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REVIEW OF PHARMACOLOGY & ESSENTIAL REVISION NOTES BY NAJEEB KHAN

RAPID REVIEW
&
ESSENTIAL REVISION NOTES
OF
PHARMACOLOGY
EDITION -1


NAJEEB KHAN
SHIRAZ SIDDIQ ALI




REVIEW OF PHARMACOLOGY & ESSENTIAL REVISION NOTES BY NAJEEB KHAN




TO OUR PARENTS WHO TAUGHT US TO HELP AND TEACH OTHERS

THIS BOOK IS BASICALLY DESIGNED FOR THE REVISION PURPOSES OF
PAHRMACOLOGY AND RAPID REVIEW FOR PREPARATION OF EXAMS.

THIS BOOK FEATURES:
1) MNEMONICS ( upto 100 )
2) DRUG CLASSIFICATIONS
3) DRUGS OF CHOICE USED IN DIFFERENT CONDITIONS
4) REVIEW OF ANTI-MICROBIAL DRUGS
5) NAME OF DRUGS TO BE REMEMBER

MY SPECIAL THANKS TO
DR RAHEEM.UD.DIN (MBBS. MD. MCPS. DCTC)
DR SIRAJ.UD.DIN (MBBS. FCPS. MRCP)
DR THAMIE GUL (MBBS. MD)
REVIEW OF PHARMACOLOGY & ESSENTIAL REVISION NOTES BY NAJEEB KHAN

Page 1

MNEMONICS
Red man syndrome - Vancomycin
Red/Purple glove syndrome - Phenytoin
Red coloured urine - Rifampin
Red colour Amniotic fluid - Abruptio placenta
Cherry Red colour - Carbon monoxide poisonin
______________________________________________________________________________
Warfarin (coumadin), and some related important information.
Warfarin (coumadin) is an anticoagulant drug, which means it works by preventing the blood
from clotting (secondary homeostasis), it's considered as vitamin K reductase inhibitor, so what is
vitamin K reductase to begin with! it's basically an enzyme that is responsible to return vitamin K
from it's "INACTIVE" form to the "ACTIVE" one, because vitamin K works in the clotting
process by converting the clotting factor "X, IX, VII, II" from their "INACTIVE" form to the
"ACTIVE" one, so when we inhibit the vitamin K reductase enzyme, the consumed vitamin K
will not return to it's active form, and that will decrease the clotting factors which are dependent
on it (X, IX, VII, II), in other words the clotting mechanism will stop.
It's worth mentioning that the clotting mechanism involves three pathways, the extrinsic, the
intrinsic, and the common pathway, the extrinsic involves factor VII,
______________________________________________________________________________
drug causing leucopenia
Anti-inflammatory: gold , penicillamine and naproxin.
Antithyroid: propylthiouracil and carbimazol
Antimicrobials : penicillins, cephalosporins and sulphonamides
Anticonvulsants: sodium valproate , carbamazepine and phenytoin
Anti arrythmias: quinidine and procainamide
Antihypertensives: captopril enalpril and nifidipine
Antimalarials: chloroquine pyrimethamine sulfadoxine and dapson
Antideppressants: amitriptyline mianserin
Others cemetidine ranitidine and zudovodine........
_______________________________________________________________________

Page 2

Uses of chloroquine:
My RED LIP
M:malaria
R:rheumtoid arthrhtis
E:extra intestinal amoebiasis
D:discoid lupus L:lepra reactions I:infectious mononucleosis
P:photogenic reaction)
______________________________________________________________________________
Its very Important To Know The Contraindicated Drugs During Breast feeding...
BREAST
B= Bromocriptine/benzodiazepines
R= Radioactive isotopes/ Rizatriptan
E= Ergotamine/ Ethosuximide
A= Amiodarone/ Amphetamine
S= Sex steroids/ Stimulant luxatives
T= Tetracycline/ Tretinoin
_________________________________________________________________________
NSAIDs: contraindication
Nursing & pregnancy
Serious bleeding
Allergy\ Asthma\ Angioedema
Impaired renal function
Drug (anticoagulant)
_____________________________________________________________________________
ACE Inhibitors contraindications
-PARK
Pregnancy
Allergy
Renal artery stenosis
K + increase

Page 3

Beta-blockers:
nonselective beta-blockers"Tim Pinches His Nasal Problem"
(because he has a runny nose...):
Timolol, Pindolol, Hismolol, Naldolol, Propranolol
______________________________________________________________________________
Antibiotics contraindicated during pregnancy MCAT:
Metronidazole, Chloramphenicol, Aminoglycoside, Tetracycline
____________________________________________________________________________
Propythiouracil (PTU):
Mechanism It inhibits PTU:
Peroxidase/ Peripheral deiodination
Tyrosine iodination Union (coupling)
______________________________________________________________________________
Warfarin: metabolism SLOW:
Has a slow onset of action.
A quicK Vitamin K antagonist, though.
Small lipid-soluble molecule
Liver: site of action
Oral route of administration.
Warfarin

Monoamine oxidase inhibitors:
Members "PIT of despair":
Phenelzine
Isocarboxazid
Tranylcypromine
A pit of despair, since MAOs treat depression
______________________________________________________________________________

Page 4

Amiodarone: action, side effects 6 P's:
Prolongs action potential duration
Photosensitivity
Pigmentation of skin
Peripheral neuropathy
Pulmonary alveolitis and fibrosis
Peripheral conversion of T4 to T3 is inhibited -> hypothyroidism
____________________________________________________________________________
Steroids: side effects BECLOMETHASONE:
Buffalo hump
Easy bruising
Cataracts
Larger appetite
Obesity
Moonface
Euphoria
Thin arms & legs
Hypertension/ Hyperglycaemia
Avascular necrosis of femoral head
Skin thinning
Osteoporosis
Negative nitrogen balance
Emotional liability
______________________________________________________________________________
Hepatic necrosis: drugs causing focal to massive necrosis
"Very Angry Hepatocytes":
Valproic acid
Acetaminophen
Halothane
____________________________________________________________________________

Page 5

Zero order kinetics drugs (most common ones) "PEAZ (sounds like pees) out a constant amount":
Phenytoin
Ethanol
Aspirin
Zero order
Someone that pees out a constant amount describes zero order kinetics (always the same amount
out)
Sodium valproate: side effects VALPROATE:
Vomiting
Alopecia
Liver toxicity
Pancreatitis/ Pancytopenia
Retention of fats (weight gain)
Oedema (peripheral oedema)
Appetite increase
Tremor
Enzyme inducer (liver)
______________________________________________________________________________
Osmotic diuretics: members GUM:
Glycerol
Urea
Mannitol
______________________________________________________________________________
Anesthesia: 4 stages "Anesthesiologists Enjoy S & M":
Analgesia
Excitement
Surgical anesthesia
Medullary paralysis



Page 6

Benzodiazepenes: drugs which decrease their metabolism
"I'm Overly Calm":
Isoniazid
Oral contraceptive pills
Cimetidine
These drugs increase calming effect of BZDs by retarding metabolism
____________________________________________________________________________
Gynaecomastia-causing drugs DISCOS:
Digoxin
Isoniazid
Spironolactone
Cimetidine
Oestrogens
Stilboestrol
______________________________________________________________________________
Teratogenic drugs "W/ TERATOgenic":
Warfarin
Thalidomide
Epileptic drugs: phenytoin, valproate, carbamazepine
Retinoid
ACE inhibitor
Third element: lithium
OCP and other hormones (eg danazol)
______________________________________________________________________________
Benzodiazepines: actions
"Ben SCAMs Pam into seduction not by brain but by muscle":
Sedation
anti-Convulsant
anti-Anxiety
Muscle relaxant

