drugs compilation -exam 2 Flashcards
atropine
anti muscarinic -tertiary -natural
Antidote for cholinergic agonists.!!
scopolamine
anti muscarinin
tertiary
natural
• Prevention of motion sickness.
• To block short-term memory: sometimes used in
anaesthetic procedures
homotropium
anti muscarnic
tertiary synthetic
• Used as mydriatic for fundoscopy.
• Produce mydriasis with cycloplegia.
• Preferred to atropine because of shorter
duration of action.
tropicamide
anti muscarinic
tertiary syntehtic
• Used as mydriatic for fundoscopy.
• Produce mydriasis with cycloplegia.
• Preferred to atropine because of shorter
duration of action.
benzatropine
parkinsons
anti muscarinic
Used to treat Parkinson’s disease and the
extrapyramidal effects of antipsychotic drugs.
trihexphenhydramine
anit muscarinic
Used to treat Parkinson’s disease and the
extrapyramidal effects of antipsychotic drugs.
irpratropium
anti muscarinic
Used as inhalational drugs in the treatment of
chronic obstructive pulmonary disease (COPD).
• Also used as inhalational drugs in asthma
tiotropium
anti muscarinic
Used as inhalational drugs in the treatment of
chronic obstructive pulmonary disease (COPD).
• Also used as inhalational drugs in asthma
glycopyrolate
anti muscarinic
Used orally to inhibit GI motility.
• Used parenterally to prevent bradycardia during
surgical procedures
tolteradone
anti muscarinic
Used for overactive bladder
nicotine
ganglion block prolong depolarizer
anti-nictonic >?
cholinergic agnoist
hexamethonium
nictonie receptor blocker
mecamylamine
nictone receptor blocekr
tubocurarine
non depoalrising NMJ blocker
Adjuvant drugs in anaesthesia during surgery to
relax skeletal muscle
succinylcholine
depolarizing NMJ blocker
- Rapid endotracheal intubation.
- EC
dantrolene
block succinylcholine hyperthermia
hemicholinium 3
ACh inhibitor of syntheiss
Prevents uptake of choline required for ACh
synthesis.
vesamicol
ach storage inhibitor
blocks the ACh-H+ antiporter that is
used to transport ACh into vesicles, thereby
preventing the storage of ACh.
botulinium toxin
release inhbitor of ach
Inhibits acetylcholine release. • Injected locally into muscles for treatment of several diseases involving muscle spasms. • Also approved for cosmetic treatment of facial wrinkles.
carbachol
direct cholinergic agonist
Both muscarinic and nicotinic agonist. USES • Miosis during surgery. • Reduces intraocular pressure after cataract surgery.
bethanichol
direct cholinergic agonist
Muscarinic agonist.
USES
• Postoperative and postpartum urinary retention.
• Atony of the urinary bladder.
methcholine
direct cholinergic agonist
• Muscarinic agonist.
USES
• Diagnosis of bronchial airway hyperreactivity in
subjects who do not have clinically apparent
asthma.
ach
direct cholinergic agonist
pilocarpine
direct actign alkaloids –ach agonist
• Second line agent for open angle glaucoma.
• Management of acute angle-closure glaucoma.
• Treatment of dry mouth due to radiotherapy for
cancer of head and neck.
• Treatment of dry mouth caused by Sjogren’s
Syndrome.
edrophonium
indirect ach agonist
Used in diagnosis of myasthenia gravis.
Edrophonium IV leads to rapid increase in
muscle strength.
• Used to reverse the neuromuscular block
produced by non-depolarizing muscular
blockers.
physostigmine
indirect ach agonist
Treatment of overdoses of anticholinergic
drugs.
pyridostigmine
indirect ach agonist
Treatment of myasthenia gravis.
neostigmine
indirect ach agonist
Postoperative urinary retention.
• Reversal of effects of non-depolarizing
neuromuscular blockers after surgery.
• Treatment of myasthenia gravis
melathion
indirect ach agonist
parathion
indirect ach agonist
echothiphate
indirect ach agonist
isoproterenol
non selective b agonist
direct acting
Isoproterenol may be used in emergencies to
stimulate heart rate in patients with bradycardia
or heart block.
dobutamine
selective b1 blocker
direct acting
Management of acute heart failure.
