A.

1.
a. :(p.o.):(i.v.)(s.c.)(i.m.)
b. :
:
:
c. :
(1) Reverse transporter(P-glycoprotein):
Rifampin P-glycoprotein Digoxin
CCBKetoconazoleAtorvastatin P-gDigoxin

2.

d. :()(eg, iv=100%)
e. :
: Vd=/ = dose/
a. Vd
b. Vd
(1) Albumin
(2) 1-acid glycoprotein

3.

:
a. ()()
b. P450(CYP) 3A4
CYP3A4:
BarbituatePhenobarbitalRifampinCarbamezepineGlu
cocorticoidsPhenytoin
CYP3A4: CimetidineDiltiazamStatin
ErythromycinKetoconazole(furanocoumarin)

4.

:
a. simple passive diffusion
b. diffusion
: AspirinAcetaminophenPhenobarbitalMTX
: AmphetamineMorphine
: Warfarin

5.

MetronidazoleFluconazoleTMP- S-Warfarin
SMX
AmiodaroneDisulfiramCimetidi RS-Warfarin
ne
Cephalosporin

Vit. K

 Cholestyramine

Warfarin

BarbiturateRifampin
B.

CYP450 Warfarin

1. ():Ion channel < G Protein < < DNA

(1) Ach(nicotinic RNa+)GABA(GABAACl-GABABK+)

(2) G protein
cAMP system: Gs Adenyl cyclase cAMP
PIP system: Gq Phospholipase C PIP2 IP3DAG
IP3 ER Ca2+DAG protein kinase C
(Therapeutic index, TI):
TI = LD50/ED50(LD: Lethal dose, ED: Effective dose)

2.

Ach Nicotinic R.

Ach Muscarinic R.

Ach Nicotinic R.

Dopamine Dopamine R.

Ach Nicotinic R. ( Epi. & NE)

A.
1. Trimethaphan(IV)Mecamylamine()Hexamethonium
nicotinic receptor


B.
1.
(1)Reserpine: dopamine
(2)Guanethidine:
2.
(1)Ephedrine()
ok!!!

(2)Amphetamine
(3)Tyramine(
octopamine)
(4)Amitriptyline(TCA)Cocai (uptake)
ne
C.
NE

Gq
(PIP2IP3,DAG)

(,,)

Gi (cAMP)

()

Gs (cAMP)

2
Ach

/ juxtaglomerular apparatus
renin
(,,)

M2

Gi (cAMP)

M3

Gq
(PIP2IP3,DAG)

(GI,,),

( blocker)

Epi(),NE(),Dopamine()

Carvedilol, Labetalol()

Phentolamine( Pheo.)
Phenoxybenzamine( Pheo.)

Phenylephrine(,),Midodrine(

Tamsulosin(),Prazosin(

Clonidine(),Methyldopa(

Mirtazapine()

)
1/

Isoproterenol(+=)

Propranolol(,), Nadolol,
Pidolol

Timolol()
1>

Dobutamine()

Atenolol(), Esmolol(
)
Metoprolol, Bisoprolol

2>

Albuterol(),Ritodrine()

1.
2.

-blocker :
-blocker :

D.
1.
(1) Hemicholinium: cholinergic Choline
(2) Botulism:
2. ( Ach Ach esterase )
(1) Neostigmine:
(2) Physostigmine: () BBB Atropine
E.
1. ( Muscarinic receptor)
(1) Bethanechol( M receptor):
(2) Pilocarpine( M receptor)Carbachol(M, N ):(

2.