Page 7

Not by brain: No antipsychotic activity.
_____________________________________________________________________________
Cholinergics (eg organophosphates): effects
If you know these, you will be "LESS DUMB":
Lacrimation
Excitation of nicotinic synapses
Salivation
Sweating
Diarrhea
Urination
Micturition
Bronchoconstriction
_____________________________________________________________________________
Benzodiazapines: not metabolized by the liver (safe to use in liver failure) LOT: Lorazepam
Oxazepam Temazepa
Inhalation anesthetics SHINE:
Sevoflurane
Halothane
Isoflurane
Nitrous oxide
Enflurane
If want the defunct Methoxyflurane too, make it MoonSHINE
______________________________________________________________________________
Morphine: effects MORPHINES:
Miosis
Orthostatic hypotension
Respiratory depression
Pain supression
Histamine release/ Hormonal alterations
Increased ICT

Page 8

Nausea
Euphoria
Sedation
______________________________________________________________________________
Myasthenia gravis: edrophonium vs. pyridostigmine
eDrophonium is for Diagnosis.
pyRIDostigmine is to get RID of symptoms.
Lead poisoning: presentation ABCDEFG:
Anemia
Basophilic stripping
Colicky pain
Diarrhea
Encephalopathy
Foot drop
Gum (lead line)
______________________________________________________________________________
Depression: 5 drugs causing it PROMS:
Propranolol
Reserpine
Oral contraceptives
Methyldopa
Steroids
_____________________________________________________________________________
Propranolol and related '-olol' drugs: usage"olol" is just two backwards lower case b's. Backward
b's stand for "beta blocker". Beta blockers include acebutolol, betaxolol, bisoprolol, oxprenolol,
propranolol.
______________________________________________________________________________
Warfarin: action, monitoring WePT:
Warfarin works on the extrinsic pathway and is monitored by PT
______________________________________________________________________________


Page 9

Ipratropium: action Atropine is buried in the middle:
iprAtropium, so it behaves like Atropine.
______________________________________________________________________________
SSRIs: side effects SSRI:
Serotonin syndrome
Stimulate CNS
Reproductive disfunctions in male
Insomnia
______________________________________________________________________________
Beta-1 vs Beta-2 receptor location "You have 1 heart and 2 lungs":
Beta-1 are therefore primarily on heart. Beta-2 primarily on lungs.
______________________________________________________________________________
Enoxaprin (prototype low molecular weight heparin): action, monitoring EnoXaprin only acts on
factor Xa. Monitor Xa concentration, rather than APTT.
______________________________________________________________________________
Morphine: effects at mu receptor PEAR:
Physical dependence
Euphoria
Analgesia
Respiratory depression
Aspirin: side effects ASPIRIN:
Asthma
Salicyalism
Peptic ulcer disease/ Phosphorylation-oxidation uncoupling/ PPH/ Platelet disaggregation/
Premature closure of PDA
Intestinal blood loss
Reye's syndrome
Idiosyncracy
Noise (tinnitus)

Page 10

Atropine use: tachycardia or bradycardia
"A goes with B": Atropine used clinically to treat Bradycardia.
______________________________________________________________________________
Anticholinergic side effects
"Know the ABCD'S of anticholinergic side effects":
Anorexia
Blurry vision
Constipation/ Confusion
Dry Mouth
Sedation/ Stasis of urine
Direct sympathomimetic catecholamines DINED:
Dopamine
Isoproterenol
Norepinephrine
Epinephrine
Dobutamine
______________________________________________________________________________
Asthma drugs: inhibitor action
zAfirlukast: Antagonist of LT
zIlueton: Inhibitor of 5-LO
______________________________________________________________________________
Routes of entry: most rapid ways meds/toxins enter body
"Stick it, Sniff it, Suck it, Soak it":
Stick = Injection
Sniff = inhalation
Suck = ingestion
Soak = absorption
______________________________________________________________________________



Page 11

Thrombolytic agents USA:
Urokinase Streptokinase Alteplase (tPA)
______________________________________________________________________________
Narcotic antagonists
The Narcotic Antagonists are NAloxone and NAltrexone. Important clinically to treat narcotic
overdose.
______________________________________________________________________________
Phenytoin: adverse effects PHENYTOIN:
P-450 interactions
Hirsutism
Enlarged gums
Nystagmus
Yellow-browning of skin
Teratogenicity
Osteomalacia
Interference with B12 metabolism (hence anemia)
Neuropathies: vertigo, ataxia, and headache
______________________________________________________________________________
TB: antibiotics used
STRIPE:
Streptomycin, Rifampicin, Isoniazid, Pyrizinamide, Ethambutol
______________________________________________________________________________
Opioids: effects BAD AMERICANS:
Bradycardia & hypotension
Anorexia
Diminished pupilary size
Analgesics
Miosis
Euphoria
Respiratory depression

Page 12

Increased smooth muscle activity (biliary tract constriction) Constipation
Ameliorate cough reflex
Nausea and vomiting
Sedation
______________________________________________________________________________
Prazocin: usage
Prazocin sounds like an acronym of "praszz zour urine".
Therefore Prazocin used for urinary retention in BPH.
______________________________________________________________________________
Phenobarbitone: side effects
Children are annoying (hyperkinesia, irritability, insomnia, aggression).
Adults are dosy (sedation, dizziness, drowsiness).
______________________________________________________________________________
Vir-named drugs: use"-vir at start, middle or end means for virus": Drugs:
Abacavir,
Acyclovir,
Amprenavir,
Cidofovir,
Denavir,
Efavirenz,
Indavir,
Invirase,
Famvir,
Ganciclovir,
Norvir,
Oseltamivir,
Penciclovir,
Ritonavir,
Saquinavir,
Valacyclovir,

Page 13

Viracept,
Viramune,
Zanamivir,
Zovirax.
______________________________________________________________________________
Succinylcholine:
action, use Succinylcholine gets Stuck to Ach receptor, then Sucks ions in through open pore. You
Suck stuff in through a mouth-tube, and drug is used for intubation.
______________________________________________________________________________
Beta-blockers: side effects "BBC Loses Viewers In Rochedale": Bradycardia
Bronchoconstriction
Claudication
Lipids
Vivid dreams & nightmares
-ve Inotropic action
Reduced sensitivity to hypoglycaemia
______________________________________________________________________________
Cisplatin: major side effect, action "Ci-Splat-In":
Major side effect: Splat (vomiting sound)--vomiting so severe that anti-nausea drug needed.
Action: Goes Into the DNA strand.
_____________________________________________________________________________
MAOIs: indications MAOI'S:
Melancholic [classic name for atypical depression]
Anxiety
Obesity disorders [anorexia, bulemia]
Imagined illnesses [hypochondria]
Social phobias
Listed in decreasing order of importance.
Note MAOI is inside MelAnchOlIc.
_____________________________________________________________________________

Page 14

Antiarrhythmics: class III members BIAS:
Bretylium
Ibutilide
Amiodarone
Sotalol
______________________________________________________________________________
Auranofin, aurothioglucose: category and indication
Aurum is latin for "gold" (gold's chemical symbol is Au).
Generic Aur- drugs (Auranofin, Aurothioglucose) are gold compounds.
If didn't learn yet that gold's indication is rheumatoid arthritis, AUR- Acts Upon Rheumatoid.
______________________________________________________________________________
Antirheumatic agents (disease modifying): members
CHAMP:
Cyclophosphamide
Hydroxycloroquine and choloroquinine
Auranofin and other gold compounds
Methotrexate
Penicillamine
______________________________________________________________________________
Beta 1 selective blockers
"BEAM ONE up, Scotty":
Beta 1 blockers:
Esmolol
Atenolol
Metropolol
______________________________________________________________________________




