Biopharmaceutics

Pharmacodynamics

Drug-Receptor
MOA
Interaction

Ph
Target protein- Non-Target protein- Features: Affinity Graded Dose Quantal Dose
Ligand Different Theories
mediated mediated and Intrinsic Activity Response Response

Structural protein Regulatory protein Colligative Agonist Antagonist Inverse Agonist (<0) Clark (All) Therapeutic Index

R
Based on
Channels Carriers Enzymes Receptors Chemical Antagonism Full agonist (>1) Based on MOA Based on Reversibility Paton (Rate Theory)
Surmountability

S,
Physiologic Ariens and
Type I - Ionotropic Type II - Metabotropic Type III - Enzyme- Type IV - Nuclear Counterfeit Partial antagonist (<1, Reversible (Non- Surmountable
Voltage-gated (functional) - different Stephension (As
(fastest) (most common) Linked (slowest) Mechanism >0) covalent) (Competetive)
receptor long...)

Pharmacologic
Ligand-gated
Gq = stimulates
phospholipase C
SC (receptor) - same
receptor
Non-reversible
(Covalent)
Non-surmountable
(Non-competetive)

Gi = inhibits adenylyl
cyclase

Gs = stimulates
adenylyl cyclase
Biopharmaceutics

Pharmacokinetics

Liberation Absorption Distribution Metabolism Excretion

Different Factors
Requirements for Pharmacokinetic
Transport Processes Biopharmaceutics Affecting Physiologic Factors Barriers First Pass Effect Phases HIPE
Absorption Factors
Absorption

Ph
Simple, Passive Carrier-mediated Convective Transport Pinocytosis (cell Biopharmaceutics Phase I - Phase II -
Ion-pair transport Bioavailability Bioequivalence LUNA Dose Cardiac Output Protein Binder Blood-Brain Barrier
Diffusion transport (via pore) drinking) Classification System Functionalization Conjugation

Pharmaceutical Volume of
Facilitated Diffusion Active Transport Absolute Surface Area Regional Blood Flow Placental Barrier Reduction Oxidation Hydrolysis Glucoronidation
Equivalent Distribution

R
Pharmaceutical
Primary Relative Perfusion Rate Nitro Acetylation
Alternative

Therapeutic
Secondary pH Carbonyl Methylation
Equivalent

S,
Therapeutic
Gastric Emptying Azo Glycine Addition
Alternative

Glutathione
SC conjugation

Pharmacokinetic
Kidneys
Principles

Glomerular Tubular
Clearance Kinetics Half-life Renal Diseases
Filtration Secretion

Acute Kidney
Zero-Order (ARI) Cockcroft-Gault
Injury

Chronic Kidney
First-Order CKD-EPI Formula
Injury
ANS drugs
Sympathetic
(-) Release of NE (+) Release of NE (-) Reuptake of NE
GGB AETAPPP NCTMM
• Guanethidine • Amphetamine • NE reuptake inh.
• Guanadrel • Ephedrine (Reboxetine)
• Bretylium • Tyramine • Cocaine
• Angiotensin II • Tricyclic
• Phentermine Antidepressant

Ph
(Amitriptyline)
• Phenmetrazine
• Methylphenidate
• Phenylpropanolamine
• Modafinil

Tocolytics

R
MaRTINA
• MgSO4
• Ritodrine
•

S,
Terbutaline
• Isoxuprine
• Nifedipine
• Atosiban
(Oxytocin
SC
Antagonist)
ANS drugs
Adrenergic/Sympathomimetic
Sympathomimetic Drugs

Direct-Acting Indirect-acting Mixed

Non-selective Selective

Ph
Epinephrine
Norepinephrine α β Dopamine
Dopamine Agonist

β-Non
α-1 α-2 β-1 β-2

R
Selective
Fenoldopam
Isoproterenol Dobutamine
Phenelephrine vs. Glaucoma vs. HTN Sedative Ropinirole
SABA LABA Tocolytic
Oxymetazoline “relievers” “controllers”

S,
Bromocriptine
Apraclonidine Clonidine Dexmedetomidine
Tetrahydrozoline
Brimonidine Salbutamol/ Bambuterol Ritodrine Pramipexole
Methyldopa
Propylhexedrine Albuterol FeRoBroPra
Guanfacine Indacaterol Isoxuprine
Methoxamine
SCGuanabenz
Terbutaline
Formoterol
Metaproterenol
Nafazoline
ABCDMGG Pirbuterol
Salmeterol

