Alpha-1 sympathetic receptor (G-protein class, major function) Alpha-2 sympathetic receptor(G-protein class, major function) Beta-1 sympathetic

receptor(G-protein class, major function) Beta-2 sympathetic receptor(G-protein class, major function) M-1 Parasymp receptor(G-protein class, major function) M-2 Parasymp(G-protein class, major function) M-3 parasymp(G-protein class, major function) What receptor is responsible for miosis and accomadation? What receptor is responsbile for mydriasis? Dopamine D-1 receptor(G-protein class, major function) Dopamine D-2 receptor(G-protein class, major function) Histamine H-1 receptor(G-protein class, major function) histamine H-2 receptor(G-protein class, major function) vasopression V-1 receptor(G-protein class, major function) vasopression V-2 receptor(G-protein class, major function) Which receptors work via Gq -> Phospholipase C ->Pip2->DAG + IP3? DAG causes activation of what? IP3 causes increase in what? Which receptors work via Gi->Adenyly cyclase ->cAMP ->Protein Kinase A? Which receptors work via Gs->adenylyate cyclase ->cAMP->Protein Kinase A? What does protein kinase A do? What are the two classes of cholinomimetics? Bethanechol(mechanism,use,toxicity) Carbachol(mechanism,use,toxicity) Pilocarpine(mechanism,use,toxicity) methacholine(mechanism,use,toxicity) Neostigmine(mechanism,use,toxicity) pyridostigmine(mechanism,use,toxicity) edrophonium(mechanism,use,toxicity) Physostigmine(mechanism,use,toxicity) Donepezil(mechanism,use,toxicity)

signs of cholinesterase inhibitor poisoning. treatment. Parathion(mechanism, treatment) Atropine, homatropine, tropicamide (mechanism, use, toxicity). Benztropine(mechanism,use,toxicity) Scopolamine(mechanism,use,toxicity) Ipratropium,tiotropium (mechanism, use, toxicity) Glycopyrrolate(mechanism,use,toxicity) Jimson Weed(mechanism, toxicity) Epinephrine(Mechanism, receptors bound, use, toxicity) Norepinephine(Mechanism, receptors bound, use, toxicity) Isoproterenol(Mechanism, receptors bound, use, toxicity) dopamine(Mechanism, receptors bound, use, toxicity) dobutamine(Mechanism, receptors bound, use, toxicity) Phenylephrine(Mechanism, receptors bound, use, toxicity) Albuterol, salmetrol, terbutaline (Mechanism, receptors bound, use, toxicity) Ritodrine(Mechanism, receptors bound, use, toxicity) Amphetamine (mechanism, use) Epinephrine(Mechanism, use, toxicity) Cocaine (mechanims, use). Why must B-Blockers be avoided in suspected cocaine intoxication? How does norepinephrine cause reflex bradycardia? How does isoproterenol cause reflex tachycardia? Clonidine, alpha-methyldopa(Mechanism, receptors bound, use) Phenoxybenzamine(Mechanism, receptors bound, use, toxicity) phentolamine(Mechanism, receptors bound, use, toxicity) Prazosin, Terazosin, Doxazosin,Tamsulosin(Mechanism, receptors bound, use, toxicity) Mirtazapine (mechanism, use, toxicity) Describe what occurs when you alpha-blockade epi vs. phenylephrine.

Give 6 applications of Beta-blockers in general.

give general toxicites of b-blockers What are the B1 selective b-blockers? When are they useful? What are the nonselective ( b1 = b2) b-blockers? what are the nonselective a and b-antagonists? What are the partial B-agonists? Why is phenoxybenzamine prefered over phentolamine for presurgery pheochromocytoma surgery? Nitrates (mechanism, use, toxicity) Adverse effects of statins Niacin (mechanism, use, toxicity) Cholestyramine, colestipol, colesevelam (mechanism, use, toxicity) Ezetimibe Fibrates (gemfibrozil + -fibrates) (mechanism, use, toxicity) Digoxin and digitoxin (mechanism, use, toxicity) Class 1A antiarrhythmics Class 1B antiarrhythmics Class 1C antiarrhythmics Class 1 antiarrhythmics (general mechanism and toxicity) Class 2 antiarrhythmics Class 3 antiarrhythmics Toxicity of amiodarone Class 4 antiarrhythmics Adeosine (mechanism, use, toxicity) Magnseium (mechanism, use, toxicity) Does digoxin cause hyper or hypokalemia? which states increases patient susceptibility to digoxin toxicity? What is first dose effect, typically seen in A1 blockers? Which nitrate can be given PO? Paclitaxil or sirolimus are commonly used in cardiac stents. why? Treatment for prolactinoma

Treatment of secondary hyperaldosteronism Treatment of carcinoid syndrome Rapid-acting insulins (3) Short-acting insulin (1) Intermediate-acting insulin (1) Long-acting insulins (2) Metformin (mechanism, use, toxicity) Tolbutamide, chlorpropamide (mechanism, use, toxicity) Glyburide, glimepiride, glipizide (mechanism, use, toxicity) Pioglitazone, rosiglitazone (mechanism, use, toxicity) Acarbose, miglitol (mechanism, use, toxicity) Pramlintide (mechanism, use, toxicity) Exenatide, liraglutide (mechanism, use, toxicity) Linagliptin, saxagliptin, sitagliptin (mechanism, use, toxicity) Propylthiouracil (mechanism, use, toxicity) Methimazole (mechanism, use, toxicity) Levothyroxine, triiodothyronine (mechanism, use, toxicity) Oxytocin (mechanism, use, toxicity) Demeclocycline (mechanism, use, toxicity) Glucocorticoids (mechanism, use, toxicity) What drugs can stimulate prolactin secretion? What is a difference in the mechanism of PTU and methimazole? Can sulfonylureas be used in type 1 DM? What drugs can be used to treat type 1 AND 2 DM? Which drug used for hyperthyroidism decreases peripheral T3->T3 conversion? Rasburicase (mechanism, use) Difference in competitive vs noncompetitve inhibitors? What is Km? What is Vmax? What is bioavailability? Time to steady state depends on? What is rate of elimination in zero order kinetics? Give three drugs that are zero order eliminated. What is the rate of elimination for first order kinetics? How does ionization relate to urine pH? How do you treat overdose of weak acid? Give drug examples.

How do you treat overdose of weak base? Give drug examples. What is phase I drug metabolism? What pt. population loses this? What is phase II metaboloism? What population depend on this? What is efficacy? What is potency? What happends to efficacy when a partial agonist and full agonist are mixed? What is therapetuic index? What is a therapeutic window? What are the two types of Nicotonic receptors? What kind of messenger do they use? What drugs inhibit dihydrofolate reductase? What can be given to those suffering from hyperammonia caused by a metabolic derangement? What keeps heparin from crossing the placental barrier? Cimetidine and ranitidine (mechanism, use, toxicity) -prazoles (mechanism, use, toxicity) Bismuth, sucralfate (mechanism, use, toxicity) Misoprostol (mechanism, use, toxicity) Octreotide (mechanism, use, toxicity) Toxicity of long-term antacid use Infliximab (mechanism, use, toxicity) Sulfasalazine (mechanism, use, toxicity) Ondansetron (mechanism, use, toxicity) Metoclopramide (mechanism, use, toxicity) Why is Lactulose fed to people with hepatic encephalopathy? Ondansetron acts on 5HT3 receptors in what location, in order to decrease nausea? Can atropine be used to block gastric secretions? why or why not? Colchine stops what specific cell to decrease gout symptoms? Orlistat(mechanism, use) giving what drug 30 minutes before Niacin can help reduce flushing? Can be used to prevent mast cell degranulation Treatment of lead poisoning Heparin (mechanism, use, toxicity)

Enoxaparin, dalteparin (mechanism, use, toxicity) Warfarin (mechanism, use, toxicity) Alteplase, reteplase, tenecteplase (mechanism, use, toxicity) Aspirin (mechanism, use, toxicity) Clopidogrel, ticlodipine, prasugrel, ticagrelor (mechanism, use, toxicity) Cilostazol, dipyridamole (mechanism, use, toxicity) Abciximab, eptifibatide, tirofiban (mechanism, use, toxicity) Methotrexate (mechanism, use, toxicity) 5-fluorouracil (mechanism, use, toxicity) Cytarabine (mechanism, use, toxicity) Azathioprine, 6-mercaptopurine, 6-thioguanine (mechanism, use, toxicity) Dactinomycin (actinomycin D) (mechanism, use, toxicity) Doxorubicin (Adriamycin), daunorubicin (mechanism, use, toxicity) Bleomycin (mechanism, use, toxicity) Cyclophosphamide, ifosfamide (mechanism, use, toxicity) Carmustine, lomustine, semustine, streptozocin (mechanism, use, toxicity) Busulfan (mechanism, use, toxicity) Vincristine, vinblastine (mechanism, use, toxicity) Paclitaxel (mechanism, use, toxicity) Cisplatin, carboplatin (mechanism, use, toxicity) Etoposide, teniposide (mechanism, use, toxicity) Hydroxyurea (mechanism, use, toxicity) Prednisone (mechanism, use, toxicity) Tamoxifen, raloxifene (mechanism, use, toxicity) Trastuzumab (mechanism, use, toxicity) Imatinib (mechanism, use, toxicity) Rituximab (mechanism, use, toxicity) Vemurafenib (mechanism, use, toxicity) Bevacizumab (mechanism, use, toxicity) Phytonadione(use) Leucovorin(use,mechanism)

