptidoglycan
Probenecid inhibits secretion & ↑
Cilastatin serum levels
Inhibits renal dehydropeptidase
& degradation of imipenem
Endocarditis, pneumonia, UTI,

pelvic, abdominal d/t aerobic &
anaerobic
Isoniazid
Antitubercular Hepatitis
Toxic metabolite acetyl-
Nicotinic acid derivative hydrazine
Reduces catalase- Vit. B6 deficiency
peroxidase
mycolic acid component of
cell wall
TB
Bimodal distribution d/t fast

& slow acetylation
Inactivates vit. B6
Itraconazole
Antifunal GI distress
Synthetic triazole Rash
Hepatitis
Inhibits 14-α-demethylase
CYP450 enzyme that
converts lanosterol
ergosterol
Blastomycosis, candidiasis,
coccidioidomycosis,
histoplasmosis
Onychomycosis – nail beds
Ivermectin
Antiparasitic Vertigo
Antihelmintic ABX Sedation
Activates glutamate-gated
Cl ion channel
Pharyngeal m.
hyperpolarization &
paralysis
Strongyloidiasis
Cutaneous larva migrans
Onchocerciasis filiariasis
W. bancrofti
Levofloxacin
Antibacterial
Fluoroquinolone

topoisomerase type II (DNA
gyrase) & type IV
separation of chromosomes
Community-acquired pneumonia
UTI
Gynecologic & skin infections
Gram (+), gram (-), P. aeruginosa,

Mycoplasma, Mycobacterium
Linezolid
Antibacterial Inhibits MAO
Oxazolidinone protein
synthesis inhibitor
Binds 23s ribosomal

RNA of 50S subunit
Prevents formation of
70s initiation complex
VRE, MS/MRSA, PCN-

sensitive pneumococci
Mefloquine
Antimalarial Neuropsychiatric syn
4-quinolone methanol Hallucination
derivative Anxiety
Confusion
Seizure
Inhibits erythrocytic Coma
schizogony
Inhibit nucleic acid synthesis
Malaria
Chloroquine-
susceptible/resistant trains of
P. falciparum & P. vivax
Perform CBC during chronic

prophylactic Tx
Metronidazole
Antiprotozoal GI pain
Nitroimidazole Anorexia
N
Dizziness
Reduced by
pyruvate:ferredoxin to
form nitro-free radicals Alcohol causes
disulfiram-like effect
that attack DNA &
proteins
Amebiasis, giardiasis,
trichomoniasis
Balantidium coli, C.
difficile, B. fragilis
Mupirocin
ABX
Protein synthesis
inhibitor
Competes w/ isoleucine
for binding bacterial
isoleucyl tRNA
synthetase
Prevents addition of
isoleucine during protein
synthesis
Impetigo by staph or strep

Eradicate nasal colonization of
MRSA
Infected traumatic skin lesions
Nafcillin
Superinfection
Antistaphylococcal, Pseudomembranous colitis
penicillinase-resistant Allergic rxn
penicillin Rash
Serum sickness
Anaphylaxis
Binds PBP
Inhibits cross-linking of cell
wall peptidoglycan Probenecid inhibits renal
tubular secretion & ↑ serum
levels
Methicillin-sensitive
penicillinase producing
staph
Bone, jt, UTI, respiratory,
skin, endocarditis,
meningitis
Nitrofurantoin
Urinary tract Anorexia
antibacterial N, V
Nitrofuran Neurotoxicity
Pneumonitis
Inhibits bacterial Probenecid inhibits

enzymes urinary excretion
UTI
E. coli, S.
saprophyticus
Oseltamivir
Antiviral
Neuraminidase inhibitor
Inhibits influenza A & B

neuraminidase
Prevents release &
spreading of viral
particles
Influenza A & B
Paromomycin
Antiprotozoal Nephrotoxic & ototoxic
if given IV
Aminoglycoside ABX
Inhibits protein
synthesis
Intestinal amebiasis
Cryptosporidiosis in
immunocompromised pts
Penicillin G
Narrow-spectrum Superinfection
penicillin Pseudomembranous
colitis
Allergic rxn
Binds PBP Rash
Inhibits cross-linking of Serum sickness
cell wall peptidoglycan Anaphylaxis
Strep, pneumococcal, Probenecid inhibits

meningococcal renal tubular secretion
Syphilis
Pentamidine
Antiprotozoal Nephrotoxic
Amidino-pentane Hematologic toxicity
derivative Hypoglycemia
Allergic rxn
Anaphylaxis
Disrupts nucleic acid
synthesis in protozoa
Erythromycin ↑ fatal
arrhythmias
P. carinii
Early stage African
trypanosimiasis –
sleeping sickness
Piperacillin-tazobactam
Antipseudomonal penicillin & β- Superinfection
lactamase inhibitor Pseudomembranous colitis
Allergic rxn
Rash
Piperacillin
Serum sickness
Binds PBP
Anaphylaxis
Inhibits cross-linking of cell
wall peptidoglycan
Tazobactam Probenecid inhibits renal tubular
secretion
Inhibits class A β-lactamases
Gram (-) bacilli, P. aeruginosa

Praziquantel
Antihelmintic Malaise
Isoquinoline derivative Anorexia
Drowsiness
dizziness
↑ Ca permeability of
schistosome tegument
Contraction & exposing
antigens to host
immunity
Schistosomiasis
Chinese liver fluke
Lung fluke
Cestodes – tapeworms
Primaquine
Antimalarial Hemolytic anemia in
G6PD deficiency
8-aminoquinoline
methemoglobinemia
Converted to oxidizing
quinoline-quinone
intermediates
Eradicate exo-erythrocytic
forms of P. vivax & P.
ovale
Pyrimethamine
Antiprotozoal N
Folate reductase inhibitor Anorexia
Hypersensitivity rxn
Inhibits folate reductase
Folate deficiency in protozoa
Malaria in combo w/ sulfadoxine

Toxoplasmosis in combo w/
sulfadoxine
NOT effective against P. vivax

Pyrantel
Antihelmintic Abdominal cramps
Pyrimidine analogue Anorexia
Diarrhea
V
Activates cholinergic
nicotinic receptors in
somatic m. of
nematodes
Produces depolarizing
NM blockade
Ascariasis
Hookworm & pinworm
Quinine
Antimalarial Abdominal cramps
4-aminoquinoline Diarrhea
V
Binds plasmodial DNA & Cinchonism

prevents replication & Tinnitus
transcription during Blurred vision
erythrocytic schizogony
Metabolism
Chloroquine-resistant malaria Cimetidine inhibits
Rifampin induce
Admin w/ doxycycline or
pyrimethamine-sulfadoxine
Quinupristin-dalfopristin
Streptogramin ABX Infusion site rxn
Protein synthesis
inhibitor
Binds 50s ribosomal

subunit
Quinupristin
Inhibits aminoacyl tRNA
synthesis & addition of AA
Dalfopristin
Inhibits peptidyl transferase
VRE, MS/MRSA
Ribavirin
Broad-spectrum antiviral Anemia
Guanosine analogue Hypotension
Cardiac arrest
Converted to ribavirin
triphosphate
Depletes guanosine
triphosphate
Inhibits viral RNA &
protein synthesis
RSV in infants or children

Chronic hepatitis C
Viral hemorrhagic fever – Lass
fever
Rifampin
Antitubercular Red discoloration of tears,
Rifampin derivative urine, saliva, sweat
Abdominal pain
V
Inhibits DNA-dependent RNA Diarrhea
polymerase Hepatitis
TB Induces CYP450
Leprosy ↓ levels
Prophylaxis meningococcal Warfarin
meningitis & H. flu B infections Theophylline
Itraconazole
Steroids
Opioids
Phenytoin
Verapamil
Ritonavir-lopinavir
Antiretroviral Anorexia
HIV protease inhibitor V
Altered taste
Abnormal thinking
Inhibits HIV protease &
Hyperlipidemia
conversion of gag-pol
polyprotein to Hyperlgycemia
functional proteins
Ritonavir
↑ lopinavir levels
HIV in combo w/
nucleoside reverse
Streptomycin
Aminoglycoside Nephrotoxic
Protein synthesis Ototoxic
inhibitor ↑ w/ loop diuretics
Binds 30s ribosome

Prevents initiation of
protein synthesis
Drug-resistant TB
Plague
Tularemia
IV admin
Terbinafine
Antifungal Itching
Allylamine Rash
Diarrhea
Anorexia
Inhibits squalene
oxygenase & formation of Metabolism
squalene epoxide during Cimetidine inhibits
fungal membrane Rifampin induce
ergosterol synthesis
Topical
Tinea corporis, cruris,
pedis, versicolor
Oral
Onychomycosis – fungal
nail infection
Trifluridine
Antiviral Ocular irritation
Thymidine analogue Redness
Itching
Inhibits HSV DNA

polymerase
Herpetic keratitis
Keratoconjunctivitis

Trimethoprim-sulfamethoxazole
Antibacterial N, V
Rash
Folate antagonist Stevens-Johnson syn
Allergic rxn
Sulfamethoxazole Anemia
Inhibits folate synthesis Hemolytic anemia
Megalobalstic anemia
Trimethoprim Leukopenia
Inhibits folate reduction Thrombocytopenia
Crystalluria
UTI, traveler’s diarrhea
Shigella enteritis Added folate deficiency w/
P. carinii & Nocardia phenytoin or MTX
pneumonia
Vancomycin
Glycopeptide ABX Red man syn
Extensive rate of infusion
Cell wall synthesis
Erythematous rash on
inhibitor face & upper body
Ototoxicity
Binds D-alanyl-D-alanine Vestibular & cochlear
portion of peptidoglycan
Prevents cross-linking of
D-alanine & pentaglycine
chain
MRSA, penicillin-resistant
enterococci, C. difficile
Zidovudine
Antiretroviral Anemia
Nucleoside reverse
Activated nucleotide
triphosphate incorporated into
DNA causing chain termination
HIV
Prevent maternal-fetal HIV
transmission
1st line Tx for HIV infections

