Generic Name

Acetaminophen

Trade "common" Common Clinical Utility name

Tylenol antipyretic/analgesic, no antiinflammatory activity, DOC for children with viral infx anti-hyperuricemic drug Xanax benzo of choice for panic disorders, Tx of agoraphobia Tx of bronchial asthma Tx of life-threatening supraventricular and ventricular tachyarrhythmias

Mechanism of action
inhibits PG synthesis in CNS (post. Hypothalamus ) inhibits xanthine oxidase GABA receptor agonist PDE inhibitor, results in higher conc of intracellular cAMP Class III antiarrhythmic, increases AP duration and refractory period

Unique Toxicity
centrilobular hepatic necrosis (can be countered with Nacetyl cysteine) hypersensitivity reaction, skin rash addiction (with protracted withdrawl) "narrow therapeutic window" pulmonary fibrosis, pts may see halos in periphery d/t corneal deposits hypersensitivity reactions

Allopurinol Alprazolam Amino(theo)phylline

Amiodarone

Amoxicillin

for non-penicillinase producing strains of beta lactam antibiotic which Strep, Staph, H. flu, E. coli, P. mirabilis, inhibits bacterial cell wall uncomplicated GC infx, otitis media synthesis DOC for systemic mycoses Aspirin anti-inflammatory/antipyretic, DOC for RA polyene antifungal, binds to membrane ergosterol to induce pore formation NSAID, inhibits COX

Amphotericin B Acdetylsalicylic Acid (ASA) Atropine Zidovudine, Retrovir

nephrotoxicity GI bleeding, Reye's syndrome

to increase HR and for Tx of competitive muscarinic receptor insufficient dose may cause cholinesteraase inhibitor-induced toxicity blocker paradoxical slowing of HR nucleoside inhibitor (T analog) part of highly active antiretroviral therapy or reverse transcriptase, bone marrow suppression (HAART), Tx of HIV/AIDS terminates viral DNA synthesis macrolide antibiotic, antibacterial, DOC or C. trachomatis bacteriostatic, binds 50s urethritis, Tx of legionella, Neisseria and rash in mono (like ampicllin) ribosomal subunit, blocks Mycoplasma infx translocation antineoplastic agent, expecially for Tx of attacks phosphodiester bonds of pulmonary fibrosis testicular tumors DNA, causing strand breakage anti-Parkinsonism drug, Tx of hyperprolactinemia anti-hypertensive, Tx of CHF, post MI therapy dopamine receptor agonist ACE inhibitor exacerbates psychiatric ilness dry cough, angioedema, fetal damage

Azidothymidine (AZT)

Azithromycin

Bleomycin Bromocriptine Captopril/enalapril/lisinop ril

Ceftriaxone

active against G- infx (nosocomial, Lyme, N. gonorrhoeae) and bacterial meningitis DOC against flaciparum malaria, Tx of extraintestinal amebiasis (esp hepatic amebiasis) antihypertensive, used for CHF, nephrotic syndrome, hypercalciuria low potency drug for Tx of schizophrenia or psychiotic symptomatology antihyperlipidemic used for type IIa and IIb hyperlipidemias

Chloroquine

3rd gen. cephalosporin, betalactam inhibitor of cell wall, blocks terminal cross-linking of can cause a positive bacterial cell wall peptidoglycan Coombs' test ad activates cell wall autolytic enzymes antimalarial drug, inhibits breakdown of heme in the plasmodial digestive tract prototype thiazide diuretic, binds Cl- channel in DCT, inhibits hypokalemia NaCl reabsorption neuroleptic agent, antagonist at contraindicated in pts with a1-adrenergic, dopamine, 5HT seizure disorders receptors in CNS anion exchange resin which binds negatively charged bile acids and bile salts, dec enterohepatic recirculation and inc their excretion prototype H2 receptor antagonist, reversibly binds to gastric parietal cells and inhibits acid secretion inhibition of bacterial DNA gyrase constipation and impaired absorption of fat-soluble vitamins inhibits cyto p450, increased conc of other drugs and may have antiandrogenic effects pediatric Achilles tendon rupture may cause pseudomembranous enterocolitis sexual dysfunction agranulocytosis strong abuse potential, respiratory depression and coronary spasm peripheral neuritis , alopecia

