Pharmacology Drug List

7/29/2019 Pharmacology Drug List

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Autacoids and NonsteroidalAntiflammatory

Drug List

PRIMARY DRUGS - All capital lettersSECONDARY DRUGS - Small letters

[Histamine/Antihistamines] - [Drugs for Motion Sickness] [Serotonin (5-HT) and pharmacology of migraine] [Nitric oxide,donors and inhibitors] - [Eicosanoids] [Treatment of asthma] [Hypersensitivity and Immunopharmacology] [Bradykinin] -[Antipyretics and Analgesics] - [Nonsteroidal AntiinflammatoryDrugs] -[Disease Modifying Antirheumatic Drugs (DMARDS)] -[Antigout Drugs]

Histamine/Antihistamines

Histaminic drugs* betazole* HISTAMINE

H1-Antihistamines* brompheniramine* CHLORPHENIRAMINE* DIPHENHYDRAMINE

* FEXOFENADINE* hydroxyzine* loratadine* promethazine

H2-Antihistamines

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* CIMETIDINE

* FAMOTIDINE* nizatidine* RANITIDINE

Antidegranulating drugs* CROMOLYN SODIUM* nedocromil sodium

Drugs for Motion Sickness* DIMENHYDRINATE* promethazine* scopolamine

Serotonin (5-HT) and

pharmacology of migraine* antiemetics (metoclopramide, ONDANSETRON)

* -adrenergic antagonists (atenolol, propranolol)* caffeine

* calcium channel blockers (amlodipine,verapamil)

* cyproheptadine* ergot derivatives (ERGOTAMINE,

dihydroergotamine)* METHYSERGIDE

* NSAIDs and analgesics (aspirin, acetaminophen,ibuprofen, indomethacin, naproxen)

* phenelzine* tricyclic antidepressants (amitriptyline,

nortriptyline)* triptans (SUMATRIPTAN, zolmitriptan)


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Nitric oxide, donors and

inhibitors* nitrates

* nitrites* sodium nitroprusside

* SILDENAFIL

Eicosanoids* alprostadil (PGE1)

* dinoprostone (PGE2)* epoprostenol* misoprostol* MONTELUKAST* zafirlukast

* ZILEUTON

Treatment of asthma* -adrenergic agonists (non-selective,epinephrine; selective short-acting, ALBUTEROL,bitolterol, METAPROTERENOL; selective long-acting, SALMETEROL)

* anticholinergics (IPRATROPIUM bromide)

* antidegranulating agents (CROMOLYN SODIUM,nedocromil sodium)

* anti-IgE antibody (omalizumab)* glucocorticoids (BECLOMETHASONE,

budesonide, flunisolide, FLUTICASONE)* leukotriene inhibitors (MONTELUKAST,

zafirlukast, ZILEUTON)


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* methylxanthines (THEOPHYLLINE,

aminophylline)

Hypersensitivity andImmunopharmacology* CYCLOPHOSPHAMIDE

* CYCLOSPORINE* interferon * interferon * METHOTREXATE

* muromonab-CD3* mycophenolate mofetil* PREDNISONE* rapamycin

* rho(D) immune globulin* tacrolimus

* thalidomide (leprosy, graft-versus-host disease,multiple myeloma)

Bradykinin* aprotinin

* BRADYKININ

Antipyretics and Analgesics* ACETAMINOPHEN

* ASPIRIN and related salicylates* non-steroidal drugs other than aspirin (see

below)* combinations - acetaminophen and ASA with

opioids and/or caffeine


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Nonsteroidal Anti-inflammatory Drugs* ASPIRIN and related salicylates* celecoxib

* DICLOFENAC SODIUM* fenoprofen

* IBUPROFEN* INDOMETHACIN* KETOPROFEN* KETOROLAC

* meclofenamate* NABUMETONE* NAPROXEN* OXAPROZIN

* piroxicam* rofecoxib

* sulindac* tolmetin

* VALDECOXIB

Disease Modifying

Antirheumatic Drugs (DMARDS)* azathioprine

* chloroquine and HYDROXYCHLOROQUINE* ETANERCEPT

* gold salts (auranofin, aurothioglucose)* INFLIXIMAB

* leflunomide* METHOTREXATE

* D-penicillamine* sulfasalazine


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Antigout Drugs* ALLOPURINOL

* COLCHICINE* methylprednisolone* NSAIDs (e.g. indomethacin, except aspirin)

* PREDNISONE* PROBENECID* SULFINPYRAZONE


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ABCIXIMAB

ACETYLSALICYLIC ACID (aspirin)

argatroban

CLOPIDOGREL

COBALAMIN (cyanocobalamin, hydroxocobalamin)

danaparoid sodium darbepoetin alpha (NESP)