Zidovudine w/ lamivudine or
emtricitabine & efavirenz or
lapinavir-ritonavir
Antineoplastic
Anastrozole Imatinib
Bleomycin Leuprolide
Busulfan
Meraptopurine
Carmustine
Cisplatin Methotrexate
Cyclophosphamide Paclitaxel
Doxorubicin Tamoxifen
Etoposide Trastuzumab
Fluorouracil Vincristine
Gemtuzumab
ozogamicin
Anastrozole
Estrogen antagonist N
Nonsteroidal aromatase HA
inhibitor Hot flashes
Back pain
Inhibits aromatase &
conversion to estrone
precursor to estradiol
Lowers estrogen levels
Halts progression of
estrogen-sensitive breast
cancers
Breast cancer in
Bleomycin
Antitumor Pneumonitis &
DNA intercalating pulmonary fibrosis
Hyperpigmentation
Complexes iron- Mucocutaneous toxicity
forming oxygen free Hematology toxicity
radicals that cause
single strand breaks
G2 phase specific
Lymphomas
SCC
Testicular carcinoma
Choriocarcinoma
Busulfan
Antineoplastic N, V
Alkyl sulfonate bifunctional Myelosuppression
alkylating agent Pulmonary fibrosis
Cross-links DNA strands by

covalently bonding guanine
residues
transcription
CML
Use w/ cyclophosphamide prior

allogenic hematopoietic
progenitor cell transplant for
CML
Carmustine
Antineoplastic N, V
Nitrosurea bifunctional Hepatotoxicity
akylating agent Anemia
Leucopenia
Cross-links DNA strands by Thrombocytopenia
covalently bonding guanine Pulmonary fibrosis
residues
transcription
Brain tumors
Myeloma
Lymphoma
Causes prolonged
myelosuppression
Cisplatin
Antineoplastic Severe N, V
Platinum compound Ototoxicity & tinnitus
Hypocalcemia
Forms reactive metabolites Hypokalemia
that covalently bond DNA
bases & cross-link DNA
Hypomagnesemia
strands Anemia
Testicular, ovarian, cervical,

bladder, lung, head/neck
cancers
Less bone marrow

suppression
Cyclophosphamide
Antineoplastic Anorexia
Nitrogen mustard bifunctional N, V
akylating agent Hemorrhagic cystitis & hematuria
Alopecia
Thrombocytopenia
Cross-links DNA strands by Leukopenia
covalently bonding guanine Anemia
residues
Prevents DNA replication & Rifampin induces CYP & ↑ toxicity
transcription
Hodgkin’s ds
Lymphomas, myeloma
Leukemia
Ovarian & breast tumors
RA
Converted to active metabolites

by CYP enzymes
Doxorubicin
Antitumor Colors urine red
DNA intercalating agent
Cardiomyopathy – dose-
Inserts b/w DNA bases limiting
Causes deformation & uncoupling Anemia
Complexes iron forming Leukopenia
hydroxyl free radicals that Thrombocytopenia
cause strand breaks Diarrhea
Inhibits topoisomerase II V
Causes strand breaks Stomatitis
S phase specific Alopecia
Breast, ovarian, bladder tumors

Bronchogenic carcinoma
Lymphoma & leukemia
Etoposide
Antineoplastic N, V
Podophyllotoxin, Leukopenia
topoisomerase inhibitor Thrombocytopenia
Alopecia
Inhibits mammalian
topoisomerase II & prevents
resealing of nicked DNA
strands
G2 phase specific
Testicular, small cell lung

carcinoma
Lymphoma
Leukemia
Fluorouracil
Antineoplastic Diarrhea
Pyrimidine antimetabolite V
Stomatitis
Converted to active Alopecia
nucleotide form
Maculopapular rash
Inhibits thymidylate
synthetase Anemia
S phase specific Leukopenia
Thrombocytopenia
Colon, breast, rectal, gastric,
pancreatic cancer
Topical for basal cell
carcinoma & actinic
keratosis
Antineoplastic Severe myelosuppression &
Monoclonal Ab & cytotoxic hypersensitivity rxn
ABX calicheamicin anaphylaxis
Severe pulmonary rxns
Gemtuzumab Chills
Binds CD33 Ag on Fever
hematopoietic cells &
sequesters lysosomes where N
calicheamicin is released
Dyspnea
Calicheamicin
Causes DNA dbl strand breaks
CD33 (+) AML

Imatinib
Antineoplastic Cough
Tyrosine kinase inhibitor Dyspnea
Pharyngitis
Inhibits oncoprotein bcr-abl Pneumonia
tyrosine kinase expressed Abdominal pain
by Philadelphia V
chromosome Petechiae
Inhibits leukemic cell Pruritis
proliferation & induced Rash
apoptosis
Night sweats
Myalgia
CML
Cause hematologic &
Arthralgia
cytogenetic remission Thrombocytopenia
Neutropenia
Leuprolide
Antineoplastic, agent for Transient ↑ in testosterone w/
precocious puberty 1st dose
GnRH analogue Use flutamide or other
androgen antagonist
Hot flashes
Pulsatile admin ↑ FSH & LH
release
Continuous admin down-
regulates GnRH receptors & ↓
FSH & LH
Central precocious puberty

Advanced prostate cancer
Endometriosis
Uterine fibroids
IM depot & implants for prostate

cancer
Mercaptopurine
Antineoplastic Cross-react w/ thioguanine
Purine antimetabolite
Myelosuppression
Hyperuricemia
Converted to nucleotide Hepatotoxicity
triphosphate by phosphoribosyl
transferase Allopurinol inhibits degradation
Inhibits purine biosynthesis &
salvage pathways
S phase specific
Acute leukemia
CML
Lymphomas
Tumors that delete

phosphoribosyl-transferase
acquire resistance
Methotrexate
Antineoplastic N, V
Folate reductase inhibitor Stomatitis
Hepatotoxicity
Inhibits dihydrofolate reductase Anemia
Prevents formation of active folate Leukopenia
& addition of single carbon units to Thrombocytopenia
DNA base precursors Nephropathy
S phase specific
Choriocarcinoma, trophoblastic tumors

Leukemia
Breast, head, neck, lung cancers
Severe psoriasis
RA
Mycosis fungoides
Leucovorin used to minimized

hematologic toxicity & Tx OD
Paclitaxel
Antineoplastic D
Mitotic inhibitor N, V
Alopecia
Binds tubulin & prevents Anemia
depolymerization of Leukopenia
microtubules of mitotic Thrombocytopenia
spindle Peripheral neuropathy
M phase specific Arthralgia
Myalgia
Advanced ovarian cancer w/
cisplatin
Non-small-cell lung cancer
Metastatic ovarian or breast
cancer
Tamoxifen
Antineoplastic CI during pregnancy &
Estrogen receptor lactation
antagonist & partial agonist
N
Competes w/ estrogen for Hot flashes
receptors in breast & other Menstrual irregularities
tissues
Suppresses breast tumor
growth
Breast cancer & ductal

carcinoma following surgery &
radiation
Advanced breast cancer
Trastuzumab
Antineoplastic Abdominal pain
Monoclonal Ab Anorexia
Diarrhea
Binds human epidermal growth
factor-2 (HER2) receptor on V
breast cancer cells Back pain
Prevents receptor stim. & cell Chills
proliferation Fever
Regression of breast cancer
metastases Allergic rxns
Metastatic breast cancer w/ Doxorubicin ↑ risk of

overexpression HER2 cardiotoxicity
Combined w/ paclitaxel
↑ blood levels
Vincristine
Antineoplastic N, V
Vinca alkaloid, mitotic inhibitor Alopecia
Binds tubulin & prevents
polymerization of tubulin dimers
forming microtubules of mitotic
spindle
M phase specific
Hodgkin’s ds
Lymphoma
Leukemia
Neuroblastoma
Rhabdomyosarcoma
Wilm’s tumor
Autonomic & Neuromuscular
Atenolol Pralidoxime
Atropine Propranolol
Dobutamine Pseudoephrine
Edrophonium Pyridostigmine
Epinephrine Rocuronium
Phenoxybenzamine Sildenafil
Phentolamine Succinylcholine
Phenylephrine Tamsulosin
Pilocarpine Terazosin
Atenolol
Sympatholytic, Bronchoconstriction w/
antihypertensive high doses b/c β1
Β1 receptor antagonist blockade
Additive hypotension w/
β1 receptor antagonist
nitrates
Angina
Post MI
Hypertension
Atropine
Anticholinergic Mydriasis & cycloplegia
Muscarinic receptor Warm, dry, flushed skin
antagonist Tachycardia
Delirium
Muscarinic receptor
blocker Hallucinations
Bradycardia
IBS
Anticholinesterase
poisoning
Antisecretory agent
Dobutamine
Sympathomimetic, cardiac Tachycardia
stimulant Arrhythmia
β1 receptor agonist
Selective β1 receptor
agonist
β1 > β2 > α1
Cardiac contractility &

output
Acute heart failure
Cardiogenic shock
Synergistic on cardiac output

w/ nitroprusside
Edrophonium
Diagnostic agent Muscarinic effects
Miosis
Cholinesterase
Salivation
inhibitor
Reversible
cholinesterase
inhibitor
Dx myasthenia gravis

Epinephrine
Sympathomimetic, HTN
bronchodilator, vasopressor Tachycardia
Nonselective adrenergic Ischemia
agonist Hyperglycemia
Activates α & β receptors

↑ IP3 & cAMP
α1 – vasoconstrict & ↑ BP
β1 – ↑ HR, conduction, &
contractility
β2 – vasodilate, ↓ BP,
bronchodilate
Cardiac arrest, V fib

Shock, asthma
COPD
Phenoxybenzamine
Vasodilator Postural hypotension
Irreversible α
Hypotension w/ β
receptor antagonist blockers & Ca channel
blockers
α receptor
antagonist
α1 > α2
Presurgical Tx of HTN d/t

pheochromocytoma
Phentolamine
α receptor antagonist
Severe hypotension w/
Epi
Blocks α1 & α2
receptors
Control BP during surgical

removal of
pheochromocytoma
IV admin only
Phenylephrine
Vasocontrictor, decongestant Rebound nasal congestion
HTN
Selective α1 receptor
agonist MAOI cause severe HTN
Activates α1 receptor
Increase IP3 causing
contraction of vascular
smooth m.
Nasal & ocular decongestant

Dilate pupil for opthalmoscopy
Mydriasis w/o cycloplegia
Paralysis of accommodation
Pilocarpine
Antiglaucoma, sialogogue Miosis
Muscarinic receptor Blurred vision
agonist Accommodative spasm
Activates muscarinic
receptors in ciliary m. &
salivary gland
Sjogren’s syn
Glaucoma
• Ciliary m. ↑ aqueous
humor
Xerostomia
• Salivary gland ↑
salivation
Pralidoxime
Organophosphate antidote
Cholinesterase reactivator
Binds phosphorous &

breaks organophosphate
bond w/ cholinesterase
Organophosphate toxicity
Reverses muscle weakness
Propranolol
Sympatholytic, Bronchoconstriction
antihypertensive Inhibits glycogenolysis
Nonselective β receptor Nightmares & depression
antagonist
Blocks β1 & β2 receptors
Angina
HTN
Benign tremor
thyrotoxicosis
Post-MI
Highly lipophilic CNS

effects
Pseudoephedrine
Decongestant Tachycardia
Indirect/direct-acting CNS stim.
adrenergic receptor ↑ BP
agonist
↑ release NE directly
activates adrenergic
receptors causing
vasoconstriction &
cardiac stim.
Allergic & viral rhinitis

Pyridostigmine
Antimyasthenic Muscarinic effects
Cholinesterase Miosis
Salivation
inhibitor, cholinergic
agonist
Prolongs effects of
succinylcholine
Reversibly inhibits
cholinesterase
Tx myasthenia gravis
Reverse nondepolarizing
NM blockers
Rocuronium
Nondepolarizing NM blockade Apnea
Blocks nicotinic receptors in

skeletal m.

