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Pharmacology

  By category
Beta Adrenergic Blockers
•   Acebutolol     HTN, ventricular dsyrhythmias
•   Atenolol       HTN, angina after MI
•   Betaxolol      HTN
•   Bisprolol      HTN
•   Carteolol      HTN
•   Carvedilol     HTN, CHF, MI
•   Esmolol        SVT, HTN
•   Labetalol      HTN
•   Metoprolol     HTN, MI, angina, CHF
•   Nadolol        Angina, HTN
•   Nebivolol      HTN
•   Pindaolol      HTN
•   Penbutolol     HTN
•   Propranolol    HTN, ANGINA, MI, MIGRAINE, HSS, dysrhythmias
•   Sotalol        dysrhythmias
•   Timolol        HTN, MI, migraines
Anticholinergic Antagonist
• Atropine           pre-surgery, GI, biliary,
                     intubation
• Belladonna         indigestion, peptic ulcer,
                     nocturnal enuresis,
                     parkinsonism
•   Dicyclomine      IBS
•   Glycopyrrolate   PUD, pre-surgery
•   Mepenzolate      PUD
•   Propantheline    PUD
Adrenergic Agents
•   Albuterol          2, 4 mg tab                bronchodilator
•   Dopamine           IV 40, 80 160mg/mL         vasopressor
•   Dobutamine         IV 250 mg/20mL             cardiac stimulant/inotropic
•   Isoetherine        Inh. 1% sol                bronchodilator
•   Isoproterenol      SQ, IM, IV 1:5000          shock, digitalis toxicity,
    Metaproterenol     Aerosol .65 mg/puff        bronchodilator,
                       Neb 0.4%, ).0.6%, 5% sol
•   Metaraminol        SQ, IM, IV 10 mg/mL        vasoconstrictor, shock
•   Teburtaline        2.5, 5 mg tabs
•   Epinephrine        1:1000 in 1 mL             anaphylaxis, cardiac arrest
•   Ephedrine          SQ, IM, IV 50 mg/mL
•   25 mg cap
•   Norepinephrine     IV 1 mg/mL in 4 mL         vasoconstrictor, shock, BP
•   Phenylephrine
Cholinergic Agents
•   Ambenonium       Mytelase     tab 10mg
•   Bethanechol      Urecholine
•   Edrophonium      Tensilon     Inj. 10mg/mL
•   Guanidine        Guanidine    tab 125 mg
•   Neostigmine      Prostigmin   15 mg tab Inj. .25-
                                  .5 1mg/mL
• Physostigmine      Antilirium Inj. 1mg/mL in
                                  2mL amp
• Pilocarpine        Isopto, Carpine, Pilcar
• Pyriodostigmine    Mestinon 60 mg tab
                                  Syrup 60mg/5mL
                                  tab SR 180 mg
                                  Inj. 5 mg/mL in 2mL
Sedative-Hypnotics
• Barbiturate-benzodiazepines
• Non-barbiturate-non-benzodiazepine
• Misc. sedative-hypnotics
Sedative Hypnotic
•   Receptor Agonists:
•   Zolpidem
•   Zaleplon
•   eszopiclone
Barbiturates
•   For Sleep Disturbances:
•   Amobarbital             Amytal    Sedation, Hypnosis
•   Butabarbital            Butisol   Sedation, Hypnosis
•   Mephobarbital           Mebaral   Sedation
                                      Anticonvulsant
• Pentobarbital                       Hypnosis, Sedation
• Phenobarbital            Luminal    Sedation, Hypnosis,
                                      Anticonvulsant

• Secobarbital             Seconal    Hypnosis
Benzodiazepines
• Estazolam                Hypnosis IA
• Flurazepam     Dalmane Hypnosis LA
• Lorazepam      Ativan    Hypnosis, anxiety
                           status epilepticus
• Midazolam      Apo-Mid.. Preop, induction of
                 SA        anesthesia,
                           conscious sedation
• Quazepam       Doral     Hypnosis LA
• Temazepam      Restoril  Hypnosis IA
• Triazolam
Misc. Sedative Hypnotics
•   Chloral hydrate   Aquachloral   Sedation
•   Dexmedetomidine   Precedex      Sedation
•   Diphenhydramine   Benadryl      Sedation
•   Doxlamine         Unisom        Sedation
•   Eszopiclone       Lunesta       Hypnosis
•   Melatonin                       Hypnosis
•   Ramelteon         Rozerem       Hypnosis
•   Valerian
•   Zaleplon          Sonata        Hypnosis
•   Zolpidem          Ambien        Hypnosis
Parkinson Agents
•   MAO B Inhibitors
•   Dopamine Agonist
•   COMT Inhibitors
•   Anticholinergic Agents
Parkinson’s Agents
• MAO B Inhibitors:
• rasagiline   Azliect   Monotherapy,
               0.5, 1 mg adjunct therapy
• Selegiline   Eldepryl At breakfast & lunch
               5 mg      orally disintegrating
               1.25 mg dissolved on tongue
               16 max
               2.5 max oral disintegrating!