POTPMN Best Friends na

STAMP nag laLABA Sa
Ilog
ANS drugs Sympathomimetic
ABCDMGG
Adrenergic/Sympathomimetic Drugs

Direct-Acting Indirect-Acting Mixed

(+) Release of NE (-) Reuptake of NE Ephedrine

Ph
Amphetamine NERI - Riboxetine

R
Ephedrine Cocaine

S,
Tyramine TCA - Amitriptyline

Angiotensin II Methylphenidate
SC
Phentermine Modafinil

NCTMM
Phenmetrazine

Phenylpropanolamine

AETAP3
ANS drugs Sympatholytic
Drugs
Anti-Adrenergic/Sympatholytic

Mixed α and β Dopamine

α-blockers β-blockers
blocker effects antagonists

Ph
Non-selective Selective

R
Phenoxybenzamine α-1 α-2

S,
Phentolamine
Prazosin Yohimbine
SC
Terazosin Rauwolscine

Doxazosin

Tamsolusin
ANS drugs
Anti-Adrenergic/Sympatholytic

Sympatholytic
Drugs

α-blockers β-blockers Mixed α and β Dopamine

blocker effects antagonists

Ph
Cardioselective Carvedilol Anti-pyschotic Prokinetics
Non-Selective Other MOA
(β1)
Labetalol

R
Metoclopramide
Nadolol Celiprolol Intrinsic Membrane Typical Atypical
Sypathomimetic stabilizing
Domperidone

S,
Sotalol Nebivolol activity activity
Haloperidol Clozapine
Timolol Bisoprolol Carteolol Pindolol
SC
Pindolol Betaxolol Labetalol Propranolol

Propranolol Esmolol Atenolol Atenolol

NSTP2 Atenolol Pindolol Labetalol

Acebutalol CLAP Metoprolol

Metoprolol PPALM

CNBBEAAM
ANS drugs
Cholinergic/Parasympathomimetic

Parasympathomimetic Drugs
• Choline Esters
• Alkaloids

Ph
Direct-acting Indirect-acting

Non-selective
Muscarinic Nicotinic
(m, n) Reversible Irreversible CNS-acting

R
Carbachol Betanechol Lobeline
Intermediate to Donepezil
Short-acting Very long acting
long acting
Acetylcholine Muscarine Varenecline (Amino Alcohol) (organophosphates)

S,
(Carbamates) Rivastigmine
Metacholine Pilocarpine Nicotine
Galantamine
Edrophonium -stigmines Ecothiophate
Arecholine Insectiside Nerve Gases
SC Tacrine

Unionized (Tertiary
Ionized
Malathion Sarin
DR. GT
(Quaternary
Amine)
Amine)
Parathion Tabun

Physostigmine Neogstigmine Soman

Pyridostigmine
ANS drugs Parasympatholytic Drugs
Anti-Cholinergic/Parasympatholytic

Antimuscarinic Antinicotinic

Atropine

Ph
Others

R
Brain Eyes Lungs GIT

No longer used

S,
Scopolamine Cyclopentolate
Anti-EPS SC SAMA LAMA M1 blockers M2 blockers

Homatropine

Hyoscine-N-
Benztropine Atropine Ipatropium Aclinium Pirenzepine
butylbromide

Biperiden Tropicamide Umeclinidium Telenzepine

CHAT
Orphenadrine Glycopyronnium

Trihexiphenidyl Tiotropium

BeBOT
ANS drugs
Anti-Cholinergic/Parasympatholytic Parasympatholytic Drugs

Antimuscarinic Antinicotinic

Ph
Neuromuscular Ganglionic
Nm Nn

R
NCRare DINsux

Nondepolarizing Depolarizing Hexamethonium

S,
Competetive Irreversible
Reversible Noncompetetive
Mecamylamine
SC
Suxamethonium
Trimethapan
Steroidal Isoquinoline (Succynylcholine)

-curonium -curium

Rocuronium Atracurium

Pancuronium Mivacurium
AUTACOIDS
Local hormones secreted near the site

Autacoids

Bradykinin Eicosanoids Serotonin Histamine

Ph
Misoprostol
RAAS (PGE1) 5HT-1a 5HT-1b/1d 5HT-2 5HT-3 5HT-4

R
Epoprostenol
(PGI2)
Partial agonist Agonist Agonist Antagonist Antagonist Agonist

