Organism
Drug |Class |Use |Side Effects |Interactions |Other | |
|Δ9-tetrahydrocannabinol |Anandamide Receptor Agonist |“Many potential therapeutic uses” |Very low acute toxicity | |“Schedule I” |
| | | |Lung cancer, CNS, Immunosuppression | |“Little evidence for physiological dependence” |
| | | |Testosterone suppression, Fetal damage | | |
|Chlorpromazine |Phenothiazine |Sedative/Neuroleptic |PD-like, Tardive dyskinesia (chronic), | |Some Anti-Cholinergic,NE & Histamine effects |
| |(DA receptor antagonist) |(Anti-Psychotic/Schizophrenia) |Amenorrhea, Photosensitivity, Dyscrasia | |Offsets PD side effects slightly |
| | | | | |Long t1/2, Renal Elimination |
|Clonazepam |Benzodiazepine |GAD & Panic |OD & OSA |Alcohol |Dose Dependent Effects-Not CNS Depressants |
| |(↑ Frequency of GABA-A Receptors) |Panic Disorder |dependency/withdrawal |Sedatives |Require GABA to hyperpolarize; Lipophilic |
| | |Absense Seizures |Tolerance, Pregnant, Elderly |Hypnotics |Can ↓ spasms @ non-sedating dose |
|Fluoxetine |SSRI |Depression |GI,CNS Activating, Sexual, ↑ Weight |↓ P450 |Most activating (insomnia) |
|(Prozac) |(Block reuptake of 5HT) | | |TCAs |Biggest P450 Inhibitor, Worst GI |
| | | | |MAOIs |Least selective, Active metabolite, long t1/2 |
| | | | |Hypericum | |
|Meperidine |Opioid Analgesic | |Abuse potential (Schedule II) | |Parkinson’s Disease associated w/ manufacture? |
|(Demerol) |(Moderate mu & kappa agonist) | |Tolerance & Physiological Dependence | | |
| | | |Overdose & Withdrawal | | |
|Methadone |Opioid Analgesic |Prevent Opiod Withdrawal |Tolerance & Physiological Dependence | | |
| | | |Overdose & Withdrawal | | |
|Methoxyflurane |Halogenated Alkane |Anesthesia (Inhaled) |Renal Toxicity (20% mortality) |Catecholamines |Very potent, ↑ solubility, analgesic at < MAC (.16%) |
| |Anesthetic Gas | | | |good muscle relaxant except uterus |
| |(GABA Potentiation?) | | | |↑ Metabolism & ↑ F- release = renal toxicity |
|Methylphenidate |Indirect Adrenergic Agonist |ADHD, Hypotension & Narcolepsy |Abuse & Tachyphylaxis | | |
|(Ritalin) | |Promotes Release/Inhibits Reuptake |Arrythmias, Hypertension & ↑ or ↓ HR | | |
| | |(DA, NE, Serotonin) | | | |
|Methysergide |5-HT Agonist/Antagonist | |Fibrosis | |5-HT Antagonist in periphery, Agonist in CNS |
| | |Migraine Headache | | |Don’t use for > 6 mos without 3-4 week “holiday” |
| | | | | |Only for not responsive to other prophylactics |
|Midazolam |Benzodiazepine |Pre-op Anesthesia & Amnesia (IV) |Respiratory Arrest if pretreated w/ narcotic|Alcohol |Effetcts can be reversed with flumazenil |
|(Versed) |(↑ Frequency of GABA-A Receptors) |Muscle Relaxant |or COPD |Sedatives |No analgesic effects |
| | | | |Hypnotics |Ultra-short t1/2 |
|Morphine |Opiate Analgesic |Analgesic |Abuse potential (Schedule II) | |From Papaver somniferum poppy plant |
| |(Strong mu/partial kappa agonist) | |Tolerance & Physiological Dependence | | |
| | | |Overdose & Withdrawal | | |
|Naloxone |Opiate Receptor Antagonist |Opiod Overdose/Coma |Precipitate Withdrawal | |Poor GI absorption (used to prevent IV use) |
| | |Prevent Dependence Relapse | | | |
|Naltrexone |Opiate Receptor Antagonist |Alcohol Dependence |Precipitate Withdrawal | |Reduces rewarding effects of alcohol |
| | |Opiod Overdose/Coma | | |Strong at mu & kappa receptors |
| | |Prevent Dependence Relapse | | |Longer acting than Naloxone |
|Nicotine |Cholinergic |Makes teenagers look |Cancer, Bronchitis, Emphysema, Asthma | |Acutely causes nausea & vomiting |
| | |“cool & glamorous” |Arteriosclerosis, Atheroma, HT | |Smoking = “biggest health disaster of this century” |
| | | |Stroke, Thrombosis, ↓ fetal growth | | |
|Nitrous Oxide |Anesthetic Gas |Anesthesia Supplement (Inhaled) |Diffusional Anoxia | |↑ MAC (>1.0); Good analgesic < MAC (endorphins) |
| |(GABA Potentiation?) | | | |Benign to CV & Respiratory, No muscle relaxation |
| | | | | |Often combined w/ other drugs (ex. Fentanyl) |
|Nortriptyline |Tricyclic Antidepressant |Depression |Overdose | |Active metabolite of amitryptyline |
|(Pamelor) |(Block reuptake of 5HT & NE) | |Moderate sedation, anti-cholinergic, | |Long t1/2, Active Metabolite |
| |(Blocks Histamine Receptors) | |Orthostatic HT & Cardiac block, Seizures | |Mildest side effects |
|Oxazepam |Benzodiazepine |GAD & Panic |OD & OSA |Alcohol |Dose Dependent Effects-Not CNS Depressants |