)
(3) Methacholine:
( Muscarinic receptor)
(1) Atropine:(24hr)

(2)
(3)
(4)
(5)
(6)

Tropicamide:()
Benztropine: Dopamine agonist
Scopolamine:
Ipratropium: agonist,COPD
Pirenzepine:(selective M1R. antagonist)

F.
1. Nicotinic receptor()
(1) Edrophonium: AchE()
(2) Neostigmine, Pyridostigmine: AchE(,)
(3) Succinylcholine:
2. Nicotinic receptor(!!!)
(1)
Diazepam: GABAA
Baclofen: GABAB
(2)
Botulism: (Ach)
(3)
a.
SuccinylcholineDecamethonium

b.
Tubocurarine(,)Pancuronium(,)
G.
1. ABCDP BD: secretion ACP: outflow

A.
1.
(1) : 2 selective agonist()
Clonidine: /Rebound hypertension

Methyldopa: Prodrug
(2)
Trimethaphan(IV): nicotinic receptor

Mecamylamine:

(3)
Reserpine: Dopamine5HT

Guanethidine:

(4)
-blocker: Prazosin(1)
-blocker: Propranolol(1) Renin (1)
2.

3.

(Calcium influx):
(1) DHP:
NifedipineAmlodipineFelodipine
(2) Non-DHP:
DiltiazemVerapamil( Na+)
(3)

:/(RAAS ) -blocker

(1) cGMP
Hydralazine:(artery)Drug-induced lupus system
Nitroprusside: NO cGMP(a./v.)Cyanide
(2) (a.)
Minoxidil(Rogaine ): iii (Hypertrichosis)

4.

Diazoxide: insulinoma

(1) (ACEI):
CaptoprilEnalaprilLisinopril(preloadafterload)
Angiotensin II :/
Bradykinin: Prostaglandin
ACEINitroprusside
(protein )( remodeling)
Bradykinin angioedema
(2) (ARB): LosartanValsartanIrbesartanCandesartan
Angiotensin type1 receptor

B.
1. : Vasospasm
CCB + Nitrate
2. :
-blocker( a. Afterload) + Nitrate( Preload)
3. Nitrate: Nitroglycerin(NTG), isosorbide dinitrate
(1) NO cGMP
(2) v. a. a. a.
(3) a. pulsation throbbing headache

(4) (tolerancetachyphylaxis)
C.
1.
(1) (): Furosemide
Loop diuretics
(2) (): Dobutamine
1 selective agonist
2.
(1) : ACEI(preloadafterload)-blocker( RAA system)
ACEI
-blocker
(2) (): ThiazideSpironolactone(E. ^^)
(3) (): Cardiac glycosidesPDE3
Cardiac glycosides: OuabainDigoxinDigitoxin
Ouabain

Digoxin(

Digitoxin

0%
21

75%
40

>90%
168

: (1) Ca (2)AV (PR )

:( Na-K ATPase)
PDE3 (Bipyridine): AmrinoneMilrinone
phosphodiesterase III(PDE) cAMP

D.
1. Class I:Na+
(1) Ia(K+)[ QRS]+[ AP QT]
Quinidine(GI)Procainamide(SLE)Disopyramide(anti-cholinergic
effect)
(2) Ib[ QRS]+[ AP QT]
Lidocaine(IV)Mexiletine()Phenytoin

Phenytoin:

2.
3.

(3) Ic[ QRS][ Atrial fibrillation]

FlecainidePropafenone
Class II( )class IV(Ca2+):[ PR]
AF
Class III: K+[ AP QT]

(1) Class Ia III K+ QT Torsade de pointes

(2) IbutilideDofetilide
(3) Amiodarone()
Torsade de pointes Symptomatic bradycardia
:
4.
5.

Atropine:
Adenosine()[Paraoxysmal supraventricular tachycardia, PSVT

!!]
Gi protein cAMP Ca2+AV node
E.
1. Osmotic diuretics: Mannitol

:
:()
2.

3.

4.

5.

Carbonic anhydrase inhibitor: Acetazolamide (Diamox)

Carbonic anhydrase HCO3-
( aqueous humor )()
:(AcetazolamideFurosemideThiazide)

Loop diuretics: Furosemide (Lasix)Ethacrynic acidBumetanide

TAL NKCC() Na+K+Cl-Mg2+Ca2+

( Aminoglycoside )+
Thiazide: ChlorothiazideHydrochlorothiazide
Na+-Cl- Na+-Ca2+ Ca2+

:(GFR )
Hyper GLUC:(G)(L)(C)(U)+
K+ sparing diuretics:
Spironolactone/EplerenoneTriamterene/Amiloride
: Aldosterone( Na+Na+-K+ ATPase )
: Na+
(Spironolactone Anti-androgen

)
:(Gynecomastia)

A. -(::)
1. () D2 receptor
(1) Haloperidol:(EPS)

(2) Chlorpromazine:

2.