S,
Dinoprostone
(PGE2)
Buspirone Ergot Methylsergide Tegaserod
Alprostadil -triptans -setrons
(PGE1)
SC Alkaloids
Cisapride
Latanoprost
Mosapride
(PGF2a) Sumatriptan Ergotamine Ondansetron

MEDAL Naratriptan Ergometrine Gravisetron Prucalopride

- Full agonist

Zolmitriptan Ergonovine Palonisetron

(longest t1/2)
AUTACOIDS
Local hormones secreted near the site
Autacoids

Bradykinin Eicosanoids Serotonin Histamine

Ph
Agonist Antagonist

Exogenous H1 -- Hypersensitivity and Anaphylaxis -- H1 H2

Histamine

R
1st generation Cimetidine
Betahistine (Serc) 2nd generation
- sedating

S,
Ranitidine

Ethanolamine Ethylenediamine Piperazine Piperidine Phenothiazine Alkylamine

Less sedating True Non-sedating
Nizatidine
SC
Diphenhydramine Hydroxyzine Famotidine
Pyrilamine Cyproheptadine Promethazine Brompheniramine
(Benadryl) (Iterax) Loratadine (most potent)
Cetirizine
(Allerta)
Diphenhydrinate Tripelennamine Cyclizine Chlorpheniramine -tidine
Levocetirizine Desloratadine
Meclizine
Doxylamine
(Bonamine)
Acrivastine Fenoxifenadine

Bilasten (Bilaxten)
RHEUMATOLOGY
Analgesics

Analgesics

Non-Narcotics Narcotic

Ph
NSAIDs Paracetamol Opioids

R
Non-Selective (COX1
Selective (COX2)
and COX2)

Aspirin Pyralazone Pyrole Alkanoic Oxicam Propionic Acid Phenylacetic Preferentially

S,
Indole derivative Fenamate Highly Selective
derivative Acid derviative derivative derivative Acid derivative selective

Phenylbutazone Indomethacin Tolmentin Peroxicam Ibuprofen Ketorolac Mefenamic Acid Meloxicam

SC -coxib
Oxyphenazone Ketoprofen Diclofenac

Sulfinpyrazone Naproxen Sulindac

Celecoxib
Nabumetone
Etoricoxib

Rofecoxib

BEQ:
Rofecoxib – withdrawn due
to cardiovascular events
RHEUMATOLOGY
Analgesics
Analgesics
Based on Pharmacodynamics:

Opioids
Non-Narcotics Narcotic

Strong Full Mild-Moderate

Partial agonists Full antagonists

Ph
NSAIDs Opioids
Agonists Full Agonists
Paracetamol

Opiates Opioids
natural synthetic Morphine Codeine Nalbuphine Naloxone

R
Morphine Heroin Hydrocodone Butorphanol Naltrexone
Semi-synthetic Synthetic
Codeine
Hydromorphine Oxycodone Buprenorphine Nalorphine

S,
Thebaine
Heroine Methadone

Meperidine/
Oxymorphine Tramadol Pentazocine Nalmefene
Apomorphine Pethioline
SC (Demerol) Methadone Levallorphan
Levorphanol
Morphine
derivatives Mephenidine
Anti-diarrheals

Hydromorphone Levorphanol
Loperamide
Oxymorphone
Diphenoxylate Fentanyl

Tramadol
Codeine
derivatives Fentanyl

Pentazocine
Hydrocodone

Oxycodone
RHEUMATOLOGY
DMARDs
Diseases Modifying Anti-Rheumatic Drugs DMARDs

Biologicals Non-biologicals

Ph
T-cell activation inhibitor
Abatacept
B-cell depleting agent
Antimalarials
Rituximab

R
IL-6 inhibitor
Tocilizumab
Hydroxychloroquine
To6lizumab
Choloroquine

S,
IL-1 neutralizing agent
Anakinra (Plaquenil)
Anak1nra

Methotrexate
Adalizumab
SC Sulfasalazine
TNF-α inhibitor Infliximab
Leflunomide
Etanercept

• -zumab – humanized Mycophenolate

• -ximab – chimeric
• -umab/mumab - human

Gold compounds

Aurothiomalate Aurothioglucose Auranofin

RHEUMATOLOGY
Glucocorticoids and Anti-gout Drugs

Anti-gout Treatment Steps:

Glucocorticoids 1. Colchicine only (2-3 weeks)