Protamine sulfate (use, mechanism) Eculizumab(mechanism, use) Cladribine(mechanism, use) Trans-retinoic acid(use) Aldesleukin (mechanism, use) Epoetin Alfa(mechanism, use) Filgrastim, Sargramostim (mechanism, use) alpha-inerferon(use) B-Interferon(use) gamma-interferon(use) Oprelvekin(mechanism, use) thromopoietin(use) Muromonab-CD3 (mechanism, use) Digoxin Immune Fab(mechanism, use) denosumab(mechanism, use) cyclosporine(mechanism, use, toxicity) Isotretinoin, tretinoin, Acitretin(mechanism,use,toxicity Calcipotrol(mechanism, use) Bortezomib(mechanism,use, toxicity) Lepirudin, Bivalirudin (mechanism, use) Which anti-inflammatories will not impair platlet aggregation? why? Difference between peniciliin G and V. Penicillin(mechanism,use,toxicity) Oxacillin,Naficillin,Dicloxacillin(mechanism,use,toxicity) Ampicillin, amoxicillin(mecanism,use,toxicity)

Which has better bioavailibility; amoxicllin or ampicillin? What does clavulanic acid do? Ticarcillin,piperacillin(mechanism,use,toxicity) List the B-lactamse inhibitors Cephalosporin(mechanism,use,toxiciity)

give use of cefazolin, cephalexin. give use of cefoxitin, cefaclor,cefuroxime`

give use of ceftriaxone, cefotaxime,ceftazidime give use of cefepime. Aztreonam(mechanism,use,toxicty) what transpeptidase inhibitor can be used in penicillin allergy? imipenem/cilastatin,meropenem,etrapenem,doripenem(mechanism,use, toxicity) Vancomycin(mechanism,use,toxicty) How is redman syndrome prevented in vancomycin use? How does vancomycin resistant occur? List antibiotic protein synthesis inhibitors Gentamicin, neomycin, amikacin,tobramycin,streptomycin(mechanism,use,toxicity) how does resistenace to aminoglycosides occur? tetracycline, doxycycline, demecycline,minocycline(mechanism, use, toxicity) how does resistance to tetracyclines occur? Azithromycin, clarithromycin, erythromycin(mechanism,use,toxicity) how does resitance to macrolides occur? Chloramphenicol(mechanism,use,toxicity) what causes grey baby syndrome? How does resistance to chloramphenicol occur? clindamycin(mechanism,use,toxicity) Sulfamethoxazole(SMX), sulfisoxazole, sulfadiazine(mechanism, use, toxicity) how does resistance to sulfonamides occur? Trimethoprim(mechanism,use,toxicity) ciprofloxacin, norfloxacin, levofloxacin, etc...(mechanism, use, toxicity)

how does resistance to fluroquinolones occur? What groups are susceptible to fluorquinolone tendon rupture? Metronidazole(mechanism, use, toxicity)

Isoniazid(mechanism,use,toxicity)

Rifampin(mechanism,use,toxicity) Pyrazinamide(mechanism, use, toxicity) Ethambutol(mechanism,use,toxicity) Amphotericin B(mechanism, use, toxicity) nystatin(mechanism,use,toxicty) Fluconazole, ketoconazole, clotrimazole, itraconazole, voriconazole(mechanism, use,toxicity) Flucytosine(mechanism, use, toxicity) Caspofungin, micafungin(mechanism, use, toxicity) terbinafine(mechanism,use,toxicity) Griseofulvin(mechanism,use,toxicity) Pyrimethamine use suramin and melarsoprol use nifurtimox use sodium stibogluconate use Chloroquine(mechanism,use,toxicity) quinidine use artemether/lumifantrine use Zanamivir,oseltamivir(mechanism,use) Ribavarin(mechanism,use,toxicity) Acyclovir,valacyclovir(mechanism, use, toxicity) Famciclovir use mechanism for resistance to acyclovir Ganciclovir,valgangciclovir(mechanism,use,toxicity) mechanism for resistance to acyclovir Foscarnet(mechanism,use,toxicity) mechanism for resistance to foscarnet

cidofovir(mechanism,use,toxicity) HAART consist of what? give mechanism and toxicity of protease inhibitors Ritonavir does what to be a "booster" Tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, didansoine, stavudine(mechanism,use,toxicity Nevirapine, Efavirenz, Delavirdine(mechanism,use,toxicity) Raltegravir(mechanism,use,toxicity) Interferons(mechanism,use,toxicity) What antibiotics must be avoided in pregnancy?

By what mechanism does isoniazid cause B6(pyridoxine) loss? What medications can be given before Amphotercin B infusion to lessen side effects? Polymixin B(mechanism, use, toxicity) Daptomycin(mechanism, use, toxicity) Why is MRSA resistant to Naficillin but normal S. Aureus is not? Palizumab(mechanism, use) What drug is used to prevent tumor lysis urate neuropathy? List acute and chronic gout drugs. probenacid(mechanism, use, tox) febuxostat(use, mechanism) Calcitrol, calcipotriene, tacalcitol (mechanism, use) Usetekinumab(mechanism, use) Natalizumab(mechanism, use, toxicity) Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac (mechanism, use, toxicity) Celecoxib (mechanism, use, toxicity) Acetominophen (mechanism, use, toxicity) Alendronate (mechanism, use, toxicity)

Allopurinol (mechanism, use, toxicity) Febuxostat (mechanism, use, toxicity) Probenecid (mechanism, use, toxicity) Colchine (mechanism, use, toxicity) Etanercept (mechanism, use, toxicity) Infliximab, adalimumab (mechanism, use, toxicity) Why must mu agonists be avoided in suspected pancreatic or biliary pain? Varenicline(mechanism, use) Fomepizole(mechanism, use) Disulfiram(mechanism, use) Entacapone, Tolcapone (mechanism, use, tox) What opioid effect is most resistant to tolerance? Memantine(mechanism, use, toxicity) What vitamin is used in alzheimer's treatment? In gas anesthesias, what is the lipid solubility and the blood solubility? Why is it required to wait 14 days after stoping a MAO-i before starting an SSRI? Ropinirole, Pramipexole (mechanism, use) what are the uses of amantidine for parkinsons? How do atypical antipsychotics avoid causing parkinson's symptoms and tardive dyskinesia? What defines induction and potency in gas anesthetics? Latanoprost (mechanism, use, toxicity) Morphine, fentanyl, cofeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate (mechanism, use, toxicity) Butorphanol (mechanism, use, toxicity) Tramadol (mechanism, use, toxicity) First-line therapy for simple partial seizures First-line therapy for complex partial seizures First-line therapies for tonic-clonic seizures (3) First-line therapy for absence seizures

Phenytoin (mechanism, use, toxicity)

Carbamazepine (mechanism, use, toxicity) Lamotrigine (mechanism, use, toxicity) Gabapentin (mechanism, use, toxicity) Topiramate (mechanism, use, toxicity) Phenobarbital (mechanism, use, toxicity) Valproate (mechanism, use, toxicity)

Ethosuximide (mechanism, use, toxicity) Benzodiazepines (mechanism, use, toxicity) Tiagabine (mechanism, use, toxicity) Vigabatrin (mechanism, use, toxicity) Levetriacetam (mechanism, use, toxicity) Phenobarbital, pentobarbial, thiopental, secobarbital (mechanism, use, toxicity) Triazolam, oxazepam, midazolam (mechanism, use, toxicity) Barbituates vs. benzodiazepines (mechanism) Zolpidem, zaleplon, eszopiclone (mechanism, use, toxicity) Ketamine (mechanism, use, toxicity) Order of sensory loss when using local anesthetics Succinylcholine (mechanism, use, toxicity) Tubocurarine, -curium drugs (mechanism, use, toxicity) Dantrolene (mechanism, use, toxicity) Levodopa/carbidopa (mechanism, use, toxicity) Selegiline (mechanism, use, toxicity) Donepezil, galantamine, rivastigmine (mechanism, use, toxicity) Sumatriptan (mechanism, use, toxicity) Give treatment for acetaminophen overdose. Give treatment for salicylates overdose. give treatment for amphetamines overdose Give treatment for antimuscarinic and anticholinergic overdose.