| |(↑ Frequency of GABA-A Receptors) |EtOH withdrawal |Pregnant |Sedatives |Require GABA to hyperpolarize; Lipophilic |
| | | | |Hypnotics |Conjugated=Not active Short t1/2 |
|Oxycodone |Opioid Analgesic | |Abuse potential (Schedule II) |NSAID ↑ |Metabolized by CYP2D6 to morphine |
|(Percodan) |(mu agonist) | |Tolerance & Physiological Dependence | | |
| | | |Overdose & Withdrawal | | |
|Paroxetine |SSRI |Depression |GI,CNS Activating, Sexual, ↑ Weight |↓ P450 |Fewest GI effects, Most potent |
|(Paxil) |(Block reuptake of 5HT) | |Mild anti-cholinergic effects & sedation |TCAs |Worst extrapyrimidal (tremor) & sex dysfunction |
| |(Antihistamine) | |Worst withdrawal, Not for kids |MAOIs |Drug Holidays for sex dysfunction |
| | | | |Hypericum | |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Pentazocine |Opioid Analgesic | |Abuse potential (Schedule IV) | | |
| |(Partial mu agonist/kappa agonist) | |Tolerance & Physiological Dependence | | |
| | | |Overdose & Withdrawal | | |
|Phencyclidine |Dissociative Anesthetic |Veterinary Medicine |Amnesia, Confusion, Paranoia | | |
|(PCP) |(Glu/NMDA receptor antagonist) | |Delusions & Hallucinations | | |
| | | |Violence, Hyperthermia, Abuse | | |
|Phenelzine |Monoamine Oxidase Inhibitor |Atypical Depression |Overdose |Food w/ tyramine|Treat hypertensive emergency with α-blockers |
| |(Block degradation of 5HT, NE & DA) | |Tyramine causes catecholamine release |Pseudoephedrine |Short t1/2 |
| | | |Hypertensive Emergency | | |
|Phenobarbital |Barbiturate |Neonatal Seizures |Impaired Cognitive Development | |Enhances its own metabolism |
| |(↑ time of open GABA-A Receptor) |Status Epilepticus |Hyperactivity, Additive Effects | | |
| | | |Drosiness, Sedation, Addictive Potential | | |
|Phenytoin |Hydantoin |Generalized Tonic-Clonic |Crystallizes (IM), Gum Hypertrophy |Many |↓ Plasma/ ↑ Lipid Soluble, ↑ Bound |
| |(Binds Ca2+ & Na+ Channels) |Partial Seizures |Macrocytosis, GI, Sedation, NT Defects | |↑ GI Absorption, Liver Metabolism (Rate Limited) |
| |(Blocks Ca2+ influx, IPSPs) |Status Epilepticus |Allergies, Ataxia, Face & Hair Changes | |t1/2 = ~day, Variations in formulations (generics) |
|Procaine |Ester Local Anesthetic |Local & Regional |CNS & CV Effects | |Metabolized in plasma & liver by esterases |
| | | | | |Less potent & short acting, rapidly absorbed |
|Propofol |??? |Anesthesia (IV) |Egg lecithing allergies & Painful | |Rapidly acting |
| |(Not a barbiturate) |(Regional anesthesia - infusion) |Vasodilation & Hypotension | |↓ BP, RR, CO2 response & Intracranial Pressure |
| | | |Bacterial Contamination/Sepsis | | |
|Risperidone |Atypical Anti-psychotic |(Anti-Psychotic/Schizophrenia) | | |↓ Extrapyramidal effects |
| |(5HT & DA receptor antagonist) | | | |Long t1/2, Renal Elimination |
| | | | | |No agranulocytosis |
|Selegiline |MAO-B Inhibitor |Parkinson’s Disease Treatment |GI, CNS, dry mouth | |Metabolized to amphetamine |
| |(Selective inhibitor of DA metabolism) | |Abuse Potential | | |
| | | |Insomnia & Psychosis | | |
|Sertraline |Selective Serotonin Reuptake Inhibitor |Depression |GI,CNS Activating, Sexual, ↑ Weight |↓ P450 |Drug Holidays for sex dysfunction |
|(Zoloft) | |(Neurovegetative = 2 weeks) | |TCAs |Least P450 Inhibitor, Least Drug Interactions |
| | |(Cognitive = 4 weeks) | |MAOIs | |
| | | | |Hypericum | |
|Sevoflurane |Halogenated Alkane |Anesthesia (Inhaled) |Airway Irritation | |Very rapid onset & recovery, |
| |Anesthetic Gas | |Dose dependent hypotension | |Hepatic metabolism & F- release; ↓ renal toxicity |
| |(GABA Potentiation?) | | | |Less airway irritation & no tachycardia |
|Sumatriptan |Triptan |Migraine Headache |Coroncary Vasospasm |Ergotamine |Structurally similar to Serotonin |
| |(Selective 5-HT Agonist) |(SubQ or Nasal Spray) |(Not for CV Disease or HBP) |MAOI |Faster onset than DHE, but higher recurrence |
| | | | |SSRI | |
|Tetracaine |Ester Local Anesthetic |Local & Regional |CNS & CV Effects | |10X more potent than procaine, |
| | | |(10X more toxic than Procaine) | |Slower onset, longer duration |
|Thiopental |Barbiturate |Anesthesia Induction (IV) |Hyperalgesia | |Ultra short acting, redistributed to tissue from brain|
| |(↑ time of open GABA-A Receptor) | |Painful tissue necrosis | |Rapidly acting (seconds) |
|Thioridazine |Phenothiazine |Sedative/Neuroleptic |PD-like, Tardive dyskinesia (chronic), | |Reduced sedative & extrapyramidal side effects |