Ph
2. Hypouricemics + Colchicine

Acute Gout Chronic Gout

R
Systemic Local
(PO/IV) (Intrasynovial) Colchicine Hypouricemics

S,
NSAIDs
Methylprednisolone Xanthine oxidase Recombinant
Uricosurics
(Solu-Medrol) Glucocorticoids inhibitors ureases
SC
Allopurinol Pegloticase Probenecid

Feboxustat Rasburicase Penicillamine

Sulfipyrazine
CARDIOVASCULAR
Drugs for Hypertension

Anti-Hypertensives

Ph
Direct Angiotensin
Sympathoplegics
Diuretics Vasodilators antagonists

R
Proximal Natriuretics Distal Aquaretics
Convuluted Thick ascending Convuluted
Tubule Loop of Henle Tubule Collecting Duct
Anywhere

S,
Carbonic Anhydrase Mannitol
Loop Diuretics Thiazides K+-Sparring Diuretics
Inhibitor

Acetazolamide
(Diamox) Sulfonamides
SC
Sulfonylurea Phenoxyacetate True Thiazides Thiazide-Like
Aldosterone
Antagonists
Epithelial Na+
Channel Inhibitor

Dorzolamide
Furosemide
Torsemide Ethacrynic acid Benzothiazides Metazolone Spironolactone Amiloride
(Lasix)
Brinzolamide

Bumetanide Hydrochlorothiazide Chlorthalidone Eplerenone Triamterene

Dichlorphenamide

Chlorothiazide
CARDIOVASCULAR
Drugs for Hypertension
Anti-Hypertensives

Diuretics Angiotensin
Sympathoplegics Direct Vasodilators Antagonists

Ph
Peripherally-acting Ganglionic
Centrally-acting Pure Arteriolar Mixed Calcium Channel
(Adrenergic Blockers
(α2-agonists) Vasodilators Vasodilators Blockers

R
Neuron Blockers) (OBSOLETE)

Clonidine Guanadrel Hexamethonium Hydralazine Nitrovasodilators

Non-

S,
Dihydropiridines
Dihydropyridines
Methyldope Guanethedine Mecamylamine Minoxidil Na nitroprusside
Mechanisms of Vasodilation
Guanfacine Bretylium Trimethapan Diazoxide
SC • Nitric Oxide (NO)
o Hydralazine -dipines Verapamil
Guanabenz HMD o Na Nitroprusside
o Nitrovasodilators
(angina) Diltiazem
• K+ Channel Opening
Can be confusing: o Minoxidil Duration of Action
Guanfacine, Guanabenz o Diazoxide • Intrinsically Short-Acting
vs. • L-type Ca2+ Channel o All Non-DHPs
Guanadrel, Guanethedine Blockade o Majority of DHPs exc.
o CCBs LAL
Remember that Guanadrel and
Guanethedine has letter “d” while • D1 activation • Intrinsically Long-Acting
Guanfacine and Guanabenz do not have o Fenoldopam o Lercadipine
• Endothelin Antagonism o Amlodipine
o -sentan o Lacidipine
▪ Bosentan • Modified Long-Acting
▪ Tezosentan o Felodipine (SA) (Plendil
• α1 blockade XR, Versant XR) → 5
o -zosin mg XR tab
o Amlodipine (LA) → 5
mg tab
CARDIOVASCULAR
Drugs for Hypertension

Anti-Hypertensives

Ph
Diuretics Sympathoplegics Direct Vasodilators

R
Angiotensin
Antagonists

S,
Angiotensin Angiotensin
SC
Converting Enzyme Receptor Blocker
Inhibitors (ACEIs) (ARBs)

-prils -sartans

Saralasin
CARDIOVASCULAR
Drugs for Angina Pectoris and Heart Failure

Anti-Angina

Ph
Ca2+ Channel
Nitrovasodilators β-blockers
Blockers

For EFFORT For PRINZMETAL

Angina Angina

R
Amyl Nitrite -olol Non-DHPs (V,D)