Give treatment for b-blocker overdose Give treatment for digitalis overdose give treatment for iron overdose. give treatment for lead overdose give treatment for mercury, arsenix, gold overdose give treatment for copper, arsenic, gold overdose give treatment for cyanide give methemoglobin treatment Give Carbon monocide treatment give treatment for methanol, ethylene glycol overdose give treatment for opiods overdose give treatment for benzodiazepine overdose give treatment for TCA overdose give treatment for heparin overdose give treatment for warfarin overdose give treatment for tPA, Streptokinase, urokinase overdose give treatment for theophylline overdose give treatment for acetylcholinesterase inhibitors list signs of ammonia overdose What is a sensitive indicator of alcohol abuse? What is the treatment for delirium tremens? Why is the naloxone-buprenorphine combo used for heroin addiction treatment? What is neuroleptic malignant syndrome? What is the treatment? What is tardive dyskinesa? Is it reversible? What is serotonin syndrome? what is the treatment? Methylphenidate, destroamphetamine, methamphetamine(mechanism, use) What class of drug can precipitate mania in those with bipolar disorder? What drugs are preferred in medication induced parkinson's treatment? why? Trifluoperzine, fluphenazine, haloperidol (mechanism, use, toxicity)

Chlorpromazine, thioridazine (mechanism, use, toxicity) Olanzapine, clozapine, quetiapine, risperidone, aripripazole, ziprasidone (mechanism, use, toxicity) Lithium (mechanism, use, toxicity)

Buspirone (mechanism, use, toxicity) Fluoxetine, paroxetine, sertraline, citalopram (mechanism, use, toxicity) Venlafaxine, duloxetine (mechanism, use, toxicity) -iptyline, -ipramine, doxepin, amoxapine (mechanism, use, toxicity) Tranylcypromine, phenelzine, isocarboxazid, selegiline (mechanism, use, toxicity) Bupropion (mechanism, use, toxicity) Mirtazapine (mechanism, use, toxicity) Maprotiline (mechanism, use, toxicity) Trazodone (mechanism, use, toxicity) causes coronary vasospam causes cutaneous flushing causes dilated cardiomyopathy causes torsades de pointes causes agranulocytoisis causes aplastic anemia causes direct coombs positive hemolytic anemia causes gray baby syndomr causes hemolysis in G6PD-defiect patients causes megaloblastic anemia Causes thrombotic complications Causes cough causes pulmonary fibrosis causes acute cholestatic hepatits, jaundice causes focal to massice hepatic necrosis causes hepatits can lead to pseudomembranous colitis can lead to adrenocortical insufficiency can causes gynecomastia causes hot flashes causes hypergylcemia causes hypothyroidism causes fat redistribution causes gingival hyperplasia causes gout causes myopathies causes osteoporosis causes photosensitivty causes rash/SJS

cause drug induced lupus causes teeth problems causes tendonitis, tendon rupture, tooth damage causes diabetes insipidus causes fanconi's syndome causes hemorrhagic cystits causes interstital nephritis causes SIADH causes cinchonism causes parkinson-like syndome causes seizures causes tardive dyskinesia acts like an anti-muscarinic can cause a disulfiram like reaction can cause nephro/ototoxicity list p450 inducers list p450 inhibitors lists the sulfa drugs cause direct toxicity to nerves cause restrictive lung disease What are the teratogenic effects of ACE inhibitors? What are the teratogenic effects of alkylating agents? What are the teratogenic effects of aminoglycosides? What are the teratogenic effects of carbamazepine? What are the teratogenic effects of diethylstilbestrol? What are the teratogenic effects of folate antagonists? What are the teratogenic effects of lithium? What are the teratogenic effects of phenytoin? What are the teratogenic effects of tetracyclines What are the teratogenic effects of thalidomide What are the teratogenic effects of valproate? What are the teratogenic effects of warfarin? At what time period is a fetus most susceptable to teratogens? What are the teratogenic effects of vitamin a? What are the teratogenic effects of cocaine? What are the teratogenic effects of smoking? What drug is the leading cause of birth defects and mental retardation? What are the toxicities of Loop diuretics? What are the toxicites of HCTZ?

By what mechanisms do thiazides and loop diutetics cause metabolic alkalosis? What is tyramine crisis caused by? What causes nitroprusside toxicity? What is the antidote? What compound can cause sickling of sickle cell trait RBC's? Mannitol (mechanism, use, toxicity) Acetazolamide (mechanism, use, toxicity) Furosemide (mechanism, use, toxicity) Ethacrynic acid (mechanism, use, toxicity) Hydrochlorothiazide (mechanism, use, toxicity) Spironolactone, eplerenone (mechanism, use, toxicity) Triamterene, amiloride (mechanism, use, toxicity) Captopril, enalapril, lisinopril (mechanism, use, toxicity) Losartan, valsartan (mechanism, use, toxicity) Contrast urine Ca with loop diuretics and thiazides What can long term Phenactin use cause? Is an increase in serum creatinine normal after starting ACE inhibitors? What is the treatment for sleep enuresis? In general, what is the best drug to use for edema of any kind? What is the first line drug used to treat hypertension in pregnancy? Rhogam(mechanism, use) What is the drug used for Pre-eclampsi and ecplamsia? Leuprolide (mechanism, use, toxicity) Finasteride (mechanism, use, toxicity) Flutamide (mechanism, use, toxicity) Ketoconazole (mechanism, use, toxicity) Clomiphene (mechanism, use, toxicity) Tamoxifen (mechanism, use, toxicity) Raloxifene (mechanism, use, toxicity) Anastrozole, exemestane (mechanism, use, toxicity)

Mifepristone (mechanism, use, toxicity) Terbutaline (mechanism, use, toxicity) Tamsulosin (mechanism, use, toxicity) Sildenafil, vardenafil (mechanism, use, toxicity) Danazol (mechanism, use, toxicity) Treat methemoglobinemia with Diphenhydramine, dimenhydrinate, chlorpheniramine (mechanism, use, toxicity) Loratadine, fexofenadine, desloratadine, cetrizine (mechanism, use, toxicity) Albuterol (mechanism, use, toxicity) Salmeterol, formoterol (mechanism, use, toxicity) Theophylline (mechanism, use, toxicity) Ipratropium (mechanism, use, toxicity) Beclomethasone, fluticasone (mechanism, use, toxicity) Montelukast, zafirlukast (mechanism, use, toxicity) Zileuton (mechanism, use, toxicity) Omalizumab (mechanism, use, toxicity) Guaifenesin (mechanism, use, toxicity) N-acetylcysteine (mechanism, use, toxicity) Bosentan (mechanism, use, toxicity) Dextromethorphan (mechanism, use, toxicity) Pseudoephedrine, phenylephrine (mechanism, use, toxicity) Oxybutynin(mechanism,use,toxicity)

q, increase: vasc. smooth muscle contraction, pupillary dilator muscle contraction, intestinal and bladder sphincter contaction. i, decrease: sympathetic outflow, insulin release, lipolysis. increase: platlet aggregation. s, increase: heart rate, contractilty, renin release, lipolysis s, vasodilation, brochodilation, increase: heart rate, contractility, lipolysis, insulin release, aqueous humor production. decrease: uterine tone, ciliary muscle tone. q, CNS, enteric nervouse system. i, decease: heart rate, contractility of atria increase: exocrine gland secretion (tears, gastric, etc), gut peristalsis, bladder contraction, bronchoconstriction, pupillary spinchter contraction, cilliary muscle contraction. Parasympathetic M-3. Sympathetic Alpha-1. s, relaxes renal vascular smooth muscle i, modulates transmitter release especially in brain. q, increase: mucus production, contraction of bronchioles, pruritus, pain. a, increase gastric acid secretion q, increase: vascular smooth muscle contraction s, increase water permeability and reabsorption in kidneys. (V2 found in 2 kidneys). H1,Alpha1,V1,M1,M3. (remember HAVe 1 M&M) Protein Kinase C. Calcium -> smouth muscle contraction M2, Alpha2, D2. (remember MAD 2's.) Beta1, Beta2, D1, H2,V2. increase calcium release in heart and blocks myosin light chain kinase. 1. direct agonsts 2. indirect agonists (anticholinesterases). Direct cholinomimetic. Postop or neurogenic ileus, urinary retention. COPD+asthma exacerbation, peptic ulcers. Direct Cholinomimetic. Identical to Ach. Glaucoma, pupillary contraction, relief of IOP. COPD+asthma exacerbation, peptic ulcers. Direct Cholinomimetic. Stimulates tears, salvia, sweat. Open and closed-angle glaucoma.COPD+asthma exacerbation, peptic ulcers. Direct Cholinomimetic. challenge test of asthma diagnosis. COPD+asthma exacerbation, peptic ulcers. Indirect cholinomimetic agonist. NO cns penetration. Postop and neurogenic ileus, myasthenia gravis, reversal of NMJ block. COPD+asthma exacerbation, peptic ulcers. indirect cholinomimetic agonist. Long acting myasthenia gravis treatment. COPD+asthma exacerbation, peptic ulcers. indirect cholinomimetic agonist. Short acting, for myasthenia gravis diagnosis. COPD+asthma exacerbation, peptic ulcers. indirect cholinomimetic agonist. for anti-cholinergic overdose, crosses BBB. COPD+asthma exacerbation, peptic ulcers. indirect cholinomimetic agonist. Alzheimers disease. COPD+asthma exacerbation, peptic ulcers.

