FOUNDATIONS FINAL

CLASS

Cidal/Static

Mechanism of Action

Black Box

Extra Info

Sulf

C

Folic acid synthesis inhibitor

Bactrim = SULFAmethoxazole + trimethoprim = p. Jirroveci / pneomocystsic + MRSA

Inhibit both steps of formic acid synthesis

Cycline

S

Inhibit protein synthesis by binding to 30S

Used for lyme disease

TIGECYCLINE = increased mortality when used to treat hospital acquired pneumonia or ventilator-associated pneumonia 

If allergic to penicilin you can used tetraccline and have ATYPICAL activity

Doxycyline children < 8 = yellow teeth (short course is safe) 

Floxacin/Fluroquinolone

S

Inhibit topoisomerase (DNA gyrase)

Achilles Tendon 

Peripheral Neuropathy

QTC Prolongation

Monoflaxin used for COPD not psuedonomas 

CLASS

drugs

C/S

MOA

use

Black Box

Lipo

glycopeptides

-vanc- 

C

Inhibit

Transglycosylase and Transpeptidase 

Inhibit peptidogylican wall 

Hospital Aquired Pneomonia + Ventilator Associated Pneuomonia +

Vancomycin Resistant Entereo + MRSA 

Telavancin = nephrotoxicity 

+ QTC prolongation 

Glycopeptide

Vancomycin

C

Binds to D-alanine preventing the synthesis and polymerization within the peptidoglycan layer

Orally = c.dif

MRSA

Nephrotoxicity + odotoxicity 

Amino

Glycosides

(AGT)

Amikacin 

Gentamicin

Tobramycin

C

30S

Post- antibiotic effect

 (only take once a day)

CONCENTRATION DEPENDENT 

Higher peak dose = higher killing affect

Peak of Cmax / MIC ration

Nephrotoxicity +Ototoxicity

Lancosimide

Clindamycin

S

50S 

Aneorobic coverage, MRSA, p.jiroveci

CAUSE C. Dif

Macrolide

(ACE) – mac and cheese is ACE

Azithromycin

Clarithromycin

Erythromycin 

Fidaxomicin

S

50S 

Mycoplasma pneumonia - atypical 

Community aquired pneumonia 

Azithromycin = torsades de pointes (QTC prolongation)

Erythomycin most likely to cause adverse effect Azith least likely 

Lanozolid

-zolid

S

50S

MRSA + VRE

More than 14 days = bone marrow suppression 

More than 28 days = peripheral + optic neuropathy

Lippeptide (Mycin) 

Daptomycin 

C

Bind, insert, oligimerization and channel formation→ Depolarize, ion efflux, cell death 

MRSA + VRE

NA

CLASS

MOA

use

Black Box

Polyenes- 

Amophotericin B 

binds to fungal cell wall and creates pores causing cell to leak 

Covers ALOT

Use LIPOSOMAL version (IV) to avoid nephrotoxicity

Nephrotoxic + Electrolyte Abnormality 

(↓ K+ ↓ Mg2+)  

Azole

Block lanosterol → Ergosterol (stability)

Flunicozole NO aspergilus

Voiconazole = drug of choice for aspergillus

Voriconozole = photosensitivity + visual changes

ALL AZOLES inhibit CYP450 enzymes

Fungin (Echinocandins) 

B-D glcuan synthase

Treat aspergillus 

WELL TOLERATED 

X

Nyastatin  (topical polyene) 

X

Orophaarngeal Cadidiasis 

THRUSH: oral pharyngeal 

X

Azole (imidazole)

X

CLOTRIMAZOLE = torche = ORAL THRUSH

X

NRTI 

(Nucleoside Reverse Transcriptase Inhibitor) 

FOVIR

VUDINE
CAVIR

2 NRTI + _______ = standard antiretroviral therapy 

Also treat Hep B= 

TenoFOVIR

EmcitricaBINE

lamiVUDINE 

PrEP= 

Emcitricatabine/TDF (truvada) - more nephrotoxic

+

Emcitricitabine/ TAF (descovy)

+

Carbotegravir + Rilpiverine 

+

Duranavir + Coricistat (Prezcobix) = once every 8 weeks for prep 

NNRTI

(Non-nucleoside Reverse Transcriptase Inhibitor)

VIRINE

(hate wolverine has too many side-effects)

Low genetic barrier to resistance so liver toxicity, rash, steven johnson syndrome

Cytochrome 3A4 interactions

Protease 

NAVIR

Ritonavir = booster to protease by inhibiting CYP3A4

Integrase Strand Transfer Inhibitor

(INSTI)

TEGRAVIR

Corbisistat = booster for elvitegravir

Bictegravir = 3 in 1 combination

CLASS

MOA

Controlled?

Black Box Warning

Benzodiazapine

Potentiate effects of GABA 

C4

Fatal overdose uncommon on own unless mixed w/ other CNS depressants (alchohol + opioids) 

Buspirone

Serotonin receptor agonist (5-HT1A) 

NO effect of GABA 

No potential for misuse bc/ seretonin

X

Skeletal Muscle Relaxant

Anticollinergic effect 

ONLY Carisoprodal

(SOMA) = C4

X

Non- Benzodiazapie Receptor Agonists (Z drugs) 

Zoldipem (Ambien) + Zaleplon + esZopiclone 

Enhance GABA activity by binding to BZD-1 

NOT BZD-2

C4

Complex sleep behavior

Doxipen

Tricyclic antidepressant act as antihistamine

X

X

Barbituates - Barbital

Minor tranquilizers 

Not in slides 

RESPRITORY DEPRESSION (die in sleep)

