Classification of Drugs

Pharmacology

Written by Aafaqi (Faculty of Pharmacy BZU)

 Classification of Drugs

Parasympathomimetics/Cholinomimetics/Cholinergic agonists

Parasympathomimetics

Direct acting Indirect acting

(Anticholinesterase)
Choline esters Alkaloids
_ Acetylcholine _ Pilocarpine
_ Methacholine _ Muscarine
_ Bethanechol
_ Carbachol

Reversible Irreversible
_ Physostigmine Carbamates Organophosphates
_ Neostigmine _ Carbaryl _ Parathion
_ Pyridostigmine _ Propoxur _ Malathion
_ Rivastigmine _ Nerve gases
_ Edrophonium _ Echothiophate

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Parasympatholytics/Cholinolytics/Cholinergic antagonists

Cholinergic receptor blockers

Antimuscarinic Antinicotinic
_Natural Alkaloids
_Atropine Ganglionic blockers Neuromuscular blockers
_Scopolamine _Nicotine
_Trimethaphan
_Synthetic/Semi synthetic
(Atropine derivatives) Depolarizing Non-depolarizing
Succinyl choline Dextro-tubocurarine
1. Mydriatics
Homatropine, Cyclopentolate
2. COPDs/Asthma
Ipratropium bromide, Tiotropium bromide, Oxitropium bromide
3. Anti-ulcers
Pirenzepine, Telenzepine
4. Anti-spasmodic
Dicyclomine, Flavoxate
5. Pre-anesthetic
Glycopyrrolate
6. Anti-parkinsonian
Benztropine, Benzhexol

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Sympathomimetics/Sympathetic agonists/Adrenergic agonists

A. On the basis of chemical structure

1. Catecholamines
Adrenaline, Nor-adrenaline, Dopamine, Isoprenaline, Dobutamine
2. Non-catecholamines
Tyramine, Ephedrine, Amphetamine, Phenylephrine, Salbutamol

B. On the basis of mechanism of action

1. Direct acting
Adrenaline, NA, Isoprenaline, Dobutamine, Ritodrine, Salbutamol
2. Indirect acting
Amphetamine, Tyramine
3. Mixed acting
Dopamine, Ephedrine, Metaraminol

C. On the basis of therapeutic use

1. Drugs that increase B.P in case of shock
Nor-adrenaline, Dopamine, Isoprenaline, Dobutamine, Phenylephrine,
Metaraminol, Methoxamine
2. Bronchodilators
Salbutamol, Salmeterol, Formoterol, Terbutaline
3. Cardiac stimulants
Adrenaline, Isoprenaline, Dopamine, Dobutamine

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 4. CNS stimulants
Amphetamine, Dextro-amphetamine
5. Local vasoconstrictors
Adrenaline
6. Nasal decongestants
Phenylephrine, Oxymetazoline, Xylometazoline, Pseudoephedrine
7. For anaphylactic shock
Adrenaline
8. Anorexiants
Dextro-amphetamine, Sibutramine
9. Uterine relaxants
Salbutamol, Salmeterol, Ritodrine, Isoxsuprine

Sympatholytics/Sympathetic antagonists/Adrenergic antagonists

Adrenergic receptor blockers

𝜶 blockers 𝜷 blockers
_ 𝜶1 blockers _ 𝜷1 selective blockers
Prazosin,Terazosin,Doxazosin Atenolol,Acebutalol,Esmolol,Metaprolol
_ 𝜶2 blockers _Non-selective 𝜷 blockers
Yohimbine Propranolol,Timolol,Nidolol,Pinolol
_ Non-selective 𝜶 blockers _ 𝜷 blockers + vasodilators
Reversible Irreversible Carvedilol,Labetalol,Celiprolol
Tolazoline,Phentolamine Phenoxybenzamine

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 Skeletal Muscle Relaxants

Skeletal Muscle Relaxants

Centrally acting Peripherally acting

_ Diazepam Drugs acing on Drugs acing on
_ Baclofen (NMJ) (skeletal muscles)
_ Gabapentin Dantrolene

