Nervous system

Central nervous Peripheral

system nervous system

nerves
Brain Spinal cord

Sensory nerves Motor nerves

(afferent nerves) (effernet nerves)

Autonomic Somatic
nevous system nervous system

Sympathatic Parathympathatic
nervous system nervous system
 Parasympathomimetics
(cholinomimetics)

Directly-acting Indirectly-acting
Muscarinic agonists Muscarinic agonists
((Agonist on ((Anticholine esterase
muscarinic +/- nicotinic Cholinesterase inhibitors))
Receptor))

reversible Irreversible
Choline esters Cholinomimetic (effect for several
hours)
acetycholine alkaloids Toxic compounds
methacoline muscarine Quaternary (selective CNS drugs) Not used as drugs
carbacol pilocarpine Carbamates ammonium For ttt of alzehimer
bethanecol cevimeline alcohols *organophosphorous
physostigmine Tacrine(*) compounds,used as:
edrophonium
donepezil pesticides:
neostigmine
rivastigmine echothiophate
{neostigmine isoflurophate
substituants} galantamine
Insecticides:
parathion
malathion
For For War gases:
myasthenia gravis glaucoma Sarin-Tabun-Soman
pyridostigmine benzpyrinium
Choline esterase
ambenonium demecarium
regenerators
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diacetylmonoxime
 Anticholinergics

Antimuscarinics antinicotics
(parathympatholytics)

Natural belladona alkaloids Synthetic(atropine&hyoscine)substituants Drugs with antimuscarinic effect

atropine First generation antihistamines
L-hyoscine(scopolamine) Antipsycotics - antidepressants
hyoscyamine

Mydriatic Bronchodilator Antisecretory Substituants Decrease For

substituants substituants antispasmodic Urinary bladder activity parkinsonism
homatropine sustituants emepronium benzhexole-benztropine
*short acting
tropicamide oxybutyline biperidine-procyclidine
cyclopentolate (SAMA): atropine-methylnitrate
flavoxate ethapropazine
ipratropium hyoscine-N-butylbromide
tolterodine-fesoterodine
oxyropium trihexethyl
darfenacin-solifenacin
*long acting trospium-propiverine
tiemonium methylsulfate
(LAMA): oxyphenonium
Tiotropium clidinium
gycopyrronium methantheline-propantheline
aclidinium pirenzepine-telenzepine
umeclidinium mebeverine-drotaverine (benzhexole = trihexphenidyl)
dicycloverine-dicyclomine
 Antinicotinic drugs

Ganglionic blocking Neuromuscular blocking Centrally-acting nicotinic

agents agents receptor blockers
dextromethorphan
Competitive, Non-competitive, Competitive, Non-competitive,
non-depolarizing depolarizing non-depolarizing depolarizing
ganglionic blocking ganglionic blocking neuromuscular blocking Neuromuscular blocking
agents agents agents agents
hexamethonium* nicotine in large dose atracurium-cisatracurium succinylcholine
pentamethomium* lobeline in large dose vecuronium-rocuronium decamethonium
pentolinium* pancuronium
tetraethylammonium*
trimethaphan
mecamylamine

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 Adrenergic drugs
(sympathomimetics)

Directly-acting Indirectly-acting
Adrenaline-Noradrenaline-Dopamine Releasing agents:
amphetamine
methamphetamine
tyramine
Selective Selective
Reuptake inhibitors:
alpha-receptor agonists beta-receptor agonists Cocaine
*selective beta1,beta2-receptor agonists: COMT&MAO
Selective Selective Isoprenaline-orciprenaline-isoxsuprine inhibitors:
entacapone
alpha1-receptor alpha2-receptor
pargyline
agonists agonists
Selective Selective Selective
phenylephrine- clonidine beta1-receptor Beta2- receptor beta3-receptor
methoxamine alpha-methyldopa agonists agonists agonists
midodrine- Drugs with Mixed
metaraminol dobutamine mirabegron
clonidine-like effect: dopexamine (direct and indirect)
apraclonidine prenalterol
nephthazoline- brimonidine ephedrine
tetrahydrozoline lofexidine pseudoephedrine
xylometazoline- guanabenz Short-acting Long-acting Ultra-long-acting
oxymetazoline guanfacine
albuterol-levalbuterol bambuterol vilanterol
pirbuterol-terbutaline salmeterol olodaterol
formoterol indacaterol
arformoterol
Ritodrine:selective short-acting beta2-receptor agonists, Selective on the beta2 receptors in the uterus,decrease uterine contractions,
Used orally or by IV to stop premature labor, Withdrown from the US market, according to FDA Orange Book.
 Anti-adrenergic drugs
(sympatholytics)

Alpha-blockers Beta-blockers Mixed alpha1,beta1-blockers

*non-selective: *non-selective: labetalol
carvedilol
-Imidazole derivatives: tolazoline
(reversible) phentolamine
(short acting) propranolol-nadolol Non-selective with
timolol-sotalol partial agonist activity
-Haloalkalamine derivatives: oxprenolol on beta1 and beta2
(irreversible) phenoxybenzamine
(long acting) celiprolol

*selective: *selective:

Selective alpha1 Selective alpha2 Selective beta1 Seletive beta1 with

Modest activity on beta2
prazocin-terazocin yohimpine atenolol-bisoprolol
doxazocin-tamsulocin metoprolol-esmolol pindolol
silodocin-alfuzocin nebivolol-betaxolol penbetolol
acebutolol

