CARDIOVASCULAR MEDICATION

Drug Class Generic Name (Brand Name) MOA Indication S/E C/I
Diuretics
1. Loop diuretics Furosemide Inhibits inhibits the sodium potassium 1. SOB in acute pulm. oedema King dehydration hypotension low hypovolemia severe dehydration
Bumetanide and chloride cotransporter in the loop 2. Sx relief in CCF electrolytes state hearing loss and hepatic encephalopathy hypokalemia
of Henle causing dilatation of veins 3. Sx treatment of fluid overload tinnitus hyponatremia
2. Thiazide diuretics Indapamide Inhibit sodium chloride cotransporter firstline for hypertension hyponatremia hypokalemia cardiac hypokalemia hyponatremia gout
Chlortalidone in the distal convoluted tubule add on treatment not if not arrhythmias hyperglycemia
Flumethiazide prevents reabsorption of sodium adequately control hyperlipidemia impotence
vasodilation
3. K-sparing diuretics Amiloride Weak diuretics counteract potassium Fluid overload with hypokalemia GI upset hypotension urinary severe renal impairment
loss acts on distal convoluted tubules symptoms electrolyte disturbance hyperkalemia hypokalemia in volume
inhibits reabsorption of sodium depletion
4. Aldosterone agonist Spironolactone Competitive binding to aldosterone ascites an edema due to liver cirrhosis hyperkalemia and gynecomastia severe renal impairment
receptor increased sodium and water 2 chronic heart failure and 3 primary impotence hyperkalemia Addison's disease
excretion and potassium retention hyperaldosteronism pregnant or lactating women
Anti-hypertensives
5. ACE-inhibitors Ramipril perindopril lisinopril Prevent conversion of angiotensin one hypertension chronic cardiac failure hypertension persistent dry cough renal artery stenosis acute kidney
to angiotensin 2 reduces peripheral ischemic heart disease diabetic hyperkalemia renal failure injury pregnancy breast feeding
vascular resistance promote sodium nephropathy & chronic kidney disease angioedema anaphylaxis dizziness chronic kidney disease
and water excretion with proteinuria
6. ARBs Losartan candesartan valsartan Block action of angiotensin 2 on the hypertension chronic cardiac failure hypo tension hyperkalemia renal renal artery stenosis acute kidney
AT1 receptor reduce peripheral ischemic heart disease diabetic failure dizziness injury pregnancy breast feeding
vascular resistance dilates efferent nephropathy and chronic kidney chronic kidney disease
glomerular arterial promotes sodium disease with proteinuria
and water excretion
7. Alpha-blockers Tamsulosin alfuzosin doxazosin Selective Alpha adreno receptor benign prostate hyperplasia first line postural hypotension dizziness existing postural hypotension
blocker causes vasodilation reduce and #2 the resistant hypertension syncope
resistance to bladder outflow
Anti-arrhythmic (Vaughan-Williams classification)
8. Na-channel blockers Lidocaine Blocks voltage gated sodium channel first choice local anesthetic minor stinging sensation on administration reduce cardiac output
reduces action potential duration procedure drowsiness restlessness tremor fits
increases refractory period ventricular tachycardia and fibrillation hypotension arrhythmia
refractory to cardioversion
9. Beta-blockers Bisoprolol ethanal propanolol Inhibits beta receptors reduce force of ischemic heart disease chronic cardiac fatigue cold extremities, headache an asthma COPD heart failure
metoprolol contraction and speed of conduction failure atrial fibrillation SVT GI disturbance sleep disturbance hemodynamic instability heart block
prolonged refractory period of AV hypertension nightmares impotence and hepatic failure
node reduce renin secretion
10. K-channels blockers Amiodarone Blockade of sodium calcium and tachyarrhythmias hypertension pneumonitis severe hypertension heart block
potassium channels bradycardia AV block hepatitis photo active thyroid disease
antagonism of Alpha and beta sensitivity Gray skin discoloration
adrenergic receptors thyroid abnormalities
11. CCBs Amlodipine nifedipine diltiazem Relaxation and visa dilatation in Hypertension stable angina SVT Nifedipine: ankle swelling flushing Poor LVF AV nodal conduction delay
verapamil arterial smooth muscle lowering headache palpitations unstable angina severe aortic stenosis
arterial pressure reduce myocardial Verapamil: Constipation bradycardia
contractility suppressed cardiac heart block cardiac failure
conduction myocardial and reduces
myocardial oxygen demand
Anti-arrhythmic (Miscellaneous)
12. AV node suppressor Adenosine Increase AV node refactory SVT bradycardia asystole sinking feeling hypertension coronary ischaemia
breaks the reentry circuit breathlessness impending doom decompensated cardiac failure
 cardioversion asthma seal PD heart transplant
13. Digitalis compound Digoxin Negative chronotropy positive atrial fibrillation atrial flutter severe bradycardia GI disturbance rash second degree heart block