Page 15

Physostigmine vs. neostigmine LMNOP:
Lipid soluble
Miotic
Natural
Orally absorbed well
Physostigmine Vs. Neostigmine, on the contrary, is:
Water soluble
Used in myesthenia gravis ,Synthetic Poor ,oral absorption
Patent ductus arteriosus: treatment
"Come In and Close the door": indomethacin is used to Close PDA.
______________________________________________________________________________
Tetracycline: teratogenicity
TEtracycline is a TEratogen that causes staining of TEeth in the newborn.
______________________________________________________________________________
Serotonin syndrome: components Causes HARM:
Hyperthermia Autonomic instability (delirium) Rigidity Myoclonus
______________________________________________________________________________
Torsades de Pointes: drugs causing APACHE:
Amiodarone Procainamide Arsenium Cisapride Haloperidol Eritromycin
______________________________________________________________________________
Tricyclic antidepressants: members worth knowing
"I have to hide, the CIA is after me":
Clomipramine Imipramine Amitrptyline
If want the next 3 worth knowing, the DNDis also after me:
Desipramine, Nortriptyline, Doxepin
______________________________________________________________________________
Busulfan: features ABCDEF:
Alkylating agent
Bone marrow suppression
CML indication

Page 16

Dark skin (hyperpigmentation)
Endrocrine insufficiency (adrenal) ,Fibrosis (pulmonary)
______________________________________________________________________________
Cancer drugs: time of action between DNA->mRNA ABCDEF: Alkylating agents
Bleomycin
Cisplastin
Dactinomycin/ Doxorubicin
Etoposide
Flutamide and other steroids or their antagonists (eg tamoxifen, leuprolide)
______________________________________________________________________________
Opiods: mu receptor effects "MD CARES":
Miosis
Dependency
Constipation
Analgesics
Respiratory depression
Euphoria
Sedation
______________________________________________________________________________
Antiarrhythmics: classification
I to IV MBA College
In order of class I to IV:
Membrane stabilizers (class I)
Beta blockers
Action potential widening agents
Calcium channel blockers
______________________________________________________________________________




Page 17

Adrenoceptors: vasomotor function of alpha vs. beta
ABCD:
Alpha = Constrict.
Beta = Dilate.
______________________________________________________________________________
Migraine: prophylaxis drugs
"Very Volatile Pharmacotherapeutic Agents For Migraine Prophylaxis":
Verpamil
Valproic acid
Pizotifen
Amitriptyline
Flunarizine
Methysergide
Propranolol
______________________________________________________________________________
Diuretics:
thiazides: indications "CHIC to use thiazides":
CHF
Hypertension
Insipidous
Calcium calculi
Delerium-causing drugs ACUTE CHANGE IN MS:
Antibiotics (biaxin, penicillin, ciprofloxacin)
Cardiac drugs (digoxin, lidocaine)
Urinary incontinence drugs (anticholinergics)
Theophylline
Ethanol
Corticosteroids
H2 blockers

Page 18

Antiparkinsonian drugs
Narcotics (esp. mepridine)
Geriatric psychiatric drugs
ENT drugs
Insomnia drugs
NSAIDs (eg indomethacin, naproxin) ,Muscle relaxants ,Seizure medicines
______________________________________________________________________________
Disulfiram-like reaction inducing drugs "PM PMT" as in Pre Medical Test in the PM:
Procarbazine
Metronidazole
Cefo (Perazone, Mandole, Tetan).

Ca++ channel blockers: uses CA++ MASH:
Cerebral vasospasm/ CHF
Angina
Migranes
Atrial flutter, fibrillation
Supraventricular tachycardia
Hypertension
Alternatively: "CHASM":
Cererbral vasospasm / CHF
Hypertension
Angina
Suprventricular tachyarrhythmia
Migranes
______________________________________________________________________________




Page 19

Sex hormone drugs: male "Feminine Males Need Testosterone":
Fluoxymesterone
Methyltestosterone
Nandrolone
Testosterone
______________________________________________________________________________
Narcotics: side effects "SCRAM if you see a drug dealer": Synergistic CNS depression with other
drugs
Constipation
Respiratory depression
Addiction
Miosis
______________________________________________________________________________
Hypertension: treatment ABCD:
ACE inhibitors/ AngII antagonists (sometimes Alpha agonists also) Beta blockers
Calcium antagonists
Diuretics
______________________________________________________________________________
Pulmonary infiltrations inducing drugs "Go BAN Me!":
Gold
Bleomycin/ Busulphan/ BCNU
Amiodarone/ Acyclovir/ Azathioprine
Nitrofurantoin
Melphalan/ Methotrexate/ Methysergide
______________________________________________________________________________
Antimuscarinics: members, action
"Inhibits Parasympathetic And Sweat":
Ipratropium Pirenzepine Atropine Scopolamine
Muscarinic receptors at all parasympathetic endings sweat glands in sympathetic.
______________________________________________________________________________


Page 20

Teratogenic drugs: major non-antibiotics TAP CAP:
Thalidomide ,Androgens, Progestins, Corticosteroids ,Aspirin , indomethacin & Phenytoin
______________________________________________________________________________
Beta blockers with CYP2D6 polymorphic metabolism
"I Met Tim Carver, the metabolic polymorph":
The following beta blockers require dose adjustment due to CYP2D6 polymorphic metabolism:
Metoprolol Timolol Carvedilol (in patients with lower or higher than normal CYP2D6 activity)
Beta blockers with intrinsic sympathomimetic activity
Picture diabetic and asthmatic kids riding away on a cart that rolls on pinwheels. Pindolol and
Carteolol have high and moderate ISA respectively, making them acceptable for use in some
diabetics or asthmatics despite the fact that they are non-seletive beta blockers.
______________________________________________________________________________
Muscarinic effects SLUG BAM:
Salivation/ Secretions/ Sweating
Lacrimation
Urination
Gastrointestinal upset
Bradycardia/ Bronchoconstriction/ Bowel movement
Abdominal cramps/ Anorexia
Miosis
______________________________________________________________________________
Sulfonamide: major side effects
Sulfonamide side effects:
Steven-Johnson syndrome
Skin rash
Solubility low (causes crystalluria)
Serum albumin displaced (causes newborn kernicterus and potentiation of other serum albumin-
binders like warfarin)
______________________________________________________________________________

Page 21

Epilepsy types, drugs of choice:
"Military General Attacked Weary Fighters Pronouncing 'Veni Vedi Veci' After Crushing
Enemies":
Epilepsy types: Myoclonic Grand mal Atonic West syndrome Focal Petit mal (absence)
Respective drugs: Valproate Valproate Valproate ACTH Carbamazepine Ethosuximide
_____________________________________________________________________________
Quinolones [and Fluoroquinolones]: mechanism
"Topple the Queen": Quinolone interferes with Topoisomerase II.
______________________________________________________________________________
Beta blockers:
B1 selective vs. B1-B2 non-selective
A through N: B1 selective: Acebutalol, Atenolol, Esmolol, Metoprolol.
O through Z: B1, B2 non-selective: Pindolol, Propanalol, Timolol.
______________________________________________________________________________
Drugs that cause
hepatitis
VAMPIRES
Valproate
Amiodarone
Methyldopa
Pyrazinamide
Isoniazid
Rifampicin
phenYtoin (sounds like E)
Simvastatin
________________________________________________________________________



Page 22

Warfarin: interactions ACADEMIC QACS:
A=Amiodarone
C=Cimetidine
A=Aspirin
D=Dapsone
E=Erythromycin
M=Metronidazole
I=Indomethacin
C=Clofibrates
Q=Quinidine
A=Azapropazone
C=Ciprofloxacin
S=Statins
______________________________________________________________________________
contraindications for use of lignocaine with adrenaline is :
Digital PEN :
Digital PEN stands for:
D Digits (Fingers and toes)
P Penis
E Ear
N Nose tip
______________________________________________________________________________
1)Acrolein - metabolite of ifosfamide & cyclophosphamide..causing hemorrhagic
cystitis.....treated by mesna(methyl ethane sulfonate)
2)Acrylate - metabolite of Atracurium..
______________________________________________________________________________
Thiazide (Hydrochlorothiazide) diuretics are well known for causing
A HYPER problems
Hyper-Uricemia = Acute gouty arthritis
Hyper-Calcemia = Kidney stone