DEFEROXAMINE

desmopressin acetate (DDAVP)

dipyridamole

epsilon-aminocaproic acid

eptifibatide

rERYTHROPOIETIN (EPOETIN ALPHA)FILGRASTIM (NEUPOGEN)FOLIC ACID

fondaparinux

GM-CSF G-CSF

HEPARIN

IRON(FERROUS SULFATE, iron dextran)

LEPIRUDIN

protamine sulfate

reteplase

sodium ferric gluconateSTREPTOKINASE

tenecteplase

TICLOPIDINE

tirofiban

TISSUE PLASMINOGEN ACTIVATOR(t-PA)

thrombopoietin

VITAMIN B-12

VITAMIN K

WARFARIN SODIUM


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Cardiovascular and Respiratory Drug ListPRIMARY DRUGS - All capital lettersSECONDARY DRUGS - Small letters

[Antiarrhythmic Drugs] - [ Inotropic Agents] - [Antihypertensives and Related Drugs]

[Antianginal Drugs] - [Antihyperlipidemic Drugs] - [Respiratory Drugs]

Antiarrhythmic Drugs ADENOSINE

AMIODARONE Atropine

-ADRENOCEPTOR ANTAGONISTS (e.g. METOPROLOL, SOTALOL)

Bretylium CALCIUM CHANNEL BLOCKERS (e.g. DILTIAZEM, VERAPAMIL)

digitoxin

digoxin disopyramide disopyramide

dofetilide flecainide ibutilide

LIDOCAINE mexiletine

PROCAINAMIDE propafenone

QUINIDINE

Management of Acute and Chronic HeartFailure

ANGIOTENSIN CONVERTING ENZYME INHIBITORS (e.g.

ENALAPRIL) ANGIOTENSIN RECEPTOR ANTAGONISTS (e.g. LOSARTAN) ADRENOCEPTOR ANTAGONISTS (e.g. CARVEDILOL; METOPROLOL) ADRENOCEPTOR AGONISTS (e.g. DOBUTAMINE; DOPAMINE) DIGOXIN

DIURETICS (e.g. Furosemide; SPIRONOLACTONE) inamrinone

PHOSPHODIESTERASE INHIBITORS (e.g. INAMRINONE;MILRINONE)

NESIRITIDE VASODILATORS (e.g. HYDRALAZINE, NITROPRUSSIDE)


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Antihypertensives and Related Drugs ANGIOTENSIN (I & 11)

atenolol CAPTOPRIL CLONIDINE diazoxide DILTIAZEM

ENALAPRIL esmolol

FUROSEMIDE guanabenz

HYDRALAZINE HYDROCHLOROTHIAZIDE indapamide

labetalol

losartan metazolone

methyldopa METOPROLOL

minoxidil NIFEDIPINE NITROGLYCERIN (i.v.)

nitroprusside pindolol

PRAZOSIN PROPRANOLOL

quinapril reserpine

spironolactone triamterene

VERAPAMIL

Antianginal Drugs ANTIPLATELET AGENTS (e.g. Clopidogrel)

ADRENOCEPTOR ANTAGONISTS (e.g. PROPRANOLOL) CALCIUM CHANNEL BLOCKERS (e.g. NIFEDIPINE) VASODILATORS

Antihyperlipidemic Drugs CHOLESTYRAMINE colestipol


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ezetimibe FIBRIC ACID DERIVATIVES (e.g. GEMFIBROZIL, FENOFIBRATE)

HMG CoA REDUCTASE INHIBITORS (e.g. ATORVASTATIN,LOVASTATIN, PRAVASTATIN)

nicotinic acid

Respiratory Drugs ALBUTEROL beclomethasone CROMOLYN SODIUM EPINEPHRINE flunisolide

IPRATROPIUM BROMIDE isoproterenol sulfate

metaproterenol

nedocromil oxymetazoline phenylephrine pseudoephedrine salmeterol

TERBUTALINE THEOPHYLLINE


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Chemotherapy Drug List


[Antimicrobial Agent] -[Penicillin plus penicillinase inhibitor ] -[Cephalosporins] - [Vancomycin; Teicoplanin] - [Inhibitors of Protein

Synthesis] - [Aminoglycosides ] - [CHLORAMPHENICOL]-[ERYTHROMYCIN]-[CLINDAMYCIN] - [Tetracyclines] - [Antimetabolites] -[Inhibitors ofDNAsynthesis]- [Sulfonamides] - [Urinary Tract Antiseptics] - [CationicSurfactants] -[Drugs for Anerobic Bacteria Only] -[Antimycobacterial Drug] -[Antifungal Drugs] -[Antiviral Drugs] - [Antiparasitic Drugs] - [AntiprotozoalDrugs] - [Antihelminthic Drugs] -[Anticancer Drugs andImmunosuppressives]

