Drug Class PDF

+-------------+-------------+-------------+-------------+-------------+ | Drug class | Drugs | MOA | Adverse | Other | | | | | effects | | +=============+=============+=============+=============+=============+ | Endocrine...

+-------------+-------------+-------------+-------------+-------------+ | Drug class | Drugs | MOA | Adverse | Other | | | | | effects | | +=============+=============+=============+=============+=============+ | Endocrine | | | | | +-------------+-------------+-------------+-------------+-------------+ | Corticoster | Prednisolon | Binds to | Immunosuppr | Must taper | | oids | e | CGR in the | ession | off | | | | cytoplasm, | | medication. | | | Cortisone | it then | Peptic | | | | | dimerises | ulcers | | | | Hydrocortis | and | | | | | one | translocate | Hyperglycae | | | | | s | mia | | | | Fludrocorti | to nucleus. | | | | | sone | There it | Hepatic | | | | (mineraloco | binds to | damage | | | | rticoid) | GRE to | | | | | | alter | | | | | | transcripti | | | | | | on. | | | +-------------+-------------+-------------+-------------+-------------+ | TH | Carbimazole | Competes | | Propylthiou | | synthesis | | with | | racil | | inhibitors | Propylthiou | oxidised | | also | | | racil | iodide in | | inhibits | | | | colloid | | conversion | | | | space and | | of T4 to | | | | inhibits | | T3. (short | | | | oxidation | | half-life) | | | | with | | | | | | thyroglobul | | Carbimazole | | | | in | | long half | | | | therefore | | life | | | | inhibiting | | | | | | synthesis | | | | | | of TH. | | | +-------------+-------------+-------------+-------------+-------------+ | TH release | Concentrate | Transient | High levels | | | inhibitors | d | inhibition | of iodine | | | | iodine | of TH | may | | | | | release | increase TH | | +-------------+-------------+-------------+-------------+-------------+ | Thyroid | Levothyroxi | Restores | Over | Not taken | | hormones | ne | negative | treating | with | | | | feedback | | calcium or | | | Liothyronin | loop. | Increased | iron, will | | | e | | BP/HR | affect | | | | | | absorption. | | | | | Arrhythmia | | | | | | | | | | | | Decreased | | | | | | bone | | | | | | mineral | | | | | | density | | +-------------+-------------+-------------+-------------+-------------+ | Thyroid | | | | | +-------------+-------------+-------------+-------------+-------------+ | vitamins | Calcium | Essential | To be taken | Not taken | | | | mineral | at night | with | | | | during bone | when bone | bisphosphon | | | | formation | formation | ates, | | | | to increase | is highest. | digoxin, | | | | bone | | levothyroxi | | | | density | | ne. | +-------------+-------------+-------------+-------------+-------------+ | | Vitamin D | Increases | Risk of | | | | | calcium | hypercalcem | | | | | absorption | ia | | | | | from GIT, | | | | | | increases | | | | | | mobilizatio | | | | | | n | | | | | | of calcium. | | | +-------------+-------------+-------------+-------------+-------------+ | Bisphosphon | Alendronate | Prevent | Osteonecros | Long half | | ates | | osteoclast | is | life | | | Risedronate | from | | | | | | binding | Musculoskel | Poor oral | | | | onto | etal | bioavailabi | | | | hydroxyapat | pain | lity | | | | ite | | | | | | of the bony | | NOT take | | | | surface | | with | | | | (reduces | | calcium | | | | bone loss). | | supplements | | | | Prevent | | , | | | | apoptosis | | will bind | | | | of | | to it in | | | | osteoblast. | | GIT instead | | | | | | of bone. | +-------------+-------------+-------------+-------------+-------------+ | HRT | Oestrogen | Reduces | | NOT first | | | | osteoclast | | line. | | | | activity | | | | | | which | | | | | | limits bone | | | | | | resorption. | | | +-------------+-------------+-------------+-------------+-------------+ | Selective | Raloxifene | Agonist of | Venous | | | estrogen | | selective | thromboembo | | | receptor | | estrogen | lism. | | | modulators | | receptor | | | | | | modulators | | | | | | increases | | | | | | BMD, | | | | | | "estrogen | | | | | | like" | | | +-------------+-------------+-------------+-------------+-------------+ | RANK ligand | Denosumab | Human IgG | Hypocalcaem | | | inhibitor | | antibody | ia | | | | | binds | | | | | | RANKL. This | Cellulitis | | | | | prevents | | | | | | RANKL from | | | | | | binding to | | | | | | its | | | | | | receptor, | | | | | | this | | | | | | reduces | | | | | | osteoclast | | | | | | synthesis | | | | | | and | | | | | | formation, | | | | | | reduces | | | | | | bone | | | | | | resorption. | | | +-------------+-------------+-------------+-------------+-------------+ | Recombinant | Teriparatid | Increases | Nausea | Calcium | | human PTH | e | calcium | | containing | | | | absorption | Dizziness | products | | | | and | | reduce | | | | decreases | Allergic | absorption | | | | its | reactions | of drug. | | | | elimination | | | | | |. | | | | | | Increases | | | | | | osteoblast | | | | | | formation | | | | | | and | | | | | | inhibits | | | | | | apoptosis. | | | +-------------+-------------+-------------+-------------+-------------+ | Anti-sclero | Romosozumab | Sclerostin | | | | stin | | inhibits | | | | | | wnt | | | | | | pathway, | | | | | | this | | | | | | inhibits | | | | | | bone | | | | | | formation | | | | | | and | | | | | | activates | | | | | | bone | | | | | | resorption. | | | | | | Romosozumab | | | | | | inhibits | | | | | | sclerostin. | | | +-------------+-------------+-------------+-------------+-------------+ | Antiepilept | Phenytoin | Inactivate | | Should also | | ics | | vitamin D, | | be on a | | | Carbamazepi | decreasing | | calcium | | | ne | calcium | | supplement. | | | | absorption | | | +-------------+-------------+-------------+-------------+-------------+ | Diabetes | | | | | +-------------+-------------+-------------+-------------+-------------+ | Insulin | Insulin | Restores or | Hypoglycaem | | | | | increases | ia | | | | | ability to | | | | | | metabolise | Weight gain | | | | | glucose | | | +-------------+-------------+-------------+-------------+-------------+ | | Metformin | Increases | Nausea, | Cleared | | | | sensitivity | vomiting | renally, | | | | to tissues | | decrease | | | | to insulin, | | dose If | | | | increases | | patient has | | | | glucose | | renal | | | | uptake by | | impairment. | | | | muscles and | | | | | | fat cells. | | | +-------------+-------------+-------------+-------------+-------------+ | Sulfonylure | Glimepiride | Inhibit the | Hypoglycaem | | | as | | SUR-1 | ia | | | | Gliclazide | subunit of | | | | | | K/ATP | Weight gain | | | | | channel, | | | | | | closing | | | | | | channel | | | | | | causing | | | | | | membrane | | | | | | depolarisat | | | | | | ion. | | | | | | increasing | | | | | | insulin | | | | | | secretion. | | | +-------------+-------------+-------------+-------------+-------------+ | SGLT 2 | Dapaglifloz | SGLT 2 | UTIs | Weight loss | | inhibitors | in | reabsorbs | | | | | | glucose | Dehydration | | | | Empaglifloz | back into | | | | | in | circulation | | | | | | , | | | | | | therefore | | | | | | the | | | | | | inhibitors | | | | | | stop | | | | | | reabsorptio | | | | | | n | | | | | | of glucose. | | | +-------------+-------------+-------------+-------------+-------------+ | GLP-1 | Dulaglutide | Mimic | GI upset | Weight loss | | analogues | | endogenous | | | | | Semaglutide | effects, | Fatigue | | | | | increasing | | | | | | glucose | | | | | | dependent | | | | | | insulin | | | | | | secretion. | | | | | | Also delays | | | | | | gastric | | | | | | emptying. | | | +-------------+-------------+-------------+-------------+-------------+ | DPP-4 | Linagliptin | DPP-4 | Head aches | | | inhibitors | | usually | | | | | Sitagliptin | degrades | Muscle pain | | | | | GLP-1 | | | | | | therefore | | | | | | the | | | | | | inhibitors | | | | | | stop DPP-4 | | | | | | therefore, | | | | | | preventing | | | | | | breakdown | | | | | | of GLP-1. | | | +-------------+-------------+-------------+-------------+-------------+ | Alpha-gluco | Acarbose | Inhibits | Flatulence | | | sidase | | alpha | | | | inhibitor | | glucosidase | Diarrhoea | | | | | enzyme | | | | | | which | | | | | | delays | | | | | | intestinal | | | | | | absorption | | | | | | of | | | | | | carbohydrat | | | | | | es. | | | +-------------+-------------+-------------+-------------+-------------+ | Obesity | | | | | +-------------+-------------+-------------+-------------+-------------+ | GLP-1 | Liraglutide | Mimic | Nausea/ | Average | | analogues | | endogenous | vomiting | weight loss | | | Smeaglutide | effects, | | 4-5% | | | o | increasing | Diarrhoea | | | | | glucose | | | | | | dependent | | | | | | insulin | | | | | | secretion. | | | | | | Also delays | | | | | | gastric | | | | | | emptying. | | | +-------------+-------------+-------------+-------------+-------------+ | Alter fat | Orlistat | Prevents | Cramps | Careful | | digestion | | fat from | | with | | | | being | Flatulence | vitamin | | | | hydrolysed | | deficiency | | | | by binding | Faecal | | | | | to | incontinenc | | | | | pancreatic | e | | | | | lipase | | | | | | (enzyme | | | | | | that breaks | | | | | | down fats). | | | | | | Therefore, | | | | | | fat cannot | | | | | | be absorbed | | | +-------------+-------------+-------------+-------------+-------------+ | Sympathomim | Phentermine | Indirect | Overstimula | Serotonin | | etics | | noradrenerg | tion | toxicity or | | | | ic | of CNS | uncontrolle | | | | sympathomim | | d | | | | etic, | Increase BP | BP | | | | supresses | | | | | | appetite. | Constipatio | | | | | | n | | +-------------+-------------+-------------+-------------+-------------+ | Gastrointes | | | | | | tinal | | | | | +-------------+-------------+-------------+-------------+-------------+ | Antacids | Alginate | Salt | | Can change | | | | component | | absorption | | | Aluminium | forms | | of other | | | hydroxide | complex | | drugs. | | | | with H | | | | | Calcium | component | | | | | carbonate | of gastric | | | | | | acid. | | | | | Magnesium | | | | | | hydroxide | Alginate | | | | | | also forms | | | | | | polysacchar | | | | | | ide | | | | | | gel | | | | | | provides | | | | | | layer | | | | | | protection. | | | +-------------+-------------+-------------+-------------+-------------+ | H2 | Famotidine | Competitive | Strong | Caution in | | antagonist | | inhibitor | inhibitor | patients | | | Nizatidine | of H2 | of CYP450 | with renal | | | | receptors | | impairment | | | | at parietal | | | | | | cells. | | | | | | Therefore, | | | | | | decrease | | | | | | acid | | | | | | secretion. | | | +-------------+-------------+-------------+-------------+-------------+ | Proton pump | Esomeprazol | Irreversibl | Headache | Safe in | | inhibitors | e | e | | pregnancy | | | | inhibitor | Nausea | | | | Pantoprazol | oh H/K pump | | Active form | | | e | at the | Vomiting | in | | | | parietal | | sulphonamid | | | Rabeprazole | cells, | | e | | | | which | | | | | | inhibits | | They | | | | the H+ | | inhibit | | | | secretion. | | CYP2C19 | +-------------+-------------+-------------+-------------+-------------+ | Prostagland | Misoprostol | Binds to | Nausea | Contraindic | | in | | PGR | | ated | | analogue | | receptor as | Diarrhea | in | | | | per PGE2, | | pregnancy | | | | stimulates | | | | | | mucous and | | | | | | bicarbonate | | | | | | secretion | | | | | | and | | | | | | inhibits | | | | | | binding of | | | | | | histamine | | | | | | to H2 | | | | | | receptors | | | | | | on parietal | | | | | | cells. | | | +-------------+-------------+-------------+-------------+-------------+ | antihistami | Promethazin | Sufficientl | Sedation | For motion | | nes | e | y | | sickness. | | | | lipophilic | Cry mouth | | | | Cyclizine | to cross | | | | | | BBB, | Blurred | | | | Betahistine | inhibits H1 | vision | | | | | receptors | | | | | Dimenhydrin | | | | | | ate | | | | +-------------+-------------+-------------+-------------+-------------+ | Antimuscari | Hyoscine | Cross the | Anti-cholin | For motion | | nic | -hydrobromi | blood brain | ergic | sickness | | | de | barrier and | | | | | | is an | Drowsiness | | | | | antagonist | | | | | | at | | | | | | muscarinic | | | | | | receptors. | | | +-------------+-------------+-------------+-------------+-------------+ | DA | Metoclopram | Inhibit | | Interaction | | antagonist | ide | dopamine | | s | | | | receptors | | with | | | domperidone | in the CTZ | | Parkinson | | | | | | drugs | +-------------+-------------+-------------+-------------+-------------+ | 5-HT3 | Ondansetron | Working by | Constipatio | Long | | antagonist | | inhibiting | n | duration of | | | | serotonin | | action, | | | | receptors | Headache | safe in | | | | in CTZ and | | children | | | | VC. | | | +-------------+-------------+-------------+-------------+-------------+ | Substance P | Aprepitant | Inhibit | | Metabolised | | antagonists | | NK-1 | | by CYP 3A4 | | | Fosaprepita | receptors | | | | | nt | in the CTZ | | | +-------------+-------------+-------------+-------------+-------------+ | Bulk-formin | Ispaghula | Absorb | Caution in | Delayed | | g | | water to | fluid | onset 2-3 | | laxatives | Psyllium | increase | restricted | days | | | | faecal bulk | and | | | | Sterculia | | immobile | | | | | | patients | | +-------------+-------------+-------------+-------------+-------------+ | Stool | Docusate | Mix water | May cause | Onset of | | softeners | | into faecal | abdominal | 1-3 days | | | Liquid | matter or | discomfort. | | | | paraffin | lubricate | | | | | | faecal | Liquid | | | | Poloxamer | matter. | paraffin | | | | | | may reduce | | | | | | absorption | | | | | | of | | | | | | fat-soluble | | | | | | vitamins | | +-------------+-------------+-------------+-------------+-------------+ | Stimulant | Bisacodyl | Stimulate | | Commonly | | laxatives | | the nerve | | abused | | | Picosulfate | endings in | | rectal dose | | | | colonic | | very quick | | | Senna | mucosa, | | onset. | | | | increase | | | | | | intestine | | | | | | motility | | | +-------------+-------------+-------------+-------------+-------------+ | Osmotic | Glycerol | Draw water | Avoid in | | | laxatives | | into the | patients | | | | Lactulose | faeces and | with | | | | | have | intestinal | | | | Macrogol | lubricating | obstruction | | | | | properties | | | | | Sorbitol | | | | +-------------+-------------+-------------+-------------+-------------+ | Weak | Loperamide | Bind to mu | Bloating | Not used in | | opioids | | receptors | | children | | | Diphenoxyla | in the GI | | under age | | | te | tract, | | of 12. | | | | inhibits | | | | | | Ach | | | | | | release, | | | | | | reduce gut | | | | | | motility. | | | +-------------+-------------+-------------+-------------+-------------+ | Anti-spasmo | Hyoscine | Relaxation | Tachycardia | | | dic | hutlybromid | of smooth | | | | agents | e | muscles by | Hypotension | | | | | reducing GI | | | | | Mebeverine | motility | | | | | | and spasms. | | | +-------------+-------------+-------------+-------------+-------------+ | Anti-foamin | Simethicone | Act as a | | Safe for | | g | | surfactant, | | infants | | agents | | coalesces | | | | | | gas bubbles | | | | | | within the | | | | | | intestine. | | | +-------------+-------------+-------------+-------------+-------------+ | 5-aminosali | Mesalazine | Potentially | Renal/liver | Rectal dose | | cylates | | , | impairment | form | | | | inhibits | | | | | | pro-inflamm | | | | | | atory | | | | | | mediators. | | | +-------------+-------------+-------------+-------------+-------------+ | Immunosuppr | Azathioprin | Inhibit | | | | essants | e | purine | | | | | | synthesis | | | +-------------+-------------+-------------+-------------+-------------+ | Contracepti | | | | | | on | | | | | | + menopause | | | | | +-------------+-------------+-------------+-------------+-------------+ | Combined | Ethinylestr | Causes | Risk of | Estrogen | | oral | adiol | negative | endometrial | has | | | with | feedback | cancer | procoagulan | | | levonorgest | inhibition | | t | | | rel | of GnRH and | Decrease | effects | | | or | FSH and LH | milk | | | | | secretion, | supply. | | | | Norethister | reducing | | | | | one | receptivity | Risk of MI | | | | | of | or stroke | | | | | endometrium | | | | | | and | | | | | | thickens | | | | | | cervical | | | | | | mucus. | | | +-------------+-------------+-------------+-------------+-------------+ | Progestogen | Levonorgest | Acts on | Same 3hr | Safer for | | only pill | rel | hypothalamu | window each | breast | | | | s | day, | feeding and | | | Norethister | to prevent | prolonged | less risk | | | one | pituitary | bleeding, | of thrombus | | | | LH surge, | breast | formation. | | | | ovulation | tenderness. | | | | | suppression | | | | | | , | | | | | | inhibit | | | | | | endometrial | | | | | | proliferati | | | | | | on. | | | +-------------+-------------+-------------+-------------+-------------+ | Emergency | Levonorgest | Blocks LH | Cannot | Must be | | contracepti | rel | surge, | disrupt | taken | | on | | blocks | implanted | within 3 | | | | follicular | egg. | days. | | | | development | | | | | | and egg | | Safe during | | | | release | | breast | | | | | | feeding. | +-------------+-------------+-------------+-------------+-------------+ | | Ulipristal | Antagonist | not | Must be | | | | effects, | recommended | taken | | | | prevents, | if breast | within 5 | | | | or delays | feeding as | days, wait | | | | ovulation | it is | 2-7 to | | | | even if LH | excreted | continue | | | | surge has | into breast | normal | | | | started. | milk. | birth | | | | | | control. | | | | | | (it | | | | | | increases | | | | | | metabolism | | | | | | via CYP3A4) | +-------------+-------------+-------------+-------------+-------------+ | Menopause | Estradiol | Replaces | Increase | Taken with | | Hormone | | estrogen in | risk of | progesteron | | therapy | | body | breast | e | | | | | cancer, | decreases | | | | | longer use | risk of | | | | | increases | endometrial | | | | | risks | cancer. | +-------------+-------------+-------------+-------------+-------------+ | | Bazedoxifen | SERM, | | Reduces | | | e | estrogen | | risk of | | | | agonist on | | endometrial | | | | bone and | | cancer. | | | | estrogen | | | | | | antagonist | | | | | | effects of | | | | | | breast | | | | | | tissue. | | | +-------------+-------------+-------------+-------------+-------------+ | | Tibolone | STEAR, | Acne | Increase | | | | metabolites | | risk of | | | | act as | Facial hair | breast | | | | estrogen on | | cancer | | | | bone and | Risk of | recurrence. | | | | vagina | strokes and | | | | | | CV events | | +-------------+-------------+-------------+-------------+-------------+ | Migraine | | | | | +-------------+-------------+-------------+-------------+-------------+ | Triptans | Sumatriptan | Agonists at | Chest pain | Onset of | | | | serotonin | | action | | | Zolmitripta | receptors, | Dizziness | 30-60 min, | | | n | decrease | | must be | | | | release of | GI upset | taken at | | | Rizatriptan | inflammator | | start of | | | | y | | migraine | | | | neurotransm | | | | | | itters, | | | | | | vasoconstri | | | | | | ction. | | | +-------------+-------------+-------------+-------------+-------------+ | Prophylaxis | Propranolol | - ? | | Onset after | | | | | | 1 week | | | Erenumab | - Blocks | | | | | | CGRP | | | | | Fremanezuma | recepto | | | | | b | rs | | | | | | | | | | | | - Bind to | | | | | | CGRP | | | +-------------+-------------+-------------+-------------+-------------+ | Insomnia | | | | | +-------------+-------------+-------------+-------------+-------------+ | Benzodiazep | Oxazepam | Bind to | Tolerance | Diazepam | | ines | | GABAa | | has a long | | | Temazepam | receptors | Drowsiness | half life | | | | which | | | | | Diazepam | increase | Oversedatio | | | | | chlorine | n | | | | | influx and | (fall risk) | | | | | decrease | | | | | | neuronal | | | | | | excitabilit | | | | | | y. | | | +-------------+-------------+-------------+-------------+-------------+ | Z drugs | Zolpidem | Bind to | Sedation | Shorter | | | | GABAa | | acting, | | | Zopiclone | receptors | Dizziness | less day | | | | only with | | time | | | | alpha 1 | Fall risk | sedation, | | | | subunit, | | less risk | | | | decrease | | of | | | | neuronal | | tolerance. | | | | excitabilit | | | | | | y. | | | +-------------+-------------+-------------+-------------+-------------+ | Dual orexin | Suvorexant | Blocks | Somnolence | | | receptor | | binding of | | | | antagonist | | wake-promot | Headache | | | | | ing | | | | | | orexin A | | | | | | and B to | | | | | | OX1/2 which | | | | | | promotes | | | | | | sleep. | | | +-------------+-------------+-------------+-------------+-------------+ | Sedating | Diphenhydra | Inverse | Sedation + | | | antihistami | mine | agonist at | falls | | | nes | | H1 | | | | | Doxylamine | receptors, | Dizziness | | | | | stabilise | | | | | | receptor, | Anticholine | | | | | affects | rgic | | | | | histamine's | effects | | | | | ability to | | | | | | regulate | | | | | | sleep. | | | +-------------+-------------+-------------+-------------+-------------+ | Depression | | | | | +-------------+-------------+-------------+-------------+-------------+ | SSRIs | Citalopram | Selectively | Nausea/vomi | Potential | | | | inhibit the | ting | for | | | Escitalopra | presynaptic | | serotonin | | | m | reuptake of | Insomnia | toxicity, | | | | serotonin. | | too much | | | Sertraline | | Dry mouth | serotonin | | | | | | in synapse. | +-------------+-------------+-------------+-------------+-------------+ | SNRI | Venlafaxine | Inhibits | Nausea | Duloxetine | | | | the | | potent | | | Desvenlafax | reuptake of | Constipatio | CYP2D6 | | | ine | serotonin | n | inhibitor. | | | | and | | | | | Duloxetine | noradrenali | Sweating | | | | | ne | | | | | | to the | Increased | | | | | presynaptic | BP | | | | | neuron. | | | | | | Increasing | | | | | | 5HT and NA | | | | | | in the | | | | | | synapse. | | | +-------------+-------------+-------------+-------------+-------------+ | TCAs | Amitriptyli | Inhibit | | | | | ne | reuptake of | | | | | | 5HT and NA, | | | | | Nortriptyli | they also | | | | | ne | block M1, | | | | | | H1 and | | | | | | alpa-1 | | | | | | adrenergic | | | | | | receptors. | | | | | | (hypotensio | | | | | | n) | | | +-------------+-------------+-------------+-------------+-------------+ | MAOIs | Tranylcypro | Inhibit | Insomnia | | | | mine | monoamine | | | | | | oxidases A | Fatigue | | | | Phenelzine | and B, MAO | | | | | | normally | Dry mouth | | | | Moclobemide | metabolise | | | | | | transmitter | Constipatio | | | | | s, | n | | | | | therefore | | | | | | increase | | | | | | synaptic | | | | | | concentrati | | | | | | on. | | | +-------------+-------------+-------------+-------------+-------------+ | Others | Agomelatine | Melatonin | Dizziness | | | | | receptor | | | | | | agonist | Blurred | | | | | | vision | | +-------------+-------------+-------------+-------------+-------------+ | | Mirtazapine | Tetracyclic | Increased | | | | | antidepress | appetite | | | | | ants, | | | | | | block | Sedation | | | | | postsynapti | | | | | | c | Peripheral | | | | | serotonin | oedema | | | | | receptors. | | | | | | H1 | | | | | | antagonist. | | | +-------------+-------------+-------------+-------------+-------------+ | | Reboxetine | Selectively | Hypotension | | | | | block NA | | | | | | reuptake, | Increased | | | | | increase NA | BP | | | | | at synapse | | | | | | | Tachycardia | | +-------------+-------------+-------------+-------------+-------------+ | | Vortioxetin | Inhibits | Nausea/ | | | | e | SERT, | vomiting | | | | | increases | | | | | | serotonin | Constipatio | | | | | activity in | n | | | | | brain. | | | | | | | Dy mouth | | +-------------+-------------+-------------+-------------+-------------+ | Schizophren | | | | | | ia | | | | | +-------------+-------------+-------------+-------------+-------------+ | Antipsychot | Clozapine | Antagonist | Metabolised | Decrease | | ics | | at D, 5HT, | by CYP1A2 | risk of | | | | alpha, M, H | | suicide | | | | receptors | | | | | | | | Smoking | | | | | | increases | | | | | | induction | | | | | | of CYP1A2 | +-------------+-------------+-------------+-------------+-------------+ | Bipolar | | | | | | disorder | | | | | +-------------+-------------+-------------+-------------+-------------+ | | Lithium | Mood | Diarrhoea | Narrow | | | | stabilizer, | | therapeutic | | | | increase | Weight gain | range. | | | | serotonin | | diuretics | | | | synthesis | | and NSAIDS | | | | and | | decrease | | | | release, | | lithium | | | | decreases | | excretion. | | | | dopamine | | | | | | synthesis, | | | | | | release and | | | | | | reuptake. | | | +-------------+-------------+-------------+-------------+-------------+ | Epilepsy | | | | | +-------------+-------------+-------------+-------------+-------------+ | Enhance | Phenytoin | Act | Increase | For focal | | sodium | | directly on | risk of | seizures | | channel | | voltage | skin | | | inhibition | | gated | reactions | Narrow | | | | sodium | | therapeutic | | | | channels, | | index | | | | prevents | | | | | | repetitive | | | | | | firing. | | | +-------------+-------------+-------------+-------------+-------------+ | | Carbamazepi | Act | Drowsiness | For focal | | | ne | directly on | | seizures | | | | voltage | | | | | | gated | | Can induce | | | | sodium | | own | | | | channels, | | metabolism. | | | | prevents | | | | | | repetitive | | | | | | firing. | | | +-------------+-------------+-------------+-------------+-------------+ | | Lamotrigine | Act | Skin | For focal | | | | directly on | reactions | seizures | | | | voltage | | | | | | gated | Diplopia | Also | | | | sodium | | inhibit | | | | channels, | | glutamate | | | | prevents | | release. | | | | repetitive | | | | | | firing. | | | +-------------+-------------+-------------+-------------+-------------+ | Act on | Ethosuximid | Inhibits | | Effective | | calcium | e | T-type | | in absence | | channels | | calcium | | seizures. | | | | channels, | | | | | | block | | | | | | conduction | | | | | | from | | | | | | thalamus | | | +-------------+-------------+-------------+-------------+-------------+ | | Gabapentin | GABA | | | | | | analogue, | | | | | | inhibitory | | | | | | effects | | | +-------------+-------------+-------------+-------------+-------------+ | Other | Valproate | Prolongs | Weight gain | Avoid in | | | | sodium | | females of | | | | channel | Tremor | childbearin | | | | inactivatio | | g | | | | n, | Decreased | potential. | | | | inhibits | BMD | | | | | T-type | | | | | | calcium | Hepatoxicit | | | | | channels | y | | | | | and | | | | | | enhances | | | | | | GABA | | | | | | effects. | | | +-------------+-------------+-------------+-------------+-------------+ | | Topiramate | Blocks Na | Somnolence | | | | | channels | | | | | | | Fatigue | | | | | Blocks AMPA | | | | | | receptors | Weight loss | | | | | | | | | | | Enhance | | | | | | GABA | | | | | | effects. | | | +-------------+-------------+-------------+-------------+-------------+ | Huntington' | | | | | | s | | | | | | disease | | | | | +-------------+-------------+-------------+-------------+-------------+ | HD | Tetrabenazi | VMAT2 | | | | management | ne | inhibitors, | | | | | | these are | | | | | | vesicular | | | | | | monoamine | | | | | | transporter | | | | | | type 2. | | | +-------------+-------------+-------------+-------------+-------------+ | Multiple | | | | | | sclerosis | | | | | +-------------+-------------+-------------+-------------+-------------+ | | Glatiramer | Synthetic | Injection | | | | | polypeptide | site | | | | | , | reactions | | | | | block | | | | | | presentatio | | | | | | n | | | | | | of myelin | | | | | | antigens to | | | | | | T cells. | | | +-------------+-------------+-------------+-------------+-------------+ | | Natalizumab | Binds to | | | | | | alpha-4 | | | | | | integrins | | | | | | on T-cells, | | | | | | inhibiting | | | | | | T cell | | | | | | migration | | | | | | from blood | | | | | | to CNS. | | | | | | Decreasing | | | | | | inflammatio | | | | | | n | | | | | | and | | | | | | demyelinati | | | | | | on. | | | +-------------+-------------+-------------+-------------+-------------+ | Sphingosine | Fingolimod | Preventing | Bradycardia | | | 1-phosphate | | lymphocytes | | | | receptor | Ozanimod | leaving | Infection | | | modulators | | lymph | | | | | Siponimod | nodes, | | | | | | decreasing | | | | | | lymphocyte | | | | | | infiltratio | | | | | | n | | | | | | of the CNS. | | | +-------------+-------------+-------------+-------------+-------------+ | | Teriflunomi | Inhibits | Infection | | | | de | pyrimidine | | | | | | synthesis | Rash | | | | | in T and B | | | | | | cells, | Alopecia | | | | | inhibits | | | | | | DHODH, | | | | | | decreasing | | | | | | numbers of | | | | | | activated T | | | | | | and B cells | | | | | | in CNS. | | | +-------------+-------------+-------------+-------------+-------------+ | Parkinson's | | | | | | disease | | | | | +-------------+-------------+-------------+-------------+-------------+ | Dopaminergi | Levodopa | Crosses the | | | | c | | BBB, and | | | | agents | | acts as | | | | | | dopamine. | | | +-------------+-------------+-------------+-------------+-------------+ | MAO-B | Slegiline | Decrease | Hypotension | | | inhibitors | | breaks down | | | | | Rasagiline | of dopamine | Insomnia | | | | | in the CNS | | | +-------------+-------------+-------------+-------------+-------------+ | COMT | Entacapone | Decrease | Risk of | | | inhibitors | | degration | levodopa | | | | | of levodopa | induced | | | | | in | dyskinesias | | | | | peripheries | , | | | | | , | GI upset, | | | | | increase | dry mouth. | | | | | amount of | | | | | | available | | | | | | levodopa. | | | +-------------+-------------+-------------+-------------+-------------+ | Dementia | | | | | +-------------+-------------+-------------+-------------+-------------+ | Acetylcholi | Donepezil | Decrease | Urinary | | | nesterase | | breakdown | incontinenc | | | inhibitors | Rivastigmin | of Ach via | e | | | | e | acetylcholi | | | | | | nesterase | Increased | | | | Galantamine | enzymes. | sweating | | | | | | | | | | | | GI upset | | +-------------+-------------+-------------+-------------+-------------+ | Motor | | | | | | neuron | | | | | | disease | | | | | +-------------+-------------+-------------+-------------+-------------+ | Treatment | Riluzole | Blocks | Hepatic | | | | | sodium | disturbance | | | | | channel, | s | | | | | prevents | | | | | | depolarisat | Neutropenia | | | | | ion | | | | | | of | | | | | | pre-synapti | | | | | | c | | | | | | neuron, | | | | | | inhibits | | | | | | NMDA | | | | | | receptors. | | | | | | Prevents | | | | | | over | | | | | | stimulation | | | | | | of motor | | | | | | neurons. | | | +-------------+-------------+-------------+-------------+-------------+ | Cerebral | | | | | | palsy | | | | | +-------------+-------------+-------------+-------------+-------------+ | Anticholine | Benzatropin | Block Ach | | | | rgics | e | from | | | | | | binding to | | | | | | muscarinic | | | | | | receptors | | | +-------------+-------------+-------------+-------------+-------------+ | Muscle | Botulinum | Block | | | | relaxants | toxin A | release of | | | | | | Ach | | | +-------------+-------------+-------------+-------------+-------------+ | | Dantrolene | Decrease | | | | | | muscle | | | | | | contraction | | | | | | preventing | | | | | | calcium | | | | | | release, | | | | | | therefore | | | | | | cannot bind | | | | | | to troponin | | | | | | on actin | | | | | | preventing | | | | | | myosin | | | | | | cross | | | | | | bridge | | | +-------------+-------------+-------------+-------------+-------------+ | ADHD | | | | | +-------------+-------------+-------------+-------------+-------------+ | Amphetamine | Dexamphetam | Inhibit DA, | Anorectic | Lis = pro | | s | ine | NA and | | drug | | | | serotonin | Insomnia | | | | Lisdexamfet | transporter | | Dex = | | | amine | s, | Increase HR | shorter | | | | increasing | and BP | duration of | | | | neurotransm | | action | | | | ission. | | | +-------------+-------------+-------------+-------------+-------------+ | Non | Atomoxetine | Selectively | Blurred | CYP2D6 | | psychostimu | | inhibits | vision | | | lant | | pre-synapti | | | | | | c | Increase HR | | | | | reuptake of | | | | | | NA in CNS | Decrease | | | | | | appetite | | +-------------+-------------+-------------+-------------+-------------+