Parkinson’s Agents
• Dopamine Agonists:
• Apomorhine Apokyn          SQ 10 mg/mL in 2
                             mL amp and 3 mL
                             cartridges
•   Carbidopa     Sinemet
•   Levodopa      Larodopa
•   Pramipexole   Mirapex
•   Ropinirole    Requip
Parkinson’s Agents
• COMT:
• Entacapone          Comtan
   –   Inhibits metabolism of dopamine
   –   Reduce motor fluctuations
   –   Increases on time
   –   Reduces off time
   –   Always give with Carbidopa-Levodopa to reduce total daily
       dosage needed
• Stalevo is a drug with all three agents
• Diarrhea, sedation, urine discolored, chorea, confusion,
  hallucinations, orthostatic hypotension
Parkinson’s Agents
•   Anticholinergics:
•   Benztropine            Cogentin
•   Biperiden              Akineton
•   Diphenhydramine        Benadryl
•   Orphenadrine citrate   Banflex, Norflex
•   Procyclidine
•   Trihexyphenidyl        Trihexy
Antianxiety Agents
•   Benzodiazepines
•   Azaspirones
•   SSRI
•   Misc. Antianxiety Agents
•   TCA
•   Beta Blocker used too! For tachycardia, HTN
•   SRNI
Antianxiety Agents
•   Benzodiazepines:
•   Alprazolam            Xanax
•   Chlordiazepoxide      Librium
•   Clorazepate           Tranxene
•   Diazepam              Valium
•   Lorazepam             Ativan
•   Oxazepam              Serax
•   CNS depressants
•   Stimulating inhibitory neurotransmitter GABA:
•   Improves sleep disturbances, tremor, muscle
    tension!
Antianxiety Agents
•   Azaspirones:
•   Buspirone              Buspar
•   Partial serotonin & dopamine agonist
•   Acts in midbrain modulator
•   Doesn’t affect GABA receptors
•   7-10 days improvement
•   PO initially 5 mg TID and increase 5 mg Q2-3 days
•   Slurred speech, sedation, lethargy, dizziness
Antianxiety Agents
• SSRI:
• fluvxoamine         Luvox
  – Inhibit reuptake of serotonin
  – Treat OCD w/marked distress
  – Doesn't prevent obsessions & compulsions
  – Decrease in level of anxiety
Misc. Antianxiety Agents
• Hydroxyzine            Vistaril, Atarax
  – Is an antihistamine
  – Worry about slurred speech!
  – Acts in CNS to produce sedation, antiemetic,
    anticholinergic, antihistamine, antianxiety,
    antispasmodic, antiprurtic
• Meprobamate            Miltown
  – CNS to produce sedation, antianxiety, muscle
    relaxation, **decrease level of anxiety to manageable
  – Worry about slurred speech, abuse, orthostatic
    hypotension, paradoxical excitation (withhold)
Antidepressants
•   MAO Inhibitors (MAOI)
•   TCA
•   SSRI
•   SNRI
•   Misc. Agents
Antidepressants
•   MAOI:
•   Phenelzine                Nardil
•   Tranylcypromine           Parnate
•   Isocarboxazid             Marplan
•   Selegiline                Emsam
•   HTN is a serious side effect food dye
    tyramine—chocolate, cheese
Antidepressants
•   TCA (block dopamine, serotonin, norepi.)