| |(DA receptor antagonist) |(Anti-Psychotic/Schizophrenia) |Amenorrhea, Photosensitivity, Dyscrasia | |Increased anticholinergic effects |
| | | | | |Long t1/2, Renal Elimination |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Tolcapone |COMT Inhibitor |Parkinson’s Disease Treatment | | |Increases L-DOPA available to brain |
| |(Increase L-DOPA availability) | | | |Crosses BBB; Reduces side effects? |
|Topiramate |Sulfamate Monosaccharide |Partial Seizures + Jacksonian |Somnolence & Fatigue |Phenytoin ↓ |An adjunct, |
| |(Binds Ca2+ & Na+ Channels) | |Impaired concentration/mental slowing |Carbamezapine ↓ |Not metabolized, renal clearance (good for liver tox) |
| |(Binds GABA-A / Blocks Glu) | |Renal Stones, Paresthesias, ↓ Appetite | |↓ bound, t1/2 = ~20 hrs |
|Trazodone |SSRI |Depression |GI,CNS Activating, Sexual, ↑ Weight |↓ P450 |Short t1/2 |
| |(Block reuptake of 5HT) | | |TCAs |Used as sedative/hypnotic in elderly |
| | | | |MAOIs | |
| | | | |Hypericum | |
|Triazolam |Benzodiazepine |Hypnotic |OD & OSA, Rebound Insomnia & REM |Alcohol |Dose Dependent Effects-Not CNS Depressants |
| |(↑ Frequency of GABA-A Receptors) |(Sleep onset) |Tolerance , Amnesia & violence |Sedatives |Require GABA to hyperpolarize; Lipophilic |
| | | |Worst dependency/withdrawal |Hypnotics |Highest Potency, Short t1/2 |
|Trihexyphenidyl |Muscarinic Antagonist |Parkinson’s Disease Treatment |PNS & CNS | | |
| | | |Can cause glaucoma crisis (↑ IOP) | | |
| | | |Not for Heart Disease or GI Obstruction | | |
|Valproic Acid (Valproate) |Branched Chain Fatty Acid |Absence & Myoclonic Seizures |NT Defects, GI, Liver Necrosis |↑ Phenobarbitol |↑ GI Absorption, 90% Bound, Highly Soluble |
| |(Binds Ca2+ & Na+ Channels) |Generalized Tonic-Clonic, Migraines |Ataxia & Tremor | |t1/2 = ~10 hrs, Oxidation metabolism |
| |(↑ GABA concentrations) |Reflex Epilepsy, Partial Seizures | | |Renal elimination |
|Zolpidem |Non-Benzodiazepine |Selective Insomnia |Dizziness, Headache, Confusion |Alcohol |Quick onset, short t1/2 |
|(Ambien) |(GABA-A Receptors in CNS) | | | |↓ Anxiolytic, anti-convulsant, muscle relaxant effect |
| | | | | |Minimal rebound insomnia |
|Atracurium |Nondepolarizing NMJ Antagonist |Long Acting NMJ Block |Less – Spontaneous Hydrolysis | |Safe with compromised renal or liver function |
| | |Short Onset | | |Hoffman/Plasma Esterase elimination |
|Atropine |Muscarinic Antagonist |AChE Inhibitor Antidote |PNS & CNS | |Mad, Hot, Blind, Dry, Red |
| |(Jimson weed) |Inhibits M receptors in PNS/CNS |Can cause glaucoma crisis (↑ IOP) | |Treat OD with physostigmine |
| | | | | |Crosses BBB |
|Bethanechol |Muscarinic Agonist |Increase Urinary & GI motility |Some PNS activity (not heart) | |Long acting (not metabolized by ChE) |
| | | | | |Possibly selective for M4 |
|Cyclopentolate |Muscarinic Antagonist |Produce mydriasis & cycloplegia |Few side-effects | |Duration of 24 hours |
| | | |Minimally absorbed after instillation | |Doesn’t Cross BBB |
|D-Tubocurarine |Nondepolarizing NMJ Antagonist |Block NMJ (40 min duration) |Histamine Release, Hypotension | |Not active orally, Excreted unchanged in urine |
| | | |(Blocks ganglia) | |Causes Histamine Release |
| | | | | |↓ MAC of inhalational anesthetics |
|Dobutamine | | | | |Not given orally - metabolized |
| |Adrenergic Agonist |CHF & Shock | | |No effect on DA1 receptors |
| | | | | |+ = β1 & β2 agonist / - = α1 agonist |
|Echothiophate |Irreversible ChE Inhibitor |Long acting Glaucoma treatment |Cataracts, CNS, PNS, SNS, NMJ effects | |Long duration of action |
| | | | | |May cause cataracts |
| | | | | |Crosses BBB |
|Edrophonium |Reversible ChE Inhibitor |Curare poisoning |PNS, SNS, NMJ effects | |Doesn’t Cross BBB |
| | |Diagnostic for M. Gravis | | | |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Hexamethonium |Ganglionic Antagonist |Rapidly Reduce Blood Pressure |Orthostatic Hypotension | |Excreted unchanged in urine |
| |(Competitive Nicotinic Blocker) | |Side effects similar to atropine | |Doesn’t Cross BBB |
|Glycopyrrolate |Muscarinic Antagonist |Dry secretions for intubation |Mainly PNS | |Doesn’t Cross BBB |
| | |Inhibit PNS muscarinic receptors |Can cause glaucoma crisis (↑ IOP) | | |
|Isoflurophate (Dfp) |Irreversible ChE Inhibitor |Prolonged Miosis |CNS, PNS, SNS, NMJ effects | |Crosses BBB |
