drug classes Flashcards
Steroid
Biologically active organic compound with four rings arranged in a specific molecular configuration
Two principle biological functions : important component of cell membranes which alter membrane fluidity, signaling molecules
Opiod
Produces morphine-like effects
Medically for pain relief
Cannabinoid
Part of the endocannabinoid system found in cells that alter neurotransmitter release in the brain
Calcium channel blocker
For cardiac conductive pathways, cardiac muscle cells, and vascular smooth muscle cells
In heart: reduce force of contraction, reduce o2 demand
In vascular smooth muscle: reduce vasoconstriction, increase blood supply
> Disrupts the movement of calcium through calcium channels
SE’s: Bradycardia, AV block, palpitations, hypotension, GI disturbance, oedema, H/A, dizziness, fatigue
Used as antihypertensive drugs (decrease blood pressure in patients w hypertension)
- Verapamil (treatment of high blood pressure, angina, supraventricular tachycardia, prevention of migraines and cluster H/A)
- Diltiazem
- Amlodipine
- Felodipine
- Lacidipine
- Lercanidipine
-Nicardipine
- Nifedipine
-Nimodipine
ACE inhibitor
Treats HBP and heart failure via vasodilation
Relaxes blood vessels, decreases blood volume that then lowers blood pressure and decreased oxygen demand from the heart
- Captopril
- Enalapril
- Lisinopril
- Ramipril
First dose hypotension, postural hypotension, renal dysfunction, hyperkalaemia, cough
Depressant/ central depressant
Downers, lowers level of arousal by lowering neurotransmission levels that reduces stimulation in various areas of the brain
Anti-diabetic medication
Lowers glucose level
- Insulin
- Exenatide
- Liraglutide
- Pramlintide
Reuptake inhibitor
Reuptake modulator that inhibits the plasmalemmal transporter-mediated reuptake a neurotransmitter from the synapse into the pre-synaptic neuron. This leads to an increase in extracellular concentrations of the neurotransmitter and an increase in neurotransmission
Antihypertensive drug
Seeks to prevent the complications of high blood pressure, such as stroke and myocardial infarction.
Thiazide
Sulfur-containing organic molecules + a class of diuretics Based on benzothiadiazine
Enzyme inhibitor
Decreases enzyme activity, can kill a pathogen or correct a metabolic imbalance
Psychoactive drug
Changes brain function and results in alterations in perception, ood, consciousness, cognition or behavior
Receptor antagonist
> Dampens a biological response by binding to and blocking a receptor r
- Alpha blockers
- Beta blockers
- Calcium channel blockers
Sedative
> Reduces irritability or excitement, CNS depressant and interacts with brain activity causing its deceleration
Benzodiazepine
> Psychoactive drugs - fusion of a benzene ring +diazepine ring that potentiate the effect of GABA
Treats anxiety, epilepsy, muscle spasm, alcohol withdrawal, insomnia, sedation
Should be limited to short term use
SE’s: Drowsiness and poor concentration
-Diazepam
-lorazepam
-Nitrazepam
-Temazepam
-Midazolam
Analgesic / painkiller
Used to achieve pain relief using PNS and CNS
Barbiturate
CNS depressant , ranges from mild sedation to death
Agonist
Chemical that binds to a receptor and causes an action
Anabolic-androgenic steroid
Natural androgens like testosterone / synthetic androgens to have similar effects
Stimulant
Increases CNS
Pleasurable and invigorating, sympathomimetic effect
Synthetic cannabinoid
Molecules that bind to the same receptors to which cannabinoids in cannabis plants THC and CBD attach
Beta blocker
Manages abnormal heart rhythms and angina, prevents second heart attacks
- Atenolol
- Propanolol
Enzyme
Macromolecular biological catalysts that converts molecules into products
Angiotensin II receptor blocker
Pharmaceuticals that modulate the renin–angiotensin system
Treats hypertension, diabetic neuropathy, congestive heart failure
Antibiotics / antimicrobial
Antimicrobial substance active against bacteria