Chlorothiazide

Chlorpromazine

Cholestyramine

Questran

Cimetidine/ranitidine

Tagamet

PUD, GERD, Z-E syndrome G- infx, gonorrhoeae, UTIs, soft tissue infx, diarrheal diseases

Ciprofloxacin Clindamycin, lincosamide Clonidine Clozapine

anaerobic bacterial infx (lung abscesses, irreversibly binds 50s subunit, intra-abdominal infx, orthopedic infx) interfering with aa transfer HTNj, opiate withdrawla, benzo withdrawal refractory schizophrenic pts or tardive dyskinesia topical anesthetic in the nose and throat alpha 2 adrenergic agonist neuroleptic agent with high affinity for 5HT2 and D4 recept inhibits reuptake of catecholamines plant alkaloid, binds tubulin, causes depolymerization of microtubules inhibits mast cell degranulation

Cocaine

Colchicine

antineoplastic agent, gout prophylactic anti-inflammatory in asthma

Cromolyn sodium

only minimal systemic toxicity

Cyclophosphamide

alkylating agent, activated by autoimmune disorders and bone marrow cyto p450 and then alkylates transplants DNA

hemorrhagic cystitis

Cyclosporine

immunosuppressant, prevents rejection of allergenic transplants , tx of graft vs host disease and selected autoimmune disorders Valium anxiety, skeletal muscle relaxant, preanesthetic med, status epilepticus

synthesis IL-2 by activated Tnephrotoxicity cells addiction (with protracted withdrawl)

Diazepam

GABA receptor agonist

Diethylstilbestrol

morning after pill, can be used to prevent pregnancy when at high doses CHF, A-V nodal depression, a-fib and flutter angina from vasospasm, Tx of arrhythmias (SVTs) and mild-moderate HTN DOC for urticaria and allergic rhinitis, Tx of insomnia CHF, promotes inc cardiac output with little change in myocardial O2 demand

Digoxin Diltiazem Diphenhydramine Benadryl

rare, clear cell cervical or vaginal adenocarcinoma via steroid hormone mechanism among daughters of women who took it during early pregnancy reversibly binds and inhibits life-threatening cardiac Na/K ATPase, positive inotropy arrhythmias Class IV antiarrhythmic drug, Ca channel blocker generally safe

1st generation antihistamine (H1 minor abuse potential receptor blocker) Beta 1 adrenergic receptor agonist anthracycline antibiotic which intercalates DNA, binds to cell memb and generates O free radicals through lipid peroxidation competitive inhibitor of acetylcholinesterase alpha and beta adrenergic agonist macrolide antibiotic, binds 50s ribosomal subunit interfering with protein synthesis, blocks translocation quite safe in lower doses

Dobutamine

Doxorubicin

antineoplastic agent

cardiotoxicity

Edrophonium

Tensilon

Dx of MG DOC for anaphylaxis, used in asthama, cardiac arrest, enhances effect of local anesthetics alternative to PCN in allergic pts, 1st choice for Legionella and M. pneumoniae, 2nd choice for Syphilis and Chlamydial

only as may relate to brevity of effect excessive dosing may precipitate hypertensive crisis sensorineural hearing loss in large doses, inhibition of cyto p450

Epinephrine

Erythromycin

Estrogen

Finasteride

OCPs, HRT, primary hypogonadism and hypopituitarism, dysmenorrhea, via steroid hormone mechanism dysfunctional uterine bleeding, palliative Tx for prostatic carcinoma 5-alpha reductase inhibitor, inhibits conversion of BPH and male pattern bladness testosterone to DHT in target tissues

thromboembolic phenomena

gynecomastia for Proscar, not Propecia

Fluoxetine

depression, panic disorder, OCD, PTSD SSRI and bulemia nervosa folate defic, dietary supplement for women of childbearing age to prevent NTDs cofactor which participates in 1 carbon transfer for DNA and methionine synthesis