Page 23

Hyper-Glycemia = Bad for diabetic patients
Hyper-Lipidemia = Increase cholesterol and LDL levels, bad for hypertension patient
A HYPO problems
Hypo-kalemia = a common side effect of all diuretics (Except potassium sparing agents)
Hypo-natriumia = reduce blood volume and pressure
Hypo-tension = reduce blood pressure
_____________________________________________________________________________________
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p
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3
8

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n
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3
9
















































































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r
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s





























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c
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p
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_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
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_
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_
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_
_
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_
_
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_
_
_
_
_
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_
_
_
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_
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_
_
_
_
_
_
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_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
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_
_
_
_
_
_
_
_
_
_
_
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E
R
G
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r
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4
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3

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4
4

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*

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t
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1
















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3


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p
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a
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4
5

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N
D

H
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L
o
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g

a
c
t
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n
g

(
2
-
8
H
o
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r
s
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(
1
0
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1
2

H
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r
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)

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o
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a
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(
2
H
o
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r
s
)

(
2
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4
H
o
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r
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)

(
2
-
4

H
o
u
r
s
)

(
6
-
8

H
o
u
r
s
)




*

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h
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l

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F
l
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5
1

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X
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O
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z
u
m
a
b

Page 52
DRUG CHOSEN FOR TRETMINT:-
1. Paracetamol:- Analgesic/pyrexia
2. Acute bronchial- asthma: - salbutamol
3. Acute gout: - NSAIDS
4. Acute hyperkalemia:- calcium gluconate
5. Severe DIGITALIS toxicity:- DIGIBIND
6. Acute migraine: - sumatriptan
7. Cheese reaction: - phentolamine
8. Atropine poisoning: - physostigmine
9. Cyanide poisoning: - amyl nitrite
10. Benzodiazepine poisoning: - flumazenil
11. Cholera: - Tetracycline and ORS
12. KALA-AZAR:- lipozomal amphotericin- B
13. Iron poisoning: - Deferoxamine
14. MRSA: - vancomycin
15. VRSA: - LINEZOLID
16. Warfarin overdose: - vitamin-K, Fresh frozen plasma
17. Obsessive compulsive disorder: - fluoxetine
18. Alcohol poisoning: - fomepizole
19. Epilepsy in pregnancy: - phenobarbitone
20. Anaphylactic shock: - Adrenaline
21. Malaria in Pregnancy:- Chloroquine
22. Whooping Cough or Pertussis:- Erythromycin
23. Heparin Overdose: - Protamine
24. Hairy Cell Leukemia: - Cladirabine
25. Multiple Myeloma: - Melphalan

Page 53
26. Wegner's granulomatosis:- Cyclophosphamide
27. Tremor: - Propranolol
28. Delirium Tremens:- Diazepam
29. Drug Induced Parkinsonism:- Benzhexol
30. Diacumarol Poisoning:- Vit-K
31. Type-1 Lepra Reaction:- Steroids
32. Type- 2 Lepra Reaction:- Thalidomide
33. Allergic Contact Dermatitis:- Steroids
34. PSVT:- 1st-Adenosine, 2nd-Verapamil, 3rd-Digoxin
35. Z-E Syndrome: - Proton Pump Inhibitor
36. Dermatitis Herpetiformis:- Dapsone
37. Spastic Type of Cerebral Palsy:- Diazepam
38. Harpies Simplex Keratitis:- Trifluridine
39. Herpes Simplex Orolabialis:- Pancyclovir
40. Neonatal Herpes Simplex:-Acyclovir
41. Pneumocystis carinii Pneumonia: - Cotrimoxazole for Nodular
42. Cystic Acne:-Retinoic acid
43. Trigeminal Neuralgia:- Carbamazepine
44. Actinomycosis:- Penicillin
45. Thrombal Plague: - Streptokinase
46. Opioid Withdrawal: - 1ST- Methadone 2nd-Clonidine
47. Alcohol Withdrawal:- 1st- Chlordiazepoxide 2nd-Diazepam
48. Post Herpetic Neuralgia:- Fluphenazine
49. WEST Syndrome:- ACTH
50. Diabetic Diarrhea:- Clonidine
51. Lithium Induced Neuropathy:- Amiloride

Page 54
52. Tetanus: PEN G Na; TETRACYCLINE; (DIAZEPAM)
53. Diphtheria: PEN G K; ERYTHROMYCIN
54. Pertussis: ERYTHROMYCIN; AMPICILLIN
55. Meningitis: MANNITOL (osmotic diuretic); DEXAMETHASONE (anti-
inflammatory); DILANTIN/PHENYTOIN (anti-convulsive);
PYRETINOL/ENCEPHABO L (CNS stimulant)
56. Acute Gastritis : MESOPROSTOL TETRACYCLINE
57. Amoebic Dysentery: METRONIDAZOLE
58. Shigellosis: CO-TRIMOXAZOLE
59. Typhoid: Ciprofloxacin/levofloxacin and PARACETAMOL
60. Rabies: LYSSAVAC, VERORAB
61. Malaria: CHLOROQUINE
62. Schistosomiasis: PRAZIQUANTEL
63. Felariasis: DIETHYLCARBAMAZINE CITRATE
64. Scabies: EURAX/ CROTAMITON
65. Chicken pox: ACYCLOVIR/ZOVIRAX
66. Leptospirosis: PENICILLIN; TETRACYCLINE; ERYTHROMYCIN
67. Leprosy: DAPSONE, RIFAMPICIN
68. Anthrax: PENICILLIN
69. Tuberculosis: R.I.P.E.S.
70. Pneumonia: COTRIMOXAZOLE; Procaine Penicillin
71. Helminthes: MEBENDAZOLE; PYRANTEL PAMOATE
72. Syphilis: PENICILLIN
73. Gonorrhea: PENICILLIN
74. Bronchitis : actylecystine (mucolytic) amd syrup for cough
75. ADDISONS DISEASE: - Corticosteroid (Hydrocortisone)

Page 55
76. AIDS: - Zidovudine
77. ALZHEIMERS DISEASE: - Tacrine Hydrochloride
78. ANGINA PECTORIS: - Nitroglycerin
79. BENIGN PROSTIC HYPERPLASIA: - Fenasteride (Proscar)
80. CARDIAC ARREST: - Epinephrine
81. CEREBRAL EDEMA: - Mannitol, Corticosteriods
82. CHRONIC ASTHMA: - Corticosteriod
83. CONGESTIVE HEART FAILURE: - Digoxin, Furosemide
84. CUSHINGS DISEASE: -Glucocorticoid Synthesis Inhibitor (Mitotane)
85. DYSENTERY: - Ciprofloxacin
86. FEBRILE SEIZURE: - Phenobarbital
87. GOUTY ARTHRITIS: - Colchicine, Allopurinol
88. GRAVES DISEASE: - Propylthiouracil
89. HEPATIC ENCEPHALOPATHY: - Neomycin, Lactulose
90. HISTOPLASMOSIS: - Amphoterecin
91. HYPERTENSIVE CRISIS: - Sodium Nitropusside
92. HYPOVOLEMIC SHOCK: - Dopamine, Dobutamine
93. INCREASE INTRACRANIAL PRESSURE: - Mannitol
94. MECONIUMS PLUG SYNDROME: - Acetylcysteine
95. MULTIPLE SCLEROSIS: - Baclofen
96. MYASTHENIA GRAVIS: - Pyridostigmine (Mestinon)
97. MYOCARDIAL INFARCTION: - Morphine Sulfate
98. MYOCLONIC SEIZURE: - Valproic Acid
99. PANIC ATTACKS: - Aprazolam (Xanax)
100. PARKINSONS DISEASE: - Levodopa
101. PARTIAL SEIZURE: - Carbamazipine