inotrope increase vagal tone heart failure dizziness visual disturbance and intermittent complete heart block ,
Inhibit NAKATPS pump increasing digoxin toxicity ventricular arrhythmia, renal failure,
contractile force hypokalemia, hypomagnesemia,
hypercalcemia
14. Antimuscarinic Atropine Competitive inhibitor of acetylcholine bradycardia tachycardia dry mouth Constipation angle closure glaucoma arrhythmias
increased heart rate and conduction urinary retention blurred vision
drowsiness confusion
15. Adrenaline AKA epinephrine Potent agonists of A1A2 beta one and cardiac arrest anaphylaxis local vaso adrenaline induced hypertension cardiac disease
beta two adrenergic receptors constriction anxiety tremor headache palpitations end artery circulation
redistributes blood flow via angina myocardial infarction Existing use of beta blockers
vasodilatation Increases heart rate arrhythmias
force of contraction and myocardial
excitability
Anti-anginal – Vasodilators
16. Nitrates Glyceryl trinitrate Relaxation of venous vessels reduce acute angina acute coronary flushing headaches Lightheadedness severe aortic stenosis hemodynamic
preload reduce cardiac work and syndrome prophylaxis of angina hypotension tolerance instability hypotension
myocardial oxygen demand reduce pulmonary edema
peripheral resistance and after load
17. Nicorandil Act as nitrate activate K ATP channels add onto treatment of stable angina flushing dizziness headache nausea poor left ventricular function
inactivate voltage gated calcium vomiting hypotension GI skin or hypotension pulmonary edema
channel mucosal ulceration on withdrawal existing use of phosphodiesterase
inhibitor
Anti-thrombotic – Antiplatelets
18. COX-inhibitors Aspirin Irreversibly inhibits Cox enzyme Acute coronary syndrome acute GI irritation ulceration bleeding children under 16 Ray's syndrome
reduce platelet aggregation ischemic stroke prevention of bronchospasm tinnitus aspirin hypersensitivity 3rd trimester
cardiovascular cerebro vascular and of pregnancy peptic ulceration gout
peripheral arterial disease atrial
fibrillation mild to moderate pain and
fever
19. ADP-inhibitors Clopidogrel Binds irreversibly to ADP receptor acute coronary syndrome coronary bleeding GI upset thrombocytopenia active bleeding elective surgery renal
prevents platelet aggregation artery stents prevention of and hepatic impairment interactions
cardiovascular cerebrovascular and with cytochrome P450 inhibitors and
peripheral arterial disease atrial antiplatelet anticoagulants
fibrillation
Anti-thrombotic – Anticoagulants
20. DOAC Dabigatran Rivaroxaban deep vein thrombosis pulmonary bleeding active bleeding
embolism are atrial fibrillation heart
valve replacement
21. Warfarin Inhibits production of vitamin K deep vein thrombosis pulmonary bleeding need to monitor INR risk of hemorrhage liver disease
coagulations factors embolism venous thromboembolism pregnancy interactions with
atrial fibrillation heart valve cytochrome P450 inhibitors
replacement
22. Heparin Enoxaparin dalteparin Thrombin and factor xa inhibitor Venous thromboembolism such as bleeding injection site reactions clotting disorder severe uncontrolled
fondaparinux unfractionated inactivates clotting factor XA deep vein thrombosis and PE acute heparin induced thrombocytopenia hypertension recent surgery or
heparin coronary syndrome trauma invasive procedures renal
impairment
Anti-anginal – Others
23. Fibro/thrombolytic Alteplase streptokinase Dissolve fibrinous clots recanalized acute ischemic stroke acute STEMI nausea vomiting bruising hypotension bleeding intra cranial hemorrhage
occluded vessels catalyze conversion massive pulmonary embolism serious bleeding allergic reaction previous streptokinase treatment
 of plasminogen to plasmin cardiogenic shock cardiac arrest
24. Statins Simvastatin atorvastatin Inhibit HMG Co a reductase decrease primary and secondary prevention of headache GI disturbance myopathy hepatic impairment renal impairment
pravastatin rosuvastatin cholesterol production increase LDL cardiovascular disease primary rhabdomyolysis muscle aches rise in pregnancy breastfeeding interactions
cholesterol clearance reduce hyperlipidemia liver enzymes cytochrome P450 inhibitor
triglyceride increase HDL cholesterol
overall reduction of serum cholesterol
25. Fibrates
RESPIRATORY MEDICATION
Drug class Generic name (brand name) Function Indication S/e C/i
26. Anti-histamines CETIRIZINE loratadine Antagonists of H1 receptor Reduce Allergies hay fever Pruritus urticaria Sedation [except for second Severe liver disease
fexofenadine chlorphenamine type one hypersensitivity reaction anaphylaxis nausea and vomiting generation as do not cross blood brain
barrier]
27. Antimuscarinic Ipratropium Tiotropium Competitive inhibitor of acetylcholine COPD asthma Dry mouth Angle closure glaucoma