|Isoproterenol |Adrenergic Agonist |Bronchodilation | | |Not given orally – metabolized |
| |(β Agonist only) | | | |Minimal effect on Blood Pressure |
|Neostigmine |Reversible ChE Inhibitor |Myasthenia Gravis |PNS, SNS, NMJ effects | |Poorly absorbed orally |
| | |Increase Urinary & GI motility | | |Agonistic at nicotinic receptors |
| | | | | |Doesn’t Cross BBB |
|Pancuronium |Nondepolarizing NMJ Antagonist |Longer DOA than Curare |Histamine Release, Tachycardia | |Less Histamine Release/Doesn’t block ganglia |
| | |Blocks M2 Receptors | | |4X more potent than D-Tubocurarine |
|Parathion |Irreversible ChE Inhibitor |Insecticide |CNS, PNS, SNS, NMJ effects | |Crosses BBB |
|Phenoxybenzamine | |Pheochromocytomas | | | |
| |Irreversible α1 & α2 antagonist | | | | |
|Phentolamine |Nonselective α1 & α2 antagonist |Pheochromocytomas | | | |
| |(Competitive) | | | | |
|Phenylephrine |Phenethylamine |Opthalmologic - Mydriasis | | | |
| |(Direct α1 agonist) | | | | |
|Physostigmine |Reversible ChE Inhibitor |Atropine Poisoning |CNS, PNS, SNS, NMJ effects | |Crosses BBB |
| | |Decrease IOP (miosis) | | | |
|Pilocarpine |Muscarinic Agonist |Glaucoma Emergency |PNS activity, CNS effects, Sweating | |DOC for Immediate Lowering of IOP |
| | |Sustained release for glaucoma | | | |
|Pirenzepine |M1 Selective |Peptic Ulcers |No effect on heart or CNS | |M1>M3>M2 |
| |Muscarinic Antagonist | | | |↓ Gastric Secretion without ↑ HR |
| | | | | |Doesn’t Cross BBB |
|Pralidoxime (2-Pam) |Organophosphate Antidote |AChE Inhibitor Antidote | | |Works by nucleophilic attack |
| | |Reactivates ChE | | |Must be used quickly |
|Prazosin |Selective α1 antagonist |Hypertension |Edema – need to take a diuretic | |Potential benefit for heart, lipids & prostate |
| |(Competitive) |(Vasodilation without ↑ HR) |↑ risk of cardiac event | |ALLHAT study indicates heart risk |
| | |↑ HDL & ↓ LDL / ↓ BPH |Postural Hypotenstion & Syncope | | |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Propranolol | β1 & β2 antagonist | |Airway Disease Exacerbation | |1st Clinical Approved Beta Blocker |
| |(Nonselective Prototype) | |↑ Peripheral Vascular Disease | |May ↑ Triglycerides & ↓ HDL |
| | | |Diabetic Hypoglycemia; ↓ CNS Fxn | | |
|Scopolamine |Muscarinic Antagonist |Motion sickness |PNS & CNS | |Crosses BBB |
| | |Pre-anesthetic/Sleep aid |Can cause glaucoma crisis (↑ IOP) | | |
|Soman |Irreversible ChE Inhibitor |Nerve Gas |CNS, PNS, SNS, NMJ effects | |Crosses BBB |
|Succinylcholine |Depolarizing NMJ Antagonist |Short Term NMJ Blocker |↑ K+, Muscle Pain | |Potentiated by AChE Inhibitor – not reversed |
| | |No long term use |Malignant Hyperthermia | |Not metabolized by AchE |
| | | | | |↓ MAC of inhalational anesthetics |
|Trimethaphan |Ganglionic Antagonist |Rapidly Reduce Blood Pressure |Orthostatic Hypotension | |Doesn’t Cross BBB |
| |(Competitive Nicotinic Blocker) | |Side effects similar to atropine | | |
|Tropicamide |Muscarinic Antagonist |Produce mydriasis & cycloplegia |Few side-effects | |Duration of 6 hours |
| | | |Minimally absorbed after instillation | |Shortest t ½ of any ophthalmologic drug |
| | | | | |Doesn’t Cross BBB |
|Acetaminophen |Central COX Inhibitor |Antipyretic & Analgesic |Hepatic Toxicicty (esp. with alcohol) | |Not an NSAID; Poorly inhibits COX |
| | |(Useful when aspirin contraindicated) | | |No platelet function |
| | | | | |No effect on acid/base or uric acid |
|Allopurinol |Xanthine Oxidase Inhibitor |Severe Gout & Renal Stones |Nausea, Vomiting, Diarrhea, BM Allergies |Probenecid | |
| | | |May induce Gout, BM Depression | | |
| | | |Hepatic/Renal Toxicity, Cataracts | | |
|Aspirin |NSAID |Integument Analgesic, Migraine |Not for use with Peptic Ulcers; Reye’s | |COX Inhibitor (Covalently modifies COX1 & COX2) |
| |(Carboxylic Acid – Salicylate) |Antipyretic, Antiinflammatory (↑ dose) |Tinnitus, Deafness, Vertigo | |Suicide Inhibitor of COX1 & stimulator of LOX |
| | |Anticoagulant, Colon Cancer, MI |Alkalosis,Acidosis,Fever, Dehydration | |Highly Dose Dependent – Not for Gout! |
|Celecoxib |NSAID |Rheumatoid | | |Reduced gastric toxicity |
| |(Selective COX2 Inhibitor) |Osteoarthritis | | | |
| |(1st Gen) | | | | |
|Colchicine |Plant Alkaloid |Gout Diagnosic |Diarrhea, Nausea, Vomiting, Hair Loss | |Relieves pain & inflammation of gout, not analgesic |