Antimicrobial AgentsCell Wall Synthesis Inhibitors:Penicillins

Narrow spectrum Penase-sensitive Pen G PEN VNarrow spectrum Penase-resistent (S. aureus) NAFCILLIN OXACILLIN dicloxacillin

Broad spectrum (aminopenicillins) AMOXICILLIN AMPICILLIN

Primarily antipseudomonal TICARCILLIN CARBENICILLIN

Extended spectrum PIPERACILLIN

Monobactams AztreonamCarbapenems Imipenem with cilastatin

Penicillin plus penicillinase inhibitor


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Amoxicillin plusclavulanic acid

(Augmentin)

Ticarcillin plusclavulanic acid

(Timentin)

Cephalosporins

First generation CEPHALEXIN CEFAZOLINSecond generation CEFOXITIN CEFACLOR CEFPROZIL

Third generation CEFTRIAXONE CEFTAZIDIME CEFOTAXIME

Fourth generation CEFEPIME

Vancomycin

Inhibitors of Protein SynthesisAminoglycosides STREPTOMYCIN GENTAMICIN TOBRAMYCIN

AMIKACIN NETILMICIN

STREPTOGRAMINS Quinupristin

Dalfopristin(Synercid)

OXAZOLIDINONES LINEZOLIDMACROLIDES Erythromycin Clarithromycin Azithromycin

CHLORAMPHENICOL

ERYTHROMYCIN

CLINDAMYCIN

Tetracyclines TETRACYCLINE DOXYCYCLINE MINOCYCLINE


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Inhibitors of DNA synthesis

Fluoroquinolones Norfloxacin Ciprofloxacin Levofloxacin

SulfonamidesBest urine solubility SULFASOXAZOLE SULFAMETH-

OXAZOLE

SODIUMSULFACETAMIDE

(ophthalmic use)

Topical (burns) SILVER SULFADIAZINETRIMETHOPRIM Use as TRIMETHOPRIM - SULFAMETHOXZAOLE combo.

Urinary Tract Antiseptics NITROFURANTOINCationic Surfactants POLYMIXIN B

Drugs for Anerobic Bacteria Only Metronidazole

Antimycobacterial Drugs ISONIAZID

ETHAMBUTOL

RIFAMPIN

STREPTOMYCIN

DAPSONE

STREPTOMYCIN Clofazamine RifabutinAntifungal DrugsPolyenes AMPHOTERICIN B NYSTATIN

FlucytosineImidazoles KETOCONAZOLE

MICONAZOLE

FLUCONAZOLE

ITRACONAZOLE

Voriconazole

Griseofulvin Terbinafine

Antiviral Drugs AMANTIDINE and

Rimantadine ACYCLOVIR

ZIDOVUDINE GANCICLOVIR

FOSCARNET

Didanosine Valacyclovir

Efavirenz Indinavir

Lamivudine

Zanamivir Ribavirin

Lopinavir Nelfinavir


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Nevirapine Enfuvirtide Stavudine Interferon alphaAntiparasitic Drugs

Antimalarial

CHLOROQUINE MEFLOQUINE Quinine

PRIMAQUINE

PYRIMETHAMINE-SULFASOXINE(Fansidar)

atovaquone

Antiprotozoal DrugsAmebiasis and Trichomonas METRONIDAZOLE Diloxanide Iodoquinol

Pneumocystis TRIMETHOPRIM -

SUFAMETHOXAZOLE pentamidine

Clindamycin plus primaquineToxoplasmosis PYRIMETHAMINE plus sulfadiazine Pyrimethamine plus clindamycinTrichomonas METRONIDAZOLEAntihelminthic DrugsFlatworms PRAZIQUANTEL

Fluke and Tapeworm InfectionsSchistosomiasis PRAZIQUANTEL

Filariasis diethylcarbamazine

ivermectin

Intestinal Roundworms (Ascaris), Enterobius (Pinworm) andHookworm mebendazole pyrantel pamoate Albendazole

Angiostroglyliasis mebendazoleTrichurius (Whipworm)Hookworm mebendazole albendazole

Trypanosomiasis


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nifurtimox or suramin pentamidine

Giadiasis metronidazole

Anticancer Drugs and Immunosuppressives

[Alkyating Agents] - [Antimetabolites] - [Natural Products] - [Antimitotics] -[Antimitotics] - [Hormones] - [Immunosuppressives]