glycopyrronium reduce smooth muscle tone of
respiratory tract reduce secretion
from mucus glands
28. Beta-agonist Salbutamol salmeterol Smooth muscle relaxation stimuli and Asthma COPD hyperkalemia Tachycardia palpitations anxiety Cardiovascular disease
formoterol terbutaline ATP is pumps potassium shift from tremor muscle cramps increase serum
extracellular to intracellular lactate
compartment
29. Compound inhalers Serotype symbicort Mix of inhaled corticosteroid and long Asthma and COPD Oral thrush hoarse voice pneumonia COPD patients with history of
acting beta two agonist systemic adverse effects growth pneumonia children cardiovascular
retardation adrenal suppression disease
osteoporosis tremor tachycardia
arrhythmia muscle cramp
30. Corticosteroids Beclomethasone budesonide Downregulates proinflammatory Asthma COPD Oral Candidiasis hoarse voice Pneumonia children
fluticasone mediators reduce mucosal pneumonia
inflammation widen Airways reduce
mucus secretion
31. Oxygen Increases delivery of oxygen to tissues Hypoxemia pneumothorax carbon Discomfort of face mask Chronic type 2 respiratory failure heat
accelerates diffusion of nitrogen monoxide poisoning Dry throat source or naked flame
throughout the body shortens half life
of carboxyhemoglobin
32. PDE-5 inhibitors Sildenafil Selective PDE inhibitor increases Primary pulmonary hypertension Flushing headache dizziness nasal Stroke acute coronary syndrome
CGMP concentration releases nitric erectile dysfunction congestion hypotension tachycardia cardiovascular disease hepatic or
oxide causes arterial smooth muscle palpitations vascular events visual renal impairment existing use of
relaxation and vaso dilation disorder vasodilators
GASTROINTESTINAL MEDICATION
Drug class Generic name (brand name) Function Indication S/E C/I
Anti-emetics (H1, D2, 5HT3 & mAch driven)
33. Serotonin antagonist Ondansetron granisetron Blocks the serotonin or 5 HT3 Nausea and vomiting especially in Rare : constipation diarrhea Prolonged qt interval
receptors in the chemoreceptor context of general anesthesia and headaches
trigger zone and reduce response to chemotherapy
serotonin neurotransmitter in the gut
34. Dopamine antagonists Metoclopramide domperidone Reduce stimulus to D2-receptor which Nausea and vomiting reduce gut Diarrhea extrapyramidal syndromes Children young adults gi obstruction
is main receptor at the chemo motility acute dystonic reaction perforation
receptor trigger zone (vomiting
centre)
35. Antihistamine Cyclizine cinnarizine Block histamine 1 & acetylcholine Nausea vomiting motion sickness Drowsiness dry throat and mouth How about thick encephalopathy
promethazine muscarinic receptors to Vertigo tachycardia palpitations prostatic hypertrophy
chemoreceptor trigger zone of the
 vomiting center and vestibular system
36. Phenothiazines Prochlorperazine Blocks the effects of dopamine Nausea and vomiting Vertigo Drowsiness postural hypotension Severe liver disease prostatic
chlorpromazine histamine and aceylcholine receptors psychotic disorders extra pyramidal side effects acute hypertrophy elderly
in the vomiting center and vestibular dystonic reaction tardive dyskinesia
system of the chemoreceptor trigger QT interval formulation
zone
Hyperacidity
37. Antacid & alginates Magnesium or aluminium Buffering stomach acid increase Gord dyspepsia Diarrhea constipation Thickened milk preparation renal
sulphate viscosity of stomach contents reduces failure
reflux of stomach acid inhibit pepsin
production
38. PPIs Lansoprazole omeprazole and Irreversibly inhibiting hkatpase gastric Peptic ulcer disease NSAID associated GI disturbance headache Disguise symptoms of gastric cancer
pantoprazole parietal cells enzyme ulcers dyspepsia gastroesophageal hypomagnesemia increase risk of C increase risk of fracture osteoporosis
reflux disease H pylori infection diff infection
39. H2-R antagonist Cetirizine loratadine H2 blockers Deregulates a proton Ulcer disease goard dyspepsia Diarrhea constipation headache Disguise the symptoms of gastric
fexofenadine chlorphenamine pump pathway reduced gastric acid dizziness generally well tolerated cancer
secretion
Laxatives
40. Bulk laxatives Phylum husk methylcellulose Hydrophilic substance attracts water Constipation fecal impaction mild Abdominal distention flatulence fecal Intestinal obstruction fecal impaction
sterculia into the stool increased stool bulk chronic diarrhea impaction GI obstruction ileus
stimulating peristalsis
41. Stimulant laxatives Senna Bisacodyl glycerol Increase water and electrolyte Constipation fecal impaction Abdominal pain cramps diarrhea Intestinal obstruction perforation
suppository secretion increase volume of colonic melanosis coli hemorrhoids anal fissure
content stimulating peristalsis
