Class of Drug Corticosteroids

Example

MOA

Indications Anti-Eicosanoids Indirect inhibtion of Asthma, arthritis (rheumatoid and osteoarthritis), phosphorlipase A1 by inducing systemic lupus erythematosus synthesis of lipocordin

C/I

A/E Teratogenic, peptic ulcers; hyperglycemia, insuline resistance, diabetes mellitus, osteoporosis, etc.

Prednisone Betamethasone Dexamethasone Triamcinolone Thromboxane Antagonists Dazoxiben Pirmagrel Ridogrel NSAIDs Inhibit COX1, 2; inhibit platelet and suppress inflammation Aspirin Non-selective COX inhibition Mild to moderate pain, headache, myalgia, arthralgia, prophylaxis for stroke and MI GI ulcers, bleeding, asthma exacerbation, bronchospasm, angioedema Reversible binding to COX enzymes Similar to aspirin Bleeding

Indometacin Sulindac Meclofenamate Ibuprofen Celecoxib

Preferentially inhibits COX1 over COX2 Preferentially inhibits COX1 over COX2 No preference of inhibition of COX1, 2 No preference of inhibition of COX1, 2 Preferentially inhibits COX2 Osteoarthritis, rheumatoid arthritis, primary over COX1 dysmenorrhea, acute pain in adult's familial adenomatous polyposis

Myocardial infarction, GI bleeding, peripheral edema, asthma

Rofecoxib

Preferentially inhibits COX2 over COX1

Osteoarthritis, rheumatoid arthritis, primary dysmenorrhea, acute pain in adult's familial adenomatous polyposis

Myocardial infarction, GI bleeding, peripheral edema, asthma

Propionic Acid

Mild to moderate pain, fever, osteoarthritis, rheumatoid arthritis, dysmenorrhea, gout

GI hemorrahge, ulceration, perforation, nephrotoxicity, Stevens-Johnson Syndrome

Ibuprofen Naproxen Ketoprofen Flurprofen Acetic Acid Derivatives Indomethacin Sulindac Etodolac Diclofenac Ketorolac Oxicams Piroxicam Ketones Nabumetone Acetaminophen COX3 inhibition Fever, mild to moderate pain Hepatotoxicity, nephrotoxicity and hypothermia Arthritis Inhibition of COX1, 2 Long term treatment of rheumatoid arthritis Closure of patent ductus arteriosus GI disturbances, tinnitus

Rheumatoid arthritis, osteoarthritis, primary dysmenorrhea

More GI bleeding than aspirin

Lipoxygenase Inhibitors

Zileuton

Asthma

Leukotriene Receptor Antagonist

Chronic asthma

Urticaria, abdominal discomfort, dizziness, and insomnia GI distress, hallucination, agitation, allergic granulomatosis angiitis, hepatitis

Montelukast Zafirlukast Example

Perennial allergic rhinitis, seasonal allergic rhinitis

Class of Drug Dinoprostone

MOA PGE2

Indications C/I Eicosanoids Induction of labor at term, 2nd trimester abortions, missed abortions, benign hydatidiform mole

A/E Prolonged vaginal bleeding and severe menstrual cramps can occur if used for menstrual regulation or early abortion

Misoprostol Alprostadil

PGE-1 derivative PGE-1

2nd trimester abortion, resistant postpartum hemorrhage 2nd line drug to treat ED; maintenance of patent ductus arteriosus Pulmonary hypertension Pulmonary hypertension

Sickle cell anemia

GI disturbances, dystonia, pulmonary edema Penile pain; apnea, bradycardia, hypotension, hyperpyrexia Hypotension, rash, GI disturbances, muscle pain

Treprostinil Epoprostenol Latanoprost Bimatoprost Travoprost Unoprostone Class of Drug First Generation AntiHistamines Example

Synthetic PGI2 Synthetic PGI2

Stable, long-acting PGF2-alpha Glaucoma Glaucoma secondary to decreased intraocular pressure Glaucoma secondary to decreased intraocular pressure Glaucoma secondary to decreased intraocular pressure MOA Indications Anti-Histamines Inverse Agonists of histmaine Rhittinis, conjunctivitis, urticaria, puritus, anaphylaxis, insomnia, motion sickness, Parkisonism

C/I Narrow angle glaucoma, peptic ulcer disease

A/E Sedation, dizziness, pupillary dilation, dry eyes and mouth, urinary retention, hesitancy

Ethelendiamine (pyrilamine and triplennamine) Ethanolamines (diphenhydramine, carbinoxamine, clemastine, dimenhydrinate) Alkylamines (chlorpheniramine, brompheniramine) Piperidines (cyrohetadine, phenidamine) Phenothiazine (Promethiazine) Piperazines (hydroxyzine, cyclizine, meclinizine)

Second Generation AntiHistamines Piperazine (Certizine) Alkylamines (Acrivastine) Allergic rhitinitis, allergic urticaria Allergic rhitinitis Somnolence, dry mouth, headache

Piperidine (Loratadine, desloratadine, levocabastine, ebastine, mizolastine, fexofenadine)

Allergic rhitinitis, allergic urticaria

H2 Blockers Cimetidine Ranintidine Fomotidine Nisatidine Example

Control stomach acid

Diarrhea, headache, fatigue, constipation

Class of Drug 5HT Receptor Agonists

MOA

Indications Serotonin

C/I

A/E

Busiprone

5HT1A agonist

Anxiolytic agent

Triptans

5HT1D/1B Agonists

Acute migraine, cluster headache

Patients with coronary artery disease; naratriptan and eletriptan are C/I in patients with hepatic and renal insufficiency

Tachycardia, palpitation, nervousness, GI distress, paresthesia Coronary artery vasopasm

SSRIs Cisapride Tegaserod

5HT4 Severe toxic effects have decreased use Irritable bowel syndrome with constipation

5HT Receptor Antagonists Ondansetron Class of Drug Tetracyclines Example 5HT3-antagonists MOA Reversibly blocks the 30S ribosomal subunit to prevent protein synthesis Prevent N/V associated with surgery and chemotherapy Indications C/I Tetracyclines Broad spectrum against gram positive and negative Pregnant women and and anaerobes; protozoa (amebas); most effective children