<p>Mini IV Pharmacology – Summary v. 1.0 D. Lazare Page 1 of 4</p><p>AN T I S E I ZU R E D R U G S</p><p>Hydantoins  Inactivated Na+ channels 1. Phenytoin – seizures of cortical origin 2. Mephenytoin 3. Ethotoin</p><p>Iminostilbenes Inactivated Na+ channels 1. Carbamazepine – DOC partial seizures and TN; ADH effects 2. Oxcarbazepine</p><p>Barbiturates and Desoxybarbiturates  Duration of GABA mediated Cl– channel opening 1. Phenobarbital – adv: sedation, porphyria, P450 induced 2. Primidone – PEMA active metabolite 3. Mephobarbital 4. Methabarbital</p><p>Valproates  "Mixed bag" ( GABA;  inactivated Na+ channels) 1. Valproic acid – absence seizures; tox fulminant hep 2. Sodium Valproate</p><p>Succinimides   Voltage–gated Ca2+ channels (t–type) in hypothalamus 1. Ethosuximide – DOC absence seizures 2. Phensuximide 3. Methsuximide</p><p>Oxazolidinediones 1. Trimethadione 2. Paramethadione</p><p>Benzodiazepines   Frequency of GABA mediated Cl– channel opening 1. Diazepam 2. Clonazepam – DOC myoclonic seizures 3. Lorazepam 4. Clorazepate</p><p>GABA–ergic Drugs GABA release from neurotransmitter terminals 1. Gabapentin 2. Vigabatrin – infantile spasms 3. Tiagabine</p><p>Others 1. Acetazolamide – carbonic anhydrase inhibitor 2. Felbamate 3. Lamotrigine 4. Topiramate</p><p>Seizure Treatment Tonic–clonic Carbamazepine Simple partial Valproic Acid Complex partial Phenytoin Absence Ethosuximide Status epilepticus Diazepam Febrile Infantile spasms ACTH & corticosteroids Mini IV Pharmacology – Summary v. 1.0 D. Lazare Page 2 of 4</p><p>–L A CT A M A N T I B I O T I CS (P EN I CI L L I N S ) G EN E RA L ANA E S T HE T I CS Penicillins – all  bacterial transpeptidase Inhaled Anaesthetics – malignant hyperthermia Streptococci, G+ cocci/rods, G– cocci, spirochetes 1. Penicillin G 1. Halothane – short procedures; halothane hepatitis 2. Penicillin V 2. Isoflurane 3. Desflurane – rapid on/off 4. Sevoflurane – rapid on/off; nephrotoxicity Aminopenicillins (+ aminoglycosides) 5. Nitrous Oxide –  effect on muscle tone; anemia  Haemphilus influenzae, e.coli, listeria, proteus, salmonella IV Anaesthetics h.e.l.p.s. 1. Ampicillin 2. Amoxicillin 1. Thiopental –  analgesia; short surgeries 2. Propofol –  analgesia/amnesia; anti–emetic 3. Etomidate – rapid on/off;  steroidogenesis Penicillinase–resistant Penicillins (IV) 4. Ketamine – dissociative amnesia = “bad trips” 1. Methicillin Met a nasty ox 2. Nafcillin staph aureus Benzodiazepines as General Anaesthetics 3. Oxacillin 1. Midazolam 2. Diazepam –  analgesia; preanaesthetic medication Penicillinase–resistant Penicillins (oral) 3. Lorazepam – cardiopulmonary bypass 1. Cloxacillin 2. Dicloxacillin staph aureus Opioids as General Anaesthetics Anti–Pseudomonal Penicillins 1. Morphine – anesthesia, analgesia, CVs depression James Bond’s 2. Fentanyl – anaesthesia but  amnesia/CVS depression– Car 1. Carbenicillin – Tick 2. Ticarcillin