Depolarizing Non-Depolarizing
_ Succinyl-choline _ Dextro-tubocurarine
_ Decamethonium _ Pancuronium
_ Rocuronium
_ Doxacurium
_ Mivacurium

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 Drugs acting on CVS

A. Anti-hypertensive
1. ACE (angiotensinogen converting enzyme) inhibitors
Captopril, Lisinopril, Enalapril, Ramipril
2. Angiotensin II receptor antagonist
Losartan, Candesartan, Valsartan, Telmisartan
3. Ca++ channel blockers
Verapamil, Diltiazem, Nifedipine, Nicardipine, Nimodipine
4. Diuretics
➢ Thiazide diuretics
Chlorothiazide, Hydrochlorothiazide, Chlorthalidone
➢ Loop diuretics
Furosemide, Torsemide, Ethacrynic acid
➢ K+ sparing diuretics
Spironolactone,Amiloride
5. Sympatholytic drugs
➢ Centrally acting adrenergic
Clonidine, Methyldopa
➢ Ganglionic blockers
Trimetaphan
➢ Neural blockers
Reserpine, Guanethidine
➢ 𝜶 blockers
Prazosin, Terazosin, Doxazosin, Phenoxybenzamine

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 ➢ 𝜷 blockers
Atenolol, Esmolol, Propranolol
6. Vasodilators
➢ Arterial vasodilator
Hydralazine, Minoxidil, Diazoxide
➢ Arteriolar + Venodilator
Sodium-nitroprusside
B. Anti-anginal
1. Nitrates
Nitroglycerine, Isosorbide mononitrate, Isosorbide dinitrate
2. 𝜷 blockers
Atenolol, Esmolol, Propranolol
3. Ca++ channel blockers
Verapamil, Diltiazem, Nifedipine, Nicardipine, Nimodipine
4. Na+ channel blockers
Ranolazine

C. Anti-arrhythmic
1. Class I (Na+ channel blockers)
➢ Ia
Quinidine, Procainamide, Disopyramide
➢ Ib
Lidocaine, Mexiletine, Phenytoin
➢ Ic
Flecainide, Propafenone

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 2. Class II (β blockers)
Atenolol, Esmolol, Propranolol
3. Class III (K+ channel blockers)
Amiodaron, Dofetilide, Sotalol
4. Class IV (Ca++ channel blockers)
Verapamil, Diltiazem, Nifedipine, Nicardipine, Nimodipine
5. Other miscellaneous drugs
Adenosine, Digoxin, Magnesium sulfate

D. Drugs to treat congestive cardiac failure (CCF)

1. Cardiac glycosides
Digoxin, Digitoxin
2. ACE (angiotensinogen converting enzyme) inhibitors
Captopril, Lisinopril, Enalapril, Ramipril
3. Angiotensin II receptor antagonist
Losartan, Candesartan, Valsartan, Telmisartan
4. Diuretics
➢ Thiazide diuretics
Chlorothiazide, Hydrochlorothiazide, Chlorthalidone
➢ Loop diuretics
Furosemide, Torsemide, Ethacrynic acid
➢ K+ sparing diuretics
Spironolactone, Amiloride
5. β blockers
Atenolol, Esmolol, Propranolol

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 6. Vasodilators
➢ Arterial vasodilator
Hydralazine, Minoxidil, Diazoxide
➢ Arteriolar + Venodilator
Sodium-nitroprusside

Diuretics

A. Carbonic anhydrase inhibitors

Acetazolamide, Dorzolamide
B. Thiazides diuretics
Chlorothiazide, Hydrochlorothiazide, Chlorthalidone, Indapamide,
Metolazone
C. Loop diuretics
Furosemide, Torsemide, Ethacrynic acid, Bumetanide
D. K+ sparing diuretics
Spironolactone, Amiloride, Triamterene, Eplerenone
E. Osmotic diuretics
Mannitol, Glycerol

