Pharma all

Adrenaline (Epinephrine)

• Increases duration of local anesthesia
• Therapeutic uses: cardiac arrest, bronchospasm, intraocular surgery
• Adverse effects: can trigger cardiac arrhythmias, tachycardia, pulmonary edema

Beta-2 Adrenergic Agonists

• Albuterol (salbutamol) used in therapy of asthma and COPD

Alpha Adrenergic Agonists

• Methyldopa (α2 selective agonist) used in hypertension in pregnancy, doesn't cross placenta, decreases NE release by stimulating presynaptic α2-adrenergic receptors

Alpha Adrenergic Antagonists

• Phentolamine (non-selective) blocks α1 and α2 receptors, used in hypertensive crisis and diagnosis of pheochromocytoma
• Prazosin and doxazosin (selective α1 receptor antagonists)

Neuromuscular Blocking Agents

• Succinylcholine (direct-acting agonist) binds to postsynaptic NM receptor, causes initial depolarization of motor end plate, brief duration of action due to redistribution and rapid hydrolysis by plasma cholinesterase
• Adverse effects: malignant hyperthermia, succinylcholine apnea, hyperkalemia, arrhythmia, myalgia

Anti-Spasticity Agents

• Dantrolene (peripherally acting direct-acting drug) used in chronic spasmolytic agent, malignant hyperthermia, and spastic states
• Diazepam (GABA-A receptor agonist) produces more sedation and weakness than Baclofen
• Baclofen (GABA-B receptor agonist) causes membrane hyperpolarization, less sedation and weakness than diazepam
• Tizanidine (α2 agonist) reduces spasticity while maintaining adequate muscle strength, relatively short-acting

Antispasm Drugs

• Cyclobenzaprine and Chlorzoxazone (polysynaptic inhibitors) are centrally acting drugs, side effects include drowsiness, dizziness, confusion, etc.

Benzodiazepines

• Triazolam and Alprazolam (short-acting), Lorazepam and Temazepam (intermediate-acting), Diazepam (long-acting)
• Flumazenil (GABA receptor antagonist) reverses effects of benzodiazepines, rapid onset but short duration, frequent administration may be necessary

Anxiolytic

• Buspirone (acts as agonist at brain 5HT1A receptors) used for chronic treatment of generalized anxiety disorder, slow onset of action, lacks hypnotic effect, anticonvulsant and muscle-relaxant properties

Dopamine Agonists

• Amantadine (releases dopamine) used as antiviral agent, treats and prevents respiratory infections caused by influenza A virus

Anticholinergic Agents

• Benztropine (anticholinergic agent) used in antiparkinsonism therapy, adverse effects include mood changes, confusion, peripheral atropine-like toxicity

Antipsychotics

• Chlorpromazine and Haloperidol (first-generation antipsychotics) reduce positive symptoms of schizophrenia, associated with elevated prolactin secretion, extrapyramidal side effects
• Risperidone and Clozapine (second-generation antipsychotics) reduce negative symptoms of schizophrenia

Opioid Receptor Agonist

• Tapentadol (agonist at μ opioid receptor and inhibitor of norepinephrine reuptake) used to manage moderate to severe acute and chronic pain, including neuropathic pain

Opioid Receptor Antagonists

• Naloxone (competitive antagonist at μ, κ, and δ receptors) reverses effects of morphine overdose, used to treat opioid overdose
• Naltrexone (competitive antagonist at μ, κ, and δ receptors) has longer duration of action than naloxone, can be given orally, used to maintain opiate abstinence

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

• Have three major therapeutic actions: reduce inflammation, pain, and fever
• Inhibit prostaglandins, reversible inhibitors of cyclooxygenase (COX) enzyme except aspirin which inactivates COX irreversibly
• Therapeutic uses: osteoarthritis, gout, rheumatoid arthritis, common conditions requiring analgesia, and fever