42. Osmotic laxatives Lactulose Osmotically active substance hold Constipation fecal impaction bowel Flatulence abdominal cramps nausea Intestinal obstruction heart failure
Macrogol water in store maintaining well preparation and hepatic diarrhea local irritation electrolyte ascites and electrolyte disturbance
phosphate enema volume and stimulating peristalsis encephalopathy disturbance
reduces ammonia absorption
increased transit rate acidifying the
stool inhibits proliferation of ammonia
producing bacteria
Supplements
43. Iron
44. Vitamins
ENDOCRINE MEDICATIONS
Drug Class Generic Name (Brand Name) Function Indication S/E C/I
Diabetic drugs
45. Insulin
46. Metformin
47. Glitazones
48. Sulphonylureas
49. Gliptin
50. Glutides
51. SGLT-2 inhibitors
Adrenal drugs
52. Corticosteroids
53. Steroidogenesis
inhibitors
54. Adrenolytics
55. Mineralocorticoid
antagonist
Thyroid drugs
56. Thyroid HRT
57. Thiourylenes
58. Iodine
Pituitary drugs
59. Dopamine agonist
60. Somatostatin
analogue
61. GH replacement
62. GH antagonist
PAIN MEDICATION & ANAESTHESIA
Drug Class Generic Name (Brand Name) Function Indication S/E C/I
63. Paracetamol Weak inhibitor of Cox#2 enzyme Acute and chronic pain fever Liver failure in overdose Chronic excessive alcohol use
involved in prostaglandin metabolism malnutrition low body weight severe
reduce prostaglandin pge two hepatic impairment
concentration
64. NSAIDs Ibuprofen naproxen Inhibiting Cox enzyme inhibit Mild to moderate pain pain related to GI toxicity renal impairment Severe renal impairment heart failure
synthesis of prostaglandin reduce inflammation cardiovascular events hypersensitivity liver failure NSAID hypersensitivity
inflammatory response fluid retention peptic ulcer disease GI bleeding
65. Weak opioids Tramadol codeine Agonist of opioid mu receptors Mild to moderate pain Nausea Constipation dizziness Significant respiratory disease renal
dihydrocodeine drowsiness neurological and and hepatic impairment elderly
respiratory depression addiction uncontrolled epilepsy
66. Strong opioids Morphine oxycodone Activation of opioid mu receptors in Acute severe pain chronic pain Respiratory depression neurological Pathetic and renal failure elderly
the central nervous system reduce breathlessness will acute pulmonary depression nausea vomiting popular respiratory failure billiary colic
neuronal excitability and pain edema reconstruction Constipation itching secondary to sphincter of oddi spasm
transmission blunt response to tolerance dependence withdrawal
hypoxia and hypercapnia reduce reaction
sympathetic nervous system activity
67. Neuropathic analgesia Gabapentin pregabalin Binds with voltage sensitive calcium Diabetic/painful neuropathy migraine Drowsiness dizziness ataxia Renal impairment existing use of
channels inhibit neurotransmitter prophylaxis focal epilepsy generalized sedating drugs like benzodiazepine
release interfere synaptic anxiety disorder
transmission and reduces neuronal
excitability
68. Local anaesthesia LIDOCAINE
69. General anaesthesia
NERVOUS SYSTEM MEDICATION
Drug Class Generic Name (Brand Name) Function Indication S/E C/I
70.
71.
72.
73.
74.
75.
76.
MUSKULOSKELETAL & SKIN MEDICATION
Drug Class Generic Name (Brand Name) Function Indication S/E C/I
77. Allopurinol
78. Amino salicylates
79. Methotrexate
80. Quinine
81. Bisphosphonate
82. Vitamin D
83. Calcium
84. Corticosteroids
85. Emollients
ANTIBIOTICS & INFECTION MEDICATION
Drug Class Generic Name (Brand Name) Function Indication S/E C/I
86. Macrolides
87. Penicillin
88. Aminoglycosides
89. Cephalosporins
90. Carbapenems
91. Metronidazole
92. Nitrofurantoin
93. Quinolones
94. Tetracyclines
95. Trimethoprim
96. Vancomycin
97. Antivirals
98. Antifungals
99. Vaccines
POISONING & ANTIDOTES
Drug Class Generic Name (Brand Name) Function Indication S/E C/I
100. Acetylcysteine N-acetyl cysteine replenish body supply of glutathione paracetamol poisoning prevention of anaphylactoid reaction secondary to history of anaphylactoid reaction
contrast Nephropathy reduce viscosity histamine release independent of IG E
of respiratory secretions antibodies bronchospasm
101. Activated charcoal adsorb toxin molecules preventing drug overdose or poison ingestion aspiration pneumonitis bronchospasm reduce level of consciousness
absorption into circulation increase airway obstruction intestinal persistent vomiting reduced GI
elimination of poisons particularly obstruction black stool and vomiting motility
ones readily diffuse back into the gut
102. Naloxone competitive antagonist to opioid opioid toxicity opioid withdrawal reaction : pain opioid dependence palliative care
receptors against morphine restlessness nausea and vomiting
dilated pupils cold dry skin with
piloerection
103. Thiamine in vitamin b12 pabrinex Correct severe thiamine deficiency alcohol toxicity WERNICKE's Anaphylaxis coexisting folate and B12 deficiency
encephalopathy korsakoff psychosis severe liver disease

