Drug - University of Kentucky
Drug |Class |Uses |Side effects |Features | |
| | | | | |
|Diuretics |
|Acetazolamide |Carbonic anhydrase inhibitor |(IOP (formation of aqueous humor);|Metabolic acidosis, sedation, |Crosses BBB |
| |(derivative of Sulfonamides) |epilepsy; |parasthesia, bone marrow |NOT used as diuretic! |
| | |motion sickness |suppression, allergic rxn | |
|Hydrochlorothiazide |Thiazide |Edema, HTN ((TPR) |Same as below | |
|Chlorhalidone |Thiazide-like long acting |Edema, HTN ((TPR) |Hypokalemia, (glucose tolerance, | |
|Indapamide | | |(LDL & TGs, impotence, arrhythmias| |
|Metolazone | | | | |
|Furosemide (Lasix) |Loop (rapid-acting) |Renal failure, ascites, nephrotic |Hypotension, hypokalemia, |Reversible ototoxicity |
| | |syndrome, pulmonary edema, CHF, |ototoxicity, hyperuricemia, (LDL &|(Ethacrynic acid) |
| | |HTN, hypercalcemia |(HDL hyperglycemia, arrhythmias | |
|Amiloride |K+-sparing |Modest diuretic prevents Na+ |Hyperkalemia | |
|Triamterene |(renal epithelial Na+-channel |reabsorption |CI—DM, renal failure, concurrent | |
| |inhibitors) | |ACE-inhibitors | |
|Spironolactone |K+-sparing |Combo Rx for HTN, prevent cardiac |Anti-androgen ((libido, |Prodrug metabolized to |
| |(aldosterone antagonist) |hypertrophy (aldosterone-mediated)|gynecomastia, impotence) menstrual|Canrenone |
| | | |irregularities, female hair growth| |
|Eplerenone |K+-sparing |HTN & CHF |NO androgen & progesterone side |Analog of Spironolactone |
| |(aldosterone antagonist) | |effects |Blocks aldosterone-induced gene|
| | | | |expression |
|Glycerine |Osmotic |Acute renal failure (maintain |Total electrolyte imbalance, | |
|Isosorbide | |renal BF), glaucoma ((IOP), |exacerbate CHF & pulmonary edema | |
|Mannitol | |(cerebral edema |((ECV) | |
|Urea | | | | |
| | | | | |
|CHF | | | | |
|Captopril |ACE-inhibitors |CHF & HTN ((TPR w/o (HR) |Persistent cough, angioedema, | |
|Enalapril | | |(renal fxn |Prodrug |
|Losartan |AT1-receptor blocker |1st-line CHF; HTN |Few side effects |Directly block AII activity |
|Hydralazine |Arterial-selective vasodilator |(TPR ((CO) for LV failure |Lupus-like syndrome, headache, |Combine w/ (-blocker & diuretic|
| |((cGMP) | |reflex tachycardia, Na+/H2O | |
| | | |retention | |
|Nitroprusside |Balanced vasodilator |HTN emergencies |Hypotension, cyanide poisoning |Light sensitive (short t1/2) |
| |(arterial & venous) | |(metabolized to cyanide & |Reconstituted & infused |
| | | |thiocyanate) | |
|Nesiritide |Balanced vasodilator |Decompensated CHF |Hypotension |NO tolerance |
| |B-type natriuretic peptide |(rapid (TPR) | | |
|Dopamine |Non-selective (-agonist |Decompensated CHF |Arrhythmias |IV dose (short t1/2) |
|Dobutamine |Selective (1-agonist | | | |
|Milrinone |PDE-inhibitors |Short-term for refractory CHF |Arrhythmias, GI upset, |NOT reduce morbidity & |
|Inamrinone | | |thrombocytopenia |mortality of CHF! |
| | | |(Milrinone less toxic) | |
|Carvediol |Non-selective (-blocker |CHF ((LV fxn & reverses |“Withdrawal” syndrome (rebound |Carvediol racemic mixture |
|Metoprolol |Selective (1-blocker |hypertrophy); DOC prophylaxis |tachycardia) |antioxidant & antiproliferative|
| | |stable angina | | |