| |(Autumn Crocus) |Gout (Inflammation Relief) |Abdominal Pain, BM Suppression | |Inhibits tubulin polymerization/LTB4 (Neutrophils) |
| | |Given 24 hrs) | |Reduce glucagons; Increase Insulin binding |
| |(Blocks ATP K+ Channels) |(Oral) |Not for renal/hepatic disease | |Well absorbed from GI, bound to plasma proteins |
| | | |Not for pregnant | |Liver metabolism, renal excretion; Longest DOA |
|Cholecalciferol |Vitamin D | | | | |
|Cyproterone | | | | | |
|Demeclocycline | |Syndrome of Inappropriate | | |Inhibits response to ADH in collecting duct |
| | |ADH Secretion | | | |
| | |(Excess ADH Production) | | | |
|Desmopressin Acetate |Hormone |Diabetes Insipidus |Excess H2O retention/ Intoxication | |V1 = s. muscle contraction; V2 = Renal Conservation |
| |Binds V1 & V2 Receptors |(Inadequate ADH Release) |Intestinal cramping, vasoconstriction | |Cutaneous Hyperstimulation |
| | |Oral or Nasal Spray |Not for CAD or Renal Failure | | |
|Desogestrel |Synthetic Progesterone | |↓HDL:LDL, Impaired Glucose Tolerance | | |
| | | |Spotting, weight gain, acne, hirsutism | | |
|Dexamethasone |Glucocorticoid Receptor Agonist |Neoplasms |Osteoporosis, Glucose Intolerance, | |High Potency, Little effect on MR |
| | | |Cataracts, Myopathy, Manic/Depression | |Better than prednisone for treating ALL |
| | | |↑BP, Ulcers, Body Fat, ↓ Growth | | |
|Dihydrotachysterol |Vitamin D Analog |Hypoparathyroidism (DOC) | | |Faster onset, shorter DOA than D2 or D3 |
| | |Pseudohypoparathyroidism (Albrights) | | | |
|Equilin Sulfate |Conjugated Estrogen |Hormone Replacement Therapy | | |Enterohepatic circulation |
|Ethinyl Estradiol |Synthetic Estrogen |Oral Contraceptives |Thrombosis, Breast & Cervical Cancer |Smoking |Enterohepatic circulation |
| | | |↑BP, ↓ Glucose Tolerance, Stroke & MI | |Side Effects: GI Upset, Fluid Retention, Spotting |
| | | |Gallbladder Disease, | | |
|Etidronate |Bisphosphonate |Osteoporosis |Induce osteomalacia (stop mineralization) | |Inhibit resorption – bind hydroxyapatite |
| | |Paget’s Disease | | | |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Finasteride |4-aza testosterone analog |Prostate Cancer | | |Competetively Inhibits Type II 5α Reductase |
| | |BPH | | | |
| | |Alopecia | | | |
|Fludrocortisone |Mineralocorticoid Agonist |Mineralocorticoid Deficiency |Hypertension | |10X higher affinity for MR than GR |
| | | |Hypokalemia | |Monitor plasma BP & renin |
| | | | | |Alternate day therapy |
|Flutamide |Non-steroidal anti-androgen |Metastatic Prostate Cancer | | |Blocks action of testosterone at receptor |
| |(Androgen Receptor Blocker) |BPH (not FDA approved) | | |Most effective when combined with Leuprolide |
|Ganirelix |GnRH Antagonist |Hypergonadotropism | | | |
|Glipizide |2nd Generation Sulfonylurea |Type II DM |Hypoglycemia (mimics CVA) | |Reduce glucagons; Increase Insulin binding |
| |(Blocks ATP K+ Channels) |(Oral) |Not for renal/hepatic disease | |Well absorbed from GI, bound to plasma proteins |
| | | |Not for pregnant | |Liver metabolism, renal excretion; |
|Glucagon | | | | | |
|Glyburide |2nd Generation Sulfonylurea |Type II DM |Hypoglycemia (mimics CVA) | |Reduce glucagons; Increase Insulin binding |
| |(Blocks ATP K+ Channels) |(Oral) |Not for renal/hepatic disease | |Well absorbed from GI, bound to plasma proteins |
| | | |Not for pregnant | |Liver metabolism, renal excretion; Smaller dose |
|Gonadorelin Acetate |GnRH Agonist | | | | |
|Insulin Glargine |Hormone |Diabetes |Hypoglycemia & Weight Gain |Heart Medicines |Better absorption than ultralente, 24 hr DOA |
|(Lantus) |(Long Acting Insulin) |(SubQ) |Insulin Allergy; Lipo-atrophy/hypertrophy |Ethanol |Once daily dose at bedtime |
| | | |Insulin Edema |Salicylates |Can’t be mixed with other insulins |
| | | | |Pentamidine | |
| | | | |Hormones | |
|Insulin Lispro |Recombinant Hormone |Diabetes |Hypoglycemia & Weight Gain |Heart Medicines |2 aa’s switched in β chain; less hypoglycemia |
|(Humalog) |(Ultra-Short Acting Insulin) |(SubQ) |Insulin Allergy; Lipo-atrophy/hypertrophy |Ethanol |mimic’s normal response, dose right before meal |
| | | |Insulin Edema |Salicylates | |
| | | | |Pentamidine | |
| | | | |Hormones | |
|Hydrocortisone |Natural Hormone |1) Topical |Osteoporosis, Glucose Intolerance, | |Low potency |
| | |2) Replacement Therapy |Cataracts, Myopathy, Manic/Depression | |Equally effective on GR & MR |
| | | |↑BP, Ulcers, Body Fat, ↓ Growth | | |