COMMON REGIMENS

SAME CLASS, DIFFERENT USES

Antimuscarinics Antihistamines (H1-receptor antagonists)

 1. Respiratory 1. Allergies
2. Cardiovascular 2. Pruritus & urticaria
3. Gastrointestinal 3. Nausea & vomiting + motion sickness & vertigo
4. Genitourinary *H2-receptor antagonist specific to gastric parietal cells

N.B. Muscarinic receptors are G-coupled protein acetylcholine receptor subtype (mAChR)

Corticosteroids Alpha & Beta Blockers

1. Systemic anti-inflammatory  Alpha 1
2. Inhaled anti-inflammatory  Alpha 2
3. Topical anti-inflammatory  Beta 1
 Beta 2
N.B These agents usually act on glucocorticoid receptors (not mineralocorticoid) although both are associated
with steroids secreted by adrenal glands.

PHYSIOLOGY & PHARMACOLOGY REVISION

THE PERIPHERAL NERVOUS SYSTEM THE CENTRAL NERVOUS SYSTEM

Divided into 2 major systems: There are 2 ways to categorize neurotransmitters (NTs), by structure or function:
1. Autonomic Structural classification Functional classification
a. Sympathetic  Monoamines  Excitatory (Upregulate)
b. Parasympathetic o Dopamine o Glutamate  NMDA-R
c. Enteric o Noradrenaline o ACh (refer to PNS)
2. Somatic o Adrenaline o Adrenaline
a. Afferent/sensory nerves o Histamine o Noradrenaline
b. Efferent/motor nerves o Serotonin o Histamine
 Amino acids  Inhibitory (Downregulate)
Acetylcholine/Cholinergic receptors o Glutamate o GABA  GABA-A, GABA-B receptors
 Muscarinic: mAChR o GABA o Glycine
o M1: CNS, salivary glands & gastric secretions o Glycine o Serotonin
o M2: CNS & heart  Peptides  Neuromodulator (Regulate intensity)
o M3: Smooth muscle, vessels, CNS, glands o Opioids o Dopamine
o M4: CNS o Endorphins o Endorphin
o M5: CNS o Somatostatin
 Nicotinic: nAChR o Oxytocin
o Nn @ autonomic ganglia (n for neuron) o Vasopressin
o Nm @ neuromuscular junction (m for muscle)  Others
o Acetylcholine
Adrenergic receptors o Adenosine
 Alpha adrenergic o Nitric oxide
o Alpha-1
o Alpha-2
 Beta adrenergic
o Beta-1
o Beta-2