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 Drugs for Hyperlipidemia

A. HMG-CoA (hydroxy methyl glutaryl CoA) reductase inhibitors

Statins
Simvastatin, Atorvastatin, Fluvastatin, Pravastatin
B. Bile acid binding resins
Cholestyramine, Colestipol
C. Fibric acid derivatives
Clofibrate, Gem-fibrate, Fenofibrate
D. Inhibitors of VLDL production
Nicotinic acid

Drugs affecting blood

Coagulants (haemostatics)

Local anesthetics (styptics) Systemic

_ Thrombin _ Vitamin K
_ Gelatin _ Fibrinogen
_ Fibrin gel _ Tranexamic acid

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 Anti-coagulants

In vitro:
Heparin, Sodium citrate, Sodium oxalate, Sodium edetate
In vivo:
A. Parenteral anticoagulants
Heparin, Low molecular weight heparin, Enoxaprin, Deltaprin
B. Oral anticoagulants
Coumarin derivatives (Warfarin, Dicumarol)

Anti-asthmatic Drugs
1. Bronchodilators
A. Sympathomimetics (𝜷2 selective agonists)
Salbutamol, Salmeterol, Formoterol, Terbutaline
Non selective (Adrenaline)
B. Methylxanthines
Aminophylline, Etophylline, Theophylline
C. Anti-cholinergic
Ipratropium bromide, Tiotropium bromide, Oxitropium bromide
2. Leukotrienes
Montelukast, Zafirlukast
3. Mast cell stabilizers
Sodium-chromo-glycate, Ketotifen, Nedocromil

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4. Corticosteroids
A. Inhalant
Beclomethasone, Fluticasone, Budesonide
B. Systemic
Hydrocortisone, Prednisolone, Methyl prednisolone

Drugs acting on GIT diseases

A. Anti-ulcer drugs
1. Proton pump inhibitors (PPI)
Omeprazole, Esomeprazole, Pantoprazole, Rabeprazole, Lansoprazole
2. H2 receptor blockers
Cimetidine, Famotidine, Nizatidine, Ranitidine
3. Anti-cholinergic drugs
Pirenzepine, Telenzepine
4. Prostaglandins analogue
Misoprostol
5. Ulcer protective (mucosal protective agents)
Sucralfate, Bismuth subsalicylate
6. Anti H. pyloric drugs (antimicrobial drugs)
Amoxicillin, Clarithromycin, Metronidazole, Tetracycline
7. Antacids (drugs that neutralize gastric acid)
A. Systemic antacids (Sodium citrate, Sodium bicarbonate)
B. Non-systemic antacids (Mg hydroxide, Al hydroxide, K carbonate)

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B. Anti-emetics
1. Anti-cholinergic
Scopolamine, Dicyclomine
2. Antihistamines (H1 blockers)
Diphenhydramine, Cinnarizine, Meclizine
3. 5-HT3 receptor antagonists
Ondansetron, Granisetron
4. Prokinetic agents
Metoclopramide, Domperidone
5. Neuroleptics
Chlorpromazine, Prochlorperazine, Fluphenazine
6. Adjuvant anti-emetics
Benzodiazepines, Cannabinoids, Dexamethasone

C. Anti-diarrheal
1. Specific therapy
Metronidazole, Ciprofloxacin, Norfloxacin
2. Non-specific therapy
ORS, Parenteral rehydration solutions
3. Anti-motility drugs
Opioids, Codeine, Loperamide, Diphenoxylate
4. 𝜶 receptor agonists
Clonidine

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D. Laxatives/Purgatives/Cathartics
1. Bulk laxative
Ispaghula, Dietary fibers, Methylcellulose, Bran
2. Stool softeners
Liquid paraffin
3. Stimulant laxatives
A. Diphenylmethanes
Phenolphthalein, Castor oil
B. Anthraquinones
Senna, Cascara sagrada
4. Osmotic laxatives
Mg sulphate/hydroxide, Na sulfate/phosphate, Lactulose

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