DUMBBELSS (diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle +CNS, lacrimation, sweating, salvia.) tx: atropine + pralidoxime. Irreversible cholinesterase inhibitor, ACH overdose. Tx: atropine + pralidoxime. Muscarinic antagonist. produces mydriasis and cycloplegia. (Atropine also used for bradycardia). Causes hot as a hare, dry as bone, red as beet, blind as bat, mad as a hatter. Muscarinic antagoist. Parkinsons disease (park my benz). Can be used in haloperiodal O.D, whihc causes torticolliosis. Causes hot as a hare, dry as bone, red as a beet, blind as a bat, mad as a hatter. Muscarinic antagonist. Motion sickness. causes hot as a hare, dry as a cone, red as a beet, blind as a bat, mad as a hatter. Muscarinic antagonist. COPD, Asthma. Causes hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter. Muscarinic anatagonist. IP: given in preop to reduce airway secretions. oral:reduce drooling, peptic ulcer. Can cause hot as a hare, dry as a bone red as a beet, blind as a bat, mad as a hatter. muscarinic antagonist, causes gardner's pupil (mydriasis). Direct Sympathomemetic. A1,A2,B1,B2. Anaphylaxis, open angle glaucoma, asthma, hypotension. direct sympathomemetic. A1,A2, some B1. used in hypotension but it decrease renal perfusion. Direct sympathomemetic. B1, B2. Used in Torsade de pointe and bradyarryhmia. Can cause tachycardia and worsen cardiac ischemia. Direct sympathomimetics. Receptors depend on dose. low = D1, med = D1,B2,B1, high = A1,A2,B1,B2,D1. Used in shock and heart failure (ionotropic and chronotropic). Direct sympathomimetic. Mostly B1, little a1,a2,b2. Used in heart failure and cardiac stresstest (ionotrpic and chronotropic) Direct sympathomimetic. A1, A2. Used in hypotension, to cause mydriasis, and rhinitis (decongestant). Direct sympathomimetic. Mostly B2, some b1. Sal = long term ashtma or copd. Albuterol for short term asthma. Terbutaline for to reduce premture uterine contractions. Direct sympathomimetic. B2 only. Used to reduce premature uterine contractions. indirect sympathomimetic. Releases stored catecholamines. Used for narcolepsy, obesity, ADD. indirect sympathomimetic. Releases stored catecholamines. Used for nasal decongestion, urinary incontience, hypotension. direct sympathomimetic. Reuptake inhibitor. Causes vasoconstriction and local anesthesia. mixing them can lead to unopposed A1 activation and extreme hypertenion. stimulates A1>B2. Causes increased vasoconstrciton -> increased BP. This causes reflex bradycardia and slowing of HR. Stimulates B2>A1. This cause vasodilation and dropping of BP. B1 is stimulated and causes tachycardia. Centrally acting alpha-2 agonists, this causes LESS peripheral sympathetic release.Used in hypertension, especially renal disease due to no increase in renal blood flow! IRREVERSIBLE nonslective alpha blocker. Used in pheochromosytoma BEFORE surgery! toxic: orhtostatic hypotension, reflec tachycardia. REVERSBILE nonselective alpha blocker. give to patients on MAOI who each tyramine contraining foods. Alpha-1 blocker. Used in hypertension, urinary rentention in BPH. tox:orthostatic hypotension, dizziness, headache. Alpha-2 blocker. Used in depression. tox: sedation, hypercholesterolemia, increased apetite. Before blockade: Both epi and phen RAISES BP. After alpha blockade: only epi raises, no change in phenyl. Why: Epi has B binding, phenyl does NOT.

Angina - decreases HR and contractility, decreasing oxygen use. MI - decrease mortality. SVT - decrease AV duction. Hypertension - decrease CO and renin secretion. CHF - slows progression. Glaucoma decrease secretion of aqueous humor. impotence, asthma exacerbation, bradycardia, seizures, sedation, hides hypoglycemia. A BEAM. acebutolol, betaxolol, Esmolol, Atenolol, Metoprolol. Useful in comorbid pum. disease. Please Try Not Being Picky. Propranolol, Timolol, Nadolol, Pindolol. B = B-blocker. Carvedilol, labetalol. Pindolol, Acebutolol. it has a MUCH longer half life, plus it is irrversible while phentolamine is reversible Cause NO release -> vasodilation (veins >>> arteries); used in angina; fast tolerance, hypotension, flushing, headache Hepatoxicity and muscle breakdown Inhibits lipolysis and reduces VLDL secretion, lowering LDL and raising HDL; hyperlipidemia; flushing and hyperuricemia Inhibits reabsorption of bile acids -> lower LDL with slight increase in HDL; unpigmented gallbladder stones and malabsorption Prevents cholesterol reabsorption -> lower LDL Upregulates LPL -> lower triglycerides, slightly inc. HDL and slightly dec. LDL; myositis and hepatoxicity Inhibits Na/K ATPase -> indirectly inhibits Na/Ca exchanger -> inc. calcium levels -> inc. contractility; stimulates the vagus; causes cholinergic symptoms and hyperkalemia Quinidine, procainamide, and disopyramide; inc. AP duration and QT interval; can cause torsades de pointes, cinchonism (qunidine), procainamide (drug-induced lupus) Lidocaine, mexiletine, and tocainide; dec. AP duration especially in depolarized/ischemia tissue; best following MI Flecainide, propafenone; no effect on AP, used in ventricular tachycardias; do not use post-MI due to risk for arrhythmias Blocks Na channels, decreasing the slope of phase 0 depolarization; toxicity exacerbated by Beta-blockers; reduces cAMP, slowing SA and AV node activity, increases PR interval; adverse effects include impotence, asthma exacerbation, sedation Amiodarone, ibutilide, dofetilide, sotalol; K channel blockers; inc. AP duration and QT interval Pulmonary fibrosis, hepatotoxicity, thyroid dysfunction Ca channel blockers; verapamil and diltiazem; dec. conduction velocity and inc. PR interval; cause constipation, flushing, and edema Inc. K efflux, hyperpolarizing the cell; used in supraventricular tachycardias; can cause flushing, hypotension, and chest pain Used in torsades de pointes and digoxin toxicity digoxin causes hyperkalemia. HOWEVER, a HYPOkalemic state increses patient susceptibility to digoxin toxicity. On first dose, patient gets severe hypotension. Correct this by starting with a small dose. Isosorbide mononitrate can be swallowed. It has an almost 100% biavailability that way. Others cannot due to first pass metabolism. Prevent growth of intima by inhibiting cellular growth = no restenosis Bromocriptine or cabergoline (dopamine agonists)

Spironolactone (or other AT2 antagonist) Octreotide (somatostatin analogues) Lispro, aspart, and glulisine Regular NPH Glargine and detemir Biguanide; unknown mechanism; increases insulin sensitivity and glycolysis and decreases gluconeogenesis; can cause lactic acidosis (don't use in renal failure patients) First-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes disulfuram-like effects Second-generation sulfonylureas; close beta-cell K channels, causing depolarization and increased insulin release; causes hypoglycemia Thiazolidinediones; activates PPAR-gamma, increasing insulin sensitivity and adiponectin levels; causes weight gain, hepatotoxicity, and heart failure Alpha-glucosidase inhibitors; prevent sugar hydrolysis and absorption, reducing blood sugar levels Amylin analog; reduces glucagon secretion; causes hypoglycemia GLP-1 analogues; increase insulin, decrease glucagon secretion; causes pancreatitis DPP-4 inhibitors; increase insulin, decrease glucagon secretion; causes mild urinary/respiratory Blocks thyroid peroxidase and 5'-deiodinase; used to treat hyperthyroidism; causes agranulocytosis, aplastic anemia, hepatotoxicity Blocks thyroid peroxidase; used to treat hyperthyrodism; teratogenic Thyroid hormone analogs; causes thyrotoxicosis Used to control uterine hemhorrage ADH antagonist used to treat SIADH; can cause photosensitivty and bone/teeth abnormalities Inhibits phospholipase A2 activity and expression of COX-2; used for immune suppression; can cause Cushing's syndrome, adrenal insufficiency (if withdrawn quickly) OCP and dopemaine antagonists (antipsychotics) PTU disables peroxidase AND 5'-deiodinase. Methimazole only inhibits peroxidase. NO, they require some islet function to release insulin. type 1 - those cells are dead. Insulins, amylin analongs(pramlintide). PTU does. Methimazole does NOT. Recombinat version of Urate oxidase, breaks uric acid down into allantoin; use in tumor lysis syndrome and gout competitive = decrease potency, noncompetitive = decrease efficacy. Inverse relation of affinity of enzyme for its substrate. Direct proportion to enzyme concentration Fraction of administered drug that reaches systemic circulation unchanged. depends on half-life. Does not depend on frequency or size of dose. constant amount eliminated per time. PEA - phenytoin, Ethanol, Aspirin. A constant FRACTION is eliminted, variable by concentration! Ionzied species are trapped in urine and not resorbed. Neutral can be resorbed. Treat with Bicarb to make neutral. Exp: phenobarbital, methotrexate, aspirin.