Phenoxybenzamine is also
sereetonin(5-HT2a) antagonist

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 Endocrine system
Autocoids
And other hormones
 {{hypothalamus}}
*Corticotropin-releasing hormone(CRH)
*Thyrotrpin-releasing hormone(TRH)
*Gonadotropin-releasing hormone(GnRH)
*Growth hormone-releasing hormone(GRH)
(also called somatotropin)
*Growth hormone-inhibiting hormone(GHIH)
(also called Somatostatin)
*Dopamine
*Antidiuretic hormone(vasopressin)
*oxytocin
{{thyroid gland}}
*follicular cells: Parathyroid hormone
thyroxine(T4)
tri-iodothyronine(T3)
{T3 more potent thanT4}
*parafollicular cells:
calcitonin
{{gastrointestinal tract}}
*enteroendocrine cells:
Seretonin: Enterocromaffin cell
Histamine: Enterocromaffin-like cell
Cholecystokinin:
I cell
Somatostatin: D cell
Gastrin: G cell Secretin: S cell
Motilin: M cell Neurotensin: N cell
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{{Pitutary gland}}
Anterior lobe {{pineal body}}
Corticotropin(adrenocoticotropic hormone) melatonin
Thyrotropin(thyroid-stimulating hormone)
Gonadotropins{follicle-stimulating hormone(FSH),
lutenizing-stimulating hormone(LH)}
Growth hormone(GH)
prolactin
Posterior lobe
Antidiuretic hormone(vasopressin)
oxytocin
{{parathyroid gland}} {{thymus}} {{heart}}
thymosins Natriuretic peptides:
Atrial natriuretic peptide(ANP)
Brain natriuretic peptide(BNP)
Also called b-type natriuretic peptide
{{pancreas}}
*islets of langerhans: alpha cells: glucagon
Incretins include 2hormones:
beta cells: insulin-amylin
1)Glucagon-like peptide1: L cell
delta cell: somatostatin
2)Gastric inhibitory peptide: K cell
gamma cells: parncreatic
polypetide
*gastric endocrine cells: Note:in addition to the endocrine function of pancreas,
Gastrin:G cell it has exocrine function secreting digestive enzymes:
Histmine:Enterochromaffin-like cell pancreatic amylase, pancretic lipase,pancretic
protease from acinar cells, into the duodenum.
 {{andrenal gland}}

Adrenal cortex

corticosteroids

(zona fasculata) (zona glomerulosa) (zona reticularis) Adrenal medulla

Glucorticoids: Mineralocorticoids: Sex hormones: Sympathomimetics:
Cortisone (inactive form) aldosterone Testosterone - Progerterone Adrenaline(epinephrine)
Cortisol (active form) Estrogens Noradrenaline(norepinephrine)
(cortisol = {estron(E1)-estradiol(E2)-
dihydrocortisone) estriol(E3)-estetrol(E4)}

{{Gonads}}
kidney
*calcitriol(1,25-dihydroxycholecalciferol =
1,25-dihydroxy vitamin D3active form of vitamin D3) Testes Ovaries
*ercalcitriol(1,25-dihydroxyergocalcitriol = (male gonads) (Female gonads)
1,25-dihydroxy vitamin D2active form of vitamin D2)
*interstitial cells: testosterone Progerteron
*erythropoietin *renin *prostaglandins *sertoli cell (nurse or mother cell) : Estrogens
activin - inhibin - {estron(E1)-estradiol(E2)-
antimullerian hormone estriol(E3)-estetrol(E4)}
(also secrete estradiol aromatase ezyme)

placenta estrogen – progesterone

human chorionic gonadotropin (hCG)
 {{ovaries}}
Estrogen preparations
Natural estrogens
estradiol
estradiol benzoate
estradiol valerate
estradiol hemihydrate
conjucated estrogens
First generation
norethisterone(norethindrone)
norethisterone acetate
ethynodiol diacetate
Second generation
norgestrel
levonorgestrel
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estrogens
Selective estrogen recetor
modulators(SERMs)
Semisynthetic estrogens Synthetic estrogens clomiphene - tamoxifen
(non-steroidal) raloxifene - bazedoxifen
ethinyl estradiol
mestranol diethylstilbesterol
progesterone
Estrogen preparations Selective progesterone recetor
modulators(SPRMs)
Third generation mifepristone
ulipristate acetate
desogestrel
norgestimate
gestodene
Other progestins
medroxyprogesterone acetate
drospirenone+ethinylestradiol
 {{adrenal cortex hormones}} Steroid hormones
{{Zona reticularis}}
Sex hormones (sex steroids)
Adrenocorticosteroid inhibitors
corticosteroids
Aminoglutethimide
metyrapone {{Zona glomerulosa}}
mineralocorticoids
Adrenocorticotropic hormone {{Zona fasculata}}
glucocorticoids *agonists: *antagonists:
cosyntropin (tertracosactide)
aldosterone spironolactone
repository corticotropin injection
deoxycorticosterone eplerenone
deoxycorticosterone acetate
fludrocortisone

otic corticosteroids otic corticosteroids+anti-infective

Systemic corticosteroids
flucinolone Dexamethasone+ciprofloxacin
*short-acting(<12hr): Flucinolone+ciprofloxacin
cortisone – cortisol Hydrocortisone+ciprofloxacin
*intermediate-acting(12-36hr): Hydrocortisone+neomycin+polymyxin b
Prednisone-prednisolone-methylprednisolone
hydrocortisone+neomycin+colistin+&&
triamcinolone – paramethasone
hydrocortisone+chloroxylenol+benzocaine
*long-acting(>48hr): Hydrocortisone+chloroxylenol+pramoxine
betamethasone - dexamethasone

Inhaled corticosteroids Ophthalmic corticosteroids+anti-infective

ophthalmic corticosteroids
beclomethasone - fluticasone (can be used for otic use) (can be used for otic use)
mometasone - triamcinolone
Prednisolone - triamcinolone Tobramycin+dexamethasone
ciclesonide – budesonide - flunisolide
Rimexolone - flucinolone Tobramycin+loteprendol
fluorometholone - dexamethasone Gentamicin+prednisolone
Intranasal corticosteroids Sulfacetamide+prednisolone
Loteprednol - difluprednate
Beclomethasone - fluticasone Dexamethasone+neomycin+polymyxin b
Mometasone - triamcinolone Hydrocortisone+neomycin+polymyxin b
Ciclesonide – budesonide - flunisolide Hydrocortisone+neomycin+polymyxin b+bacitracin
 Topical corticosteroids

*Ultra high potency topical corticosteroids: *Moderate potency topical corticosteroids:

Group I Group IV
Clobetasol propionate cream (0.05%) Desoximetasone cream (0.05%)
Diflorasone diacetate ointment (0.05%) Fluocinonide acetonide ointment (0.025%)
Hydrocortisone valerate ointment (0.2%)
Triamcinolone acetonide cream (0.1%)
*High potency topical corticosteroids:
Group II Group V
Amcinonide ointment (0.1%) Betamethasone dipropionate lotion (0.02%)
Betamethasone dipropionate ointment (0.05%) Betamethasone valerate cream (0.1%)
Desoximetasone (cream or ointment) (0.025%) Fluocinonide acetonide cream (0.025%)
Fluocinonide (cream, ointment, or gel) (0.05%) Hydrocortisone butyrate cream (0.1%)
Halcinonide cream (0.1%) Hydrocortisone valerate cream (0.2%)
Triamcinolone acetonide lotion (0.1%)
Group III
Betamethasone dipropionate cream (0.05%)
Betamethasone valerate ointment (0.1%) *Low potency topical corticosteroids:
Diflorasone diacetate cream (0.05%) Group VI
Triamcinolone acetonide ointment (0.1%) Betamethasone valerate lotion (0.05%)
Desonide cream (0.05%)
Fluocinolone acetonide solution (0.01%)
Group VII
Dexamethasone sodium phosphate cream (0.1%)
Intra-articular corticosteroids
Hydrocortisone acetate cream (1%)
*lower anti-inflammatory potency: Methylprednisolone acetate cream (0.25%)
hydrocortisone – prednnisolone
methylprednisolone
*higher anti-inflammatory potency:
betamethasone - dexamethasone
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 {{thyroid gland}}
Thyroxine and tri-iodothyronine
*thyroid stimulating hormone:
thyrotropin alpha
*thyroid drugs:
levothyroxine(T4)-liothyronine(T3)
liotrix - tiratricol
*antithyroid drugs:
methimazole-carbimazole
methylthiouracil-propylthiouracil
bezylthiouracil
{{anterior lobe pitutary
gland}}
growth hormone
*somatotrpin: somatropin
*somatostatin: octreotide-
lanreotide
*growth hormone receptor
antagonist: pegvisomant
{{kidney}}
calcitonin calcitriol and ercalcitriol
calcitonin (1,25-dihydroxycholecalciferol =
(1,25-dihydroxy vitamin D3)
{{parathyroid gland}} (1,25-dihydroxyergocalcitriol =
(1,25-dihydroxy vitamin D2)
ergocalciferol – cholecalciferol
Parathyroid hormone
1-hydroxycholecalciferol (alfacalcidol)
parathyroid hormone 1,25-dihydroxycholecalciferol (calcitriol)
*parathroid hormone analogs: dihydrotachysterol
teriparatide - abaloparatide
erythropoietin
Epoietin alpha – darbepoietin alpha
Epoietin beta – methoxyPEG-epoietin beta
{{posterior lobe of pitutary gland}}
Oxytocin hormone
renin
Oxytocin
*Angiotensin-converting enzyme inhibitios(ACEIs):
*oxytocin analogs: carbetocin-demoxytocin
captopril-enalapril-lisinopril
*oxytocin antagonists: atosiban fosinopril-zofenopril-ramipril
anti-diuretic hormone imidapril-perindopril-trandolapril
cilazapril-qinapril-benzapril
*antidiuretic hormone analog: *Angiotensin-ІІ receptor blockers (ARBs):
Desmopressin losartan-candesartan-valsartan
*antidiuretic hormone antagonists telmisartan-olmesartan
(vasopressin V2-receptor antagonists): azilsartan-irbesartan
Conivaptan – tolvaptan fimasartan-eprosartan
demeclocycline *Renin inhibitors:
aliskiren
 {{hypothalamus(GRH) and anterior pitutary gland(gonadotropins)}}
*gonadotropin-releasing hormone(GRF) analogues: *follicle-stimulating hormone(FSH) preparations:
leuprolide –nafarelin –buserelin –goserelin –histerelin -derived from urine of menopausal women: urofollitropin
deslorelin - treptorelin -recombinant preparations: follitropin alpha
*gonadotropin-releasing hormone(GRF) antagonists: follitropin beta
abarelix –goserelix – cetrorelix - degarelix *luteninzing hormone(LH) preparation: lutropin
*other preparations:
human menopausal gonadotropins (menotropin)
human chorionic gonadotropins

{{ testis }}

Testosterone (androgen)

Testosterone preparations antiandrogens

testosterone enanthate – methyltestosterone
testosterone cypionate – mesterolone
testosterone undecanoate - fluoxymesterone androgen receptor antagonists 5α-reductase inhibitors
Cyproterone acetate – spironolactone finasteride – dutasteride
Flutamide – nilutamide - bicalutamide alfatradiol

Anabolic steroids CYP17A1 inhibitor

nadrolone
(inhibit 17,20-lyase and 17 α-hydroxylase enzymes)
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 {{ovaries}}
estrogens

Estrogen preparations Selective estrogen recetor

Natural estrogens
estradiol
estradiol benzoate
estradiol valerate
estradiol hemihydrate
conjucated estrogens
Semisynthetic estrogens
ethinyl estradiol
mestranol
modulators(SERMs)
Synthetic estrogens clomiphene - tamoxifen
(non-steroidal) raloxifene - bazedoxifen
diethylstilbesterol
Aromatase inhibitors
letrozole – anastrozole
exemestane - testolactone

progesterone

Estrogen preparations Selective progesterone recetor

modulators(SPRMs)
First generation Third generation mifepristone
ulipristate acetate
norethisterone(norethindrone) desogestrel
norethisterone acetate norgestimate
ethynodiol diacetate gestodene
Second generation Other progestins
norgestrel medroxyprogesterone acetate
levonorgestrel drospirenone+ethinylestradiol
 Autocoids
Decarboxylated amino acids polypeptids eicosanoids
*histamine *angiotensin-II *Prostaglandins (D2
*serotonin E1-E2
*kinins(kallidin- I2-F2α)
bradykinin)
*thromboxane A2 (TXA2)
*vasopressin(=antidiuretic hormone)
*leukotrienes (A4-B4-C4
*natriuretic peptides D4-E4)
(antrial natriuretic peptides(ANP)-
brain natriuretic peptide(BNP))

*vasoactive intestinal peptides (VIP)

*substance P

Note:
Prostaglandin I2 (PG I2)=
prostacyclin

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 prekallikreins kininases

kallikreins Kinin receptors

Kininogens Kinins B1
B2a,B2b

Plasma prekallikrein

Plasma kallikrein
HMW kininogen Bradykinin
Kinin receptors
(B1,
Tissue prekallikrein kininases
B2a,B2b)

Tissue kallikrein
LMW Kiininogen Kinins
 Phospholipids from the cell
membrane

Lipoxygenase-A1 enzyme

Arachidonic acid

Lipoxygenase enzyme Cycloxygenase enzyme

leukotrienes Prostaglandins
And thromboxane A2

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 {{ seretonin }}
Seretonin receptors Seretonin agonists Seretonin antagonists

*5-HT  1A,1B,1D *selective 5-HT1A agonist: buspirone *selective 5-HT3 inhibitors:

(sedative, hypnotic, anxiolytic) ondansetron-granisetron-tropisetron
*5-HT  1A,2B,2C *selective 5-HT1B,1D agonists:
palonosetron-dolasetron
*5-HT3 (triptans, for migraine) alosetron-cilansetron
*5-HT4 sumatriptan-zolmitriptan-almotriptan *phenoxybenzamine:
eletriptan-naratriptan-rizatriptan
*5-HT5A,5B
frovatriptan
α-adrenergic receptor blocker
*5-HT6 with 5-HT2A blocking effect
*selective 5-HT4: mosapride (GIT prokinetic)
*5-HT7 *olanzapine:
tegaserod(*)-cisapride(*)
dopamine(D2)receptor blocker
*tricyclic antidepressants: imipramine-amitriptyline-
clomipramine-trimipramine-
with 5-HT2A blocking effect
desipramine-nortriptyline-protriptyline *pizotifen:
*seretonin/norepinephrine reuptake inhibitors(SNRIs):venlafaxine-desvenlafaxine antihistamine
duloxetine-levomilnacipran with 5-HT2A,2C blocking effect
*monoamine oxidase inhibitors(MAO inhibitots): *ketanserin:
Non-selective(MAO-A and MAO-B)inhibitors: phenelzine-isocarboxazid- α-adrenergic receptor antagonist,
tranylcypromine with antihistaminic,
Selective(MAO-A) inhibitors: moclobemide and 5-HT2A,2C blocker
*selective seretonin reuptake inhibitor(SSRIs): fluoxetine - paroxetine *cyproheptadine:
fluvoxamine – sertraline antihistamine
citalopram - escitalopram and 5-HT2A,2B,2C blocking effect

{{ leukotrienes }} {{ kinins }} {{ Substance P (neurokinin-1)

*leukotriene antagonists(LTRAs): *kallikrein inhibitors: receptor antagonists }}
monelukast-zafirlukast. aprotinin - ecallantide apripatant – fosapripatant
*5-lipoxygenase inhibitors: *kinin receptor antagonists: rolapitant – neutipitant
zileuton icatibant casopitant
 {{antihistamines}}
H1-receptor antagonists

{First generation antihistamines} {second generation antihistamines}

Advantages: Effective and less expensive. Advantages:
Disadvantages: Long duration:12 to 24 hours.
Short duration:4-6 hours. high selectivity:
Low selectivity: - don’t pass CNS, don’t have CNS effects not sedating.
- pass CNS ,have CNS effects, sedating. -anticholinergic, antiseretonergic effects.
- anticholinergic, antiseretonergic effects. Disadvantages: More expensive.
cetirizine -loratidine
olopatadine -alcaftadine
Highly sedating Moderately sedating mild sedating
acrivastine -azelastine
diphenhydramine pheniramine chorpheniramine ebastine -emedastine
dimenhydrinate brompheniramine dexchlorpheniramine mizolastine -bepotastine
hydroxizine mepyramine cyclizine ketotifen
doxylamine meclizine dimethindine
buclizine
promethazine cinnarizine triprolidine
{third generation antihistamines}
(Mepyramine= orphenadrine fexofenadine
Pyrilamine) cyproheptadine levocetirizine-desloratidine

{{histamine H2- receptor antagonists}} {{histamine H3- receptor antagonists}}

cimetidine* - ranitidine
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 {prostaglandin analogues}

Prostaglandin E1(PGE1) analog Prostaglandin E2(PGE2) analog

Misoprostol -alprostadil dinoprostone

Prostaglandin I2(PGI2) analog Prostaglandin F2α(PGF2α) analog

epoprostenol carboprost-travoprost
latanoprost-bimatoprost
unoprostone

{prostaglandin synthsis inhibitors}

{{{Prostaglandins}}}

Cyclo-oxygenase inhibitors Phospholipo-oxygenase II inhibitors

(COX-inhibitors) (LOX-inhibitors)
(non-steroidal anti-inflammatory drugs) NSAIDs corticosteroids

(1) Non-selective COX inhibitors

salicylates oxicams pyrazolones Aryl alkanoic acids

Acetylsalysylic acid piroxicam antipyrine=phenazone *indole acetic acid derivatives: indomethacin-sulindac
Diflunisal tenoxicam aminopyrine* *profens: ibuprofen – ketoprofen - fenoprofen
*5-aminosalicylates: lornoxicam propylphenazone naproxen – nabumetone
-azo-compounds: analgin(=novalgin=
Sulfa:sulfasalazine dipyrone=metamizole)
*fenamates: mefenamic acid
Non-sulfa:balsalazine *others: diclofenac sodium - diclofenac potassium
olsalazine aceclofenac - ketorolac
-mesalamine
(2) Selective Cox-II inhibitors (3) Selective COX-III inhibitors Topical NSADs
(Central COX )
diclofenac sodium
celecoxib - meloxicam paracetamol
 {{ drugs acing on ion-channels }}

Sodium channels Calcium channels

*sodium channel blockers; *calcium channels blockers:
*class A (intermediate): *class I: amlodipine–nifedipine–nimodipine-nitrendipine
quinidine-dispyramide-procainamide isradipine-lacidipine-lercanidipine.
*classB (fast): Class II: verapamil.
Class III: deltiazem.
lidocaine
mexiletine *calcium influx inhibitor: memantine
(NMDA-receptor blocker)
*classC (slow):
flecainide
propafenone

Potassium channels Chloride channel activators

*potassium channels operners: Lupirostone
sodium nitroprusside – hydralazine
minoxidil - diazoxide
*potassium channel blocker:
amiodarone-dronedarone-sotalol
tofetilide-ibutilide

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 {{ important physiological enzymes}}

Phosphodiesterase(PDE) enzyme inhibitors Protease-activated receptor-1 antagonists

*PDE-1 inhibitor: vinpocetine(*) atopaxar-vorapaxar
*PDE-2 inhibitors: anagralide(*)-oxindole(*)
*PDE-3 inhibitors:
amrinone(inamrinone) – milrenone - cilastazol
Carbonic anhydrase inhibitors
acetazolamide – methazolamide
brinzolamide – dorzolamide
*PDE-4 inhibitors: dichlorphenamide
drotaverine – roflumilast - crisaborole

*PDE-5 inhibitors: Guanylate cyclase-c agonists

sildenafil – tadalafil –
vardinafil – avanafil linaclotide
dipyridamol
*PDE-6 inhibitors: dipyridamole

*PDE-7 inhibitors:
quinazoline-containing drugs as
gefitinib – lapatinib – erlotinib – afatinib

*PDE-10 inhibitor: Acetylcholine esterase inhibitors

papaverine Monoamine oxidase inhibitors
Angiotensin-converting enzyme inhibitors
α-glucosidase inhibitors
Dipeptidylpeptidase-4 inhibitors
Aromatase inhibitors
5α-reductase inhibitors -- CYP17A1 inhibitors
Discussed before
 Cardiovascular system
and blood

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 Diuretics
(1) Thiazid diuretics

Short-acting Long-acting Thiazid analogures

chlorothiazide chlorthalidone
(thiazid-like diuretics)
hydrochlorothiazide indapamide-clopamide
xipamide-metolazone