|Digoxin |Cardiac glycosides |(+)inotropism & anti-arrhythmic |GI upset, visual disturbances, |t1/2=42h, renal metabolism |
|Digitoxin |(inhibit Na+/K+ ATPase) | |arrhythmias |t1/2=5d, hepatic metabolism |
| | | | | |
|Anti-ischemics |
|Metoprolol |Selective (1-blocker |DOC for stable angina prophylaxis |“Withdrawal” syndrome (rebound |(-)inotropism & |
| | | |tachycardia) |(-)chronotropism |
|Nitroglycerine |Organic nitrates |DOC for stable & variant angina |Headaches, hypotension, reflex |Spray (short onset & duration) |
| | |Prophylaxis |tachycardia |Patch (slow onset, long |
|Isosorbide dinitrate | | | |duration) |
| | | | |Tablets go bad after 6m |
|Verapamil |Ca2+-channel blocker |Angina, HTN, arrhythmias |Bradycardia, AV nodal block, |Strongest cardiac effects |
| | | |hypotension | |
|Diltiazem |Ca2+-channel blocker |NOT unstable angina |Better tolerated |Intermediate effects |
|Amlodipine |Ca2+-channel blocker |NOT unstable angina OR arrhythmias|Hypotension w/ reflex tachycardia |Strongest vasodilation |
|Nifedipine |Dihydropyridines | |((mortality), edema, headache, |Fast-release capsules |
| |(NOT cardiac Ca2+-channels) | |gingival hyperplasia | |
| | | | | |
|Anti-arrhythmics |
|Procainamide |Class IA |Ventricular tachycardia |Widened QRS complex, Lupus-like |Torsade de pointes |
|Quinidine |Blocks Na+ & K+-channels | |syndrome, bone marrow depression, | |
| | | |proarrhythmic | |
|Lidocaine |Class IB |Post-MI ventricular tachycardia; |Agitation (CNS effects), | |
|Phenytoin |Weakest Na+-channel blocker |NOT prophylaxis |proarrhythmic | |
|Flecainide |Class IC |Prophylaxis of atrial fibrillation|Very proarrhythmic |CI for structural heart dz & |
| |Strongest Na+-channel blocker | |(-)inotropism |depressed LV fxn |
|Propranolol |Class II |DOC for rate control of atrial | |(mortality following MI |
| |(-blocker |fibrillation | | |
|Amiodarone |Class III |Most arrhythmias (especially |Pulmonary toxicity, hypothyroidism|(Warfarin & Digoxin levels |
| |K+-channel blocker |structural heart dz) |OR thyrotoxicosis | |
|Sotalol |Class III |Prophylaxis of atrial fibrillation|Torsade de pointes, |ONLY for severe arrhythmias OR |
| |(-blocker & K+-channel blocker |(especially ischemic heart dz) |bronchoconstriction |low risk of proarrhythmias |
|Verapamil |Class IV |DOC for rate control of atrial | | |
| |Ca2+-channel blocker |fibrillation | | |
|Adenosine |G-protein receptor agonist |Paroxysmal supraventricular |Flushing, cardiac arrest (SA/AV |A1 (negative inotropism) |
| | |tachycardia, AV nodal reentry |nodal block), bronchoconstriction |A2 (vasodilation) |
| | |tachycardia | |A3 (histamine release) |
| | | | | |
|HTN |Diuretics, ACEIs (1st-line), AT1-blockers (1st-line), (-blockers (1st-line), Ca2+-channel blockers, (2-agonists |
|Prazosin |Selective (1-blocker |HTN w/ benign prostatic |Fluid retention, 1st-dose syncope,| |
| | |hyperplasia ((HDL & (LDL) |orthostatic hypotension | |
|Hydralazine |Arterial-selective vasodilator |Severe HTN |Lupus-like syndrome, headache, |Combo w/ (-blockers & diuretics|
| | | |Na+/H2O retention, reflex | |
| | | |tachycardia | |
|Minoxidil |Direct vasodilator |Severe HTN |Hair growth (Rogaine) |Stimulates K+ channels to |