|Lente Insulin |Hormone |Diabetes |Hypoglycemia & Weight Gain |Heart Medicines | |
| |(Intermediate Acting Insulin with Zinc) |(SubQ) |Insulin Allergy; Lipo-atrophy/hypertrophy |Ethanol | |
| | | |Insulin Edema |Salicylates | |
| | | | |Pentamidine | |
| | | | |Hormones | |
|Levonorgestrel |Synthetic Progesterone | |Androgenic | |Most potent; Longer t1/2 |
| | | |↓HDL:LDL, Impaired Glucose Tolerance | | |
| | | |Spotting, weight gain, acne, hirsutism | | |
|Levothyroxine Sodium | |Hypothyroidism (DOC) |Avoid with Elderly & Heart Disease |Ca2+ |Longer Duration |
| | |Thyroid Replacement |Arrythmias & Nervousness |Fe2+ |Take on empty stomach |
| | | | |AlOH | |
|Liothyronine Sodium | |Myxedema Coma | |Ca2+ |Rapid Onset |
| | |(Oral & IV) | |Fe2+ |Take on empty stomach |
| | | | |AlOH |Higher cost |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Liotrix | | | |Ca2+ |Take on empty stomach |
|(T3 & T4 Mixture) | | | |Fe2+ | |
| | | | |AlOH | |
|MedroxyProgesterone |Synthetic Progesterone | | | |Longer t1/2 |
|(Depro-Provera) | | | | | |
|Metformin |Biguanide |Type II DM |Diarrhea, Anorexia, ↓ B12 & Folate | |Alone or Combined; Slowly escalate dose |
|(Glucophage) |(Inhibits Gluconeogenesis) |(Oral) |Not for lactate (renal, CHF, lung, liver) | |No ↑ wt (may ↓); ↑HDL ↓LDL; Intestinal Absorption |
| | | |Don’t use with contrast dye or Creat >1.5 | |Doesn’t bind plasma proteins; short t1/2 |
|Methimazole |Thiureylenes | | | |Inhibits oxidation & coupling |
| |(Inhibit Thyroidperoxidase) | | | | |
|Metyrapone |Selective P-450c11 Inhibitor |Diagnostic Test of Adrenal Function | | |Selectively inhibits cortisol production |
| |(Inhibits 11β-Hydroxylase) | | | | |
|Micronized Progesterone |Natural Hormone |IM | | |Rapidly absorbed & metabolized to pregnanediol |
|Mifepristone |Synthetic Progesterone |Abortion | | |Can only be used up to 7 weeks of pregnancy |
|(RU-486) |Glucocorticoid Receptor Blocker |Cushing’s Disease | | |Used in Cushing’s if etiology unknown |
|Miglitol |Alpha-Glucosidase Inhibitor |Type I & II DM | | |Monotherapy or Combined |
| |(Inhibits α-glucosidase) |(Oral) | | |Better tolerated than Acarbose |
| |(Blocks carb/starch absorption) | | | | |
|Norethindrone |Synthetic Progesterone | |Androgenic | |Potent; Longer t1/2 |
| | | |↓HDL:LDL, Impaired Glucose Tolerance | | |
| | | |Spotting, weight gain, acne, hirsutism | | |
|Norgestimate |Synthetic Progesterone | |↓HDL:LDL, Impaired Glucose Tolerance | | |
| | | |Spotting, weight gain, acne, hirsutism | | |
|NPH Insulin |Hormone |Diabetes |Hypoglycemia & Weight Gain |Heart Medicines | |
| |(Intermediate Acting Insulin) |(SubQ) |Insulin Allergy; Lipo-atrophy/hypertrophy |Ethanol | |
| | | |Insulin Edema |Salicylates | |
| | | | |Pentamidine | |
| | | | |Hormones | |
|Octreotide |Synthetic Somatostatin Analog |GH Excess-Acromegaly |Diarrhea & Nausea | |Bind Somatostatin Receptor on Pituitary Tumor |
| | |SubQ & IM |Gallstones | |↓ GH Secretion & Tumor Size |
| | | | | |Only effective on tumors with high #s of receptor |
|Pegvisomant |GH Antagonist |GH Excess |Abnormal Liver Tests (Reversible) | |Action independent of tumor properties |
| | | | | |Inhibits receptor dimerization |
| | | | | |Monitor efficacy with IGF-1 |
|Pentamidine |??? |AIDS |1º = Hyperglycemia | |Destroys Pancreatic β-Cells |
| | | |2º = Hypoglycemia (loss if insulin) | | |
|Pergolide |D2 receptor agonist |Hyperprolactinemia |GI Upset, CNS, Insomnia | |Cheaper than Bromocriptine |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Pioglitazone |Thiazolinedione (2nd gen Glitazone) |Type II DM | | | |
| |(Increases # of Glut Transporters) |(Oral) | | | |
|Prednisone |Glucocorticoid Receptor Agonist |Acute Eczema (oral), Ulceraritve |Osteoporosis, Glucose Intolerance, | | |
| | |Colitis |Cataracts, Myopathy, Manic/Depression | | |
| | |Graft Rejection, Neoplasms |↑BP, Ulcers, Body Fat, ↓ Growth | | |
| | |Multiple Sclerosis, Crohn’s Disease | | | |
|Propylthiouracil |Thiureylenes |Hyperthyroidism |Agranulocytosis | |Inhibits oxidation, coupling & deiodination |
| |(Inhibit Thyroidperoxidase) | |BM Suppression | |Used prior to surgical removal or radiation |
| |(Inhibits Deiodinase D1) | |Rash, Liver Damage | | |
|Raloxifene |Selective Estrogen Receptor Modulator |Osteoporosis | | |No evidence of breast/endometrial cancer |
| | | | | |Avoids effects of 17β |