•   Amtritriptyline
•   Amoxapine
•   Clomipramine            Anafranil
•   Desipramine             Norpramin
•   Doxepin                 Subequan
•   Imipramine              Tofranil
•   Mortriptyline           Aventyl
•   Protriptyline           Vivactil
•   Trimipramine            Surmontil
•   Serious effects tremor, numbness, parkinson’s,
    seizure, heart failure—higher the dose the lower
    seizure threshold!
Antidepressants
•   SSRI:
•   citalopram             Celexa
•   Escitalopram           Lexapro
•   Fluoxetine             Prozac
•   Fluvoxamine            Luvox
•   Paroxetine             Paxil
•   Sertraline             Zoloft
•   OCD
•   Suicidal ideation is serious don’t take MAOI or
    Lithium, Warfarin
Antidepressants
•   SNRI
•   Desvenlafaxine     Pristiq
•   Duloxetine         Cymbalta
•   Venlafaxine        Effexor big for Panic
Antidepressants
•   Misc. Agents:
•   Bupropion hydrochloride   Wellbutrin
•   Mirtazapine               Remeron
•   Nefazodone
•   Trazodone hydrochloride
Anti-manic Agents
• Lithium fall under mood disorder Mood Stabilizer
   – Eskalith
   – Lithane
• Replaces intracellular & intra-neuronal sodium, stabilizing the
  neuronal membrane
• Therapeutic Blood level
• Reduces release of norepinephrine
• Increase uptake of tryptophan (the precursor to serotonin)
• Treats acute mania
• Prophylaxis of recurrent manic & depressive episodes in Bipolar
• Maintain optimal level of functioning w/minimal exacerbations of
  mood swings
• PO 300-600 mg TID or QID
• N/V, anorexia, excessive thirst & urination, fine hand tremor
• Persistent vomiting, profuse diarrhea, hyper-reflexia, weakness,
  progressive fatigue, weight gain, Nephrotoxicity, Hyperglycemia
Antipsychotics
• Typical 1st Generation Phenothiazines
    –   Chlorpromazine     Largactil
    –   Fluphenazine       Moditen
    –   Perphenazine
    –   Prochlorperazine   Compazine
    –   Thioridazine
    –   Trifluperazine
• Thioxanthenes
    – Thiothixene          Navane
• Nonphenothiazines
    – Haloperidol          Haldol
    – Loxapine             Loxitane
    – Molindone            Moban
• Atypical 2nd Generation APA
    –   Aripiprazole       Abilify
    –   Clozapine          Clozaril
    –   Olanzapine         Zyprexa
    –   Quetiapine         Seroquel
    –   Resperidone        Risperdal
    –   Ziprasidone        Geodon
Antiepileptic
•   Tonic Clonic
•   Absence
•   Atonic, Myoclonic
•   Partial Seizure
Seizures: Anticonvulsants
Misc. Anticonvulsants            Benzodiazepines
                                 Clonzapam      Klonopin
Carbamazepine       Tegretol     Clorazepate    Tranxene
Gabapentin          Neurontin    Diazepam       Valium
                                 Lorazepam      Ativan
Lamotrigine         Lamictal
Levetiracetam       Keppra
Oxcarbazepine       Trileptal    Hydantions
                                 Ethotoin       Peganione
Phenobarbital       Luminal      Fosphenytion   Cerebyx
                                 Phenytion      Dilantin
Pregabalin          Lyrica
Primidone           Mysoline
Tiagabie            Gabitril     Succinimides
                                 Ethosuximide   Sarontin
Topiramate          Topamax      Methsuximide   Celontin
Valproic Acid       Depakene
Zonisamide          Zonergran
Pain: Opiate Agonists
•   Opioid Agonists                     Merperidine-Like Derivatives
•   Codeine                             Alfentanil        Alfenta
•   Hydrocodone                         Fentanyl          Duragesic
•   Hydromorphone           Dilaudid    Merperidine       Demerol
•   Levorphanol             Levo-       Sufentanil        Sufenta
    Dromoran
•   Morphine                Roxanol,    Methadone-Like Derivatives
    Oxycodone               OxyContin   Methadone        Methadone
•   Oxycodone w/ASA         Percodan                     Dolophine
•   Oxycodone w/tylenol
                                        Other Opiate Agonists
•   Oxymorphone             Opana
                                        Tramadol          Ultram