intubation, surgery, ECT
Effects reversed by
neostigmine & edrophonium
Sildenafil
Vasodilator HA
Phosphodiesterase Nasal congestion
inhibitor Back pain
Visual disturbances
Inhibits type 5
phosphodiesterase &
degradation of cGMP
vasodilation in corpus
cavernosum d/t Ach
release from sacral PNS
neurons
Erectile dysfunction
Succinylcholine
Depolarizing NM blockade Apnea
Binds nicotinic receptors

causing prolonged
depolarization of skeletal m.
& paralysis

intubation & surgery
Transient m. fasciculations
Tamsulosin
Urologic agent Dizziness
Uroselective α1 HA
receptor antagonist Postural hypotension
Blocks α1A Cimetidine increases

blood levels & effects
receptors in
prostate
Tx urinary outflow

obstruction d/t prostatic
hyperplasia
Terazosin
Antihypertensive, 1st dose syncope
urologic agent
Selective α1
receptor antagonist
Blocks α1 receptors
HTN
Outflow obstruction d/t
prostate hyperplasia
Cardiovascular
Acetazolamide Hydrochlorothiazide
Adenosine Labetalol
Amiloride Mannitol
Amiodarone Methyldopa
Amlodipine Minoxidil
Carvedilol Nesiritide
Clonidine Nitroglycerin
Digoxin Nitroprusside
Diltiazem Propafenone
Dofetilide Quinidine
Enalapril Sotalol
Esmolol Spironolactone
Fenoldopam Valsartan
Furosemide verapamil
Hydralazine
Acetazolamide
Diuretic Parasthesia
Carbonic anhydrase
inhibitor Urinary stone formation
Inhibits interconversion of
carbonic acid & bicarbonate
↑ NaHCO3 excretion
Inhibit aqueous humor
formation
Hyperchloremic metabolic
acidosis
Tx open-angle glaucoma
Mtn sickness
Metabolic alkalosis
Adenosine
Antiarrhythmic Transient asystole
Purine nucleoside,
cardiac node membrane
stabilizer
Opens K channels &

blocks Ca influx in SA &
AV nodes
Slows AV conduction
Terminate SVT
Amiloride
K-sparring diuretic Hyperkalemia
Epithelial Na channel
blocker
Blocks Na Channel
distal tubule &
collecting duct
Inhibits Na reabsorption
& K excretion
Prevent & Tx hypokalemia

Amidarone
Antiarrhythmic Hypo/hyperthyroidism
Cardiac ion channel Photosensitivity
blocker Blue-gray skin
Corneal microdeposits
Pulmonary fibrosis
Blocks K, Na, Ca
channels & β receptors
Prolongs repolarization
↑ refractory period
Slows HR
↑ PR & QT intervals
SVT, VT, VF
Amlodipine
Antihypertensive, HA
antianginal Edema
Dihydropyridine Ca Hypotension
channel blocker
Ca channel blocker in Effects ↑ w/ grapefruit

vascular smooth m. juice
Arteriolar vasodilation
& ↑ coronary blood
flow
HTN
Angina pectoris
Carvedilol
Antihypertensive & heart Orthostatic hypotension
failure Tx Dizziness
Nonselective Bradycardia
adrenergic receptor
agonist
Blocks β1, β2, α1

receptors
Cause vasodilation
HTN
Heart failure
↓ remodeling
Clonidine
Antihypertensive Abrupt w/drawal
α2 receptor agonist severe rebound HTN
Sedation
Central α2 receptor agonist Dry mouth
↓ sympathetic outflow from
vasomotor center
Inhibits pain
neurotransmission in spinal
cord
HTN
Opioid w/drawal
Digoxin
Cardiac stimulant Arrhythmias
Digitalis glycoside N, V
Blurred vision
Inhibits Na/K ATPase Yellow vision
↑ IC Ca & cardiac
contractility
↓ AV conduction
Heart failure
Serum levels assess
dosage & toxicity
Diltiazem
Vasodilator, antiarrhythmic Dizziness
Non-dihydropyridine Ca Hypotension
channel blocker Peripheral edema
Constipation
Block Ca channels in cardiac
tissue & vascular smooth m.
Vasodilation
↓ HR & conduction Grapefruit juice ↑ serum
↓ contractility levels
HTN
Angina pectoris
SVT
Dofetilide
Antiarrhythmic QT prolongation
K channel blocker Torsade de pointes
Blocks delayed K channels

in cardiac tissue
Slows repolarization &
prolongs refractory period
↑ QT interval
AF, A flutter
Monitor QT interval during

initial dose titration
Enalapril
Antihypertensive Cough & angioedema
ACE inhibitor Inhibits bradykinin
degradation
Inhibits ACE & formation of AT
II Hypotension
Vasodilation Taste disturbances
↓ aldosterone secretion
↑ CO
↓ V remodeling
↑ survival in heart failure
HTN
Heart failure
Post-MI
↓ progression of diabetic
nephropathy
Esmolol
Antiarrhythmic Hypotension
Class II
Selective β1 blocker Bradycardia
Blocks SNS stim. SA & AV

nodes
↓ HR
↓ AV conduction
Sinus tachycardia & SVT

during/after surgery
Rapidly metabolized by plasma

esterase
Fenoldopam
Antihypertensive ↓ serum K levels
D1-like receptor agonist Monitor for
hypokalemia
D1 receptor agonist
Arteriolar vasodilation
Afferent & efferent renal
arterioles
↑ renal blood flow
Hypertensive
emergencies
Furosemide
Loop-acting diuretic Hypokalemia
Membrane ion transport Metabolic alkalosis
inhibitor Hyperuricemia
Hypomagnesemia
Inhibits Na/K/2Cl cotransporter
in ascending loop of Henle ↑ ototoxicity of
Blocks NaCl reabsorption aminoglycoside ABX
Edema
Heart failure
HTN
Hypercalcemia
↑ Ca excretion
↑ Na/K exchange in collecting duct
Hydralazine
Antihypertensive. heart failure Edema
Vasodilator Reflex tachycardia & MI
Lupus syndrome
Alters IC Ca metabolism
Relaxes arteriolar smooth m.
vasodilation
↓ afterload
Heart failure in combo w/

isosorbide dinitrate
More effective than ACEI in
black people
Moderate-severe HTN
Hydrochlorothiazide
Antihypertensive Hypokalemia
Thiazide diuretic Metabolic alkalosis
Hyperuricemia & gout
Inhibits NaCl
↓ excretion of lithium
transporter in distal
tubule
↑ excretion Na, K, Cl
↓ Ca excretion
HTN
Nephrogenic DI
Nephrolithiasis
Labetolol
Antihypertensive Postural hypotension
Abrupt w/drawal
Adrenergic α & β
cause life-threatening
receptor antagonist HTN, arrhythmias, or
MI
Selective α1 &
nonselective β1, β2
blockers
HTN
Mannitol
Diuretic Electrolyte imbalances
Osmotic Diuretic Transient volume
expansion
Pulmonary edema or
Osmotic attraction of heart failure
edematous & ocular
fluid
Filtered by glomerulus
↑ electrolyte excretion
Oliguric renal failure

Cerebral edema – ↑ ICP
Acute glaucoma
Methyldopa
Antihypertensive Positive direct Coomb’s
Adrenergic α2 receptor test
agonist
Converted to active
form methyl-
norepinephrine which
activates central α2
receptor agonist
↓ SNS outflow from
vasomotor center
HTN
HTN in pregnancy
Minoxidil
Antihypertensive, hair growth Systemic admin.
stimulant Reflex tachycardia
Vasodilator, K channel Angina pericarditis
opener Pulmonary HTN
hypertrichosis
Opens K channels in
vascular smooth m.
Hyperpolarization
m. relaxation
vasodilation
Stim. resting hair follicle
growth follicles
Severe HTN
Topical for alopecia
Nesiritide
Heart failure Tx Hypotension
Recombinant human B-type
natriuretic peptide
Activate guanylate cyclase

↑ cGaMP
Dilates venous & arterial
smooth m.
↓ venous pressure, cardiac
preload, vascular
congestion, & dyspnea
Decompensated heart failure

Nitroglycerin
Antianginal HA
Organic nitrate Hypotension
Syncope
Reflex tachycardia
Releases NO in vascular
smooth m.
Vasodilation ↑ vasodilative effect of
↑ coronary blood flow sildenafil, tadalafil,
↓ myocardial O2 demand vardenafil
Angina pectoris
Sublingual or lingual admin.
Short half-life
Nitroprusside
Antihypertensive CN toxicity
HA
Relaxes venous & arteriolar
smooth m.
Metabolized to CN &
thiocyanate
Tx toxicity w/ sodium nitrite
& sodium thiosulfate
HTN crisis
Acute heart failure or
cardiogenic shock
Controlled hypotension during
pregnancy
Propafenone
Antiarrhythmic Proarrhythmic 1st 2 wks
Class IC Na channel Monitor ECG when
blocker starting Tx
GI disturbances
Blocks Na channel in
cardiac tissue ↑ digoxin levels
↓ conduction & prevent
re-entry
↑ PR, QRS, & QT
duration
SVT & life-threatening

V arrhythmias
Quinidine
Antiarrhythmic Cinchonism
Class IA Na channel Blurred vision
blocker Tinnitus
Photophobia
Blocks Na & K channels
in cardiac tissue ↑ levels w/
↓ conduction Amiodarone
↑ QRS & QT duration Cimetidine
Diltiazem
SVT & VT Verapamil
D-isomer = quinine, Grapefruit juice
used to treat malaria
pts
Sotalol
Antiarrhythmic Torsades de pointes
Class III K channel blocker
Blocks K channels in cardiac

tissue
Prolongs repol.
↑ refractory period & ↑ QT
interval
Blocks adrenergic β
receptors
SVT & life-threatening

arrhythmias
Spironolactone
K-sparring diuretic Gynecomastia
Aldosterone antagonist Impotence
Hyperkalemia
Blocks aldosterone
receptors
↑ Na excretion
↓ K excretion
Primary
hyperaldosteronism
HTN
hypokalemia
Valsartan
Antihypertensive
Angiotensin receptor
antagonist
Blocks AT II receptor in
vascular smooth m. &
adrenal cortex
Vasodilation & ↓ aldosterone
secretion
HTN
Nephropathy
Less cough & angioedema

than ACEI
Verapamil
Antihypertensive, antianginal Peripheral edema
Non-dihydropyridine Ca Constipation
channel blocker
Blocks Ca channels in cardiac
m. & vascular smooth m.
Vasodilation
↓ HR & conduction
↓ contractility
Suppress contractility more
than other Ca channel
blockers
HTN
Angina pectoris
SVT
Prevent migraine HA
CNS Depressants
Buspirone Lorazepam
Carbamazepine Phenobarbital
Diazepam Phenytoin
Disulfiram Topiramate
Ethosuximide Valproate
Flumazeil Zolpidem
Gabapentin
Lamotrigine
Busprione
Antianxiety Dizziness
5-HT1A partial agonist Drowsiness
Fatigue
HA
Activates presynaptic 5-HT1A
receptors in dorsal raphe Excitement
nucleus Nervousness
↓ firing serotonergic neurons Blurred vision
Tachycardia
Generalized anxiety disorder N
Rash
NO Myalgia
Drug dependence Sweating
Significant sedation
Muscle relaxation ↑ levels by
Anticonvulsant effects Erythromycin
Itraconazole
Grapefruit juice
Carbamazepine
Anticonvulsant Ataxia
Neuronal Na channel blocker Drowsiness
Blurred vision
Blocks Na channels in CNS Agranulocytosis
Aplastic anemia
↓ firing of ectopic foci &
spread of epileptic seizures Thrombocytopenia
Partial seizures & generalized Induces its own metabolism

tonic-clonic seizures
Bipolar disorders
Trigeminal neuralgia
Neuropathic pain
Diazepam
Antianxiety Drowsiness
Benzodiazepine Lethargy
Physical/psychological
dependence
Binds ω receptors on GABA Tolerance
operated Cl ion channel
↑ channel affinity for GABA &
Potentiates inhibitory effects of
GABA
Anxiety
Status epilepticus
Muscle spasm
Alcohol w/drawal
Anterograde amnesia
Long-lasting active metabolites