Page 56
102. PATENT DUCTUS ARTERIOSUS: - Indomethacin
103. PULMONARY EDEMA: - Furosemide
104. RHEUMATOID ARTHRITIS: - Aspirin
105. SINUS BRADYCARDIA: - Atropine Sulfate
106. SINUS TACHYCARDIA: - Propanolol, Metoprolol
107. STATUS ASTHMATICUS: - Epinephrine
108. STATUS EPILEPTICUS: - Diazepam
109. TETANUS SPASM: - Diazepam
110. TOURETTES SYNDROME: - Haloperidol
111. TRICHOMONIASIS: - Metronidazole
112. TYPHOID FEVER: - Chloramphenicol
113. DIADETIC NEPHROPATHY : - ACE inhibitors

Page 57
Review of Anti-microbial Drugs


Antibiotic Grouping By Mechanism
Cell Wall Synthesis Penicillins
Cephalosporins
Vancomycin
Beta-lactamase Inhibitors
Carbapenems
Aztreonam
Polymycin
Bacitracin
Protein Synthesis Inhibitors Inhibit 30s Subunit
Aminoglycosides (gentamycin)
Tetracyclines
Inhibit 50s Subunit
Macrolides
Chloramphenicol
Clindamycin
Linezolid
Streptogramins
DNA Synthesis Inhibitors Fluoroquinolones
Metronidazole
RNA synthesis Inhibitors Rifampin
Mycolic Acid synthesis inhibitors Isoniazid
Folic Acid synthesis inhibitors Sulfonamides
Trimethoprim



Page 58

Antibiotic Classification & Indications

Inhibits Cell Wall Synthesis
Penicillins
(bactericidal: blocks cross linking via competitive inhibition of the transpeptidase enzyme)
Class/Mechanism Drugs Indications (**Drug of
Choice)
Toxicity
Penicillin Penicillin G
Aqueous penicillin
G
Procaine penicillin
G
Benzathine
penicillin G
Penicillin V
Strep. pyogenes (Grp.A)**
Step. agalactiae (Grp.B)**
C. perfringens(Bacilli)**
Hypersensitivity
reaction
Hemolytic anemia
Aminopenicillins Ampicillin
Amoxicillin
Above +
Gram-negative:
E. faecalis**
E. Coli**
Above
Penicillinase-
resistant-penicillins
Methicillin
Nafcillin
Oxacillin
Cloxacillin
Dicloxacillin
Above +
PCNase-producingStaph.
aureus
Above +
Interstitial nephritis
Antipseudomonal
penicillins
Carbenicillin
Ticarcillin
Piperacillin
Above +
Pseudomonas aeruginosa**
Above

Cephalosporins
(bactericidal: inhibits bacterial cell wall synthesis via competitive inhibition of the
transpeptidase enzyme)
1st generation Cefazolin
Cephalexin
Staph. aureus**
Staph. epidermidis**
Some Gram-negatives:
E. Coli
Klebsiella
Allergic reaction
Coombs-positive anemia (3%)
2nd generation Cefoxitin
Cefaclor
Cefuroxime
Above +
Gram-negative
Allergic Reaction
ETOH Disulfiram reaction
3rd generation Ceftriaxone
Cefotaxime
Ceftazidime
Above +
Gram-negative
Pseudomonas
Allergic Reaction
ETOH Disulfiram reaction

Page 59




4
th
generation Cefepime
Other Cell Wall Inhibitors
Vancomycin
(bactericidal: disrupts
peptioglycan cross-linkage)
Vancomycin MRSA**
PCN/Ceph allegies**
S. aureus
S. epidermidis
Red man syndrome
Nephrotoxicity
Ototoxicity
Beta-lactamase Inhibitors
(bactericidal: blocking cross
linking)
Clavulanic Acid
Sulbactam
Tazobactam
S aureus**
S epidermis**
E.Coli**
Klebsiella**
Hypersensitivity
Reaction
Hemolytic anemia
Carbapenems Imipenem (+
cilastatin)
Meropenem
Doripenem
Ertapenem
Broadest activity of
any antibiotic
(except MRSA,
Mycoplasma)

Aztreonam Aztreonam Gram-negative rods
Aerobes
Hospital-acquired
infections

Polymyxins Polymyxin B
Polymyxin E
Topical Gram-
negative infections

Bacitracin Bacitracin Topical Gram-
positive infections


Page 60




Protein Synthesis Inhibition
Anti-30S ribosomal subunit
Aminoglycosides
(bactericidal:
irreversible
binding to 30S)
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
Aerobic Gram-
negatives
Enterobacteriaceae
Pseudomonas
Nephrotoxicity
Ototoxicity
Tetracyclines
(bacteriostatic:
blocks tRNA)
Tetracycline
Doxycycline
Minocycline
Demeclocycline
Rickettsia
Mycoplasma
Spirochetes (Lyme's
disease)
Hepatotoxicity
Tooth discoloration
Impaired growth
Avoid in children <
12 years of age
Anti-50S ribosomal subunit
Macrolides
(bacteriostatic:
reversibly binds
50S)
Erythromycin
Azithromycin
Clarithromycin
Streptococcus
H. influenzae
Mycoplamsa
pneumonia
Coumadin
Interaction
(cytochrome P450)
Chloramphenicol
(bacteriostatic)
Chloramphenicol H influenzae
Bacterial Meningitis
Brain absces
Aplastic Anemia
Gray Baby
Syndrome
Lincosamide
(bacteriostatic:
inhibits peptidyl
transferase by
interfering with
amino acyl-tRNA
complex)
Clindamycin Bacteroides fragilis
S aureus
Coagulase-negative
Staph & Strep
Excellent Bone
Penetration
Pseudomembranous
colitis
Hypersensitivity
Reaction
Linezolid
(variable)
Linezolid Resistant Gram-
positives

Streptogramins Quinupristin
Dalfopristin
VRE
GAS and S. aureus
skin infections


Page 61




DNA Synthesis Inhibitors
Fluoroquinolones
(bactericidal: inhibit DNA gyrase enzyme, inhibiting DNA synthesis)
1st
generation
Nalidixic
acid
Steptococcus
Mycoplasma
Aerobic Gram +
Phototoxicity
Achilles tendon
rupture
Impaired fracture
healing
2nd
generation
Ciprofloxacin
Norfloxacin
Enoxacin
Ofloxacin
Levofloxacin
As Above +Pseudomonas as above
3rd generation Gatifloxacin As above + Gram-positives as above
4th generation Moxifloxacin
Gemifloxacin
As above + Gram-positives +
anaerobes
as above
Other DNA Inhibitors
Metronidazole
(bacteridical: metabolic biproducts
disrupt DNA)
Metronidazole
(Flagyl)
Anaerobics
Seizures
Crebelar dysfunction
ETOH disulfram
reaction

Page 62









RNA Synthesis Inhibitors
Rifampin
(bactericidal: inhibits RNA transcription
by inhibiting RNA polymerase)
Rifampin Staphylococcus
Mycobacterium (TB)
Body fluid
discoloration
Hepatoxicity (with
INH)
Mycolic Acids Synthesis Inhibitors
Isoniazid Isoniazidz TB
Latent TB

Folic acid Synthesis Inhibitors
Trimethoprim/Sulfonamides
(bacteriostatic: inhibition with
PABA)
Trimethoprim/Sulfamethoxazole
(SMX)
Sulfisoxazole
Sulfadiazine
UTI
organisms
Proteus
Enterobacter
Thrombocytopenia
Avoid in third
trimester of
pregnancy
Pyrimethamine Pyrimethamine Malaria
T. gondii

Splenectomy
x Splenectomy patients or patients with functional hyposplenism require the
following vaccines and/or antibiotics
o Pneumococcal immunization
o Haemophilus influenza type B vaccine
o Meningococcal group C conjugate vaccine
o Influenza immunization
o Lifelong prophylactic antibiotics (oral phenoxymethylpenicillin or
erythromycin)