(3) Thioridazine: Antimuscarinic effect EPS

D4 receptor(EPSProlactinemia

)
(1) Clozapine:(Agranulocytosis)
(2) Olanzapine()Ziprasidone(QTc )
B. -(Mood stabilizer)
1. Lithium(): Gq PIP IP3 PIP2

[0.4--0.8--1.2mEq/L]>1.5mEq/L

C. - SerotoninNE
1. (TCA): ImipramineClomipramineAmitriptyline
(1) NE Serotonin
(2) :(Muscarinic)(H1)(
adrenergic)
(3) () Imipramine( Anti-M effect)
2.

(1) Bupropion(DNRI): NEDopamine

(2) Maprotiline NE Trazodone serotonin

3.

NESerotonin
(1) Venlafaxine(SNRI): Serotonin, NE SSRI

(2) Mirtazapine(NaSSA): 2 receptor

4.

5.

SSRI Serotonin []
(1) Fluoxetine(Prozac)Sertraline(Zoloft)Paroxetine
(2)
(3) :
(4) : GI
MAOI monoamine oxidase
(1) TranylcyprominePhenelzineIsocarboxazid
(2) (Hypochondriasis)
(3)
a. (Cheese reaction):Tyramine MAO
Octopamine(false transmitter)
Hypertensive crisis

b.

Serotonin syndrome: SSRI Serotonin

HyperthermiaMyoclonus

D. - GABA Cl-
1. Barbiturates: GABA GABAA Cl-
(1) Thiopental
(2) SecobarbitalPentobarbital():
(3) Phenobarbital
Porphyria()
2. Benzodiazepines(BDZs): GABA GABAA Cl-

3.

4.

BDZ /
(1) Alprazolam()
(2) Midazolam()
(3) BDZ BDZ
Lorazepam
Flunitrazepam(FM2) antegrade
amnesia
(4) Diazepam
(5) Flumazenil Benzodiazepines
Non-BDZ BZ1 BDZ

(1) Zolpidem(Stilnox)
(2) Zopiclone(Imovane)
5-HT1A receptor partial agonistBuspirone(pf: Bupropion)
1~2 (slow onset)

5. Baclofen()
BarbiturateBDZ GABA GABAA Cl-
GABAergic nerve
Baclofen GABA GABAB G protein Ca2+
K+!!
E. - DopamineAch
1. Dopamine : Amantadine A
2. Dopamine : Levodopa(L-dopa)+ Carbidopa
L-dopa BBB dopa decarboxylase
dopamine
Carbidopa dopa decarboxylase L-dopa

Pyridoxine(Vit. B6) decarboxylase cofactor

3.

4.

Dopamine (Dopamine agonist)

(1) (Ergot alkaloid): BromocriptinePergolide
GH Prolactin
(2) : PramipexoleRopinirole
MAOB: Selegiline (= Deprenyl) MAOB Dopamine

L-dopa L-dopa
Hypertensive crisis
MAOA

NE, Serotonin,

Tyramine
MAOB

Dopamine

TranylcyprominePhenelzine [
MAO]

Selegiline [ MAOB]

5.

COMT: EntacaponeTolcapone (levodopa )

levodopa 3-O-methyldopa( levodopa )

6.

Ach : BenztropineTrihexyphenidylBiperiden

F. -
1. Na+
(1) Carbamazepine:()
Steven-Johnson syndrome
(2) Phenytoin:()

Vit. D
Vit. K-dependent
(3) Primidone: Phenobarbital Phenytoin
2.

3.

4.

Ca
(1) Ethosuximide:() Steven-Johnson
syndrome
Na+Ca2+: Valproic acid

Steven-Johnson syndrome
: GI()2
2+

GABA
(1) Barbiturates
Phenobarbital:()
Primidone: Phenobarbital
(2) BZD
Clonazepam:


5.