(2) Loop-diuretics (3) Potassium-sparing diuretics

Sulfonamide Non-sulfonamide Aldosterone Non-aldosterone

derivatives derivatives antagonists antagonists
furosemide ethacrynic acid spironolactone amiloride
torsemide eplerenone triamterene
bumetanide

(4) Carbonic anhydrase inhibitors (5) Osmotic diuretics

acetazolamide – methazolamide glucose(IV) – glycerol(oral)
brinzolamide – dorzolamide mannitol(Ivinfusion) – sorbitol
dichlorphenamide isosorbide(oral) - urea

(7) Cardiac glycosides (9) aquaretics

(6) methylxanthines digoxin
Caffeine – theophylline Herpal medicine Synthetic aquaretics
Theobromine - aminophylline (vasopressin V2-receptor antagonist)
(8) dopamine Common horse tail
Common nettle Antidiuretic hormone antagonist)
Conivaptan – tolvaptan
demeclocycline
 {{haematopoietic drugs}} {{myeloid growth factors}}
*erythropoeisis-stimulating agents: *granulocyte colony-stimulating factor:
Epoietin alfa - darbepoietin alfa Filgrasiem
Epoietin beta - methoPEG-epoien beta. Tbo-filgrastim
Peg-filgrastim
*iron supplements:
Oral iron formulations: *granulocyte colony-stimulating foctor:
Ferrous sulfate - polysaccharide-iron complex sargramostim
Ferrous gluconate - carbonyl iron
Ferrous fumarate - lactoferrin(a transferrin).
Parenteral iron formulations:
Iron dextran - sodium ferric gluconate complex
Iron sucrose - ferumoxytol
Iron carboxymaltose
Iron isomaltoside 1000.
{{iron chelation: deferoxamine-deferiprone-deferasirox}} {{megakacyocyte growth factors}}
*thromboepoietic growth factor: oprelvekin
*vitamin B12(cobalamin) supplements:
cyanocobalamin
hydroxycobalamin *throboepoietic analog: romiplostim
methylcobalamin(mecobalamin).
*thromboepoietin-receptor agonists: eltrombopag
*follic acid supplements:
Follic acid.
*other drugs for anemia:
hydroxyurea
pentoxyphelline
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 Professional pharmacist
From A to Z course. {{Antithrombotic drugs}}

antiplatelets
*thromboxan -A2 inhibitors
(inhibit prostaglandin synthesis): aspirin.
*glycoprotein ІІb/ІІІa inhibitors
(block glycoprotein ІІb/ІІІa receptors):
abciximab-tirofiban-eptifibatide.
*P2Y12 receptor inhibitors
(inhibit ADP-induced platelet aggregation):
clopidogrel-prasugrel-ticagrelor-ticlopidine.
*protease-activated receptor-1(PAR-1)antagonists:
atopaxar-vorapaxar.
anticoagulants
*vitamin K antagonists(coumarin anticoagulants):
warfarin.
*indirect thrombin inhibitors(heparins):
-unfractionated heparins: heparin.
-low molecular weight heparin: enoxaparin
tinzaparin-dalteparin.
*direct thrombin inhibitors(DTIs):
-parenteral DTIs: desirudin-lepiredin-bivalirudin.
-oral DTIs: dapigatran etexilate.
*direct factor Xa inhibitors:
-parenteral agents: fondaparinux.
-oral agents: apixaban-rivaroxaban.

*other antiplatelet drugs: dipridamol-cilostazol.

Thrombolytics(fibrinolytics)
streptokinase-urokinase-anistreplase
Tissue plasminogen activators(t-Pas): alteplase-reteplase-tenecteplase
 {{anti-hemorrhagics}}

Plasma fractions
Vitamin k1
recombinant human coagulation factor VIIa
dried factor VIII fraction
factor IX complex

anti-inhibitor coagulant complex

Aminocaproic acid anti-inhbitor coagulant complex heat treated
Tranexamic acid
cryoprecipitate

Ethamsylate

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 {{antihyperlipidemics}}

*HMG-CoA inhibitors (statins): *niacin (Vit B3=nicotinic acid).

atorvastatin-lovastatin-rosuvastatin
simvastatin-fluvastatin-pravastatin. *omega-3 fatty acid (present in fish oil).

*cholesterol absorption inhibitor: *garlic.

ezetimibe.
*red yeast rice.

*bile acid sequestrants (resins):

cholestyramine
colestipol
colesevelam.

*fibrates (fibric acid derivatives):

fenofibrate-etofibrate
benzofibrate-gemfibrate.
 Antihypertensives

Adrenergic Non-adrenergic
antihypertensives antihypertensive
*alpha1-antagonists *angiotensin-converting enzyme inhibitors (ACE inhibitors)
*alpha2-agonists *angiotensin-II receptor blockers (ARBs)
*non-selective beta-blockers *renin inhibitors
*selective beta1-blockers
*mixed alpha1,beta1-blockers *calcium-channel blockers(CCBs): classI,II,III
*potassium-channel operners

*centrally-acting antihypertensives *diuretics

*peripherally-acting antihypertensives *natural antihypertensives
*ganglionic blockers

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 Adrenergic antihypertensives

*alpha1-antagonists: *non-selective beta-blockers:

Prazocin – terazocin - dozazocin Propranolol - nadolol

*alpha2-agonists: *selective beta1-blockers:

Clonidine Atenolol – bisoprolol
alpha-methyldopa Metoprolol – esmolol
nebivolol
*Mixed alpha1,beta1-blockers:
Lapitalol - carvidolol

*centerally-acting sympathetic inhibitors: *peripherally-acting sympathetic inhibitors:

Rilmenidine Guanethidine
moxonidine reserpine

*ganglionic blockers:
Trimethapan
mecamylamine
 Angiotensin-converting enzyme
inhibitors
captopril – enalapril – lisinopril Calcium channel blockers
fosinopril – zofenopril - ramipril
Imidapril – perindopril - trandolapril *class I: amlodipine – nifedipine – nimodipine - nitrendipine
cilazapril – quinapril - benzapril isradipine-lacidipine-lercanidipine.
Class II: verapamil.
Angiotensin-II receptor blockers Class III: deltiazem.

losartan – candisartan - valsartan

telmisartan - olmesartan Potassium channel openers
azilsartan - irbesartan
fimasartan - eprosartan sodium nitroprusside – hydralazine
minoxidil - diazoxide

Renin inhibitor
aliskiren

Diuretics
*thiazide diuretics: *loop diuretics:
Hydrochlorothiazide – chlorthalidone Furosemide – torsemide
Indapamide – clopamide Bumetanide – ethacrynic acid
Xipamide - metolazone
*carbonic anhydrase inhibitors:
*potassium-sparing diuretics:
*osmotic diuretic: Acetazolamide – metolazone
Spironolactone – eplerenone Brinzolamide – dorzolamide
mannitol
Amiloride - triamterene dichlorphenamide

Natural
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 {{drugs for Heart failure}}
*angiotensin-converting enzyme inhibitors (ACEIs).
*angiotensin-ІІ receptor blockers (ARBs).
*angiotensin-receptor neprilysin inhibitors(ARNIs): (a combination of neprilysin inhibitor and angiotensin-ІІ receptor antagonists)
sacubitril/valsartan.
*β-blocker: bisoprolol-metoprolol-carvedilol.
*diuretics: loop diuretics and aldosterone antagonists(potassium-sparing diuretics).