• Management of cardiogenic shock.
albuterol
b2 selective blocker
direct acting
Asthma –fast acting
solmeterol
b2 slecetive blocker
direct acting
Asthma -slow acting
formoterol
b2 slective blocker
direct acting
asthma -slow acting
phenlephrine
a1 selective blocker
direct acting
direct acting
• Nasal decongestant . Given orally or topically. • Mydriatic. • Used to increase blood pressure in hypotension resulting from vasodilation in septic shock or anesthesia. • Used to increase blood pressure and terminate episodes of supraventricular tachycardia
clonidine
a2 selective blocker
direct acting
Partial 2 agonist.
• Centrally acting antihypertensive.
• Activates central presynaptic 2-adrenoceptors.
• Reduces sympathetic outflow. This reduces
blood pressure.
• Adverse effects: lethargy, sedation, xerostomia
methyldopa
a2 selective blocker
direct acting
!!Drug of choice for treatment of hypertension
during pregnancy.!!
brimonidine
a2 selective blocker
direct acting
Given ocularly to lower intraocular pressure in
glaucoma.
amphetamine
indirect acting
releasing inhibitors
ADHD
• Narcolepsy
mehylphendiate
indirect acting
release inhibitors
- Structural analogue of amphetamine.
- Used to treat ADHD in children
tyramine
indirect acting
release inhibitors
Found in fermented foods such as ripe cheese and Chianti wine. • Normally oxidized by MAO. • If the patient is taking MAO inhibitors, it can precipitate serious vasopressor episodes
cocaine
indirect acting
uptake inhibitors
This results in potentiation and prolongation of
their central and peripheral actions
atomoxetine
indirect acting
uptake inhbitors
Indicated for the treatment of ADHD
modafenil
uptake inhibtor
indirect acting
• Used for the treatment of narcolepsy
ephdrine /pseudepdrine
mixed acting adrenergic agonist
ephdrine –Used as a pressor agent, particularly during
spinal anesthesia.
• Used in myasthenia gravis.
pseud—One of four ephedrine enantiomers.
• Available over the counter as a component of
many decongestant mixtures.
phenoxybenzamine
non selective adrenergic blocker
Used in Pheochromocytoma
• Prior to surgical removal of the tumor.
• For chronic management of inoperable
tumors.
phentolamine
non selective adrenergic blocker
Pheochromocytoma: control of hypertension
during preoperative preparation and surgical
excision.
• Diagnosis of pheochromocytoma: phentolamine
blocking test.
• Prevention of dermal necrosis after extravasation
of norepinephrine.
•!!!Hypertensive crisis due to stimulant drug
overdose. 1!!
prazosin
a1 selective adrenergic blocker
terazosin
a1 selective adrenergic blocker
Used for hypertension and BPH.
doxazosin
a1 selective adrenergic blocker
Used for hypertension and BPH.
tamsulosin
a1 selective adrenergic blocker
Tamsulosin is selective for α1A
-receptors.
• Approved for BPH.
propranolol
non selective b blocker
nadolol
non selective b blocker
timolol
non selective b blocker
lowers intraocular proessure
atenolol
b1 selective blocker
Useful in hypertensive patients with impaired
pulmonary function.
• Useful in diabetic hypertensive patients who are
receiving insulin or oral hypoglycemic agents.
metoprolol
b1 selective blocker
Useful in hypertensive patients with impaired
pulmonary function.
• Useful in diabetic hypertensive patients who are
receiving insulin or oral hypoglycemic agents.
esmolol
b1 selective blocker
For rapid control of ventricular rate in patients
with atrial fibrillation or atrial flutte
labetolol
a/b blocker
Competitive antagonist at and 1 receptors.
• More potent as a -antagonist than as an αantagonist.
• Used in hypertension.
carvidolol
a/b blocker
Has antioxidant properties.
• Used in hypertension and CHF
pindolol
partial b blocker
a methyltyrosine
inhibitor of NE synthesis
Used for management of malignant
pheochromocytoma.