Diazepam: IV

:
(1) NMDA : Felbamate
(2) AMPA : Topiramate
(3) Na+: Lamotrigine
(4) GABA: Gabapentin(), Tiagabine(),
Vigabatrine(transaminase)

G. -
1. Ergot alkaloids: partial 5-HT agonist + agonist + dopamine agonist
(1) : ErgotamineErgonovine
(2) : Methylsergide
!!
2.

5-HT1D agonist: Sumatriptan:

H. -
1.
(1) : inductionmaintain
a. Thiopental: Barbituate
b. Propofol:
c. Etomidate:
d. Ketamine: Glutamine NMDA IV

(2) : maintain
(MAC): MAC
/=/:/
N2O Des* Sevo* Iso* En* Halothane Methoxy*
(*=flurane)

2.

: MAC/
N2O Halothane

a. Halothane:
Halothane hepatitis:
Myocardial depression:
Arrhythmia: amine Epi.
Malignant hyperthermia: Succinylcholine
: Na+


(1) Ester ()
Pseudocholinesterase

Tetracaine()Cocaine()Procaine()
(2) Amide
(first-pass effect)
Bupivacaine()Lidocaine()Mepivacaine()prilocaine()
Disulfiram Aldehyde dehydrogenase

3.

I. -
1. ( ) Meperidine: Morphine: Fentanyl 0.1: 1: 80
(1) Meperidine: Morphine
(2) MorphineFentanyl:

(3) Heroin:!!! morphine

(4) Methadone: morphine

(5) Naloxone: morphine ( antagonist)

2.
3.

(2 )morphine
(1) Loperamide:
( )
(1) Codeine: R. weak agonist

(2) Dextromethophan:

A. (Asthma)
1.
(1) 2 selective agonistSalbutamol, Albuterol, Terbutaline(),
Salmeterol()
Adenyl cyclase cAMP
:
(2) Anti-cholinergicIpratropine
2 agonist COPD
(3) Theophylline(:)
Phosphodiesterase(PDE) cAMP
histone deacetylation
2.

(1) SteroidBudesonideFluticasone
cytokine
-adrenergic receptor
(2) Mast cell stabilizerCromolynNedocromil

(3) Leukotriene modifier

Zileuton: 5-lipoxygenase
MontelukastZafirlukast: Leukotriene receptor antagonist
aspirin-induced asthma
B. (Peptic ulcer)
1.
(1) (antacids): MgOAl(OH)3CaCO3
(2) H2 blocker: CimetidineRanitidineFamotidine
(3) M1 blocker: Pirenzepine(selective)Propantheline(:)
M3
(4) Proton pump inhibitor(PPI):
Omeprazole Lansoprazole Exomeprazole
H+,K+-ATPase GERD
2.
(1) Sulcrafate: prostaglandin( proton pump/&HCO3-)

(2) Misoprostol: prostaglandin E1 (PGE1) analogue

3.

(1) Omeprazole+ Clarithromycin+ Amoxicillin

(2) Omeprazole+ Clarithromycin+ Metronidazole
(3) Bismuth+ Metronidazole+ Tetracycline

C.
1.
(1) D2 receptor antagonists: MetoclopramideDomperidone
BBB
(2) Cholinomimetic agents: Bethanechol
M3 receptor
(3) 5-HT4 agonist: Cisapride
ENS (QT prolong)
2.

(1) D2 receptor antagonist: MetoclopramideDomperidone

4th CTZ D2 receptor
(2) Selective 5-HT3 antagonist: TropisetronOndansetron
4th CTZ 5-HT3
(3) Neurokinin receptor antagonist: Aprepitant
4th CTZ Neurokinin 1(NK1) receptor
(4) H1 Antihistamine & Anticholinergic: DiphenhydramineMeclizine
Anticholinergic

3.

(1) : PsylliumMethylcelluloseNormacol

(2) : Glycerin suppositoryMineral oil

(3) : Magnesium oxideLactulose


(4) : Castor oil()
Enteric nervous system
4.