Page 63
LIST OF DRUGS TO BE REMEMBERED
Cell wall synthesis inhibitors:-
1. B-lactam antibiotics:-
2. Others:-
B-lactam antibiotics:-
1. Penicillin:-
2. Cephalosporin:-
3. Miscellaneous:-
Penicillin:-
Narrow spectrum:
x Short acting
x Long acting
x Penicillanase (B-lactmase) resistant penicillin
o Anti-staphylococcal
o Penicillin against penicillanase producing gram ve bacteria except
pseudomonas
Broad spectrum:-
o Miscellanams
o Effective against gram ve bacteria except pseudomonas aeruginose
Cephalosporins:-
Narrow spectrum
o 1st generation
Wide spectrum
o 2
nd
, 3
rd
& 4
th
generation
Miscellaneous:-
o Carbapenems:
o Imipramine
o Cilastatin
o Etrapenem
o Meropenem
Monobactams:
o Aztreonam
o Vancomycin
Antipseudomonal:-
Others:-
o Vancomycin
o Bacitracin
o cycloserine


Page 64
Quinolones & urinary tract antiseptic:-
First line drugs:-
x Norfloxacin
x Ciprofloxacin
x Ofloxacin
x Levofloxacin
x Gatifloxacin
x Sparfloxacin
x Moxifloxacin
x Tovafloxacin
x Nalidixic acid
x Oxolinic acid
x Cinoxacin
Urinary tract antiseptic:-
x Methenamic
x Nitrofurantoin

Anti-tuberculosis
x Isoniazid
x Pyranzamide
x Rifampin
x Ethambutol
x Sireptomycin
x Aminosalicyclic acid
x Cycloserine
x Ethionamide
Anti-leprosy
x Dapsone
x Rifampin
x Clofazimine



Page 65
Penicillins:-
Narrow spectrum penicillin:-
Short acting: (natural penicillin)
x Benzyl penicillin (penicillin G)
x Phenoxymethyl penicillin (penicillin V)
x phenethicillin
Long acting:
x Procaine penicillin
x Benethamine pencillin
x Benzathine penicillin
Penicillinase resistant pencillin:-
B- lactmase resistant:
x Anti-staphylococcal penicillin:
o Clozacillin
o Dicloxacillin
o Oxacillin
o Nafcillin
o Flucloxacillin
x Penicillin against penicillanase producing gram ve bacteria
x Except pseudomonas:
o Temocillin
Broad spectrum:-
x Amoxycillin
x Ampicillin
x Becampicillin
x Pivampicillin
x Tolampicillin
x Mezlocillin
x Ciclacillin
Broad spectrum penicillin combination:-
Co-amoxiclav:
x Amoxicillin & calvulanic acid (oral)
Fluampicil:-
x Amoxicillin & flucloxacillin
Vnisyn:
x Amoxicillin & salbactum (I/V or I/M)
Timetin:
x Ticarcillin & calvulanic acid
Miscellaneous:-
Beffective against gram ve bacteria except pseudomonas aeruginose

Page 66
x Mecillinam (parenteral)
x Pirmecillanam
Anti pseudomonal penicillin:-
x Azlocillin (Anti-Pseudomonal & klebsella) broad spectrum
x Mezlocillin (Anti-Pseudomonal & klebsella) broad spectrum
x Carbecillin (broad spectrum)
x Piperacillin (Anti-Pseudomonal & klebsella) broad spectrum
x Ticarcillin (anti-pseudomonal)
Combination:-
x Ticarcillin & calvulanic acid
x Piperacillin & tozxabactam (acylueido penicillin)

































Page 67
Cepnalosporins:-
1
st
generation: -
x Cefezolin
x Cefadroxil
x Cephalexin
x Cephalothin
x Cephloridin
x Cephradine
x Cephapirin
2
nd
generation:-
x Cefaclor
x Cephamandole
x Cefonicid
x Cefmetazole
x Loracarbef
x Cefotetan
x Cefuroxime
x Cefoxitin
x Ceforamide
x Cefprozil
3
rd
generation:-
x Cefixime
x Cefoperazone
x Ceftoxamine
x Ceftazidime
x Ceftizoxime
x Ceftriaxone
x Moxalactum
x Cefpodoxim
x Ceftibuten
x Cefdinir
x Latamoxef
4
th
generation:-
x Cefepine
x Cefemonomine
@, cephamycin derivatives
*, oral, rest given I/V
=, cross BBB
=, mainly excreted in bile, rest in the urine.

Page 68
Protein synthesis inhibitors:-
Teracyclines:-
x Teracyclines
x Doxycycline
x Minocycline
x Demeclocycline
x Lymecycline
x Oxytetracycline
Aminoglycoside:-
Streptomycin group:
x Streptomycin
Gentamycin group:
x Gentamycin tobramycin
x Netilmicin
x Sisomicin
Neomycin group:
x Neomycin
x Freamycetin
x Kanamycin
x Amikacin
x Parmomycin
Combination:-
To enlarge antibacterial spectrum:
x Septicaemia & sepsis:
o Gentamycin & penicillin
x Pelvic sepsis:
o Gentamycin & Metronidazole
x Conjuctival & skin infection:
x Neomycin & bacitracin
To increase bacterial sensitivity:-
Bacterial endocarditis:
Gentamycin & penicillin
Pseudomonas infection:
Gentamycin & cerbencillin or Ticarcillin
Coliform infection:
Gentamycin & ampicillin or cephalosporin
Macrolides:-
x Azithromycin
x Clarithromycin
x Erythromycin
x Roxithromycin
x Dirithromycin


Page 69
Chloramphenicol:
Clindamycin:
Telithromycin:
Streptogramines:
x Quinupristin
x Dalfopristin
Linezolide
x Vencamycin resistant organism



Page 70
Anti Helmintics:-
Chemotherapy for nematodes:-
x Ivermectin (intensifies GABA mediated neurotransmission in nematodes
immobilize parasite)
x Mebendazole (inhibit microtubels synthesis)
x Pyrentel pamoate (neuromuscular blocked by interaction with nicotinic
reception )
x Thibendzole (same as metronidazole)
x Albendzole (decrease uptake of glucose decrease ATP )
x Levamisole [causes depolarizing NM blocked (Nicotinic receptors )]
x Piperazine
x Bephenium hydroxynaphtoate
x Diethylcrbamazine
Chemotherapy for trematodes:-
x Prazquantal (increase membrane permeability to ca
+
)
x Bithionol
x Metrifinate (prodrug form cholenestrase inhibitor)
x Oxamniquine
Chemotherapy for cestodes:-
x Niclosamide (Uncoupling of oxidative phosphorylation, activate ATPase)
x Praziquantel
x Albendazole
x Mebendazole
Drugs for Amebiasis
x Chloroquine
x Emetines
x metrodinazole
x Diloxanide furoate
x Iddoquinol
x Paromomycin


Page 71
Anesthesia:-
Adjuncts of anesthetics:-
Pre-anesthetics medicine:-
Anxiolytics:-
x Benzo-diazepine
x Diazepam
Sedatives:-
x Barbiturates
x Promethazine
Narcotic analgesics:-
x Morphine
x Pethidine
Anti-cholinergic:-
x Atropine
x Hyoscine
Anti-emetics or prokinetic agent:-
x Metoclopramide
x Domperidone
H2 receptor antagonists:-
x Ranitidine
x Fomatidine
General Anesthesia:-
I/V GA:-
Barbiturates:-
x Methahexital
x thiopental
x Thiamylal
Benzodiazepines:-
x Diazepam 2) lorazapam 3) midoxalam 4) Etomidate
Opiads:-
x Fentanyl 2) Morphine
Neuroleptics:-
x Fentanyl
x Droperidol
Dissociatives:-
x Ketamines
Propofol:-
x Ultra short acting drugs similar to thiopental
Inhaled GA:-
Gases:-
x Nitrous oxide
x Cyclopropane