Alkyating Agents MECHLORETHAMINE

CYCLOPHOS-PHAMIDE

busulfan

Nitrosoureas

(carmustine,lomustine)

procarbazine

melphalan

Antimetabolites METHOTREXATE 6-MERCAPTOPURINE

6-THIOGUANINE Cytosine arabinoside

5-Fluorouracil gemcitabine

Fludarabine CapecitabineNatural Products dactinomycin DAUNORUBICIN

DOXORUBICIN

BLEOMYCIN mitomycin C

ETOPOSIDE (VP-16)

Camptothecinanalogs: irinotecan

and topotecan

Antimitotics VINCRISTINE VINBLASTINE paclitaxel/docetaxel

Miscellaneous HYDROXYUREA

CISPLATIN/

asparaginase

mitoxantrone

amsacrine

ImatinibCarboplatin

Hormones Estrogens

Anti-estrogen(TAMOXIFEN)

PREDNISONE

flutamide leuprolide

goserelin

Immunosuppressives azathioprine

CYCLOSPORIN A

TACROLIMUS

(FK506)


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Diuretics and Renal Drug List

PRIMARY DRUGS - All capital letters

SECONDARY DRUGS - Small letters

acetazolamide AMILORIDE bumetanide CHLORTHALIDONE

DEMECLOCYCLINE DESMOPRESSIN ACETATE (DDAVP) dopamine

FUROSEMIDE HYDROCHLOROTHIAZIDE mannitol metolazone SPIRONOLACTONE TRIAMTERENE


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Endocrine Drug List

Pituitary-Hypothalamic Drugs

arginine vasopressin BROMOCRIPTINE

cabergoline corticotropin (ACTH)

cosyntropin (ACTH 1-24)

corticotropin releasinghormone (CRH)

demeclocycline DESMOPRESSIN ACETATE ganirelix

GONADOTROPIN RELEASINGHORMONE (gonadorelin)

goserelin GROWTH HORMONE

growth hormone-releasinghormone and releasingpeptides

human chorionicgonadotropin (hCG)

human menopausalgonadotropins (hMG)

levodopa

LEUPROLIDE nafarelin OCTREOTIDE (synthetic

somatostatin octapeptide) OXYTOCIN

pegvisomant pergolide

prolactin recombinant human growth

hormone (somatropin,somatorem)

somatomedin C (IGF-1)

urofollitropin (FSH)

Adrenocorticoids aldosterone

aminoglutethimide androstenedione angiotensin (I, II & III)

beclomethasone betamethasone

dehydroepiandrosterone(DHEA)

DEXAMETHASONE FLUDROCORTISONE

fluocinonide HYDROCORTISONE (cortisol) ketoconazole METYRAPONE

mifepristone (RU486) mitotane

PREDNISOLONE triamcinolone

trilostane

Gonadal Hormones

anastrozole bicalutamide


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CLOMIPHENE CONJUGATED ESTROGENS

(Premarin, estrone, equilin) cyproterone acetate

danazol

desogestrol DIETHYLSTILBESTROL

drospirinone

dutasteride ESTRADIOL (in salts-

benzoate, valerate,cypionate)

ETHINYL ESTRADIOL ethynodiol exemastane

fadrozole faslodex

FINASTERIDE fluoxymesterone

FLUTAMIDE formestane

ketoconazole letrozole

MEDROXYPROGESTERONE megestrol acetate methyltestosterone

mestranol methyltestosterone

mifepristone (RU 486)

nandrolone NORETHINDRONE

norgestimate l-NORGESTREL OXANDROLONE oxymethalone phytoestrogens

raloxifene spironolactone

TAMOXIFEN TESTOSTERONE-salts

(propionate, heptanoate,cypionate)

Thyroid/Parathyroid Drugs

alendronate, etidronate,

pamidronate, risedronate calcium carbonate

calcitonin calcitriol (1,25-dihydroxy

Vitamin D3)

cinacalcet cholecalciferol

dihydrotachysterol ergocalciferol

fluoborate fluoride

iocetamic acid iopanoic acid LEVOTHYROXINE (T4)

liothyronine sodium

(triiodothyronine (T3) liotrix (T4 plus T3)

lithium methimazole mithramycin (plicamicin)

parathyroid hormone POTASSIUM IODIDE

potassium perchlorate PROPYLTHIOURACIL

radioactive iodide teriperatide (PTH 1-34)

thiocyanate thyrotropin stimulating

hormone (TRH)

zoledronic acid


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Insulins/Oral Hypoglycemic

Drugs acarbose ACETOHEXAMIDE aspart insulin

chlorpropramide EXTENDED ZINC INSULIN

(ultra-lente) glimipiride

GLIPIZIDE glucagon

GLYBURIDE Human insulin types: lente

insulin, NPH insulin, regularinsulin. ultralente insulin)

glargine insulin LIS PRO INSULIN (fast

acting)