*vasodilators: hydralazine/isosorbide dinitrate

Na nitroprusside or IV nitroglycerin
Nesiritide.

*inotropic agents: cardiac glycosides:digoxin-digitoxin-ouabain

digoxin immune Fab (ovine).
β1-adrenergic agonists: dobamine-dobutamine.
phosphodiesterase-ІІІ inhibitors: amrinone(inamrinone)-milrinone.

{{drugs for Angina}}

Organic nitrates Β-blockers Calcium channel blockers Newer antianginal drugs

nitroglycerin atenolol ranolazine-trimetazidine
amyl nitrate metoprolol nicorandil-ivabradine
isosorbide mononitrate esmolol
isosorbide dinitrate
 {{Anti-arrhythmic drugs}}
Class І Class ІІ Class ІІІ Class ІІІІ
(sodium channel blockers) (β-blockers) (potassium channel blockers) (calcium channel blockers)
*ІA(intermediate): atenolol amiodarone Verapamil
quinidine metoprolol dronedarone deltiazem
dispyramide esmolol sotalol
procainamide dofetilide
*ІB(fast): Ibutilide
vernakalant Miscellaneous
lidocaine
antiarrhysmic drugs
mexiletine
*ІC(slow): adenosine
flecainide aigoxin
propafenone magnesium sulfate

{{drugs for hypotension}}

sympathomimetics Synthetic mineralocorticoids
etilefrine-midodrine-heptaminol. fludrocortisone
Sympathomimetic agents used for hypotensive shock:
for anaphlactic shock: epinephrine.
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for cardiac and septic shock:norepinephrine-dopamine-dobutamine.
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 Respiratory
And digestive system
 {{ Allergic rhinitis }}

antihistamines corticosteroids
*oral antihistamines: *intranasal corticosteroids:
Second generation: loratidine-cetirizine beclomethasone-fluticasone
ebastine-mizolastine-acrivastine mometasone - triamcinolone
Third generation: desloratidine - levocetirizine bedesonide-ciclesonide-flunisolide
fexofenadine
*intranasal antihistamines: azelastine

Mast cell stabilizers Leukotriene receptor antagonists

*intranasal mast cell stabilizers: *oral leukotriene receptor antagonists:
cromolyn sodium montelukast

decongestants anticholinergics
*oral or intranasal: *intranasol antimuscarinic:
pseudoephedrine - phenylephrine ipratropium
naphthazoline - tetrahydrozoline
xylometazooline - oxymetazoline

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 {{ drugs for asthma }}

bronchodilators Anti-inflammatory drugs

Beta2-agonists Corticosteroids
Antimuscarinics Leukotriene
Methyxanthines Monoclonal antibodies modefiers
Mast cell stabilizers

Chronic obstructive pulmonary disease (COPD)

(1) bronchodilators

Beta2-agonists antimuscarinics Phosphodiesterase -4 inhibitors

(PDE-4 inhibitors)

(2) corticosteroids (3) Antibiotics

(anti-inflammation) (antimicrobials)
(5) Alpha1-proteinase inhibitors

(4) Mucolytic and anti-oxidants

 Professional pharmacist {{ drugs for asthma }}
From A to Z course.

Reliever medications Controller medications

(quick relief) (long-term control)
*SABA (short-acting β2-agonists): *LABA (long-acting β2-agonists):
albuterol-levalbuterol
(1) β2-agonists
salmeterol-formoterol
pirbuterol-terbutaline. *ultra-LABA (ultra-long acting β2-agonists):
vilanterol

*SAMA: ipratropium (2) Antimuscarinics *LAMA: tiotropium

(3) methyxanthines theophylline

*OCSs (oral corticosteroids): *ICSs(inhaled corticosteroids):

(1) corticosteroids beclomethasone-fluticasone
prednisone-prednisolone
methylprednisolone mometasone-triamcinolone
ciclesonide-budesonide-flunisolide

(2) Leukotriene modefiers *leukotriene receptor antagonists(LTRAs):

(LTMs) monelukast-zafirlukast.
Monoclonal antibodies *5-lipoxygenase inhibitors: zileuton.
omalizumab
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 Chronic obstructive pulmonary disease (COPD)
Beta2-agonists
Short-acting beta2-agonists(SABA)
albuterol – levalbuterol
pirbuterol – terbutaline
Long-acting beta2-agonists(LABA)
salbutamol – formoterol
arformoterlol
Ultra-long-acting beta2-agonists
(ultra-LABA)
vilanterol – olodaterol
indacaterol
(1) bronchodilators
antimuscarinics Phosphodiesterase -4 inhibitors
(PDE-4 inhibitors)
roflumilast
Short-acting muscarinic antagonists(SAMA)
ipratropium – oxitropium
Long-acting muscarinic antagonists(LAMA)
tiotropium – glycopyrronium
aclidinium - umeclidinium
(3) Antibiotics
(2) corticosteroids
(anti-infectives)
(anti-inflammation)
azithromycin - erythromycin
Inhaled corticosteroids (ICSs)
(4) Mucolytic and anti-oxidants
beclomethasone - fluticasone
mometasone - triamcinolone N-acetycysteine
ciclesonide – budesonide - flunisolide carbocysteine
Oral corticosteroids (OCs)
(5) Alpha1-proteinase inhibitors
Alpha1-antitrypsin
augmentation therapy
 {{ emetics }}

Central emetics Peripheral (local)

Apomorphine S.C.