                                        Misc. Analgesics
                                        Acetaminophen      Tylenol
NSAID & Anti-inflammatory
•   Salicylates
     –   Aspirin             ASA
     –   Diflunisal          Dolobid
     –   Magnesium S         Doan’s
     –   Salsalate           Salsitab
•   NSAID COX-1 Inhibitors
     –   Diclofenac          Cataflam
     –   Etodolac
     –   Fenoprofen          Nalfon
     –   Flurbiprofen        Ansaid
     –   Ibuprofen           Motrin, Advil
     –   Indomethacin        Indocin
     –   Ketoprofen          Novi-Ketorolac
     –   Meclofenamate
     –   Mefenamic acid      Ponstel
     –   Meloxican           Mobic
     –   Nabumetone
     –   Naproxen            Naprosyn
     –   Oxaparozin          Daypro
     –   Piroxicam           Feldene
     –   Sulindac                       Clinoril
     –   Tolmetin
•   NSAID COX-2 Inhibitors
     – Celecoxib             Celebrex

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Pharmacology by category

  • 1. Pharmacology By category
  • 2. Beta Adrenergic Blockers • Acebutolol HTN, ventricular dsyrhythmias • Atenolol HTN, angina after MI • Betaxolol HTN • Bisprolol HTN • Carteolol HTN • Carvedilol HTN, CHF, MI • Esmolol SVT, HTN • Labetalol HTN • Metoprolol HTN, MI, angina, CHF • Nadolol Angina, HTN • Nebivolol HTN • Pindaolol HTN • Penbutolol HTN • Propranolol HTN, ANGINA, MI, MIGRAINE, HSS, dysrhythmias • Sotalol dysrhythmias • Timolol HTN, MI, migraines
  • 3. Anticholinergic Antagonist • Atropine pre-surgery, GI, biliary, intubation • Belladonna indigestion, peptic ulcer, nocturnal enuresis, parkinsonism • Dicyclomine IBS • Glycopyrrolate PUD, pre-surgery • Mepenzolate PUD • Propantheline PUD
  • 4. Adrenergic Agents • Albuterol 2, 4 mg tab bronchodilator • Dopamine IV 40, 80 160mg/mL vasopressor • Dobutamine IV 250 mg/20mL cardiac stimulant/inotropic • Isoetherine Inh. 1% sol bronchodilator • Isoproterenol SQ, IM, IV 1:5000 shock, digitalis toxicity, Metaproterenol Aerosol .65 mg/puff bronchodilator, Neb 0.4%, ).0.6%, 5% sol • Metaraminol SQ, IM, IV 10 mg/mL vasoconstrictor, shock • Teburtaline 2.5, 5 mg tabs • Epinephrine 1:1000 in 1 mL anaphylaxis, cardiac arrest • Ephedrine SQ, IM, IV 50 mg/mL • 25 mg cap • Norepinephrine IV 1 mg/mL in 4 mL vasoconstrictor, shock, BP • Phenylephrine
  • 5. Cholinergic Agents • Ambenonium Mytelase tab 10mg • Bethanechol Urecholine • Edrophonium Tensilon Inj. 10mg/mL • Guanidine Guanidine tab 125 mg • Neostigmine Prostigmin 15 mg tab Inj. .25- .5 1mg/mL • Physostigmine Antilirium Inj. 1mg/mL in 2mL amp • Pilocarpine Isopto, Carpine, Pilcar • Pyriodostigmine Mestinon 60 mg tab Syrup 60mg/5mL tab SR 180 mg Inj. 5 mg/mL in 2mL
  • 7. Sedative Hypnotic • Receptor Agonists: • Zolpidem • Zaleplon • eszopiclone
  • 8. Barbiturates • For Sleep Disturbances: • Amobarbital Amytal Sedation, Hypnosis • Butabarbital Butisol Sedation, Hypnosis • Mephobarbital Mebaral Sedation Anticonvulsant • Pentobarbital Hypnosis, Sedation • Phenobarbital Luminal Sedation, Hypnosis, Anticonvulsant • Secobarbital Seconal Hypnosis
  • 9. Benzodiazepines • Estazolam Hypnosis IA • Flurazepam Dalmane Hypnosis LA • Lorazepam Ativan Hypnosis, anxiety status epilepticus • Midazolam Apo-Mid.. Preop, induction of SA anesthesia, conscious sedation • Quazepam Doral Hypnosis LA • Temazepam Restoril Hypnosis IA • Triazolam
  • 10. Misc. Sedative Hypnotics • Chloral hydrate Aquachloral Sedation • Dexmedetomidine Precedex Sedation • Diphenhydramine Benadryl Sedation • Doxlamine Unisom Sedation • Eszopiclone Lunesta Hypnosis • Melatonin Hypnosis • Ramelteon Rozerem Hypnosis • Valerian • Zaleplon Sonata Hypnosis • Zolpidem Ambien Hypnosis
  • 11. Parkinson Agents • MAO B Inhibitors • Dopamine Agonist • COMT Inhibitors • Anticholinergic Agents
  • 12. Parkinson’s Agents • MAO B Inhibitors: • rasagiline Azliect Monotherapy, 0.5, 1 mg adjunct therapy • Selegiline Eldepryl At breakfast & lunch 5 mg orally disintegrating 1.25 mg dissolved on tongue 16 max 2.5 max oral disintegrating!