inhibits cyto p450 , potentially fatal 5HT syndrome when combined with MAOIs ~

Folic acid

Furosemide

Lasix

protoype loop diuretic, inhibits CHF, pulm edema, renal and liver failure, reabsorption of Na, K and Cl in hypokalemia , ototoxicity, severe HTN, hypercalcemia ascending thick limb by blocking allergic interstitial nephritis Na/K/Cl cotransporter G- bacteria, for serious infx, topically in irreversibly binds 30s burns infected with Pseudomonas and ribosome, inhibiting the initiation ototoxicity and nephrotoxicity ocular infx of protein synthesis psycotic symptoms or schizo, severe manic or agitated episodes, Tourette's dopamine receptor antagonist (esp D2) in mesolimbic and mesocortical areas may cause Parkinsonism, akathisia, dystonia, tardive dyskinesia, hyperprolactinemia,

Gentamicin

Haloperidol

Haldol

Heparin

in pts at high risk for thrombosis and pulm emboli, used to stop ongoing thrombosis, used in acute phase of MI

accelerates antithrombin III binding to thrombin and antithrombin III, inactivates thrombin, Ixa, Xa, XIa, XIIa and thrombocytopenia kallikrein, inhibits clot formation,

does not dissolve clots!

Hydralazine direct relaxation of vascular moderate-severe essential HTN, CHF (in smooth muscle, greater effect combo with oral nitrates) on arterioles than venules Advil analgesic, anti-inflammatory, antipyretic NSAID, inhibits COX lupus-like syndrome with +ANA (in slow acetylators) nephrotoxicity

Ibuprofen

Imipramine

severe major depression

Indinavir sulfate

part of HAART for HIV/AIDS closure of PDA, moderate-severe RA, OA, ankylosing spondylitis, Bartter's synd, tendinitis, bursitis, acute gout, dysmenorrhea, DOC for Reiter's IDDM, NIDDM, diabetic ketoacidosis, hyperosmolar hyperglycemic nonketotic coma

prototype tricyclic antimuscarinic effects, antidepressent, decreases reuptake of NE and 5HT in the orthostatic hypotension CNS inhibits viral protease, preventing formation of thrombocytopenia functional reverse transcriptase NSAID, inhibits PG-forming COX blood dyscrasias, hepatotoxicity, contraindicated in pregnant women

Indomethacin

Insulin, regular

binds tyrosine kinase receptors on cell surface, promoting anabolic reactions withing target hypoglycemia cells, promotes translocation of GLUT transporters to plasma memb

Isoniazid (INH)

tx and prevention of TB

inhibits mycolic acid synthesis of lupus-like syndrome with mycobacterial cell wall +ANA (in slow acetylators) beta agonist unknown (may inhibit sebaceous gland size and function) blocks synthesis of fungal cell membrane ergosterol dopamine precursor (converted by dopa decarboxylase) activation of nuclear non-histone protein receptors attached to DNA, increasing trnascription of mRNA decreases automaticity in Purkinje fibers and vent tissue by blockin inactivated Na+ channels, favoring phase III repolarization antidepressent effect - may decrease supersensitivity of dopamine receptors, increase Ach, enhance 5HT activity for depression; antimania effect - it may prevent recycling of phosphoinositides, causing depletion of IP3 and DAG, diminishes excess catecholamines and 5HT angiotensin II receptor blocker HMG-CoA reductase inhibitor opioid receptor agonist sinus tachycardia teratogenic suppression of cyto p450 (be careful of any patient taking Warfarin, etc..) hyperkinetic movement disorders, psychotic behavior ~

Isoproteronol Isotretinoin

bronchial asthma, bradycardia severe cystic acne that is recalcitrant to standard therapy coccidiomycosis, histo, blasto, paracoccidio, mucocutaneous candidiasis for Parkinson's disease (usually with carbidopa) DOC for hypothyroidism