(1) : Kaolin-Pectin

(2) : Opioid agonist(: Loperamide)

opioid receptor Ach
D. (Inflammatory bowel disease, IBD)
1. (5-aminosalicylic acid, 5-ASA)
(1) Azo compound( 5-ASA N=N
)
Sulfasalazine
Balsalazide
Olsalazine
2.

(GlucocorticoidCyclosporineAzathioprine)


A.

TRH(+)

TSH

Thyroxine(T4)Triiodothyrodine(T3)

ACTH

GlucocorticoidMineralocorticoidAndrog

CRH(+)

en

GnRH(+)
GHRH(+)

FSHLH

EstrogenProgesteroneTestosterone

GH

Insulin-like growth factor-1(IGF-1)

Somatostatin(-

)
Dopamine(-)

PRL

Oxytocin

Vasopressin(ADH)

(V1) Water pore(V2)

1.

(1) (GH)191 PRL

IGF
GH : SomatostatinOctreotide
(2) (Prolactin, PRL)198 GH
EstrogenProgesterone
PRL
PRL : Bromocriptine(Dopamine analog)

2.

(1) (ADH)(Vasopressin): receptor(V1V2)

a. V1:
b. V2: Water pore VIII, vW
c. ADH : Terlipressin(V1)Desmopressin(V2)
V1 :
V2 :
d. ADH : Demeclocycline
ADH
(SIADH)

(2) (Oxytocin)


B. -()
1. : iodide(thyroidal peroxidase) iodine Thyroglobulin Tyrosin
MIT/DIT
2.

3.

4.

(Thyrotoxicosis)

(Hypothyroidism)

Alkaline
phosphatase LDH AST

(1) Liothyronine(T3):(24hr)
(2) Levothyroxine(T4): T3(7day)
(3) Hashimotos thyroiditis: Anti-TPO AbAnti-Tg Ab Levothyroxine

(1) Thioamides :
MethimazoleCarbimazolePropylthiouracil(PTU)
Thyroglobulin
(Deiodination)
3~4
(10%)(0.1~0.5%)
(2) Iodides:(2~7 )jodbasedow (
(3)
(4)
(5)
(6)

)
-blocker: T4T3
Hydrocortisone:(Thyroid storm)
T4T3
Radioactive iodine media(131I):
Levothyroxine
Graves disease:(type II) TSH receptor

: Thioamides()

C. -(PTH) D(Calcitonin)
1. []

::
2. D[]

3.

[]

D. -(Somatostatin)
1.
(1) :

(2)
(3)
(4)
(5)
2.

: Lipoprotein lipase Lipase

:
: K+

SGLT

GLUT1

RBC

GLUT2

GLUT3

GLUT4

GLUT5

(Fructose)

3.

(1)
a. Sulfonylurea(SU):
GlimepirideGlibenclamideGliclazideGlipizide
K+
:
b.

c.

Glinides : RepaglinideNateglinide
SU K+
SU
GLP-1(Glucagon like peptide-1): Sitagliptin()
GLP-1 (Incretin)
GLP-1 (DPP-4) GLP-1
Incretin

(2)
a. Biguanide : Metformin

lipid profile
()
b.

TZD(Glitazone): RosiglitazonePioglitazone
PPAR lipolysis FFA
GLUT4
lipid profile
()(ALT 2.5 )

(3)
a. glucosidase inhibitor: Acarbose

Sulfonylur

ea

(2-5hr)

SU

GI

Glinides
GLP-1
Biguanide

TZD

glucosidas

e inhibitor

4.

(Somatostatin, IVSC): Octreotide(Somatostatin analog,

IV SC IM)
(1) 14 D cell
(2) GH GlucagonInsulin
Gastrin
(3) :
(4) :

E. -(Glucocorticoid)
1. Phospholipase A2
2. (GFR)
3. (Agonist)
(1) :
HydrocortisonePrednisoloneMethylprednisolone(

4.

)
(2) :
BetamethasoneDexamethasone
:(Synthetic inhibitor)
(1) Metyrapone: 11-hydroxylation cortisol & corticosterone

(2) Aminoglutethimide: CholesterolPregnenolone

(3) Ketoconazole: 17,20-lyase3-hydrosteroid dehydrogenase

(4) Mitotane: 1/3 Adrenal carcinoma

F. -

1.