Treat with ammonium chloride. exp: amphetamines. Reduction, Oxidation, hydrolysis with CYP450. Often gives neutral products. Geriatrics lose this phase. Conjugation (Glucuronidation, Acetylation, and Sulfation.) Gives charged products. Geriatrics depend on this, old people have GAS. maximal effect a drug can produce. amount of drug needed for the same effect. DECREASED efficacy. fight for same binding site, full agonist cant exert full effect. LD50/ED50. Median lethal dose divded by median effective dose. Safer drugs have a higher TI. Minimum effective dose to minimum toxic dose. Think of it as range of use. 1. Nicotinic - Ligang gated Na/K channels. Two nicotinic types: Nm(NMJ) and Nn(autonomic ganglia. 2. Muscarinic - G-proteins. 5 types, M1-M5. trimethoprim, methotrexate, pyrimethamine. Benzoate or Phenylbutyrate will bind amino acids and lead to excretion. It's high water solubility. Things with a high lipid solubility (unconjugated bilirubin) tend to cross the placenta while things with high water solubility(conjugated bilirubin) tend to not. binds albumin = H2 antagonists; used to treat hyperchloridia; cimeditine is a P-450 inhibitor and has antiandrogenic effects, both reduce creatinine secretion Irreversibly inhibit the H/K pump; used to treat hyperchloridia; increased risk of C. difficile infection and hypomagnesemia Coats ulcer base and protects underlying tissue PGE1 analog that decreases acid production and increases bicarb production; used to prevent NSAID ulcers; abortifacient Somatostatin analog; used to treat VIPoma and carcinoid syndrome Hypokalemia Anti-TNF; used to treat IBD and RA; can cause activation of latent microbes Combination of sulfapyridine (antibacterial) and 5-aminosalicylic acid (anti-inflammatory); used to treat IBD; causes oligospermia 5-HT3 antagonist; used as an antiemetic D2 antagonist; used to increase gut muscle activity and as an antiemetic; causes parkinson signs It is broken down in the gut into an acid. This acid acts as both as osmotic (draws out some ascites) and also it gets rid of excess ammonia, which is causing the encephalopathy. chemoreceptor trigger zone (area postrema), the solitary nucleus, and in the presynpatic vagus nerve. NO. G cells are under vagal influence but they do not use ACh as a neurotransmitter. Instead, they use Stops chemotaxis of neutrophils Inhibits intestinal lipase, decreasing fat absorption; used to treat obesity aspirin. Niacin increases prostaglandin D2. release. asprin blocks this release = lower flushing Cromolyn sodium Dimercaprol and EDTA, succimer in kids Activates antithrombin, which inactivates thrombin and Xa; used for immediate coagulation and in pregnant women; some patients develop antibodies to platelet factor 4 (HIT)

Same actions as heparin, but has a longer half-life, does not have to be monitored as closely, and has a reduced risk of HIT Inactivated gamma-carboxylation of factors II, VII, IX, X, C, and S; used for long-term and nonimmediate anticoagulation; can cause tissue necrosis, teratogenic Converts plasminogen to plasmin; used as a thrombolytic Irreversibly inhibits COX-1 and COX-2; anti-platelet and anti-inflammatory; gastric ulcers, tinnitus, Reye's syndrome in childhood viral infections Irreversibly blocks ADP receptors on platelets, preventing degranulation; used for acure coronary syndrome; ticlodipine causes neutropenia Phosphodiesterase inhibitor, increases cAMP and decreases ADP, preventing platelet degranulation; nausea, headache, facial flushing, hypotension GPIIb/IIIa inhibitors, preventing platelet aggregation; bleeding, thrombocytopenia Inhibits dihydrofolate reductase, inhibiting DNA synthesis; myelosuppression, macrovesicular fatty change in liver Pyrimidine analog that is activated and inhibits thymidylate synthase, inhibiting DNA synthesis; myelosuppression, photosensitivity Pyrimidine analog that inhibits DNA polymerase; leukopenia, thrombocytopenia, megaloblastic anemia Purine analogs that are activated by HGPRT and inhibit purine synthesis; toxicity is increased with allopurinol, causes bone marrow, GI, and liver toxicity DNA intercalator; used for childhood tumors; myelosuppression Generates free radicals that cause DNA strand breaks; dilated cardiomyopathy(Dexrazoxone, an iron chelator, prevents this), myelosuppression, alopecia Generates free radicals that cause DNA strand breaks; pulmonary fibrosis with minimal Crosslinks DNA (must be activated by liver); myelosuppression, hemhorragic cystitis (can be minimized with mesna) Used to treat CNS tumors Alkylates DNA; pulmonary fibrosis, hyperpigmentation Block microtubule polymerization; vincristine causes neurotoxicity, vinblastine causes bone marro Blocks microtubule breakdown; myelosuppression Crosslinks DNA; nephrotoxicity (minimize with chloride diuresis, amifostine), acoustic n. damage Inhibits topoisomerase II; myelosuppression, GI upset, alopecia Inhibits ribonucleotide reductase and increases HbF; used in cancers and HbSS disease; bone marrow suppression Unknown but may trigger apoptosis in dividing cells; Cushingoid symptoms Prevents estrogen receptor binding; used in breast cancer and prevention of osteoporosis; tamoxifen increases the risk of endometrial cancer due to agonist effects. Raloxifene = no increase in endometrial Antibody against HER-2 receptor; cardiotoxicity Antibody against bcr-abl tyrosine kinase Antibody against CD20; used to treat non-Hodgkin's lymphoma and rheumatoid arthritis B-raf kinase inhibitor (V600 mutation); used in metastatic melanoma Antibody against VEGF this is vitamin K, used in warfarin overdose folinic acid, it is a metabolite of folic acid; given with methotrexate to replish the body's folate stores.

antidote to heparin overdose. Protamine is a postive ion that binds to negative heparin, inactivating it. Complement inhibitor, used in Paroxysmal Nocturnal Hemoglobinuria. adenosine analog, used in treatment of hairy cell leukemia Used in treating the M3, promyelocytic subtype of AML. IL 2; used in RCC, metastaic melanoma erythropoietin; anemias, especially in renal failure Fil = GC-SF, Sar = GM-CSF; both used in recovery of bone marrow, aplastic anemia hepatitis B and C, Kaposi sarcoma, Leukemias, Malignany Melanoma Multiple sclerosis Chronic Granulamatous disease IL-11; thrombocytopenia thrombocytopenia antibody to CD3; used in acute transplant rejection antibody to digoxin; used as antidote to digoxin intoxication monoclonal anitbody that binds to RANKL and prevents its interaction with RANK, inhibiting osteoclasts; decreases bone loss in bone mets Used in transplant anti-rejected, treatment of graft-vs-host disease, and psoriasis; binds calineurin on T cells, stopping IL2 from being expressed, lowering T cell response; nephtrotox and lymphomma risk a retinoid that has immunomodulatory effects, binds nuclear receptors; psorisias and acne; severe vitamin D analog; used in topical psoariasis treatment Protease inhibitor, proteases are overactive in some cancers and can destroy pro-apototic proteins; used in multiple myeloma; peripheral neuropathy from leeches, inhibit thrombin; used as an alternative to heparin in HIT. Celecoxib. It only impairs COX2. COX1 is predominate in platlets. G = IV and IM. V = oral. Bind penicillin-binding proteins(transpeptidases), block cross linking of peptidoglycans;most effective on G+, also N. Meningitidis, Treponema;hypersensitivy reaction, hemolytic anema. bind transpeptidases, penicillanse resistant due to bukly r-group blocking B-Lactamse; S. Aureus, except MRSA; hypersensitivity and interstitial nephritis. bind transpeptidases, wide spectrum and more penicillinase sensitive. combo with claculanic acid to protect from B-lactams;kills enterococci(HELPSS)H.iB, E.coli,Listera,Proteus,Salmonella,Shigella,enterococci;hypersensitivity reaction,rash,pseudomemrane amOxicllin has better Oral bioavilability. B-lactamse inhibitor transpeptidase inhibitor but extended spectrum;pseduomonas and g- rods, use with claculanic acid due to B-lactamse suspectibilty; hypersensitivity reaction. (CAST) Clavulanic Acid, Sulbactam,Tazobactem. inhibit cell wall synthesis but are less susceptible to B-lactamases, are bactericidal;use depends on generation, there are four;hypersensitivty reactions, vitamin K defiency, increased nephrotoxicity of aminoglycosides. 1st generation cephalosporins. PEcK. Proteus, E.coli,Klebsiella. Cefazolin used preop to prevent A.aureus infections. 2nd generation cephalosporins. HEN PEcKs. H.ib, Enterbacter, Neisseria, Proteus, E.coli,Klebsiella,

