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• LorazepamAtivan Hypnosis, anxiety

status epilepticus• MidazolamApo-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– ResperidoneRisperdal– Ziprasidone Geodon

Antiepileptic

• Tonic Clonic• Absence• Atonic, Myoclonic• Partial Seizure

Seizures: Anticonvulsants

Misc. AnticonvulsantsCarbamazepine TegretolGabapentin NeurontinLamotrigine LamictalLevetiracetam KeppraOxcarbazepine TrileptalPhenobarbital LuminalPregabalin LyricaPrimidone MysolineTiagabie GabitrilTopiramate TopamaxValproic Acid DepakeneZonisamide Zonergran

BenzodiazepinesClonzapam KlonopinClorazepate TranxeneDiazepam ValiumLorazepam Ativan

HydantionsEthotoin PeganioneFosphenytion CerebyxPhenytion Dilantin

SuccinimidesEthosuximide SarontinMethsuximide Celontin

Pain: Opiate Agonists

• Opioid Agonists• Codeine• Hydrocodone• Hydromorphone Dilaudid• Levorphanol Levo-

Dromoran• Morphine Roxanol,

Oxycodone OxyContin• Oxycodone w/ASA Percodan• Oxycodone w/tylenol• Oxymorphone Opana

Merperidine-Like DerivativesAlfentanil AlfentaFentanyl DuragesicMerperidine DemerolSufentanil Sufenta

Methadone-Like DerivativesMethadone Methadone

Dolophine

Other Opiate AgonistsTramadol Ultram

Misc. AnalgesicsAcetaminophen 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