Disulfiram
Alcohol abuse Tx Drowsiness
Acetaldehyde dehydrogenase
inhibitor
Inhibits acetaldehyde
degradation following alcohol
ingestion
Blurred vision
Chest pain
Dizziness
Palpitations
N, V
HA
Weakness
Reinforcement of alcohol
abstinence
Ethosuximide
Anticonvulsant Dizziness
Succimide Drowsiness
Gastric distress
Binds T-type Ca N
channels in thalamic
neurons
Suppresses nerve
transmissions to
motor cortex
Generalized absence
seizures
Petit mal epilepsy
Flumazenil
Antidote Seizures
Benzodiazepine Dizziness
receptor antagonist Emotional lability
Blocks benzodiazepine
receptors
Counteract adverse
effects of
benzodiazepines
d/t IV OD
CI in status epilepticus
Gabapentin
GABA analogue Dizziness
Drowsiness
Nystagmus
↑ GABA release from
Tremor
central neurons
Inhibits neuronal
discharges from seizure
foci
Inhibits pain
neurotransmission
Partial seizures
Chronic pain
Lamotrigine
Anticonvulsant Skin rash in 1st 8 wk of
Tx
Phenyltriazine Can progress to
Stevens-Johnson syn
Blocks voltage-
Ataxia
sensitive Na channels
Dizziness
Release of glutamate
Drowsiness
Prevents spread of Photosensitivity
seizure foci discharges
↓ metabolism & ↑ ADR w/
Adjunct/monotherapy for valproate
partial seizures in adults
Lorazepam
Sedative-hypnotic, anxiolytic Dizziness
Drowsiness
Benzodiazepine Apnea & cardiac arrest w/ rapid IV
admin
Binds benzodiazepine ω
receptors on GABA operate Cl Additive depression w/ alcohol & other
depressants
ion channel
↑ channel affinity for GABA &
Potentiates inhibitory effects of
GABA
Anxiety
Insomnia
Light anesthesia
Anterograde amnesia
Flumazenil used to counteract

severe OD
Phenobarbital
Sedative-hypnotic, Drowsiness
anticonvulsant Lethargy
Barbiturate Delirium
Hangover
Physical & psychological
Binds GABA operated Cl ion dependence
channel increasing duration
of channel opening Induces CYP P450 ↑ metabolism
of drugs
↑ Cl influx in absence of
GABA
Tonic-clonic & partial seizures

Febrile seizures in children
Short-term hypnotic
↑ folate requirement during

long-term Tx
Phenytoin
Hydantoin Diplopia
Nystagmus
Blocks voltage-sensitive Na
channels
Release glutamate
Prevents spread of seizure foci
discharges
Partial seizures
Generalized tonic-clone seizures
Status epilepticus following IV
diazepam
Zero-order @ high doses

Fosphenytoin for IV use
Topiramate
Monosaccharide derivative Dizziness
Drowsiness
Block voltage-sensitive Na Fatigue
channels Impaired concentration &
memory
Augments GABA activation
of GABA receptors Psychomotor slowing
Blocks glutamate Speech problems
receptors Diplopia
Nystagmus
Partial & tonic-clonic seizures
Decrease dose in pts w/ renal

impairment
Valproate
Anticonvulsant Indigestion
Branched-chain FA N, V
Dizziness
↑ GABA levels by ↑ release Sedation
or ↓ metabolism or reuptake Hepatotoxicity
Reduced Na dependent
action potentials
Simple & complex absence

seizures
Complex partial seizures
Tonic-clonic seizures
Myoclonic seizures
Migraine prevention
Manic phase of bipolar
Zolpidem
Non-benzodiazepine hypnotic
Imidazopyridine
Activates ω BZBP receptors

on GABA operated Cl ion
channel
↑ channel affinity for GABA
& frequency of channel
opening
Neuronal
hyperpolarization
Insomnia
Endocrine
Acarbose Insulin
Alendronate Levothyroxine
Calcitonin Medroxyprogesterone
Danazol Metformin
Desmopressin Methimazole
Ergocalciferol Mifepristone
Ethinyl estradiol & Octreotide
drospirenone Oxytocin
Ethinyl estradiol & Pioglitazone
norethindrone Prednisone
Finasteride Raloxifene
Fludrocortisone Repaglinide
Glyburide Somatropin
Hydrocortisone Testosterone
Acarbose
Antidiabetic Intestinal bloating
α-glucosidase inhibitor Flatulence
Inhibits intestinal enzyme

that converts ↑ oral bioavailability of
oligosaccharides & metformin
disaccharides to glucose ↓ iron absorption
↓ digestion of starch &
sucrose
↓ postprandial blood
glucose & HbA1c
Type II DM
Alendronate
Bone resorption inhibitor Absorption ↓ by Ca
Bisphosphonate supplements, antacids,
foods, beverages (except
water)
Prevents attachment of
osteoclast precursor cells to
bone
↓ metabolic activity of
osteoclasts & ability to
resorb bone
Prevent/Tx
Osteoporosis
Corticosteroid-induced
osteoporosis
hypercalcemia
Calcitonin
Ca hormone
Thyroid gland hormone
Binds calcitonin receptor on

osteoclasts
↑ cAMP & inhibits osteoclast
activity
↓ bone resorption, bone
pain, & serum [Ca]
Postmenopausal osteoporosis
hypercalcemia
Danazol
Ovarian inhibitor CI in pregnancy –
Synthetic androgen, androgenic effects on
antiestrogen female fetus
Feedback inhibits pituitary

FSH & LH secretion ↓ Emotional lability
ovarian estrogen secretion & Deepening voice
stim. endometrial & breast
tissue. Acne
Hirsutism
Endometriosis Amenorrhea
Fibrocystic breast ds ↓ breast size
Hereditary angioedema
↑ C1 esterase inhibitor &
C4 complement
component
Desmopressin
Posterior pituitary hormone
Vasopressin, ADH analogue
Mimics natural vasopression

Increases water
reabsorption in kidneys
Vasoconstriction
DI
Nocturnal enuresis
Control bleeding in
hemophilia & wWF’s ds
Intranasal, oral, or IV
Ergocalciferol
Vit. D Hypercalcemia
Fat-soluble Hypercalciuria
Activated in liver & kidneys Cholestyramine inhibits

to form calcitriol vit. D absorption
↑ Ca & phosphorus Induce vit. D
absorption from gut
metabolism
Vit. D deficiency Phenytoin
Rickets, osteomalacia Barbiturates
Familial hypophosphatemia
Hypocalcemia d/t
hypoparathyroidism
Postoperative & idiopathic
tetany
Ethinyl estradiol & drospirenone
OCP Drospirenone
Estrogen & progesterone Antiandrogenic
Blocks aldosterone
Feedback inhibit GnRH ↓ salt & water retention
Estrogen ↓ BP
↓ FSH secretion &
maturation of dominant Thromboembolism
follicle
↑ risk w/ smoking
Progesterone
Inhibits midcycle LH Edema
surge & ovulation
Efficacy ↓ w/
Contraception ABX
Regulate menstrual cycle Carbamazepine
Acne in women phenytoin
Ethinyl estradiol & norethindrone
OCP Norethidrone
Estrogen & progesterone
Slightly androgenic
Feedback inhibit GnRH

Estrogen Thromboembolism
↓ FSH secretion & Edema
maturation of dominant
follicle Depression
Progesterone Gallbladder ds
Inhibits midcycle LH
surge & ovulation
Contraception
Regulate menstrual cycle

Acne in women
Finasteride
Androgen synthesis inhibitor CI pregnancy
5-α-reductase inhibitor Risk to male fetus
Do NOT handle tablets
Inhibits conversion
testosterone
dihydrotestosterone & ↓ Impotence
androgenic stimulation of
prostate & skin
↓ prostate size & promotes
hair growth
BPH
Male pattern baldness
Fludrocortisone
Corticosteroid Hypokalemia
Mineralocorticoid ↑ by thiazide & loop
diuretics
Activates aldosterone
receptors in renal distal
tubule
↑ Na reabsorption
↑ K & H excretion
Adrenal insufficiency
Addison’s ds
Congenital adrenogenital syn
Tx idiopathic orthostatic
hypotension w/ ↑ Na intake
Glyburide
Antidiabetic Photosensitivity
Sulfonylurea hypoglycemia Hypoglycemia
channels preventing K efflux
& depolarizing pancreas B
cells
Influx Ca & relaxing insulin
↑ amount of insulin secreted
during each pulse
Type II DM
Hydrocortisone
Short-acting corticosteroid,
low-potency topical
corticosteroid
Glucocorticoid
Replaces endogenous
cortisol in deficiency states
Suppresses inflammation &
immune response – topical
Adrenocortical insufficiency
Topical
Insect bites
Contact dermatitis
Insulin
Pancreatic hormone
β-blockers mask signs
Replaces endogenous of hypoglycemia &
insulin prolong recovery
DM
Rapid acting – lispro

Intermediate acting –
lente
Long acting – ultralente
Levothyroxine
Thyroid hormone Insomnia
Tetraiodothyronine Irritability
Tachycardia
Binds nuclear receptors Wt loss
& ↑ gene transcription
↑ metabolic rate, protein
synthesis, Bile acid sequestrants ↓
gluconeogenesis, cell absorption
growth & differentiation,
& CNS development
Converted to T3 in
tissues
Hypothyroidism
Medroxyprogesterone
Progestin, contraceptive Amenorrhea
Progesterone analogue Breakthrough bleeding
Dysmenorrhea
↓ endometrial hyperplasia in
women receiving estrogen
Prevents conception by
thickening cervical mucus
Estrogen-progestin HRT
Injectable contraceptive
Progestin-only injectable
contraceptive
IM depot injection lasts 3mo

Metformin
Antidiabetic N, V, D
Biguanide, antihyperglycemic
Abdominal bloating
↑ # & affinity of insulin
receptors in peripheral tissues
↓ hepatic glucose output
↓glucose absorption from gut
↑ glucose uptake & utilization in
skeletal m. & adipose tissue
Type II DM
Used in combo w/ sulfonylureas

Methimazole
Antithyroid Rash
Thiourea, thyroid Agranulocytosis
hormone synthesis
inhibitor
Inhibits peroxidase &

iodination & coupling of
tyrosine residue of
thyroglobulin
↓ thyroxine secretion
Hyperthyroidism –
Grave’s ds
Mifepristone
Abortificient Abdominal pain
Progesterone antagonist Diarrhea
N, V
Partial agonist or antagonist
progesterone receptors Uterine bleeding
Cramping
Medical termination of
pregnancy through 49d
gestation
Single dose + prostaglandin

for 48hr stim. uterine
contractions
Octreotide
GH inhibitor, antidiarrheal Arrhythmias
Somatostatin analogue w/ Hyperglycemia
greater effects on GH than Hypoglycemia
insulin secretion Constipation
Diarrhea
Suppresses secretion of GH, Flatulence
insulin-like growth factors,
5-HT & GI peptides – gastrin, N
motilin, secretin, & VIP
Acromegaly
Severe diarrhea & flushing d/t
carcinoid tumors & VIP
tumors
Bleeding GE varices
Complications of pancreatic
surgery
Oxytocin
Oxytocic Excessive & painful
Posterior pituitary hormone uterine contractions
Stim. Uterine smooth m. &

induce labor
Stim. mammary gland
smooth m. & lactation
Induce labor @ term

Facilitate uterine contractions
Postpartum control of uterine
bleeding
Promote milk let-down
IV for uterine stim.