Ketoconazole

Levodopa

Levothyroxine

Lidocaine

primary therapy for ventricular arrhythmias, local anesthetic

cimetidine and propranolol increase its toxicity

Lithium

mania, depression, bipolar disorder

teratogenic, interstitial nephritis, nephrogenic DI

Losartan K+ Lovastatin Meperidine Mevacor Demerol

HTN Type Iia and Iib hyperlipoproteinemia and secondary hyperlipoproteinemia analgesic anti-neoplastic agent, RA, abortion, ectopic pregnancy, psoriasis CNS simulant, stimulates mood and alertness and depresses apetite, Tx of ADHD HTN, tachyarrhythmias, heart disease

fetal damage elevated liver enzymes, rhabdomyolysis relative mydriasis

Methotrexate

folic acid analogue, blocks DHF reductase, results in decreased pneumonitis, fatty liver , dTMP -> decreased DNA and myelosuppression protein synthesis stimulates release of significant abuse potential in catecholamines (cross the BBB) non-ADHD subjects Beta 1 adrenergic receptor blocker ~

Methylphenidate Metoprolol/lopressor

Metronidazole

entry into cells of infectious amebic infx, DOC for trichomoniasis and organism, chemically reduced giardiasis, Bacteroides fragilis, C. diff, and products cause death by Gardnerella vaginalis interaction with DNA and interfering with cell division sever pain primary activity at opioid mu receptors beta-lactam antibiotic, inhibits bacterial synthesis by preventing peptidoglycan crosslinking, penicillinase resistant opioid receptor antagonist with very high affinity at mu receptors, can also block kappa and delta Ca channel blocker

disulfiram-like reaction with alcohol consumption, avoid in pregnant women contraindicated with sedative hypnotics, MAOIs and antipsychotics acute tubulo-interstitial nephropathy (ATIN), though much less than methicillin ~ Raynaud's phenomenon

Morphine

Nafcillin

penicillin-resistant Staph and Strep infx

Naloxone Nifedipine

acute opioid overdose

mild-moderate HTN, coronary vasospasm angina, coronary vasospasm, Prinzmetal's angina, CHF, short term management of HTN

Nitroglycerine

coronary vasodilation and systemic venous pooling to postural hypotension, reflex reduce preload and vasodilation, tachycardia d/t metabolism to NO -> activate guanylate cyclase -> cGMP thiocyanate poisoning

Nitroprusside

hypertensive emergencies, acute CHF, directly relxes vascular smooth sever mitral regurgitation with pulmonary muscle via NO, relaxes both congestion arterioles and venules controls excessive horomone secretion in acromegaly, glucagonemia, insulinoma GERD, PUD, Z-E syndrome somatostatin analog

Octreotide Omeprazole Phentolamine Phenoxybenzamine

~ ~ orthostatic hypotension inhibits ejaculation , may cause orthostatic hypotension tissue necrosis gingival hyperplasia, hirsutism ~

Phenylephrine

Phenytoin Physostigmine

irreversibly inhibits the gastric parietal cell H+/K+ ATPase competitive and reversibly hypertensive crisis associated with pheo blocks alpha adrenergic receptors irreversibly blocks alpha pheo, hypertensive crisis secondary to adrenergic receptors by MAO OD, prophylaxis for Raynaud's covalent attachment nasal decongestant, hypotension, to alpha 1 adrenergic receptor prolong local anesthetic, to terminate agonist paroxysmal atrial tachycardias, mydriatic for epilepsy except absence seizures, inhibits voltage-gated Na trigeminal neuralgia, limited use as an channels antiarrhythmic glaucoma cholinesterase inhibitor

Pilocarpine KCL

topically for narrow and open-angle glaucoma to reduce IOP antiarrhythmic Tx of hypoalemia DOC for ALL trematode infx, active in cestode infx anti-inflammatory and immunosuppressant agent, when lonterm therapy is needed

direct-acting muscarinic receptor ~ agonist involved in maintenance of cellular membrane potential antihelminthic, increases memb permeability of susceptible worms to Ca -> paralysis of parasite enters target cells and binds to cytosolic receptor, complex is translocated to nucleus, regulates protein synthesis Class IA antiarrhythmic, blocks Na+ channels, thereby slowing rate of phase O depolarization and conduction beta adrenergic receptor antagonist inhibits thyroid peroxidasecatalyzed reactions, also inhibits peripheral deiodination of T4>T3 Class IA antiarrhythmic, blocks Na+ channels, thereby slowing rate of phase O depolarization and conduction, also blocks muscarinic and alpha 1 receptors inhibits phosphodiesterase death if given too quickly as bolus, arrhythmias eosinophilia