Page 72
Volatile liquids:-
x Fluranes
x Halothane
Fluranes:- MISED
x Enflurane
x Desflurane
x Isoflurane
x Methoxyflurane
x Sevoflurane
Solubility in blood:- He-IS-Dn
x Halothane is more soluble than,
x Enflurane,
x Isoflurane,
x Sevoflurane,
x Desflurane,
x Nitrous oxide.
Local Anesthesia:-
According to duration of action:-
Long duration i.e. 90 min:-
x Bupivacaine
Medium duration i.e. 45min:-
x Cocaine
x Lidocaine / lignocaine
x Prilocaine
Short duration i.e 15 min:-
x Procaine
According to chemical composition:-
Esters:-
Long acting:-
x Tetracaine
Short acting:-
x Procaine
Surface action:-
x Cocaine
x Benzocaine
Amides:-
Long action:-
x Bupivacaine
x Ropiracaine
Medium action:-
x Lidocaine
x prilocaine

Page 73
Folate antagonists:-
Folate synthesis inhibitors:-
x Mafenide
x Silver sulfadiazine
x Sulfadiazine
x Sulfamethoxazole
x Sulfisoxazole
x Succinyl sulfathiazole
x Sulfasalazine
x Sulfacetamide
Folate reduction inhibitors:-
x Pyrimethamine
x Trimethorprim
x Methotrexate
Folate synthesis & reduction inhibitors:-
Cotrimoxazole
Sulfamethoxazole 400 mg & trimethorprim 80mg
Sulfadiazine & pyrimethamine . . . . . toxoplasmosis
Anti-Fungal
For Subcutaneous
Systemic Mycosis
x Amphotericin
x Flu cytosine
x Ketoconazole
x Fluconazole
Superficial Mycosis
x Griseofulvin
x Nystatin
x Miconazole
x Clotrimazole
x Econazole










Page 74
Drugs affecting respiratory system:-
Bronchiodilators:-
Sypathomimetics:-
Alpha and beta Non selective:-
x Ephedrine
x Epinephrine
x Adrenaline
Beta 1 and beta 2 Non pselective:-
x Isoproterenol
Beta 2 adrenergic agonist:-
Short acting:-
x Salbutamol
x Terbutaline
x Pirbuterol
x Bitolterol
Long acting:-
x Salmetrol
x Formoterol
x Reprotelol
x Pirbuterol
Methylxanthine:-
Short acting mediators:-
x Amoniphylline
Long acting:-
x Theophylline
Others:-
x Theobromine
x Caffine
Muscarinic:-
x Ipratropium
x Tiotropium
x Oxytropium
Leukotrienes inhibitors:-
x Zafirlukast
x Zileuton
x Montelokast


Page 75
Corticosteroids:- Anti-inflammatory drugs
Inhalation:-
x Beclomethasone
x Budesonide
x Flunisolide
x Fluticasone
Systemic:-
x Hydrocortisone
x Prednisolone
x Dexamethasone
x Methyl prednisolone
Mast cell stabilizers:-
Carmolyn sodium cromoglycate
Nedocromil
Miscellaneous:-
x Anti-IgE monoclonal antibodies
x Ketotifen
x Cacium channel blockers
x Methotrexate
x Nitric oxide donors
Anti-Histamine:-
x Azelastine
x Ketotifen
Long acting Non sedatives:-
x Cetrizen
x loratidine


Page 76
Drugs used to treat cough:-
Central anti-tussives:-
Opiates:-
Non addicting
a. Codeine phosphate
b. Pholcodeine
c. Dihydrocodeinone
Addicting Drugs
a. Morphine
b. Methadone
c. Dihydromorphinone
Non Opiates:-
x Benzonatate
x Caramiphene ethyidisulfate
x Carbetapentane
x Chlophedianol
x Dextromethorphan
x Levopropoxyphen
x Oxeladine
x Pipazethate
Peripheral anti-tussives-nonproductive cough:-
Demulcents:-
x Liquorice lozenges
Steam inhalation:-
x With tincture benzoin or menthol
Local anesthetics:-
x benzonatate
x Oxolamine
Anti-histamine:-
x Chlophenoirpentane
x Diphenyhydramine
x Promethazine
Expectorant:-
Directly acting:-
x Glyceryl guaiacolate
x Potassium iodide
x Na++ and K
+
citrate or acetate
x Balsum of tolu
x Vasaka syrup
x Terpine hydrate

Page 77
Reflexly acting:-
x Ammonium chloride or carbonate
x Syrup ipecac
x Scilla syrup
x Volatile oil eucalyptus, turpentine , camphor, thymol , menthols etc
Mucolytics:-
x Bromhexine
x Acetylcysteine
x Carbocysteine
x Pancreatic dornase (PROTEOLYTC BENZYME
x Potassium iodide


Page 78
Anti-Hypertensive Drugs:-
Diuretics:-
Thiazides:-
1. Bendrofluazide
2. Chlorothalidone
3. Chlorothiazide and others
Loop Diuretics:-
1. Furosemide
2. Ethacrynic acid and others
Potassium sparing diuretics:-
1. Spironolactone
2. Triamterene and others
Adrenoceptor blocking Drugs:-
Alpha receptor blockers:-
1. Prazoin
2. Pnenoxybenzamine
3. Terazosine
4. Doxazosin
Beta preceptor blockers:-
1. Propranolol
2. Atenolol
3. Pindolol
4. Timolol
Alpha beta receptor blockers:-
1. Labetalol
Angiotensin Blockers:-
Angiotensin Type-II Receptor Blocker:-
1. Losartan
2. Valsartan
3. Candesartan
4. Eprosartan
5. Irbesartan
6. Telmisartan
ACE-Inhibitors:-
1. Captopril
2. Enalapril
3. Fosinopril
4. Lisinipril
5. Quinapril
6. Benazepril
7. Moexipril
8. Ramipril


Page 79
Ca++ channel blockers:-
1. Verapamil
2. Nifedipine
3. Diltiazem
4. Nisoldipine
5. Nicardipine
6. Amlodipine
7. Felodipine
8. Isradipine
Direct acting vasodilators:-
1. Hydralazine
2. Diazoxidil
3. Minoxidil
4. Sodium Nitroprusside
5. Fenoldopam
Centrally acting sympathplegic:-
1. Methyl dopa
2. Clonidine
3. Guanabenz
4. Guanfacine
Adrenergic Neuron Blocking dugs: - postganglionic
1. Reserpine
2. Guanethidine
3. Guanadral
Ganlionic blocking drug:-
1. Trimethaphan
2. Mecamylamine
3. Hexamethonium
Ca++ channel blockings:-
Divided into three chemical classes,
Diphenylalkylamine
x Verapamil
Benzothiazepine
x Diltiazem
Dihyydropyridines
1
st
generation:-
x Nifedipine
2
nd
generation:-
x Amlodipine
x Felodipine
x Isradipine
x Nisoldipine
x nicardipine


Page 80
Anti-Hyperlipidemic drugs:-
Nicotinic acid group:-
1. Niacin
2. Nicofuranose
3. Acipimox
Fibrates:-
1. Clofibrate
2. Gemfibrozil
3. Benzafibrate
4. Fenofibrate
Bile acid binding resins or sequestrants:-
1. Cholestyramine
2. Colestipol
HMG CoA Reductase:-
1. Lovastatin
2. Simvastatin
3. Pravastatin
4. Fluvastatin
5. Cerivastatin
6. Atorvastatin
Drugs which Increase LDL catabolism:-
1. Probucol
Miscellaneous:-
1. Neomycin
2. Beta sitosterol
3. Dextro thyroxin
4. Oestrogen
5. Fish oil like omega3 marine TG