LH: Cholesterol Progesterone(Theca cell)FSH: Testosterone

Estradiol(Granulosa cell)

2.

(Estrogen):
(1) PTH
(2) HDLLDL Leptin
(3) IIVIIIXX antithrombin III

3.

(Progesterone):
(1)
(2) CO2

(1) : Estrogen
a. (Unopposed estrogen):
b. (Estrogen + Progesterone)
Estrogen Progesterone
withdraw

4.

5
c. Selective estrogen receptor
modulator=SERM(Tamoxifen Raloxifen)
Agonist Antagonist
Tamoxifen Raloxifen
(2) : Mifepristone(RU486) progesterone receptor
5.

(1) : Testosterone:Danazol(weak androgen):

(2) :
a. GnRH analog: Leuprolide
b. FinasterideDutasteride: 5-reductase inhibitor DHT
c.

CyproteroneFlutamide: Androgen receptor antagonist

d.

Spironolactone: Aldosterone/Androgen receptor antagonist

A.
lactam Transpeptidase
Glycopeptide : D-alanine-D-alanine G(+) peptidoglycan
1.

Penicillin(PCN):(GP)

(1) Penicillinase(= lactamase)

a. Penicillinase-resistant penicillin(PCN )
Oxacillin(IV)Cloxacillin(PO)Dicloxacillin(PO)Methicilli
n()
(Cellulitis)
b.

Penicillin lactamase
inhibitor(Clavulanate Sulbactam Tazobactam)
i.
Aminopenicillin(Anti-staphylococcal PCN)
Amoxicillin(PO): Streptococcus
Augmentin = Amoxicillin+ ClavulanateUnasyn =
Ampicillin + Clavulanate :

ii.

2.

(CAP)
Carboxypenicillin(Anti-peudomonal PCN)
Ticarcillin + ClavulanatePiperacillin + Tazobactam

(Pseudomonas)
(HAP)
(2) Penicillin binding protein(PBP): Penicillin
MRASPRSP
(3) Porin : Penicillin
Cephalosporin : Penicillin

Cephalosporin (L. monocytogenes) Penicillin

(1) : CefazolinGPC GN
(2) :CefuroximeGP GN
(3) :Cefmetazole

(4) :Ceftriaxone*1Ceftazidime*2Cefoperazone(CPZ)GP GN

*1 BBB*2
(5) :Cefepime:GPC()GN()
CefmetazoleCeftriaxoneCefoperazone(CPZ)

lactamase
a. AmpC -lactamase:~ Cephalosporin lactam
Cefepime Carbapenems
b. Extended-spectrum -lactamase(ESBL):Penicillin~
Monobactam
Carbapenems Cephamycin ()

3.
4.

5.
6.

Carbapenems : ImipenemMeropenemErtapenem
GPCGNB MRSA
Monobactam : Aztreonam
GNB (P. aeruginosa)Penicillin

Glycopeptides : VancomycinTeicoplanin
GPC MRSAPRSP
Bacitracin: Neomycin

B.
1. 50S
(1) Clindamycin():
GPC()
PCN Clindamycin + Aztreonam
(2) Macrolide (): Erythromycin Azithromycin
GPC() 50S G(-)
Mycoplasma Azithromycin
(3) Oxazolidinones (): Linezolid
: MRSAPRSPVRE( Vancomycin )
(4) Chloramphenicol():
()
2.

30S
(1) Aminoglycoside : GN
:/
a. Streptomycin:
b. Gentamycin:GNB ()
c. Tobramycin:
d. Amikacin:
(2) Tetracycline :
: Aminoacyl-tRNA 30S ribosome

i.
(!!)
ii.

iii.

a. Tetracycline: 60-70%
b. MinocyclineDoxycycline:(95-100%)
c. Tigecycline:
MRSAPRSPVRE
Tetracycline
: Ca2+

C.

1.

2.