Nitrogylcerin

S,
Long-acting DHPs
(LAL) Drugs for Heart Failure
TAMAD na heart PAGOD na heart
Isosorbide dinitrate
Short-acting DHPs
Isosorbide
SC (all exc. LAL) Inotropic
agonists
Unloader
Medications
mononitrate
Duration of Action
Cardiac Biperidens ACEIs and
• Very short-acting β1-Agonist Diuretics Vasodilators β-blockers
Glycosides (PDE3-Inh.) ARBs
o Amyl Nitrite
• Short-acting
o Nitroglycerin (SL) tab
Loop and/or Hydralazine
o ISDN (SL) tab Digoxin Dobutamine Inamrinone Bisoprolol
Thiazides +ISDN
• Intermediate-acting
o Nitroglycerin (PO) SR Metoprolol
tab Digitoxin Dopamine Milrinone K-sparring Nesertide
succinate
o ISDN (PO) tab
• Long-acting Endothelin
Carvedilol
o Nitroglycerin (TD) antagonists
patch (-sentans)
o ISDN (PO) SR tab Nebivolol
o ISMN (PO) tab Bosentan

Tezosentan
CARDIOVASCULAR
Drugs for Arrythmia

Anti-Arrythmia

Ph
Class I Class II Class III Class IV Others
Sodium Beta Potassium Calcium

Sotalol (β- CCBs (Non- Digoxin

R
IA IB IC β-blockers
blocker) DHPs)
Adenosine
Amiodarone

S,
Disopyramide Tocainamide Moricizine Penbutalol Verapamil MgSO4
Dronedarone
Quinidine Mexiletine Flecainide Esmolol Diltiazem MAD
SC Miscellaneous
Procainamide LIdocaine Propefanone Atenolol
PEA Dofetilide
Phenytoin Encainide

Ibutalide
IA IB IC
Na+ channel
Bretylium
Moderate Weak Strong
blockade
Effect on APD
BIDDAS
(Action Potential Prolong Shortens No effect
Duration)
ENDOCRINE
Hypothalamic and Pituitary Hormones/Agents

Hypothalamic and Pituitary

Hormones/Agents

Hypothalamic Pituitary

Ph
Posterior Pituitary
GnRH Anterior Pituitary Gland
Gland

Growth

R
Analogues Prolactin Oxytocin Vasopressin
Hormone/Somatotropin

Oxytocin Excess: Syndrome of

Gonadorelin Excess: Gigantism, Oxytocin Antagonist Deficiency: Diabetes
Hyperprolactinemia Deficiency: Dwarfism (Nasal spray, IV) Inappropriate ADH
Acromegaly (tocolytic) Insipidus
secretion (SIADH)

S,
Goserelin

Buserelin Somatropin Pegvisomat Atosiban

Vasopressin receptor
D2 agonist Somatostatin Analogues Central (Neurogenic) Nephrogenic Tetracycline
antagonist

Nafarelin Mecasermine
SC
Triptorelin Conivaptan
Bromocriptine Octreotide Thiazide diuretics Demeclocycline
Vasopressin receptor (non-selective)
agonists (-pressin)
Histrelin Tolvaptan
Lanreotide
(V2-selective)

Leuprolide
Vasopressin
(non-selective)

Desmopressin
(V2-selective)
ENDOCRINE
Thyroid and Anti-thyroid Agents
Thyroid and Anti-
thyroid Agents

Anti-thyroid
Thyroid Agents
Agents

Ph
Levothyroxine (T4) Radioactive Iodine
Thioamides Anion Inhibitors Iodides B-blockers Dexamethasone
Therapy (RAI)

R
Liothyronine (T3)

Liotrix (T3 & T4) Propylthiouracil

S,
Percholarate I2-containing I131 Propranolol
(PTU)
medications
Methimazole
Pertechmetate Carvedilol
(Tapdin)
Thiamazole
SC
Thiocyanate SSKI
(Tapazole) (Sat. Solution of KI)

Lugol’s Solution
(Strong I2 Solution)
ENDOCRINE Adrenocortical Hormones
Adrenocortical Hormones

Glucocorticoids Mineralocorticoids
zona fasciculata zona glomerulosa

Ph
Intermediate- Aldosterone Aldosterone
Short-acting Long-acting
acting Antagonists Agonist

R
Hydrocortisone Meprednisolone Betamethasone Spironolactone Fludrocortisone

S,
Cortisone SCTriamcinolone Dexamethasone Eplerenone

Prednisone Fluocinolone

Prednisolone Paramethasone

Meprednisone
ENDOCRINE Pancreatic Hormones and Drugs
Pancreatic Hormones and Drugs for DM for DM