> For respiratory or skin infections including sepsis or meningitis or h.pylori
- Cephalosporins (For septicaemia, pneumonia, meningitis, biliary-tract infections, peritonitis, UTI) (2nd & 3rd generation include cefotaxime and ceftriaxone for meningitis)
- Tetracycline (SIDE: diarrhea, upset stomach, sore mouth, skin color change, rectal/vagina itch)
- Penicilin V, amoxicillin, ampicillin, flucloxacilin (B-lactam antibiotic, taken orally)
Benzylpenicilin (via IV) - Erythromycin
- Gentamycin
- Tetracyclines
- Chloramphenicol
- Metronidazole (interacts w alcohol causing severe flushing, H/As, dizziness, nausea, vomiting, breathlessness, increased heartbeat. Used for anaerobic and protozoal infections like leg ulcers, bowel infections, h.pyloric eradication, giardiasis)
- Tetracyclines Doxycycline ( used in GUM for chlamydia and is also anti-malarial)
- Chloramphenicol (for life-threatening infections, commonly as eye drops for conjunctivitis, rarely orally d/t bone marrow toxicity)
Amoxiclav - Combined pill to fight bacteria resistance (Amoxicilin + clavulanic acid)
Antidepressant
Treats major depressive disorder, some anxiety disorders, some chronic pain conditions, and to help manage some addictions
Side effects: Dry mouth, weight gain, dizziness, headaches, sexual dysfunction
Anticonvulsant/ anti-epileptic/ anti-seizure
Treats epileptic seizures, bipolar disorder, borderline personality disorder (mood stabiliser), neuropathic pain
- Topirimate (Taken by mouth; treats generalised and focal epilepsy, prevent migraine, helps alcohol dependence)
- Phenytoin (Side effect: limb malformation for the pregnant’s future kid)
- Sodium valproate (Teratogenic, requires monitoring of effective contraception, liver function and CBC)
- Lamotrigine (Partial & tonic-clonic)
- Carbamazepine (Focal seizure & tonic-clonic)
- Lithium ( L.Chloride/ L.Carbonate as mood stabiliser for bipolar disorder or acute manic; Metabolism: Renal) (SE’s: Tremor, polydipsia+uria, GI disturbance, taste disturbance, weight gain, thyroid disturbance, hyperparathyroidism, renal impairment)
Hormone
Signaling molecules, produced by glands in multicellular organisms, that are transported by the circulatory system to target distant organs to regulate physiology and behavior
Designer drug
Designed to mimic the pharmacological effects of the original drug, while avoiding classification as illegal and/or detection in standard drug tests
Anti-inflammatory
Remedying pain by reducing inflammation as opposed to opioids, which affect the CNS to block pain signaling to the brain
Nonsteroidal anti-inflammatory (NSAIDs)
> Reduce pain, decrease fever, prevent blood clots and, in higher doses, decrease inflammation > SE's: Haemorrhage or fluid overload with liver disease, affect prostaglandin synthesis that's also involved in regulation of renal blood flow that reduces renal function causing acute tubular necrosis, causing hyperkalaemia >GI tract ulcers > Heart attack - Naproxen - Aspirin - Diclofenac - Flurbiprofen - Ibuprofen (safe for breastfeeding) - Celecoxib
Inhalant
Broad range of household and industrial chemicals whose volatile vapors or pressurized gases can be concentrated and breathed in via the nose or mouth to produce intoxication, in a manner not intended by the manufacturer
- Nitrates (vasodilation of coronary arteries, used in angina and heart failure)
Statin
AKA HMG-CoA reductase inhibitors
Lipid-lowering medications that reduce illness and mortality in those who are at high risk of cardiovascular disease (blocks synthesis of lipid)
SE’s: Muscle pain, weakness, cramps, rhabdomyolysis
The major concern when using a statin-fibrate combination is the potential increased risk for myopathy and rhabdomyolysis
Dissociative
Hallucinogen which distort perceptions of sight and sound and produce feelings of detachment – dissociation – from the environment and self. This is done through reducing or blocking signals to the conscious mind from other parts of the brain.