METFORMIN miglitol

nateglinide pioglitazone

repaglinide rosiglitazone

somatostatin tolbutamide

Uterine Drugs

carboprost DINOSPROSTONE

dinoprostone ERGONOVINE MALEATE

MAGNESIUM SULFATE

misoprostol OXYTOCIN

PROSTAGLANDIN E2 ritodrine

terbutaline


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Gastrointestinal Drug List


[Gastric Antacid/Secretory/Antisecretory Drugs] -[Laxatives andAntidiarrheal Drug] - [Therapy of H. pylori infection] -[Anti-inflammatoryDrugs]

GastricAntacid/Secretory/Antisecretory

Drugs

ALUMINUM HYDROXIDE calcium carbonate CIMETIDINE ESOMEPRAZOLE HYDROXIDE LANSOPRAZOLE

MAGNESIUM magnesium oxide

MISOPROSTOL OMEPRAZOLE Pentagastrin propantheline RABEPRAZOLE RANITIDINE

sodium bicarbonate SUCRALFATE

Laxatives Drugs

bisacodyl docusate (dioctyl sodium

sulfosuccinate)

lactulose MAGNESIUM HYDROXIDE methylcellulose

mineral oil

polyethylene glycol


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Antidiarrheal Drugs

atropine

bismuth subsalicylate diphenoxylate

LOPERAMIDE

octreotide clonidine

Prokinetic Drugs

bethanechol cisapride ERYTHROMYCIN METOCLOPRAMIDE

TEGASEROD ALVIMOPAN neostigmine

Therapy of H. pylori infection bismuth subsalicylate clarithromycin

amoxicillin

tetracycline metronidazole

Treatment of Inflammatory BowelDisease (IBD)

Steroids (hydrocortisone,

prednisone, prednisolone,

budesonide) balgalazide

infliximab

mesalamine sulfasalazine

Treatment of Irritable Bowel

Syndrome (IBS)


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5HT3 antagonists:

ALSOSETRON,

CILANSETRON

5HT-4 agonists:TEGASEROD


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Herbals Drug List



Black Cohosh

Chamomile

Echinachea

GINGKO

GINGSENG

GLUCOSAMINE CHONDROITIN

Kava

MILK THISTLE

SAW PALMETTO

ST. JOHN'S WORT

Valerian

Yohimbe


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Priority toxic chemicals and antidotes which should be

discussed



ACETAMINOPHEN

N-ACETYL-L-CYSTEINE

ACTIVATED CHARCOAL

AIR POLLUTANTS

ALCOHOLS (ETHANOL,

METHANOL, ETHYLENE

GLYCOL)

ARSENIC

CARBON MONOXIDE

CHELATOR THERAPY (2,3-

DIMERCAPTOSUCCINIC ACID,

DIMERCAPROL, EDETATE)

cyanide AND ANTIDOTES

DIG-SPECIFIC ANTIBODY

FRAGMENTS

GLUCAGON

HEROIN

IRON AND DEFEROXAMINE

LEAD

MERCURY

METHYLENE BLUE

NALOXONE

SALICYLATES

SODIUM BICARBONATE

TRICYCLIC

ANTIDEPRESSANTS

SELECTED PESTICIDES

(ANTICHOLINESTERASE,

PRALIDOXIME[2-PAM])


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Vitamins Drug List



BIOTIN

FOLIC ACID

NICOTINIC ACID (NIACIN)

panthotenic acid

tretinoin

VITAMIN A

VITAMIN B1 (THIAMIN) VITAMIN B12

(CYANOCOBALAMIN)

VITAMIN B2

(RIBOFLAVIN)

VITAMIN C (ASCORBIC

ACID)

VITAMIN D

VITAMIN E

VITAMIN K


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Central and Peripheral (Somatic)Nervous System Drug ListPRIMARY DRUGS - All capital letters

SECONDARY DRUGS - Small letters[Endogenous Agents] - [Inhalation and Intravenous Anesthesia] - [Local Anesthetics]

- [Opioids] -[Antitussives, Expectorants and Mucolytics] - [Drugs for Motor Disorders/Muscle

Relaxants] -[Antiepileptics] - [Hallucinogens] - [Mood Disorders] - [Sedative-Hypnotics] -

[Amphetamines,

Anorexogenics and CNS Stimulants] - [Anxiolytics] - [Ethanol and Alcoholism] -[Drugs of Abuse and