• Used in preoperative preparation of patients for
resection of pheochromocytoma.
reserpine
NE storage blocker
Gradual decrease in blood pressure and slowing
of cardiac rate.
• Used in the past to treat hypertensionv
tetrabenzine
ne storage block reversible
Indicated for the treatment of chorea associated
with Huntington’s Disease.
nedocromil
histamine release inhibitor
Reduce immunologic mast cell degranulation.
• 2-agonists also appear capable of reducing
histamine release.
cromolyn
histamine release inhbitor
Reduce immunologic mast cell degranulation.
• 2-agonists also appear capable of reducing
histamine release.
chlorpheniramine
H1 antagonist -1st gen
somanifacients/motion sickness/allergic ehinitis/ utricaria
cyclizine
H1 antagonist -1st gen
somanifacients/motion sickness/allergic ehinitis/ utricaria
meclazine
H1 antagonist -1st gen
somanifacients/motion sickness/allergic ehinitis/ utricaria
dimenhydrinate
H1 antagonist -1st gen
somanifacients/motion sickness/allergic ehinitis/ utricaria
diphenhudramine
H1 antagonist -1st gen
somanifacients/motion sickness/allergic ehinitis/ utricaria
hydroxyzine
H1 antagonist -1st gen
somanifacients/motion sickness/allergic ehinitis/ utricaria
promethazine
H1 antagonist -1st gen
somanifacients/motion sickness/allergic ehinitis/ utricaria
fexofenadine
H1 antagonist -2nd gen
loratedine
H1 antagonist -2nd gen
cetirizine
H1 antagonist -2nd gen
cimitidine
H2 antagonist
Peptic ulcers: promote healing of duodenal and
gastric ulcers.
• Acute stress ulcers
• GERD: effective in prevention and treatment of
heart-burn.
rantidine
H2 antagonist
Peptic ulcers: promote healing of duodenal and
gastric ulcers.
• Acute stress ulcers
• GERD: effective in prevention and treatment of
heart-burn.
famotidine
H2 antagonist
Peptic ulcers: promote healing of duodenal and
gastric ulcers.
• Acute stress ulcers
• GERD: effective in prevention and treatment of
heart-burn.
nizatidine
h2 antagonist
Peptic ulcers: promote healing of duodenal and
gastric ulcers.
• Acute stress ulcers
• GERD: effective in prevention and treatment of
heart-burn.
sumatriptan
5-HT1d/1b agonist
migraine
metoclopramide
5-HT4 antagonist
Prokinetic agent.
• Its administration results in coordinated
contractions that enhance transit.
• The most common adverse effects are
somnolence, nervousness and dystonic reactions.
• Extrapyramidal effects and tardive dyskinesia,
although rare, may occur.
cisapride
5-HT-4 agonist
Prokinetic agent.
• Prolongs QT interval.
• Due to serious cardiac adverse effects it is no
longer generally available in the US.
• The drug is available only on a limited basis.
cyproheptadine
5-ht-2 antagonist
- Allergic rhinitis
- Vasomotor rhinitis
- Management of serotonin syndrome.
ondansetron
5-HT3 receptor antagonist
Anti-emetic.
• Particularly for the severe nausea and vomiting
that occurs with cancer chemotherapy.
egotamine
serotonin antagonist
migraine
dihydroergotamine
serotonin antagonist
migraine
bromocriptine
serotonin antagonist
hyperprolactinemia
cabergoline
serotonin antagonist
hyperprolactinemia
oxytocin
serotonin antagonist ??
postpartum hemmorhage
ergonovine
serotonin antagonist ??
postpartum hemmorhage
dignosis of variant angina
methylergonovine
serotonin antagonist ??
postpartum hemmorhage
dinoprostone
PGE2 eicosanoid
To ripen cervix at or near term.
• Abortifacient.
misorpostol
PGE1 eicosanoid
Prevention of peptic ulcers in patients taking high
doses of NSAIDs.
• To ripen the cervix at or near term.
• Management of postpartum hemorrhage.