Anti-coagulant
> Mechanism: Vitamin K cycle
Blood thinners
Reduces clotting time
Treats liver disease
- Heparin (strong, needs continuous blood tests)
- Warfarin (affected by vit K in diet, bruises easily, X for pregnancy so change to heparin) (Contraindications: risk of major bleeding eg asymptomatic active peptic ulcer, aneurysms// severe hypertension, recent surgery or stroke, renal or hepatic impairment, hypersensitivity like heparin induced thrombocytopenia, osteoporosis w prolonged heparin use)
- Rivaroxaban (newer, better bc 1 dose only required, taken orally)
- Apixaban
- Aspirin
- Clopidogrel
Proton-pump inhibitor
> Pronounced and long-lasting reduction of stomach acid production
Irreversible inhibitors of parietal cell proton pump, secretes H+ ions into gastric lumen
SE’s: Generally well tolerated, diarrhea, skin rash, H/A
Used in GORD, dyspepsia, peptic ulceration
- Omeprazole
- Lansoprazole
- Pantoprazole
- Rabeprazole
- Esomeprazole
Hallucinogen
Psychoactive agent which most likely causes hallucinations, perceptual anomalies, and other substantial subjective changes in thoughts, emotion, and consciousness
Types: psychedelics, dissociatives and deliriants
Antipsychotic
AKA neuroleptics or major tranquilizer to relieve symptoms of psychosis in the short term
Manages schizophrenia and bipolar disorder
SE’s: Extrapyramidal eg Parkinsonian, dystonia + dyskinesia, akathisia meaning restlessness, tardive dyskinesia// Hyperprolactinaemia meaning dopamine inhibiting prolactin release leading to sexual dysfunction, reduced bone mineral density, menstrual disturbance, breast enlargement, galactorrhoea// Cardiovascular SE// Hyperglycaemia + weight gain// Neuroleptic malignant syndrome
- Chlorpromazine
- Haloperidol
- Olanzapine
Antiviral
Treats viral rather than bacterial infections
- Reverse transcriptase (inhibited by Zidovudine for HIV)
- DNA polymerase (Viral DNA replication inhibited by Aciclovir from herpes drug class)
Narcotic
Any psychoactive compound with sleep-inducing properties
Associated with opiates and opioids, commonly heroin and morphine, any compound from raw opium latex
Anesthetic
Induce temporary loss of sensation or awareness
Nootropic
Smart drugs//cognitive enhancers
Serotonin reuptake inhibitor
Blocks action of the serotonin transporter. This in turn leads to increased extracellular concentrations of serotonin and, therefore, an increase in serotonergic neurotransmission.
Selective serotonin reuptake inhibitor (SSRI) - better tolerated and safer in overdose than TCAs
Antidepressants in the treatment of major depressive disorder and anxiety disorders SE's - nausea, diarrhea, H/A, insomnia, agitation, discontinuation symptoms, increased risk of bleeding (old ppl esp) when taken with NSAIDs - Lexapro - Fluoxetine - Fluvoxamine - Paroxetine (most SE prone) - Sertraline - Citalopram - Venflafaxine - Duloxetine - Flupenthixol - Vortioxetine
Corticosteroid
Steroid hormones that are produced in the adrenal cortex of vertebrates
- Prednisolone (steroid medication for some allergies, inflammatory conditions, autoimmune disorders, and cancers e.g. adrenocortical insufficiency, high blood calcium, rheumatoid arthritis, dermatitis, eye inflammation, asthma, & MS; Taken orally, injection into a vein, as a skin cream & as eye drops)
- Beclometasone dipropionate
- Budesonide
- Circlesonide
- Fluticasone propionate
- Mometasone furoate
Anti-epileptic drug decrease effect of corticosteroid
Liver disease
Hypnotic / Soporific
Sleeping pills, psychoactive drugs whose primary function is to induce sleep and to be used in the treatment of insomnia, or for surgical anesthesia.
