Meds Function and remarks To treat (disease)

Steroids - Stop itch scratch cycle - Itchiness

(Topical, oral) - Psoriasis

Moisturisers - Humectants: attract and bind - Dry skin (ichthyosis)

water from the deeper
epidermis and the
environment to the stratum
corneum.
- Occlusives: Form a barrier to
prevent transepidermal water
loss
- Emollients: Restore the
intercellular lipid bilayer
(vaseline)

Antifungal antiseptics - Two groups: - Skin diseases esp

- Dyes with weak activity: fungal infection like
Gentian violet, Castellani’s Tinea corporis
paint
- 2% selenium sulphide and
20% sodium thiosulphate

Topical antifungals - Skin diseases esp

- Amorolfine fungal infection like
- Cyclopiroxola Tinea corporis/pedis
mine
- Tolfnate

Keratolytics - Remove stratum corneum

- Salicylic acid - E.g: Salicylic acid (+benzoic
acid)

Oral therapy for skin - Fungal infections of scalp,

diseases nails, palms, soles
- Griseofulvin - Terbinafine: Inhibits action of
- Ketoconazole squalene epoxidase leading
- Itraconazole to membrane disruption and
- Fluconazole cell death, against
- Terbinafine dermatophytes
- Itracon-azole: Inhibit
cytochrome P-450 dependent
demethylation, impaired in
the presence of
phenobarbitone
- Griseofulvin: Inhibit cell
division and nucleic acid
synthesis in fungi,
 contraindicated during
pregnancy and liver disease.

Analgesics - Relieve of pain without - Any

- NSAIDS impairment of conciousness
- Opioids
- Paracetamol
- Tricyclic
antidepressant
s
- Antiepileptics
- Ketamine
- Lignocaine

Opiates
- Alkaloids like:
- Morphine
- Codeine

Synthetic opioids
- Heroine
- Pethidine
- Pentazocine
- Buprenorphine
- Methadone

Endogenous opioids - Mu (Endorphins):

- Enkephalins Supraspinal and spinal
- Endorphins analgesia, sedation, inhibition
- Dynorphins of respiration, slows GIT
transit, modulation of
hormone and
neurotransmitter release
- Delta (Enkephalins):
Supraspinal and spinal
analgesia, modulation of
neurotransmitter and
hormone
- Kappa (Dynorphins):
Supraspinal and spinal
analgesia, psychotomimetic
effects; slowed GIT transit.

Opioids (based on - Agonist: Function:

actions of opioids Strong: Morphine, Pethidine,
receptors) Methadone
Moderate: Codeine
Weak: Tramadol
- Mixed agonist-antagonist:
Buprenorphine, Pentazocine
- Close voltage gated
Ca2+ on presynaptic
nerve terminals and
decrease
neurotransmitters
release
 - Antagonist: Naloxone,
Naltrexone
Anaesthesia - Premedication
- Regional analgesics
(Epidural)
Codeine - Use superceded by
dextromerthophan which is a
synthetic cough depressant
Loperamide - Does not cross CNS
Diphenoxylate and - To reduce abuse
Atropine
Intravenous Morphine - Anxiolytic
- Vasodilatory- Reduce preload
and afterload
- Depressant actions enhanced
by phenothiazines,
monoamine oxidase inhibitors
(MAO), TCA
Oral Methadone - Longer duration than
morphine
- Withdrawal symptoms are
milder
- Miu receptor agonist
- Long duration
- Bound in the extravascular
compartment and slowly
released
- Can produce physical
dependence and milder
withdrawal
Heroine - Highly effective for severe
- Hyperpolarize and
thus inhibit
postsynaptic neurons
by opening K+ and
decrease response
- Pharmacological
actions: sedation
kappa, miosis kappa
mu, emesis, histamine
release, hypotension
and bradycardia, GIT,
biliary tract, Urinary
bladder and ureter,
Neuroendocrine,
Immune system
- Contraction pain
- Cough
- Acute diarrhea
- Acute diarrhea
- Acute pulmonary
oedema
- Opioid dependance
- Relieves withdrawal
symptoms
- Block euphoric effects
of heroine and
morphine
- Severe pain
 pain
- Metabolized by glucuronide
conjugation to
morphine-6-glucuronide and
excreted by kidney
- Less emetic compared to
morphine but same
respiratory depressant effects
- Strong agonist at V opioid
receptor