• Abortifacient in combination with the antiprogestin
mifepristone or methotrexate
alprostadil
PGE1
eicosanoid
(keeps ductus arteriosus patent +impotence)
prostacyclin -epoprostenol
PGI2
for reducing pulmonary hypertension
To prevent platelet aggregation in dialysis
machines.
latanoprost
treatment of glaucoma
PGF2a derivative
zileuton
antagonist for 5-lipoxygenase
zafirlukast
LTD4 antagonist
furosemide
loop diuretic
Increased Ca2+ excretion • Increased Mg2+ excretion • Decreased renal vascular resistance • Increased renal blood flow • Increased prostaglandin synthesis
hydrochlorothiazide
thiazide diuretic
hypertension/heart failure/hypercalciuria/ diabetes insipidus/prementrual edema
chlorthalidone
thiazide diuretic
hypertension/heart failure/hypercalciuria/ diabetes insipidus/prementrual edema
metolazone
thiazide diuretic
hypertension/heart failure/hypercalciuria/ diabetes insipidus/prementrual edema
spironolactone
k sparing diuretics
Heart failure/hypertension/primary hyperaldosteronism/edema
epleronone
k sparing diuretics
Heart failure/hypertension/primary hyperaldosteronism/edema
amiloride
k sparing -inhibitors of Na channels
triamterene
k sparing -inhibitors of Na channels
acetazolamide
CA inhibitor
- Glaucoma
- Epilepsy (used alone or with other antiepileptics)
- Mountain sickness prophylaxis
- Metabolic alkalosis
mannitol
osmotic diuretics
Increase urine flow in patients with acute renal
failure
• Reduce increased intracranial pressure &
treatment of cerebral edema
• Promote excretion of toxic substances
conevaptan
ADH antagonist
• Euvolemic and hypervolemic hyponatremia
• SIADH (syndrome of inappropriate ADH secretion)
• Heart failure (only when benefits outweigh risks –
safety not established)
donepezil
The mainstay of therapy for patients with
Alzheimer disease is the use of centrally acting
acetylcholinesterase inhibitors
rivastigmine
The mainstay of therapy for patients with
Alzheimer disease is the use of centrally acting
acetylcholinesterase inhibitors
galantamine
The mainstay of therapy for patients with
Alzheimer disease is the use of centrally acting
acetylcholinesterase inhibitors
pralidoxime
Pralidoxime can be used as
cholinesterase regenerator –
epinephrine
Anaphylactic Shock: drug of choice.
• Acute asthmatic attacks.
• Cardiac arrest
• In Local Anesthetics: Epinephrine increases
duration of local anesthesia by producing
vasoconstriction at the site of injection
NE
Agonist at a1, a2, and b1 receptors
• Little action on b2 receptors
To treat shock because it increases vascular
resistance and therefore increases blood
pressure.
dopamine
D1>b1>a1
Vasodilation
• Increase in GFR
• Increase in renal blood flow
• Increase in sodium excretion
captopril
Hypertension (most effective in white and/or young
patients)
+ diuretic = effectiveness similar in non-black and black
patients
• Preserve renal function in patients with either diabetic
or non-diabetic nephropathy
• Effective in treatment of chronic HF
• Standard of care for patients following MI (started 24h
after end of infarction)
enalapril
Hypertension (most effective in white and/or young
patients)
+ diuretic = effectiveness similar in non-black and black
patients
• Preserve renal function in patients with either diabetic
or non-diabetic nephropathy
• Effective in treatment of chronic HF
• Standard of care for patients following MI (started 24h
after end of infarction)
lisinopril
Hypertension (most effective in white and/or young
patients)
+ diuretic = effectiveness similar in non-black and black
patients
• Preserve renal function in patients with either diabetic
or non-diabetic nephropathy
• Effective in treatment of chronic HF
• Standard of care for patients following MI (started 24h
after end of infarction)
losartan
ARBs
valsartan
ARBs
Aliskiren
renin inhibtor
verapamil
CCB (calcium channel blocker)
dilitazem
CCB
Nifedipine
CCB- dihydropyridines
Amlodipine
CCB-dihydropyridines