Pancreatic
Drugs for DM
Hormones

Ph
Insulin Oral Antidiabetic
Insulin
Agents

R
Glucagon

Rapid Acting Short Acting Intermediate Acting Long Acting

S,
SC Isophane (Neutral
Lispro Regular Insulin (IV) Glargine
Protamine Hagedorn) peakless

Aspart Detemir

Glulicine
ENDOCRINE
Pancreatic Hormones and Drugs for DM Pancreatic Hormones and Drugs for DM Anti-DM
o Injectables:
▪ Insulin
Pancreatic Hormones ▪ GLP-1 Agonists
Drugs for DM
▪ Amylin Analogue
o Non-injectables
▪ “the rest”
Insulin

Ph
Oral Antidiabetic Agents

Thiazolidinediones/Insulin
Insulin Secretagogues Biguanides α-glucosidase inhibitors Incretin-based drugs
Sensitizers

R
Pioglitazone
Metformin Acarbose SGLT-2 Inhibitors (-
Sulfonylureas Meglitinides (Actos, Prialta) Incretin-Mimetics Amylin Analogue
gliflozin)
Phenformin Rosiglitazone
Voglibose
(withdrawn) (withdrawn)

S,
PPAR-γ agonist Miglitol
Repaglinide Dapagliflozin Pramlintide (SQ)
First-generation Second-generation GLP-I Agonists (SQ) DPP-IV Inhibitor (-gliptins)

Nateglinide Canagliflozin

Longest t½ Glibenclamide/ -linide Sitagliptin

Chlorpropamide

Tolbutamide
Glyburide

Gliclazide
SC Exenatide

Liraglutide
(Januvia)

Linagliptin
Empagliflozin

Luseogliflozin
(Trajenta)

Vildagliptin
Acetohexamide Glipizide Lixisenatide
(Galvus)

Saxagliptin
Tolazamide Glimepiride
(Onglyza)

-amide Gli_ide Teneligliptin

(Blipten)
ENDOCRINE
Gonadal Hormones Gonadal Hormones

Estrogen and
Androgen Agents
Progestin Agents

Ph
Selective Estrogen
Progesterone Aromatase 5-α-reductase Androgen

R
Receptor
Antagonist Inhibitors Inhibitors Antagonists
Modulators (SERMs)

S,
Mifeprestone Anastrazole Tamoxifen Finasteride Bicalutamide
SC
Letrozole Roloxifene Dutasteride Flutamide

Cyproterone Acetate
Exemestane
HEMATOLOGY Hematologic Drugs

Hematologic Drugs
Drugs for Coagulation

Fibrinolytics Pro-Thrombotics
Antithrombotics

Ph
Anticoagulants Antiplatelets

Direct-Acting/Direct Phosphodiesterase
Indirect-Acting

R
Thrombin Inhibitors TXA2 synthesis ADP Inhibitors GP IIb/IIIa Inhibitors
(PDE) Inhibitors

Aspirin Dipyridamole Eptifibatide

Parenteral Orally-Administered Parenteral Oral (Persantin)

S,
Irriversible Reversible
Abciximab
Cilostazol
(Pletaal)
Ticagrelor Tirofiban
Hirudin Dabigatran
(Pradaxa) Newer Agents Thienopyridines
Heparin Coumarin Derivatives
Lepirudin
SC (-xaban) (CLOP)

Bivalirudin

Apixaban Warfarin TiCLOPidine

Argatroban
HMWH LMWH
Rivaroxaban CLOPidogrel

Unfractionated
Enoxaparin
Heparin

Regular Heparin Dalteparin

Tinzaparin

Fondaparinux

Danaparoid
HEMATOLOGY Hematologic Drugs
Hematologic Drugs

Drugs for
Coagulation

Ph
Antithrombotic Fibrinolytic / Thrombolytic
Pro-Thrombotic
(-ase)

R
Streptokinase ε-aminocaproic Aprotinin

S,
Vitamin K
acid Analogue
SC Anistrepase

Alteplase Vit. K1
Tranexamic Acid
Phytonadione

Reteplase Vit. K2
Menaquinone

Urokinase Vit. K3
Menadione
LIPIDS Drugs for Dyslipidemia
Drugs for Dyslipidemia

Fibric Acid Derivatives / Sterol Absorption

HMG-CoA reductase Nicotinic Acid Bile Acid Sequestrants
Fibrates Inhibitor

Ph
-statins except Cilastatin Cholestyramine Ezetimibe
(w/ Imipinem), Nystatin (Vytorin – Ezetimibe +
PPAR- α Agonists
(antifungal), Simvastatin)
Somatostatin (GHIH) Colestipol

R
Colesevelam
Fenofibrate

S,
Short-acting
Long-acting
(t½ = 1-3 hrs.)
Clofibrate
SC
Gemfibrozil
Majority except Atorvastatin
A, R (Lipitor)
t½ = 14 hrs.