Dependence] - [Drugs for Migraine] - [Drugs for Alzheimer's Disease]

Endogenous Agents ACETYLCHOLINE (ACH) ADENOSINE TRIPHOSPHATE (ATP)

aspartate (asp) Beta-Amyloid BRADYKININ DOPAMINE (DA) NOREPINEPHRINE

dynorphins endocannabinoids

beta-endorphin met-enkephalin

leu-enkephalin 5-HYDROXYTRYPTAMINE (5HT)

GAMMA-AMINOBUTYRIC ACID(GABA)

GLUTAMATE (glu) glycine HISTAMINE

Nerve Growth Factor (and othergrowth factors)

substance P

Inhalation and Intravenous Anesthesia ALFENTANIL DESFLURANE enflurane

etomidate fentanyl halothane

ISOFLURANE KETAMINE

methohexital

methoxyflurane MIDAZOLAM MORPHINE

NITROUS OXIDE (N20) PROPOFOL SEVOFLURANE

SUFENTANIL thiopental

Local Anesthetics BENZOCAINE bupivacaine cocaine

levobupivacaine LIDOCAINE

lidocaine/prilocaine eutectic

mixture (EMLA) prilocaine PROCAINE

ROPIVACAINE tetracaine


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OpioidsAgonists CODEINE

DIPHENOXYLATE

fentanyl heroin

loperamide

MEPERIDINE

METHADONE

MORPHINE

OXYCODONE d-propoxyphene

combinations - opioids plus

acetaminophen and ASA

Agonist/Antagonistsand Antagonists BUPRENORPHINE butorphanol nalbuphine

nalorphine

NALOXONE NALTREXONE PENTAZOCINE

Antitussives,Expectorants and Mucolytics acetylcysteine ammonium chloride

CODEINE

DEXTROMETHORPHAN GUANIFENESIN

HYDROCODONE

Drugs for Motor Disorders/MuscleRelaxants amantadine

apomorphine BACLOFEN

BENZODIAZEPINES BENZTROPINE

bromocriptine CARBIDOPA

cyclobenzaprine

DANTROLENE

ENTACAPONE LEVODOPA (L-DOPA)

PRAMIPEXOLE ROPINIROLE

SELEGILINE TRIHEXYPHENIDYL

Antiepileptics acetazolamide

CARBAMAZEPINE clonazepam

DIAZEPAM ETHOSUXIMIDE

fosphenytoin GABAPENTIN

Lamotrigine

LORAZEPAM

PHENOBARBITAL PHENYTOIN

primidone tiagabine

topiramate VALPROIC ACID

Hallucinogens atropine scopolamine


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LYSERGIC ACIDDIETHYLAMIDE (LSD)

MARIJUANA MDMA

MESCALINE PHENCYCLIDINE (PCP)

dronabinol (delta-9 THC)

Mood DisordersAntidepressants AMITRIPTYLINE

BUPRIOPION CITALOPRAM

clomipramine desipramine

doxepin FLUOXETINE IMIPRAMINE

maprotiline

mirtazapine NORTRIPTYLINE

PAROXETINE phenelzine

SERTRALINE TRANYLCYPROMINE VENLAFAXINE

Mood Stabilizing drugs ARIPIPRAZOLE OLANZAPINE QUETIAPINE

RISPERIDONE ZIPRASIDONE

LITHIUM CARBONATE

carbamazepine gabapentin

lamotrigine VALPROIC ACID

Antipsychotics ARIPIPRAZOLE CHLORPROMAZINE (CPZ)

CLOZAPINE

fluphenazine HALOPERIDOL OLANZAPINE

QUETIAPINE RISPERIDONE

thioridazine

trifluoperazine thiothixene ZIPRASIDONE

Hypnotics chloral hydrate diphenhydramine

eszopiclone flurazepam

oxazepam

pentobarbital TEMAZEPAM

triazolam ZOLPIDEM

zaleplon


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Amphetamines, Anorexogenics and CNSStimulants AMPHETAMINE