3rd gen. cephalosporins. Serious gram - infections. Ceftriaxone = meningitis and gonorrhea. Ceftazidime = pseudomonas. increased activity against pseudomonas and G+ bugs. a monobactem resistant to B-lactamases, prevents binding to PBP3 and is synergistic with aminoglycosides;gram - rods only;very nontoxic, some GI upset. aztreonam. broad spectrum, B-lactamase resistent but imipenem needs cilastatin to inhibit renal dehydropeptidase. later carbepenems do not;G+ cocci,G- rods, anerobes. used only in life threating events;skin rash, CNS toxicity, seizures. inhibits cell wall binding peptidoglycan formation by binding D-ala percursors, is bacterialcidal; G+ only, especially for multidrug resistant onces;NOT - nephrotoxicity, ototoxicity, thrombophlebitis, red man slow infusion and rate and antihistamines. amino acid change of D-ala D-ala to D-ala D-lac. AT 30, CCEL at 50. 30S = Aminoglycosides, Tetracyclines. 50S = Chloramphenicol, Clindamycin, Erythromycin, Linezolid. aminoglycosides, bacterialcidal, block translocation but require oxygen for uptake;ineffective in anaerobes,use in gram - rod infections and before bowel surgery; nephrotoxicty, NMJ block, transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation. bacteriostatic, prevents aminoacyl-tRNA binds;Borrela, M. Pneuomo, Rickettsia, Chlamysia; can't take with milk, antacids, iron because ions bind it, GI distress, discoloration of teeth, inhibition of bone growth, contraindication in pregnancy. decrease uptake into cells or increased efflux by pumps. bacteriostatic, blocks translocation; atypical pneumonias, chlamydia, gram + cocci; MACRO: increased Motility, arrhythmia, Cholestatic hepatitis, Rash, eOsinophilia. methylation of 23s rRNA binding site. Bacterialstatic, blocks peptidlytransferase; Meningitis in adults, used in power countries due to being cheap; dose dependent anemia, dose independent aplastic anemia, gray baby syndrome. use of chloramphenicol in premature infants, they lack UDO-glucuronyl-transferase. plasmid-encoded acetyltransferase. Bacteriostatic. Blocks peptide transfer; anaerobic infections in lung infections and oral anerobes; C. Diff infection, fever, diarrhea. Bacteriostatic, PABA metabolites inhibit dihydropteroate synthase; Gram +, G-, Nocardia, Chlamydia, UTI; hypersensitivty, hemolysis in G6PD, nephrotoxic, kernicterus, displaces other drugs from albumin. altered bacterial dihydropteroate or increased PABA synthesis. Bacteriostatic, inhibits bacterial dihydrofolate reductase, blocks folate synthesis; used in UTI, PCP (prophylacis and treatment), shigella, salmonella; megaloblastic anemia, leukopenia, granulocytopenia. bactericidal, inhibits DNA gyrase(topo II and IV);G- rods of urinary and GI tracts, Neisseria, some G+;( lones hurt the bones) tenonitis and tendon rupture, superinfections, don't give to kids or pregnant women due to cartilage damage. mutation in DNA gyrase or efflux pumps. older than 60 or taking prednisone bacterialcidal, forms free radical toxic metabolites that damge bacterial DNA damage; (GET GAP) Giardia, Entamoeba, trichomonas, Gardnerella, Anaerobes, Pylori; causes disulfiram like reaction, headache, metallic taste.

decrease synthesis of mycolic acids, bacterial catalase peroxidase(KatG) must activate INH; TB drug, only one used as prophylaxis and in latent TB; peripheral neuropathy, hepatoxic, lupis like drug interaction, pyridoxine antagonist. inhibits DNA-dependent RNA polymerase; TB, Leprosy, prophylaxis in meningococcus and Hib type B; hepatotox, p450 inducer, orange body fluids. unknown; TB; hyperuricemia, hepatotoxic. decreased carbohydrate polymerization of TB cell wall, blocks arabinosyltransferase; TB; optic neuropathy(red-green color blindness_ binds fungal ergosterol, causes holes in membranes; use in systemtic and CNS mycoses infections; fever/chills, hypotension, arrythmias, nephrotoxic, IV phlebitis, must supplement K and MG. binds fungal ergosterol;topical only due to high toxicity, used for oral thrush and topical diaper rash or vaginal candidiasis. inhibits fungal ergosterol synthesis by binding p450;Fluconazole for suppression of cryptococcus in AIDs patients, itraconazle for blasto, coccio, histo. inhibits fungal DNA and RNA synthesis by conversion to 5FU; used in systemic fungal infections, especially cryptococcus; bone marrow suppression. inhibits fungal cell wall synthesis by inhibiting B-glucan synthesis; invasive aspergillosis, candida; flushing via histamine releae. inhibits fungal squalene epoxidase; treat dermatophytes - toe nail infection especially;abnormal LFT, visual disturbances. interferes with microtubules, stops mitosis in fungi;deposits in keratin so used in superficial infections, stops dermatophytes; teratogenic, carcinogenic, confusion, p450 inducer. toxoplasmosis trypanosoma brucei trypanosoma cruzi leshmaniasis blocks formation of heme into hemozoin. Heme accumulates and is toxic to plasmodia;used on all species but falciparum(too much resitance); retinopathy lifethreatening malaria p. falciparum killing inihibits influenza neuraminidase, stops progeny release; treamt of influenze a and b inhibits sythesis of guanine nucleotides by competitvely inhibiting IMP dehydrogenase; RSV, chronic hep C; hemolytic anemia, severe teratogen Guanosine analog, inhibits viral DNA polymerase; monophosphorylated by thymidine kinase in HSV/VZV so active in lesions and encephalitis, good for prophylaxis, used in herpes zoster active infections mutated viral thymidine kinase guanosine analog, 5'-monophosphate formed by CMV viral kinase, inhibits viral DNA polymerase;CMV infections;leukopenia,neutopenia,thrombocytopenia,renal toxicity mutated CMV DNA polymerase or lack of viral kinase viral DNA polymerase inhibitor, binds to pyrofosphate binding site, doesn't need viral kinase activation;CMV retinitis when ganciclovir fails and acyclovir restitant HSV; nephrotoxic mutated DNA polymerase

inhibits DNA polymerase, doesn't require activiation by viral kinase; CMV retenitis, acyclovir resistant HSV; nephrotoxic(coadminister with probenacid and IV saline to reduce toxicity). [2 NRTI] +[1 NNRTI OR 1 protease inhibitor OR 1 integrase inhibitor] all end in -NAVIR! stops HIV mRNA cleavage into functional parts; hyperglycemia, GI upset, inhibits cytochrome p-450, boosting concentration of other drugs. (NRTI)competitively blocks binding of nucleotide to reverse transcriptase, only tenofovir doesn't need to be activated;all NRTIs, zidovidine used in pregnancy to reduce fetal transmision; bone marrow suppression, lactic acidosis, peripheral neuropathy. (NNRTI) bind at a site different from NRTIs, no don't require activation don't compete with nucleotides; bonow marrow suppression, peripheral neuropathy, lactic acidosis, inhibits integrase, which stops HIV integration into host cells;HIV;hypercholesterolemia glycoproteins synthesized my virus infected cells, block RNA and DNA virus replication; INFa- chronic hep b and c, Kaposi sarcoma, IFN-b -MS, INF-gamma -NADPH oxidase defiency; neutropenia, myopathy. SAFe Children Take Really Good Care. sulfonamides(kericterus), aminoglycosides(ototox), fluoroquinolones(cartilage damage), Clarithromycin(embryotoxic), Tetracycline(teeth,bone damage),Ribavarin(teratogenic),Griseofulvin(teratogenic),Chloramphenicol(grey baby) isoniazid structurally similar to B6, which causes renal excretion of B6 and competes for B6 binding antihistamines and antipyretics. binds to G- cell membrane phospoholipids, disrupting them; only works in g-; peripheral neuropathy, dizziness, nsytagmus, nephrotoxicity. causes depolarization of cellular membrane; used in invasive MRSA; myopathy, raised CPK, inactivated by pulmonary surfactant All S. Aureus has Beta-lactamases. Naficillin fights this. But MRSA has this AND altered penicillin binding proteins, which prevents Naficillin from working in MRSA. antibody against F protein, prevents pneumonia from RSV in infants allopurinol stops urate crystal collection -> no gout. acute: NSAID, indomethicin. Chronic: allopurinol, febuxostat, probenacid, colchicine used in chronic gout; inhibits reabsorption of uric acid in the proximal tubule; inhibits secretion of penicillin; do NOT use in renal dysfunction. used in chronic gout, inhibits xanthine oxidase. topical vitamin D analogs, activate nuclear receptors that inhibit keratinocyte proliferation and enhance keratinocyte differentiation; psoriasis monoclocal antibody that binds IL-12 and IL-12 thus inhibiting activation of Th1 cd4+ t cells; used in binds alpha-4 integrin, which blocks movement of WBC into orgrans;used in crohns and MS; can cause PML and hepatotoxicity. Reversible COX inhibitor; gastric ulcers, renal ischemia (due to constriction of afferent arteriole) Reversible COX-2 inhibitor; anti-inflammatory without damage to gastric mucosa; sulfa allergy, thrombosis COX inhibitor in the CNS (not anti-inflammatory); causes hepatic necrosis Pyrophosphate analog that inhibits osteoclasts; used to treat osteoporosis, hypercalcemia, and Paget's disease; corrosive esophagitis