Rapidly acting Slower acting

Hypertonic salt solution Tincture ipecacuanha
Tincture senega
Ammonium chloride
Ammonium carbonate

{{ anti-emetics }}
dopamine(D2) antagonists Seretonin(5-HT3) receptor antagonist
domperidone – metoclopramide ondansertron – granisetron – tropisetron
Butyrophenones: haloperidol – droperidol dolasetron - palonosetron
Phenothiazines: chlorpromazine
prochlorperazine - thiethylperazine

antimuscarinics Substance P (neurokinin-1) receptor antagonists

hyoscine(scopolamine) apripatant – fosapripatant
*antihistamine with antimuscarinic effects: rolapitant – neutipitant
(first generation antihistamines) caso[pitant
diphenhydramine - dimenhydrinate
doxylamine - promethazine others
meclizine - cyclizine

corticosteroids cannacinoids benzodiazepines herbs

dexamethasone
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methylprednisolone
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 {{ Drugs for diarrhea }}
Oral rehydration solution

antimicrobials

antibiotics Anti-protozaols Anti-parasitics

*3rd generation cephalosporins: metronidazole - tinidazole albendazole
cefixime-cefotaxime-ceftrixone secnidazole - ornidazole mebendazole
*azithromycin nitazoxanide flubendazole
*fluroquinolones:
ciprofloxacin-levofloxacin
*sulfamethoxazole/trimethoprim

Nifuroxazide – rifaximin
Bismuthsubsalicylate

neomycin - doxycycline

Anti-diarrheal drugs

*anti-motility agents: diphenoxylate/atropine – loperamide Zinc

*anti-secretory agents: bismuth subsalicylate – racecadotril Probiotics(bacterial replacement therapy)
*adsorbent agents: methylcellulose – kaolin/pectin Lactase enzyme
 {{ laxatives }}

(1) Stimulant laxatives (2) Bulk laxatives

Bisacodyl – sodium bicosulfate Psyllium – methylcellulose
Senna – castor oil Inulin – polycarbophil
Wheat bran – wheat dextran

(3) Osmotic laxatives (4) Saline osmotic laxatives

Glycerin Magnesium sulfate – sodium sulfate
Lactose Magnesium citrate – sodium phosphate
lactitol Magnesium hydroxide

(5) Stool softeners (6) Lubricant laxatives

(emollient laxatives) Mineral oils
(surfactants) Paraffin oil
Docuste sodium

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 (1) {{ antacids }} (3) {{ muocsal protective agents }}

Physical antacids Chemical antacids *prostaglandin analog: misoprostol

*colloidal bismuth compounds:
demulcents Bismuth subcitrate
Bismuth subsalicylate

Systemic antacids Local antacids *carbenoxolone

Sodium bicarbonate magnesium oxide -aluminium hydroxide gel *sucralfate (aluminium sucrose sulfate)
Calcium carbonate magnesium hydroxide-aluminium phosphate gel
magnesium trisilicate
Note:
magaldrate: magnesium hydroxide
+aluminium hydroxide

(2) {{ antisecretory drugs }} (4) {{ prokinetic agents }}

(drugs decrease gastric HCl sectetion)
*dopamine(D2)-receptor antagonists:
domperidone – metoclopramide
H2-receptor antagonists Proton-pump inhibitors Prostaglandin analogues
Cimetidine(*) omeprazole-esomeprazole misoprostol *selective seretonin(5-HT4)-receptor agonists:
ranitidine lansoprazole-deslansoprazole mosapride – cisapride(*)
nizatidine pantoprazole-rabeprazole
famotidine Gastrin antagonists *muscarinic-receptor agonists:
bethanecol
*gastrin-receptor blocker:
proglumide *itopride
*inhibition oh gastrin release: {dopamine(D2)-receptor antagonist,
*note: somatostatin acetylcholine esterase inhibitor)
antimicrobials used for GIT H.pylori infection, include: octreotide
clarithromycin – amoxicillin Note:
metronidazole – tetracycline mosapride: selective seretonin agonist 
bismuthsubcitrate Increase acetycholine in stomach
bismuthsubsalicylate Prokinetic and increase LES tone
 Drugs for inflammatory bowel diseases
{{ crohn’s disease(CD) , ulcerative colitis(UC) }}

aminosalicylates Biologic agents

*azo compounds: *TNF: adalimumab - golimumab
sulfa drugs: sulfasalazine infliximab - certolizumab
non-sulfa drugs: balsalazine-olsalazine *anti-integrin agents: natalizumab - vedolizumab
*methalamine

glucocorticoids Antibiotics
*intravenous: hydrocortisone-methylprednisolone ciprofloxacin
*oral: prednisone-prednisolone-budesonide metronidazole
*topical: enema-suppository-foam preparations

Drugs for exocrine pancreatic insufficiency

*pancreatic enzyme replacement therapy:
immunomodulators pancrelipase (pancreatic enzyme products,
Azathioprine(AZA) contain lipase, protease and amylase)
methotexate(MTX)
6-mercaptopurine(6-MP)
Drugs for gallstones
*oral bile salts: ursodeoxycholic acid (ursodiol)
chenodeoxycholic acid (chenodiol)
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*rowachol
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 Chemotherapeutics

Antimicrobials Anticancer drugs

*antibiotics(antibacterials)
*antivirals
*antifungals
*antiparasitics  atiprotozoals
anthelmintics
insecticides
*antiseptics
 {{ antibiotics }}
(1) Inhibitors of cell wall synthesis

Beta lactams Non-beta lactams

*penicillins *glycopeptides
*cephalosporins *others: bacitracin
*monobactms cyclosporine
*carbapenems fosfomycin

(2) Cell membrane inhibitors: *polypeptides:polymyxin B - polymyxin E(colistin)

*lipopeptide: daptomycin

(3) Inhibitors of protein synthesis (4) Inhibitors of DNAsynthesis

30 s 50 s others *quinolones and Antifolates (folic acid

Muprocin - plazomicin fluoroquinolones synthesis inhibitors)
*aminoglycosides *macrolides
*tetracyclines *ketolides Rifaximin - retapamulin *sulfonamides
Fusidic acid
*glycylcyclines *macrocyclic *DHFR inhibitors
*oxazolidinones
*lincosamides
*strptogramines
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 penicillins

Penicillin G(benzyl penicillin)

IV, short-acting,
Narrow spectum

IM, prolonged-action Oral, short-acting Oral, short-acting

Narrow spectrum penicillins Narrow spectrum penicillin Broad spectrum penicillins
*intermediate-acting penicillin: Penicillin V Amoxicillin
Procaine penicillin (phenoxymethyl penicillin) Ampicillin
*long-acting penicillin: bacampicillin
Benzathine penicillin

preparations for
Beta-lactam resistant bacteria
Antipseudomonal penicillins

Beta-lactamase Beta-lactamase sensetive penicillin+ Oral, short-acting *carboxypenicillin group:

resistant penicillins
*IV drug: methicillin
*IV or IM drug: nafcillin
*oral drug:oxacillin
cloxacillin
Dicloxacillin
flucloxacillin
Beta-lactamase inhibitor
Amoxicillin+clavulinic acid
Ampicillin+sulbactam
Piperacillin+tazobactam
Broad spectrum penicillins
Amoxicillin+flucloxacillin
ampicillin+cloxacillin
Ampicillin+dicloxacillin
Carbenicillin – ticarcillin
*ureidopenicillin group:
Piperacillin – mezlocillin
azlocillin