Fentanyl - Pure mu receptor agonist - Analgesia during

- Extremely potent surgery
- Sufentanil> Fentanyl> - Neurolepanalgesia
Alfentanil - Enhancement of
- High lipid solubility analgesia
- May cause rigidity, require
mechanical ventilation
- Minimal CVD effects, does
not release histamine

Pethidine - Binds to mu opioid receptor - For acute eps of

(Meperidine) - Demethylated to norpethidine moderate to severe
in the liver and excreted in pain
urine - Not for chronic pain
- Antimuscarinic action like dry - Used during labor
mouth/blurring of vision
- Contraindicated in the
presence of underlying
tachycardia

Codeine - A prodrug: can covert to - Oral analgesic for mild

morphine types of pain
- More readily absorbed by - Headache
mouth than morphine - Backache
- Has marked antitussive
activity
- Has respiratory depressant
activity
- Significant constipation
- Little/no euphoria

Dextromethorphan - Anti tussive @ brain stem and - Neuropathic pain

medulla
- Less constipation compared
to codeine

Tramadol - Better side profile than - Moderate to severe

morphine pain
- No respiratory depression - Safe for breastfeeding
 - May caue convulsions mothers
- Avoid in taking MAO - Postoperative pain
inhibitors

Loperamide - Miu receptor agonist - Treatment of

- No analgesic activity neuropathic pain
- Control diarrhea by inhibit - Diarrhea
peristalsis

Buprenorphine - Long DOA and difficult to be

reversed by naloxone
- More potent than morphine

Pentozocine - Produce less euphoria - Same as morphine

Opioid antagonists - Reverse effect of agonist - Precipitate the

quickly if opioids are taken symptoms of opiate
withdrawal
- Treatment of
respiratory
depressants, on baby,
detect opioid
addiction, opioid
detox, decrease
alcohol craving

NSAIDS - Inhibit COX enzymes - Joint disorder with

- COX-1: Produce inflammatory
physiologically important PGs presentations
- COX-2: Mediate inflammatory - Arthritis
and pain, induced by
cytokines
- Short term
- Acute and chronic
inflammatory conditions
- Do not produce sedation and
have very low addiction rate
-

Low dose aspirin - Prevention of CVS events

Ibuprofen - Closing patent ductus - PDA

Indomethacin arteriosus in preterm infants - Indomethacin or
before birth etoricoxib: Ankylosing
spondylitis

Glucocorticoids - Decrese inflammation

- Slow disease progression
- Short term treatment of acute
RA flare
- Glucocorticoids and
 mineralocorticoids

DMARDS (Disease - Suppress an overactive

Modifying immune system
Anti-Rheumatic - Delay disease progression
Drugs) - Preserve joint integrity
- Decrease systemic
complications

Methotrexate - First line DMARDS treatment - Rheumatoid Arthritis

Allopurinol - Decrease high blood uric acid - Gout

- Used in long term treatment
for gout

Colchicine - Combat pain and - Gout

inflammation due to gout
causes
- Acute an short-term treatment

● Opioids adverse effects: DESIGNER (dry mouth, euphoria, sedation, itch, GI tone
constipation, nausea and vomiting, eyes constriction and respiratory depression.
● Opioids withdrawal symptoms: WITHDRAWAL (withdrawal, irritability/insomnia,
tremors/tachycardia, hypertension, diarrhea, rhinorrhea, anxiety/arthralgia/myalgia,
weight loss, abdominal cramps, lacrimation(cries))