Xanthine oxidase inhibitor, reduces production of uric acid Xanthine oxidase inhibitor Inhibits reabsorption of uric acid in PCT Inhibits microtubule polymerization, preventing neutrophil extravasation TNF-alpha receptor that binds free TNF-alpha Anti-TNF-alpha antibody They cause constriction of the spinchter of oddi -> increased billiary pressures -> billiary colic. partial agonist for nicotinic aCh channels in CNS. fights with ciggeratte nicotine for channel. reduces nicotine withdrawl cravings while attenuating the rewarding effects. Inhibits alcohol dehydrogenase; used as an antidote to methanol or ethylene glycol poisoning. Inhibits acetaldehyde dehydrogenase, makes acetaldehyde accumulate leading to hanger; used in alcohol abuse. COMT blockers, which increase DOPA levels; Both stop peripheral methylation and only Tolcapone stops central methylation; tolcapone causes hepatotoxicity Constipation blocks NMDA-type glutamate receptors; used in alzheimers; confusion Vitamin E (generic name is alpha-tocopherol) Lipid solubility = potency (MAC). Blood solubility = speed of induction. MAO-inhbitors (phenelzine) inactive the MAO-I enzymes. It takes 2 weeks for them to get resynthesized. If both SSRI and MAO-I are active at the same time, serotonin syndrome could occur are D2 agonists that DON'T need to be activated like l-dopa does; used in parkinsons and restless leg syndrome indirect and direct D agonist, also some anticholingergic functions which reduces tremors They act on D4 instead of D2 receptors -> no risk of tardive dyskinesia or parkinson's like symptoms induction = lower solubility in blood, quicker induction. potency = higher with higher lipid solubility PGF2 analog that increases the outflow of aqueous humor; can cause darkening of the iris Mu opioid agonists that open K channels and close Ca channels, inhibting synaptic transmission; addiction, respiratory depression, constipation, miosis Mu opioid partial agonist; used to treat severe pain; causes withdrawal if being treated with full Weak opioid agonist that inhibits serotonin and NE reuptake; increases risk for seizures Carbamazepine Carbamazepine Carbamazepine, phenytoin, valproate Ethosuximide

Increases Na channel inactivation and inhibits glutamate release; used for simple, complex, and tonicclonic seizures and status epilecticus prophylaxis; nystagmus, gingival hyperplasia, hirsutism, megaloblastic anemia, teratogenic, drug-induced lupus, P450 inducer Increases Na channel inactivation; first-line for simple, complex, and tonic-clonic seizures and trigeminal neuralgia; agranulocytosis, aplastic anemia, P450 inducer, SIADH, liver toxicity Blocks Na channels; used for simple, complex, and tonic-clonic seizures; Steven-Johnson syndrome Inhibits Ca channels; used for simple, complex, and tonic-clonic seizures, migraine prophylaxis, peripheral neuropathy, bipolar disorder; ataxia Blocks Na channels and increases GABA secretion; used for simple, complex, and tonic-clonic seizures and migraine prevention; mental dulling, kidney stones, weight loss Increases GABA channel action; first-line for simple, complex, and tonic-clonic seizures in children; P450 inducer Increases Na channel inactivation and increases GABA levels; first-line for tonic-clonic seizures, used for simplex, complex, tonic-clonic, and myoclonic seizures; hepatotoxicity, neural tube defects, weight gain, tremor Blocks thalamic Ca channels; first-line for absence seizures; GI distress, Steven-Johnson syndrome Increases frequency of GABA channel opening; first-line for status epilepticus (diazepam, lorazepam), used for eclampsia seizures (diazepam, lorazepam), anxiety, alcohol withdrawl, sleep walking, night Inhibits GABA reuptake; used for simple and complex seizures Irreversibly inhibits GABA transaminase, increasing GABA concentration; used for simple and complex Unknown mechanism; used for simple, complex, and tonic-clonic seizures Increase duration of GABA channel opening; induction of anesthesia, sedative; CNS depression, P450 inducer, contraindicated in patients with porphyrias Short-acting benzodiazepines; more addictive potential Increase duration vs. increase frequency BZ1 subtype GABA channel agonists; used to treat insomnia Blocks NMDA receptor; used as an anesthetic; increases cardiac activity, hallucinations, bad dreams Pain -> temperature -> touch -> pressure ACh receptor agonist, produces sustained depolarization and desensitization; used as a paralytic; hypercalcemia, hyperkalemia, malignant hyperthermia ACh antagonists; used as paralytics Inhibits release of Ca from sarcoplasmic reticulum and skeletal muscle; used to treat malignant hyperthermia and neuroleptic-malignant syndrome Converted to dopamine by dopa decarboxylase in CNS/inhibits peripheral dopa decarboxylase activity; used to treat parkinson symptoms; can cause arrhythmias and "on/off" phenomenon MAO-B (prefers dopamine for breakdown) inhibitor, inhibits dopamine breakdown; used to treat parkinson symptoms; enhances adverse effects of levodopa ACh esterase inhibitors; used to treat Alzheimer's disease; cholinergic symptoms Agonist at 1B/1D serotonin receptors; used to treat acute migraines and cluster headaches; coronary vasospasm N-Acetylcysteine (replenishes glutathione). NaHCO3 (alkalinize urine) NH4Cl (acidify urine) Phygostigmine and control the hyperhermia.

Glucagon (KLAM) normalize K, Lidocaine, Anti-dig fab fragments, Mg2 deFEroxamine, deFErasirox. CaEDTA, dimercaprol, succimer, penicillamine Dimercaprol, succiner penillamine nitrite + thiosulfate, hydroxocobalamin Methylene blue, vitamin c 100% oxygen or hyperbaric oxygen Fomepizole>Ethanol, dialysis naloxone/naltrexone flumazenil NaHCO3 (alkalinize plasma) protamine Vitamin K, fresh frozen plasma aminocaproic acid B-Blockers atropine + pralidoxime ataxia, slurred speech, somnolence, vomiting Serum gamma-glutamyltransferase. benzodiazepenes The naloxone is only active if inected, making it hard to abuse the combo. rigidity, myoglobinuria, autonomic instability. seen with antipsychotics overdose. treatment: dantrolene and bromocriptine (d2 agonist) sterotypical oral-facial movements, from long term antipsychotic use. often NOT reversible. occurs with any drug that increases serotonin (MAO inhibitor, SNRI, TCA) hyperthermia, confusion, myoclonus, cardio collapse, flushing. tx: cyproheptadine (5ht antagonist) increase catecholamines at synaptic cleft, especially NE + dopamine; ADHD, nacrolepsy, appetite control antidepressants Anti-muscarinics (Benzotropine). Giving dopamine agonists would exacerbate psychosis. High potency antipsychotics that antagonize D2 receptors; used to treat schizoprehnia, psychosis, mania, and Tourette's; hyperprolactinemia, anti-cholinergic symptoms (dry mouth, constipation), extrapyramidal effects (dyskinesia), neuroleptic malignany syndrome, tardive dyskinesia (haloperidol) Low potency antipsychotics that antagonize D2 receptors; used to treat schizophrenia, psychosis, mania, and Tourette's; corneal deposits (chlorpromazine), retinal desporits (thioridazine) Atypical antipsychotics with unknown mechnism; used for schizophrenia, bipolar disorder, OCD, and others; weight gain (olanzapine, clozapine), agranulocytosis (clozapine), seizures (clozapine), prolonged QT (ziprasidone) Unknown mechanism; used for bipolar disorder and SIADH; tremor, sedation, edema, hypothyroidism,