Related to sedatives.
Anxiolytic
Inhibitis anxiety
Contrasts anxiogenic agents (increases anxiety)
Opiate
Drug derived from opium
Alkaloid compounds naturally found in the opium poppy plant Papaver somniferum
- Ioperamide (relatively selective to GI tract, may cause drowsiness and nausea)
Psychedelic drug
Triggers psychedelic experiences via serotonin receptor agonism, causing thought and visual/auditory changes, and altered state of consciousness
- Mescaline
- Lysergic acid diethylamide
How are drugs handled by the body?
Dose administration > Absorption distribution > adequate concentration in target tissues > effects > elimination
Administration methods
Oral, sublingual, rectal, inhalation, injection (intravenous, subcutaneous, intramuscular, intrathecal), other epithelial surfaces (eg skin, cornea, vagina, nasal mucosa)
Triptans
Serotonin receptor agonists
Contraindicated in CVD & some migraines - hemiplegic
- Sumitriptan (oral, subcut or intranasal)
Tri-cyclic antidepressants (TCAs)
> Unlicensed lower dose for neuropathic pain and migraine prophylaxis
Characteristics: Blocks a-adrenoceptors // anticholinergic (SE’s dry mouth, constipation, urinary symp, sexual dysfunction, mydriasis, glaucoma) // antihitaminergic // sedative
SE’s: Fatigue, hypertension, oedema, restlessness, stomatitis, postural hypotension esp in elderly, cardiac tachyarrthmias in overdose, palpitations
- Amytriptylline (SE’s: Dry mouth, sedation, dizziness, nausea) also used for GI problems or tension headache
- Nortriptyline
- Imipramine
- Clomipramine
Serotonin-1b and Serotonin-1d Receptor Agonist
- Sumatriptan (for migraine and cluster H/A; taken by mouth, nose or subcut inject.)
Monoamine oxidase inhibitors (MAOIs)
SE’s: Hypertensive crisis related to amine-containing food or drugs like cheese, meat, yeast extract, red wine
- Tranylcypromine
- Phenelzine
- Isocarboxazid
β 2 (beta 2) adrenergic receptor agonists
> Results in bronchodilation, vasodilation, increased HR, visceral smooth muscle relaxation, glycogenolysis, muscle tremor
Used for asthma and reversible component of COPD
SE’s: hypokalaemia
Usually inhaled
SABAs : Salbutamol, terbutaline, fenoterol
LABAs : Salmeterol, formoterol
Anticholinergic
> Blocks parasympathetic nervous system (vasoconstriction via Ach neurotrans.)