  • 13. Parkinson’s Agents • Dopamine Agonists: • Apomorhine Apokyn SQ 10 mg/mL in 2 mL amp and 3 mL cartridges • Carbidopa Sinemet • Levodopa Larodopa • Pramipexole Mirapex • Ropinirole Requip
  • 14. Parkinson’s Agents • COMT: • Entacapone Comtan – Inhibits metabolism of dopamine – Reduce motor fluctuations – Increases on time – Reduces off time – Always give with Carbidopa-Levodopa to reduce total daily dosage needed • Stalevo is a drug with all three agents • Diarrhea, sedation, urine discolored, chorea, confusion, hallucinations, orthostatic hypotension
  • 15. Parkinson’s Agents • Anticholinergics: • Benztropine Cogentin • Biperiden Akineton • Diphenhydramine Benadryl • Orphenadrine citrate Banflex, Norflex • Procyclidine • Trihexyphenidyl Trihexy
  • 16. Antianxiety Agents • Benzodiazepines • Azaspirones • SSRI • Misc. Antianxiety Agents • TCA • Beta Blocker used too! For tachycardia, HTN • SRNI
  • 17. Antianxiety Agents • Benzodiazepines: • Alprazolam Xanax • Chlordiazepoxide Librium • Clorazepate Tranxene • Diazepam Valium • Lorazepam Ativan • Oxazepam Serax • CNS depressants • Stimulating inhibitory neurotransmitter GABA: • Improves sleep disturbances, tremor, muscle tension!
  • 18. Antianxiety Agents • Azaspirones: • Buspirone Buspar • Partial serotonin & dopamine agonist • Acts in midbrain modulator • Doesn’t affect GABA receptors • 7-10 days improvement • PO initially 5 mg TID and increase 5 mg Q2-3 days • Slurred speech, sedation, lethargy, dizziness
  • 19. Antianxiety Agents • SSRI: • fluvxoamine Luvox – Inhibit reuptake of serotonin – Treat OCD w/marked distress – Doesn't prevent obsessions & compulsions – Decrease in level of anxiety
  • 20. Misc. Antianxiety Agents • Hydroxyzine Vistaril, Atarax – Is an antihistamine – Worry about slurred speech! – Acts in CNS to produce sedation, antiemetic, anticholinergic, antihistamine, antianxiety, antispasmodic, antiprurtic • Meprobamate Miltown – CNS to produce sedation, antianxiety, muscle relaxation, **decrease level of anxiety to manageable – Worry about slurred speech, abuse, orthostatic hypotension, paradoxical excitation (withhold)
  • 21. Antidepressants • MAO Inhibitors (MAOI) • TCA • SSRI • SNRI • Misc. Agents
  • 22. Antidepressants • MAOI: • Phenelzine Nardil • Tranylcypromine Parnate • Isocarboxazid Marplan • Selegiline Emsam • HTN is a serious side effect food dye tyramine—chocolate, cheese
  • 23. Antidepressants • TCA (block dopamine, serotonin, norepi.) • Amtritriptyline • Amoxapine • Clomipramine Anafranil • Desipramine Norpramin • Doxepin Subequan • Imipramine Tofranil • Mortriptyline Aventyl • Protriptyline Vivactil • Trimipramine Surmontil • Serious effects tremor, numbness, parkinson’s, seizure, heart failure—higher the dose the lower seizure threshold!