| | | | |hyperpolarize SM |
|Nitroprusside |Balanced vasdodilator |HTN emergency (quickest onset & |Thiocyanate toxicity, (ICP |IV infusion VS. Diazoxide (IV |
| |(arterial & venous) |shortest duration) | |bolus) |
| | | | | |
|Hyperlipidemia |Combo therapy (Statin + Resin + Niacin) can (LDL >70% |
|Simvastatin (Zocor) |HMG-CoA reductase inhibitor |1st-line (LDL, (HDL, (TGs |Minimal |Lovastatin & Pravastatin |
|Atorvastatin (Lipitor) |(reversible, competitive) |Upregulate liver LDL receptors |CI—liver dz, pregnancy & nursing |prodrugs |
| | | | |Extensive 1st-pass p450 |
|Cholestyramine |BA sequestrants |Moderate (LDL (younger persons & |GI upset, reduced drug absorption |Combo w/ Statins for very high |
|Colesevelam (WelChol) |(anion exchange resins) |pregnancy), |CI—TGs >400mg/dL |LDL |
| | |slight (HDL, NO effect TGs |familial dysbetalipoproteinemia |NOT absorbed b/c so large |
|Ezetimibe (Zetia) |Selective cholesterol absorption |(LDL, (HDL, (TGs |CI—liver dz, pregnancy & nursing |NOT effect fat-soluble vitamins|
| |inhibitor |(additive effect w/ Statin) | | |
|Niacin |Nicotinic acid |Atherogenic dyslipidemia, |Flushing, hyperglycemia, gout, GI |Niaspan (extended-release) |
| | |Modest (LDL, (HDL, |upset (combine w/ ASA/NSAID or |Mono OR combo therapy |
| | |Marked (TGs |titer up) | |
| | | |CI—liver dz, PUD, gout, DM | |
|Gemfibrozil (Lopid) |Fibrates |Modest (LDL, (HDL |Dyspepsia, GI upset, gallstones, |Mono OR combo therapy |
| | |Marked (TGs |myopathy |(risk for acute pancreatitis |
| | | |CI—liver OR renal insufficiency | |
| | | | | |
|Anti-thromboembolics |
|Aspirin |Irreversible COX-1 & 2 inhibitor |MI, unstable angina, TIA, stroke |CI—ulcer, hypersensitivity, |7-10d duration |
| | | |thrombocytopenia, bleeding | |
| | | |disorder, 24h duration |
| |(oral) | |tachycardia | |
|Fexofenadine (Allegra) |2nd-generation H1-blocker |Nasal allergies, dermatoses |Minimal sedation, antimuscarinic, |1-12h duration |
| |(oral) | |NO QT prolongation | |
|Promethazine (Phenergan) |H1-blocker (less selective than |Motion sickness, vomiting |BP effects (central anti-ACh), |Combo w/ cold meds |
| |2nd-generation) | |rash, sedative |Quick onset, 2-8h duration |
| | | | | |
|GI |
|Omeprazole (Prilosec) |Proton pump inhibitors |GERD, combo therapy for H.pylori |Hypochlorhydria w/ gastric |Protonix acid stable |
|Pantoprazole (Protonix) |(selective, irreversible H+/K+ |ulcers |bacterial overgrowth, |Omeprazole inhibits drug |
| |ATPase inhibitors in gastric | |hypergastrinemia, gastric cancer |metabolism |
| |parietal cells) | |(long-term) | |
|Cimetidine (Tagamet) |Selective H2-blockers |Duodenal ulcer healing, prevent |Mental confusion, renal |Structure similar to histamine |
|Ranitidine (Zantac) |(competitive, reversible) |nocturnal acid breakthrough (some |disturbances, inhibits p450 |(basal acid secretion |
| | |PPIs) |(Cimetidine) | |
|Magnesium hydroxide (Milk |OTC antacids |Acid neutralization |GI upset, renal problems, altered |Diazepam absorption ( w/ AlOH &|
|of magnesia) | | |drug absorption |( w/ MgOH |
|Aluminum hydroxide |(Amphojel) | | | |
|Bismuth | |Mucosal protection & healing | |NOT neutralize acid |