Trimethoprim(TMP)/Sulfamethoxazole(SMX)
SMX PABA Dihydropteroate synthaseTMP Dihydrofolate
reductase
AIDS (Pneumocystis carinii)Norcardiosis
!
Fluoroquinolone
Ciprofloxacin(2nd)Levofloxacin(3rd)Moxifloxacin(4th)
DNA DNA
2nd: G(-)() G(-)()()
3rd: G(+)(CAP)
4th:
!!

3.

Metronidazole DNA
(Protozoa)
Disulfiram

4.

Rifampin DNA-dependent RNA polymerase RNA

Mycobacterium tuberculosis

D. HERZ

Isoniazid(INH, H)

Mycolic acid

Pyridoxine(Vit. B6)

Ethambutol(EMB,
E)

Quinolone DNA gyrus

Rifampin(RIF, R)

RNA polymerase

Pyrazinamide(PZ
A, Z)

phagosome

Streptomycin(SM) 30S
1.

2.
3.
4.

HERZ 2 HER 4 Ethambutol

IsoniazidRifampin Ethambutol
Streptomycin
(H, R, Z)(E, SM)
CiprofloxacinAmikacinParamimosalicylate(PAS)Cycloserin
Mycobacterium leprae(Leprosy )
(1) Dapsone:G6PD
(2) Rifampin: 600mg Leprosy Dapsone

(3) Clofazimine: DNA binding Dapsone

E.
1. Azole
CYP450 lanosterol
(ergosterol,)

2.

3.

(1) Ketoconazole:
(2) Itraconazole:
(3) Fluconazole: BBB
(4) Voriconazole:30% Amphotericin B
(5) ClotrimazoleEconazole
Polyene
(1) Amphotericin B:()
Aspergillus Candida
(2) Nystatin:(thrush)

(1) DNARNA :Flucytosine 5-Fluorouracil(5-FU)

CNS Amphotericin B
(2) microtubule :Griseofulvin

F.
1.
(1) Acyclovir: HSV1HSV2VZV
Thymidine kinase DNA polymerase
DNA
DeliriumSeizure
(2) Ganciclovir: CMV
Acyclovir HSVVZV CMV Acyclovir
100

(3) Fomivirsen: CMV
Antisense nucleotide CMV mRNA
(4) Foscarnet: HSVCMV
DNARNA polymerase
2.

(1) (Nucleotide reverse transcriptase inhibitor, NRTI)

Zidovudine(ZDV)Didanosine(ddI)Zalcitabine(ddC)Lamivudine(
3TC)
HIV :2 NRTI+ 1 PI
: Zidovudine+ Lamivudine +/- Indinavir or

Nelfinavir
:ZDV()ddI()ddC()
Lamivudine(3TC) HBV
(2) (Non-nucleotide reverse transcriptase
inhibitor, NNRTI)

NevirapineDelavirdineEfavirenz

(3) (Protease inhibitor, PI):

IndinavirNelfinavirRitonavirSaquinavirAmprenavir

A. (cell cycle non-specific)

1.
(1)Platinum
Cisplatin, Carboplatin, Oxaliplatin
90%(5-HT3 antagonist ,
Tropisetron,Ondansetron)
(2)Mechlorethamine
Cyclophosphamide, Ifosfamide
50%( Mesna )
Prodrug Mustard
(3)Busulfan
B. (cell cycle specific)
1. S phase: DNA
(1) Purine(purine antagonist)
Mercaptopurine(6-MP)
(2) Pyrimidine(pyrimidine antagonist)
Fluorouracil(5-FU), Cytarabine(Ara-C)
5-FU 5-FdUMP Thymidylate synthase Thymidine

Ara-C DNA polymerase DNA

(3)
Methotrexate(MTX)
Purine, Pyrimidine ()

( Folic acid )
2.

G2 phase: Topoisomerase inhibitors

(1)Topoisomerase I inhibitors
Irinotecan(CPT-11)
Cholinergic reaction:24 ( Atropine )
90%( Loperamide )

(2)Topoisomerase II inhibitors
(Anthracycline):Daunorubicin, Doxorubicin
Etoposide(VP-16)
3.