CAFFEINE

COCAINE ephedrine

mazindol

METHAMPHETAMINE

METHYLPHENIDATE

MODAFINIL phentermine

sibutramine

AnxiolyticsBenzodiazepines alprazolam

chlorazepate chlordiazepoxide clonazepam

DIAZEPAM

FLUMAZENIL (antagonist) LORAZEPAM OXAZEPAM

Non-Benzodiazepine AMITRIPTYLINE beta-adrenergic blocking agents

BUSPIRONE

FLUOXETINE

SERTRALINE

PAROXETINE VENLAFAXINE

Ethanol and Alcoholism disulfiram ETHANOL

METHANOL fomepizole

Drugs of Abuse and Dependence AMPHETAMINES,METHAMPHETAMINE

Bufotenin

COCAINE

DIAZEPAM ETHANOL

Glutethimide HEROIN

LSD MDMA (ecstacy) Organic solvents

MARIJUANA/THC

NICOTINE PENTOBARBITAL

PHENCYCLIDINE

Drugs for Migraine

butorphanol CAFFEINE

ERGOTAMINE METHYSERGIDE

PROPRANOLOL

PROSTAGLANDINS(carboprost, tromethamine,

dinoprostone, dinoprost) SUMATRIPTAN (other triptans)


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Drugs for Alzheimers DiseaseDONEPEZIL GALANTAMINE MEMANTINE

rivastigmine

tacrine


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Pharmacology Semester 1 page 1 of 4By Duy Thai, 1997

STEROIDAL ANTI-INFLAMMATORY DRUGS

& DRUGS USED TO TREAT RHEUMATOID ARTHRITIS AND GOUT

Steroidal anti-inflammatory drugs are also known as corticosteroidsFunctions

Anti-inflammatory ImmunosuppressantMechanisms of action

Corticosteroids, being steroids, are highly lipophilic and can thus penetrate cell membranes fairly easily. They bind to intracellular receptors which modify gene transcription. Corticosteroids have wider ranging effects than NSAIDs because they inhibit a wider variety of enzymes by

reducing their synthesis:

Inhibit phospholipase A2 Inhibit COX 2 (not COX 1) Inhibit cytokine system

Glucocorticoids bind to a glucocorticoid receptor in the cytosol. Once bound, the drug-receptor complex (in this case the negative glucocorticoid response element) goes into the

cell nucleus and acts on the promoter region of a gene to block the transcription of cytokines, COX 2 and

phospholipase A2.

By inhibiting phospholipase A2 we are able to achieve a higher level of anti-inflammation by reducing thesynthesis of all eicosanoids (both prostinoids and leukotrienes).

The nGRE inhibits the transcription of certain genes. There is also the formation of a +GRE which increases thetranscription and synthesis of lipocortin 1.

Reduction in the synthesis of:

Cytokines

COX 2

Phospholipase A2

Glucocorticoid

Glucocorticoid

receptor

nGRE

Negative

glucocorticoid

response element

Increased synthesis of

lipocortin 1

Glucocorticoid

Glucocorticoid

receptor

+GRE

Positiveglucocorticoid

response element

mRNA


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Lipocortin 1 is an endogenous anti-inflammatory agent. Normally, phospholipase A2 is inactive and must be activated for it to breakdown phospholipids into arachidonic

acid. If it were always active, cell membranes would be constantly breaking down. Lipocortin 1 binds to the inactive phospholipase A2 and keeps it inactive. Normally, inflammation will activate protein kinase C which converts lipocortin 1 into an inactive form It then releases phospholipase A2 which can now become active. Corticosteroids act to increase the synthesis of lipocortin.

Note that the inflammatory system is still active (we have done nothing to inhibit it) and so it is still acting toinactivate lipocortin. However, since at the same time, we are stimulating the synthesis of active lipocortin at a

faster rate, there will be a net increase in lipocortin levels. Lipocortin is thus more likely to hold phospholipase A2in an inactive form. Also, there is reduced synthesis of phospholipase A2 which makes it even better, because lots

of lipocortin can find and bind easily with small levels of PLA2.

Uses

Usage of these drugs are associated with a higher level and more severe adverse effects. Anti-inflammatory E.g. Asthma. Local inhalation of beclomethasone.

Topical (local)administration to a specific site E.g. On the skin, or eyes A topical administration is useful to try and diminish the systemic side effects

Rheumatoid arthritis Treated with prednisolone This is a systemic treatment and is often used only as a last resort. We tend to use NSAIDs as the first

resort.

Adverse effects

Suppression of endogenous glucocorticoid synthesis. High levels of steroids negatively feed back on the pituitary to decrease the release of ACTH from theanterior pituitary. ACTH, apart from stimulating the release of adrenal hormone, is also trophic to the

adrenal cortex. Hence, reduced ACTH will eventually lead to atrophy of the adrenal glands.

If we try to remove steroid treatment, we often get symptoms similar to a withdrawal effect, e.g. fever, muscle pain If steroid treatment is initiated, it is often for life. In order to stop treatment, we need to slowly reduce the

dosage over a long period of time to minimise withdrawal effects.

Suppression of the response to infection or injury These drugs are immunosuppressants and also suppress wound repair due to the reduction in protein

synthesis.