  • 24. Antidepressants • SSRI: • citalopram Celexa • Escitalopram Lexapro • Fluoxetine Prozac • Fluvoxamine Luvox • Paroxetine Paxil • Sertraline Zoloft • OCD • Suicidal ideation is serious don’t take MAOI or Lithium, Warfarin
  • 25. Antidepressants • SNRI • Desvenlafaxine Pristiq • Duloxetine Cymbalta • Venlafaxine Effexor big for Panic
  • 26. Antidepressants • Misc. Agents: • Bupropion hydrochloride Wellbutrin • Mirtazapine Remeron • Nefazodone • Trazodone hydrochloride
  • 27. Anti-manic Agents • Lithium fall under mood disorder Mood Stabilizer – Eskalith – Lithane • Replaces intracellular & intra-neuronal sodium, stabilizing the neuronal membrane • Therapeutic Blood level • Reduces release of norepinephrine • Increase uptake of tryptophan (the precursor to serotonin) • Treats acute mania • Prophylaxis of recurrent manic & depressive episodes in Bipolar • Maintain optimal level of functioning w/minimal exacerbations of mood swings • PO 300-600 mg TID or QID • N/V, anorexia, excessive thirst & urination, fine hand tremor • Persistent vomiting, profuse diarrhea, hyper-reflexia, weakness, progressive fatigue, weight gain, Nephrotoxicity, Hyperglycemia
  • 28. Antipsychotics • Typical 1st Generation Phenothiazines – Chlorpromazine Largactil – Fluphenazine Moditen – Perphenazine – Prochlorperazine Compazine – Thioridazine – Trifluperazine • Thioxanthenes – Thiothixene Navane • Nonphenothiazines – Haloperidol Haldol – Loxapine Loxitane – Molindone Moban • Atypical 2nd Generation APA – Aripiprazole Abilify – Clozapine Clozaril – Olanzapine Zyprexa – Quetiapine Seroquel – Resperidone Risperdal – Ziprasidone Geodon
  • 29. Antiepileptic • Tonic Clonic • Absence • Atonic, Myoclonic • Partial Seizure
  • 30. Seizures: Anticonvulsants Misc. Anticonvulsants Benzodiazepines Clonzapam Klonopin Carbamazepine Tegretol Clorazepate Tranxene Gabapentin Neurontin Diazepam Valium Lorazepam Ativan Lamotrigine Lamictal Levetiracetam Keppra Oxcarbazepine Trileptal Hydantions Ethotoin Peganione Phenobarbital Luminal Fosphenytion Cerebyx Phenytion Dilantin Pregabalin Lyrica Primidone Mysoline Tiagabie Gabitril Succinimides Ethosuximide Sarontin Topiramate Topamax Methsuximide Celontin Valproic Acid Depakene Zonisamide Zonergran
  • 31. Pain: Opiate Agonists • Opioid Agonists Merperidine-Like Derivatives • Codeine Alfentanil Alfenta • Hydrocodone Fentanyl Duragesic • Hydromorphone Dilaudid Merperidine Demerol • Levorphanol Levo- Sufentanil Sufenta Dromoran • Morphine Roxanol, Methadone-Like Derivatives Oxycodone OxyContin Methadone Methadone • Oxycodone w/ASA Percodan Dolophine • Oxycodone w/tylenol Other Opiate Agonists • Oxymorphone Opana Tramadol Ultram Misc. Analgesics Acetaminophen Tylenol
  • 32. NSAID & Anti-inflammatory • Salicylates – Aspirin ASA – Diflunisal Dolobid – Magnesium S Doan’s – Salsalate Salsitab • NSAID COX-1 Inhibitors – Diclofenac Cataflam – Etodolac – Fenoprofen Nalfon – Flurbiprofen Ansaid – Ibuprofen Motrin, Advil – Indomethacin Indocin – Ketoprofen Novi-Ketorolac – Meclofenamate – Mefenamic acid Ponstel – Meloxican Mobic – Nabumetone – Naproxen Naprosyn – Oxaparozin Daypro – Piroxicam Feldene – Sulindac Clinoril – Tolmetin • NSAID COX-2 Inhibitors – Celecoxib Celebrex