M phase:
(1)Vinca alkaloids()
Vinblastine, Vincristine

(2)Taxanes()
Paclitaxel(Taxol), Docetaxel(Taxotere)

:(Corticosteroid) :

A.
1.
Glucocorticoid, Prednisolone, Cyclosporine
ProstaglandinLeukotriene ()
IL-2 T cell
2. Th ( IL2 )
Cyclosporine, Tacrolimus, Sirolimus
Cyclosporine, Tacrolimus Calcineurin
Sirolimus mTOR G1-S phase

3.

TB ()
(1)Cyclophosphamide
DNA

(2)Azathioprine
6-MP purine purine
DNA
()
6-MP xanthine oxidase allopurinol(xanthine oxidase
inhibitor)
(3)Mycophenolate mofetil (MMF)
Inosine monophosphate dehydrogenase purine
(de novo pathway) purin3
:Prednisolone + Tacrolimus + MMF

B.
1. (Interferons)
(1)IFN-()IFN-() Type I IFN

 RNA

(2)IFN-( T ) Type II IFN

NK cell, Tc cell

2. TNF-
(1)
Thalidomide
TNF- T cell

(2)

Etanercept(Enbrel, ), Infliximab, Adalimumab

TNF

Rituximab: B cell CD20

Abatacept: T cell CTLA4 APC B8(CD80/86)

(3)

A.
1. ()
(1) Aspirin:
Cyclooxygenase(COX)
Thromboxane(TXA)Prostaglandin(PG)

(2) ClopidogrelTiclopidine:
P2Y Adenosine diphosphate(ADP)
Aspirin
(3) Abciximab()Tirofiban:
GP IIb/IIIa

(4) Dipyridamole(Persantin):
Phosphodiesterase(PDE) cAMP
cAMP Coronary steal
phenomenon
2.

()
( PT):3710[ 10]
( aPTT):12119810[ 10]
Thrombin(2a) 5811Protein CS 5811
(1) : Warfarin()
Vit. K Factor 2,7,9,10Warfarin Vit. K

3.

Factor 7 PT

()

(1)
Anti-thrombin III Thrombin 5a8a
Protein C/ Protein S 5a8a
Plasmin Fibrin
(2) Heparin(IV, SC)
Heparin 10a Antithrombin 2a aPTT

LMWH 10a aPTT

(3) UrokinaseStreptokinasetPA
Plasminogen Plasmin Fibrin
Thrombin: Fibrinogen FibrinPlasmin: Fibrin Fibrin split
product
B.
1. Desmopressin(= DDAVP)
Receptor V1:Receptor V2: VIII, vW

2.

(1) Terlipressin(V1):
(2) Desmopressin(V2):ESRD
Aminocaproic acidTranexamic acid( IV )
UrokinaseStreptokinasetPA Plasminogen
Plasmin

C.
MCV < 80flIDA()Thalassemia()
MCV > 100flMegaloblastic anemia( B12 )
Transferrin ferritin hemosiderin
Fe2+ Fe3+HClVit. C
1.

(Iron deficiency anemia, IDA)

Transferrin()ferritin()
(1) (Ferrous iron)Ferrous sulfateFerrous gluconateFerrous
fumarate
GI
(2) (Ferric iron)Iron dextran

2.

Iron(12 ) Folate() Vit. B12()

(1) Iron Vit. C 12
(2) Folate()
(3) Vitamin B12 IF

D.
1. EPO
2. G-CSF(Filgrastim,)

3.

IL-11 IL-11 oprelvekin

thrombocytopenia

E.
1. HMG CoA reductase inhibitor(statin ):Cholesterol (LDL)
Cholesterol HMG CoA

2.

3.

Ezetimibe: NPC1L1(transport protein)

LDL
Statin Statin 3
Fibric acid(GemfibrozilFenofibrate):TG (VLDL)VLDL
TG
HDL lipoprotein lipase TG fatty acid
VLDL

4.

Bile acid resin(Cholestyramine):

LDL

5.

Nicotinic acid(Niacin):(Wiki )
(1) adipose tissue Triacylglycerol fatty acid( lipolysis)
(2) cholesterol VLDL VLDL
(3) lipoprotein lipase VLDL VLDL
(4) HDL HDL