First generation
Cefalaxin - cefazolin
Cefadroxil - cefradine
second generation
Cefaclor - cefprozil
Cefoxitin - cefuroxime
monobactam
aztreonam
Others: Bacitracin – cyclosporin - fosfomycin
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cephalosporins
Third generation Fourth generation
Cefotaxime - cefoperazone Cefepime - cefpirome
Ceftazidime - ceftriaxone
Cefixime - cefpodoxime
Cefdinir - cefditoren
Fifth generation
Ceftaroline - ceftolazone
ceftobiprole
carbapenems glycylcyclines
Imepenem/cilastatin Vancomycin – dalbavancin
Meropenem Telavancin – oritavancin
Doripenem teicoplanin
Ertapenem
 aminoglycosides tetracyclines glycylcycline
Streptomycin – gentamycin – tobramycin Tetracycline – oxytetracycline tigecycline
Amikacin – neomycin – kanamycin Doxycycline - minocycline

macrolides ketolides macrocyclic

erythromycin – azithromycin – clarithromycin telithromycin fidaxomicin
Spiramycin – josemycin

oxazolidinones lincosamides streptogramines

Linezolid clindamycin Quinupristin/dalfopristin
tedizolid pristinamycin

Others:
chloramphenicol
Mupirocin – plazomycin
Rifaximin – retapamulin
Fusidic acid
 Quinolones and fluoroquinolones

First generation fluoroquinolones

(quinolones)
Nalidixic acid Second generation Third generation fourth generation
cinoxacin
Ciprofloxacin – norfloxacin Levofloxacin Gemifloxacin
Ofloxacin – enoxacin Sparfloxacin Gatifloxacin
Lomefloxacin - pefloxacin grepafloxacin Moxifloxacin
trovafloxacin

antifolates

Sulfonamides Dihydrofolate reductase inhibitors

(sulfa drugs) (DHFR inhibitors)
Trimethoprim
pyrimethamine
systemic Systemic and local
Sulacetamide – sulfadiazine sulfasalazine
Sulfamethoxazole - sulfadoxine
Combination of
Sulfa drug and DHFR inhibitor
Sulfamethoxazole/trimethoprim
topical Sulfadoxine/pyrimethamine
Silver sulfadiazine
Mafenide
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 {{ Antiviral drugs }}:
*for respiratory viral infections:
Adamantines: amantadine – rimantadine - tromantadine
Neuromanidase inhibitors: oseltamivir - zanamivir
Guanosin analog(RNA synthesis inhibitor): ribavirin

*for hepatitis b virus: *for hepatitis c virus:

lamivudine - telbivudine PEG-interferon alfa – ribavirin – sofosbuvir
adefovir – entecavir ledipasvir+sofosbuvir
simeprevir+sofosbuvir
daclatasvir+sofosbuvir
ritonavir/paritaprevir/ombitasvir

*for human immunodeficiency virus(HIV):

{neucleoside reverse transcriptase inhibitors(NRTIs)}: {protease inhibitors}:
zisovudine – stavudine – lamivudine First generation: ritonavir Second generation
abacavir - tenofovir lopinavir - saquinavir tazanavir – tipranavir
didanosine - emtricitabine nelfinavir – indinavir draunavir

{non-neucleoside reverse transcriptase {entry(fusion)inhibitors}:

inhibitors(NNRTIs)}: enfuvirtide - maraviroc
nevirapine – delavirdine – efavirnez {integrase strand transfer inhibitors(ISTIs)}:
etravinine-rilpivirine raltegravir – elvitegravir - dolutegravir

*others: acyclovir – valacyclovir - ganciclovir – valganciclir - famciclovir – penciclovir

foscarnet – cidofovir - fomiversen
 {{ antiparasitic drugs}}:

{ anthelmintic drugs }

{ anti-nematodes } { anti-cestodes } { anti-trematodes }

(for round worms) (for tapeworms) (for flate worms (=fluks) )
mebendazole niclosamide praziqantel
flubendazole
albendazole

{ antiprotozoal drugs }
chloroquinol metronidazole
mefloquinol tinidazole
sulfadoxine+pyimethamine secnidazole

{anti-insecticide drugs }

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 {{ antifungals }}
For systemic mycosis
Systemic antifungals
*polyene antifungal:
amphotericin B
*triazole antifungals:
Itraconazole – fluconazole
Voriconazole – posaconazole
isavuconazole
*antimetabolite antifungals:
flucytosine(5-flurocytosine)
*echinocandins:
caspofungin – micafungin
anidulafungin
Tor cutaneous mycosis
Local antifungals
@polyene antifungal:
nystatin
@topical antifungals:
*imidazole antifungals:
econazole –miconazole – ketoconazole – butaconazole
Isoconazole – sulconazole – oxiconazole
terconazole – tioconazole – sertaconazole
Clotrimazole
bifonazole
*allylamine antifungals:
terbinafine - butenafine
naftifine - amorolfine
*others
ciclopirox – clioquinol - tolnaftate
Griseofulvin
Systemic antifungals terbinafine
 Immune system

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 {{ immunosuppresants }}:

1- corticosteroids: 4- mycophenolates:
mycophenolate sodium
mycophenolate mofutile

2- antibodies: 5- calcineurin inhibitors (CaN inhibitors:

*monoclonal antibodies: belatacept cyclosporine
tacrolimus
*polyclonal antibodies:
pimecrolimus
antilymphocytic globulin & antithymocytic globulin
Immunoglobulin intravenous

3- chemotherapy (cytotoxic drugs): 6- mechanistic target of rapamycin:

azathioprine - methotrexate sirolimus (rapamycin)
everolimus

7- immunomodulatory derivatives of thalidomide:

lenalidomyde
 {{ anti-inflammatory agents}}:

corticosteriods NSAIDs
Discussed before mycophenolate sodium
mycophenolate mofutile

antihistamines Mast cell stabilizers

Discussed before Cromolyn sodium-nedocromil sodium.

Lekotriene receptor antagonists 5-lipoxygenase inhibitors

montelukast - zafirlukast ziluton

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