Nasal for milk let-down
Pioglitazone
Antidiabetic
Thiazolidinedione
antihyperglycemic
Activates peroxisome
proliferator-activated receptor-γ
in adipose tissue, skeletal m., &
liver
↑ gene transcription, insulin
sensitivity, & glucose
transports in muscle & adipose
tissue
Suppresses hepatic glucose
output
Type II DM
Used w/ metformin
Prednisone
Anti-inflammatory Depression or euphoria
Corticosteroid HTN
Acne
Suppresses Impaired wound healing
inflammation & immune
response Adrenal suppression
Muscle wasting
Inflammatory, allergic, Osteoporosis
autoimmune, & neoplastic Cushingoid appearance
ds
Moon facies
Prevent organ transplant
rejection Buffalo hump
Asthma ↑ susceptibility to infection
Raloxifene
Bone resorption inhibitor Hot flashes
Selective estrogen receptor
modulator – SERM Cholestyramine inhibits
absorption
Estrogen-like effect on bone
& lipid metabolism
Estrogen antagonist in
breast & uterine tissue
↑ bone mineral density & ↓
vertebral fractures
Osteoporosis in
Used in woman @ risk for

breast cancer
Repaglinide
Meglitinide hypoglycemic
channels & ↑ insulin
secretion
↓ postprandial blood
glucose & [HbA1c]
Taken before meals to control

postprandial hyerglycemia
Used w/ metformin
NOT sulfonylureas
Somatropin
GH
Recombinant somatotropin
↑ release of insulin-like
growth factors in liver &
cartilage
Stim. skeletal growth, AA
transport, protein synthesis,
nucleic acid synthesis & cell
prolif.
Short stature in children d/t

GH deficiency
Turner syn
Prader-Will syn
Testosterone
Androgen Edema
Gonadal steroid Acne
Gynecomastia
Activated gene transcription &
development of male sex organs & Impotence
secondary sex characteristics Oligospermia
↑ lean body mass Priapism
Stim. skeletal growth
Accelerates epiphyseal closure
↑ sebaceous gland sebum
production
↑ EPO secretion
↓ HDL levels
Hypogonadism in androgen-deficient
men
Delayed puberty in males
Gastrointestinal
Bisacodyl Misoprostol
Calcium carbonate Omeprazole
Dicyclomine Ondansetron
Docusate Promethazine
Lactulose Ranitidine
Loperamide Sucralfate
Mesalamine Tegaserod
Metoclopramide
Bisacodyl
Stimulant laxative Cramping
N
Fluid & electrolyte
Inhibits GI fluid depletion
reabsorption & Hypokalemia
stimulates
peristalsis
Bowel evacuation prior

colonoscopy or surgery
Acute constipation
Calcium carbonate
Antacid, Ca supplement Constipation
Ca salt
↓ absorption of drugs
Tetracyclines
Neutralizes gastric acid
Fluoroquinolones
Provides Ca Phenytoin
supplementation Iron salts
Dyspepsia
Hypocalcemia
Prevention of osteoporosis
Admin 1-1.5hr after meals &

@ bedtime
Dicyclomine
Antispasmodic Constipation
Muscarinic receptor Dyspepsia
antagonist Dry mouth
Urinary retention
Blurred vision
Blocks PNS stim.
intrinsic nervous Decreased sweating
system & ↓ GI tone &
motility
Directly relaxes GI
smooth m.
IBS – cramping & pain

Docusate
Stool softener, laxative
Surface-active agent
Facilitates hydration of
fecal material & softens
feces
Constipation
Fecal impaction – rectal
enema
Lactulose
Laxative Cramping
Osmotic agent Abdominal distention
Flatulence
↑ water content & softens
feces
Lowers pH of colon
Converts ammonia
ammonium ion & ↓ ammonia
absorption & blood levels
Chronic constipation
Hepatic encephalopathy
Improves mental status
Loperamide
Antidiarrheal Constipation
Opioid analogue Drowsiness
Additive effects
Activates opioid receptors in GI Kava
smooth m. Chamomile
Segmental contraction & inhibits Valerian
peristalsis
Mild-moderate acute diarrhea

Chronic diarrhea d/t IBD
↓ volume of ileostomy drainage
AVOID
Pregnancy
Lactation
Children < 2 y/o
Mesalamine
GI anti-inflammatory
Salicylate – 5-ASA
Inhibits prostaglandin synthesis

& migration of inflammatory
cells into bowel wall
Scavenges superoxide-free
radicals
IBD
UC
Proctitis
Sulfasalazine mesalamine &

sulfapyridine
Metoclopramide
Promotility & antiemetic CI in Parkinson’s ds & seizure
D2 receptor antagonist disorders
Drowsiness
Blocks relaxant effect of D on EPS rxns
GI smooth m. restlessness
Blocks presynaptic D receptors
& ↑ Ach release & stim. smooth
m.
Blocks D2 receptors in
chemoreceptor trigger zone &
vomiting center
Chemotherapy-induced emesis
Gastric stasis – postsurgical &
diabetic
GE reflux
Misoprostol
Cytoprotective CI in pregnancy
Synthetic PGE1
analogue Abdominal pain
D
Miscarriage
↓ gastric mucosal
secretion & ↑ secretion
of bicarbonate & mucus
Prevent gastric mucosal

injury from NSAIDs
Abortificient in combo w/
mifepristone
Omeprazole
Antiulcer Abdominal pain
Proton pump inhibitor
Inhibits metabolism
Diazepam
Irreversibly inhibits H/K ATP
Cyclosporine
pump in gastric parietal cells
Phenytoin
Prevents gastric acid
secretion
Peptic ulcer ds
GE reflux
Zollinger-Ellison syn
dyspepsia
Ondansetron
Antiemetic HA
5-HT3 receptor antagonist Constipation
D
Blocks 5-HT3 receptors in GI
vagal afferent nerves,
solitary tract nucleus, &
chemoreceptor trigger zone
Prevent N, V from
chemotherapy & radiation
therapy
Postoperative N, V
Promethazine
Antiemetic, antihistamine, Neuroleptic malignant syn
sedative
H1 receptor antagonist, Sedation
phenothiazine Confusion
Disorientation
Blocks H1 & M1 receptors
Inhibits stim. chemoreceptor
trigger zone & vomiting
center
N, V
Allergic rxns
Ranitidine
Antiulcer
gastric parietal cells
↓ gastric acid secretion
Peptic ulcer ds
GE reflux
Dyspepsia
Sucralfate
Antiulcer Constipation
Cytoprotective, sulfated
polysaccharide ↓ absorption
Fat soluble vitamins
fluoroquinolones
Adheres ulcer crater & forms
protective barrier
Prevents acid secretion &
pepsin hydrolysis of mucosal
proteins
Stim. prostaglandin synthesis
Peptic ulcer ds
GE reflux
Prevent NSAID-induced gastric
injury
Tegaserod
GI motility agent Diarrhea
Partial agonist @ 5-HT4 Ischemic colitis
receptors
Activates 5-HT4
receptors on sensory
neurons in enteric
nervous system
Release
neurotransmitters & ↑
peristalsis
IBS in women w/
constipation
Hematologic
Abciximab Epoetin
Alteplase Eptifibatide
Aspirin Ezetimibe
Atorvastatin Filgrastim
Bivalirudin Folic acid
Cholestyramine Gemfibrozil
Cilostazol Heparin
Clopidogrel Niacin
Cyclosporine Sirolimus
Enoxaparin Warfarin
Abciximab
Antithrombotic Bleeding
Monoclonal Ab Thrombocytopenia
Inactivates platelet gp
llb/llla receptors
Prevents platelet
aggregation
Prevent thrombosis during

coronary angioplasty &
stent placement
Alteplase
Thrombolytic Reperfusion arrhythmia
Plasminogen activator
Contraindications
Internal bleeding
Converts plasminogen
Recent CNS surgery or
plasmin trauma
Degrades fibrin & fibrinogen
AMI
Acute ischemic stroke
Occluded central venous
access devices
Streptokinase & urokinase for

pulmonary embolism
Atorvastatin
Cholesterol lowering agent Myalgia
HMG-CoA reductase Myositis
inhibitor Rhabdomyolysis
Hepatitis
HMG-CoA reductase, rate- GI distress
limiting enzyme for
cholesterol Effects ↑ w/
↑ hepatic cholesterol uptake Grapefruit juice
↓ LDL levels Azole antifungals
cyclosporine
Cholesterol-lowering effects ↑
w/ ezetimibe & bile acid-
binding agents
Bivalirudin
Anticoagulant Bleeding
Hirudin analogue
Inhibits thrombin
Prevents blood coagulation
Thrombosis in unstable
angina
AMI
Stent insertion
Used in pts w/ heparin-

induced thrombocytopenia
Cholestyramine
Cholesterol-lowering Constipation
agent Abdominal discomfort
Bile-acid binding resin
Binds intestinal bile

acids
Prevents reabsorption
↑ cholesterol utilization
↓ LDL levels
Diarrhea d/t excess bile
acids
Cilostazol
Antiplatelet HA
Platelet aggregation
inhibitor Effects ↑ w/ CYP3A4 inhibitors
Azole antifungals
Inhibits phosphodiesterase Erythromycin
III & ↑ cAMP in platelet & Grapefruit juice
blood vessels
Inhibit platelet aggregation
Causes vasodilation
Intermittent claudication
Improves blood flow &
walking distance

Clopidogrel
Antiplatelet Hypersensitivity reaction
Platelet aggregation
inhibitor
Irreversibly inhibits binding

of ADP to platelet receptors
↓ gp IIb/IIIa mediated
aggregation
Stroke
MI
Peripheral vascular ds