E.g. For an eye infection, we may treat the inflammation but the micro-organisms which caused theinflammation is still around (because the bodys immune system has not responded to eliminate the

organism) and so things can get worse. E.g. Sometimes a combination of steroid treatment with NSAIDs are given. NSAIDs may cause gastric

ulceration and GIT disorders, but the steroids only exacerbate the adverse effects of NSAIDs because they

suppress the repair of the ulcers.

The point is that we must treat the cause, not the symptoms. We may be able to treat the inflammationassociated with a wound but wi ll not get any wound repair.

Behavioural disturbances Cataract, glaucoma

An increase in intraocular pressure is the normal response to steroidal treatment. Fluid and electrolyte disturbances.

Similarity to aldosterone or cortisol increased reabsorption of Na, increased secretion of K.Metabolic effects Osteoporosis


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Muscle wasting Hyperglycemia Inhibition of bone growth in children

Steroids cause fusion of the epiphyseal plates. A lot of children are given steroids to treat asthma not good!

The use of topical steroids is more desirable to reduce the systemic effects. Both NSAIDs and steroid treatment aim to treat the symptoms (reduce pain, inflammation and discomfort),

but may not do a good job in treating the cause of the disease. Unless the cause is treated, the disease will

keep on getting worse.

Anti rheumatoid drugs

NSAIDs are the first line of defense Alternatively, specific drugs used to treat the rheumatoid arthritis can be used. These drugs do not have

general anti-inflammatory effects.

The drugs are often known as Slow acting anti rheumatoid drugs (SAARDs) or Disease modifying antirheumatoid drugs (DMARDs).

The following drugs used for rheumatoid arthritis are effective but we do not know their mechanism ofaction.

Gold compounds Aurothiomalate

Intramuscular injection Auranofin

Oral, less common lymphocyte proliferation lysosomal enzyme release superoxide production neutrophil chemotaxis IL-1 synthesis May take months to see a beneficial effect. Adverse effects:

Commonly allergic type reactions at the skin and mucous membranes Renal injury Blood dyscrasias (any adverse change in blood function)

Chloroquine Is used in the treatment of malaria An anti-inflammatory only in rheumatic disease Less adverse systemic effects but tends to seriously affect the eyes

The cornea of the patient undergoing this treatment needs to be monitoredcarefully. Retinopathy which occurs may be irreversible, causing blindness.

Very slow onset (months) Sulphasalazine

A combination of sulphonamide and salicylate A free radical scavenger?

Free radicals cause cell injury and inflammation Has marked GI irritation and so is only available with an enteric coating.

Methotrexate Immunosuppresant Folate antagonist Also used to treat cancer (see lecture enzymes 1)

Penicillamine Adverse effects similar to gold compounds. Not as effective, most probably be obsolete soon.

All these drugs are slow releases, with the effects being seen in weeks to months. Once the effects areobserved, they will slow the disease progress, not just treating the inflammation.

Due to mimicking the actions of cortisol.


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Drugs used in the treatment of gout

Gout is due to an accumulation of uric acid (a breakdown product of adenosine). High concentrations of uricacid leads to crystallisation and deposition in the synovium of joints, resulting in arthritic pain.

Acute treatment of gout involves: NSAIDs (but NOTaspirin because aspirin inhibits the excretion of uric acid) Colchicine Glucocorticoids

Chronic treatment involves: Allopurinol Colchicine Probenecid

Colchicine An antimitotic agent. It interferes with tubulin, which prevents leukocyte migration

Reduced leukocytes in the synovial joints affected by gout would reduce the pain anddiscomfort as a result of the cytokines released by neutrophils.

Can be used as an acute treatment Also can be used as a chronic treatment as prevention (prohpylacticaly) in conjunction with

allopurinol.

Allopurinol An analogue of hypxanthine It thus competitively inhibits the enzyme xanthine oxidase, preventing hypoxanthine from binding. The product of allopurinol with xanthine oxidase is alloxanthine.

Alloxanthine is an irreversible inhibitor of xanthine oxidase. Thus, there is decreased synthesis of uric acid and the concentrations fall. Probenecid

A uricosuric agent (increases the excretion of uric acid) It inhibits the tubular reabsorption of uric acid in the kidneys It has a limited use, not as effective as allopurinol It is used when a person has an inability to excrete uric acid (in most patients, an increased uric

acid is mainly due to an increase in production and so allopurinol is better suited).

Adenosine

Hypoxanthine

Xanthine oxidase

Xanthine oxidase

Uric acid

Synovial deposition

(inflammation, classically

in the big toes)

Xanthine

Pharmacology Drug List

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