Agonizes 1A serotonin receptors; used for generalized anxiety disorder; no side effects, but takes 1-2 weeks for improvement Block reuptake of serotonin from the synaptic cleft; depression and others; sexual dysfunction, sertonin syndrome (hyperthermia, myoclonus, flushing, diarrhea, seizures) Block reuptake of NE and serotonin from synaptic cleft; depression, diabetic neuropathy (duloxetine); hypertension TCAs, block reuptake of NE and serotonin; depression, bewetting (imipramine), OCD (clomipramine); convulsions, coma, arrhythmias, sedation, hypotension, anti-cholinergic effects Inhibit breakdown of NE, serotonin, and dopamine; used for atypical depression, anxiety, and hypochondriasis; hypertensive crisis (tyramine in wine/cheese), don't use with other serotonin agonists Increases NE and dopamine; used for smoking sensation, depression; seizures Alpha-2 antagonist, increases NE and serotonin release, and serotonin receptor agonist; used for depression; sedation, increased appetite with weight gain; Blocks NE reuptake; used for depression; sedation, hypotension Inhibits serotonin uptake; used for insomnia; pripism cocaine, sumatriptan, ergots (VANC) Vancomycin, Adenosine, Niacin, Ca blocker doxorubicin, daunorubicin class III (sotalol) and class Ia (quinidine) Clozapine, Carbamazepine, Colchine, Propylthiouracil, Methimazole, Dapsone chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole methyldopa, penicillin chloramphenicol (hemolysis IS PAIN)isoniazid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin (females with PMS are on full BLAST mode) Phenytoin, Methotrexate, Sulfa drugs OCPs like estrogen ACE inhibitors Bleomycin, amiodarone, Busulfan erthryomycin Halothane, Amanita Phalloides, Valrpoic acid, Acetaminophen isoniazid clindamycin, ampicillin glucocorticoid withdrawl via HPA suppression `(Some drugs create awkward knockers) spironolactone, digitalis, cimetidine, chronic alcohol use, estrogen, clomophene niacin, tacrolimus, protease inhibitor, HCTZ, corticosteriods lithium, amiodarone, suldonamides glucocoricoids, protease inhibitors phenytoin, verpamil furosemide, thiazides, niacin, cyclosporine fibrates, niacin, colchine, hydroxychloroquine, interferon-alpha, penicillamine, statins, glucocorticoids corticosteroids, heparin (SAT for a PHOTO) Sulfonamides, amiodarone, tetracycline penicillin, ethosuximide, carbamazepine, sulfa drugs, lamotrigine, allopurinol, phenytoin, phenobarbital

Hydralazine, isonizid, procainamine, phenytoin tetracyclines fluoroquinolones lithium, demeclocycline expired tetracycline Cyclophosamide, ifosfamide methicllin, NSAID, furosemide carbamazepine, cyclophosamide Quinidine, qunine antipsychotics, resperine, metoclopramide (with seizures, I BITE My tongue) isoniazid, Buproprion, imipenem, Tramadol, Enflurane, antipsychotics Atropine, TCA, H1-blocker, neuoleptics metronidazole, some cephalosporins, procarbazine, 1st gen sulphonoureas aminoglycosides, vancomycin, loop dieuetics, cisplatin (Momma Barb Steals Phen-phen and Refuses Greasy Carbs Chronically)Modafinil, Barbiturates, St. John wart, phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol use. (MAGIC ROCKS in GQ) Macrolides, amiodarone, grapefruit juice, isoniazid, cimetidine, ritonavir actue alcohol use, ciprofloxacin, ketoconazole, sulfonamides, gemfibrozil, quinidine. (Popular FACTSSS) probenacid, furosemide, acetazolamide, celecoxib, thiazide, sulfonamide antibiotics, sulfaasalazine, sulfonylureas vincristine and paclitaxil bleomycin, busulfan, amiodarone, methotrexate renal damage absence of digits, toes CV VIII toxicity neural tube defects, craniofacial defects vaginal clear cell adenocarcinoma, congenital mullerian anomalies neural tube defects ebstein's anomaly -> atrialized right ventricle fetal hydantoin syndrome->microcephaly,dysmorphic face discolored teeth limb defects like flipper arms inhibitor of maternal folate absorption ->neural tube defects bone deformities, fetal hemorrhage, abortion 3rd -8th week. extremely high risk for spontaneous abortion placental abruption, developmental abnormalities preterm labor, placental problems, ADHD alcohol (OH DANG) Ototox, hypokalemia, dehydration, allergy(sulfa), Nephritis, Gout (hyperGLUC) hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia.

1. Volume contraction ->AT II increases ->increased bicarb absorbed in PT. 2. K loss leads to K leaving all cells and thus H entering all cells. 3. in a low K state, H is exchanged instead of K for Na in the CCT leading to paradoxical aciduria. When someone taking MAO inhibitors eats hard cheeses and drinks wine, causing a crisis. Nitroprusside degrades into cyanide. Give thiosulfide to inactivate. sodium metabisulite, found as a food additive and sanitizer Osmotic diuretic; used to treat drug overdose and increased ICP; pulmonary edema, CHF Carbonic anhydrase inhibitor; used for glaucoma, metabolic alklalosis; hyperchloremic metabolic acidosis, ammonia toxicity, sulfa allergy Inhibits NKCC channel, preventing urine concentration; used in hypertension, CHF, hypercalcemia; ototoxicity, hypokalemia, hypocalcemia, nephritis, gout, sulfa allergy Inhibits NKCC channel; used in patients with furosemide (sulfa) allergy; hyperuricemia Inhibits NaCl reabsorption in DCT and increases Ca reabsorption; hypertension and hypercalcinuria; hyperglycemia, hyperlipidemia, hyperuricemia, hypercalcemia, sulfa allergy Aldosterone receptor antagonists; hyperaldosteronism, CHF, hypokalemia; hyperkalemia (arrhythmias), antiandrogen effects with spironolactone Block sodium channels in cortical collecting duct; hyperaldosteronism, CHF ACE inhibitor, leads to reduced angiotensin II levels and decreases GFR; prevents heart remodeling, hypertension, CHF; cough, angioedema, transient creatinine increase, hyperkalemia Angiotensin II receptor antagonists; similar to ACE inhibitors, but do not cause cough due to normal metabolism of bradykinin loop diuretics: increased urine Ca via decreased reabsorption. thiazides: decreased urine Ca. Translitional cell carcinoma of the bladder Yes, they lower GFP by stopping efferent arteriole constrinction. Creatinine can increase up to 30% and should peak by 1 weak. This can be BAD in renal artery stenosis, where ACE II is what is keeping the Desmopression (sleep enuresis = bed wetting) furosemide. TAL of Henlee absorbs the most NA here compared to where over diuretics work. will reduce edema quickly. methlydopa IgG anti-RH antibodies. given to mom at 28 weeks and also at birth, it sticks to the RH antigens in the MOM's blood, keeping her from developing antibodies. IV magnesium sulfate for seizures GnRH analog that acts as an agonist in pulsatile doses and an antagonist in continuous doses; used as an agonist for infertility and an antagonist for prostate cancer, fibroids, and precocious puberty; 5-alpha reductase inhibitor; used for BPH and male-pattern baldness Testosterone receptor antagonist; used in prostate cancer Inhibits 17,20-desmolase, stopping sex steroid synthesis; used to treat polycystic ovarian syndrome Partial estrogen agonist in the hypothalamus, increases release of LH and FSH, stimulating ovulation; used for infertility and PCOS Estrogen receptor antagonist at the breast; used for breast cancer; partial agonist at the uterus, can cause endometrial hyperplasia Estrogen receptor agonist at bone, inhibits osteoclast activity and stimulates osteoblast activity; used to treat osteoporosis Aromatase inhibitors; used in breast cancer

Progesterone receptor antagonist, given with misoprostol for abortion; abortifacient; bleeding, Beta-2 agonist, inhibits uterine contractions Alpha-1 antagonist; used to treat BPH Phosphodiesterase 5 inhibitors, causing inc. cGMP levels and smooth muscle relaxation; used in erectile dysfunction; impaired blue-green vision, contradindicated with nitrates Partial androgen receptor agonist; used to treat endometriosis and hereditary angioedema; weight gain, acne, hirsutism, low HDL, hepatoxicity Methylene blue (First generation) H1 antagonists; used in allergies, motion sickness, insomnia; sedation, antiadrenergic, antiserotonergic, and antimuscarinic effects due to CNS penetration H1 antagonists, 2nd gen; used in allergies; less fatigue than 1st gen antihistamines due to decreased CNS penetration Short-acting beta-2 agonist; asthma Long-acting beta-2 agonist; asthma; tremor, arrhythmias Phosphodiesterase inhibitor, increases cAMP and causes bronchodilation; asthma; cardiotoxicity, Muscarinic antagonist, prevents bronchoconstriction; asthma and COPD Inhibit cytokine synthesis, reducing inflammation due to asthma; 1st line for chronic asthma Leukotriene receptor antagonists; especially useful in aspirin-induced asthma Inhibits activity of 5-lipoxygenase, inhibiting leukotriene production; reduces inflammation Anti-IgE antibody; used in refractory allergic asthma Thins respiratory secretions Loosens mucus plugs; used in CF patients and as an antidote to acetominaphen posioning Antagonizes endothelin-1 receptors, reducing vascular resistance in the pulmonary vessels; used in pulmonary hypertension Antagonizes NMDA receptors, inhibiting coughing; produces opioid effects in large doses and carries mild abuse potential Alpha-1 agonists that reduce edema and nasal congestion; rhinitis; hypertension, quick tolerance (recurrence of symptoms despite continued treatment) Muscarinic anatagonist. reduces urgency in mild cystitis and reduce bladder spasms. causes hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.

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