Cyclosprine
Immunosuppressant HTN
IL2 expression inhibitor Nephrotoxic
Hirsutism
Bind immunophilins
Tremor
Complex binds
calcineurin inhibits
transcription of IL2 Induce metabolism
gene Rifampin
Barbiturates
Prevent rejection of renal, Carbamazepine
cardiac or hepatic
allografts Inhibits metabolism
Severe RA & psoriasis Grapefruit juice
Enoxaparin
LMWH
III on factor Xa
Prevent
DVT
Pulmonary embolism after
knee, hip, or abdominal surgery
Thrombosis in unstable angina
& non Q-wave MI
Effects reversed w/ protamine

sulfate
NO monitoring w/ PTT
Epoetin
Hematopoietic growth factor HTN
Recombinant human EPO
Binds receptors on erythroid

progenitor cells & stim. cell
Reticulocytosis & ↑ Hct
Anemia d/t
CRF
Chemotherapy
Zidovudine therapy
Hematologic malignancy
• lymphoma
Used as performance-enhancing
drug by athletes
Eptifibatide
Antiplatelet
GP IIb/IIIa receptor Bleeding
antagonist
Reversibly inhibits
fibrinogen binding to gp
IIb/IIIa receptors
Prevents platelet
aggregation
Prevent coronary thrombosis

in
Unstable angina or non-ST
segment elevation MI
Coronary angioplasty or
stent placement
Ezetimibe
Cholesterol-lowering agent
Cholesterol absorption inhibitor
Disrupts annexin-caveolin
complex mediating cholesterol
transport intestinal brush
border
Inhibits absorption of biliary
dietary cholesterol
Pro-drug converted to active

glucuronide metabolite
Additive effect w/ statins

Filgrastim
Hematopoietic growth factor Bone pain
Recombinant human GCSF
Binds receptors on myeloid

progenitor cells & stim.
Accelerates neutrophil recovery
after myelosuppressive
chemotherapy
↓ infection incidence
Neutropenia assoc/ w/
chemotherapy & bone marrow
transplants
Avoid 24 hrs prior & after

chemotherapy
Folic acid
Vitamin, hematologic agent Absorption ↓ by
Metabolic cofactor for DNA Phenytoin
synthesis Cholestyramine
Activated folate transfer Folate reductase inhibited by

MTX
one-carbon units to purine &
pyrimidine precursors
Megaloblastic anemia
Fetal neural tube defects
Coronary artery ds
Pregnant woman have ↑

requirements
Gemfibrozil
Lipid-lowering agent GI distress
Fibric acid derivative Myositis
Activates peroxisome Statins ↑ risk

rhabdomyolisys
proliferator activated
receptor-α
Oxidizes FA & apo-AI & AII
↓ plasma triglycerides
↑ HDL
↓ HDL levels
Monitor LFTs throughout Tx

Heparin
Antithrombotic
III
↑ inactivation factor Xa &
thrombin
Venous thromboembolism
Pulmonary embolism
AF w/ embolism
Consumptive coagulopathies
In vitro & catheter coagulation
Monitor PTT
Protamine sulfate for OD
Niacin
Vitamin, lipid-lowering agent Flushing
G-protein coupled receptor Pruritis
ligand GI distress, peptic ulcer
Hyperglycemia
Activates G-protein coupled Hepatotoxicity
receptor
Inhibits lipolysis & release Statins ↑ risk
of FA rhabdomyolysis
↓ hepatic triglyceride
synthesis & VLDL secretion
↑ HDL
Pellagra
Sirolimus
Immunosuppressant Leukopenia
T-lymphocyte inhibitor Thrombocytopenia
Hyperlipidemia
Rash
Inhibits regulatory
kinase in cytokine-
driven T-cell prolif. ↑↑ blood levels
Cyclosporine
Combo w/ corticosteroid
& cyclosporine Azole antifungals
Erythromycin
Grapefruit juice
Prevent Cimetidine
Rejection renal allograph
Coronary stent
restenosis
Warfarin
Oral anticoagulant Fetal malformations
Coumarin vit. K antagonist Abnormal bone
development
Inhibits reduction of
oxidized vit. K
Prevents vit. K dependent
carboxylation of glutamate
residues of factors II, VII, IX,
X, proteins C & S
Delayed onset d/t circulating

coagulation factors
Monitor INR
Give vit. K if bleeding
Musculoskeletal
Acetaminophen Indomethacin
Allopurinol Infliximab
Celecoxib Ketorolac
Cyclobenaprine Probenecid &
Etanercept colchicine
Ibuprofen
Acetaminophen
Analgesic, antipyretic OD cause fatal hepatic failure
COX-3 inhibitor
↑ hepatotoxicity w/ alcohol
↑ renal toxicity w/ salicylates &
Inhibits COX-3 selectively
NSAIDs
Inhibits synthesis of PG
causing pain & fever
Mild-moderate pain
Fever
Lacks anti-inflammatory &

antiplatelet activity
Allopurinol
Antigout Rash
Xanthine oxidase
inhibitor Inhibits metabolism
Mercaptopurine
Inhibits xanthine
oxidase & catabolism of
purines xanthine &
uric acid
↓ uric acid levels
Prevent hyperuricemia &

gout
Celecoxib
NSAID GI bleeding
COX-2 inhibitor ↑ risk stroke & MI
Inhibits COX-2 &

synthesis of PG
causing pain, fever, &
inflammation
OA
RA
Inflammatory jt ds
Cyclobenzaprine
Skeletal m. relaxant Dizziness
Tricyclic central-acting Drowsiness
m. relaxant Dry mouth
AVOID MAOI
Acts on brainstem &
spinal cord to reduce
tonic somatic m.
activity via γ & α motor
neurons
Acute muscle spasm

Etanercept
Antirheumatic agent, URI
antitumor necrosis factor HA
Antitumor necrosis
factor – p57 combined ↓ Ab response to live
w/ Fc of IgG virus vaccines
Binds TNF-α & ↓ jt

inflammation & pain
RA
RA
Ibuprofen
NSAID GI bleeding
Dyspepsia
Inhibits COX-1 & COX-2 & Allergic rxns
synthesis of PG causing Hepatitis & renal failure
Mild-moderate pain or
dysmenorrhea
OA
RA
↓ risk colon, breast, lung, &

prostate cancers
Indomethacin
NSAID GI bleeding
Dyspepsia
Allergic rxns
Inhibits COX-1 & COX-2
Dizziness
Drowsiness
HA
Gouty arthritis
OA
RA
Ankylosing spondylitis
PDA in premature neonates
Infliximab
Ds modifying Fatigue
antirheumatic N, V
Monoclonal Ab to TNF- URI
α
Inactivates TNF-α & ↓ jt

inflammation, pain, &
destruction
↓ Sx of Crohn’s ds
RA
Crohn’s ds
Ketorolac
NSAID Aspirin-allergy
Nonselective COX inhibitor Allergic rxn in pt w/ asthma
Nasal polyps
Inhibits COX-1 & COX-2 &
Short-term pain management
Prolongs bleeding time

Limit use to < 5d
Probenecid & Colchicine
Antigout Probenecid
Uricosuric – probenicid Inhibits renal tubular secretion
of Penicillins
Anti-inflammatory – colchicine
Used to ↑ penicillin serum
levels
Probenecid Colchicine
Inhibits renal reabsorption of D
uric acid & ↑ uric acid secretion N, V
Colchicine Agranulocytosis & aplastic
Inhibits leukocyte response to anemia
monosodium urate crystals in jt
Acute gouty arthritis

Prevent gouty arthritis
Neurodegenerative
Baclofen Levodopa-carbidopa
Benztropine Memantine
Donepezil Pergolide
Entacapone Selegiline
Interferon-beta-1b
Baclofen
Antispasticity Drowsiness
GABA-B receptor agonist Dizziness
Fatigue
↓ neuronal cAMP & Ca Weakness
influx
↑ K influx Additive effects
Alcohol
↓ motor neuron excitability
& inhibits spinal reflexes Kava
Valerian
Chamomile
Spasticity
MS
Spinal cord injury
ALS
Benztropine
Anti-Parkinson Blurred vision
Central anticholinergic Dry eyes
Constipation
Dry mouth
Blocks cholinergic
receptors & restores Urinary retention
neurotransmitter balance
in basal ganglia
Parkinson’s ds
Drug-induced EPS
↓ tremor > bradykinesia &

rigidity
Donepezil
Anti-Alzheimer N, D
Cholinesterase inhibitor HA
Inhibits cholinesterase in
CNS
↑ Ach neurotransmission
Slows decline in cognitive
function
Alzheimer’s ds
Does NOT prevent ds

progression
Entacapone
Anti-Parkinson Rhabdomyolysis
Neuroleptic malignant syndrome
Catechol-O-
methyltransferase inhibitor
Inhibits catechol-o-
methyltransferase
inactivation of levodopa
↑ levodopa in CNS
Prolongs response to levodopa &
↓ S/Sx Parkinson’s ds
Adjunct to levodopa/carbidopa for

Parkinson’s ds
AVOID nonselective MAOI

Interferon-beta-1b
Anti-multiple sclerosis HA
Interferon Weakness
GI distress
Sweating
Binds cell surface Neutropenia
receptors producing Myalgia
immuno-suppressive Chills
effects Fever
↓ relapse & slows
physical disability in MS
Relapsing-remitting MS
SubQ daily
Levodopa-carbidopa
Anti-Parkinson Dyskinesia – involuntary movements
Dopamine precursor, N, V
decarboxylase inhibitor Hallucinations
↑ arrhythmia w/ halothane
Levodopa
Converted to D in CNS
Augments neurotransmission in
basal ganglia
Carbidopa
Inhibits peripheral dopa-
decarboxylase
↑ levodopa availability in CNS
Parkinson’s ds
HTN crisis w/ MAOI

Memantine
Anti-Alzheimer
Glutamate antagonist
Glutamate NMDA
receptor antagonist
Prevent excitotoxic
effects of glutamate
causing neuronal loss
Slows decline in
cognitive function
Alzheimer’s ds
Pergolide
Anti-Parkinson Dyskinesia
Dopamine receptor Hallucination
agonist Orthostatic hypotension
Constipation
Activates D receptors
in basal ganglia
Parkinson’s ds in
conjunction w/
levodopa/carbidopa
Selegiline
Anti-Parkinson AVOID
Meperidine & opioids
Type B MAOI • Fatal rxn
• Excitation
• Rigidity
• HTN
Converted to active form • coma
by MAO SSRI
Irreversibly inhibits D • Serotonin syn
Tricyclics
degradation by MAO • Asystole
↑ response to • HTN
levodopa/carbidopa Tx • Syncope
• Rigidity
• seizures
Parkinson’s ds w/
levodopa/carbidopa
Parkinson’s ds
Other Drugs
Alprostadil Latanoprost
Bosentan Mesna
Epoprostenol Succimer
Alprostadil
Vasodilator IV infusion
Prostaglandin E1 Apnea
Hypotension
Arrhythmia
Activates PG EP receptors
Local products
Vascular smooth m.
Prolonged/painful erection
relaxation & vasodilation
lightheadedness
Maintain PDA in neonates

awaiting surgery
IV infusion
Male erectile dysfunction
Local injection or pellets
Bosentan
Vasodilator CI in pregnancy
Endothelin-1 receptor Causes birth defects
antagonist
↑ serum aminotransferase
levels
Blocks endothelin A & B
receptors
↓ pulmonary vascular
resistance & dyspnea
Improves walking distance
Pulmonary arterial HTN

Epoprostenol
Vasodilator Flushing
Naturally occurring Hypotension
prostacyclin (PGI2) Tachycardia
Diarrhea
Activated prostaglandin IP N, V
receptors
Vascular smooth m.
relaxation
↑ pulmonary blood flow &
reduces dyspnea
Pulmonary arterial HTN

Latanoprost
Ocular hypotensive agent Alters color of iris causing
Prostaglandin F2α analogue permanent eye color change
by ↑ amount of melanin in
melanocytes
Activates prostaglandin FP
receptors
↑ aqueous humor outflow via
uveoscleral pathways
Lowers intraocular pressure
Chronic open-angle glaucoma