Praziquantel

Prednisone

exogenous Cushing's syndrome

Procainamide

atrial and ventricular arrhythmias, including ventricular ectopic beats

lupus-like syndrome with +ANA use with caution in diabetics, may cause impotence maculopapular pruritic rash, agranulocytosis patient must be pretreated with b-blocker, digitalis or Ca channel blockers to avoid possible increase in vent response to atrial flutter, may cause Torsades and cinchonism affects color vision causing difficulty in blu e /green discrimination

Propranolol

HTN, angina, arrhythmias post-MI

Propylthiouracil (PTU)

thyrotoxicosis

Quinidine

atrial and ventricular arrhythmias, including ventricular ectopic beats

Sildenafil citrate

ED in combo with K+ losing diuretics to maintain proper K+ balance, useful in presence of high aldosteone levels, used in Dx and Tx of primary hyperaldosteronism, used in Tx of PCOD and female hirsutism Tx of DVTs, PE, unclogging of catheters and shunts, acute MI, hypersensitivity reactions, anaphylaxis

Spironolactone

blocks aldosterone action by competitively binding to its receptor

gynecomastia

Streptokinase

Tamoxifen

no enzymatic action, forms complexes with plasminogen, which can then cleave free plasminogen into plasmin competative antagonist to reduce recurrence of estrogen-receptorestrogen at receptors in the positive breast cancer, particularly in breast, partial agonist at other postmenopausal women estrogen receptors

hemorrhagic stroke

Terfenadine

prevent or Tx symptoms or allergic reactions, without causing drowsiness sedative, immunomodulatory actions, recently reintroduced for Leprosy, skin manifestations of lupus depression, phobias, narcolepsy, panic attacks

H1 receptor blocker (2nd generation antihistomine)

metabolism is easily inhibited by many hepatic microsomal enzyme inhibitors, high conc can cause Torsades teratogenic, causes phcomelia avoid tyramine-containing foods

Thalidomide

unknown

Tranylcypromine

monoamine oxidase inhibitor

Trimethoprime/ Sulfamethoxazole

Vancomycin

Vasopressin Verapamil

Warfarin

Coumadin

Zafirlukast Zileuton

acts as inhibitor of two sequential steps in synthesis of UTIs, shigellosis, salmonellosis, H.flu folic acid, sulfa inhibits PABA resp infx, Strep pneumo, PCP, typhoid incorporation into folic acid, and paratyphoid fevers, Isospora belli triemth inhibits the reduction of DHF to THF G+ only, for C. diff psudomembranous inhibits cell wall synthesis by colitis, MRSA, enterococcal infx in PCN binding to D-Ala-D-Ala, thus allergic pts, PCN-resistant pneumococci, preventin its incorporation into w/ gentamicin for S. faecalis and S. peptidoglycan viridans endocarditis increases water reabsorption in the collecting ducts of the central DI kidney by binding to ADH receptor mild-moderate Htn, SVTs, migraine Ca channel blocker headache prophylaxis derivative of Coumarin, interferes with synthesis of simialr to heparin, but not useful for vitamin K -dependent clotting rapid anticoagulation factors (II, VII, IX, X, protein C, protein S) leukotriene receptor asthma antagonist (LTD4) asthma 5-lipoxygenase inhibitor, blocks arachidonic acid -> leukotrienes

Steven-Johnson syndrome , blood dyscrasias

rapid infusion may cause facial and neck erythema ("red man syndrome"), ototoxicity, nephrotoxicity ~ significant negative inotrope

warfarin skin necrosis

hepatotoxicity