pseudomonas – Pipe bomb Neuroleptanaglesia 3. Piperacillin aeruginosa 4. Mezlocillin 1. Fentanyl + Droperidol – minor surgeries  – Lactamase Inhibitors L O CA L A NA E S T HE T I CS 1. Augmentin = Clavulanic acid + amoxicillin 2. Unasyn = Sulbactam + ampicillin Esters – metabolized in plasma 3. Zosyn = Tazobactam + Piperacillin 1. Procaine 2. Tetracaine First Generation Cephalosporin PEK 1. Cefazolin Amides – metabolized in highly perfused organs 2. Cephalexin Gram +ve 1. Lidocaine 3. Cephalothin proteus 2. Bupivacaine 4. Cephapirin e.coli 3. Prilocaine 5. Cephradine klebsiella Second Generation HN PEK</p><p>“ The Perfect Anaesthetic” Fam 1. Cefamandole h.influenza  Anaesthesia Fur 2. Cefuroxime neisseria Fox 3. Cefoxitin proteus  Analgesia Tea  Muscle relaxant 4. Cefotetan e.coli  CV stability 5. Cefaclor klebsiella  Respiratory stability ax to the head Third Generation HN PEKS [CNS] 1. Ceftriaxone h.influenza Brain 2. Cefotaxime neisseria Kidney 3. Ceftazidime proteus Liver Skin 4. Cefoperazone e.coli Lung Skeletal muscle 5. Moxalactam klebsiella Adipose 6. Cefixime serratia e s</p><p> o Fourth Generation ESPN</p><p>D 1. Cefepime</p><p>Comparison of Cefalosporins: Gram –ve Strep. Gram +ve Generation Tim e (e.coli) pneumonia (staph aureus) 1st    2nd    Mini IV Pharmacology – Summary v. 1.0 D. Lazare Page 3 of 4</p><p>3rd    Monobactams – magic bullet for gram –ve aerobes 1. Astreonam – pseudomonas aeruginosa</p><p>Carbapenems – broadest spectrum I’m a pen crossing 1. Imipenem – DOC enterobacter everything out! 2. Meropenem</p><p>Glycopeptides – all gram +ve organisms 1. Vancomycin – MRSA, enterococcus, clostridium difficile 2. Teicoplanin 3. Bacitracin – G+ organisms</p><p>AN T I –R IB O S O M A L D R U G S</p><p>A minoglycosides – 30S Mn: GNATS 1. Gentamicin 2. Neomycin 3. Amikacin – broadest spectrum 4. Tobramycin – pseudomonas aeruginosa Buy AT 30 5. Streptomycin Cell at 50</p><p>T etracycline – 30S “the Tet offensive” 1. Tetracycline 2. Doxycycline 3. Demeclocycline</p><p>Chloramphenicol – 50S “chlorine” broad but toxic 1. Chloramphenicol – gray baby, aplastic anemia</p><p>Macrolides – 50S 1. Erythromycin – DOC m. pneumonia 2. Azithromycin – chlamydia (1 dose for 4 days) 3. Clarithromycin – toxo. gondii, MAI</p><p>Lincosamines – 50S 1. Clindamycin – anaerobic infections; proph. endocarditis</p><p>O T H ER A N T I B I O T I CS</p><p>Inhibitors of Folic Acid Synthesis 1. Trimethoprim (TMP) – “treats marrow poorly” 2. Pyrimethamine 3. Oral Sulfonamides a. Sulfamethoxazole (SMX) – e.coli (acute UTI), b. Sulfisoxazole ocular chlamydia c. Sulfasalazine 4. TMP/SMX – DOC AIDS, recurrent UTI</p><p>Inhibitors of Nucleic Acid Synthesis 1. Fluoroquinolones – “hurt attachments to your bones” a. Ciprofloxacin CPNS 3 b. Norfloxacin Campylobacterdoc 2. Metronidazole – “GET on the Metro” Providencia a. Giardia Neisseria b. Entamoeba histolytica Serratia Shigella c. Trichomonas Salmonella Mini IV Pharmacology – Summary v. 1.0 D. Lazare Page 4 of 4</p><p>AN T I –F UN G A L D RU G S A N T I –V IR A L DR U G S</p><p>Systemic Anti–Fungals 1.  