|Regular Insulin |Hormone |Diabetes & Ketoacidosis |Hypoglycemia & Weight Gain |Heart Medicines |Treat Ketoacidosis with low dose infusion |
| |(Short Acting Insulin) |(IV or SubQ) |Insulin Allergy; Lipo-atrophy/hypertrophy |Ethanol |Treat with IV before surgery or childbirth |
| | | |Insulin Edema |Salicylates | |
| | | | |Pentamidine | |
| | | | |Hormones | |
|Repaglinide |Meglitinide (Glitinide) |Type II DM |Hypoglycemia, Hyperinsulinemia | |More potent if glc is only moderately elevated |
| |(Blocks ATP K+ Channels) |(Oral) |GI (uncommon) | |Rapid onset, short DOA, taken before meals |
| | | | | |Metabolized in liver; “Dose & Eat” |
|Rosiglitazone |Thiazolinedione (2nd gen Glitazone) |Type II DM |URIs | |Once Daily Dosing; Monotherapy or combined |
| |(Increases # of Glut Transporters) |(Oral) |Headaches | |Requires liver testing; ↑HDL ↓LDL |
| | | |Weight gain | |Delayed onset of effect; No hepatotoxicity |
|Sermorelin Acetate |Synthetic GHRH |Dwarfism |Headaches, Vomiting, Intracranial HT | |Less effective than Somatriptan |
| | |(SubQ) |Edema, Myalgia, Arthralgia | |Effective in children only |
| | | | | |Cheaper than somatropin |
|Somatropin |Recombinant Human |Dwarfism/GH Deficiency |Headaches, Vomiting, Intracranial HT | |Effective in children & adults |
| |Growth Hormone | |Edema, Myalgia, Arthralgia | | |
|Tamoxifen |Cancer Chemotherapeutic |Mammary Carcinoma |Changes in fat distribution, muscle mass | |Competitive Inhibitor of estrogen receptors |
| |Hormone/Antihormone | |Osteoperosis | |Given for metastases |
| |Estrogen Deprivation | |Hot Flashes/Nausea | | |
|Tolbutamide | | | | | |
|Triamcinolone Aceonide |Glucocorticoid Receptor Agonist |Asthma (Inhaled) |Osteoporosis, Glucose Intolerance, | |Medium Potency, Little effect on MR |
| | |Periarticular Inhection (Long duration)|Cataracts, Myopathy, Manic/Depression | |Highly metabolized |
| | |Intralesional & Joint Injections |↑BP, Ulcers, Body Fat, ↓ Growth | | |
|Ultralente |Hormone |Diabetes |Hypoglycemia & Weight Gain |Heart Medicines |Insulin Isophane |
|(Insulin Isophane) |(Long Acting Insulin with Zinc) |(SubQ) |Insulin Allergy; Lipo-atrophy/hypertrophy |Ethanol |(Ultralente) |
| | | |Insulin Edema |Salicylates | |
| | | | |Pentamidine | |
| | | | |Hormones | |
|Vitamin D |Vitamin |Rickets/Osteomalacia | | |Same as Calcitriol? |
| |(↑ Ca2+/P Intestinal Absorption) | | | | |
| |(↑ Ca2+ Bone Absorption) | | | | |
|Activated Charcoal | | | | | |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Calcium Disodium EDTA |Chelator |DOC for Lead > 45 υg/dL |Nephrotoxic (RT necrosis) | |1º therapy for lead poisoning (follow w/ succimer) |
| | |Iron & Zinc | | |↓ toxicity by adequate hydration & treat < 5 days |
| | |(IV) | | | |
|Deferoxamine |Chelator |Acute Iron Poisoning |Skin reactions | |Poorly absorbed from GI |
| | |(Parenteral) |Neuro, hepato & renal toxicity | | |
| | | |Histamine & Hypotensive shock | | |
|Dimercaprol |Chelator |Arsenic & Acute Mercury |Painful Injection, Tachycardia, ↑ BP | |Unstable & Toxic |
| | | |N&V, ↑ Prothrombin time | |Low Therapeutic efficacy |
| | | |Avoid with Cadmium & Iron (renal failure) | | |
|Fomepizole |Alcohol Dehydrogenase Inhibitor | | | | |
|(4-Methylpyrazone) | | | | | |
|Ipecac | | | | | |
|Methanol |Alcohol | |Metabolic acidosis & Blindness (Formate) | |Rx = emesis/lavage, NaBicarbonate, EtOH or Fomepizole |
| |(Industrial, Sterno, Moonshine) | | | | |
|N-Acetylcysteine | | | | | |
|D-Penicillamine |Chelator |Copper |Nephrotoxicity | |Well absorbed in GI (1º advantage) |
| | |Adjunct for gold, lead, arsenic |Autoimmune (SLE & hemolytic anemia) | | |
|Succimer |Chelator |DOC for Lead |GI Distress, CNS effects, skin rash | |More water soluble than Dimercaprol |
| | |Also good for arsenic and mercury |Liver enzyme elevation | |High therapeutic index |
| | | | | |Well absorbed from GI Tract |
|Carbon Monoxide |Air Pollutant | |Tissue Hypoxia (brain & Heart) | |Combines with hemoglobin, ↓ O2 capacity of RBC |
| | | |Mild CNS effects at 30-50% | |Hallmark is pink-cherry red skin |
| | | |↓pulse & respiration at 60-70% | |Rx = Relieve ischemia & Pure O2 (Hyperbaric) |
|Sulfur Dioxide |Air Pollutant | |↑ # mucous cells, secretion | |Forms sulfurous acid on contact w/ membranes |
| |(Fossil Fuels) | |Bronchoconstriction | |Rx = Remove from exposure, provide relief |