Rosuvastatin
(Crestor)
t½ = 19 hrs.
CNS
Anti-Psychotics

Drugs for Psychosis

Mood D/O: Mood D/O:

Schizophrenia
Major Depression Mania

Ph
Second Tricyclic Anti- Lithium
First Generation: 5-HT2a Presynaptic α2 Atypical
Generation: depressants SSRIs MAOIs SNRIs
TYPICAL Antagonists antagonist Antidepressants
ATYPICAL (TCAs) Haloperidol

Anticonvulsants
Butyrophenones Clozapine Trazodone Mirtazapine – Fluoxetine Venlafaxine Bupropion
Phenothiazines Thioxanthene (-pramine) MAOa Non-selective MAOb
(-peridol) NaSSA

R
Olanzapine Nefazodone Fluvoxamine Desvenlafaxine Amoxapine

Quetiapine Sertraline Duloxetine Maprotiline

Thiothixene Haloperidol Imipramine Moclobemide Phenelzine Selegiline
Aliphatic
Risperidone Paroxetine Milnacipran Trazodone
Droperidol Clomipramine Isocarboxazid

S,
Ziprasidone Citalopram Tranylcypromine Nefazodone
Chlorpromazine
Aripiprazole Not a PPI! Escitalopram Mirtazapine
(-triptyline)

Piperazine Amisulpride SC
Molindone
Amitriptyline

Fluphenazine
Nortriptyline

Piperidine

Thioridazone

POTENCY:
Butyrophenones>Piperidine>Piperazine>Thiothexene>Aliphatic
CNS
Sedative-Hypnotics

Sedative-Hypnotics

Ph
Benzodiazepines Barbiturates Miscellaneous

-zepam, -zolam (exc. Intermediate-Acting

Ultra-Short Acting Short-Acting (5,6,7): Orexin antagonists (-
ChlordiaZEPoxide and (sing Barbie Girl – Long-Acting same MOA with BZDs 5-HT1a agonist Melatonin agonists
(“Sulfur”): Anesthetics Sedatives rexant)
ChlorZEPate) Aqua): Hypnotics

R
THIOpental PENTObarbital Amobarbital Phenobarbital Zolpidem Buspirone Suvorexant Ramelteon
Intermediate-acting
Short-acting (TOM) Long-acting (“the rest”)
(TALE-O)
THIamylal HEXObarbital Butobarbital Barbital Zaleplon Almorexant Tasimelteon

S,
methTHohexital SEcobarbital Eszopiclone

Triazolam Temazepam Diazepam ThiThiMo

Ultra-short
Midazolam Alprazolam Quazepam

Lorazepam Flunitrazepam
SC
Estazolam Chlordiazepoxide

Oxazepam Chlorzepate
CNS
Anti-Parkinsonism

Anti-Parkinsonism Agents

DA (↑) ACh (↑)

Ph
Levodopa Apomorphine Amantadine Central
D2 Agonists MAOIs COMTIs
Anticholinergics

R
Bromocriptine PIT Entacapone Benztropine

S,
Pergolide SCSelegiline Tolcapone Biperiden

Pramipexole Trihexyphenidyl

Ropinirole
CNS
Anti-Seizure Agents
Anti-Seizure Agents

Classical Newer

Ph
Carbamazepine – Partial Vigabatrin – GABA-T inh.

Phenytoin – Partial and Generalized Felbamate – NMDA antagonist

R
Valproic Acid – Generalized Tonic-
Tiagabine – GABA uptake inh.
Clonic (Grand-Mal)