globulin – IV or IM; measles, hepatitis, rabies, polio 1. Amphotericin B 2. Amantadine – influenza A 2. Flucytosine 3. Vidarabine 3. Itraconazole 4. Idoxuridine Herpes keratitis 4. Ketoconazole 5. Trifluridine 5. Fluconazole 6. Sorivudine – HSV 7. Acyclovir – HSV I/II, varicella, zoster Topical Anti–Fungals 8. Ganciclovir – CMV retinitis 9. Ribavirin – RSV 1. Clotrimazole 10. Foscarnet – IV; CMV; bone marrow suppression 2. Miconazole 11. Interferon (IFN) – IV; HIV, HBV, HCV, CMV</p><p>AN T I –P R O T O Z O A L D RU G S AIDS D R U G S Suramin Trypanosomiasis Nifurtimox Chaga’s dz (trypomasigotes) Nucleoside RT inhibitors (NRTIs) 1. Zidovudine (ZDV) – same as AZT Metronidazole Amebiasis, trichomoniasis 2. ZDV/3TC (Combivir) Iodoquinol Amebiasis 3. Didanosine – pancreatitis Quinacrine Giardiasis 4. Lamivudine; 3TC Stibogluconate Leishmaniasis 5. Ziagen – new; hypersensitivity Pyrimethamine Toxoplasmosis Sulfonamide NNRTIs 1. Nevirapine – ok for pregnancy AN T I –H E L M I N T H I C DR U G S 2. Delaviridine 3. Efavirenz Intestinal nematodes 4. Emivirine – ok for pregnancy Ascaris lumbricoides (roundworm) Necator americanus (hookworm) Protease Inhibitors Mebendazole Strongyloides stercoralis 1. Saquinavir Thiabendazole Trichinella spiralis 2. Ritonavir Albendazole Enterobius vermicularis (pinworm) 3. Indinavir Trichuris trichiura (whipworm) 4. Nelfinavir Cutaneous & visceral larva migrans 5. Amprenavir Onchocerca volvulus (river blindness) Ivermectin Wuchereria bancrofti O P P OR T U N I S T I C I N FE C T I O N S I N AIDS Strongyloides stercoralis Metronidazole Dracunculus (guineaworm) Viral Treatment/Prophylaxis Praziquantel Schistosomiasis Disseminated herpes simplex Acyclovir Cestodes Herpes zoster Acyclovir Niclosamide Nematodes CMV Ganciclovir or foscarnet</p><p>Fungal T U BE R CU L O S I S D RU G S Candida albicans Fluconazole/amphotericin B R Cryptococcal meningitis Fluconazole/amphotericin B E 1. Rifampin – RNA polymerase, revs up P450, red urine, resist. + flucytosine S 2. Ethambutol – optic neuritis Disseminated Histoplasmosis Amphotericin B, ketoconazole P 3. Streptomycin – CN VIII damage I 4. Pyrazinamide – works on inactive organisms Protozoal R 5. Isoniazid (INH) – alone for prophylaxis Pneumocystis carinii TMP–SMX or pentamidine/ E TMP–SMX + Dapsone Leprosy – use rifampin + dapsone Toxoplasmosis TMP–SMX Cryptosporidiosis Paromomycin M A LA R I A L D RU G S Bacteria 1. Chloroquine m. Tuberculosis INH, rifampin, pyrazinamide 2. Pyrimethamine–Sulfadoxine (Fansidar)  ethambutol (streptomycin) 3. Mefloquine Clarithromycin or azithromycin 4. Quinine MAI + ethambutol 5. Quinidine  rifabutin 6. Primaquine Campylobacter erythromycin or cipro 7. Doxycycline Treponema pallidum benzathine PCN</p>