|Nitrogen Oxide |Air Pollutant | |Deep irritation & pulmonary edema | |Rx = Reduce irritation & edema |
| |(Fires, Silage, kerosene) | |Irritation to eyes, nose & throat | | |
|Ozone |Air Pollutant | |Shallow rapid breathing, Cough | |Rx = Reduce inflammation & edema |
| |(UV Light) | |Decrease in pulmonary compliance, pulmonary | | |
| | | |edema, bronchitis | | |
|Arsenic |Heavy Metal | |Acute = Death, corrosive to GI, bleeding | |Colorless and tasteless |
| |(Environment or Industry) | |Rice water stool; Chronic = skin changes, BM| |Interacts with sulfhidryl groups |
| | | |Depression & cancer | |Interferes with Pyruvate Dehydrogenase/TCA Cycle |
|Cadmium |Heavy Metal | |Inhaled = Pulmonary Edema, emphysema, | |Inhibits sulfhidryl groups (α-1-antitrypsin) |
| |(Manufacturing & Fossil Fuels) | |nephrotoxicity; Oral = osteomalacia | |Only 5% GI absorption |
| | | | | |Rx = Chelators ineffective, Give Vitamin D |
|Lead |Heavy Metal | |Acute = (rare) Colic & CNS changes | |Binds Sulfhidryl (ALA Dehydratase); Replaces Ca2+ |
| |(Paint) | |Chronic = neuropathy, anorexia, anemia, | |Rx: >45 = chelation, Et Glycol>EtOH>IPA |
| | | | | |↑ Anion gap |
| | | | | |Rx = avoid stimulants, correct electrolytes/sugar |
|Methanol |Alcohol | |Metabolic acidosis & Blindness (Formate) | |Rx = emesis/lavage, NaBicarbonate, EtOH or Fomepizole |
| |(Industrial, Sterno, Moonshine) | | | | |
|Ethylene Glycol |Alcohol | |Calcium Oxalate damge to kidneys | |Metabolites more toxic than parent |
| |(Antifreeze) | |Pulmonary edema, CHF, Tachycardia | |Inhibits oxidative phosphorylation |
| | | |Renal Failure, N/V | |Rx = NaBicarb, ethanol or fomepizole |
|Hydrocarbons |Hydrocarbons | |Pulmonary(worst): Pneumonitis, Hemorrhagic | |Halogenated Hydrocarbons sensitize heart to |
| | | |bronchopneumonia, CNS, GI, Hepatic & Heart | |catecholamines & arrythmias |
| | | | | |Rx: prevent aspiration, emesis, support |
|Acetylcholine |Muscarinic/Cholinergic Agonist |None - naturally occuring |Hypotension, Multiple PNS Effects | |Not effective orally - short duration (ChE) |
|Atropine |Muscarinic Antagonist |AChE Inhibitor Antidote |PNS & CNS | |Mad, Hot, Blind, Dry, Red |
| |(Jimson weed) |Inhibits M receptors in PNS/CNS |Can cause glaucoma crisis (↑ IOP) | |Treat OD with physostigmine |
| | | | | |Crosses BBB |
|Nicotine |Ganglionic (Nicotinic) Agonist |Low Dose: Stimulate ganglia |CNS (stimulate or depress), PNS, NMJ | |Metabolized by liver, Excretion pH dependent |
| | |High Dose: Block ganglia |Stimulates Carotid Body Receptors | |Crosses BBB |
|Epinephrine |Adrenergic Agonist |Anaphylaxis |Low Dose: Vasodilation ( β2) | |Not given orally – metabolized |
| | |Shock & Bronchodilation |High Dose: Vasoconstriction (α) | |DOC for anaphylaxis |
| | | |Can cause hypertension | | |
|Norepinephrine |Adrenergic Agonist |Limited clinical use |Can cause hypertension | |Not given orally - metabolized |
| |(Low affinity for β2) |(Neurotransmitter) | | | |
|Dopamine |Adrenergic Agonist |CHF & Shock |Arrythmias & ↑ TPR (OD) | |Not given orally - metabolized |
| |DA1> β1> α1> α2 |Renal vasodilation ( DA1) | | |Short t ½ |
| | |↑ Myocardial contraction (not rate) | | | |
|LMW Heparin |Anticoagulant |Clotting | | |↑ inhibition of Xa, ↓ inhibition of Thrombin |
| |(Heparin) | | | |Easier administration (subQ), no APTT |
| | | | | |↑ t1/2 , renal elimination, ↓ thrombocytopenia |
|Vasopressin |Natural Hormone |Diabetes Insipidus |Excess H2O retention/ Intoxication | |V1 = s. muscle contraction; V2 = Renal Conservation |
| |Binds V1 & V2 Receptors |(Inadequate ADH Release) |Intestinal cramping, vasoconstriction | | |
| | | |Not for CAD or Renal Failure | | |
| | | | | | |
|Drug |Class |Use |Side Effects |Interactions |Other |
|Ferrous gluconate |Anti-Anemic |Anemia |Fewer than ferrous sulfate |Vitamin C ↑ |More expensive, Complex preparations |
| |(Iron – Organic Salt) | | |Milk ↓ |Empty stomach = ↑ absorption, side effects |
| | | | |Antacids ↓ |Absorbed in duodenum & jejunum |
| | | | |Tetracycline ↓ | |
|Hydroxycibalamin |Vitamin |Megaloblastic Anemia | | |Only organic compound with metal-carbon bond |
|(Vitamin B12) | | | | |Absorbed in ileum |
|Folic Acid |Vitamin |Megaloblastic Anemia | |Contraceptives ↓|Absorbed in jejunum |
| | | | | | |
| | | | |Antifolates ↓ | |
| | | | |Anticonvulsants | |
| | | | |↓ | |
| | | | |Antiepileptics ↓| |
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