Orexin Antagonists

Sleep onset and maintenance

C4

X

MOA

Drugs

Side Effects 

1st Gen

Block Dopamine (D2)

ChlorpromaZINE

fluphenaZINE

TrifluoperaZINE

ThiridaZINE

perphenAZINE

Haloperidol

Thiothixene

Molindone

Lozapine

(molin and loza get  a halo for being thio)

Extrapyramidal 

**Dyskenesia often irreversible

High Potency= 

Halo 

Thio ZINE

Flu  ZINE

TriFlu ZINE

(obsessed with triple flu + halo) 

2nd Gen

Block Dopamine (D2) AND Seretonin 

caripraZINE rest of zines are 1st gen except Cari she is FAKE

Metabolic 

(diabetes, cholesterol, weight gain) 

Class

MOA

Drugs

SSRI (6) 

Selective Seretonin Reuptake Inhibitors

Whatever is NOT SNRI or MAOI

SNRI (4)

Cardiovascular Effects 

DUO and LEVO might be FAX but they also bad for your heart 

Seretonin + Norepinephrine Reuptake Inhibitors 

FAXINE + 

Duoloxetine+ 

Levomilnacipram

DUO and LEVO are FAX 

TCA 

messy SNRI

(tryptaline or pramine) 

Serotonin + Norepinephrine Reuptake Inhibitors 

ALSO blocks: 

Histamine -1 

Alpha -1

Muscarininic 

Secondary is used more for Norepinephrine than Teritiary 

Secondary: 

Desi

Norti

Protri 

They sound like brown girl names

Brown girls be secondary :( but love NE ways

MAOI

Irreversiblely inhibit MAO-A and MAO-8

Which breakdown serotonin, dopamine, and NE

These names are interesting and arent LEVO, DUO, FAX

1. Phenelzine

Tranylcypromine

2. Isocarnpxazid

3. Selegiline Transdermal

USE

What to know:

CAINE

Regional anethesthetic

Block nerve signal (pain) propagation 

Bupivicaine = epidural anesthesia (B for baby)

BBW- cardiac arrest CNS 

CUR

Neuromuscular blocker (PARALYSIS) 

CisatraCURium is NOT dependent on liver or kidneys for elimination so favorable in patients w/ kidney+ liver malfunction

(Cista don’t need no kidney or liver)

Depolarizing = Succinylcholine (rest are NONdepolarizing) – he be SUS cause why is he the only CUR thats depolarizing

TRIPTAN

anti–migraine

Seretonin 1B/1D agonist 

DITAN: 5HT-1F agonist

Only SUMA and ZOLMI auntie are intranasal they be all up in there + SUMA can be sub

Aunties will give u a heart attack dont take TRIPTAN if you’ve had heart attack ( tightness pressure on chest – coronary artery vasospasms)

AFIL

Erectile dysfunction 

Phosphodiesterase 5 - inhibitors 

CLASS

MOA

BBW

Platinums  (-platin)

Mutation in DNA

NOT CELL CYCLE SPECIFIC 

CarBo= bone marrow suppression (dose limiting) 

Cisplatin = nephrotoxicity (dose limiting) – cis got kidney issues

Ox = peripheral neuropathy (not dose limiting) 

Taxanes

(bark of yule tree)

Bind to Tubulin to arrest division

M- CELL CYCLE SPECIFIC  

Allergic reaction due to emulsifying agent 

Polysorbate 80 

Creamophor EL (castor oil) 

PacliTAXil = cremophor EL

DoceTAXol + CabaziTAxal = Polysorbate 80 

Monoclonal Antibodies 

(MAB) 

Linked to Radionuclei Target cancer cells NOT normal cells 

X

Small Molecule KInase Inhibitors (NIB) 

Gleevac= magic bullet= tyrosine kinase inhibitor specifically target PHILADELPHIA chromosme (Bcr-Abl) 

NILOtinib = QTC Prolongation 

Immmunomodulato (Thalidomide)

X

Need REMS for thalidomide 

Pregnancy category X 

Immunosupressors (LIMUS) 

EveroLIMUS= mTOR inhibitor 

= renal cancer + graft vs host disease 

TacroLIMUS= calcineurin inhibitor 

Sirolimus = mammalian/mechanistic target 

X

Class

MOA

BB

extra

1st Gen

SEDATING antihistamine

Anticholinergic + CNS depression + fall risk due to sedation 

Anticholinergic depression = GLAUCOMA= asthma contraindication 

ZINES are most sedating

hydroxyZINE

mecliZINE

Ex. dramamine, promethazine

2nd Gen

NONSEDATING antihistamine

More tolerable 

DINE is the LEAST sedating 

SOOOO if the question asks which is the least sedating then the answer is ANY DINE BUTTTT 

CyporoheptADINE 

(cypro seems like hes overstimulating anyways so he’s not sedating) 

LEVIDOPA + CARBIDOPA

Levidopa → Dopamine once it reaches the blood brain barrier THEN it can get decarboxylated 

Carbidopa → prevent levadopa from getting decarboxylated into dopamine before it reaches the brain DOES NOT CROSS BBB

tremor/ridgitity of parkinsons returns (shaking – muscle spasms when you first take it) — can delay these side effects with CAPONE and GILINE (adjunctive drugs)

CAPONE

ADJUNCTIVE

Inhibits the conversion of L-dop to 3-o-methyl Dopa

DECREASE WEAR OFF TIME

TolCAPONE- hepatotoxicity 

GILINE

ADJUNCTIVE

Inhibits MAO-B (prevents dopamine from being metabolized to decrease wear off time)

Rasagiline - hypertensive crisis warning