Mesna
Antidote
Sulfhydryl compound
Detoxifies urotoxic
metabolites acrolein of
ifosfamide &
cyclophosphamide
Hemorrhagic cystitis d/t

ifosfamide &
cyclophosphamide
Succimer
Antidote
Metal chelating agent –
dimercaptosuccinic
acid
Chelates lead
Water-soluble chelates
to excreted in urine
↓ blood lead levels
Psychotherapeutics
Amitriptyline
Amphetamine & Methylphenidate
dextroamphetamine Mirtazapine
Atomoxetine Olanzapine
Buproprion Phenelzine
Desipramine Risperidone
Fluoxetine Thioridazine
Haloperidol Venlafaxine
Lithium
Amitriptyline
Antidepressant Lethargy
Sedation
Tricyclic Blurred vision
Constipation
Blocks neuronal reuptake of Urinary retention
serotonin > norepinephrine ↑ appetite & wt gain
Blocks muscarinic & α-
adrenergic receptors OD wide QRS complex VT
Altered effects by drugs that

Chronic pain inhibit/induce CYP450
Depression Carbamazepine
Quinidine
Rifampin
Delayed onset of antidepressant
effect >4 wks
AVOID
MAOI
SSRI
Amphetamine
CNS stimulant Tachycardia
HTN
Sympathomimetic Anorexia
amine Irritability
Insomnia
↑ neuronal release of Tremor
norepinephrine Growth inhibition
Drug dependence
ADHD HTN crisis w/ MAOI

↑ attention span
↓ motor restlessness
Narcolepsy
↑ mental alertness
↓ drowsiness & fatigue
Atomoxetine
ADHD agent ↓ appetite
Selective NE reuptake Insomnia
inhibitor
Levels & effects altered by
drugs that inhibit/induce
Inhibits neuronal CYP2D6
reuptake of NE in CNS
ADHD in children/adults
↑ levels & effect in slow

metabolizers – CYP2D6
Bupropion
Antidepressant Agitation
Neuronal reuptake HA
inhibitor Dry mouth
N
Inhibits neuronal Tremor
reuptake of DA > 5-HT & Impaired motor &
NE cognitive skills
Depression MAOI ↑ adverse effects

Smoking cessation Seizure risks w/
phenothiazines
Delayed onset for
antidepressant effects
Desipramine
Tricyclic Sedation
Blurred vision
Constipation
Blocks neuronal reuptake NE >
5-HT Urinary retention
↑ appetite & wt gain
adrenergic receptors
OD wide QRS complex VT
Depression
Chronic pain
Delayed onset for antidepressant

effects
AVOID
MAOI
SSRI
Fluoxetine
Antidepressant Anxiety
SSRI Drowsiness
Insomnia
Nervousness
Inhibits neuronal reuptake of Sexual dysfunction
serotonin
Sweating
Tremor
Depression
OCD ↑ levels metabolized by CYP2D6
Bulimia nervosa
Anorexia nervosa
Fibromyalgia
Panic attacks
Phobias
Prementsrual dysmorphic disorder
Active metabolite 5-7d half-life

AVOID MAOI
Haloperidol
Typical antipsychotic Neuroleptic malignant syn
Fever
Butyrophenone
Respiratory distress
Tachycardia
Blocks D2 receptors in Seizures
mesolimbic area, Severe m. stiffness
chemoreceptor trigger Altered BP
zone, solitary tract, & Extrapyramidal rxns
basal ganglia Tardive dyskinesia
Blocks muscarinic & α- Blurred vision
adrenergic receptors Constipation
Dry mouth
Urinary retention
Psychotic disorders
Hypotension
Schizophrenia
Tourette’s syn
Lithium
Mood stabilizer, antimanic Polyuria
Impaired memory
Inorganic cation Acne
Tremor
↓ noradrenergic ECG changes
neurotransmission or effects GI distress
b/c of ↓ cAMP Hypothyroidism
Inhibition of inositol-1- Leukocytosis
phosphatase
NM toxicity w/ haloperidol
Depletion of inositol & IP3 ↑ toxicity
Improved Na transport via Na Diuretics
pump NSAIDS
Fluoxetine
Bipolar affective disorder

Toxicity > 2.5
Methyphenidate
Sympathomimetic HTN
amine Anorexia
Irritability
↑ neuronal release NE Insomnia
Tremor
ADHD Growth inhibition
↑ attention span
Dependence
↓ motor restlessness
Narcolepsy
↑ mental alertness HTN crisis w/ MAOI
↓ drowsiness & fatigue
Mirtazapine
Antidepressant ↑ appetite & wt gain
Constipation
Tetracyclic Dry mouth
Drowsiness
Inhibits presynaptic α2
autoreceptors &
heteroreceptors
↑ NE & 5-HT release
Depression
Appetite stimulation
AVOID MAOI
HTN, seizure, death
Olanzapine
Atypical antipsychotic Agitation
Thienobenzodiazepine Dizziness
Restlessness
Sedation
Blocks D2 & 5-HT2 receptors in
CNS Amblyopia
Orthostatic hypotension
Blocks H1, muscarinic, & α-
adrenergic receptors Tachycardia
Constipation
Dry mouth
Schizophrenia
Wt gain
Manic episodes of biploar
Tremor
Anorexia nervosa
Oral tablets contain aspartame

Avoid in phenylketonuria
Phenelzine
Antidepressant Dizziness
MAOI Insomnia
Restlessness
Blurred vision
Inhibits MAO & ↑ CNS levels of
NE & 5-HT Orthostatic hypotension
Diarrhea
Neurotic & atypical depression
Potentially fatal
SSRI
Avoid Tricyclics
Fluoxetine
Tyramine
HTN crisis
Tyramine
Amphetamines
Methyldopa
Levodopa
Risperidone
Atypical antipsychotic Aggressive behavior
Benzisoxazole Extrapyramidal rxns
Sleep disturbances
Insomnia
Blocks 5-HT2 > D2 Sedation
receptors in CNS Constipation or diarrhea
Blocks H1 & α-adrenergic Wt gain
receptors
Schizophrenia
Psychotic disorders
Monitor pt for neuroleptic

malignant syn
Thioridazine
Typical antipsychotic Extrapyramidal rxns
Phenothiazine Tardive dyskinesia
Photosensitivity
Potential for V
Blocks D2 receptors in arrhythmias & sudden
mesolimbic area, death
chemoreceptor trigger Retinal pigmentation w/
zone, solitary tract, & high doses
basal ganglia melanosis
Blocks muscarinic
receptors
Psychotic disorders
Schizophrenia
Venlafaxine
Antidepressant Sexual dysfunction
Phenethylamine GI distress
Dizziness
Insomnia
Inhibits neuronal
Nervousness
reuptake 5-HT & NE
Depression
Generalized anxiety
disorder
AVOID MAOI
Respiratory
Albuterol Montelukast
Cromolyn Omalizumab
Diphenhydramine Salmeterol
Fluticasone Theophylline
Ipratropium Zileuton
Loratadine
Albuterol
Bonchodilator Muscle tremor
β2 receptor agonist Nervousness
Restlessness
Activates β2 receptors in Tachycardia
bronchial smooth m.
↑ cAMP activating kinases HTN crisis w/ MAOI
Inhibiting myosin
phosphorylase m. relaxation
Asthma
Acute bronchospasm
Prevent exercise-induced
asthma
Chronic bronchitis & emphysema
Reversible airway obstruction
Cromolyn
Antiasthmatic & antiallergy Nasal & throat irritation
Mast cell stabilizer
Prevents Ca influx &

stabilizes mast cell &
eosinophil membranes
Prevents degranulation &
release of histamine,
leukotrienes
Asthma prophylaxis
Exercise-induced
bronchospasm
Allergic disorders
Oral or nasal inhalation

Diphenhydramine
Antihistamine, sedative, Drowsiness
antiemetic Blurred vision
H1 receptor antagonist Dry mouth
Urinary retention
Anorexia
Blocks H1 & muscarinic
receptors
Prevents histamine-
induced allergic rxns
Prevents vestibular stim.
of vomiting center
Sedation
Allergic rxns
Prevent motion sickness
Insomnia
Fluticasone
Anti-inflammatory Nasal & throat irritation
Corticosteroid Oral candidiasis
Inhibits cytokine production

by Thelper cells
Prevents mediator release
from mast cells, basophils,
eosinophils
Stabilizes lysosomal
membranes
Vasoconstriction & ↓
capillary permeability
Allergic rhinitis
Chronic nasal inflammation
Chronic asthma
Ipratropium
Bronchodilator Cough
Muscarinic receptor Nasal dryness & irritation
antagonist
Blocks muscarinic receptors

in bronchial smooth m. &
nasal mucosa
Prevents vagal-stimulated
bronchoconstriction
COPD
Rhinitis
Asthma
Inhalation admin
Loratadine
Antihistamine
nasal mucosa
Prevents allergic rxns
Seasonal rhinitis
Chronic idiopathic
urticaria
Less sedating than

diphenhydramine
Montelukast
Antiasthmatic
Leukotriene antagonist
Blocks cysteinyl leukotriene-

1 receptor for leukotrienes
C4, D4, E4
Prevent airway inflammation,
edema, bronchoconstriction,
& secretion viscous mucus
Inhibits early/late phase
bronchoconstriction
Long-term asthma control
Oral admin
Omalizumab
Antiasthmatic Allergic rxns
IgE antagonist anaphylaxis
Blocks IgE
Severe asthma in
combo w/ corticosteroid
therapy
SubQ every 2-4 wks

Salmeterol
Bronchodilator Tachycardia
β2 agonist Nervousness
HA
↑ cAMP
Relaxes bronchial smooth
m.
Inhibits late phase allergen-
induced
bronchoconstriction
Asthma
Prevent nocturnal attacks
Exercise-induced asthma
NOT acute bronchospasm
Inhalation admin
Theophylline
Bronchodilator N, V
Methylxanthine Anxiety
Insomnia
Inhibits phosphodiesterase Tachycardia
isoenzymes & ↑ cAMP
Relaxes bronchial smooth m.
Inhibits T-lymphocyte proliferation
& cytokine production
Chronic asthma
Obstructive pulmonary ds
Neonatal apnea – respiratory stim.
Half-life
Shorter in smokers & children
Longer in elderly
Monitor blood levels
Zileuton
Antiasthmatic Flu-like syn
Leukotriene synthesis HA
inhibitor Drowsiness
Dyspepsia
↑ serum
Inhibits 5-lipoxygenase aminotransferase levels
& leukotriene synthesis & hepatitis
Prevents airway
inflammation &
Inhibits CYP450 & 3A4
bronchoconstriction
↑ theophylline &
warfarin levels
Psychotherapeutics
Amitriptyline
Amphetamine & Methylphenidate
dextroamphetamine Mirtazapine
Atomoxetine Olanzapine
Buproprion Phenelzine
Desipramine Risperidone
Fluoxetine Thioridazine
Haloperidol Venlafaxine
Lithium
Amitriptyline
Tricyclic Sedation
Blurred vision
Constipation
Blocks neuronal reuptake of Urinary retention
serotonin > norepinephrine ↑ appetite & wt gain
adrenergic receptors OD wide QRS complex VT
Chronic pain Altered effects by drugs that

inhibit/induce CYP450
Depression • Carbamazepine
• Quinidine
• Rifampin
Delayed onset of
antidepressant effect >4 wks
AVOID
• MAOI
• SSRI
Amphetamine
Sympathomimetic HTN
amine Anorexia
Irritability
Insomnia
↑ neuronal release of Tremor
norepinephrine Growth inhibition
Drug dependence
ADHD
• ↑ attention span HTN crisis w/ MAOI
• ↓ motor restlessness
Narcolepsy
• ↑ mental alertness
• ↓ drowsiness & fatigue
Atomoxetine
ADHD agent ↓ appetite
Selective NE reuptake Insomnia
inhibitor
Levels & effects altered by
drugs that inhibit/induce
Inhibits neuronal CYP2D6
reuptake of NE in CNS
ADHD in children/adults
↑ levels & effect in slow

metabolizers – CYP2D6
Bupropion
Antidepressant Agitation
Neuronal reuptake HA
inhibitor Dry mouth
N
Inhibits neuronal Tremor
reuptake of DA > 5-HT Impaired motor &
& NE
cognitive skills
Depression
MAOI ↑ adverse effects
Smoking cessation
Seizure risks w/
phenothiazines
Delayed onset for
Desipramine
Tricyclic Sedation
Blurred vision
Blocks neuronal reuptake NE Constipation
> 5-HT Urinary retention
Blocks muscarinic & α- ↑ appetite & wt gain
adrenergic receptors
OD wide QRS complex VT
Depression
Chronic pain
Delayed onset for