S,
Phenobarbital – Febrile
SC Topiramate

Ethosuximide – Absence (Petit-Mal) Lamotrigine

Gabapentin – GABA analogue

Pregabalin – Gabapentin analogue

CNS Anesthetics
Anesthetics

General Local
Anesthetics Anesthetics

Esters: 1i – exc.
Inhalational Intravenous Xylocaine-BN of

Ph
Lidocaine

Ultra-Short Opioid Propofol Etomidate

Gas Volatile Oils BZDs Amides: 2i

R
Acting BRBs combinations

Nitrous Oxide Desflurane Thiopental Midazolam Fentanyl

S,
Sevoflurane Thiamylal
SC Lorazepam

Isoflurane Methohexital Diazepam

ThiThiMo Ultra-short
Enflurane

Halothane

Methoxyflurane

POTENCY:
Nitrous oxide – least potent
Desflurane
Sevoflurance
Isoflurane
Enflurane – used for asthmatic patients (Esthma)
Halothane
Methoxyflurane – most potent (used for pregnant - Mommy)
Gastrointestinal
GI Drugs
GI drugs

Diarrhea Constipation
Dyspepsia

Ph
Prokinetic Rebamipide
Antacids PPIs H2 Blocker Alginates Misoprostol Sucralfate
Agents (Mucosta)

R
Sodium -prazole exc. Metoclopramide
-tidine Gaviscon, Algina
bicarbonate Aripiprazole – (Plasil)
(NaHCO3) anti-schizophrenic

S,
Domperidone
Magnesium (Motilium)
hydroxide
(MgOH2)
SC
Aluminum
hydroxide (AlOH3)

Calcium
carbonate (CaCO3)
Gastrointestinal
GI Drugs GI drugs

Dyspepsia Constipation
Diarrhea

Ph
Antimotility
ORS Antibiotics Probiotics
Agents

R
Traveler’s Diarrhea –
Opioids Antimuscarinic
Ciprofloxacin

Pseudomembranous colitis

S,
– Metronidazole and
Vancomycin Codeine Atropine
SC Giardiasis and Amoebic
Dysentery – Metronidazole Loperamide

Salmonellosis –
Ciprofloxacin

Cholera – Tetracycline
Gastrointestinal
GI Drugs

GI drugs
Dyspepsia Diarrhea
Constipation

Ph
Bulk-Forming Stimulant
Osmotic Agents Prokinetic Agents
Agents Laxatives

Poorly-absorbed

R
Psyllium Docusates Bile Acids Diphenylmethane Cholinergic Opiate Serotonin
ions Ricinolein acid Anthraquinones
derivative Agonists Antagonists Agonists
Poorly-absorbed
Polycarbophil
disaccharides
Senna, Cassa
Phenolphthalein Castor oil Bethanechol Naloxone Prucalopride

S,
Methylcellulose Glycerin Sagrada

PEG Bisacodyl Neostigmine Cisapride

SC Sodium Picosulfate Colchicine Tegaserod

Credits to: Doc Nico

Respiratory
Respiratory Drugs

Respiratory Drugs

Colds Bronchospastic D/O

Cough
(Acute Coryza)

Ph
Common Colds Allergic Colds Productive Dry

R
Antihistamines Mucoregulatory
If symptomatic Mucolytic Expectorant Centrally-acting Peripheral-acting
Agents

S,
Ambroxol N-acetylcysteine Guiafenesin Butamirate citrate
Codeine
α-agonists Analgesics
SC (Mucosolvan) (Fluimucil) (Robitussin) (Sinecod Forte)

Bromhexine Levodropropizine
Dextromethorphan
(Bisolvan) (Levopront)

Phenylephrine Paracetamol Carbocisteine

Noscapine
(Loviscol)

PPA Ibuprofen
Respiratory
Respiratory Drugs

Respiratory Drugs
Colds (Acute Coryza) Cough

Ph
Bronchospastic D/O

Anti-inflammatory
Bronchodilators Mast-Cell Stabilizers
Agents

R
Antimuscarinics (- Cromolyn Na Leukotriene
β2-agonists Methylxanthines Glucocorticoid
tropium) Modifiers
Nedocromil

S,
Theophylline
SABAs LABAs SAMAs LAMA 5-LOX inhibitor LTB4 inhibitor LTC4, LTD4 inhibitors Inhaled (neb, MDI) Oral (Sol’ns, tab) Parenteral (IV)

Salmeterol – slow- Prednisone Hydrocortisone IV

Salbutamol/Albuterol Ipatropium Tiotropium Zileuton Zafirlukast Montelukast Budesonide
onset (Pred) (Solu-cortef)

Terbutaline (SQ)
Formoterol – fast-
onset
Oxytropium
SC Fluticasone
Methylprednisolone
(Medrol)
Methylprednisolone
IV (Solu-Medrol)

Metaproterenol Bambuterol Dexamethasone

(Decilone)

Pirbuterol Indacaterol