Reduces excessive bronchial secretion
Treats acute and chronic asthma, COPD
- Ipratropium bromide
- Tiotropium
SE’s: Constipation, cough, diarrhoea, dry mouth, GI motility disorder, H/A, sinusitis
Methylxanthine
- Theophyllines (SE’s : GI)
Mucolytics
For COPD with chronic cough productive of sputum
Selective phosphodiesterase-4 enzyme inhibitor
- Roflumilast (for severe COPD)
Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor
- Aciclovir
Macrolides
Site: Bacterial ribosomes > Useful for pts w penicillin allergy - Erythromycin -Clarithromycin - Azithromycin
Cardiac glycoside
- Digoxin (For atrial fibrillation as it slows AV conduction, increases refractory period, acts on Na/K-ATPase of cell membrane) (SE’s: GI disturbance, arrhythmias, conduction disturbance, dizziness, xanthopsia, blur vision)
Diuretics
> Result in salt+water loss from body
Used for heart failure (reduced oedema) and hypertension
Increased urinary freq, incontinence, sleep disruption
- Thiazide diuretics (may cause erectile dysf. and affect glucose tolerance from long term use)
-Furosemide
Antacids
> Symptom relief in early dyspepsia,GORD
> Reaction liberates CO2 (burps)
H2 receptor antagonists
Reduce parietal cell acid secretion Generally well tolerated, may cause diarrhea, dizziness, h/a - Ranitdine - Cimetidine - Famotidine - Nizatidine
Anti-emetic
- Cyclizine (H1 receptor antagonist) for motion sickness, may cause drowsiness
- Domperidone (D2 receptor antagonist) may cause dystonic changes, gynaecomastia, menstrual changes
- Metoclopramide (Same as domperidone)
- Ondansetron (5HT3 receptor antagonist) used with cytotoxic drugs
Nitrates
For angina (Vasodilation of coronary arteries)
For heart failure (Vasodilates to reduce preload)
SE’s: Postural hypotension, tachycardia, headache, dizziness
For constipation
- Bulk laxatives - polysaccride polymers not broken down higher in GI tract
Slower to act e.g. Ispaghula husk - Osmotic laxative - increase osmotic load drawing fluid into the lumen, e.g. lactulose (disaccharide) - may cause abdominal cramps
- Stool softeners e.g. Docusate
- Stimulant laxatives e.g. senna or bisacodyl
For IBD
> Crohn’s disease (mouth to anus); ulcerative colitis (colon only)
Characterised by inflammation
Glucocorticoids for acute inflammation, orally or rectally
- Aminosalicylates e.g. Mesalazine (acute attacks to main remission in UC and some CDs, reduces need for steroids)
- Immunosupressants e.g. ciclosporin, azathioprine (main adverse effect bone marrow suppression causing increased risk of infection, anaemia, thrombocytopenia etc
For diabetes
- decrease gluconeogenesis, increase insulin sensitivity, increase peripheral utilization of glucose, increase fatty acid oxidation, decrease absorption of glucose from GI tract
Short acting: Human actrapid, Humulin S
Intermediate acting: Human Insulatar, Humulin I
Oral antidiabetic drugs: Biguanides (metformin) , sulphonylureas, and other antidiabetics
Biguanides
METFORMIN
Drug of choice bc of weight loss, fewer hypo events and cardiovascular benefit
May provoke lactic acidosis especially with pts that develop degrees of renal impairment
Should not be used in patients with even mild renal impairment
Sulphonylureas
> Stimulate insulin secretion from beta cells
Require functioning B-cells, therefore useful in early diabetes
May cause hypoglycaemia persisting for hours (uncommon)
Stimulate appetite and therefore often cause weight gain
Gi upset
Allergic skin rashes and rarely bone marrow damage
[Interactions] >Increased hypoglycaemic effect with alcohol, anti-diabetic drugs, some antibiotics, antifungals, okra
- Gliclazide
- Glimepiride
- Glipizide
- Tolbutamide
Glitazones (Diabetes type 2 treatment)
- Pioglitazone
> Slow onset action (months)
> Reduce hepatic glucose output, increase glucose uptake into muscle
> Reduce endogenous insulin needed to maintain blood glucose
[Mechanism] > Bind to receptor on nuclei of adipose, muscle and fat cells, binding effects DNA transcription, producing products important in insulin signally
> SE’s: Weight gain, fluid retention
> Increased risk of bone fracture, heart failure, and bladder cancer
Gliptins (Diabetes type 2 treatment)
> Inhibitors of enzyme dipeptidyl peptidase 4 (DPP-4)
SE’s: GI (common), rashes, risk of certain infection, liver disease, back pain, arthralgia
- Sitagliptin
- Saxagliptin
- Vildagliptin
- Linagliptin
- Alogliptin
Acarbose (Diabetes type 2 treatment)
> Alpha glucosidase inhibitor
Delays digestion and absorption of starch and sucrose
Used alone or together with antidiabetics like metformin
SE’s: Flatulence, diarrhea