AVOID
• MAOI
• SSRI
Fluoxetine
Antidepressant Anxiety
SSRI Drowsiness
Insomnia
Inhibits neuronal reuptake of Nervousness
serotonin Sexual dysfunction
Sweating
Depression Tremor
OCD
Bulimia nervosa ↑ levels metabolized by CYP2D6
Anorexia nervosa
Fibromyalgia
Panic attacks
Phobias
Prementsrual dysmorphic disorder
Active metabolite 5-7d half-life

AVOID MAOI
Haloperidol
Typical antipsychotic Neuroleptic malignant
Butyrophenone syn
• Fever
• Respiratory distress
Blocks D2 receptors in • Tachycardia
mesolimbic area, • Seizures
chemoreceptor trigger • Severe m. stiffness
zone, solitary tract, & • Altered BP
basal ganglia Extrapyramidal rxns
Blocks muscarinic & α- Tardive dyskinesia
adrenergic receptors Blurred vision
Constipation
Psychotic disorders Dry mouth
• Schizophrenia Urinary retention
Tourette’s syn Hypotension
Lithium
Mood stabilizer, antimanic Polyuria
Inorganic cation Impaired memory
Acne
Tremor
↓ noradrenergic ECG changes
neurotransmission or effects GI distress
b/c of ↓ cAMP Hypothyroidism
Inhibition of inositol-1- Leukocytosis
phosphatase
Depletion of inositol & IP3 NM toxicity w/ haloperidol
Improved Na transport via Na ↑ toxicity
• Diuretics
pump • NSAIDS
• Fluoxetine
Bipolar affective disorder

• Toxicity > 2.5
Methyphenidate
Sympathomimetic HTN
amine Anorexia
Irritability
↑ neuronal release NE Insomnia
Tremor
ADHD
Growth inhibition
• ↑ attention span
• ↓ motor restlessness Dependence
Narcolepsy
• ↑ mental alertness HTN crisis w/ MAOI
• ↓ drowsiness &
fatigue
Mirtazapine
Antidepressant ↑ appetite & wt gain
Tetracyclic Constipation
Dry mouth
Drowsiness
Inhibits presynaptic α2
autoreceptors &
heteroreceptors
↑ NE & 5-HT release
Depression
Appetite stimulation
AVOID MAOI
• HTN, seizure, death
Olanzapine
Atypical antipsychotic Agitation
Thienobenzodiazepine Dizziness
Restlessness
Blocks D2 & 5-HT2 receptors Sedation
in CNS Amblyopia
Blocks H1, muscarinic, & α- Orthostatic hypotension
adrenergic receptors Tachycardia
Constipation
Schizophrenia Dry mouth
Manic episodes of biploar Wt gain
Anorexia nervosa Tremor
Oral tablets contain

aspartame
• Avoid in phenylketonuria
Phenelzine
Antidepressant Dizziness
MAOI Insomnia
Restlessness
Inhibits MAO & ↑ CNS levels Blurred vision
of NE & 5-HT Orthostatic hypotension
Diarrhea
Neurotic & atypical
depression Potentially fatal
• SSRI
Avoid • Tricyclics
• Fluoxetine
• Tyramine HTN crisis
• Tyramine
• Amphetamines
• Methyldopa
• Levodopa
Risperidone
Atypical antipsychotic Aggressive behavior
Benzisoxazole Extrapyramidal rxns
Sleep disturbances
Blocks 5-HT2 > D2 Insomnia
receptors in CNS Sedation
Blocks H1 & α-adrenergic Constipation or diarrhea
receptors Wt gain
Schizophrenia
Psychotic disorders
Monitor pt for
neuroleptic malignant
syn
Thioridazine
Typical antipsychotic Extrapyramidal rxns
Phenothiazine Tardive dyskinesia
Photosensitivity
Blocks D2 receptors in Potential for V
arrhythmias & sudden
mesolimbic area, death
chemoreceptor trigger
zone, solitary tract, & Retinal pigmentation
w/ high doses
basal ganglia • melanosis
Blocks muscarinic
receptors
Psychotic disorders
Schizophrenia
Venlafaxine
Antidepressant Sexual dysfunction
Phenethylamine GI distress
Dizziness
Inhibits neuronal Insomnia
reuptake 5-HT & NE Nervousness
Depression
Generalized anxiety
disorder
AVOID MAOI
Respiratory
Albuterol Montelukast
Cromolyn Omalizumab
Diphenhydramine Salmeterol
Fluticasone Theophylline
Ipratropium Zileuton
Loratadine
Albuterol
Bonchodilator Muscle tremor
β2 receptor agonist Nervousness
Restlessness
Tachycardia
Activates β2 receptors in
bronchial smooth m.
↑ cAMP activating kinases HTN crisis w/ MAOI
Inhibiting myosin
phosphorylase m. relaxation
Asthma
Acute bronchospasm
Prevent exercise-induced asthma
Chronic bronchitis & emphysema
Reversible airway obstruction
Cromolyn
Antiasthmatic & antiallergy Nasal & throat irritation
Mast cell stabilizer
Prevents Ca influx & stabilizes

mast cell & eosinophil
membranes
Prevents degranulation &
release of histamine,
leukotrienes
Asthma prophylaxis
Exercise-induced bronchospasm
Allergic disorders
Oral or nasal inhalation

Diphenhydramine
Antihistamine, sedative, Drowsiness
antiemetic Blurred vision
H1 receptor antagonist Dry mouth
Urinary retention
Blocks H1 & muscarinic Anorexia
receptors
Prevents histamine-induced
allergic rxns
Prevents vestibular stim. of
vomiting center
Sedation
Allergic rxns
Prevent motion sickness
Insomnia
Fluticasone
Anti-inflammatory Nasal & throat irritation
Corticosteroid Oral candidiasis
Inhibits cytokine production by

Thelper cells
Prevents mediator release from
mast cells, basophils,
eosinophils
Stabilizes lysosomal membranes
Vasoconstriction & ↓ capillary
permeability
Allergic rhinitis
Chronic nasal inflammation
Chronic asthma
Ipratropium
Bronchodilator Cough
Muscarinic receptor antagonist Nasal dryness & irritation
Blocks muscarinic receptors in

bronchial smooth m. & nasal
mucosa
Prevents vagal-stimulated
bronchoconstriction
COPD
Rhinitis
Asthma
Inhalation admin
Loratadine
Antihistamine
Blocks H1 receptors in nasal

mucosa
Prevents allergic rxns
Seasonal rhinitis
Chronic idiopathic urticaria
Less sedating than

diphenhydramine
Montelukast
Antiasthmatic
Leukotriene antagonist
Blocks cysteinyl leukotriene-1

receptor for leukotrienes
C4, D4, E4
Prevent airway inflammation,
edema, bronchoconstriction, &
secretion viscous mucus
Inhibits early/late phase
bronchoconstriction
Oral admin
Omalizumab
Antiasthmatic Allergic rxns
anaphylaxis
IgE antagonist
Blocks IgE
Severe asthma in combo w/

corticosteroid therapy
SubQ every 2-4 wks

Salmeterol
Bronchodilator Tachycardia
β2 agonist Nervousness
HA
↑ cAMP
Inhibits late phase allergen-
induced bronchoconstriction
Asthma
Prevent nocturnal attacks
Exercise-induced asthma
NOT acute bronchospasm
Inhalation admin
Theophylline
Bronchodilator N, V
Methylxanthine Anxiety
Insomnia
Tachycardia
Inhibits phosphodiesterase
isoenzymes & ↑ cAMP
Inhibits T-lymphocyte proliferation
& cytokine production
Chronic asthma
Obstructive pulmonary ds
Neonatal apnea – respiratory stim.
Half-life
Shorter in smokers & children
Longer in elderly
Monitor blood levels
Zileuton
Antiasthmatic Flu-like syn
Leukotriene synthesis HA
inhibitor Drowsiness
Dyspepsia
↑ serum aminotransferase
Inhibits 5-lipoxygenase levels & hepatitis
& leukotriene synthesis
Prevents airway Inhibits CYP450 & 3A4
inflammation & ↑ theophylline &
bronchoconstriction warfarin levels

Pharmacology Flash Cards 2017

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Analgesic & Antimigraine

↓ respiratory depression, constipation,

Injection or nasal spray

Chronic pain AVOID MAOI in past 14d

Lacks antitussive activity

Orally, once per day

Opioid OD, dependence

Short half-life needs

Oral, nasal, & subQ

Naloxone reverses some but

Blocks Na channels & nerve conduction

Irritates skin when 1st applied

Blocks Na channels &

Local or regional anesthetic

Potentiates GABA binding to

High blood:gas partition

Does NOT depression respiration

Blocks Na channels & nerve

Preoperative sedation &

Potentiates GABA binding

Minor surgery & dental

Rapid induction & recovery

Potentiates GABA binding

Intubation & maintenance of

Potentiates GABA binding

↓ viral shedding, pain, &

Intestinal nematode infections

Respiratory tract infections

Binds 50s ribosome

Respiratory infections d/t

Binds PBP including

Drug resistant gram (-)

Surgical wound infections

NOT active against MRSA

Drug-resistant gram (-)

Gram (+), gram (-), &

Pneumonia, meningitis, UTI,

Single IM injection Tx acute

Urinary tract, prostate,

Gram (+), gram (-), Pseudomonas

Strep, staph, gram (+)

High fat meal ↑ absorption

Antiretroviral Injection site rxn

Binds HIV virus gp41 &

Pharyngitis, otitis media,

Cystitis d/t E. coli or

Single dose Tx for UTI

Antiviral ↓ visual acuity

Gram (-) bacilli including

Monitor serum levels

Bimodal distribution d/t

Inhibits bacterial DNA

Gram (+), gram (-), P.

Antibacterial Inhibits MAO

Binds 23s ribosomal

VRE, MS/MRSA, PCN-

Perform CBC during

Competes w/ isoleucine for

Impetigo by staph or strep

Urinary tract Anorexia

Inhibits influenza A &

Antiprotozoal Nephrotoxic &

Gram (-) bacilli, P. aeruginosa