Pharmacology Drug Chart PDF

Case 1: Shock Antagonists Physiological Outcome and Responses of Agonists/natural ligand Receptor Agonists α1 Epi, Norepi Prazosin Contraction Phenylephrine Contraction...

Case 1: Shock Antagonists Physiological Outcome and Responses of Agonists/natural ligand Receptor Agonists α1 Epi, Norepi Prazosin Contraction Phenylephrine Contraction Glycogenolysis & gluconeogenesis Inc contractile force/ arrhythmias Hyperpolarization/ relaxation α2 Epi, NE, Yohimbine Decreased insulin secretion Clonidine Aggregation Decreased release NE Contraction β1 Dobutamine Epi, Metoprolol Increased renin secretion NE Increased force, rate of contraction, AV nodal conduction velocity β2 Terbutaline, Epi, Propranolol Relaxation NE Glycogenolysis, uptake K Glycogenolysis & gluconeogenesis Medication Mechanism Clinical Usage Aminocaproic Inhibits conversion of Preserve integrity of clot formation to stop active bleed Acid plasminogen to plasmin, an Useful in surgery, trauma (knife, gunshot) Tranexamic inhibitor of fibrinolysis Acid  Case 2: Pharmacotherapy of Asthma Management Class Mechanism of Action Role in Asthma Side Effects/ Pearls Short Acting Stimulation of adenylyl Rescue treatment Tachycardia Beta-2 Agonists cyclase to increase cAMP “As needed” Palpitations (SABA) which results in airway Cough and smooth muscle Quickly reverse ↓ K+ Albuterol relaxation bronchoconstriction – most Levalbuterol profound bronchodilators Frequent or over-usage reduces number of available, no effect on beta-receptors and reduced efficacy of inflammation agent Long-acting Stimulation of adenylyl Must be used with Inhaled Boxed Warning Beta-2 Agonists cyclase to increase cAMP corticosteroids Increased risk of asthma related death (LABA) results in airway and Cannot be used as when used as monotherapy (only in smooth muscle relaxation monotherapy in asthma – used asthma – this does not occur in COPD) Salmeterol (longer duration of action as a chronic treatment due to its’ Formoterol than SABA) prolonged bronchodilatory effects Side effects similar to SABA Aformoterol Short and long Antagonize effects of Short acting agents are only used Dry mouth, sedation, constipation, acting anti- acetylcholine on for asthma during exacerbations cholinergic muscarinic receptors when in the emergency room to Other anticholinergic effects (SAMA/LAMA) resulting in airway prevent hospitalization with relaxation albuterol therapy Short acting (SAMA) Ipratropium Leukotriene Block leukotriene receptor Utilized as adjunctive therapy to Generally, well tolerated: Modifier (LTRA- (LTRA-M) OR blocks patients who are currently on ICS/ M) synthesis (5-LO) and thus LABA, and still remain Hepatoxicity, and rare psychiatric effects reduce granulocyte symptomatic 5-Lipoxygenase migration, and increases Inhibitors bronchodilation Oral formulation tablets can be utilized as a first line therapy in children Very useful in patients with Methylxanthines Phosphodiesterase 4 Last line agent for asthma due to Nausea/vomiting Theophylline inhibitor that results in an high risk of adverse effects CNS toxicity, seizures Caffeine increase of cAMP and thus Arrythmias (extremely high levels of inhibits cytokine and Narrow therapeutic index drugs) leukotriene synthesis (also bronchodilation due Requires serum drug monitoring to inhibition of adenosine) Inhaled Inhibits transcription of First line for all patients with Dysphonia (difficulty speaking) Corticosteroids pro-inflammatory genes, persistent asthma –, per new Cough (ICS) and reduces airway guidelines can also use prn to Oral candidiasis (thrush) Inhaled inflammation prevent exacerbations in mild Rinse mouth and throat with warm water Beclomethasone asthma and spit out after using inhaled Budesonide Block late phase reaction to corticosteroid to reduce thrush Fluticasone allergen, and reduce airway Mometasone hyperresponsiveness Oral: adrenal suppression, hyperglycemia, hypertension, weight Should be initiated early on in gain, psychosis Oral course of therapy - reduces Corticosteroids asthma mortality and reduces Oral: prednisone exacerbation risk Monoclonal Omalizumab : IgE antibody Injection site reactions (fever, Utilized for patients who are maximized on antibodies that reduces IgE mediated MSK pain, hypersensitivity) other entities and still remain symptomatic IgE antibody cytokine and histamine or patients with refractory asthma Omalizumab release Black box warning for anaphylaxis IL-5 Inhibitors: Mepolizumab IL-5 Inhibitors: Reduce IL-5 Reslizumab mediated eosinophil Benralizumab recruitment  Case 3: Treatment of Cystic Fibrosis Medication MOA Use in Cystic Adverse Clinical Pearls Fibrosis Effects Ivacaftor Targets the G55ID Patients with Hepatotoxicity Drug Interactions because it’s a CYP3a4 mutation and G551D mutation substrate increases opening of chloride channel Trikafta Assist in moving Patients with (combination of the CFTF protein DeltaF508 elexacaftor, within the cell mutation texacaftor, (addresses protein ivacaftor) processing mutation) (elexacaftor and texacaftor), in combination with MOA of ivacaftor