|(Pepto Bismol) | | | | |
|Sucralfate (Carafate) |AlOH & sulfated sucrose complex |Mucosal protection, promotes PG |Constipation, altered drug |Forms viscous suspension that |
| | |synthesis |absorption |binds mucosa |
|Misoprostol (PG) |Inhibits acid production (binds |(mucosal thickness, (mucosal BF, |Diarrhea, uterine stimulant | |
| |parietal cell receptor & (cAMP) |HCO3- secretion |CI—pregnancy | |
|Metoclopramide |Serotonin receptor agonists |GERD (rarely used) |Parkinson’s-like Sx |Cisapride removed from market |
|Cisapride | | |(Metoclopramide) |for arrhythmias |
|Tetracyclines |Antibiotics |H.pylori-associated PUD |Disruption of GI flora |Triple-component regimen (TCN, |
| | | | |PPI, Bismuth, Metronidazole) |
| | | | |for 14d |
|Ondansetron (Zofran) |5-HT3-receptor blockers |N&V (esp. w/ chemo) |Constipation, diarrhea, headache, |Extensive p450 metabolism |
|Granisetron (Kytril) | | |light-headedness | |
|Metoclopramide (Reglan) |D2-receptor blocker, |N&V (esp. w/ chemo) |Extrapyramidal effects, |Promote gastric emptying |
| |5-HT3-receptor blocker, & | |restlessness, sedation, fatigue, |(peripheral) & suppress |
| |5-HT4 agonist | |nausea, diarrhea |vomiting (central) |
|Prochlorperazine |D2-receptor blocker (in CTZ) |N&V |Masks gag reflex, tranquilizer, | |
|(Compazine) | | |jaundice | |
|Sulfasalizine (Azulfidine)|5-aminosalicylates |Mild UC & IBS |Fever, malaise, N&V, headaches, |Prodrug metabolized to |
| |(inhibits arachidonic acid | |epigastric discomfort, diarrhea, |Sulfapyridine (causes SE) & |
| |metabolism, scavenges ROS, immune| |allergic rxns |5-ASA mesalamine (active |
| |effects) | | |portion) in colon |
|Prednisone |Glucocorticoids |90% remission UC & | | |
|Budenoside |(outside US) |60-90% Crohn’s dz | | |
|6-Mercaptopurine |Immunosuppressive |Severe UC & maintain UC remission |Bone marrow loss, opportunistic |May take 3-6m to work |
| |(inhibits lymphocyte | |infection, teratogenic | |
| |proliferation) | | | |
|Infliximab (Remicade) |Chimeric Ig |Crohn’s dz |SLE & lymphoma (long-term) | |
| |(binds & neutralizes TNF-() | | | |
|Entanercept (Enbrel) |Fusion protein of TNF-(R & IgG1 |Crohn’s dz | |Neutralizes TNF-( |
| |Fc portion | | | |
|Mineral oil |Stool softeners (lower ST) |Constipation | |Little efficacy |
|Docusates | | | | |
|Phenolphthalein |Diphenylmethane derivative |Constipation |Removed from market over concerns |Induce low-grade inflammation, |
| | | |w/ long-term use |fluid accumulation, & (motility|
|Bisacodyl |Diphenylmethane derivative |Constipation & pre-op colonic |Severe intestinal cramps, damaged |Stomach (>6h onset) |
| |(stimulates mucosal nerve plexus |cleanse |colonic tone (long-term) |Rectal (30-60min) |
| |of colon) | | | |
|Loperamide (Imodium) |Opioid |Diarrhea |CNS effects (overdose, esp. in |Binds peripheral (-opioid |
| |(improves anal sphincter tone) |(activity against cholera & some |kids) |receptors & relaxes intestinal |
| | |E.coli toxins) | |contractions |
|Diphenoxylate |Opioid |Diarrhea |CNS effects |Marketed w/ Atropine (Lomotil |
| |(metabolized to Difenoxin) | | |or Motofen) to discourage abuse|
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