Page 81
Anti-Anginal drugs
Nitrates:-
Short acting Drugs:-
x Glyceryl trinitrate
x Amyl nitrate
Long acting drugs:-
x Isosorbide dinitrate
x Isosorbide mononitrate
x Pentaerythritol tetranitrate
x Erythrityl tetranitrate
Beta blockers:-
x Propranolol
x Atenolol
x Metoprolol
Ca++ channel blockers:-
x Verapamil
x Nifedipine
x Diltiazem
x Lidoflazine
x Prenylamine
Miscellaneous:-
x Papavarine
x dipyridamole
Therapeutic classification
For an acute attack:-
x Nitroglycerine
For immediate pre-exertional attack:-
x Nitroglycerine
x Nifedipine
For long term prophylaxis:-
Beta blockers:-
x Propranolol
x Atenolol
x Metoprolol
Long acting nitrate:-
x Isosorbide dinitrate
x Isosorbide mononitrate
Ca++ channel blockers:-
x Verapamil
x Nifedipine
x diltiazem



Page 82
Drugs used to treat heart failure:-
Renin-Angiotensin System Blocker:-
ACE inhibitors:-
x Captopril
x Enalapril
x Fosinopril
x Lisinopril
x Quinapril
x Benazepril
x Moexipril
x Ramipril
Angiotensin type-1 receptor blocker:-
x Candesartan
x Losartan
x Telmisartan
x Valsartan
Direct vasodilators:-
x Hydralazine
x Isosorbide dinitrate
x Minoxidil
x Sodium nitroprusside
Diuretics:-
x Bumetanide
x Furosemide
x Hydrocholrothzide
x Metlazone
Aldosterone Antagonist:-
x Spironolactone
Inotropic Agent:-
Cardiac glycosides:-
x Digoxin
x Digitoxin
x Ouabain
Beta-adrenergic agonist:-
x Dobutamine
x Dopamine
Bipyridines and phosphodiestrase inhibitors:-
x Amrinone
x Milrinone
Beta-Adrenergic Angtagonist:-
x Atenolol
x Carvedilol
x Metoprolol



Page 83
Drugs Affecting the Blood:-
Platelet inhibitors:-
Phosphodietrase inhibitors:-
They increase cyclic AMP, decreases thromboxane, and hipotentiat PG12 effect to
antagonize platelet adhesion.
1. Dipyridamole
Glycoprotein IIb and IIIa receptor antagonist:-
1. Abciximab I/V
2. Tirofiban
3. Eptifibatide
ADP receptor antagonist:-
1. Ticlopidine
2. Clpidogrel
Cyclooxygenase inhibitors:-
Inhibit thromboxane A2 synthesis by irreversible acetylation.
1. Aspirin
2. Sulphinpyrazone
Inhibitors of thromboxane synthase:-
1. Dazoxiben
Others:-
1. Epoprosenol
2. timolol
3. clofibrate
4. Dextrane-70 , Dextrane-75
Thrombane inhibitors:-
1. Lepirudin
2. danaparoid



Page 84
Diuretics:-
Loop diuretics:-
Sulfonamides:-
1. Furosemide
2. Bemetanide
3. Piretanide
4. Toremide
Non Sulfonamides:-
1. Ethacrynic Acid
2. Ticrynaten
3. Indacrynic acid
Thiazide Diuretics:-
Thiazides:-
1. Chlorothiazide
2. Hydrochlorothiazide
3. Bendrofluazide
4. Bendroflumethiazide
5. Polythiazide
6. Cyclopenthiazide
Thiazide like:-
1. Chlorothalidone
2. Metolazone
3. Indapamide
4. Xipamide
5. Quinethazone
Potassium sparing Diuretics:-
Aldosterone Antagonist:-
1. Spironolactone
Non Aldosterone Antagonist:-
1. Triamterece
2. Amiloride
Osmotic Diuretics:-
1. Mannitol
2. Glycerol
3. Isosorbide
4. Urea
Carbonic anhydrase inhibitor:-
1. Asetazolamide
2. Ethoxzolamide
3. Methazolamide
4. Dichlorphenamide
5. Topical preparation , 4 angle glaucoma Dorzolamide, brizolamide


Page 85
Anti-Diuretics:-
1. Anti- Diuretics hormone.
2. Drugs which release ADH.
I. Morphine
II. Nicotine
III. Yohimbine
IV. Ether cyclopropane
3. Drug that cause afferent renal arterioles constriction
i. Adrenaline
4. Thiazides act as Anti-Diuretics in nephrogenic diabetes insipidus



Page 86
Anti-Arrhythmic Drugs:-
Class I Na++ channel blockers:-
Ia.
1. Disophyramide ( prolong refractory period and slow conduction)
2. Procainamide (SLE)
3. Quinidine
4. Imipramine
5. Cifenline
6. Amiodarone
Ib.
1. Phenytoin ( short Duration of refractory period)
2. Tocainide (pulmonary Fibrosis)
3. Mexiletine
4. Moricizine
5. Lidocaine (I/V)
Ic.
1. Propafenone (slow Conduction)
2. Indecianide
3. Ecainide
4. Flecainide
Class II beta Adrenoceptor Blockers:-
1. Propranolol
2. Pindolol
3. Metoprolol
4. Esmolol
Class III K+ Channel blockers:-
1. Bretylium
2. Amiodarone (pulmonary fibrosis, thyroid dysfunction)
3. Soralol
4. Dofetilide
5. Ibutilide
Class IV Ca++ channel blockers:-
1. Diltiazem
2. Verapamil
3. Bepridil
Other Anti-Arrhythmic Drugs:-
1. Adenosine
2. Digoxin
Therapeutic classification:-
Drugs Effective in Supra-Ventricular Arrhythmia:-
Act mainly on AV nodes.
1. Beta blockers
2. Verapamil
3. Digoxin

Page 87
Drugs Effective in Ventricular Arrhythmia:-
1. Lignocaine
2. Phenytoin
3. Mexiletine
Drugs in Both:-
1. Quinidine
2. Procanamide
3. Disopyramide
4. Amiodarone
Sotalol is chiral compound. It has two optical isomers. One isomer is an effective B-
blocker and contributes to anti-arrhythmic action.


Page 88
Drugs used for Parkinsonism:-
Dopaminergic drugs:-
DA precursor:-
x Levodopa (loredopa)
Peripheral decarboxylase inhibitor:-
x Carbidopa
x Benserazide
Dopamine releasing drugs:
x Amantadine
MAO-BH inhibitor:-
x Selegiline
Dopamine agonists:-
x Ergot Alkaloid:-
o Bromocriptine
o Pergolide
Partial agonist at D2 receptor in brain :- (hyperprolactenemia)
Non ergot dopamine receptor agonist:-
o Pramipexole
o Ropinirole
COMT inhibitor: - catechol-o-methyltransferase:
Entacapone
Tolcapone
Anticholinergic drugs:-
Natural belladonna alkaloid:-
x Atropine
x Hyoscine
Synthetic anticholinergics:-
x Bentropine
x Procyclidine
x Biperiden
Antihistamine:-
x Diphenhydramine
x Or phendrine
Phenothiazine:
Ethopronazine
Drugs for other movement disorder:-
Tremors:-
x Propranolol
Huntingtons & tourettes:-
x Haloperidol
x Phenothiazine
wilson disease:-
Penicillamine (chelating agent remove excess copper)


Page 89
Drugs Use in Rheumatoid Arthritis:
1. Immune Suppressant
Methotrexate, Azothioprine , Cyclosporine
2. Sulfa salazine
3. Chloroquine
4. B cell Cytotoxic Agent. Eg. Rituximab
5. Leflurnomide
6. T cell modulating Eg. Abetacept
7. TNI Blocking abalimubad, infliximab, Entacept
8. Adjuvant Drug
Corticosteroids, Prednisolone

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